How harm reduction advocates and the tobacco industry capitalized on pandemic to promote nicotine
Scientific papers suggesting that smokers are less likely to fall ill with COVID-19 are being discredited as links to the tobacco industry, reveals an investigation by The BMJ today.
Journalists Stéphane Horel and Ties Keyzer report on undisclosed financial links between certain scientific authors and the tobacco and e-cigarette industry in a number of COVID research papers.
In April 2020, two French studies (shared as preprints before formal peer review) suggested that nicotine might have a protective effect against COVID-19—dubbed the "nicotine hypothesis."
The stories made headlines worldwide and led to concern that decades of tobacco control could be undermined.
It has since been roundly disproved that smoking protects against COVID-19, and several studies show that smoking, when adjusted for age and sex, is associated with an increased chance of COVID-19 related death.
Horel and Keyzer point out that one of the study authors, Professor Jean-Pierre Changeux, has a history of receiving funding from the Council for Tobacco Research, whose purpose was to fund research that would cast doubt on the dangers of smoking and focus on the positive effects of nicotine.
From 1995 to 1998, tobacco industry documents show that Changeux's laboratory received $220,000 (£155,000; €180,000) from the Council for Tobacco Research.
Changeux assured The BMJ that he has not received any funding linked "directly or indirectly with the tobacco industry" since the 1990s.
In late April 2020, Greek researcher, Konstantinos Farsalinos, was the first to publish the "nicotine hypothesis" formally in a journal, in an editorial in Toxicology Reports.
The journal's editor in chief, Aristidis Tsatsakis featured as a co-author, as did A Wallace Hayes, a member of Philip Morris International's scientific advisory board in 2013, who has served as a paid consultant to the tobacco company.
Another co-author is Konstantinos Poulas, head of the Molecular Biology and Immunology Laboratory at the University of Patras, where Farsalinos is affiliated.
The laboratory has received funding from Nobacco, the market leader in Greek e-cigarettes and the exclusive distributor of British American Tobacco's nicotine delivery systems since 2018.
Neither Farsalinos nor Poulas has ever declared this Nobacco funding in their published scientific articles.
Yet Horel and Keyzer show that two grants were attributed in 2018 by the Foundation for a Smoke Free World—a non-profit established by Philip Morris International in 2017—to "Patras Science Park."
The grants, whose amounts are not disclosed on the foundation's website, but tax documents show came close to €83,000, went to NOSMOKE, a university start-up incubator headed by Poulas, which markets an "organic" vaping product.
Last month, the European Respiratory Journal retracted a paper co-written by Poulas and Farsalinos, among others, after two authors failed to disclose conflicts of interest.
The retracted article had found that "current smoking was not associated with adverse outcome" in patients admitted to hospital with COVID, and it claimed that smokers had a significantly lower risk of acquiring the virus.
The foundation has invested heavily in the COVID-19/nicotine hypothesis, say Horel and Keyzer.
In June 2020 it set aside €900,000 for research "to better understand the associations between smoking and/or nicotine use, and COVID-19 infection and outcome."
Its request stated that the pandemic offered "both an opportunity and a challenge for individuals to quit smoking or transition to reduced risk nicotine products."
They conclude: "In 2021, amid a global lung disease pandemic, tobacco industry figures are increasingly pushing the narrative of nicotine as the solution to an addiction that they themselves created, with the aim of persuading policy makers to give them ample room to market their "smoke-free" products. This makes studies on the hypothetical virtues of nicotine most welcome indeed."