To celebrate the launch of its new Ice Mint coated nicotine gum a few years ago, Pfizer Canada hired “brand ambassadors” dressed in ski suits to give out free samples in Calgary and Toronto. The company’s press release declared:
“The new formulation of Nicorette gum is another option for smokers who want to free themselves from tobacco dependence. Quitting smoking is a difficult addiction to overcome. People who quit smoking may suffer severe cravings and withdrawal symptoms; however, using Nicorette Ice Mint Coated Gum can help smokers quit by reducing nicotine cravings and withdrawal symptoms and significantly improve their chances to quit smoking.”
Sounds pretty straightforward, except that the pitch isn’t attributed to the Pfizer PR firm, but to a physician, Dr. Rob Weinberg – a doctor who was paid by Pfizer for participating in drug promotion. He is a family practice physician in Toronto.
Canadians expect doctors to provide sound, neutral advice about treatment for health issues. But some, like the good Dr. Weinberg, are paid by pharmaceutical companies to publicize and promote specific drugs, in this case helping to influence even the way smokers approach their battle to quit.
And Pfizer regularly pays physicians in Canada in exchange for testimonials about its smoking-cessation aids without publicly disclosing those financial ties – even though research shows that the vast majority of ex-smokers have successfully quit on their own.
Australian research published this spring in the Public Library of Science Medicine now suggests that unaided cessation methods (cold turkey or gradually reducing before quitting) is actually the most successful way to quit after all, despite Big Pharma’s expensive campaigns to convince us why we need to buy their products if we really want to quit.
In fact, as with problem drinking, gambling, and narcotics use, population studies show consistently that up to three-quarters of smokers who permanently stop smoking do so without any form of assistance.
Dr. Jerome P. Kassirer, professor at the Tufts University School of Medicine and editor-in-chief emeritus of the New England Journal of Medicine, says:
“There are enormous connections between what the drug companies do – and what doctors practice, say, and write.”
Although these Big Pharma-funded conflicts-of-interest don’t receive the same level of media attention in Canada as they do in the U.S., the problem is “alive and well here”, according to Dr. Kassirer, author of On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health.
“It’s been swept under the rug in Canada. I think it’s a problem.”
A Canadian study reported by CanWest Media found that researchers working in the area of smoking cessation who receive money from pharmaceutical companies are more likely to conclude in their research that nicotine replacement therapy has a better chance of helping people quit than those researchers without drug company funding.
Dr. Paul McDonald, a health studies professor at the University of Waterloo who conducted the study, observed:
“It’s possible that because of the way this science has been conducted, the benefits of the therapy have been overestimated. In the last year, there have been growing calls within the medical community for a change in rules to limit relationships with drug companies that could impact a doctor’s impartiality.”
The trouble with smoking cessation medication like Pfizer’s Nicorette gum doesn’t lie with product safety — most experts agree they can help some people quit smoking.
But there are growing concerns that doctors funded by the drug industry may overly promote the benefits to encourage more people to buy the medication that they’re being paid to push.
Read the rest of the report. See also: True or False? Smokers Need Help To Quit.
The Ethical Nag 
Yeah I guess doctors really need the extra income, ay?
Yep, nothing like paying a doctor to lend credibility to your sales pitch, no matter what you’re selling.
I was a 2 pack a day guy for decades. Quit cold turkey with a countdown calendar and a great support group at our local YMCA. Thanks for this and your other links to smoking cessation info – I think it’s interesting how quitting without pharmaceutical help seems to be psychologically better for actual success rates.
Smoking for nearly 20 years, I didn’t think I would ever be able to stop. I wanted to and tried about 8 years ago using the nicotine patch. Well that attempt failed miserably and back fired. I couldn’t last longer than five hours without a cigarette. I was really wary about trying any other quitting program. Then one year ago, I purchased Nicorette gum, read through the directions and set a quit date.
The nicotine being released into your system helps calm the cravings almost immediately, but for the first few days I did have a little anxiety about not having a smoke.
First of all, you have to really want to quit because YOU WANT TO QUIT and not for ANY other reason. You can’t quit for your friends, family, husband, wife, lover etc., you have to quit for yourself and the reasons can be many. My reason for wanting to quit was so that I could have control over my life. I was able to overcome a cocaine addiction that took me over in the 80s and 90s. And you would think that if I could beat that, quitting cigarettes would be a cake walk. Not so. And of all the cigarettes I was smoking each day, I only enjoyed one or two (and sometimes none) of them.
It’s been over a year now and I am happy to say that I’ve been able to break the cigarette habit. I did gain about 10 pounds but that’s about it. Just wanted to give an update.
(excerpt from a much-too-long original comment that MAY have originated from an industry insider based on very detailed package directions included!)
Sincere thanks Ms. Thomas. Excellent piece. But why is it so difficult for journalists to label consumer fraud fraud? After 29 years and billions in Nicorette marketing, a July 2013 Gallup Poll found that only 1 in 100 U.S. ex-smokers credited nicotine gum for their success. The fraud isn’t simply the fact that every independent population level quitting method study over the past decade has found replacement nicotine substantially less effective than on-your-own quitting (30-100%) or that the phrase “double YOUR chances” is a population level effectiveness assertion, not a clinical efficacy representation.
It was fraud to label more than 200 placebo-controlled clinical trials “blind” when, regardless of whether evaluating NRT, bupropion or varenicline, 3 to 4 times as many placebo group members could correctly declare their randomized assignment as declared wrong, and could do so within 24-48 hours of ending nicotine use (peak withdrawal).
As I asserted in a November 4, 2008 CMAJ letter, “pharmacologic treatment of chemical dependency may be the only known research area in which blinding is impossible.” If unable or unwilling to call a spade a spade, will we debate the more critical question asked by the title of my February 7, 2012 BMJ letter, “Are those who quit smoking paying with their lives because of NRT’s failure?”
Ask yourself, how many millions of smokers died because pharma convinced them that the addictive natural insecticide nicotine was “medicine”?
If peer-reviewed medical journals are willing to note that the emperor has no clothes, why such fear by the media? It’s critical because the same failed junk science which anointed NRT now serves as the e-cigs cessation yardstick. What’s needed are honest studies which pit nicotine cessation against nicotine cessation, where the accomplishment of an addict who has fully arrested their dependency isn’t defeated by those still using.
John R. Polito
Nicotine Cessation Educator