Dentists and Other Medical Professionals Are Still Being Targeted by the Tobacco Industry

Summary:

• The tobacco industry has targeted medical professionals to try to boost its credibility since the 1930s.
• These efforts are resurfacing as the industry tries to frame its heated tobacco products, e-cigarettes and nicotine pouches as “reduced-risk” alternatives to smoking.
• The tobacco industry is making a concerted effort to reach dental professionals by publishing industry-linked content in dental magazines, sponsoring continuing education courses and exhibiting at dental conferences.

If you believed the tobacco industry’s latest narrative, you might think the era of cigarettes is coming to an end, or, at least, that the industry wants it to. Its “tobacco harm reduction” messaging promotes the use of its heated tobacco products (HTPs), and nicotine pouches as the long-awaited solution to the smoking epidemic.

The truth is the industry still produces hundreds of billions of cigarettes annually, and that tobacco use still kills more than 7 million people every year. In short: The industry hasn’t changed.

Many of its tactics from decades past are still in use today—including trying to influence or partner with medical professionals to boost its credibility. New research highlights how the industry is trying to reach dentists and other practitioners.

New products, new messaging… same goal

Researchers from the Tobacco Control Research Group at the University of Bath found that the industry’s efforts to reach and influence medical professionals as the industry has expanded its menu of products, and appear to show concerted attempts to reach dental professionals. The researchers also note that the aim of the messaging has evolved, and focuses less on ending tobacco use and more on “accepting continued consumption of newer products.”

According to their analysis, the industry and its allies are targeting health professionals using five key tactics:

• Funding conferences, trainings and continuing professional development
• Engaging in and funding research
• Offering sponsorship or resources to professional associations
• Supplying clinical, educational and professional media materials that normalize product substitution
• Recruiting medical professionals to disseminate industry narratives

Why does the tobacco industry want medical professionals on its side?

In many parts of the world, the tobacco industry has low credibility due to the decades of lies it told the public. Partnering with health professionals is an attempt to boost its credibility.

It’s a strategy that started in the 1930s with tobacco companies trying to persuade doctors to recommend their brands to patients, and continued for decades in different forms. Today, by partnering with or influencing medical professionals, the industry may influence how practitioners advise and treat their patients, and stand to benefit if practitioners champion tobacco industry messaging that promotes the use of its products. This influence campaign is running despite the long-term health effects of the industry’s newer products remaining unknown.

Dentists appear to be the industry’s latest target

The industry’s targeting of physicians is well documented, but only recently have we begun to see the extent to which it also targets dentists.

Research from the German Cancer Research Center and the Tobacco Control Research Group illustrates one tobacco company’s multi-pronged strategy to influence dentists in Germany, starting in 2021.

The researchers found that Philip Morris (PM) GmbH, a subsidiary of Philip Morris International (PMI), was publishing content in multiple dental magazines. The articles typically focused on the industry’s version of “tobacco harm reduction” and framed HTPs, e-cigarettes or nicotine pouches as “an opportunity for oral health.” The articles often cited the company’s own research, and sometimes did not disclose that the company itself was the creator of the content.

PM GmbH also tried to reach practitioners through sponsored continuing education opportunities. Researchers identified at least 10 webinars sponsored by PM GmbH and PMI Science, another subsidiary of PMI, on dental e-learning platforms. They covered topics such as the role of e-cigarettes and HTPs in overcoming “barriers” to quitting smoking, and whether such products are reduced-risk options. (This, despite the FDI World Dental Federation’s 2021 policy statement, which states that dental professionals should not recommend e-cigarettes or HTPs as alternatives to cigarettes, nor as cessation tools, since neither has been proven safe.)

PMI Science also partnered with Aktionsbündnis gesundes Implantat (Action Alliance Healthy Implant, a group of companies, associations, publishers and scientists supporting dental implant health, and was an exhibitor at the “Innovations Implantology” symposium, a long-running series of continuing education and professional events. Such involvement is a known industry tactic to try to normalize its presence in scientific discourse and events.

PM GmbH tried to boost its credibility further by recruiting dentists and other dental professionals to appear in its sponsored webinars.

Targeting dentists appears to be a global strategy

These tactics aren’t only being used in Germany.

Leaked documents from Philip Morris Japan (PMJ) showed the tobacco giant was strategizing to influence dentists in 2019. One presentation revealed PMJ’s strategy to create a “dentist referral program” and to run a pilot program with 15-50 dentists to promote its HTP, IQOS.

In 2021, researchers called out a PMI advertisement running in Japan Dental News. The ad cited four studies that were led by a PMI scientist and that were partially funded by the company. The messaging in the ad contains striking similarities to a tobacco industry ad targeting medical professionals that ran more than 80 years ago. Both speak directly to medical professionals in their capacity to advise patients, and directly promote industry-linked research.

Left: Philip Morris International ad, 1939. Source.
Right: Philip Morris International ad, 2021. Source.

Further, several cases of industry attendance and presentations at dentistry and oral health conferences in Bulgaria, Canada, Italy, Japan, Serbia, the United Kingdom and the United States have been recorded since 2017.

Allies continue to create opportunities for industry-aligned messaging to reach medical professionals

While the industry funds and disseminates its own studies to try to influence science, it has also funded other organizations that, in turn, fund research—distancing and distorting the industry link. The Foundation for a Smoke-Free World was founded by PMI in 2017 and remained solely funded by the tobacco company through 2023. In 2024, the group rebranded and is now known as Global Action to End Smoking (GAES).

GAES has given grants to organizations such as Knowledge-Action-Change and the Centre of Excellence for the Acceleration of Harm Reduction (CoEHAR), both of which have funded scholarships or research relating to tobacco industry products and oral health.

Most recently, CoEHAR’s SMILE study examined the oral health outcomes of people who switched from cigarettes to the industry’s newer tobacco and nicotine products. The study involved dentists and the findings have been presented in dentistry journals.

This targeting is harmful and needs to stop

To protect patients’ health and to prevent industry influence ove and clinical guidelines, action must be taken on several fronts.

Dental and medical publications and research journals can implement policies against publishing advertisements or studies linked to the tobacco industry. Dental, medical and scientific conferences can exclude participation from those and medical education organizations can reject all sponsorship from tobacco and nicotine companies.

Calling out these practices makes a difference. U.S.-based medical education company Medscape after medical professionals and the public health community widely and publicly criticized the courses.

If you see instances of tobacco industry involvement in dental and medical conferences, publications or education, report it to STOP to help us hold the industry accountable.“…the aim of the messaging has evolved, and focuses less on ending tobacco use and more on ‘accepting continued consumption of newer products