On July 21 news, the American media salon published a review article on the publication of paid research in the American Journal of Health and Behavior. The article very sharply commented on this behavior of JUUL and made a mockery of it. The following is the full text :

Facing the imminent corporate death threat, the troubled e-cigarette manufacturer Juul is doing its best to convince the Food and Drug Administration that its e-cigarette products have more advantages than disadvantages.

If this sounds far-fetched, it might be true.

Last month, Juul settled a $40 million lawsuit that accused the company of inducing teenagers to use its flavored e-cigarette products, thereby enabling Juul to avoid the potential public relations nightmare of extensive jury trials. In the past few years, Juul has also spent tens of millions of dollars on federal lobbying activities, presumably to prevent full regulation of e-cigarette sales.

But the most bizarre Juul news appeared two weeks ago, when the New York Times reported that the company funded an issue of a scientific journal, each of which provided evidence that e-cigarettes are a beneficial harm reduction practice. Ask smokers to quit tobacco cigarettes.

Last month, the 44-year-old American Journal of Health and Behaviour (AJHB), a 44-year-old academic journal that published many well-known national scholars, released a special edition to discuss whether e-cigarettes are harmful or beneficial. This 219-page publication is unique not only because of its niche theme—e-cigarettes are a relatively new phenomenon in the field of healthy behavior—but also because its publication is funded entirely by one source: Juul Labs.

For e-cigarette manufacturers, this worrying incident occurred during an unusually turbulent period. At the beginning of 2019, Juul, a company that was only four years old, was riding an explosive wave of success with $1 billion in revenue. From 2016 to 2017 alone, sales increased by 641%. A national survey in 2019 found that nearly 30% of American high school students reported using e-cigarettes in the last month, and 60% of them listed Juul as their preferred brand.

In 2018, tobacco giant Altria, formerly known as Philip Morris, acquired a 35% stake in Juul, believing that the acquisition can help restore some companies' losses.

Facing a series of potentially devastating lawsuits and pressure from the U.S. Food and Drug Administration (FDA), Juul took the initiative to remove its products from the shelves of many stores, cancelled its youth advertising campaigns, and quickly lost its market The share exceeds 30%.

Juul is still in a company predicament, waiting for FDA approval to continue selling its e-cigarette products in the United States. The agency may decide this year whether the alleged health benefits of Juul products outweigh their addictive potential.

Therefore, it is not entirely surprising that Juul wants to fund a full-page medical journal: its survival as a company is at stake.

But are the journals sponsored by Juul ethical? This is a more vague question than it seems. The AJHB special issue does not attempt to conceal the fact that all the research it contains is basically funded and promoted by Juul. As pointed out by The American Prospect, a cursory glance at the magazine’s conflict of interest statement reveals that 18 co-authors in the special issue are Juul employees.

The other five co-authors work at Pinney Associates, a company that specializes in providing hazard reduction consulting for the JUUL laboratory. Its senior scientific adviser, Dr. Saul Shiffman, told Salon via email.

"We participated in the work of JUUL and published their scientific research to inform the public dialogue on reducing the harm of tobacco," he added. Three other co-authors participated in the Center for Substance Use Research, another consulting company that has a contract with Juul. Almost all studies in this question use brand names in their titles, and all studies have effectively concluded that Juul's products are a safe form of harm reduction.

As a paper in the journal, a study based on population modeling pointed out, "After considering the potentially beneficial and potentially harmful changes and based on the evidence available so far-the continued availability of ENDS, that is, e-cigarette products , Such as Juul, is likely to have a positive impact on population mortality in the United States.

The ending point of this edition is written by Dr. Karl O. Fagerström, a Swedish psychologist, who specializes in smoking cessation and reducing the harm of tobacco, and is more philosophical. "Because humans are unlikely to give up drugs including nicotine," he wrote, "The results of this study show that ENDS, especially JUUL, can be an acceptable substitute for more harmful cigarette substitutes."

It is worth noting that Fagerström served as a paid consultant for Philip Morris International and British American Tobacco.

Outside of corporate-sponsored research, the existing scientific literature is at best about whether products such as Juul provide effective means to quit smoking. A study by the University of California, San Francisco last year found that Juul's products inhale more nicotine per mouth than cigarettes or the previous generation of e-cigarettes, and damage blood vessel function is equivalent to cigarette smoking. "

Another study published this year in Pediatrics, the official journal of the American Academy of Pediatrics, found that people who smoke e-cigarettes are three times more likely to switch to tobacco in the future. Other studies have also found that e-cigarettes increase the risk of heart disease, high cholesterol and depression.

To better understand how this strange version of this previously respected journal was born, Salon contacted dozens of people listed as AJHB associate editors or senior associate editors-none of them were paid for their work there. Before the release, almost no one knew about the version sponsored by Juul.

Dr. Richard Olmsted, a research psychologist at the Semel Institute of Neuroscience and Human Behavior at the University of California, Los Angeles, and associate editor of AJHB, told the media that, of course, no editors sent emails saying this would happen. I think if there is some warning about it, there will be quite a lot of resistance.

Dr. Carl Fertman, professor emeritus of the University of Pittsburgh School of Education and associate editor of the magazine, described the special issue as "completely unexpected."

"There is no transparency," he said in an interview. "I don't want to get involved with this magazine. It's upsetting."

Another deputy editor, who asked not to be named, told Sharon: I think it is quite unusual for a company to sponsor a special issue. I was surprised to see that they mentioned a specific company in every article. The person added that this was different from anything they had previously seen in any scientific behavior journal.

However, some editors admit that it is nothing new to see companies sponsor scientific research that they believe will benefit their bottom line.

For decades, the tobacco industry has worked hard to keep the scientific consensus away from the now generally accepted conclusion that smoking can cause lung cancer, emphysema, and other serious or life-threatening health problems. The core of this strategy is to spark false controversy by promoting junk science that seems to contradict the overwhelming scientific and medical evidence. Tobacco companies invest money in behind-the-scenes groups that support dubious science, hire consultants to prepare expert testimony for Congress and regulators, and suppress internal research results that clearly show that the company knows that their products will kill people.

In 1998, as part of the Tobacco General Settlement Agreement, a large number of secret internal documents from some tobacco giants were made public. By the early 2000s, the veil had just been lifted. As early as 2006, when the U.S. District Judge Gladys E. Kessler ruled on a landmark lawsuit by the Department of Justice, he found that several well-known tobacco companies, including Philip Morris, The company has been systematically deceiving the American public for decades to support the scientific money laundering of tobacco.

To be clear, Juul is not a tobacco company. It manufactures and sells electronic cigarettes, also known as vapes, which contain no tobacco and are designed to simulate the experience of smoking. They deliver high doses of nicotine to the brain through water vapor, usually flavored in various ways. Whether e-cigarettes are safe is still an open question, but this is different from smoking.

Nevertheless, even though the products of the two companies appear to be competing, the fact that Altria holds a significant interest in Juul is still disturbing. Juul's decision to fund a full-page medical journal reminds many people of the big tobacco company's script.

According to the "New York Times" report, after AJHB published a special edition, some editors resigned from the magazine. Most editors declined to comment on the scientific value of papers published in the special issue. But there are reasons to doubt how the journal’s peer review process works in this case.

Before research is published in any scientific journal, they are usually peer reviewed, and experts in the relevant field read the paper and post comments. As the AHJB stipulates in its ethical code: To reduce bias in the editing process, we use the classic double-blind peer review process... the editor-in-chief review transmits the evaluation and comments to the corresponding author, usually within 4 weeks.

However, according to the Philadelphia Inquirer, AJHB editor-in-chief Dr. Elbert Glover told reviewers that this issue is generally related to e-cigarettes-and then offered them cash rewards for them to complete their reviews within a week. Many editors told Salon that this is unusual in itself. According to reports, Glover revealed that the entire issue was funded by Juul only after the reviewers started asking questions about the suspicious aspects of the research.

A commenter told The Inquirer that the design of a particular study seemed biased, so much so that she suggested rejecting it altogether

In an email exchange with Salon, Glover admitted that Juul had contacted him in private, and Juul personally paid him $57,500 to publish the edition. Glover is the sole owner of the publication. However, he insisted that the peer review process was conducted in good faith.

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