The European Union and Big Pharma: A tale of corporate lobbying
When the most effective means of smoking cessation are sidelined in favour of inferior products, are we looking at venal corporatism at its most despicable?
This week Maltese EU Health Commissioner John Dalli saw his work leaked to the press, the new, albeit draft, EU Tobacco Product Directive. Among the pearls of wisdom was a complete ban on electronic cigarettes and smokeless forms of tobacco such as Swedish snus, and plain packaging with 75 percent of the packet enjoying medical pornography that would make even Larry Flynt blush.
There was an extensive EU consultation last year attracting a response of 85,000 people which reported that: “A significant majority of respondents were against extending the scope of the Directive…..as a whole demanded more scientific inquiry about the relative safety of novel forms of tobacco and other nicotine products. These respondents also argued about the consumer's freedom of choice, so long as they are properly informed with the risks involved, and they criticised the tendency to over-regulate and prohibit products in this area.”
Never mind chaps, being in the EU is a lesson in a post democracy era.
I am all for informed choice on smoking. It is true that smokers live on average seven years younger than non-smokers. Some studies suggest as much as ten years. Furthermore, 90 percent of lung and emphysema cases are smokers. Reducing smoking is not an aim without medical merit.
But if that is so then the proposed banning of electronic cigarettes and snus is an absolute disgrace. Quite simply, it is just cynical lobbying by pharmaceutical companies to keep a monopoly on nicotine replacement therapy (NRT).
Firstly let us take snus – and I am grateful for the input of Chris Snowdon. The size of a very small teabag, they are placed in the mouth, between your gum and lip, and diffuse nicotine into the blood stream. Sweden is allowed to sell snus by special EU dispensation – a precondition to Sweden joining the EU – but it is a banned product everywhere else inside the union.
But consider this: Sweden has the EU's lowest rate of male smoking and consequently the lowest rate of lung cancer and emphysema. The health risks of snus are non existent – perhaps explaining why Sweden also has some of the lowest oral and oesophagal cancer rates in the world.
The Swedish Karolinska Institute in Stockholm has tried time and again to discredit snus, but their failure to release data on their Swedish Construction Workers Cohort for their claims just adds to raised eyebrows. The researchers were exposed in May 2012 as being in the pay of a….drum roll, please….pharmaceutical company, namely Pfizer.*
Pfizer make the anti-smoking drug varenicline, marketed in the US as Chantix and Champix in the EU. Endorsed by Action on Smoking and Health, it is associated with mood changes, depression and over 200 suicides. Pfizer are now subject to a class action from victim’s families and there is strong evidence that they suppressed these findings before the Food and Drug Administration licensed it.
Electronic cigarettes have also been to be next to harmless. Most informed health professionals claim they are 99 percent safer. They also offer very encouraging quit rates of up to 45 percent. I even have one. If smoking rates for the most hard-bitten smokers are to be reduced then it would be madness to ban them.
The electronic cigarette market in the European Union, in 2011, was €400–500 million. 7 percent of citizens in the EU have tried electronic cigarettes; in the UK, figures are set to rise from a small number in 2006 to over 1 million by 2013. No wonder pharmaceuticals are worried as this World Health Organization paper states.
Let us move onto nicotine replacement (NRT). Normally in the shape of chewing gum and patches these are the products manufactured by pharmaceutical companies. The one year quitting rate is extremely poor. “The long term..quit rates for NRT was 1% and 6% in two studies and 8–11% in five other studies. These results were not homogenous; however, when combined the estimate was 7%.” Others are as low as 0.8% and 1.6%.
The NRT market was worth £117 million in turnover to pharmaceuticals in 2011, most given away free to “quitters” by the NHS. They have a business to protect.
The pharmaceutical companies first got involved in influencing world and European opinion in 1999 with the launch of the World Health Organization. Since then, companies have lobbied in favour of their products, such as Novartis, which makes nicotine patches, and proudly declares on its website that:
“[It] is campaigning to encourage policies to complement non-smoking environments with smoking cessation, with nicotine replacement therapy (NRT) as an important component of an EU strategy on tobacco control. Our aim is to foster a policy and legislative environment which leads to better public health through strong tobacco control measures and increased availability of NRT in line with the WHO Framework Convention on Tobacco Control."
Another example of this is Pfizer and GSK joining forces with “Boehringer Ingelheim and the European Respiratory Society to found the European COPD Coalition (ECC).” Labour MEP Glenis Wilmott confirms she is on board on her blog states: “I have been getting involved with the newly formed European COPD Coalition as we look towards revising the Tobacco Products Directive next year.”
In total, it is estimated that the pharmaceutical industry spends €40 million on lobbying the EU annually. That is what is entered in the EU Registry of Interests, although €91 million maybe nearer the mark.
The reality is that NRT is the most ineffective way to quit, yet, with the connivance of the EU, pharmaceutical companies have lobbied for the banning of all nicotine substitutes other than tobacco.
Despite snus and electronic cigarettes being far more effective, prospective “quitters” will have the choice of a product which, at worst, may provoke suicide, or another which is entirely ineffective. This is plainly venal corporatism at its most despicable.
My knowledge is of the tobacco control industry, but I wouldn’t be surprised to learn that this is a model that infects the entirety of the EU machinery. And then they wonder why the British want a referendum…
* Declaration of Interests. I have been paid and expensed by Pfizer who make smoking cessation drugs.
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