A conflict of interest exists when professional judgement concerning such primary interests as patients’ welfare or validity of research may be influenced by possible financial gain or personal rivalry. It may arise for the authors of an article when they have a financial interest that may influence their interpretation of their results or those of others.

The ERJ will not reject papers simply because of a conflict of interest but believe that any competing interests should be acknowledged and openly stated; therefore, a declaration of interest will be printed along side the final published article.

Name:
Manuscript Title:

1. Have you, in the past 5 years, accepted the following from an organisation that may in any way gain or lose financially from the results of your study or the conclusions of your review, editorial or letter, please answer yes or no:

Reimbursement for attending a symposium?                          YES/NO*      

A fee for speaking?                                                                YES/NO*

A fee for organising education?                                              YES/NO*

Funds for research?                                                                YES/NO*

Funds for a member of staff?                                                  YES/NO*

Fees for consulting?                                                                YES/NO*

Gifts exceeding €500 per year?                                                YES/NO*

2. Have you, in the past 5 years, been employed by an organisation that may in any way gain or lose financially from the results of your study or the conclusions of your review, editorial or letter? Please answer yes or no.

YES/NO* 

3. Do you hold any stocks or shares in an organisation that may in any way gain or lose financially from the results of your study or the conclusions of your review, editorial or letter? Please answer yes or no.

YES/NO*

4. Have you acted as an expert witness on the subject of your study, review, editorial or letter? Please answer yes or no.

YES/NO* 

5. Do you have any other competing financial interests? If so, please specify.

YES/NO*

6. Are you or have you ever been in any relationship with or receipt of any benefit (financial or other) from the tobacco industry or corporate affiliates? Please answer yes or no.

YES/NO*

7. Do you or your spouse knowingly hold any shares in the Tobacco industry? Please answer yes or no.

 YES/NO*

*Please delete as necessary

If you have answered "yes" to any of the above questions, the ERJ considers that you or your institution may have a conflict of interest, which, in the spirit of openness, should be declared. Please draft a statement to publish with the article detailing these interests and add it to this form. This statement will be published along side your article in the event of acceptance. An example of such a statement is given below:

Conflict of interests: JB has received an educational grant from Acme Pharmaceutical industries; KT has stocks in excess of £5000 in Grace Bros drugs plc; and travel to the ERS congress was funded by Acme Biotechnologies.

PLEASE ADD STATEMENT HERE:

If you did not answer "yes" to any of the questions above, we will publish "Competing interests: None declared."

The above questions are limited to financial interests; however, you might want to disclose another sort of conflict of interest that would embarrass you if it became generally known after publication. The following list gives some examples:

A close relationship with, or a strong antipathy to, a person whose interests may be affected by publication of your paper.

An academic link or rivalry with somebody whose interests may be affected by publication of your paper.

Membership of a political party or special interest group whose interests may be affected by publication of your paper.

A deep personal or religious conviction that may have affected what you wrote and that readers should be aware of when reading your paper.

If you want to declare such a competing interest then please add it to your statement.