TOBACCO TALKS

Tobacco Talks

Brown defends Marlboro-maker rep’s talk, but one professor calls it an “example of corporate influence”

Brown University’s Warren Alpert Medical School recently hosted a speaker who is a fellow at Altria Client Services, the company that makes Marlboro cigarettes and, until recently, owned a large stake of Juul. The talk raises questions about corporate involvement in the medical school.

Theoretically, the October 12 lecture was about harm reduction for smokers. But medical school professor David Egilman told the College Hill Independent that in reality, it was a promotion of e-cigarettes. Those involved with inviting the speaker, Dr. Mohamadi Sarkar, to talk to the Healthcare in America elective have framed his talk as a way of exposing students to different perspectives. Though medical school policy says students are not allowed to interact with industry representatives, a medical education dean for the school says Sarkar’s talk didn’t violate school policy.

Egilman, who has testified against tobacco companies and has researched some of the chemicals that go into e-cigarettes, said this talk is “another example of corporate influence at Brown.”

It’s a topic he’s familiar with. Several years ago, Brown sent him a cease and desist letter, and his class was canceled after he published a peer-reviewed article about a study by a Johnson and Johnson subsidiary.

“I don’t think you should have someone from Altria come talk unless there’s someone [to make a rebuttal] who’s more neutral about the impact of Altria, which is primarily a cigarette company, on health in America,” Egilman said.

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The talk wasn’t recorded, but Egilman said Sarkar—whom he describes as a “representative of the company that’s killing more Americans than any other company in existence”—made misleading claims and omissions in his Zoom lecture.

The talk was advertised to the Brown community via a Today@Brown email that did not mention what kind of business Altria conducts. An email invitation for Sarkar’s talk, signed by the Healthcare in America course heads, included an abstract that also does not disclose that Altria is a tobacco company.

Sarkar disclosed that Altria is a tobacco company at the start of his talk, student course leader Alex Philips told the Indy in an email.

The lecture was supposed to be in-person, with dinner after, but someone at the beginning of the Zoom meeting said it was moved online after a Sunrise Movement protest of ExxonMobil the day before led to concern about an additional demonstration, Egilman said.

Isaac Slevin, the head of Sunrise Brown, said in a phone interview that there was no protest planned for the event; his group was unaware of Sarkar’s talk.

At the lecture, Sarkar said that Juuls or e-cigarettes only have nicotine so there are no health effects, according to Egilman. He left out that flavorings—such as diacetyl, which Egilman has researched and which is used for butter flavoring in popcorn—could be toxic, according to Egilman. Sarkar also neglected to mention menthol, which Egilman describes as essentially a way to target Black people.

“The tobacco industry aggressively targets its marketing to certain populations, including young people, women, and racial and ethnic minority groups, particularly Black people,” according to the Centers for Disease Control and Prevention. “These groups are more likely to smoke menthol cigarettes compared to other population groups.”

Sarkar claimed that nicotine doesn’t cause cancer, Egilman said, but omitted that the drug is likely part of the reason why cigarettes cause heart disease and other cardiovascular disease. “He didn’t mention cardiovascular risk at all, which is I think a major omission in a talk like that,” Egilman said. Sarkar also didn’t talk about how Juuls or e-cigarettes have become a gateway drug to cigarettes, Egilman said.

The abstract for Sarkar’s talk appears to partially corroborate Egilman’s description of it, stating:

“The harm from cigarettes comes from inhaling more than 7,000 toxicants created by the combustion of tobacco. While nicotine is addictive, it’s the exposure to smoke in cigarettes—not nicotine—that causes most tobacco-related diseases … A harm reduction framework of switching adults who are unwilling or unable to quit smoking cigarettes to smoke-free, less risky products should complement—not compete with— the traditional strategies [to help smokers quit].”

What’s more, Egilman said Sarkar didn’t mention that the FDA banned Juul (before a court overturned the ban), until the person who introduced Sarkar asked him about it because of a note Egilman put in the Zoom chat. In response, Sarkar said the FDA did an inadequate job of looking at toxicological submissions, according to Egilman.

Altria formerly owned 35 percent of Juul, but in July the company reduced its stake from $12.8 billion to $450 million, according to Reuters. That allowed Altria to end a non-compete agreement with Juul and pursue its own e-vapor products.

Reached by phone, Sarkar said he was in a meeting but would call back. He never called. In a subsequent text message, he said, “I checked with our media team and we have a longstanding policy of not responding to media inquiries from college publications. Thanks a bunch for taking the time. But at this time I have no comments.”

The same day of his lecture at the medical school, Sarkar also spoke to a public health seminar with David Sylvia, Altria’s senior director of government affairs outreach. Sylvia did not respond to a request for comment. Students and faculty involved in the Healthcare in America course also declined interviews or did not respond to interview requests. In emailed statements, some of them framed Sarkar’s talk as an exercise in engaging with dissenting speech.

In an email, Healthcare in America faculty liaison Star Hampton said that the course is student-run, but, “As faculty liaison for this course, I support having the opportunity for open discourse with diversity of thought and experience. I believe there was opportunity for thoughtful, respectful questions, comments and discussion during this presentation.”

“We decided to invite Dr. Mohamadi Sarkar to speak so that students could form opinions on and engage with controversial perspectives in an amicable way,” said student leader Juliana Katz via email. “We student leaders discussed the event with our faculty advisors and the Dean of the medical school, and collectively we decided that it was appropriate. Further, since Dr. Sarkar has given lectures in an undergraduate course at Brown in the past without issue, the precedent was already set by the university.”

The medical school’s written industry policy, provided by Associate Dean of Medical Education Sarita Warrier, says that interacting with industry is prohibited, “in any setting.”

“Industry representatives are not allowed on the Brown University [c]ampus,” it says. But Warrier said in an email that “[g]iven Dr. Sarkar’s academic affiliation [as a professor at Virginia Commonwealth University], and that he provided disclosure of his work, we do not believe this was a violation of our industry policy.”

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As Katz said, this is not the first time Sarkar has spoken at Brown. He’s visited public health classes taught by Professor Jasjit Ahluwalia, who declined an interview request, but said in an email that Sarkar talked about regulatory issues and “challenged the students to think about an industry that has a long track record of deception and hiding the truth, and whether or not the industry can take meaningful steps towards harm reduction.” A student who took Ahluwalia’s seminar last fall, and spoke on the condition of anonymity due to a fear of retaliation by university administration, said that after the talk a year ago, students questioned why Sarkar came to the class. “The predatory nature of these companies is, in my mind, something that should raise a lot of red flags if they’re brought to a lecture with students in public health, if they’re brought to a lecture at a medical school,” this student said in an interview.

“Exposing students to this kind of corporate reputation laundering is really dangerous.”

Asked why he spoke out, Egilman said he’s worried about students getting misinformation about health risks. “I’m concerned when corporations use their power and money to make more money at the expense of people’s health,” he said. “And I don’t think that it’s appropriate for the university to have them have access to medical students without opposition.”

NOBLE BRIGHAM B’24 believes in putting two spaces after a period.