Tobacco & Drugs: Strange Bedfellows

Quick! What does the tobacco industry and drug industry have in common?

Yes, they are both among the most distrusted industries in the US today. It's a sad fact often cited by industry experts who shake their heads in wonderment (see, for example, "The Empire Strikes Back").

But that association is pure happenstance. There is really no connection or commonality among these two industries. After all, one industry's products destroy our health, the other restores it. In the future, however, there may be ties between Big Tobacco and Big Pharma.

As reported in today's Wall Street Journal ("Rx From Marlboro Man") Phillip Morris -- the Marlboro people -- are quietly laying plans to partner with the pharmaceutical industry to deliver drugs. Specifically, Chrysalis -- a business unit of Phillip Morris -- is developing a device designed to deliver a smoke-like mist deep into the lungs. The mist can be composed of nicotine or it can be a drug to treat asthma, pain, etc. Phillip Morris needs a drug company partner "to share the cost and burden of the clinical trials required to secure Food and Drug Administration approval for the device," according to the WSJ.

It's actually a pretty cool device that is more effective than inhalers currently in use by the pharma industry. According to the WSJ:

Philip Morris believed its device, which was designed to deliver a smoke-like mist deep into the lungs, was more efficient at releasing particles tiny enough for deep penetration. Company scientists figured it would appeal to patients who had trouble using traditional inhalers, which require them to push a button and breathe in at the same time. To use Philip Morris's device, they would need only to breathe in as if they were drawing on a cigarette. That allowed for "more consistent and effective dosing," said a Philip Morris scientist in a 1998 memo on the subject. That claim is plausible, according to two independent scientists who say they have discussed the device with the outside researcher testing it for Philip Morris.

Also, tests showed the device could deliver as much as 90% of drug doses into the lungs, compared with as little as 10% for traditional inhalers.

Here's how it works:



The technology of the device was born out of the need to deliver nicotine without smoke! According to the WSJ:

Philip Morris USA's bid to diversify into pharmaceutics, the science of preparing and dispensing drugs, was born of one of its most notable failed attempts to cope with the backlash against smoking. In 1986, Philip Morris set out to create a tobacco-free smoking product that would deliver the nicotine dose that smokers crave.

In 1994, Dr. David Kessler -- at the time commissioner of the FDA -- commented that "Some of today's cigarettes may, in fact, qualify as high technology nicotine delivery systems that deliver nicotine in precisely calculated quantities -- quantities that are more than sufficient to create and to sustain addiction in the vast majority of individuals". Kessler argued that cigarettes should be regulated by the FDA as drug-delivery devices. Coincidently (?), Phillip Morris hit pay dirt in 1994. "It invented a device it called a capillary aerosol generator, which heats liquid as it is forced through a thin tube. When the liquid boils, a jet of fine vapor shoots out. When the vapor hits cooler air, it condenses to form a dense mist." (WSJ)

Could Kessler's inquiries have inadvertently given Phillip Morris the idea for the device? We will never know.

Meanwhile, the initiative "has thrust Philip Morris across the battle lines of the war between the tobacco industry and public-health advocates. Longtime foes of the nation's No. 1 cigarette maker are suddenly grappling with an unfamiliar question: Should Philip Morris be treated as a force for good?"

Many medical societies and journals prohibit accepting money from tobacco companies or publishing articles funded by tobacco companies. This could put any potential drug partner (e.g., Isis Pharmaceuticals) in an uncomfortable position viz-aviz physician groups opposed to helping tobacco companies make a profit. According to the WSJ:

Isis Pharmaceuticals Inc. of Carlsbad, Calif., which is developing an asthma drug it wants to offer in aerosol form, is among the companies considering the device. Chief Executive Stanley T. Crooke says Isis is weighing whether to select Aria as the inhaler device to deliver the asthma drug. Dr. Crooke, former president of research at SmithKline Beckman Corp., now part of GlaxoSmithKline PLC, devoted part of his career to the development of anticancer drugs. Although he would have serious qualms about working for a tobacco company unit, he says, he will not reject a promising new technology simply because of its origins in the tobacco business.

OK, but Will It Play in Peoria?