Earlier today, Dr. Michael Siegel posted a blog commentary suggesting that NAQC’s actions are destroying the scientific integrity of the global tobacco control movement. As many of you may know, Dr. Siegel is opposed to the use of medications in the treatment of tobacco dependence. NAQC’s response and Dr. Siegel’s commentary are provided below:
Dear Dr. Siegel,
Thank you for the opportunity to respond to your commentary and to share NAQC’s position. I respectfully disagree with your opinion that “the acceptance of pharmaceutical industry sponsorship by a conference which aims to objectively discuss science and objectively consider policy strategies to promote smoking cessation destroys the scientific integrity of the global tobacco control movement.”
NAQC’s mission is to improve the quality of quitline services in North America and to make high quality cessation services more available to all tobacco users. We support cessation and encourage quitlines to adopt evidence-based practices. FDA-approved cessation medications are well-accepted evidence-based treatments for cessation. They are included as part of the U.S. Public Health Service’s Guideline on Tobacco Cessation Treatment. Currently, 75 percent of all U.S. quitlines provide medications along with counseling services. We hope to report 100 percent of quitlines are providing cessation medications to smokers in the near future. Providing medications as part of a quitline’s treatment protocol increases the likelihood that smokers will successfully quit.
NAQC Conference 2012 is supported by ClearWayMN, the American Cancer Society, the Canadian Cancer Society, the American Legacy Foundation, GlaxoSmithKline, Novartis and Pfizer. NAQC is grateful to all of the organizations that sponsor and support our programs, including those who support the upcoming conference. This is the first year pharmaceutical company contributions have helped support the NAQC conference and we are proud to have them on-board. We look forward to working with these partners in the pharmaceutical industry to advance NAQC’s mission and ensure that all tobacco users have access to evidence-based treatment services.
Thank you, again, for the opportunity to express NAQC’s opinion.
Linda A. Bailey, JD, MHS
President and CEO
North American Quitline Consortium
This commentary appears today on my tobacco policy blog, at: http://tobaccoanalysis.blogspot.com/2012/08/norht-american-quitline-consortium-is.html
North American Quitline Consortium is Sacrificing its Scientific Integrity by Taking Money from Big Pharma
The North American Quitline Consortium
is an organization of individuals and groups which serves to promote and improve the use of smoking cessation quitlines. One of its major goals is to improve the effectiveness of quitline services by ensuring that the services provided are the most evidence-based and effective as possible.
According to its web site: "The North American Quitline Consortium (NAQC) is an international, non-profit membership organization based in Oakland, California. NAQC seeks to promote evidence-based quitline services across diverse communities in North America. Quitlines are telephone-based tobacco cessation services that help tobacco users quit. Today, residents in all 10 provinces and two territories in Canada, Mexico, and all 50 U.S. states, Puerto Rico, Guam, and the District of Columbia have access to quitline services."
Next week, on August 13 and 14, NAQC will hold its annual conference
in Kansas City. Two critical objectives of the conference, according to NAQC, are:
1. to explore "factors that impact on the effectiveness and reach of quitlines";
2. "to strengthen the quitline community’s knowledge and application of best and promising practices"; and
3. "to participate in the generation of new research questions informed by dialogue about current experience from the quitline practice community, findings from the research community and issues important to partners in tobacco control, chronic diseases and health systems."
Thus, the conference will include discussion of strategies for ensuring the effectiveness of quitlines. This encompasses important issues, such as the use of nicotine replacement therapy and other smoking cessation drugs in quitline advice, the potential role of electronic cigarettes as a treatment alternative, and the risks versus benefits of the use of varenicline for smoking cessation.
These are all issues in which pharmaceutical companies have a vested financial interest. The information and advice that quitlines provide about varenicline (Chantix), for example, could well affect Pfizer profits on sale of that drug. The decision of quitlines about whether to recommend smoking cessation drugs for every smoker could certainly affect the profits of a number of pharmaceutical companies that manufacture these drugs. Clearly, then, the pharmaceutical companies have a significant financial interest in the discussions that take place at this conference.
The Rest of the Story
Given the degree to which Big Pharma has a financial interest in the issues to be discussed at this conference, you can imagine my surprise when I got to the fine print at the bottom of the conference agenda
and discovered that the 2012 NAQC annual conference is being sponsored by GlaxoSmithKline, Novartis, and Pfizer.
GlaxoSmithKline markets Commit lozenges, Nicoderm CQ (the nicotine patch), Nicorette (nicotine gum), and a behavioral smoking cessation program called Committed Quitters.
Novartis markets Nicotinell (nicotine patches and gum).
Pfizer markets varenicline (Chantix).
Thus, the conference is being sponsored by the very companies which stand to gain or lose most by the supposedly objective scientific discussions that are supposed to take place at the conference. There is simply no way that objective scientific discussions can take place when the conference is being sponsored by these very companies!
In my view, the acceptance of pharmaceutical industry sponsorship by a conference which aims to objectively discuss science and objectively consider policy strategies to promote smoking cessation destroys the scientific integrity of the global tobacco control movement.
How can you objectively discuss the population impact of NRT (nicotine replacement therapy) use at a conference sponsored by two of the leading nicotine replacement therapy drug companies?
How can you objectively discuss effective national strategies for smoking cessation at a conference sponsored by two of the leading nicotine replacement therapy drug companies and the leading manufacturer of non-nicotine smoking cessation medication?
How can you objectively discuss all aspects of individual and population-based approaches to helping people quit smoking at a conference sponsored by two of the leading nicotine replacement therapy drug companies and the leading manufacturer of non-nicotine smoking cessation medication?
The answer, in my opinion, is that you can't.
You can't objectively discuss the appropriate role, if any, of nicotine replacement products in a global smoking cessation strategy when the very conference you are attending is being sponsored by perhaps the two leading companies that have a great financial interest in the results of that discussion.
You can't objectively consider the risks and benefits of recommending Chantix when the manufacturer of the drug is contributing toward allowing the conference to occur in the first place.
The upshot is that the NAQC conference cannot and will not offer an objective consideration of the role of quitlines in smoking cessation and of the most effective strategies for quitlines to promote smoking cessation.
By accepting Big Pharma money in order to fund its conference, the NAQC, in my opinion, is selling its name for what I consider to be an unworthy purpose. The Conference is allowing itself to be used as a pharmaceutical marketing agent, simply to make money, when the over-reliance on pharmaceutical agents is in my opinion one of the main reasons why smoking cessation efforts and policies have been so ineffective. And it is sacrificing the scientific objectivity of the conference in order to obtain this funding.
The preoccupation with nicotine replacement therapy, spurred on by the infusion of pharmaceutical dollars into the tobacco control field, is causing us to lose sight of the actual root of the problem: the addictive state itself. And that is a shame, because it may be severely hampering our efforts to help smokers quit.
The benefits and importance of drugs in the smoking cessation process have been over-emphasized, and I urge readers to read extensively on the web site
of John Polito
, who I find has the most insightful understanding of the smoking cessation
process and the potential role of NRT products
as anyone I know in the tobacco control field.
In my view, the acceptance of Big Pharma money to fund a quitline conference at which smoking cessation strategy is going to be discussed is not just a private matter. It represents a disservice to the public who we in tobacco control are supposed to serve.
Thus, the rest of the story is that not only is the North American Quitline Consortium sacrificing its scientific integrity by accepting Big Pharma money, it is also betraying the clients who it is supposed to be serving.
Michael Siegel, MD, MPH
Department of Community Health Sciences
Boston University School of Public Health
801 Massachusetts Avenue, 3rd
Boston, MA 02118