Juul: bringing academic corruption to a new level

For years, I have followed the story of Juul, who came out of nowhere to control almost the entire e-cigarette market. Altria, maker of Marlboros, bought 35% of Juul in late 2018, valuing it on par with Target, Delta Airlines and Ford Motor Company at the time.

Juul’s dominance wore off as more than a thousand people contracted a mysterious vaping-related illness in the fall of 2019, and state and federal regulators began to investigate the blatantly obvious marketing of the. business with adolescents. Within weeks, Walmart stopped stocking e-cigarettes, TV ads for the product fell, cities and states banned sales, and Juul eliminated flavored vape pods that were most clearly designed to appeal to young people. . Juul’s market share in electronic cigarettes has increased from around 75% to 42%.

Today, the company is fighting for its survival. The Food and Drug Administration (FDA) will soon decide whether to allow Juul to continue selling its products in the United States. The problem is whether the public health benefits of converting cigarette smokers to vaping outweigh the introduction of a whole new generation to nicotine addiction. The decision will be taken in early September.

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Juul is spending millions on lobbying and persuasion to get the FDA green light to continue operations. But on a Tuesday New York Times article on the subject contained a fascinating mid-term nugget, which could be described as the buried lede (diary to put the most explosive part of a story in the middle of the room). Juul, the Time reports, “Paid $ 51,000 to have the entire May / June issue of the American Journal of Health Behavior dedicated to publishing 11 company-funded studies providing evidence that Juul products help smokers to stop smoking”.

Corruption in academic research is not a new topic. Companies finance studies by third parties and constantly benefit from “independent” validation of their perspectives. But it’s a new wrinkle. Juul didn’t just pay money for some college work; he bought a all editing of American Journal of Health Behaviors (AJHB), which it can then point to as “proof” that its product has a public health interest, the key issue currently before the FDA.

And the more you watch this story, the stranger it gets.

The $ 51,000 fee included $ 6,500 to unlock the entire journal for public access. So you can read the entire 219-page Juul special here. It’s fascinating. There are 26 named co-authors out of the 11 studies. According to the associated “conflict of interest” statements, 18 of the co-authors were either current full-time employees of Juul or full-time employees at the time they conducted the research. Five others are consultants to PinneyAssociates, working “on an exclusive basis for Juul Labs”. And the last three, who co-authored one of the 11 studies, are employees of the Center for Substance Use Research, an “independent” consulting firm that designed this study under contract with… Juul Labs .

Almost all of the articles echo the Juul Party line that e-cigarettes help distract smokers from combustible tobacco products and thereby contribute to public health. Hardly any of the articles mention that Juul and other vaping companies are making money by attracting countless new people to nicotine addiction. And it’s hardly worth commenting on the quality of the search when it comes from the same business source.

Saul Shiffman, one of PinneyAssociates’ consultants, obtained co-author credit on ten of the 11 studies. “In this role, he acted as internal editor and article coordinator for this special issue,” reads the conflict of interest statement in the introductory note. So not only were these studies all funded by Juul, not just anyone who wrote them on Juul’s payroll, either indirectly or (in most cases) directly, but the in-house editor of the “outside newspaper”. Was also under contract with Juul. .

Juul has yet to respond to a request for comment. In response to a query, PinneyAssociates returned the Perspective to a previous response from Shiffman and Erik Augustson, one of Juul’s former employees. “Our intention with these publications was to provide the nicotine and tobacco research community, as well as the public health community at large, the opportunity to assess the research for themselves,” said they wrote. “All articles have gone through the journal’s standard peer review and editorial process and we believe the science behind it is solid.” They added that Dr. Elbert Glover, the newspaper’s editor, oversaw all content.

But the American Journal of Health Behaviors is also under scrutiny, beyond selling a special issue to a company. The journal has been in existence for 45 years and prides itself on scrupulous ethical guidelines, including the mandatory list of conflict of interest disclosures in all articles. But the AJHB follows a trend among a handful of academic and scientific journals: its authors have to pay to publish.

There is a whole price list on the journal’s website. Authors pay $ 895 per article, and if they want the article to be open access so that everyone can read it, that goes up to $ 1,595. (Only part of the articles are accepted in open access, as most of the AJHB is closed.) If you want more than six tables and figures in your article, it will cost you $ 150 each. And a “topic issue,” similar to the one Juul bought, costs $ 2,500 per item, with an additional $ 500 to make each item unlocked, not including the $ 195 per item service charge for review.

In this context, the $ 51,000 Juul paid for the May / June issue is not that far from what the AJHB would have. normally charge for a thematic issue with 11 studies ($ 33,000, plus a supplement for checking copies and any additional tables and figures above the prescribed limit). It turns the work of a science journal into what looks like advertising.

I asked Rebecca Tushnet of Harvard Law School, who specializes in advertising law, about the relevance of this arrangement. “If Juul’s sponsorship is adequately disclosed, that would resolve most advertising law issues,” she said. Tushnet added that marketing can be seen as misleading if the target audience is the general public, but here the publication, a scholarly journal, is designed for experts. “It is questionable whether experts are in fact so resistant to bullshit – it is common knowledge among crooks that doctors are among the easiest to deceive because of their self-confidence and expectations of deference.” , she noted, “but the courts are understandably reluctant to weigh in on the publication of expert battles.

FDA officials might not be aware of the degree of the pay-to-play relationship in this special issue of Juul.

There are several scams at the same time here. Academics desperately want to publish in journals to prove to their universities that they are working diligently. Companies recognize the ability to subscribe to research and produce independent validation of their goals. And they turn around and use that research to persuade policymakers, who claim to be sophisticated at spotting bogus research, but probably aren’t.

On its FAQ page, the AJHB recognizes that paid scholarly journals have become a real scourge in the scientific community: “[T]he recent proliferation of journals with the obvious objective of generating for-profit income without regard to science is a development that creates a major problem for reputable journals that have to charge to provide their services to the academic and practice communities. Indeed, the Federal Trade Commission issued a formal warning against “predatory” journal editors in 2016. But the AJHB justifies the accusations by saying that as a small organization with no large membership base, it has ” no other choice without incurring financial risks. . ” the American Journal of Health Behaviors did not respond to a request for comment.

To me, there seems to be little difference between the corruption of for-profit scientific journals that degrade the quality of available research, and the corruption in this particular scenario, where an entire issue of a decades-old scholarly journal goes directly into the hands of a private company who will use it to persuade a federal regulator of the effectiveness of its product. FDA officials might be unaware of the degree of the pay-to-play relationship in this special issue of Juul, and how that could compromise science.

Obviously, some people associated with American Journal of Health Behaviors were uncomfortable with the arrangement; according to Time, three members of the editorial board resigned following the special issue.

I don’t know if this academic journal bet will save Juul’s business or not. I know Juul has done its part to innovate in the area of ​​corrupting the very notion of scientific inquiry. So thank you for that.

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