The University of California and Tobacco Funding: An Update

1. Michael Ong October 24, 2007 The University of California and Tobacco Funding: An Update

2. Academia & Research Funding Promotion Criteria • teaching • research and creative work • professional competence and activity • University and public service

3. Trends in Federal Research Spending From AAAS, 2008

4. Academia & Industry Funding

5. Relationship Between Industry Funding and Outcomes of Studies • Close financial ties between industry sponsors and clinical investigators may influence the quality and outcome of clinical studies (Boyd et al, 2003) • Small amounts of funds have been shown to influence health professionals • Discovery of these influences also undermine public trust of clinical research • The tobacco industry (TI) uses funding to suppress, manipulate, and distort scientific research • To support industry positions and counters scientific work (Barnes & Bero, 1996) • To cultivate credibility and generate positive public image (Malone & Bero, 2003)

6. Tobacco Industry (TI) Funding • Center for Indoor Air Research (CIAR) • Central element of 2006 federal court ruling that TI violated Racketeer Influenced Corrupt Organizations (RICO) Act • "special reviewed" projects by lawyers outside of their "peer" review system • Philip Morris External Research Program is a continuation of CIAR activity • Funded scientists are often same as those funded through CIAR (Hirschhorn, et al, 2001 & 2006)

7. LeVois & Layard, 1995 concluded no cardiac risk from passive smoking Did not separate current smoking spouse from former smoking spouse, when comparing to never smoking spouse Exclusion of older CPS data and former smoking spouse shows 20% increase in cardiac risk from passive smoking (Steenland, et al, 1996) Enstrom & Kabat, 2003 Long-term follow up on LeVois & Layard data repeats same exposure misclassification error reports same conclusion of no cardiac risk from passive smoking Warned specifically by ACS that older CPS data used is inappropriate for passive smoking studies Example: TI-Funding of Studies Using ACS Cancer Prevention Studies Data From Tong & Glantz, 2007

8. TI-Funding Bans: Issues Academic Integrity • The tobacco industry has a history of, and continues to restrict and undermine academic freedom • stringent and rigorous thresholds must be met before undertaking any restriction • lower levels of safeguards are unlikely to result in adequate protection from manipulation by the tobacco industry

9. Schools of Public Health Columbia University Harvard University John Hopkins University Loma Linda University Louisiana State University Ohio State University University of Arizona University of Iowa University of Medicine and Dentistry of New Jersey University of North Carolina University of Puerto Rico University of South Carolina Schools of Medicine Emory University Harvard University John Hopkins University Institutions & Hospitals Brigham and Women’s Hospital MD Anderson Cancer Center in Houston, Texas Massachusetts General Hospital Roswell Park Cancer Institute in Buffalo, New York TI-Funding Bans at U.S. Academic Institutions From http://www.academic-integrity.com

11. UC and TI-Funding • 23 current TI funded projects at UC campuses • All funded by Philip Morris USA • Total $: 16,647,661 in funding • Total UC research funding in FY 2006: $4 billion • $39 million in total funding from 113 total TI funded projects among the UC campuses since 1995 • 11 gifts from TI to UC campuses • Total $: 485,000 between 1/2005 – 6/2007 • Total UC gifts in FY 2006: $1.29 billion From UCOP, 2007

12. TI-Funded UC Projects From UCOP, 2007

13. Individual UC units implement tobacco industry funding bans UC Berkeley: School of Public Health (2004) UC Los Angeles: School of Nursing (2004) UC San Diego: Cancer Center (2004) UC San Diego: Department of Family and Preventative Medicine (2003) UC San Francisco: Cancer Center (2003) UC San Francisco: Institute for Health Policy Studies (2005) 2005: UC Academic Assembly overturn individual UC unit policies. States only the UC Regents can adopt policies to decline funding based on source 1/2007: Regents ban on tobacco industry funding proposed (RE-89) 4/2007: 8 of 10 UC campus Academic Senates vote to oppose RE-89 (UCSF approves, UC Merced abstains) 9/2007: UC Regents adopt a compromise version of RE-89 TI-Funding Debate at UC From UCOP, 2007

14. TI-Funding Bans: Issues Academic Freedom • “slippery slope”: Although the tobacco industry is bad, other funding sources may be singled out solely based on political winds • accepting funding from a corporate sponsor is not an endorsement of the corporate sponsor’s products or actions • individual investigators and the peer review system can ensure the integrity of research regardless of the source of its funding

15. Can we count on individual disclosure or peer review? • Conflict-of-interest disclosures often are inadequate to describe relationships • Many researchers are not familiar with their own institution’s policies (Boyd et al, 2003) • Scientific journal financial disclosure statement requirements are too general to identify actual funding arrangements (Bero et al, 2005) • Example: Enstrom & Kabat, 2003

16. Bero et al. Tob Control 2005

17. UC Regents Policy • Scientific review and Chancellor approval of research proposals prior to submission to TI for funding • reviewed by a Chancellor-designated scientific review committee drawn from the community of scholars • committee advises the Chancellor whether the proposed study uses sounds methodology and appears designed to allow the researcher to reach objective and scientifically valid conclusions • approved by the Chancellor, who will use the committee recommendations as part of the decision-making process • Annual report to UC Regents on proposals • number submitted to the scientific review committees • number approved by the Chancellors • number funded by the tobacco industry • description or abstract of each proposal From UCOP, 2007

18. UC Regent Policy: Little Impact • Policy focuses only on the initial proposal • will only detect initially flawed research that could be manipulated by the tobacco industry • does not review ongoing work or identify any manipulation of the findings afterward • TI-funded research may actually increase • scientists may feel projects are “sanctioned” by the new process • public reporting to UC Regents may uncover effects