An investigation by The Investigative Desk and The BMJ has revealed that research funded by the tobacco industry continues to appear in highly cited medical journals, despite efforts by some publications to sever ties with the industry entirely. The findings document hundreds of relationships between major tobacco companies’ pharmaceutical subsidiaries and published medical research.
Key Findings
The investigation identified 876 studies on PubMed dating to 1996 in which conflict-of-interest disclosures indicated that at least 1 researcher had a relationship with a medical company that was financially tied to the tobacco industry. Notably, at least 13 journals with explicit tobacco policies published 27 studies linked to companies with tobacco industry investments.
Among the 40 top medical journals examined—the top 10 general medical journals and the top 10 in each of 3 therapeutic areas heavily impacted by smoking (oncology, cardiac and cardiovascular medicine, and respiratory medicine)—only 8 (20%) had policies prohibiting research wholly or partly funded by the tobacco industry.
Policy distribution varied by specialty: 6 of 10 journals in respiratory medicine had tobacco policies, while only 1 oncology journal and no cardiology journals did. Among general medical journals, only The BMJ had such a policy.
Industry Investment Patterns
The “big four” global tobacco companies—Philip Morris International (PMI)/Altria, British American Tobacco (BAT), Imperial Brands, and Japan Tobacco International (JTI)—have invested billions in pharmaceutical and medical product companies. These investments include therapies for conditions caused or worsened by smoking, such as chronic obstructive pulmonary disease (COPD), asthma, lung cancer, heart disease, psoriasis, and atopic dermatitis.
Vectura, a PMI subsidiary since 2021, manufactures inhalers for patients with COPD and asthma. JTI’s pharmaceutical arm develops treatments for lung cancer, skin diseases, and heart conditions. Imperial Brands has invested in medicinal cannabis for chronic pain and cancer. According to a BMJ visualization, these firms hold investments in at least 24 companies across the health sector, many of which have had research published in peer-reviewed journals.
Case Studies and Enforcement Challenges
One case that illustrates the complexity of enforcement involves Dutch pulmonologist Wytse van den Bosch, MD, PhD, who accepted a research grant from Vectura in 2018. After PMI acquired the company in 2021, van den Bosch faced a dilemma.
“Your gut feeling tells you: just quit. As a pulmonologist I would never get involved with a tobacco company,” van den Bosch stated. Yet, the study was published in a journal of the European Respiratory Society, which had a policy against publishing work from authors with tobacco ties.
The European Respiratory Society justified the decision: “The research grant from Vectura was initiated in 2018. Therefore, this would not be a breach of the ERS publications and ERS conflict of interest policy relating to tobacco.”
Other examples show further difficulty in enforcement. In 2023, BMJ Open retracted a study after it was revealed that the funder, ECLAT SRL, was supported by the Foundation for a Smoke-Free World, which is fully funded by PMI.
Publisher Responses and Policy Gaps
Journals and publishers without explicit tobacco policies often point to general transparency and conflict-of-interest requirements. However, gaps remain. The Swiss publisher MDPI, which claims to reject tobacco-funded research, was found to have published 12 studies linked to the tobacco industry across multiple journals, including Journal of Clinical Medicine and Vaccines.
“We expect all our authors to fully adhere to all our publication ethics policies,” said Ana Stankovic, research integrity and publication ethics specialist at MDPI.
Expert Commentary on Industry Strategy
Ruth Malone, professor of social behavioral sciences at the University of California and former editor-in-chief of Tobacco Control, called for total rejection of tobacco funding: “Anyone who understands the history, extent, and nature of the epidemic and the tobacco industry’s strategic efforts to divide the public health community knows that industry money should be rejected.”
Nicholas Hopkinson, MD, professor of respiratory medicine at Imperial College London, emphasized, “Given the industry’s longstanding history of dishonesty, it is very straightforward that researchers should cut ties to companies after acquisition by big tobacco, as otherwise they would be working with the tobacco industry.”
Pediatric pulmonologist Harm Tiddens, MD, noted that research into inhaled medications could even aid tobacco companies in designing more efficient vaping devices—an observation that highlights an underrecognized consequence of such affiliations.
Updated BMJ Policy
Coinciding with the investigation’s release, The BMJ expanded its tobacco policy to include not only research funding but also personal financial ties to tobacco companies. The policy now applies across all BMJ journals, broadening from the 2013 policy that had covered The BMJ, Heart, Tobacco Control, Thorax, and BMJ Open.
Helen Macdonald, head of research integrity at The BMJ, acknowledged the policy's difficulty in implementation: “The policy is challenging to implement for journals that rely in large part on the accuracy of authors’ declarations. It is further complicated by how the tobacco industry is defined, which also evolves, as recent moves to take over pharmaceutical companies have shown.”
She added that the updated policy seeks to create “a stronger firewall between the tobacco industry and BMJ content [to] provide space for editors to curate and publish content that is more independent and trusted, and contributes to a healthier world.”
Research Implications and Future Concerns
As tobacco companies diversify into health products, concern grows that industry-funded research may shape not only therapies but also potentially future tobacco and nicotine delivery products. Medical data from studies of asthma inhalers, for instance, could inform the design of e-cigarettes, according to Tiddens.
Leslie London, chair of public health medicine at the University of Cape Town, called funding research on smoking-related treatments with tobacco money “surely the most insurmountable conflict of interest imaginable.”
The investigation concluded that current transparency and disclosure mechanisms are likely insufficient to insulate medical research from tobacco industry influence, especially as subsidiaries blur the boundaries of disclosure and accountability.