COMPASSION FOR FELLOW CITIZENS AND PASSION FOR TRUTH AND CLARITY ARE COMPETING INTERESTS ACCORDING TO THE CMAJ

****** After publishing this post, it was brought to my attention by a reader that my first letter is posted but under a different URL at http://www.cmaj.ca/content/183/18/E1334/reply .   I don’t quite understand why that is, but different URL’s show different letters.  Sometimes mine appears, sometimes it doesn’t.  I think apologies to the CMAJ are in order as far as the first letter goes but I still don’t understand how intellectual passion can be viewed as a competing interest so I will leave my post up. ********

Please note that I have been having a lot of problems getting my links to work in these posts lately.  If any link doesn't work for you, please copy paste it in a new browser.  Thank you.


There has been a lot of talk in the last few months about unintended consequences of smoking bans and how they may actually be hurting the more vulnerable members of society. 

In November The Winnipeg Free Press reported the case of a 54-year old woman who found herself locked out of the hospital when she exited to smoke and was a victim of severe frost bite.  Four fingers on her right hand had to be amputated. She was left with limited mobility in her left hand. http://www.winnipegfreepress.com/local/hospital-smoking-bans-endanger-patients-study-132980933.html

The Canadian Civil Liberties Association reacted to this tragic story by inviting citizens to express their views on hospital smoking bans.  http://www.ccla.org/rightswatch/2011/11/01/do-hospital-smoking-bans-put-addicted-patients-in-danger/comment-page-1/#comment-28655  

The CMAJ (Canadian Medical Association Journal) published an article highlighting that hospitalized smokers require more assistance with compliance and nicotine withdrawal symptoms.  http://www.cmaj.ca/content/early/2011/10/31/cmaj.110235.full.pdf+html
  
There were a few responses to this article.  One was from Dr. Stuart H. Kreisman, endocrinologist at St. Paul's Hospital who opined that ‘’ The distinction between smoking (which is just a habit) and nicotine (which is the addictive drug) becomes blurred at several points in this article and the responses to it. (…) Viewing smoking as addictive, which most of the population superficially does, plays directly into the hands of "smokers' rights" advocates and their claims that smoking bans (be it in hospitals or elsewhere) are discriminatory. Remembering that the actual addiction is to nicotine leads directly to realizing that there are many other forms in which nicotine can be delivered (even if less gratifying) without exposing others.’’  Read complete comment at http://www.cmaj.ca/content/early/2011/10/31/cmaj.110235/reply#cmaj_el_674876

To this, I, Iro Cyr, the writer of this blogpost, replied under my personal name with the following comment:

Conscientious professionals must stop perpetuating the ''nicotine addiction'' theory

It is unfortunate and even a tragedy that so many, if not most, health professionals bought into nicotine being the only substance responsible for addiction in people who smoke. Unbiased studies have consistently shown that NRT has a 93 - 98% long term failure rate to help people stop smoking. Already this should be ringing loud bells. Isn't it time that the medical community who would like us to believe that they care for people, started exploring different avenues that will lead them to understand what motivates a person to continue smoking? How many more years and unnecessary suffering will it take before serious and conscientious professionals stop perpetuating the ''nicotine addiction'' theory and started looking at the issue with an honest critical mind?

In the wise words of Pr. Robert Molimard who spent most of his career analyzing tobacco and helping smokers quit '' The big fraud in the tobacco issue was none other than the publication of the 1988 Surgeon General Report entitled "Nicotine Addiction''. This fraud is incomprehensible unless one sees the link with the launch of the nicotine gum. The major premise of the Report seems to be a syllogism that states: "Tobacco products cause a powerful addiction'' The minor premise is: "Tobacco contains a neurotropic poison - nicotine''. Hence follows the conclusion: "Therefore nicotine is responsible for the addictiveness of tobacco''. But there is no evidence that allows us to draw such a conclusion. A host of other assumptions are possible, and there are even major arguments to oppose it, such as the fact that no cases of nicotine dependence have ever been documented when this substance was used in isolation (...) This duplicity is more than amazing when you consider how common it is for addicts to experiment with the purified extracts of their plants of choice. Since no formal evidence of dependence to pure nicotine has yet to be produced, the conclusion that nicotine alone is addictive is not a syllogism, but rather, pure sophistry. And yet, against all scientific rigor, this fallacy was implanted through repetition, hammered in as an unassailable truth, all with the support of health authorities and politicians (...) '' End of citation. Read English translation of the French original at:
http://cagecanada.blogspot.com/2010/12/beliefs-manipulation-and-lies-in.html

But let's pretend that we agree that smoking is a habit and that addiction is caused by nicotine alone, does the medical profession truly believe that an already stressful hospital stay is the right time to break one of their lifetime habits whether ones wants to or not, causing additional suffering and stress? And being quasi-prisoners of the healthcare establishment, wouldn't insisting on medicating someone with NRT to alleviate them of their withdrawal symptoms caused by their inability to smoke, be considered a form of forced medication? Isn't it comparable to deliberately causing unnecessary physical pain to someone and later insisting that they take pain relievers to make it all better? Only dogmatic ideology bordering sadism justifies entertaining such beliefs.

The CMAJ published my comment and left it posted for a few days but then I received a letter from them as follows : 

Good afternoon Ms. Cyr:

Thank you for your recent eLetter to CMAJ, which was posted on our website (www.cmaj.ca) Dec. 5 in response to the article “A qualitative investigation of smoke-free policies on hospital property.” It has since been brought to my attention that your affiliation with CAGE, a competing interest, was not disclosed in your letter. Could you please comment on that?
Many thanks,
Leesa D. Sullivan
Managing Editor, CMAJ

To which I promptly replied the following: 

Hello Ms. Sullivan,

Thank you for checking with me about this.  Perhaps you are relying upon a definition of “conflict of interest” that I am unaware of?  I don't understand how being an unpaid volunteer for a 100% non-profit grassroots organization that is comprised of ordinary citizens would be a “competing interest.”  I am neither a remunerated activist nor a registered lobbyist.  Sometimes I sign under my own name, sometimes I sign as vice-president of CAGE (I hope you can see clearly that if I had the intention of hiding my affiliation with CAGE, I would not have used my real name in my submission to your publication).

In any case, I am not paid to do what I do.  Are volunteers for groups concerned with patients rights, the Canadian Civil Liberties Union, or similar organizations considered to have “competing interests”? If you could make clear your working definition of “conflict of interest” and “competing interest,” I will be happy to provide you with any additional information to help you determine if such concerns apply in my case.
With thanks,
Iro Cyr

After a couple of days of not getting a reply I attempted to post the following comment, again under my personal name.

Following my last comment, a very timely article appeared (that I translated with Pr. Robert Molimard's kind permission) on how and why Karl Fagerstrom has now changed his famous dependence to nicotine test to become a dependence to cigarettes test. You can read it here :
http://cagecanada.homestead.com/fagerstromfindshiswaytodamascus.html
Dr.Fagerstrom's article that Pr. Molimard refers to can be found here: http://ntr.oxfordjournals.org/content/early/2011/10/20/ntr.ntr137.extract

It all makes sense when one considers what pushed the nicotine addiction theory to become dogma.

Closer to home, ''The Ottawa Model'' is a program implemented in hospitals that seizes the opportunity hospitalization provides, to get as many smokers as possible to quit. The program they offer is strongly focused on pharmacological therapy including nicotine replacement and bupropion and varenicline. When one reads the conflicts of interest of those who promote ''The Ottawa Model'' is it really surprising that they offer pharmacotherapy to supposedly alleviate the symptoms of those patients who have clearly expressed that they don't wish to stop smoking? Wouldn't a sheltered warm designated area be more respectful of these patients' wishes? Apart from conflicts of interest that may arise from '' research support, speaking fees, and honoraria from Pfizer'' to at least two of the promoting medical professionals of this program, Pfizer has financed the Smoking Cessation Rounds Publication that describes the program. http://www.smokingcessationrounds.ca/crus/screng0507.pdf

Note: It has been brought to my attention that I should be declaring my affiliation to C.A.G.E. a 100% Canadian grassroots group that is comprised of a 100% ordinary citizen membership. I do not get paid either directly or indirectly for expressing my own opinion or C.A.G.E.'s point of view. (I am the president of a private company totally unrelated to health, tobacco, pharmaceuticals or anything remotely related to health). Neither I nor C.A.G.E. are registered lobbyists. C.A.G.E. receives no funding from anyone with any competing interests and gets by on tiny donations from its members to cover some of the costs of maintaining its websites, stamps, stationary etc. I am above all a concerned citizen and it is because of my personal deep concern towards the sick, the elderly and the psychiatric patients that I expressed myself in this forum.

I understand that a number of interested parties have made complaints or accusations against me, but these are usually done covertly, in secret and without my having an opportunity to respond. Should you receive any such accusations, I would request that you accord me the basic courtesy of disregarding any statements to which I am not made a party and to which I have not had an opportunity to respond.

The CMAJ editor replied with this comment: 

Thank you for the following eLetter to CMAJ and your email of Dec. 7. I
want to clarify what is meant by competing interests from the point of
view of the journal. It is not just about a monetary association.

For the purposes of the journal, the International Committee of Medical
Journal Editors has defined competing interests as:

"Conflict of interest exists when an author (or the author's institution), reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions
(such relationships are also known as dual commitments, competing interests, or competing loyalties). These relationships vary from those with negligible potential to those with great potential to influence
judgment, and not all relationships represent true conflict of interest. The potential for conflict of interest can exist whether or not an individual believes that the relationship affects his or her scientific
judgment. Financial relationships (such as employment, consultancies, stock ownership, honoraria, paid expert testimony) are the most easily identifiable conflicts of interest and the most likely to undermine the credibility of the journal, the authors, and of science itself. However, conflicts can occur for other reasons, such as personal relationships, academic competition, and intellectual passion."

You are an author (given that you have submitted and have had a letter posted online at cmaj.ca) and therefore should have mentioned your affiliation for the benefit of our readers.

We ask that you declare your involvement in CAGE as a potential competing interest. If you agree to cite this information as we suggest, then perhaps you'll want to revise the final two paragraphs in the
letter below before we consider it for online publication.

With thanks

To which I replied : 

Thank you for your explanation of your working definition of "competing  interests."  I suppose your journal believes that CAGE represents a "competing interest" as a result of "intellectual passion," since I don't  see any other way it could be constructed as a competing interest.  In this case, the "intellectual passion" comes from a commitment against coercive  forms of health promotion.  I personally do not feel that such adherence to basic liberal principles represents a competing interest (and I would ask  you to apply the same standard as you do to other authors and organizations), but I defer to your judgement on the matter given that this  is your journal.  If you prefer, I can sign as Iro Cyr, Vice-President, C.A.G.E. but I will not declare any competing interests because that would
neither be true nor fair.   I have less of a competing interest than Mr.  Povah from the anti-smoking group Airspace Action on Smoking and Health, who  did not declare any competing interest when he submitted his letter to you.

If you agree with this I can revise my letter taking off the two last  paragraphs and resubmitting it under Vice-President of C.A.G.E..  Would you like me to resubmit it through an e-mail form or through the comment section of your website?

Thank you very much.

Evidently that wasn’t good enough because she replied : 

I have added an editor's note to your first letter, stating your affiliation, and reposted the letter it this morning.

I have spoken at length with our senior editors about your latest email. We will consider posting your second letter, but only if you declare your affiliation with CAGE as a competing interest, according to the definition I sent you previously. If you agree, then yes, please resubmit your revised letter (with the deleted two paragraphs, as discussed) through the CMAJ eLetters process.

Many thanks for your patience

She never reposted my first letter that she had taken down although she said she would.  And because I refuse to declare a competing interest that I absolutely don’t consider I have, she never posted the second either.  ****please see note on top of this page****
 

If the CMAJ considers intellectual passion a competing interest, why are the letters from the following two entities still up with undeclared competing interests? 

Dr. Stuart H. Kreisman  has been instrumental in instituting smoking bans in parks and beaches in Vancouver and is now actively promoting multi unit housing bans. 

Errol Povah, President of Airspace Action on Smoking and Health B.C., as it appears on their web site:   ''Canada's Sworn Enemies of the Tobacco Industry’’  ****Mr. Povah's letter no longer appears on the URL mentionned on top of this page****

In conclusion, it appears that concern and compassion for fellow humans is  considered a "competing interest" according to an association that purports to care for the health and well being of the people.  The CMAJ will not tolerate our efforts to state documented facts that may help hospitalized patients for the sole reason that these facts contradict the accepted dogma of  The Canadian Medical Association.  Being a member of any organization that questions the established medical and scientific dogma is a competing interest according to them.  How reasonable is that?  I call it tyranny of the medical establishment.  I have no stakes whatsoever in this issue except for a deep concern for the truth.  If working hard for the purpose of truth and clarity is considered a competing interest by the CMAJ who will apply a double standard depending on who the authors are, then I am now certain that the medical establishment is suffering from its own form of competing interests bias.

LETTER TO THE EDMONTON JOURNAL

Hello Mr. Staples,

I read your article about the government not giving an explanation about why they are delaying the new health warnings on cigarette packages.

Let me first agree with you that their delays do not seem to be warranted. Not that in my opinion these million dollar warnings will deter many remaining smokers to quit and therefore are an urgent life or death necessity, but the fact that they're not justifying their decision is very intriguing.

However, I truly wish journalists would once in a while be as critical with another unethical corporation playing hanky panky with government as they are with the tobacco industry. It seems mostly every mainstream journalist is keeping his eyes tightly shut on the shenanigans of the pharmaceutical industry and their emerging nicotine market when so much blatant evidence is just screaming to be reported! Why?

One of those examples is electronic cigarettes which have been nixed by Health Canada very shortly after they were introduced in Canada. The e-cigarette is a smokeless, odorless electronic device that has become very popular with smokers who wish to give up smoking without giving up nicotine intake but find no satisfaction in the patches, inhalers, gums or lozenges of the pharmaceutical industry which have been documented to have but a 1,6% long term success rate. Although most of them are not marketed as a smoking cessation device, hundreds of thousands of smokers throughout the world have either significantly cut down or quit smoking totally thanks to them. The various manufacturers and distributors of such devices being completely independant of the tobacco and the pharmaceutical industries, have thus become a real threat to the two big players in the nicotine market. These devices contain nicotine, propylene glycol and flavorings, three substances already approved by Health Canada. Yet Health Canada has banned them giving reasons that do not fly with reality, common sense or ethics. You may want to read this story here: http://cagecanada.blogspot.com/2009/05/e-cigarettes-letter-to-health-canada.html

Another example is nicotine lozenges. The tobacco industry and the pharmaceutical industry both produce almost identical products. The only difference is the price, the pharmaceutical ones being almost four times more expensive than the tobacco products. Read this story here: http://cagecanada.blogspot.com/search?q=orbs These tobacco products will probably never be marketed in Canada because the anti-tobacco lobby is condemning them as we have read from the latest recommandations to the Ontario government (page 11 of http://media.thestar.topscms.com/acrobat/34/88/1283a0ca484494ea3e8badfc828b.pdf ) :

Ban smokeless tobacco products in Ontario by the end of the 5-year revised SFO Strategy. '
Prohibit the approval, sale and marketing of any new tobacco product or non-therapeutic nicotine product.

Which brings me to another observation. Why would anti-tobacco activists who claim to want smokers to quit, do everything in their power to block smokeless products which have been proven to be far less harmful than smoked tobacco if it isn't to either protect the pharmaceutical industry's profits or to carry out their vendetta against the tobacco industry (most probably both reasons) at the smoker's expense? Why would they block the e-cigarette (referred to in their report as the ''non-therapeutic nicotine product) which should instead be heiled as a much, if not totally, harmless product, and as a solution to a divisive smoking/non-smoking society, smoking bans and the hospitality industry hardships?

Why don't reporters ever investigate such blatant conflicts of interest?

Remaining hopeful,

Iro Cyr
Vice-president
C.A.G.E.

NICOTINE WARS (2)

Last April we commented on a paper from the Harvard School of Public Health that contended that the nicotine lozenges marketed by Big Tobacco were a lure to children that could even be poisoned by the abuse of such a product. We questioned why they didn’t express any worries about the similar pharmaceutical product, Commit and then went on to compare the pharmaceutical produced nicotine lozenges Commit, to the tobacco produced lozenges Orbs. Our findings were quite interesting:

Orbs contain 0,6 - 3,5 ml of nicotine

Commits contain 2 - 4 ml of nicotine

Orbs are fruit and candy flavored

Commits are fruit and candy flavored

Orbs come in attractive packaging

Commits come in attractive packaging

Because they’re a tobacco product minors cannot purchase Orbs

Commits are marketed over the counter and are available to everyone

Orbs dissolve in the mouth in minutes are small in size and can be conveniently hidden anywhere

Commits dissolve in the mouth in minutes are small in size and can be conveniently hidden anywhere

In the U.S. Orbs are priced at around 4.00 $ before tax for 15 pieces (approx. 15 cents per piece)In the U.S. Commits are priced at around 40 $ for 72 pieces tax exempted (approx 55 cents per piece).

Up until then we could only suspect that this paper was to be served as ammunition to Big Pharma for their scheme to eliminate the cheaper competition, namely tobacco manufactured lozenges, but now our suspicions have been confirmed.

Glaxo Smith Klein, makers of Commits, recently urged the FDA to take dissolvable smokeless tobacco products off the market contending that they are a threat to public health.

But what will the FDA, that has several members with financial ties to Glaxo Smith Klien sitting at the Tobacco Products Scientific Advisory Committee, do? It remains to be seen. Dr. Michael Siegel has already called for the resignation of such members. Will the FDA do the right thing? We somehow doubt it, but we will just have to wait and see. To follow.

Glaxo urges FDA to withdraw dissolvable tobacco

DISEASE MONGERING

In the pages of our main website and this blog, we have often commented on the role the pharmaceutical industry plays in dictating policies through their charitable foundations, astroturfing and direct marketing. We have also been very critical of the media reporting Big Pharma’s and its front groups’ press releases verbatim, without any further investigation especially when it pertains to political incorrect issues such as smoking, alcohol, and obesity.

We came across an article in The Health Reformer recently that deals with this very subject of corporate and professional interests shaping public opinion using the media as their showcase to the population. The author of the article Disease Mongering / Medicalization: A wasteful threat to public health explains how the pharmaceutical giants grow markets by promoting sickness for milder and milder conditions by redefining disease. They denounce the regulators’ complacency in this issue and organize world conferences to rectify the situation.

It is heartening to see that fortunately there is an ever increasing concern on this very important issue that has become a hazard not only to our emotional and physical well-being but to the worldwide economies as well.

In following the links in this article we have discovered that there are now specialized websites dedicated to analyze health articles in the media and criticize their value in an effort to help people make informed decisions about their body and what they want or do not want to ingest as a cure to what may not long ago have been a normal part of living. Please visit the Canadian website: Media Doctor and its U.S. counterpart: Health News Review to read their analysis on selected health news articles.

Additional literature:

The pharmaceutical industry is making a lot of money by telling healthy people they're sick

Selling sickness: the pharmaceutical industry and disease mongering

MORE ON CHILDHOOD OBESITY MYTHS

We came across this dated but more apropos than ever public comment prepared by Sandy Szwarc for the FTC/HHS Workshop in 2005. It is rich with references to studies that find that except for extreme cases of obesity, children can lead healthy and happy lives regardless of their weight.

Much like we have commented on October 12th, low BMI is not necessarily a synonym of good health. You will find that many references in Ms Szwarc’s comments are in line with the study we referenced on our FOLLOW THE MONEY BEHIND THE OBESITY ‘’DISEASE’’ comment. The irony of this particular study is that the actual research was likely attempting to find the complete opposite results because even the concluding remarks tend to tip the scale to the side of the rhetoric that children must be lean to enjoy good health, when in fact their own findings support that children can improve their health through moderate exercise even if they don’t lose weight.

Similar to our line of thinking, Ms Szwarc concurs that exaggerated public health and corporate campaigns against obesity are far more damaging to the psychological and physical health of our children and young adolescents.

Public Comment on Childhood Obesity Initiatives

FOLLOW THE MONEY BEHIND THE OBESITY ‘’DISEASE’’

Is obesity a disease? We refer you to an excellent analysis on the issue as published in the International Journal of Obesity .

Real life observations and many studies including the latest one that found that overweight and obese children can improve their health even if they don’t lose weight, make of us firm believers that obesity is increasingly being qualified as a disease for the only purpose of serving corporate agendas.

This dated article (hot links no longer function) in the Center for Consumer Freedom website, gives us the history of how Medicare in the U.S. has agreed to recognize obesity as a disease and the key players that persistently lobbied government in that direction.

One of the key players lobbying was the American Obesity Association (AOA), a pressure group heavily funded by pharmaceutical and other connex corporate interests. From their own website we can read the following:

AOA is a non-profit tax-exempt educational and advocacy organization with approximately five hundred members, both professional and lay. Our financial support comes principally from pharmaceutical research and development companies as well as other companies in the weight management field including Abbott, Amylin, Aventis, Bristol Myers-Squibb, Ethicon-Endo Surgery, Eli Lilly, Glaxo Smith-Kline, Pfizer, Merck, Regeneron, Roche, Sanofi-Synthelabo, Weight Watchers Intl. Inc. and Wellspring Camps. I also serve as a consultant to the American Society for Bariatric Surgery and as a member of the Scientific Advisory Board of Ethicon Endo-Surgery Inc.

But similar to the smoking issue, the most influential player in the creation of the obesity hype seems to be none other than the Robert Wood Johnson Foundation, the charitable branch of Johnson & Johnson Pharmaceuticals who much like they did with the anti-smoking campaign for the last decade, they are funding in the order of millions the anti-obesity campaign which more than serves the bottom profit of their corporate affiliations. Read: Robert Wood Johnson Foundation Announces $500 Million Commitment to Reverse Childhood Obesity in U.S.

In partnership with the American Heart Association, they released a joint report on the obesity epidemic in the U.S.A.: A Nation at Risk – Obesity in the United States

There are many more instrumental players causing our children to be stigmatized as ‘’sick fatsos’’ in schools and society in general, albeit they are perfectly healthy and lead happy fulfilling childhood lives and a google search will yield more results than is required to convince you if you read the findings with a critical mind.

And by the way, the next time your pediatrician suggests that your child is sick because he’s over the ‘’ideal’’ limit these alleged do-gooders have set for your child, ask him/her to do some research and use some critical thinking him/herself before suggesting diets or treatment that can cause more psychological and emotional trauma to your child than the few extra pounds he may be healthily and cheerfully carrying around!

DANGEROUS LIAISONS

As we have mentioned before, an ever increasing number of journalists now dare report the incestuous relationships between the pharmaceutical industry and different entities such as scientists, doctors as well as non-profits and charities.

In Britain, where the healthcare system is public like ours, many patients see their lives and well-being threatened when the NHS (National Health Service) refuses to cover their expensive treatments. Patients who find themselves in such situations often turn to charitable associations to help them plead their case.

What the article from The Independent linked below exposes, is that while many of these charitable entities loudly advocate for the patients who were refused by the NHS for the coverage of their treatments, they never bring up the issue of how prohibitively expensive these treatments can be. The investigative reporter attempted to throw some light as to why.

Please link to the article below to discover the portion of the funding of certain charitable organizations that comes from Big Pharma resulting in a severe conflict of interest between pharmaceutical interests and those advocating for the patients.

As stated in the article: ‘’Tim Kendall, director of research at the Royal College of Psychiatrists said the pharmaceutical industry reached into "every corner of the health service" in order to gain influence. ‘’

Drug firms bankroll attacks on NHS

A PUBLIC MESSAGE PAID BY BIG PHARMA

As we commented on our French post below, the following press release is a paid message from your friendly legal drug dealers Pfizer, using the Lung Association as their mouthpiece. Read it by clicking on the title:

The Lung Association Calls for Improved Support to Help Smokers Butt Out for Good

Don’t believe us? Read the ‘’NOTE TO EDITOR’’ near the bottom of the press release:
''About The Report
- Making Quit Happen: Canada's Challenges to Smoking Cessation was sponsored by an unrestricted educational grant from Pfizer.''

From our observations on what has happened in other countries, we are convinced that this piece of propaganda has only one purpose: It is a marketing tool to lobby governments to reimburse smokers for the purchase of nicotine replacement therapy, a very lucrative market for Big Pharma especially that the very low rate of success keeps customers coming back for more again and again. An excellent source of repeat business to be paid with both smokers’ and non-smokers’ taxes!

Yet the Canadian Press who picked up on the press release that was also parroted by Canoë, never published this blatant conflict of interest in their article. They left readers with the impression that the initiative was a well-intentioned call from the oh so charitable Lung Association.

FORCES has coincidentally reposted on their website today, a 2001 report by Wanda Hamilton titled ‘’Big Drug's Nicotine War’’ which brilliantly illustrates the Big Pharma tactics and strategies to gain control over the very lucrative nicotine market. That was in 2001 and their ways were already obvious back then. Today they have become so blatant, only those who have stakes in the issue still pretend they don’t exist.

Read Wanda Hamilton’s analysis at: Big Drug's Nicotine War

CHEMICAL LOBOTOMY

Not only are the ‘’do-gooders’’ lobbying aggressively to coerce people in giving up pleasurable habits, their pharmaceutical partners are meddling with that part of the brain that controls hedonistic experiences, as we understand from the article below. The result? The very same drugs that are allegedly destined to help smokers and the obese lead healthier physical lives, cause their users to feel depressed, have nightmares and can even lead them to take their own lives.

It is only natural for the makers of these drugs to tout that it cannot be proven that it’s the drugs’ fault, but let’s not forget that it is these same interested parties that claim that the debate is over when it comes to smoke and obesity when in fact the studies on these issues are at best inconclusive.

Articles such as this one do not only flash red lights for smokers and the obese to weigh all sides when taking powerful prescription drugs, but also prove to our readers that smoking and obesity is big business for drug makers. Is it any wonder that they finance in billions anti-smoking and anti-obesity campaigns?

Risk of depression dims hopes for anti-addiction 'super pills' to curb overeating, smoking

CHICAGO - Two years ago, scientists had high hopes for new pills that would help people quit smoking, lose weight and maybe kick other tough addictions like alcohol and cocaine.

The pills worked in a novel way, by blocking pleasure centers in the brain that provide the feel-good response from smoking or eating. Now it seems the drugs may block pleasure too well, possibly raising the risk of depression and suicide.

Margaret Bastian of suburban Rochester, N.Y., was among patients who reported problems with Chantix, a highly touted quit-smoking pill from Pfizer Inc. that has been linked to dozens of reports of suicides and hundreds of suicidal behaviors.

"I started to get severely depressed and just going down into that hole ... the one you can't crawl out of," said Bastian, whose doctor took her off Chantix after she swallowed too many sleeping pills and other medicines one night.

Side effects also plague two other drugs:

_ Rimonabant, an obesity pill sold as Acomplia in Europe, was tied to higher rates of depression and a suicide in a study last month. The maker, Sanofi-Aventis SA, still hopes to win its approval in the United States.

_ Taranabant, a similar pill in late-stage testing, led to higher rates of depression and other side effects in a study last month. Its maker, Merck & Co., stopped testing it at middle and high doses.

The makers of the new drugs insist they are safe, although perhaps not for everyone, such as people with a history of depression. Having to restrict the drugs' use would be a big setback because it would deprive the very people who need help the most, since addictions and depression often go hand-in-hand, doctors say.

A bigger fear is that the whole approach may be in trouble. Researchers say blocking pleasure, especially the way the obesity drugs do, might take the fun out of many things, not just the harmful substances and behaviors these drugs target.

It may be possible to improve the drugs so they act more precisely. Chantix targets a different pathway — nicotine pleasure switches — and in a different way than the obesity drugs, which aim at the same pathway that gives pot smokers the munchies. That is one reason many doctors are optimistic that any risks about Chantix will prove manageable.

But doctors are no longer talking about so-called "super pills" for a host of addictions.

"It certainly diminishes my enthusiasm" to see these side effects, said Mark Egli, co-leader of medicine development at the National Institute on Alcohol Abuse and Alcoholism.

The buzz started four years ago, when studies showed rimonabant helped people shed weight and keep it off longer than previous pills had. It also was being tested for smoking cessation. The Associated Press and other media reported extensively on prospects for a pill that might tackle two big problems at once.

Rimonabant won approval in Europe. But advisers to the U.S. Food and Drug Administration opposed it because of depression risks that became clearer with further study. Sanofi withdrew its U.S. application and said it hoped to resubmit after more research.

But in a new study last month, 43 percent of people taking rimonabant developed psychiatric issues versus 28 percent of those on dummy pills. One rimonabant patient committed suicide and one in the placebo group tried to. Unlike previous studies, this one did not exclude people who had depression in the past.

"I felt it was important to do an 'all-comers' study" to see how real-world patients might fare, said Cleveland Clinic's Dr. Steven Nissen, who led the work.

Sanofi now tells doctors to avoid giving the drug to people with a history of depression, said a company vice president, Dr. Douglas Greene.

"We are at the cutting edge of being able to manage this risk," he said.

Meanwhile, Merck had bad news from a study of its obesity drug, taranabant, which showed an increased risk of depression and other side effects among people taking medium and high doses.

"We're doing a lot to define this risk-benefit," including adding another year to all studies under way and going forward only with the lowest dose, said a Merck vice president, Dr. John Amatruda.

Others were less optimistic.

"The door is closing" on this approach, said Dr. James Stein, a University of Wisconsin-Madison cardiologist. If another study he is helping lead does not show benefit for rimonabant, "this drug's already slim chances of approval will be even more jeopardized," he said.

The situation is murkier with Chantix, which went on sale in the U.S. in 2006 and is sold as Champix in other countries.

The drug binds to the same spots in the brain that nicotine does when people smoke, causing release of a "feel-good" chemical, dopamine. Taking it is supposed to keep any inhaled nicotine from giving the same buzz.

In February, the FDA said a link between Chantix and psychiatric problems appears "increasingly likely." Pfizer added warnings to the drug's label and said that although a link had not been proved, it could not be ruled out.

But a Pfizer vice president, Dr. Ponni Subbiah, said nicotine withdrawal and even quitting smoking can cause mood swings and depression.

It is hard to know "what is causing what," she said. "We know that smokers are at higher risk of suicide than non-smokers, and heavy smokers are at higher risk than lighter smokers."

Some doctors agreed.

"Psychologically, just giving up this 'friend' that they've had many years in their life can be depressing," said Dr. Geoffrey Williams, co-director of the Greater Rochester Area Tobacco Cessation Center and a paid speaker for Pfizer.

Jeanne Morrison, 63, of suburban of Louisville, Ky., looked forward to giving up cigarettes when she and a friend went on Chantix. The friend did well, but Morrison lasted only 10 days on it.

"I got so depressed, I didn't want to go anywhere. I didn't want to do anything, and I'm a very high-energy person. It was a depression like I've never experienced in my life," she said. She also had "major, major nightmares. These would wake me up, and I would be absolutely shaking and sweating."

Several doctors said such reactions are rare, and that most patients do well on Chantix.
Morrison's doctor, psychiatrist Dr. Jesse Wright at the University of Louisville, said Chantix helped one of his schizophrenic patients, "who smoked like a smokestack," without worsening his psychological symptoms.

"The risk-benefit ratio is still very much on the side of use of the medication," Williams said. "The alternative, smoking, is extremely highly risky."

BIG PHARMA INFLUENCE MAY BE HAZARDOUS TO OUR HEALTH

JAMA, the Journal of the American Medical Association, Vol. 99, April 6, 2008, includes an article on The Adverse Effects of Industry Influence.

The article starts with the following disturbing facts that we have consistently been bringing to your attention for the past 3 years:

The profession of medicine, in every aspect—clinical, education, and research—has been inundated with profound influence from the pharmaceutical and medical device industries. This has occurred because physicians have allowed it to happen, and it is time to stop.

It is a long read but well worth our time in order to understand how important it is to second guess our physician and do our own research and analysis for any medication or procedure he/she prescribed. Our doctor is probably part of the majority of honest and dedicated professionals, but our medical system being what it is, he/she simply doesn’t have the time to read and analyze every study, the possible conflict of interest of its funders and the integrity of the researchers conducting the studies. As responsible citizens, it is our duty to adequately document ourselves before we agree to chemical or surgical treatment.

Without being overly alarmist or paranoid and until our elected officials put their energies and our taxes where it really counts and clean house on such unethical, if not outright fraudulent practices that are a true hazard to our health, each and everyone of us should get educated so that we may make informed choices for our well-being.

WOMEN TARGETED IN DRINK CAMPAIGN

The interest in the UK Telegraph article about alcohol that you can read here, is not so much the article itself which is just another piece of fear mongering from public health in the UK (soon to come to a neighborhood near you), but the comments that the readers left.

The UK citizens that commented, are collectively outraged at how much their government is now controlling their lives based on false statistics and outright lies. The general sentiment portrayed in the comments, is a cry that enough is enough and that the UK Telegraph should stop serving as a mouth piece for all this propaganda and do some investigative journalism instead.

As public health becomes more and more aggressive against lifestyle issues, people are opening their eyes to a reality we predicted only three years ago.

The driving force behind government encroachment into our lives, starts at the WHO (World Health Organization) and spreads like a cancer throughout all civilized societies starting with those countries where pharmaceutical giants have a bigger control and powerful front groups to do their bidding.

One commentator suggested that the killjoys take a pill and get over it already. May we remind this commentator that this is indeed where they’re leading us. A pill for every ailment real or invented!

From Scientists predict brave new world of brain pills here are some of the items on their menu:

On the menu: range of treatments

· Ritalin (methylphenidate) is used by a small number of students in an attempt to improve exam results and by business people to improve performance in the boardroom

· D-amphetamine also improves memory but only for people of a certain genetic make-up

· Rimonabant is used as an antidote to the intoxicant effects of cannabis and a treatment for heroin relapse. But it is sometimes also used to enhance the high produced by these drugs by reducing their side-effects

· Naltrexone is already used to treat chronic alcoholism and narcotic abuse. It works by blocking the pleasure receptors that are normally activated in the brain when people use the drugs

· Propranolol, a beta-blocker, is used to treat high blood pressure, angina, and abnormal heart rhythms. It is also used sometimes by snooker players to calm their nerves

· Modafinil, a stimulant developed to treat narcolepsy, has been used by soldiers to improve memory and judgment. It is also used in treatment of cocaine addiction

From University of Connecticut is fighting alcoholism with a pill

The potential market for alcoholism drugs is huge. Roughly 17.6 million Americans -- about 8 percent of the adult population -- suffer from alcohol dependence or abuse, according to the NIH. And alcohol-related illness costs the nation an estimated $86 billion a year in lost productivity, according to government data. By shifting treatment into the private realm of a doctor's office, these new drugs could appeal to people who would otherwise never seek help in a group setting such as AA.

"What it will do is make alcoholism a mainstream problem that family practitioners deal with," says Bankole Johnson, professor of neuroscience and psychiatry at the University of Virginia, who oversees clinical trials on some of the new drugs.

In many ways, the move to treat alcoholism with drugs mirrors the shift in treating depression that came more than a decade ago, when new antidepressants like Prozac hit the market. The drugs helped doctors view depression as medical problem and treatment expanded to include pills as well as behavioral interventions.

TAXATION WITHOUT REPRESENTATION

Although smokers dish out 75% on taxes on every pack of cigarettes they purchase, they are invited to stay out of any decisions taken on their behalf -- decisions that affect their daily life, their health, their wallet and their future. It is certainly a case of taxation without representation.

Mychoice.ca, the Canadian smokers’ rights organization, had issued a press release to this effect on June 17, 2005 that summarized quite eloquently how smokers are consistently and deliberately left out of the discussions:

Excerpts of the press release:

June 17, 2005 - The National Conference on Tobacco or Health being held in Ottawa June 19-22 is a triumph of ideology and propaganda over logic and accurate information as the basis for laws against smokers in Canada. “The publicly funded conference is an abuse of tax dollars as it uses them to establish laws against a minority while denying that minority a place at the table,” Nancy Daigneault, president of Canada’s largest smokers’ rights group, mychoice.ca, said today. ………….

“If the government really wants smokers to quit and to promote health, then why wouldn’t they at least invite smokers to the table? Smokers have a vested interest in the formulation of policies that directly affect them. To deny them an opportunity to be at the table indicates the contempt policy makers have for smokers, ” said Ms. Daigneault.

Mr. Simon Clark, director of the European smokers’ rights group Forest, recently attempted to sit at the table of one such meetings. The account on how he was treated, that we linked to below, is an eye-opener that raises more questions than it answers.

If you feel that smokers should participate in discussions affecting all spheres of their life and that what they have to say is just as, if not more, important than what Pfizer, Novartis, Johnson & Johnson, GlaxoSmithKline and some other self-serving participants, then please write to your MP’s and MPP’s and demand that a group or several groups representing smokers, be not only invited but welcomed. You can find their addresses here:

Excerpts from: Smoking bans and open government? EU couldn't make it up

Hilarious! That’s the only word for it (although I can think of a few others). I don’t, as a rule, use blogs to report private meetings and conversations, but here’s what happened when I attended a meeting in Brussels yesterday of “EU experts, civil society and social partners to support the Commission’s Impact Assessment on the forthcoming initiative on smoke-free environments”:

I sensed, as soon as I entered the room and introduced myself (“Hello, I’m Simon Clark – from the smokers’ lobby group Forest”), that there could be trouble. The guy from Pfizer (yes, the pharmaceutical company) didn’t look pleased, and there were mutterings from some of the other delegates. (There were around 20 in all.)

No surprise then, when, as soon as the meeting began, and we had all formally identified ourselves, two or three hands shot up. As I suspected, some of my fellow delegates were none too happy that a representative of Forest was in the room. If I didn’t leave, said one, she would. Others nodded their heads in agreement.

The facilitator (chairwoman) looked at me. “Sorry,” I said, “I’m not trying to be difficult because I know some of you have come a long way for this meeting, but Forest represents adults who choose to smoke and tolerant non-smokers like me. The consumer is entitled to be represented in the political process. So, on a point of principle, I’m not going to leave.”

Compromise

And that was how it stood until the facilitator suggested a compromise – of sorts. I could stay for the presentation and return to have my say at the end of the meeting. For the duration of the “facilitated discussion”, however, I would have to leave the room. (For some reason the other delegates didn’t want me to hear what they had to say. So much for transparent, open government! What do these people have to hide?)
…………..
And so, at the end of the meeting, after the other delegates had left, I was invited back in and given 15 minutes to answer questions and make our views abundantly clear. Amusingly, even this session didn’t go entirely smoothly. At one point, having pointed out the flaws in the “evidence” on passive smoking, I was asked to apologise (seriously!) by a woman who said she was an epidemiologist with a degree at Harvard. (So what? as Ed Balls might say.) Apparently my comments had upset her, poor soul. (Don’t worry, I didn’t apologise.)
…………..
Participants

Pfizer, Novartis, Johnson & Johnson, GlaxoSmithKline (all pharmaceutical companies), Eurofound (European Foundation for the Improvement of Living and Working Conditions), InwatEurope (International Network of Women against Tobacco), International Health and Social Affairs Office, NHS Health Scotland, Business Europe, EUN, HOTREC (representing hotels, restaurants and cafes in Europe), AESGP (Association of the European Self-Medication Industry), SFP (Smoke-Free Partnership) and EHN (European Heart Network).

PROSTITUTION

Dr. Michael Siegel is seeing more and more clearly through his movement. In one of the latest posts in his blog, he’s commenting on the partnership between tobacco control and the pharmaceutical industry. ‘’The Rest of the Story’’ comment begins with this paragraph: ‘’ In my view, the acceptance of pharmaceutical industry sponsorship by a conference which aims to objectively discuss science and objectively consider policy strategies to promote smoking cessation amounts to prostitution of the scientific integrity of the global tobacco control movement.’’

C.A.G.E. and others, have been denouncing this conflict of interest incessantly without any politician or media paying any attention, let alone conducting an investigation or inquiry on it. It does not only amount to prostitution of the scientific integrity, Dr. Siegel. The pharmaceutical lobby is shaping policy and our lives not only through the smoking issue but on various other fronts that affect us all.

There will never be too many of us decrying this dangerous conflict of interest, so all citizens should get involved in making politicians aware that we are clearly seeing through Big Pharma tactics and we demand that public health should be totally independent of any powerful lobbies that are in business selling cures for diseases they often invent through social engineering.

Please read Dr. Siegel’s comment: Prostitution of Tobacco Control Science and Policy: World Conference on Tobacco or Health Accepts Big Pharma Sponsorship

OBESITY EPIDEMIC CHALLENGED BY EXPERTS

When reading an article such as the one from Pennlive.com we tend to think that perhaps there is hope that the anti-obesity campaign will not corrupt public opinion to the level the anti-tobacco fear mongering campaign did.

The article exposes exactly the same points we have been bringing up for the last three years on the obesity issue. There is a very important factor that the article doesn’t highlight however, but that must be emphasized at every opportunity because it has changed the ‘’technical’’ perception of obesity, overnight: ‘’ In 1998, the U.S. National Institutes of Health brought U.S. definitions into line with World Health Organization guidelines, lowering the normal/overweight cut-off from BMI 27.8 to BMI 25. This had the effect of redefining approximately 30 million Americans, previously "technically healthy" to "technically overweight". (source Wikipedia). As for Health Canada, they made their ‘’adjustment’’ in 2003. In Quebec alone, that ‘’adjustment’’ created an additional 1 million obese people from one day to the next.

Excerpts from the long but most interesting read: Some experts doubt obesity epidemic

LONDON (AP) — Go on, have another doughnut. According to some experts whose views are public health heresy, the jury is still out on how dangerous it is to be fat.
"The obesity epidemic has absolutely been exaggerated," said Dr. Vincent Marks, emeritus professor of clinical biochemistry at the University of Surrey.
…….

But obesity contrarians say that there's no data proving why being fat — in itself — would be dangerous. "There's no good causal connection," said Eric Oliver, author of Fat Politics and a political science professor at the University of Chicago.

Blaming obesity for diabetes and heart attacks, Oliver says, is like blaming lung cancer on bad breath rather than on smoking. Excess weight may actually be a red herring, Oliver says, since other factors like exercise, diet or genetic predispositions towards diseases are harder to measure than weight.

In addition to questioning the dangers of being fat, researchers like Marks also criticize oft-repeated alarmist projections about the rise in obesity — like the British government's warning that nearly half of Britain will be obese by 2050.

Those simply aren't based on good evidence, they say.
……..

In 2005, Katherine Flegal of the United States' Centers for Disease Control and Prevention published a study in the Journal of the American Medical Association, finding that overweight people typically live longer than normal-weight people. More than a dozen other studies have come to the same conclusion.

Outrage ensued. Prominent health experts called the research flawed and worried that people would gleefully supersize their meals.
………

Some obesity skeptics question the motives of experts who make dire predictions about obesity.
With millions of dollars for obesity researchers, an industry of anti-fat drugs, and a boom in the number of doctors offering surgeries like stomach-stapling, the more fat people there are, the more profits there will be in selling them solutions.

Experts on both sides of the obesity debate have often criticized WHO's overweight and obesity measures, saying they are too low.

When WHO defined the body mass index scores constituting normal, overweight and obese, they appeared to be the result of an independent expert committee convened by WHO.

Yet the 1997 Geneva consultation was held jointly with the International Obesity Task Force, an advocacy group whose self-described mission is "to inform the world about the urgency of the (obesity) problem."

According to the task force's most recent available annual report, more than 70 percent of their funding came from Abbott Laboratories and F. Hoffman La-Roche, companies which make top-selling anti-fat pills.

The task force remains one of Europe's most influential obesity advocacy groups and continues to work closely with WHO.

The blurred lines between pharmaceutical money and obesity groups have also caused concern in Britain. In 2006, one of the country's top obesity doctors quit the organization he founded to combat obesity, the National Obesity Forum, complaining that its goals had been skewed by drug money.

"There's not a lot of money in trying to debunk obesity, but a huge amount in making sure it stays a big problem," said Patrick Basham, a professor of health care policy at Johns Hopkins University.

Still, while skeptics insist that obesity warnings must be taken with a grain of salt, nearly all agree that while a little bit of extra padding may not be too deadly, too much almost certainly is.

"The vast majority of people who get labeled under the obesity epidemic are well under 300 pounds and probably are not facing big health consequences," Oliver said. "It's the morbidly obese people who should be worried."

CONFLICTS OF INTEREST IN THE SCIENTIFIC AND MEDICAL PROFESSIONS

The British Medical Journal published two articles debating the issue of conflict of interest that corporate funding causes in the scientific and medical profession.

The ‘’No’’ side to the question: Has the hunt for conflicts of interest gone too far? No, is defended by Kirby Lee, assistant professor of clinical pharmacy who declares no competing interests and the ‘’Yes’’ side to the same question: Has the hunt for conflicts of interest gone too far? Yes, is defended by Thomas P Stossel, professor, who declared the following competing interests: TPS is on the boards of directors and owns stock options in ZymeQuest and Critical Biologics Corporations, and his employer has licensed intellectual property to these companies, which may result in his receiving milestone payments, royalties and in the stock options having financial value. He receives fees for speaking to corporations and other organisations on the topic of conflict of interest. He has served on scientific advisory boards for Biogen, Dyax, and Merck.

You may want to read both sides of the debate and vote on the poll (during the time it’s available) on either of the pages. You may also wish to post a comment on the comments to the article section.

As far as our views on this, from our past articles and our critical analysis on the pharmaceutical industry, you may have correctly guessed that we think that the hunt on conflicts of interest, hasn't gone far enough.