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Reading the conflict of interest statement is as important as reading the result section
YPMED-04541; No of Pages 1 Preventive Medicine xxx (2016) xxx
Contents lists available at ScienceDirect
Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed
Letter to the Editor Reading the conflict of interest statement is as important as reading the result section Response to the letter by Dr. Kosmider: ideology versus evidence: investigating the claim that the literature on e-cigarettes is undermined by material conflict of interest Keywords: Electronic cigarettes Conflict of interest
In our systematic review on electronic cigarettes and health we have identified many articles with conflicts of interest. In most cases the authors had stated their conflict but in a few cases they had not. In the appendixes we show each paper's conflict of interest in detail. Most of the studies with conflict of interest were funded or otherwise supported by manufacturers of e-cigarettes, but many authors had also been consultants for manufacturers of medicinal smoking cessation therapy or received research grants from them. In several cases e.g. when an author previously only had received few lecture fees or travel expenses from a manufacturer no influence on the actual study is expected. We believe that all readers should assess themselves whether the paper's conclusions might be influenced by a sponsor or not. Of course, only studies with severe conflicts of interest should be read with caution. I have just updated the systematic review and added almost hundred papers (not published yet). In the recent years the tobacco industry, a manufacturer of e-cigarettes, has published a significant part of studies with conflict of interest; primarily studies investigating content of fluid. To make it easier for the readers I have marked tobacco industry studies with a red warning label. Studies funded by e-cigarette manufacturers or performed in close collaboration with e-cigarette industry were labeled with another red warning label. I systematically describe the findings e.g. identification of specific harmful substances starting each section with studies finding most harm and ending the section with studies finding little or no harm. As studies with severe conflicts of interest now are marked with a red warning sign it gives a nice overview: most warning labels are at the end of each section — studies showing little or no harm. History has shown that we cannot have blind trust in results of the studies performed or sponsored by industries, as they have huge economic interests. For many years the harm of second hand smoking was a very controversial topic. Out of more than one hundred reviews on passive smoking and health approx. one third was written by authors with connections to the tobacco industry; 94% of these papers concluded that there was no/insufficient evidence of harm of passive
smoking whereas only 13% of authors without connection to the tobacco industry reached the same conclusion (Barnes & Bero, 1998). The tobacco industry has been a ‘role model’ (Barnes & Bero, 1996; Bero, 2005; Proctor, 2011) for e.g. the food and sweet beverage industry (Bes-Rastrollo et al., 2013; Brownell & Warner, 2009) — so why expect that other industries with huge economic interests have a higher moral? It also has been shown that there is a strong link between the orientation of authors' expressed views on a medical controversy and their financial conflicts of interest with manufacturers of the medicinal product (Wang et al., 2010) so it is important that we as researchers contemplate on whom we collaborate with. We thank Dr. Kosmider et al. for performing a high-quality study which was an important contribution to the research on e-cigarettes and health. Transparency document The Transparency document associated with this article can be found, in online version. References Barnes, D.E., Bero, L.A., 1996. Industry-funded research and conflict of interest: an analysis of research sponsored by the tobacco industry through the center for indoor air research. J. Health Polit. Policy Law 21, 515–542. Barnes, D.E., Bero, L.A., 1998. Why review articles on the health effects of passive smoking reach different conclusions. JAMA 279, 1566–1570. Bero, L.A., 2005. Tobacco industry manipulation of research. Public Health Rep. 120, 200–208. Bes-Rastrollo, M., Schulze, M.B., Ruiz-Canela, M., Martinez-Gonzalez, M.A., 2013. Financial conflicts of interest and reporting bias regarding the association between sugarsweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med. 10, e1001578. Brownell, K.D., Warner, K.E., 2009. The perils of ignoring history: big tobacco played dirty and millions died. How similar is big food? Milbank Q. 87, 259–294. Proctor, R.N., 2011. Golden Holocaust. Origins of the Cigarette Catastrophe and the Case for Abolition. University of California Press, Berkeley and Los Angeles, California. Wang, A.T., McCoy, C.P., Murad, M.H., Montori, V.M., 2010. Association between industry affiliation and position on cardiovascular risk with rosiglitazone: cross sectional systematic review. BMJ 340, c1344.
Charlotta Pisinger Research Center for Prevention and Health, Capital Region, Center for Sundhed, Rigshospitalet – Glostrup, Copenhagen University, Building 84/85, Nordre Ringvej 57, 2600 Glostrup, Denmark E-mail addresses: [email protected], URL: http://www.fcfs.dk. 8 January 2016 Available online xxxx
http://dx.doi.org/10.1016/j.ypmed.2016.01.025 0091-7435/© 2016 Published by Elsevier Inc.
Please cite this article as: Pisinger, C., Reading the conflict of interest statement is as important as reading the result section, Prev. Med. (2016), http://dx.doi.org/10.1016/j.ypmed.2016.01.025
Contents lists available at ScienceDirect
Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed
Letter to the Editor Reading the conflict of interest statement is as important as reading the result section Response to the letter by Dr. Kosmider: ideology versus evidence: investigating the claim that the literature on e-cigarettes is undermined by material conflict of interest Keywords: Electronic cigarettes Conflict of interest
In our systematic review on electronic cigarettes and health we have identified many articles with conflicts of interest. In most cases the authors had stated their conflict but in a few cases they had not. In the appendixes we show each paper's conflict of interest in detail. Most of the studies with conflict of interest were funded or otherwise supported by manufacturers of e-cigarettes, but many authors had also been consultants for manufacturers of medicinal smoking cessation therapy or received research grants from them. In several cases e.g. when an author previously only had received few lecture fees or travel expenses from a manufacturer no influence on the actual study is expected. We believe that all readers should assess themselves whether the paper's conclusions might be influenced by a sponsor or not. Of course, only studies with severe conflicts of interest should be read with caution. I have just updated the systematic review and added almost hundred papers (not published yet). In the recent years the tobacco industry, a manufacturer of e-cigarettes, has published a significant part of studies with conflict of interest; primarily studies investigating content of fluid. To make it easier for the readers I have marked tobacco industry studies with a red warning label. Studies funded by e-cigarette manufacturers or performed in close collaboration with e-cigarette industry were labeled with another red warning label. I systematically describe the findings e.g. identification of specific harmful substances starting each section with studies finding most harm and ending the section with studies finding little or no harm. As studies with severe conflicts of interest now are marked with a red warning sign it gives a nice overview: most warning labels are at the end of each section — studies showing little or no harm. History has shown that we cannot have blind trust in results of the studies performed or sponsored by industries, as they have huge economic interests. For many years the harm of second hand smoking was a very controversial topic. Out of more than one hundred reviews on passive smoking and health approx. one third was written by authors with connections to the tobacco industry; 94% of these papers concluded that there was no/insufficient evidence of harm of passive
smoking whereas only 13% of authors without connection to the tobacco industry reached the same conclusion (Barnes & Bero, 1998). The tobacco industry has been a ‘role model’ (Barnes & Bero, 1996; Bero, 2005; Proctor, 2011) for e.g. the food and sweet beverage industry (Bes-Rastrollo et al., 2013; Brownell & Warner, 2009) — so why expect that other industries with huge economic interests have a higher moral? It also has been shown that there is a strong link between the orientation of authors' expressed views on a medical controversy and their financial conflicts of interest with manufacturers of the medicinal product (Wang et al., 2010) so it is important that we as researchers contemplate on whom we collaborate with. We thank Dr. Kosmider et al. for performing a high-quality study which was an important contribution to the research on e-cigarettes and health. Transparency document The Transparency document associated with this article can be found, in online version. References Barnes, D.E., Bero, L.A., 1996. Industry-funded research and conflict of interest: an analysis of research sponsored by the tobacco industry through the center for indoor air research. J. Health Polit. Policy Law 21, 515–542. Barnes, D.E., Bero, L.A., 1998. Why review articles on the health effects of passive smoking reach different conclusions. JAMA 279, 1566–1570. Bero, L.A., 2005. Tobacco industry manipulation of research. Public Health Rep. 120, 200–208. Bes-Rastrollo, M., Schulze, M.B., Ruiz-Canela, M., Martinez-Gonzalez, M.A., 2013. Financial conflicts of interest and reporting bias regarding the association between sugarsweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med. 10, e1001578. Brownell, K.D., Warner, K.E., 2009. The perils of ignoring history: big tobacco played dirty and millions died. How similar is big food? Milbank Q. 87, 259–294. Proctor, R.N., 2011. Golden Holocaust. Origins of the Cigarette Catastrophe and the Case for Abolition. University of California Press, Berkeley and Los Angeles, California. Wang, A.T., McCoy, C.P., Murad, M.H., Montori, V.M., 2010. Association between industry affiliation and position on cardiovascular risk with rosiglitazone: cross sectional systematic review. BMJ 340, c1344.
Charlotta Pisinger Research Center for Prevention and Health, Capital Region, Center for Sundhed, Rigshospitalet – Glostrup, Copenhagen University, Building 84/85, Nordre Ringvej 57, 2600 Glostrup, Denmark E-mail addresses: [email protected], URL: http://www.fcfs.dk. 8 January 2016 Available online xxxx
http://dx.doi.org/10.1016/j.ypmed.2016.01.025 0091-7435/© 2016 Published by Elsevier Inc.
Please cite this article as: Pisinger, C., Reading the conflict of interest statement is as important as reading the result section, Prev. Med. (2016), http://dx.doi.org/10.1016/j.ypmed.2016.01.025