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What do you research?
What I research is, I look at the effect of cigarette smoke on the immune system.
In there, it is relevant to COPD because COPD is a smoking related disease.
By and large, I don't specifically focus on COPD.
It is more a larger area where I look at the effect of cigarette smoke.
How large would you say this field is?
Is there significant interest in researching COPD in Canada?
And a problem is that if you actually look at public awareness of COPD, then it is only
about 14% of the general population that knows what COPD is, which is a bit at variance or
at odds to the actual prevalence.
COPD is projected to be the 3rd killer by 2030 now.
The number for 2020 will supply the 4th killer.
It is a health problem; it is a fairly big health problem.
It is a problem that a lot of people don't know about.
The field is not that large at this point in time.
It is a big health problem but there is not as much research in it as there should be
in it.
In that respect, it should, if anything, it should grow.
It should get larger.
The part that is interesting about COPD research is that Canada is actually doing quite well.
Because some of the key proponents in that field are in Canada.
And who comes to mind?
That would be Jim Hogg.
Jim Hogg is one of the pioneers in that field.
What would you say is the most frustrating thing about COPD research?
Lack of funding.
And the lack of public awareness.
And probably to some extent, the denial of the patients that do have COPD.
Because they would often resort to, "It's a self-inflicted disease and it's my own fault"
-- not acknowledging that smoking, at the end of the day, is an addiction.
People do smoke, it is an addiction.
From that end, we need to know disease pathways.
Is it difficult for a COPD researcher to get funding?
At this point in time, getting funding is not easy, period.
It really doesn't matter in what area you are researching.
Is it now more difficult for COPD than for other disease?
And in there, the answer is probably yes.
Because there is the notion of it being a preventable disease, it being a smoker's disease.
Anti-smoking campaigns have done an excellent job at marginalizing smokers.
Cessation is critical.
Preventing people to start smoking is critical.
By the same token, we have a large patient population where we need to know what are
the mechanisms that contribute to the disease.
On top of that, another issue is smoking related diseases - there is a strong socioeconomic
component to it that the prevalence is higher in lower socioeconomic levels.
From that end, you don't have a rich affluent patient population.
Often times, you have a not very well educated patient population.
From a fundraising perspective, you are facing a little bit of an uphill battle.
Was there a time when your application was turned down in favour of another, less stigmatized
illness?
Being turned down, not necessarily.
Having said that, the flip side of the coin is, for other diseases there are very strong
funding agencies.
In there what comes to mind is the cancer funding agencies, the Heart and Stroke, diabetes.
There are a number of very strong organizations.
What is interesting in there is that if you look at cancer, a high proportion of cancers
are related to smoking.
Funding should actually go toward smoking related cancers.
In there we have lung cancer.
Lung cancer is now killing more people that prostate and breast cancer combined.
It is the number one killer.
If you look at the amount of funding that is going into lung cancer, then it is disproportionate.
COPD is projected to be the 3rd leading cause of death in 2020.
Does the current research funding climate reflect such a projection?
I think more researchers have to get involved into this kind of research, and then there
will be more funding going into COPD research.
As opposed to top-to-bottom, where you say, we've got to allocate specific funding.
You also have to have the pool of researchers that go in that direction.
What are some other struggles and barriers for COPD research?
Struggles and barriers of COPD, right, it comes down to chronic diseases in general.
I think that is where one of the fundamental issues lies.
In that, chronic diseases are often not clearly defined diseases.
They are more like syndromes.
You are actually dealing with a very broad patient heterogeneity, where one COPD patient
is not the same like the next one.
One of the challenges, one of the struggles is, the patient heterogeneity.
The other problem is that COPD is not a disease that develops overnight.
It is a disease secondary to years and years and years of smoking.
These are slow-developing diseases.
In there, to research slow-developing disease has its own logistics, logistical problems.
What about bans on research funding from tobacco companies -- do you have any experience with
that?
If you do research, respiratory research, and you take tobacco funding, then by and
large, you are banned from any activities of the American Thoracic Society, of the European
Thoracic Society, the list goes on.
Which, the ban means, a ban in presenting at the meetings, a ban in publishing at their
papers.
So it is a very real thing.
But ultimately, there was a lot of denial.
There was a lot of trying to bias research.
So there is a history there.
So tobacco companies have done things they should not have done.
One time a program that was at our arm's length, there still was, first of all, perception
that it was still tobacco and the reality that it could still be abused.
Should research not be able to obtain any tobacco funding?
I think it will have to be revisited.
It has to be revisited very carefully.
At the end of the day, if done properly, if monitored properly, if it really is in support
of the patient population and in the support of developing new knowledge how those diseases
develop, then I would think it should be okay.
But, it has to be truly at arms length.
At the end of the day, it has to be a company that will, by attempts to prevent people from
starting to smoke and attempts for cessation as well.
It has to be a concerted effort, but it is a very hot topic and there is no simple answer.