First, disclosure of conflicts of interest has become a widely accepted guideline for ethical practice in medicine and public health. Most, if not all, reputable public health and medical journals require authors to disclose any relevant conflicts of interest and most journals publish any conflicts that are disclosed.

I argued as follows:

In my view, this refutation and undermining of its own black box warning violates accepted standards of pharmaceutical company conduct, and should prompt either penalties or the removal of the drug from the market. If Pfizer is going to publicly undermine the required black box warning, then clearly that warning is not adequate to protect consumers and the FDA must either penalize Pfizer so that it desists from this behavior or pull the drug from the market since it is becoming clear that the company is undermining that warning in the eyes of the public.

Similar data from the U.S. would be very helpful. But unlike prior reports, these ones should quantify not only experimentation, but also regular use, stratified by prior status as smokers versus nonsmokers.

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