Vigilance needed to stop new wave of tobacco company promotion

IT took less than one week after nicotine was rescheduled in Australia for a tobacco company to insert itself into a role associated with health practice.

On 6 October, a pharmacy industry magazine, the Australian Journal of Pharmacy, published a (now removed) article on nicotine vaping products with a footer stating, “Development of this article was supported by an unrestricted educational grant from Philip Morris International”. The author was the Chief Pharmacist of the Australasian College of Pharmacy, a not-for-profit training organisation owned by the Pharmacy Guild of Australia’s Queensland Branch.

Few, if any, universities or health or medical organisations do not have a policy specifically prohibiting partnerships with tobacco or related industries. The Pharmaceutical Society of Australia has a sponsorship and advertising policy and processes that ensure funding from tobacco companies is not permitted (Mr Mark Kinsela, Chief Executive Officer, Pharmaceutical Society of Australia; personal communication, 7 October 2021). The Pharmacy Guild itself has stated categorically that it “is totally opposed to any tobacco company being involved in the training of pharmacists”.

It is baffling why anyone in a pharmacy training organisation would think it acceptable to take funding from a tobacco company for any purpose.

Indeed, the owner of the Australian Journal of Pharmacy responded promptly to a request for more information to state they had already taken steps to ensure such an article would not be published again. The chair of the organisation that owns the journal wrote in an email response that “benefits — either directly or indirectly — from the tobacco industry [are] unacceptable” (Mr P Naismith 7 October 2021).

There have already been consequences for the Australasian College of Pharmacy. The National Asthma Council logo disappeared from the list of Australasian College of Pharmacy partners within 24 hours. And late the following day, a statement on the nicotine vaping products article was posted on the Australasian College of Pharmacy website. It read, in part, “No financial transactions have occurred” (contradicting the original publication) and that the arrangement had been “discontinued … to allay any further concerns about its probity”.

There is a broader context.

The World Health Organization Framework Convention on Tobacco Control, ratified by 181 countries, specifically precludes any tobacco industry involvement in health policy. But the global tobacco industry is sparing no effort to reinvent its image, from social media to Formula 1 racing teams, and even to energy and wellness drinks. Further recent efforts by Philip Morris International to infiltrate the health sector have been well documented and criticised, notably in relation to its acquisition of the manufacturer of the Vectura inhaler and speedy subsequent efforts to use this purchase as a platform “to legitimise the tobacco industry’s participation in public health”. This approach complements a long-standing tobacco industry strategy of identifying organisations and individuals susceptible to offers of financial support and using them to influence opinion or health policy and/or legitimise their activities. John Safran’s book disclosing some of Philip Morris International’s tactics to promote vaping (including involvement in successful lobbying for a Senate inquiry into vaping) and subvert public discourse in Australia has found a well deserved place in some best-selling book lists.

Australia is a world leader in reducing smoking among adults and children, and should now be aiming for new, more ambitious targets. However, national mass media campaigns – for which there is overwhelming evidence – have been inexplicably de-funded for the past decade, and there has been an absence of action on other evidence-based recommendations from health authorities. This has created a vacuum into which nicotine vaping and other novel products have been promoted to Australian adolescents, rendered vulnerable to predatory, tobacco-like marketing.

Tobacco companies globally have a large and growing stake in companies that produce nicotine vaping products, and we can expect more efforts from them to generate links with reputable health sector organisations. The Australasian College of Pharmacy statement included this telling sentence, “Such arrangements with objective third parties facilitate awareness of the products or services and their additional uses and implications beyond the company’s promotional and compliance messaging.”

That is precisely the point: the “additional uses and implications” are manifestly designed to further the tobacco industry’s escalating efforts to establish itself as a credible source of health information and advice. But this industry still knowingly promotes a product that causes 8 million deaths annually, and now cynically seeks to promote products that encourage youth nicotine addiction and transition to smoking.

Unprofessional conduct, as defined in the National Law, means “professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner’s professional peers”. Accepting funding from a tobacco company is surely below the standard which might reasonably be expected.

It has never been more important for health organisations to be aware of, resist and expose the new wave of tobacco industry promotion, and to call out the behaviour of those health and related professionals that knowingly engage with tobacco companies or their front groups for what it is: unprofessional conduct.

Dr Sarah L White is Director of Quit, Cancer Council Victoria.

Emeritus Professor Mike Daube AO is with the Faculty of Health Sciences at Curtin University

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.