London School of Hygiene & Tropical Medicine

A public-health article published online by The Lancet (www.thelancet.com) suggests that Philip Morris, one of the world's leading tobacco manufacturers, was covertly involved in scientific research into the health effects of tobacco 30 years ago, and conducted research into the dangers of passive smoking which do not appear to have been published.

Martin McKee (London School of Hygiene & Tropical Medicine, UK), and colleagues Pascal Diethelm and Jean-Charles Rielle from Switzerland highlight how Philip Morris used a German-based research facility to do research into the health effects of tobacco smoke from the early 1970s onwards. Dr McKee explains: "The tobacco industry maintained, for many years, that it was unaware of research about the toxic effects of smoking. By the 1970s, however, the industry decided that it needed this information but they were unwilling to seek it in a way that was open to public scrutiny. By means of material from internal industry documents it can be revealed that one company, Philip Morris, acquired a research facility in Germany and created a complex mechanism seeking to ensure that the work done in the facility could not be linked to Philip Morris. Arrangements were made to conceal this process, not only from the wider public, but also from many within Philip Morris, although some senior executives did know."

The article also highlights how the published research appears to reflect the interests of the tobacco industry. Professor McKee adds: 'The scientists involved appear to have published only a small amount of their research and what was published appears to differ considerably from what was not. In particular, the unpublished reports provided evidence that second-hand smoke is even more harmful than mainstream smoke, a finding of particular relevance given the industry's continuing denial of the harmful effects of passive smoking. By contrast, much of its published work comprises papers that seek to cast doubt on methods used to assess the effects of passive smoking'.

Professor McKee concludes: "we believe that it is essential that those involved in reviewing evidence on smoking and health should be aware of what appears to be the selective nature of what is eventually published by some scientists with links to the industry, and the evidence that sometimes mechanisms appear to have been used to disguise these links. Any research in this field must involve full disclosure of competing interests and any involvement of the tobacco industry in the instigation, design, analysis or interpretation of findings. Specifically, Philip Morris should be required to explain why it took the steps documented here to maintain what appears to have been considerable secrecy about its role in research on the effects of sidestream (passive) smoke and consequently its knowledge of its effects, effects that appear at odds with its public statements."

Lancet Editor Richard Horton comments: "Given the continuing debate about the way governments should respond to calls for a ban on smoking in public places, we have published this work early online to inform that discussion as a matter of urgency. Pascal Diethelm and his colleagues reveal attempts by one company-Philip Morris-to conceal their links to a research centre in Germany studying the health effects of smoking. The research conducted in that facility appears to have been selectively reported in order to favourably shape public impressions about the safety of passive smoking."

Dr Horton adds: "As the UK government launches its white paper on public health, ministers must be alert to the fact that parts of the tobacco industry have apparently attempted to hide important research that could and should influence government policy. It is essential not only that ministers are aware of this apparent strategy of concealment, but also that they formulate a public-health response to protect people from the known damaging effects of environmental tobacco smoke. Not to do so would be a capitulation to an industry that seems to have manipulated evidence which might undermine their ability to profit from an addictive drug-one that continues to cause extreme human suffering."