Morgen begint in Washington DC de vier-daagse World Conference on Tobacco or Health. Tijdens de conferentie komen tabaksbestrijders vanuit alle delen van de wereld bij elkaar om zich te bezinnen over methodes om het Grote Kwaad nog verder uit te roeien. De dames en heren van deze nobele beweging lijken echter in geldproblemen te zitten: de conferentie wordt zwaar gesponsord door de nicotineproducenten GlaxoSmithKline en Pfizer, die zelfs een speciaal reclamefilmpje voor de conferentiegangers gemaakt hebben waarin ze er op aandringen om de strijd tegen rokers toch vooral via gratis verstrekking van nicotinepleisters en -kauwgom aan te binden.
Michael Siegel merkte deze invloed van Big Pharma al in april in een artikel op. Maar ook andere kritische anti-tabaksactivisten beginnen zich nu af te vragen of dit wel door de beugel kan. De altijd kritische John Polito van whyquit.com vraagt zich op zijn site af:
“Is it coincidence that Philip Morris’ website has touted replacement nicotine as a key to successful quitting? Is it coincidence that the per use cost of over-the-counter replacement nicotine remains at or near the cost of cigarettes when NRT products are not subject to tobacco excise taxes? What are NRT production costs?“
Met andere woorden: hoe hecht is de band tussen pro- en anti-tabak? En hoe effectief zijn die middelen eigenlijk?
What they’ll find instead is that the conference’s two corporate sponsors — GlaxoSmithKline and Pfizer – have produced a well orchestrated commercial designed to convince them that government subsidized nicotine is the answer – replacement nicotine or NRT. What they won’t hear is the truth, that replacement nicotine has never proven effective in any real-world setting and likely never will.
The California tobacco survey, the Minnesota insurance survey, Quebec Quit and Win, the Tobacco in London survey, Western Maryland, UK NHS Smoking Cessation Services, Australia family practice survey, two decades after its 1984 introduction NRT does not have a single real-world performance victory, none. But that isn’t stopping the pharmaceutical industry from encouraging health officials to waste precious resources purchasing a worthless remedy.
NRT Clinical Studies Were Not Blind and Are Not Trustworthy
The reason NRT will never be effective in head-to-head real-world competition is that the expectations of cold turkey quitters to abruptly end all nicotine use are beyond the ability of the pharmaceutical industry to exclude, redefine, tease, torment, play upon, frustrate, defeat or destroy.
The clinical lesson kept quiet by the pharmaceutical industry and its army of loyal research consultants is that clinical efficacy studies were an expectations nightmare. Study participants joined in hopes of receiving weeks or months of free replacement nicotine. Instead of NRT clinical odds ratio victories evidencing NRT efficacy they reflect the frustration and fulfillment of the nicotine addict’s nicotine expectations.
Nicotine is a psychoactive chemical and a substantial percentage of participants knew what it felt like when their dopamine/adrenaline high was or was not replaced. This isn’t news to a replacement nicotine industry that appears to be operating from the tobacco industry’s nicotine play-book. Researchers found themselves resorting to the extreme of toying with small amounts of nicotine as a placebo device masking agent as early as a 1982 nicotine gum study. The practice is also noted in a number of nicotine patch studies.
Clinical efficacy and community effectiveness are two entirely different standards. According to an August 2004 article by Dr. Lois Biener, PhD, Senior Research Fellow, University of Massachusetts, “the effectiveness of NRT in the general population has not been established. In spite of the fact that NRT and other drugs are included in the Public Health Service guidelines, their efficacy has only been demonstrated in carefully controlled clinical trials. Evidence of their effectiveness in general population has been difficult to find.”
Dr. Biener is one of two Conference presenters who have demonstrated the courage to speak truth to pharmaceutical industry muscle, money and influence. It isn’t as common as integrity would hope. The other is Dr. John Pierce, PhD, Professor of Family and Preventive Medicine, University of California, San Diego.
Dr. Pierce analyzed seven years of data from the California Smoker’s Survey, one of the world’s largest. His study, published in the September 11, 2002 issue of the Journal of the American Medical Association, concluded that “NRT appears no longer effective in increasing long-term successful cessation in California smokers.”
There is growing awareness that highly manipulated clinical studies involving chemicals which alter perception, heart rate, extremity temperature, mood and behavior cannot and must not be accepted at face value. Equally important are real-world performance evaluations, a step that both GlaxoSmithKline and Pfizer know they must avoid and belittle as unscientific if their golden nicotine goose is to continue laying golden eggs.
With Pfizer and GlaxoSmithKline serving as two of the largest corporate sponsors of the 13th World Conference, there is simply no way that this can be an objective scientific symposium, especially when it comes to a discussion of the appropriate role (if any) of NRT in a national and international strategy to promote and enhance smoking cessation.
Dr. Michael Siegel’s commentaar (dd. 12 juli 2006)
Ondertussen maken de tabaksbestrijders zich openlijk zorgen over de financiering van hun strijd. Dat blijkt uit een artikel in het mei-nummer van het Canadese anti-rokersblad Info Tabac. Daarin wordt geklaagd dat de FCTC, een initiatief van de WHO, veel te weinig financiële armslag heeft om haar ambitieuze programma uit te voeren:
The entire budget on which the FCTC secretariat is supposed to develop guidelines for its 124 countries, assist countries with implementation, provide research support, hire experts to help develop protocols and monitor implementation is one-seventh of the tobacco control budget for Quebec. Several very wealthy countries, including Japan and many European countries, argued for an even lower budget.