January 1, 2019

Stanton A. Glantz, PhD

E-cig industry-funded research is less likely to find harms

Charlotta Pisinger, Nina Godtfredsen, and Anne Mette Bender recently published “A conflict of interest is strongly associated with tobacco industry-favourable results, indicating no harm of e-cigarettes” in Preventive Medicine.  The title says it all; like research funded by cigarette companies (and a range of other corporate interests), research funded by e-cigarette interests makes e-cigs look (relatively) good.  Work not funded by industry showed higher dangers.

Policymakers and practitioners need to pay attention to these conflicts when assessing what they read.

Here is the abstract:

Researchers reach contradictory results when trying to assess the potential harm of e-cigarettes. This study investigated whether the findings and conclusions in papers published on e-cigarettes and health differ depending on whether the authors had a financial conflict of interest (COI) or not. A total of 94 studies (identified in a previous systematic review) that investigated the content of fluid/vapor of e-cigarettes or in vitro experiments were included. The type, level and direction of the financial COI were coded. Abstracts were blinded and evaluated by two assessors. Fischer's Test and Logistic regression analyses were used to investigate the associations between findings of harm/conclusions and COI. All three dimensions of COI showed the same tendency: studies with industry-related COI, found potential harm significantly less often than studies without a COI. 95.1% of papers without and 39.4% of papers with a COI found potential harmful effects/substances. Only 7.7% of tobacco industry-related studies found potential harm. The odds of finding of no harm were significantly higher in studies with an industry-related COI (OR 66.92 (95% CI 8.1-552.9)) than in studies without a COI. A strong/moderate COI was associated with very high odds (OR 91.50 (95% CI 10.9-771.4)) of finding of no harm compared with studies with no/weak COI. This blinded assessment showed that almost all papers without a COI found potentially harmful effects of e-cigarettes. There was a strong association between industry-related COI and tobacco- and e-cigarette industry-favourable results, indicating that e-cigarettes are harmless.

The full citation is: Pisinger C, Godtfredsen N, Bender AM.  A conflict of interest is strongly associated with tobacco industry-favourable results, indicating no harm of e-cigarettes. Prev Med. 2018 Dec 18. pii: S0091-7435(18)30386-4. doi: 10.1016/j.ypmed.2018.12.011. [Epub ahead of print].  It is available here.





Another study finds papers with COI more likely to support e-cigs

In June 2018, Christina Martinez and colleagues published "Conflicts of interest in research on electronic cigarettes"  in Tobacco Induced Diseases.  They examined publications on e-cigs from 2014 to 2017 and found that papers that disclosed conflicts of interests (mostly pharma-supported studies) were more likely to support e-cigs.  This paper covers a wider range of papers than the Pisinger et al paper.

Here is the abstract:

Introduction: The tobacco control community has raised some concerns about whether studies on electronic cigarettes (e-cigarettes) published in scientific journals hide conflicts of interest (COI) and whether such reports are biased. This study assessed potential COI in the e-cigarette scientific literature.
Methods:  Cross-sectional study was conducted on e-cigarette publications indexed in PubMed up to August 2014. We extracted information about the authors (affiliations, location, etc.), publication characteristics (type, topic, subject, etc.), results and conclusions, presence of a COI statement, and funding by and/or financial ties to pharmaceutical, tobacco, and/or e-cigarette companies. An algorithm to determine the COI disclosure status was created based on the information in the publication. Prevalence ratios (PRs) and confidence intervals (CIs) were calculated to identify associations with COI disclosure, controlling for several independent variables.
Results: Of the 404 publications included in the analysis, 37.1% (n=150) had no COI disclosure statement, 38.6% declared no COI, 13.4% declared potential COI with pharmaceutical companies, 3.0% with tobacco companies, and 10.6% with e-cigarette companies. The conclusions in publications with COI, which were mainly tied to pharmaceutical companies, were more likely to be favourable to e-cigarette use (PR=2.23; 95% CI: 1.43–3.46). Publications that supported the use of e-cigarettes for both harm reduction (PR=1.81; 95%CI: 1.14– 2.89) and smoking cessation (PR=2.02; 95% CI: 1.26–3.23) were more likely to have conclusions that were favourable to e-cigarettes.
Conclusions: One-third of the publications reporting studies on e-cigarettes did not have a COI disclosure statement, and this proportion was even higher in news articles, editorials and other types of publications. Papers with conclusions that were favourable to e-cigarette use were more likely to have COI. Journal editors and reviewers should consider evaluating publications, including funding sources, to determine whether the results and conclusions may be biased.

The full citation is: Martinez C, et al. Conflicts of interest in research on electronic cigarettes.  Tob. Induc. Dis. 2018;16(June):28 DOI: https://doi.org/10.18332/tid/90668.  It is avaiable here.

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