Nicholas Hopkinson

Philip Morris International (PMI) products kill at least one million people per year. Its acquisition of Vectura, a company which specialises in inhaled medications, taken by many people who have lung disease caused or aggravated by smoking, is grotesque. The move has been widely condemned by professional and patient groups including the American Lung Association, the American Thoracic, British Thoracic and European Respiratory Societies, The European Lung Foundation, the COPD Foundation and the Asthma UK and British Lung Foundation Partnership.

PMI asserts that it can run Vectura at arm’s length, and that all will be business as usual. In fact, now that Vectura has become part of the tobacco industry it becomes subject to the rules and guidelines that rightly exclude the tobacco industry from a range of activities. These rules exist because of the way that the industry’s long history of killing people for profit has gone hand in hand with deception, dishonesty, and corrupt practices. Vectura, its employees and people who continue to collaborate with the company will be excluded from membership of professional societies, from participation in conferences (a measure enacted immediately when the takeover was announced), from publication in respectable peer-reviewed journals and from grant schemes and collaborations with respectable universities. Its employees will need to consider their positions. Universities should urgently review and terminate any existing collaborations with Vectura and ensure that no new ones are established.

The latest Global Tobacco Industry Interference Index highlights the pervasive, malign impact of the tobacco industry in obstructing the tobacco control measures that are needed to bring the smoking epidemic to an end. Enforcement of Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) must be heightened, to ensure that the tobacco industry project to insinuate itself into discussion about public health and policy is not allowed to succeed.

Neither people with COPD and asthma nor their healthcare professionals will wish inhaled treatments to be providing a profit to the tobacco industry whose primary business causes or worsens these illnesses. Fortunately, the inhaler market is crowded, and many alternatives are available so that most people with lung disease can be initiated onto a non-tobacco industry linked drug or, where they are already on one, switched across to a different device which is similarly effective.

The takeover of Vectura has only been possible because PMI has been allowed to avoid paying the external costs that accrue through the life cycle of its products – the environmental degradation, lost productivity, death and disease. Smoking is estimated to cause a global social burden of more than $2 Trillion/year. This takeover is a wakeup call – we urgently need to address this market failure, claw back these costs through measures including “polluter pays” levies on tobacco industry profits and accelerating the implementation of FCTC measures which are known to be effective on affordability, advertising and industry interference.

Nicholas Hopkinson is a Professor of Respiratory Medicine at Imperial College, London and a chest physician at Royal Brompton Hospital. His clinical and research focus is on smoking related lung disease. He is Chair of ASH(UK) and also Medical Director of the British Lung Foundation.