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Tobacco industry influence on the definition of tobacco related disorders by the American Psychiatric Association

机译：烟草业对美国精神病学协会对烟草相关疾病定义的影响

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Objective: The Diagnostic and statistical manual of mental disorders, third edition (DSM-Ⅲ), published by the American Psychiatric Association (APA) in 1980, included the first official definitions by the APA of tobacco dependence and tobacco withdrawal. Tobacco industry efforts to influence the DSM-Ⅲ were investigated. Method: Searches of previously secret tobacco industry documents, primarily the University of California San Francisco Legacy Tobacco Documents Library and British American Tobacco collections. Additional information was collected through discussions with editors of DSM-Ⅲ, and library and general internet searches. Results: The tobacco companies regarded the inclusion of tobacco dependence as a diagnosis in DSM-Ⅲ as an adverse event. It worked to influence the content of the DSM-Ⅲ and its impact following publication. These efforts included public statements and private lobbying of DSM-Ⅲ editors and high ranking APA officers by prominent US psychiatrists with undisclosed ties to the tobacco industry. Following publication of DSM-Ⅲ, tobacco companies contracted with two US professors of psychiatry to organise a conference and publish a monograph detailing controversies surrounding DSM-Ⅲ. Conclusions: The tobacco industry and its allies lobbied to narrow the definition of tobacco dependence in serial revisions of DSM-Ⅲ. Following publication of DSM-Ⅲ, the industry took steps to try to mitigate its impact. These actions mirror industry tactics to influence medical research and policy in various contexts worldwide. Such tactics slow the spread of a professional and public understanding of smoking and health that otherwise would reduce smoking, smoking induced disease, and tobacco company profits.
机译：目的：1980年由美国精神病学协会（APA）出版的《精神障碍诊断和统计手册》第三版（DSM-Ⅲ）包括了APA最初对烟草依赖和戒烟的正式定义。研究了烟草业影响DSM-Ⅲ的努力。方法：搜索以前秘密的烟草业文件，主要是加利福尼亚大学旧金山遗留烟草文件图书馆和英美烟草公司的藏书。通过与DSM-Ⅲ的编辑讨论以及图书馆和一般互联网搜索收集了更多信息。结果：烟草公司认为将烟草依赖纳入诊断是DSM-Ⅲ的不良事件。它的工作是影响DSM-Ⅲ的内容及其出版后的影响。这些努力包括公开声明和DSM-Ⅲ编辑的私人游说，以及与烟草业有未公开联系的美国著名精神病医生的高级APA官员。在DSM-Ⅲ出版之后，烟草公司与两名美国精神病学教授签约，组织了一次会议并出版了专着，详细介绍了围绕DSM-Ⅲ的争议。结论：在DSM-Ⅲ系列修订中，烟草业及其盟友游说以缩小对烟草依赖的定义。在DSM-Ⅲ发布之后，该行业采取了一些措施来减轻其影响。这些行动反映了在全球范围内影响医学研究和政策的行业策略。这种策略减缓了专业人士和公众对吸烟与健康的理解的传播，否则将减少吸烟，吸烟引起的疾病以及烟草公司的利润。

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