In 2000, Philip Morris Incorporated (PM) announced a new research grants programme, Philip Morris External Research Program (PMERP)¹ the first known tobacco industry research solicitation since the dissolution of the Council for Tobacco Research (CTR) and the Center for Indoor Air Research (CIAR) under the terms of the 1998 Master Settlement Agreement.² Using internal company documents,³ we analysed PMERP’s research foci and organisation, the attributes of its more than 100 potential external peer reviewers, and PM’s rationale for its existence. We showed that the programme’s structure was nearly identical to that of CIAR; that the majority of the external reviewers had previous tobacco industry affiliation, and that research topics seemed designed to invite exculpatory evidence concerning risks of both active and passive smoking. We concluded that a principal motive lay in bolstering the company’s scientific credibility and noted “we remain skeptical about the scientific integrity of PMERP”.³

Through analysis of internal PM documents and studies by grantees published in peer-reviewed journals, it is now possible to assess the first round of awards, issued in mid-2001, the publications they generated, and PMERP’s progress.

METHODS

On the PM documents website (www.pmdocs.com), we searched all documents loaded after our initial research,³ using the terms “external research program”, “external research focus”, ERP, ERF (external research funding), PMERP. All documents were accessed between November 2004 and January 2005, with the last relevant, available document dated July 2002. To ensure future retrieval, the references provide links to the documents stored on the University of California San Francisco Legacy Tobacco Documents Library Legacy website (http://legacy.library.ucsf.edu/).

Using the name of every scientist listed on the awarded projects document, we searched for evidence of any prior tobacco industry funding in all collections on the Legacy website. For each principal investigator (PI), we conducted searches on the National Library of Medicine’s PubMed website to determine as precisely as possible the total number of scientific publications each had authored or co-authored, noting how many papers addressed tobacco-related subjects. The grant amounts of the PMERP awards were determined by locating the contracts for each project through the Legacy collection. We also attempted to locate all progress reports submitted to PM. By matching the project descriptions to the PI’s published work after 2001, we determined the number of published articles (up to 15 May 2005) that likely resulted from this first round of awards and considered which ones investigated potential benefits or harm from tobacco and its ingredients.

RESULTS

According to the most recently available report on PMERP, 2600 copies of the Year 2000 Request for Applications (RFA) were mailed out, and the RFA was advertised in Science and Nature.⁴ A total of 153 applications were subsequently received and, of these, 66 (43%) were recommended for funding by the Science Advisory Board (SAB).⁴ The most extensive document accounting for the programme provides a summary list and progress reports for 61 projects actually funded.⁵ The identity of the other five is not known.

Ninety-one investigators are listed in the progress report,⁵ of whom 47 (52%) had either previously received tobacco industry research funding (40), the majority through CIAR or CTR, or had applied unsuccessfully (7). We were able to identify through PubMed 50 of the 61 principal investigators. They had published an average of 50 scientific papers prior to PMERP (range 0–398); 32 of the 91 investigators had published on topics identified by keywords “cigarette” or “smoke” or “nicotine”.

Of 61 awards, the amounts for the first year ranged from US$43 200 to $816 674 (median $230 967). Forty of the contracts anticipated a three-year project length, seven were for two years, and the rest ranged from one year to 18 months. Awards went to 40 universities for a total of 55 grants, plus five private research organisations and one hospital. Eleven researchers from outside the United States were funded. In addition to the research awards, PM provided 16 post-doctoral fellowships “covering PM’s eight [international] regions” at $40 000 per year, for one to two years.⁶

Criteria upon which the final awards were given are not known from the documents. An indication of PMERP’s priorities may be found by comparing the PM-reported categories of research in the 66 recommended for funding⁴ with those of the 153 original proposals.⁶ Thus in proportionate terms: cardiovascular/respiratory diseases and cancer 28/51 (55%); toxicology 17/28 (61%); neuroscience 12/25 (48%); genetics 7/16 (44%); exposure and risk assessment, and general epidemiology were the most poorly received with only 2/33 projects (6%) recommended.

A typical contract between PM and a grantee stated that PMERP was established:

(i)n order to support high quality research that contributes to fundamental scientific knowledge, helps address the concerns of the public health community regarding cigarette smoking, and enables SPONSOR [PM] to continue its pursuit of product modification(s) or new product design(s) that might reduce the health risks of smoking.⁷

Based on the titles and project descriptions in the progress report,⁵ we found 78 articles from 36 PIs published under the sponsorship of PM as of 15 May 2005. (To view online appendix with abstract links, visit the Tobacco Control website—http://www.tobaccocontrol.com.) Each contract also specified that authors must credit PM as a funder; authors of eight of the 78 published articles failed to do so.

Fifty-one (65%) of the 78 papers dealt with nicotine or tobacco and its chemical constituents. Regarding concerns that PMERP might propel research mitigating tobacco’s role in disease induction, we found 11 published papers that dealt with perceived positive aspects of nicotine, including its potential application to neurodegenerative diseases such as Alzheimer’s and Parkinson’s, or to wound healing, including recovery from spinal cord injury. However, 25 others dealt with aspects of tobacco and smoking that lead to addiction, damage to the central nervous system or cancer induction.

A second round of awards was made after July 2002; 80 grants had been recommended for funding by the SAB.⁸ After extensive searches online and at the Minnesota depository (M Muggli, personal communication) we were unable to uncover any description of subsequent funded projects, but a 2004 RFA demonstrates that PMERP is still operating.⁹ We reviewed Philip Morris/Altria annual reports from 2001 to 2004 and found no specific reference to PMERP.¹⁰

DISCUSSION

Whether or not a consequence of our initial paper on PMERP³ demonstrating the programme’s resemblance to CIAR, Roger Walk, PM’s director of worldwide scientific affairs and PMERP’s manager, handwrote on a December 2001 draft of a PMERP status report, “we make changes”.¹¹ The only major structural change after the first round seemed to be the elimination of an anonymous PM internal scientific research review committee that vetted SAB recommendations.¹² The use of an internal review committee echoed CIAR’s procedure where company executives bypassed the SAB to choose projects in support of the company’s scientific proclamations.¹³ We do not know if the PM internal reviewers actually overrode any of the PMERP SAB’s decisions, but for Helmut Reif (director of Science and Technology at Philip Morris’s Fabriques du Tabac Reunies in Switzerland), “the change in the research funding source from CIAR to PMERP was immaterial from his perspective”.¹⁴

It is unknown how important the several rounds of PMERP will be to public health in designing products that reduce the harm of smoking. PM conducts an extensive internal research programme devoted to all aspects of smoking, health, biomarkers, tobacco ingredients, passive smoke and reduced exposure products, one of which goes well beyond PMERP and is conducted in house, mainly at INBIFO (Institut für Biologische Forschung), PM’s research centre in Germany.^15–17 In addition, PM recently announced plans for a $300 million research facility to be built in Richmond, Virginia, where the focus will be on the development of putatively reduced harm products.¹⁸ PM separately funds Duke University’s Center for Nicotine and Smoking Cessation Research.¹⁹ It thus appears the main body of research conducted to help “address the concerns of the public health community regarding cigarette smoking”⁷ is not done through PMERP.

Since our initial report,³ there has been increased debate over researchers’ acceptance of tobacco industry funding.^20,21 Several academic units in the United States have adopted policies stating they will under no circumstance accept any tobacco industry research funding.²² Others have called for “rules of engagement”, which include forthright declaration of the source of funds before accepting such funding.²³ Ten per cent of the papers published in the first round of PMERP, inadvertently or not, failed to do so. Bero et al find even such a simple declaration inadequate to reveal the extent of ties a scientist may have with the tobacco industry.²⁴

Whatever arguable public health benefits may derive from PMERP, the continuing acceptance of tobacco companies’ largesse by scientists more demonstrably contributes to a continuing industry effort to secure a place among the set of socially responsible corporations.^25,26 We can understand why young and mid-career scientists would find tobacco industry funding attractive, particularly when other non-commercial sources are scarce. From the perspectives of tobacco control and public health, however, the overall record shows this to be undesirable.^13,27

Indeed, a hand-written note from a PMERP planning session summarises the overall goals of PMERP, only one of which is directly related to the product: “Measure of success 1- product knowledge 2- contribute valuable knowledge to science 3- goodwill 4- gain credibility… Find young scientists!!!”²⁸ Given these motives and PM’s own substantive internal research programme, we conclude that PMERP is less weighty as critical scientific inquiry, but is a programme more intended to burnish PM’s public image.