In this special section, we explore how medicine–industry relationships have worked to the detriment of public health and professionalism by using the tobacco, alcohol, and pharmaceutical industries as our point of departure. There is a rich literature analyzing the relationship between tobacco and medicine that has made important contributions to our understanding of how these companies have attempted to advance their interests. It is the goal of this section to extend these findings by broadening the frame of analysis. To our knowledge, a comparative, multi-industry analysis of this type has never been pursued in such a systematic fashion.

We recognize that each of these industries has a different impact on public health. Tobacco, through nicotine and addiction, is overwhelmingly damaging to health. Alcohol, depending on the quantity consumed, can also be damaging and addictive (e.g., alcoholism, liver disease, alcohol-related violence). Although the pharmaceutical industry makes important contributions to the health care system and their products have benefited countless patients, it has a history of suppressing clinical information and manipulating research.

The three industries addressed in this section have appropriated medical authority to improve marketing. They have dispensed research grants, made sizeable gifts to medical institutions, and given sizeable honoraria and consultantships, all as mechanisms of influence. Moreover, these industries have mounted extensive public relations campaigns that appeal to the needs of public health but that, in reality, serve industry's own economic interests.

This special section begins with Mosher, who examines how industry has launched extensive marketing campaigns at a cost to public health. It then follows with articles by Brandt and Ross et al., who analyze how industry has appropriated medical authority and compromised scientific knowledge to further its own interests. It concludes with an article by Jernigan, who explains how industry has countered public health policy initiatives that would limit access to markets.

By identifying and exposing broad trends across the boundaries of these industries, we believe this special section will help equip medicine and public policy to better protect the public health. The strategies that might be implemented included: transparency, so that regulators, legislators, and the public at large can follow industry money. The Physician Payment Sunshine Act, enacted as part of the Patient Protection and Affordable Care Act (Pub L No. 111–1481, §2705 [2010]), requires pharmaceutical companies to report all gifts and funds given to physicians. The food, tobacco, and alcohol industries should be required to do the same. In addition, the US Food and Drug Administration has recently become active in regulating the tobacco industry. At the same time, regulation of claims made by the food and alcohol industries demand far greater scrutiny. Finally, academic medical centers should make certain that research grants from these industries are not marketing ventures in disguise.

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David J. Rothman, PhDColumbia University College of Physicians and Surgeons “Consequences of Industry Relationships for Public Health and Medicine”, American Journal of Public Health 102, no. 1 (January 1, 2012): pp. 55-55.

https://doi.org/10.2105/AJPH.2011.300507

PMID: 22095334