As Duke officials consider adding vaping to its smoking ban, one prominent smoking researcher has been a proponent of allowing vaping on campus. His industry relationships, however, have raised some doubts.
Jed Rose, director of the Duke Center for Smoking Cessation and professor in psychiatry and behavioral sciences, is pushing a pro-vaping point of view. He accepts research funding from the tobacco and e-cigarette industries, which has raised concerns about potential conflicts of interest.
Rose, a longtime smoking-cessation researcher, says the benefits of vaping outweigh the risks.
“There’s virtually no plausible scenario where e-cigarettes can have a negative public health impact,” Rose said in an October 2019 Law School event titled “Vaping: Crisis or Lost Opportunity.”
As of now, Duke’s Smoke-Free Campus initiative that takes effect July 1, 2020, remains consistent with Rose’s stance that e-cigarettes are a healthier alternative to smoking combustible cigarettes and should be allowed on campus. Yet, his views are at odds with some faculty, public health experts and the Centers for Disease Control and Prevention.
Who is Jed Rose?
Rose said he has accepted research grants from the tobacco industry since around 2000 when he first collaborated with Vector Tobacco Company. In 2011, Rose sold a patent for a device he developed in the 2000s at Duke that eliminates combustion of tobacco while still delivering nicotine. He sold this patent to Philip Morris International, the leading tobacco company worldwide in 2018, for an amount he said he is contractually obliged not to disclose.
In addition to his role as director of the Duke Center for Smoking Cessation and president and CEO of the Rose Research Center, he works as a consultant for the same company that bought his patent, Philip Morris. Rose also has outside financial interests with companies such as JUUL Labs Inc., the leader in e-cigarettes, and Altria Group Inc., which owns Philip Morris USA.
As Duke prepares for the upcoming smoking ban, Rose has been highly vocal on the issue, pushing back against the faculty who are urging the University to include e-cigarettes in the ban.
“What we do know is that in the United States alone, there are 540,000 premature deaths from combustible cigarette smoking and the related diseases every single year,” Rose told The Chronicle. “There is no solid evidence that nicotine acting on an adolescent brain causes any significant impairment.”
However, his stance is not in line with CDC recommendations, which say that e-cigarettes are unsafe for kids, teens and young adults. Exposure to nicotine can harm brain development by changing the ways synapses linked to memory form, a CDC warning states. The warning also notes that young e-cigarette users may also be more likely to smoke cigarettes in the future.
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Not all faculty agree with Rose on vaping
Eight Duke professors urged the University to impose a vaping ban in a letter to The Chronicle, published in October 2019. Almost 2,000 U.S. campuses have already done the same, they said.
“Our university and its host city Durham have navigated a long and fraught relationship with tobacco, and we now face a new opportunity to impact the tobacco industry’s threats to local and world public health,” the letter read. “Vape manufacturers and marketers have made excessive claims of benefit in smoking cessation while targeting youth, who are especially vulnerable to addiction.”
Associate Professor in Anesthesiology Sven-Eric Jordt was one of the eight signatories. Jordt said by allowing vaping on campus, Duke would in effect give students who have never used e-cigarettes or smoked before a green light to start.
“I’m not sure if I’d send my kids to Duke necessarily if they start vaping like two weeks later,” said Jordt, whose research is funded by the Food and Drug Administration Center for Tobacco Products and the National Institute on Drug Abuse.
There has been a marked increase in vaping among high school seniors. About 37% of 12th graders in America reported vaping in 2018, compared to 28% in 2017, according to the National Institutes of Health’s annual survey on drug, alcohol and cigarette use.
According to Healthy Duke, vaping is “considered important in order to provide an avenue for individuals who are unable to quit smoking.” Many of those still smoking combustible cigarettes are faculty and staff, and the policy hopes to provide assistance to this already-addicted population.
Cynthia Kuhn, professor of pharmacology and cancer biology, also signed the letter urging Duke to expand the ban to include e-cigarettes. Kuhn studies addiction in the adolescent brain and considers herself a “knowledgeable observer” in part because she is not funded by any tobacco or vaping companies.
While experts agree that e-cigarettes reduce exposure to fewer carcinogens than tobacco-burning cigarettes, they worry that young people might be of greater risk than others to become addicted to nicotine when using e-cigarettes, Kuhn said.
Four days after the letter calling for a Duke vaping ban, Rose and more than a dozen other e-cigarette supporters wrote their own letter to The Chronicle opposing it. Rose was listed first among the signatories, most of whom are not Duke faculty and many of whom are based outside the U.S.
That pro-vaping letter criticized Jordt, Kuhn and others for suggesting all e-cigarette products may contribute to the recent outbreak of lung diseases that federal investigators have linked to a subset of vaping products containing tetrahydrocannabinol (THC), the intoxicant in marijuana.
“It’s all so typical of the anti-vaping forces that they will cite an unknown effect and weigh it as heavily as what we do know,” Rose said to The Chronicle.
The CDC, the FDA and state and local health departments are investigating more than 2,602 cases of a newly observed lung injury associated with vaping. So far, e-cigarettes designed or altered to give users doses of THC are the prime suspects in the outbreak, though not all cases involved THC.
Disclosing industry ties
Some faculty have also questioned whether Rose adequately discloses his tobacco and e-cigarette industry ties when he promotes his position.
Rose has been unapologetic about taking research money from the tobacco industry. In 2018, he co-wrote an article for the journal Addiction, titled “Why we work with the tobacco industry.” The piece defends his and other researchers’ ties with major tobacco corporations such as Philip Morris, Altria and Juul.
“[W]e believe that scientists should assist the development and testing of reduced risk products, regardless of who makes a profit from such products,” Rose and co-authors wrote.
Rose did not explicitly disclose these industry relationships in his letter urging the administration not to ban e-cigarettes, outside of linking to a video of a talk he gave in which he mentions his conflicts.
Theodore Slotkin, professor of pharmacology and cancer biology, commented on Rose’s letter in The Chronicle that he should have disclosed his industry funding in the letter he co-authored in the newspaper.
“It is disingenuous to publish a letter of this type without any disclosures of his conflicts of interest and personal gain from vapes. Dr. Jed Rose fails to disclose that he has received funding from Juul Labs, Philip Morris, and Altria, all of whom directly profit from vapes,” Slotkin wrote.
Rose said that the label of “disingenuous” is unfair.
“Perhaps because there were no disclosures noted on the other side by the original letter with Dr. Jordt, so honestly I didn’t think of it in that context,” he said.
Academic journals frequently require researchers to fully disclose any industry ties when publishing research papers. There is little guidance, however, on how and when to mention disclosures in opinion pieces, such as letters to the editor. In two recent talks in support of allowing e-cigarette use on campus, Rose showed a slide summarizing his financial ties to the industry.
Slotkin said to The Chronicle that he believes Rose is “obligated to always disclose all conflicts of interest.”
“It’s inappropriate because it leads the reader to believe he is a dispassionate reporter on the science or policy, when in fact he has a personal stake in promoting these products,” Slotkin said.
Some public health researchers oppose accepting money from the tobacco industry, especially given its history of manipulation and marketing to push a product that is implicated in 480,000 deaths from smoking per year in the U.S.
Rose said he is not at all personally conflicted.
“The only work that I’m doing with the industry is completely to help people stop using combustible cigarettes in favor of less harmful ways of getting nicotine,” Rose said.
Correction: Rose's patent that he sold to Philip Morris International was based on work he did at Duke in the 2000s, not in the 1980s when he was at UCLA. The Chronicle regrets the error.