Did the United States smokeless tobacco industry use cigarette industry strategies to sponsor and manipulate research?

Abstract

Background and aim: The cigarette industry in the United States (US) laid the foundation for sponsoring research to improve public relations and defend against product liability cases. Fewer threats of litigation facing the US smokeless tobacco (SLT) industry may have contributed to the sponsorship of independent research on SLT use and health outcomes. This study aimed to determine whether the SLT industry used cigarette industry strategies to manipulate research on health risks.

Methods: Internal industry documents (e.g. letters, memos) from the 1970s through 1990s were accessed through the online Truth Tobacco Industry Documents Library at the University of California, San Francisco. A framework of tobacco industry strategies and criteria for evaluating sponsored research formed the basis for categorizing and synthesizing documents identified via snowball sampling (n = 177). Summaries of awarded projects in annual reports of the Smokeless Tobacco Research Council (STRC) were coded for content (n = 189, 1982-1997).

Results: Guided by legal counsel, the SLT industry sponsored research to support its interest group position; advocated against research on tobacco-specific carcinogens such as N-nitrosonornicotine (NNN); heavily criticized a case-control study on oropharyngeal cancer; and relied on a cadre of grantees and STRC leadership to testify against SLT restrictions. The STRC awarded a high proportion of projects on nicotine (78/189), including use for therapy (e.g. Tourette's syndrome), but underfunded epidemiologic research (n = 3). However, the STRC awarded projects on extracts or constituents (e.g. NNN, n = 30) that may have implicated SLT's role in carcinogenesis.

Conclusions: While the Smokeless Tobacco Research Council awarded some research that may have weakened the industry, the Council's imbalanced portfolio of projects and inextricable link to industry likely favored the interest group position. Thus, we cannot conclude that the smokeless tobacco industry sponsored research solely for scientific discovery. Greater independence of industry-sponsored research could be achieved by delegating scientific decision-making to scientists (not legal counsel), limiting governance to those unaffiliated with the industry sponsor and not relying on grantees to defend the interest group position.