The tricks that tobacco companies used to hide the risks of cigarettes are no secret.
Internal corporate documents disclosed during the litigation against cigarette companies show the way the industry worked to create uncertainty about tobacco’s cancer risks long after mainstream scientists had reached a consensus. “Doubt is our product,” a tobacco executive famously wrote in 1969.
A 2005 paper in Public Health Chronicles outlined a six-part strategy by the companies, including suppressing research that did not support their position and taking their case directly to the media. The companies knew that reporters might quote industry representatives in a false quest for balance that misled readers about the actual state of the science.
Millions of Americans died from smoking-related illnesses before legal and political pressure forced the industry to admit the truth. Now, we run the risk of history repeating itself, with a different drug and a new generation of conflicts of interest — but, sadly, some of the same companies.
Millions of Americans died from smoking-related illnesses before legal and political pressure forced the industry to admit the truth. Now, we run the risk of history repeating itself.
In the last two decades, scientists have found a link between cannabis use and severe mental illness. Even in controlled laboratory settings, some people dosed with THC, the psychoactive chemical in cannabis, will have hallucinations. Cannabis use in adolescence appears to change structures in the brain in ways that may contribute to mental illness. And many large studies — dating back to one that covered more than 50,000 people and was published in 1987 — show that people who use cannabis as teenagers have a much higher risk of developing schizophrenia, the most devastating mental illness.
Reviewing the science in 2016 in Biological Psychiatry, three British epidemiologists reported “enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders.” (The research that led to findings like those formed the core of my new book, “Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence.”)
The next year, the National Academy of Medicine, a non-profit group that advises the government on health and medical issues, released a landmark 468-page report on the health effects of marijuana. After reviewing the evidence, a 16-member committee convened by the academy found that “cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater risk.”
But investors and companies in the legalized cannabis industry, which already reaps billions of dollars annually, are doing everything possible to squelch that message. The industry — comprised of venture capital companies, specialized media outlets, consultants, delivery services and large growers — provides users with few warnings about the mental health risks of cannabis while making unproven claims about cannabis’s effectiveness as medicine, even for people with psychiatric disorders.
Some of the people spreading these messages and downplaying the risks are scientists, drug policy groups and even public health experts. And some of these have conflicts of interest reminiscent of those of tobacco-funded scientists.
For example, the Cannabis Research Initiative at UCLA promises “timely education, research, and service to lead public policy and public health decisions regarding cannabis.” Yet the institute accepts donations from cannabis investors, like — better known as Snoop Dogg — who is not just a prominent user but the general partner of a $45 million venture capital fund focused on marijuana companies.
The best known pro-legalization group, the Drug Policy Alliance, also takes money from cannabis companies. It openly solicits money from corporate partners, asking them to “give back:” “Drug policy should create opportunities, not take them away. Support DPA’s work to end marijuana prohibition…[by] making a corporate donation to the Drug Policy Alliance. We’re all in this together.”
Those corporate partners will likely be happy to hear that the alliance refuses to support simple and straightforward warnings on the psychiatric risks of cannabis — warnings I, for one, have suggested — such as “If you have panic attacks or unusual thoughts, especially paranoid thoughts, while using cannabis, the drug may be increasing your risk for severe mental illness and you should not use it.”
Then there is Dr. Mark Kleiman.
Dr. Kleiman, a professor at New York University, is one of the most prominent cannabis public-policy researchers in the United States and an advocate of legalization. Politico called him “the policy wonk behind legal pot.”
In addition, Kleiman is the chairman of a private research firm, BOTEC Analysis LLC, which promises, “The Right Answer to the Right Question.” He has downplayed the connection between cannabis and psychosis, comparing it to the extraordinarily rare risk that vaccines may cause paralysis. (In fact, the evidence suggests that heavy adolescent cannabis users have a doubling or tripling of their baseline risk of developing schizophrenia, implying that at least 1 in 100 additional users may develop it. Flu vaccines cause paralysis roughly 1 in 1 million times they are dosed — a risk one-ten-thousandth as large.)
In response to recent questions about potential conflicts of interest related to BOTEC’s work, Kleiman vehemently and unequivocally denied any conflicts. "BOTEC has never had any business dealings with any firm involved in any way with the cannabis industry,” he told me recently via email.
Yet on its own website, BOTEC discloses that its clients include the cigarette companies Altria and Philip Morris International. All by itself, that relationship would be troubling. Many academic researchers have committed to refuse any tobacco funding, arguing the companies are inherently untrustworthy because of the way they manipulated science. And cigarette companies have considered investing in marijuana for almost 50 years.
Now they are no longer bystanders. In 2016, Philip Morris International put $20 million into Syqe Medical Ltd., an Israeli company whose primary product is a "pocket-sized selective-dose cannabis inhaler." In 2018, Altria made a $1.8 billion investment in Cronos Group, a Canadian cannabis grower — a sum so large that it ends any fiction that tobacco and cannabis are separate industries.
BOTEC’s involvement with for-profit companies involved in cannabis does not end with cigarette makers, and the company is less forthcoming about other conflicts. For example, in 2016, NYU hosted a cannabis-related summit that was chaired by Kleiman and produced by BOTEC. For-profit companies in the cannabis industry sponsored the summit, which included a talk on “Investing in Cannabis.”
It is hard to square BOTEC’s work on the summit with Kleiman’s denials of any conflicts. And given Kleiman’s personal importance in the debate around cannabis and the convergence of the cannabis and tobacco industries, he should end any consulting for the cigarette industry.
But Kleiman is far from alone. As the debate about whether and how the United States should legalize at the federal level heats up, other key scientists, advocacy groups, and public-policy experts on cannabis must also make full disclosures of their conflicts, and not just about marijuana itself.
Recently, another prominent drug policy researcher told me unequivocally that they had never taken money from tobacco, alcohol, gambling, or cannabis industries. That kind of clear, direct, and simple disclosure leaves no room for doubt — and eliminates questions about bias.
Big Tobacco used friendly researchers, polluted science and resisted controls on its product for generations. Millions of Americans died as a result. Marijuana is another addictive smoked product, and even as its use rises, we are still trying to figure out exactly how dangerous it might be and how to discourage its use.
Let's not make the same mistake twice.
Alex Berenson's new book "Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence" was published on January 8, 2019.