Alcohol, tobacco and time spent outdoors linked to brain connections


Alcohol, tobacco and time spent outdoors linked to brain connections

Exciting early results from analysing the brain imaging data, alongside thousands of measures of lifestyle, physical fitness, cognitive health and physical measures such as body-mass-index (BMI) and bone density have been published in Nature Neuroscience.

 The high quality of the imaging data and very large number of subjects allowed researchers to identify more than 30,000 significant associations between the many different brain imaging measures and the non-imaging measures. The findings have now been made available for use by researchers worldwide.

Results included:

  • Strong associations between people’s cognitive processing speed and markers of the integrity of the brain’s “wiring” and the size of brain structures. These effects increased in strength as people aged.
  • A negative correlation between during a simple shape-matching task and intelligence, an effect that didn’t relate to participants’ age. This might be because the people who scored more highly on the cognitive tests needed to use less of their brain to carry out the task.
  • A pattern of strong associations between higher blood pressure, greater alcohol consumption, and several measures that could reflect injury to connections in the brain.
  • A separate pattern of correlations, linking intake of alcohol and tobacco and changes in red blood cells and cardiac fitness, to brain imaging signals associated with increased iron deposits in the brain.
  • Researchers also unearthed some more complicated patterns of correlation. For example, one pattern links brain imaging to intelligence, level of education, and a set of lifestyle factors that at first appear unrelated – including amount of time spent outdoors. It is plausible that, taken together, these factors create a profile of socio-economic-status and its relation to the brain.
  • However, because UK Biobank is an “observational” study that characterizes a cross-section of individuals, it’s not always straightforward to establish which factors cause which, but such results should help scientists to define much more precise questions to address in the future search for ways of preventing or treating brain disease.

UK Biobank will be the world’s largest health imaging study. The imaging is funded by the Medical Research Council, Wellcome Trust, and the British Heart Foundation. It was launched in April 2016 after a number of years of planning and consultation with a large number of health and scanning experts. With the ambitious goal of imaging 100,000 existing UK Biobank participants, it is creating the biggest collection of scans of internal organs, to transform the way scientists study a wide range of diseases, including dementia, arthritis, cancer, heart attacks and stroke.

 Today’s paper describes the brain imaging part of UK Biobank, led by Professsors Steve Smith and Karla Miller from the University of Oxford, and Professor Paul Matthews from Imperial College London.

Professor Miller said: “We are using cutting-edge MRI scans and Big Data analysis methods to get the most comprehensive window into the brain that current imaging technology allows.”

“These results are just a first glimpse into this massive, rich dataset will that emerge in the coming years. It is an unparalleled resource that will transform our understanding of many common diseases.”

Professor Matthews, Edmond and Lily Safra Chair and Head of Brain Sciences at Imperial, added: “These results are exciting, but merely provide a first hint of what can be discovered with the UK Biobank. This project also is a landmark because of the way it has been done: 500,000 volunteers across the U.K. are donating their time to be part of it and more than 125 scientists from across the world contributed to the design of the imaging enhancement alone. Imperial College scientists played a major role in its inception and leadership as part of a team recruited by the U.K. biobank from a number of UK universities. This is a wonderful example of “open science”.

The paper reports first results from this remarkable data resource, which includes six different kinds of brain imaging done in the 30 minutes that each volunteer is in the brain scanner.

Professor Smith explained: “We have ‘structural imaging’ – that tells us about brain anatomy – the shapes and sizes of the different parts of the brain. Another kind – ‘functional MRI’ – tells us about complex patterns of brain activity. Yet another kind – ‘diffusion MRI’ – tells us about the brain’s wiring diagram. The rich and diverse information contained in these scans will reveal how the working of the brain can change with aging and disease; different diseases will best be understood through different combinations of information across these different images.”

UK Biobank has already scanned 10,000 participants, including images of the heart, body, bone and blood vessels in addition to brain scans. This will be by far the largest brain imaging study ever conducted; within another 5 years UK Biobank will have completed the scanning of 100,000 participants.

One reason for needing such large numbers of participants is to have enough subjects to allow discovery of early, possibly subtle, markers of future disease risk, both for a range of and for rare neurological disorders like motor neuron disease.

An important objective of the UK Biobank is to provide a resource for discovery of new insights into diseases like Alzheimer’s, which demands scanning healthy subjects years or decades before they develop symptoms. From the UK Biobank data, scientists anywhere can aim to learn much more about brain diseases – and their relationship to a broad range of other diseases or disease risks – to guide the development of earlier targeted treatment (or changes in lifestyle) that could in the future prevent major diseases from ever happening.

Marijuana is less dangerous than sugar, alcohol and tobacco


Image: Marijuana is less dangerous than sugar, alcohol and tobacco

Three substances far more dangerous than marijuana are readily available at your nearest convenience store. Tobacco, alcohol and sugar are all substances that are more addictive than pot, and they’re more likely to make you sick too.

Polling conducted by NBC News and The Wall Street Journal  in 2014, revealed that more and more people are starting to agree that pot is safer than “everyday” items like beer and cigarettes. Who would have thought? Nearly half of those polled (49 percent) believed that tobacco was the most dangerous substance, while alcohol trailed behind at 24 percent, followed by sugar at 15 percent. Only a mere 8 percent of people polled felt that marijuana was the most dangerous.

Some doctors even agree that alcohol is more dangerous than pot. Dr. Aaron Carroll, a professor of pediatrics at Indiana University School of Medicine, told CBS News that while he feels the first answer should always be that neither is a “safe” option, he does believe that alcohol is worse.

Carroll said, “After going through all the data and looking at which is more dangerous in almost any metric you would pick, pot really looks like it’s safer than alcohol.” He also goes on to note that most of the crimes committed that involve marijuana have to do with illegal distribution, and there are not a lot of violent crimes perpetrated by pot smokers. Conversely, there are a very large number of crimes committed that involve alcohol as a component. Alcohol is known for contributing to violent assaults, in particular. Carroll says, “It’s far worse than what’s going on with pot.”

In addition to causing less crime, pot also appears to be less addictive. Studies show that only 9 percent of people who experiment with pot will become addicted or dependent on it. In contrast, more than 20 percent of people who experiment with booze will become dependent or abuse it. So, in reality, alcohol is far more likely to cause problems later in life.

The only real reason why booze and tobacco are generally more “accepted” by society is because they’ve been part of our culture for longer. Marijuana is being treated the same way alcohol was treated duringprohibition . Prohibition on alcohol ended in 1933; isn’t it time we did the same for marijuana?

Effects Of Secondhand Pot Smoke: Exposure May Be Just As Harmful To Blood Vessels As Tobacco


A new study published Wednesday in the Journal of the American Heart Association suggests that secondhand smoke is dangerous to our cardiovascular system, regardless of whether it comes from marijuana or tobacco.

Laboratory rats who were exposed to secondhand smoke from a marijuana cigarette had a similar problem with their blood vessels’ ability to widen as rats who were exposed to tobacco secondhand smoke. Rats exposed to marijuana smoke for one minute took 90 minutes to recover fully, about three times as long as it took for those exposed to tobacco.

Secondhand smoke

“While the effect is temporary for both cigarette and marijuana smoke, these temporary problems can turn into long-term problems if exposures occur often enough and may increase the chances of developing hardened and clogged arteries,” said senior author Dr. Matthew Springer, professor of medicine at the University of California, San Francisco’s Division of Cardiology, in a statement.

Springer and his colleagues were motivated to conduct their study after feeling that there was little public attention being paid to the possibility that marijuana smoke can be harmful.

“There is widespread belief that, unlike tobacco smoke, marijuana smoke is benign,” Springer said. “We in public health have been telling the public to avoid secondhand tobacco smoke for years, but we don’t tell them to avoid secondhand marijuana smoke, because until now we haven’t had evidence that it can be harmful.”

The truth is, we’re still not even really sure how harmful directly smoking marijuana is to our hearts. A2014 study found that serious heart problems rarely occur immediately following cannabis use. Anotherfound that a marijuana smoker’s risk of heart attack within a hour was five times greater compared to nonsmokers — a very small risk comparable to an especially strenuous bout of sex or exercise. Yet another study found an increased risk of death among patients who already suffered an earlier heart attack and who regularly smoked pot.

But longer-term studies are lacking, much less those looking only at secondhand smoke. And there’s some evidence to suggest that there might be a sort of “marijuana paradox,” where the inhaling of marijuana can temporarily increase the risk of some cardiovascular problems, but the active cannabinoids contained in it can also slow down the progression of atherosclerosis (the hardening and narrowing of arteries).

That theory lines up well with some of the findings of the current study. When the researchers removed tetrahydrocannabinol (THC) from the marijuana cigarettes they exposed their rats to, the blood vessel disruption could still be seen; the same thing happened when they removed the paper the cigarette was rolled in. The later experiments indicate that the burning smoke itself, rather than the active components of marijuana, may be to blame for the rats’ narrower blood vessels.

Still, while animal studies are an important tool for discovery, we can only glean so much from them. Springer and his colleagues acknowledged that their study is far from the final word on the subject, but they hope their results can motivate other scientists to look more closely at marijuana.

“Increasing legalization of marijuana makes it more important than ever to understand the consequences of exposure to secondhand marijuana smoke,” they concluded. “It is important that the public, medical personnel, and policymakers understand that exposure to secondhand marijuana smoke is not necessarily harmless.”

A study of pyrazines in cigarettes and how additives might be used to enhance tobacco addiction


Abstract

Background Nicotine is known as the drug that is responsible for the addicted behaviour of tobacco users, but it has poor reinforcing effects when administered alone. Tobacco product design features enhance abuse liability by (A) optimising the dynamic delivery of nicotine to central nervous system receptors, and affecting smokers’ withdrawal symptoms, mood and behaviour; and (B) effecting conditioned learning, through sensory cues, including aroma, touch and visual stimulation, to create perceptions of pending nicotine reward. This study examines the use of additives called ‘pyrazines’, which may enhance abuse potential, their introduction in ‘lights’ and subsequently in the highly market successful Marlboro Lights (Gold) cigarettes and eventually many major brands.

Methods We conducted internal tobacco industry research using online databases in conjunction with published scientific literature research, based on an iterative feedback process.

Results Tobacco manufacturers developed the use of a range of compounds, including pyrazines, in order to enhance ‘light’ cigarette products’ acceptance and sales. Pyrazines with chemosensory and pharmacological effects were incorporated in the first ‘full-flavour, low-tar’ product achieving high market success. Such additives may enhance dependence by helping to optimise nicotine delivery and dosing and through cueing and learned behaviour.

Conclusions Cigarette additives and ingredients with chemosensory effects that promote addiction by acting synergistically with nicotine, increasing product appeal, easing smoking initiation, discouraging cessation or promoting relapse should be regulated by the US Food and Drug Administration. Current models of tobacco abuse liability could be revised to include more explicit roles with regard to non-nicotine constituents that enhance abuse potential.

Are E-Cigs a Gateway to Smoking?


Lots of questions remain about the effects that using electronic cigarettes have on adolescents, including whether they are a “gateway” drug to regular cigarettes, several speakers said Wednesday.

Most young people who use them also use other forms of tobacco.

“Do e-cigarettes cause children to progress to other tobacco products that are extremely harmful?” Andrea Villanti, PhD, MPH, director for regulatory science and policy at the American Legacy Foundation’s Schroeder Institute for Tobacco Research and Policy Studies here, asked at a briefing on public health challenges related to e-cigarette usesponsored by George Washington University. “To know that … we need to track patterns over time. We need to know if ‘never users’ stayed never users, transferred to combustible use, dual use, or e-cigarette use, and what happened over time.”

Whether e-cigarettes are a gateway to other types of tobacco use is unclear, but surveys do show that the number of young people using e-cigarettes alone is small, Villanti said. “The bulk of e-cigarette use is happening among people using other tobacco products.”

For example, the University of Michigan’s “Monitoring the Future” survey for 2014 found that among 12th graders, 62% had used neither e-cigarettes nor conventional cigarettes, while 4% had used e-cigarettes only, 21% had used conventional cigarettes only, and 13% had used both.

E-cigarettes have gone through several iterations since they were first introduced, explained Naomi Freedner-Maguire, principal researcher at ICF International, a Fairfax, Va., consulting firm. While first-generation products tried to mimic the look of conventional cigarettes, the next generation, also known as “personal vaporizers,” were two-part devices with a tank and a separate battery, and offered thousands of flavor choices to users.

Today, there is a third generation of devices available, with the biggest difference being “mods” — components that can be modified to change the vaping experience, Freedner-Maguire said. “This is a much more effective nicotine delivery system, and it’s moved into a subculture of e-cigarette users and ‘vapers’ that are really committed to creating mods that will increase the power of the device or the flavor.”

“Sub-ohming” — modifying the coils in the atomizer to produce more vapor — is a popular pastime among e-cigarette users, she continued. “There’s a whole vaping culture dedicated to producing as much vapor as possible.”

Some people call themselves “cloud-chasers,” said Freedner-Maguire, “and there are cloud-chasing competitions where people square off back-to-back and inhale, and release the biggest plume of vapor that they can. Somebody stands with a yardstick on the other side and measures the size and density of the plume, and there are cash prizes for things like this.”

Dripping” is another popular practice, in which “nicotine e-liquid is dripped directly onto wicked material in the atomizer to simulate more closely the experience of smoking a cigarette,” she said. “You can find these things on blogs and all over online about how people inhale, and the difference between mouth inhalation versus lung inhalation — a ‘lung hit.'”

Surveying young people about their e-cigarette use is complicated for many reasons, saidJennifer Pearson, PhD, MPH, a research investigator at the Legacy Foundation’s Schroeder Institute. For one thing, “E-cigarettes have many names. What’s a vape pen to someone in California is an e-hookah to someone in the Northeast, and who knows what to someone in Texas,” she said.

In addition, “young adults might call products different things than older adults,” Pearson continued. “If it’s an older adult, they might call it an e-cigarette and a younger adult might call it an e-hookah.”

Then there’s the issue of dosing. “It’s easy to ask about cigarettes per day, but with e-cigarettes it’s not sensible to ask that — even disposable ones can last several days,” said Pearson. “We’re telling people a ‘use episode’ is when you use an e-cigarette, then put it down and don’t intend to pick it back up for a while.”

 The fact that e-cigarettes are used differently from conventional cigarettes also raises other questions, said Ray Niaura, PhD, associate director for science at the Schroeder Institute.

With conventional cigarettes, “They’re very much compelled to smoke the entire thing,” said Niaura. “That means the way nicotine is delivered into the brain is very different; you’re getting a very intense bolus of inhaled nicotine. With e-products, if you work at it, you can do that, but is that how people really use them?”

Instead, “you can take a puff, put it in your pocket … and walk around, then take another couple of puffs. I don’t know the liability [of that] for producing long-term addiction.”

Do e-cigarettes help people quit smoking conventional cigarettes? “The evidence there is mixed,” he said. “There are a couple of randomized trials, but they’re not slam-dunk positive and not slam-dunk negative.”

Smoking Injurious to Genes Too


Here comes another shocker for those reluctant to kick the butt.

Smoking not only affects your health but also increases health risks of your children and grandchildren; today’s puffs of pleasure can permanently damage your genes, according to a new study.

Smoking can also affect the genes important for sperm quality or immune response.

The research findings from Uppsala University and Uppsala Clinical Research Center of Sweden showed that smoking alters several genes that can be associated with health problems for smokers, such as increased risk for cancer and diabetes.

The research, led by Asa Johansson, researcher at the Department of Immunology, Genetics and Pathology, said the genes of smokers as well tobacco users can change and expose them to more health risks.

However, according to the findings, tobacco itself may not be the cause of gene alterations, but the different elements that are formed when the tobacco is burnt.

“Our results therefore indicate that the increased disease risk associated with smoking is partly caused by epigenetic changes. A better understanding of the molecular mechanism behind diseases and reduced body function might lead to improved drugs and therapies in the future,” Johansson said.

The findings of the study have been published in the journal Human Molecular Genetics.

Electronic Cigarettes Contain Higher Levels of Toxic Metal.


Electronic Cigarettes Found To Contain Dangerous Metal Nanopartices

A concerning new study found that the aerosol from electronic cigarettes contains higher levels of measurable nanoparticle heavy metals than conventional tobacco smoke.

A new study published in the journal PLoS One has uncovered a concerning fact about electronic cigarettes (EC): toxic metal and silicate particles including nanoparticles are present in both the cigarette fluid and aerosol.1

Researchers at the Department of Cell Biology and Neuroscience, University of California Riverside, tested the hypothesis that electronic cigarettes (EC) contain metals from various components in EC.  They employed a variety of testing methods to ascertain the level of contamination, including light and electron microscopy, cytotoxicity testing, and x-ray microanalysis. Their results were reported as follows:

The filament, a nickel-chromium wire, was coupled to a thicker copper wire coated with silver. The silver coating was sometimes missing. Four tin solder joints attached the wires to each other and coupled the copper/silver wire to the air tube and mouthpiece. All cartomizers had evidence of use before packaging (burn spots on the fibers and electrophoretic movement of fluid in the fibers). Fibers in two cartomizers had green deposits that contained copper. Centrifugation of the fibers produced large pellets containing tin. Tin particles and tin whiskers were identified in cartridge fluid and outer fibers. Cartomizer fluid with tin particles was cytotoxic in assays using human pulmonary fibroblasts. The aerosol contained particles >1 µm comprised of tin, silver, iron, nickel, aluminum, and silicate and nanoparticles (<100 nm) of tin, chromium and nickel. The concentrations of nine of eleven elements in EC aerosol were higher than or equal to the corresponding concentrations in conventional cigarette smoke. Many of the elements identified in EC aerosol are known to cause respiratory distress and disease.

The study authors concluded that “The presence of metal and silicate particles in cartomizer [atomizer/cartridge connecting to the battery] aerosol demonstrates the need for improved quality control in EC design and manufacture and studies on how EC aerosol impacts the health of users and bystanders.”

Cartomizer Anatomy

Discussion

While e-cigarettes are rightly marketed as safer than conventional tobacco cigarettes, which contain thousands of known toxic compounds including highly carcinogenic radioactive isotopes, they have not been without controversy.  In May 2009, the US Food and Drug Administration Division of Pharmaceutical Analysis found diethylene glycol, a poisonous liquid used in explosives and antifreeze, in one of the cartridges they sampled. They also discovered the cancer-causing agent, tobacco-specific nitrosamines, in a number of commonly used brands.2

The findings of this latest PLoS One study refutes proponents of e-cigarettes who claim that the health risks of smoking are eliminated with their use. Heavy metals like tin, aluminum, cadmium, lead and selenite are increasingly being recognized as carrying significant endocrine disrupting potential and belong to a class of metals known as ‘metalloestrogens.’

One of the unintended, adverse consequences of nanotechnology in general is that by making a substance substantially smaller in size than would occur naturally, or though pre-nanotech production processes, the substance may exhibit significantly higher toxicity when in nanoparticle form. Contrary to older toxicological risk models, less is more: by reducing a particle’s size the technology has now made that substance capable of evading the body’s natural defenses more easily, i.e. passing through pores in the skin or mucous membranes, evading immune and detoxification mechanisms that evolved millions of years before the nanotech era.

For example, when nickel particles are reduced in size to the nanometer range (one billionth of a meter wide) they may actually become more toxic to the endocrine system as now they are capable of direct molecular interaction with estrogen receptors in the body, disrupting their normal structure and function.3 4 5 Moreover, breathing these particles into the lungs, along with other metals, ethylene glycol and nicotine produces a chemical concoction exhibiting synergistic toxicity, i.e. the toxicity of the whole is higher than the sum of their parts. These sorts of “chemical soups” are exceedingly difficult to study, as they embody a complexity that analytical and theoretical models within toxicology are not equipped to readily handle. Nonetheless, it is likely that when taken together the harms done by e-cigarettes are significant, and will likely manifest only after chronic use when identifying ‘singular causes’ of disease is nearly impossible. Regulators will have a hard time, therefore, identifying a “smoking” gun even after a broad range of health issues do emerge in exposed populations.

Ultimately, finding a less harmful alternative to tobacco smoking is justified, but let buyer (and user) beware, the products are not without possible harm as some marketers falsely advertise.

 

E-Cigarette Smoking Could be Banned at L.A. Restaurants, Beaches


Thumbnail image for e_cigarette_Michael_Dorausch_Flickr_ok.JPG
Michael Dorausch/Flickr

Hold onto to your e-cigarettes while you can, people, because using them might soon be banned in the same places that prohibit lighting up regular smokes.

The L.A. City Council today will consider a new motion to be introduced by Councilman Mitch O’Farrell that would treat electronic devices the same way that cigarette smoking is regulated in town.

And means no puffing, electronic or otherwise, in or on:

-elevators
-supermarkets
offices
-restaurants
-city beaches, or
-within 25 feet of playground equipment, bleachers, backstops, sports courts and fields, and picnic areas.

Yep. O’Farrell’s spokesman, Tony Arranaga, confirmed to the Weekly the gist of today’s proposal.

According to a statement put out by the offices of O’Farrell and the City Attorney:

The motion directs the City Attorney’s office to draft an ordinance to regulate the usage of electronic smoking devices where smoking is prohibited by law.

But wait, there’s more:

The council today will also weigh Councilman Paul Koretz‘s motion to raise the age limit on e-cigarette purchases to those 18 or older. As it stands, electronic tobacco retailing has no age limit for customers.

There have also been efforts on the state level to treat the battery-operated “vapes” (for nicotine vaporizers or atomizers) the same as regular cigs.

Proponents of e-cigarettes have been enjoying loopholes in the law, often smoking at bars and restaurants without reprisal. They argue that the water vapor emitted by the devices is not smoke and that it is not harmful.

However, some critics say that scientific testing has yet to catch up with the devices. The jury is still out about whether they are the source of second-hand smoke danger.

Hormone removes the pleasure of smoking.


The hormone GLP-1 is released when we eat and makes us feel full or sated toward the end of the meal.

 GLP-1 receptors are also activated in parts of the brain that are linked to satisfaction or a sense of reward. This indicates the hormone is directly involved in our experience of gratification.

Scientists reason that by blocking these receptors they can prevent smokers from feeling satisfied after a cigarette.

“Without this kind of reward, a smoker will not keep smoking. It can reduce addiction and the risk of a relapse,” says Elisabet Jerlhag, a researcher at the Sahlgrenska Academy of the University of Gothenburg.

Jerlhag and colleagues have investigated this new potential weapon in the battle against smoking.

Smokers require treatment

The ranks of daily, habitual smokers are on the decline but tobacco smoke remains a substantial public health challenge. One in four Norwegians smoke on occasion and the numbers of such “party smokers” are fairly stable.

Even those who are not heavy, daily smokers can find it hard to stub their cigs for good.

“Nicotine is remarkably habit-forming, and many people find it terribly hard to quit smoking. We need to start accepting dependency as a disorder that requires treatment,” says Jerlhag.

Tested on nicotine mice

To test whether GLP-1 regulates gratification, the researchers experimented with another chemical substance, Exendin-4 (Ex4), which imitates GLP-1’s effect on receptors. The substance was administered to a group of lab mice who had been given doses of nicotine.

The researchers then observed the mice’s movement patterns as well as the dopamine releases in their brains.

They found that nicotine made the mice more active, but the addition of Ex4 reduced that activity. However, mice that had not been given nicotine to start with did not experience the mitigating effect of Ex4. Nicotine increased the release of dopamine in their brains, but this was reduced when Ex4 had been given earlier.

The researchers concluded that GLP-1 receptors regulated the effect of nicotine on the reward functions in the brains of mice, and that Ex4 diminished the effect of nicotine.

Same effect on alcohol, amphetamines and cocaine

The researchers point out that other experiments have shown the same mitigating effect of Ex4 with other habit-forming substances such as alcohol, amphetamines and cocaine.

“Because Ex4 also reduced the motivation for consuming sucrose, this could indicate that GLP-1 receptors play a key role in the gratification created by addictive substances and the rewards of natural activities,” they add.

The researchers believe that substances that mimic the GLP-1 hormone should be considered for new prospective treatment regimens to help battle smoking and nicotine addiction.

Developing new medications

This method, which prevents smoking from soothing the nicotine cravings, is different from existing methods for treating habitual tobacco use, such as nicotine patches, or drugs such as bupropion or varenicline.

The hope is that the findings can lead to the development of new medications that mimic GLP-1. These kind of drugs have already been approved for diabetes, so that it should be relatively easy to get the green light to use them to help smokers kick their habit.

“Rewards are a prime reason why we become addicts. So we think medications that work in the same way as GLP-1 can have a positive impact on nicotine dependency. This is a whole new approach,”  Jerlhag says.

BMJ to ban research funded by the tobacco industry


The tobacco industry has been shown to mislead with its research, but is forcing it to become more hidden a better option?

woman with an e-cigarette

The BMJ‘s ban on Big Tobacco-funded research could harm work on e-cigarettes. Photograph: Alamy

Last week, the BMJ announced that it was finally implementing a practice that it had been discussing since the mid 1990s. Research partly or fully funded by the tobacco industry will no longer be published in BMJ, BMJ Open, Thorax and Heart.

This brings the journal in line with its own Tobacco Control journal, as well as a number of other publications, including PLoS Medicine, PLoS One, PLoS Biology and the Journal of Health Psychology.

It’s a turnaround for the BMJ, who published an editorial criticising the American Thoracic Society when it brought in the policy in 1996. It started a debate at the time, and since then, more and more evidence has shown that the tobacco industry has deliberately skewed scientific knowledge by presenting findings in a misleading way, withholding certain findings, and promoting false evidence of doubt in the scientific consensus about the harms of tobacco.

Not only that, internal documents have revealed this practice is still very much alive today, with memos earlier this year coming to light detailing a campaign to “ensure that PP (plain, or standardised packaging) is not adopted in the UK“.

While a lot of public health researchers are delighted by this news, even feeling that the BMJ are late to the game in implementing these restrictions, some are more worried by this censorship. Consider electronic cigarettes as an example. Nicoventures is in the process of developing the first MHRA-approved approximation of an e-cigarette (its device is not technically an e-cigarette, but is similar).
The company is running trials on the product at the moment. But though Nicoventures is a stand-alone company, it is owned by British American Tobacco. Under these new rules, it will not be able to publish its results in any of these journals.

At the moment e-cigarettes are unregulated, so current knowledge of their potential harms and benefits, is based on anecdote and speculation rather than data. As tobacco companies buy up e-cigarettes companies, this will make researching their efficacy as a nicotine replacement therapy difficult or potentially even impossible. Already there are plans to regulate them as a medical product, which may mean they could be removed from sale until they had been properly tested.

I personally believe this would be a poor decision; although we are unsure of the long-term harms resulting from the use of these devices, it’s practically inconceivable that they will be more harmful than smoking cigarettes, and will likely be considerably less so. Given the tales of hardened smokers finding them an effective replacement for cigarettes, removing them from the market may well result in a lot of people going back to smoking, which would be a negative outcome.

Finally, as we already know from the work of people like Ben Goldacre, a big problem in medical literature is the selective withholding of data by those with vested interests. Not just the tobacco industry, but the pharmaceutical industry as well.

Goldacre calls for regulations that would force all this unpublished data to be made public, rather than for banning pharma from funding research. Perhaps it’s a slightly different issue, since pharma are creating products to cure, whereas the tobacco industry creates a product that kills. But ultimately, both are businesses, primarily concerned with making money.

Might banning the tobacco industry from funding work to be published in these journals lead to it adopting worse practices, and actively obscuring its role in funding research? At the moment, declaration of financial support is essentially an honour system. There’s not really anything beyond integrity stopping a researcher from simply not disclosing who funded research. If tobacco companies deliberately obscure their involvement with research, we would be in an even worse situation, where we as scientists would not know if research had a higher chance of bias due to the involvement of the tobacco industry.