[Intl-tobacco] Israel: Philip Morris funds smoking study

[Robert Weissman]

http://www.jpost.com/servlet/Satellite?cid=1134309568055&pagename=JPost%2FJPArticle%2FPrinter

Exclusive: Philip Morris funds smoking study

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Judy Siegel-Itzkovich, THE JERUSALEM POST 	Dec. 13, 2005

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Although there are strict professional guidelines on Israeli medical
research funded by pharmaceutical companies, neither the government nor
the Israel Medical Association (IMA) has put any limitations on studies
financed by tobacco companies.

The extent of foreign and Israeli tobacco companies' supply of research
grants here is not known, but /The Jerusalem Post/ has learned that
$250,000 was invested by Philip Morris USA and Philip Morris
International - the world's leading international cigarette business
with products sold in 160 countries - in a study of the effects of
genes, environment and psychological characteristics on smoking patterns
in young Israeli women.

Lead researcher Prof. Bernard Lerer - head of the biological psychiatric
laboratory at the Hadassah-University Hospital's psychiatry department
in Ein Kerem, Jerusalem - told the /Post/ on Monday that "we are not the
only ones. There are at least four or five other Hadassah research teams
currently conducting research on tobacco with funding from Philip Morris."

Lerer stressed that his study - just published in the on-line edition of
the prestigious /Molecular Psychiatry/ journal and due to be in the
print edition in February - was his initiative, "completely objective
and conducted according to scientific criteria." The supplier of the
research funds "had no ability to intervene in the way the research was
conducted, analysis of the results or their publication."

He said he initiated the study because he was "concerned about the
worrisome rise in smoking rates among young Israeli women, especially
when they complete military service." The Hadassah Medical Organization
added that Philip Morris, while providing the money through an
"independent research granting arm," did not set any conditions for the
research.

The Hadassah Medical Organization - though its hospitals were the first
in the country to voluntarily become smoke-free (the Hadassah Women's
Zionist Organization of America's /Hadassah Magazine/ was among the
first to refuse tobacco advertising) - declined to provide any
information about who else in its hospitals are currently conducting
tobacco studies with Philip Morris or other tobacco company funding.

"We will provide such information only after the /Post/ gets
documentation on such research at all the country's other hospitals,"
said external relations director Ron Krumer.

The published study, conducted in cooperation with the department of
molecular genetics of the Weizmann Institute of Science in Rehovot,
studied 501 Israeli women students aged 20-30 and looked at their
background, details of smoking (or non-smoking), psychological
characteristics and life experiences. They then took blood samples and
studied cholingeric receptor genes that bind with nicotine. Lerer and
his team concluded that the "strongest influences on whether young women
begin to smoke are psychological and background," (especially if their
parents smoked and the women themselves suffered traumatic experiences);
but if they are already hooked on tobacco, carrying such receptor genes
is the "strongest determinant" of how long and how much they will smoke.
In small print, at the end of his article, the authors acknowledge that
the study was "partially funded" by Philip Morris.

Asked to comment, the Health Ministry spokesman said it was not aware of
tobacco company funding of Israeli tobacco research in hospitals and did
not know the extent of this phenomenon - whether it was just at Hadassah
or in other hospitals as well - including government hospitals owned and
supervised by the ministry.

"We will investigate this. The Health Ministry was not a signatory of
the IMA document restricting pharmaceutical company funding of doctors'
medical research, because we are ourselves the regulator. But if there
is tobacco industry funding of research in the state hospitals, we will
decide what action to take. Even if there is no such phenomenon in the
government hospitals, we'll examine the implications of this matter," he
said.

IMA chairman Dr. Yoram Blachar, informed of the Hadassah research, said,
"this is the first time I hear that Philip Morris or other tobacco
companies finance physicians' research on smoking. If companies want to
give money, it should go to the state and to the health funds, which
cover the costs of treating the diseases of smokers and those exposed to
tobacco smoke, and not directly to hospital research institutes for
researchers' work. It sounds absurd to me and a clear conflict of
interest."

Blachar said he would discuss the matter with Hadassah-University
Hospital neurology Prof. Avinoam Reches, head of the IMA's ethics bureau
when he returns from abroad this week.

"I do not think that his working for Hadassah would affect his judgment
in this case, but if he saw it as a problem, he could name a deputy to
deal with it," he said.

Blachar added that $250,000 for a single research study of 500 subjects
was "indeed a great deal of money" and an unusually large grant.

Prof. Gabi Barabash, director-general of Tel Aviv's Sourasky Medical
Center and a former Health Ministry director-general, said that with the
decline in government funding of medical research, doctors have no
choice but to accept funding from commercial interests.

"I see no major difference between financing of research by
pharmaceutical companies and tobacco companies. There must be
supervision and care to keep the research objective, and I hope that
Hadassah does this to prevent bias," he said.

He added that although his medical center does not have any research
projects financed by tobacco companies, he would not rule them out if
bias was eliminated. "Such research requires care and supervision, but
we can't rule it out," he said.

Amos Hausner, chairman of the Israel Council for the Prevention of
Smoking, maintained that Israel could have been specifically chosen by
Philip Morris as the site of this research, apparently because it was a
main defendant in several major Israeli lawsuits against tobacco
companies. Hausner himself has since 1998 represented Clalit Health
Services in a NIS 11.2 billion lawsuit against tobacco companies,
including Philip Morris, for health costs paid for by Clalit.

"One of the main arguments in our case is that tobacco company
advertising encourages people, including the young, and targeted women
to start smoking and to keep on smoking. The Hadassah research, even
though it involved psychiatrists, did not investigate whether
advertising encourages Israeli women to start smoking," Hausner said.

"It is strange that although the study was carried out by psychiatrists,
they did not investigate how cigarette advertising psychologically
induces women to start smoking. Instead, the company is probably very
pleased to be supplied with alleged proof that one's own genes, rather
than tobacco ads, are largely responsible for why women continue to
smoke and smoke more," he added.

When the companies decide which research proposals to finance, they are
inherently selected what factors would be taken into account, while
others are excluded, Hausner noted, thus the the way the studies are
conducted are seriously flawed.

Another problem is that researchers who anticipate getting future
tobacco money are likely to be careful not to upset the financiers with
"whatever they research and the way they report it," he said.

Hausner added that the 1997-1998 US court settlement required tobacco
companies there to pay $246 billion over 25 years to the states
themselves, which may designate the money for treatment or genuine,
independent research. "If tobacco companies do donate money for
research, the money should not go to individual research teams in
hospitals, but to the state and the health funds, which can objectively
decide what research on smoking has to be conducted, especially on how
to prevent young people from starting to smoke," Hausner said.

Prof. Shimon Glick, a senior medical ethics expert at Ben-Gurion
University of the Negev and former dean of its health sciences faculty,
commented: "It is very bad policy for medical researchers to take money
from tobacco companies. They must be very careful. Tobacco companies'
products spread death: Smoking is the leading preventible public health
problem in the world. If taking their money is not absolutely forbidden,
at least there should be strict limitations; if not, it may present a
serious ethical problem."