Public health urgently needs a “new deal”



By Dr Farsalinos

Science is about being open-minded, engaging into an open debate, respecting the different opinion (even when you disagree) and exchanging views, arguments and ideas. This is how science progresses. Dialogue is an absolute necessity. On the contrary, secrecy, censorship, exclusions and intimidation are not only useless but dangerous.

Perhaps it is not surprising, but it is certainly discouraging, to see that several scientists have recently received letters from the organizations Campaign for Tobacco-Free Kids (CTFK) and European Network for Smoking and Tobacco Prevention (ENSP), informing them that the 2016 Global Tobacco & Nicotine Forum conference (GTNF), in which they were invited, includes participation of the tobacco industry and organizations related to the tobacco industry. They list several tobacco and tobacco-related companies as participants to the conference. They even included PriceWaterhouseCoopers, an accounting firm, in the list of “inappropriate” (my word) participants, probably because it has clients from the tobacco industry. The authors of the letter (signed by the two organizations but not by any particular person) called the scientists to cancel their participation to the conference. Some perceived this as a demand, not a call. Expressions like: “your involvement with an industry that has been misleading and deceiving the general public for many decades could be not only detrimental to your reputation but also the notoriety of your affiliated association or institution”, can be perceived as indirect threats of initiating an attempt to discredit scientists and create problems in their working environment, not because of bad science but because they should be present, discuss with, confront or even criticize the tobacco industry when the latter are present. It is impressive that the participation to a conference is considered as “involvement with an industry”. Moreover, it seems to be perceived as a positive sign that “some initial presenters have immediately cancelled their participation”. Other expressions (such as: “As professionals with high credibility, who should be placing patients’ health and well-being as their highest priority,…” (my emphasis) could be perceived as insulting.

If these organizations want to do something productive, they should seek to participate to these events. Yes, the tobacco industry has repeatedly lied in the past. Yes, they sell a deadly product. Of course we need to be very cautious with their data, motivation and strategies, and I have repeatedly mentioned that their research should be verified by independent studies. The cautious and critical approach is needed because of the past history and tactics of the tobacco industry. But this is different from hiding and censoring research, or pretending it does not exist. Some feel that the only goal should be the destruction of the tobacco industry, and this effort is evolving over many years. I am not sure if you can consider this a successful strategy when the share price of some tobacco companies have increased by 100-240% over the last 10 years. Some have used the article 5.3 of the WHO FCTC as an argument against the participation of scientists in conferences where the industry is present. The article refers to the Parties of the FCTC, not to scientists. Moreover, are the Parties really respecting this article? What about those Parties who are members of the FCTC and at the same time own tobacco companies?

Therefore, the need for scientific debate is now more imminent than ever. Scientists need to influence, press and even encourage the industry to change course and switch to the development and marketing of safer and more effective harm reduction products. If they do not actively and rapidly make this switch, the fight against smoking will never end and smokers will continue to die annually, as they do today. Participation to a conference where the industry is present is a good opportunity to criticize them, to apply pressure to change, to present the ethical dilemmas that we face in dealing with the smoking epidemic and to discuss the best and most feasible approach in reducing smoking-related disease and death.

The situation today can be characterized as academic obscurantism and McCarthyism. It is not just the letter sent to scientists about the GTNF conference. In the past we have seen criticism unrelated to the scientific content, such as “accusing” scientists and journals for publishing research from tobacco scientists (without even mentioning a single problem in the content of the study) and criminalizing evidence-based opinion and, now, participation to a scientific conference. Criticism is welcomed and needed when it is focused on the scientific content. Personal insults, direct or indirect threats and attacks on the scientific, personal and professional integrity are not only inappropriate but can also be considered as defamation and have legal implications. Public health has been divided into two opposing groups (pro and against harm reduction) which never meet or participate in the same conference to exchange ideas and present their arguments collectively in an honest, open and public debate. Is this what public health and smokers deserve? Is this going to solve the problem of smoking? Is this scientific progress? Does anyone really believe that the more than 1 billion smokers worldwide do not deserve our immediate attention, sympathy and care? Are we willing to sacrifice more generations? Is the health of everyone (including smokers) our first and most important priority, or not?

Public health needs a “new deal”. Every side needs to engage into an open dialogue. The current situation of parallel monologues (avoiding direct confrontation), the “political game” which is distanced from science, and the media hunt to intimidate smokers and to promote unsubstantiated claims need to stop. Scientists from “both sides” need to find ways of merging, rather than distancing, their approach. Accusations from one side to the other should stop. The current situation is creating confusion and allows the establishment of major misconceptions among smokers. This is not promoting the interests of public health and our goals. It is time for science to come to the table, become the priority and dominate in all discussions.



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