War. Mighty tobacco against the U.S. surgeon general, the Food and Drug Administration, federal and state and local politicians, the media, the no-smoking crusaders, lawyers for dead and dying cigarette smokers.
Attacks against cigarette makers grew more ferocious this year. Tobacco's skeletons popped out monthly in media exposes and in testimony before Rep. Henry A. Waxman's congressional committee hearings. Politicians papered the nation with proposed legislation to ban smoking here, there and everywhere. More recent, more ominous, is the FDA Drug Abuse Advisory Committee's conclusion that cigarettes could be classified as a drug because of nicotine. That decision is crucial if the FDA decides to regulate tobacco products.
Government control of nicotine alone portends a death rattle for tobacco's allure. At stake is $45.3 billion a year in cigarette sales and 2.3 million tobacco-dependent jobs. Understandably, cigarette makers dare not weaken. They must doggedly defend the smoke they sell. And money is their shield, their weapon. With it, they reward the friendly and savage the enemy through a legion of scientists, lawyers, publicists and lobbyists. Their approach is nothing new. It was conceived in 1953 during a similar anti-smoking frenzy--so far, it has worked.
What follows is a keyhole peek into the genesis, reasoning and execution of tobacco's strategy these 40 years. The story is told by the participants themselves through excerpts drawn from confidential notes, memos and letters never intended for public rummaging. We focus on the decade before and the decade following the 1964 U.S. surgeon seneral's report that concluded that smoking can kill.
It is 1953. New scientific studies have connected cigarettes to lung disease. America has awakened to the dangers of smoking. Scientists have begun to expose the connections between cigarettes and lung disease. Shaken by unrelenting bad press and declining tobacco stocks, the chief executive officers of six leading cigarette makers--American Tobacco Co., R. J. Reynolds, Philip Morris, Benson & Hedges, U.S. Tobacco Co. and Brown & Williamson--agreed that "drastic action" was necessary. They held a historic secret meeting Dec. 15, 1953, in New York City with John Hill, a founder of Hill & Knowlton, the world-class public-relations firm. Their mission was to plan tobacco's counterattack.
". . . before the current health crisis arose, cigarette manufacturers never met together at any time except at dinners honoring some industry leader. (Tobacco should) sponsor a public relations campaign which is positive in nature and is entirely 'pro-cigarettes.' The current plans are for Hill & Knowlton to serve as the operating agency of the companies, hiring all the staff and disbursing all funds." (Hill & Knowlton memo, Dec. 15, 1953.)
"The situation is one of extreme delicacy. There is much at stake . . . . There is nothing the manufacturers can say or refrain from saying that can stop people from being interested in their health, nor allay their fear of cancer. So long as the causes and cure of this dread disease remain unknown, people will be subject to waves of fear regarding it.
"We should create a committee with 'research' in the title so that the public recognize the existence of weighty scientific views which hold there is no proof that cigarette smoking is a cause of lung cancer . . . . The underlying purpose of any activity at this stage should be reassurance of the public . . . . this project would explore such questions as: Why do mice show no tendency to develop lung cancer in experiments where they live half their lives in smoke filled chambers? Why has the rise in lung cancer been most marked among men, although the greatest rise in the use of cigarettes in the last 25 years seems to have been among women? What are the benefits and enjoyment derived from smoking . . . ? What are the smoking habits of long-lived distinguished public leaders? What are the human ills erroneously attributed to tobacco over the centuries?" (Hill & Knowlton memo to cigarette executives, Dec. 24, 1953.)
Cigarette manufacturers followed Hill & Knowlton's advice. They formed the Tobacco Industry Research Committee in January, 1954, with a first-year budget of $1.2 million and supported by 23 Hill & Knowlton employees.
STOP THE PRESSES
The Tobacco Industry Research Committee's media blitz began with a two-page advertisement: "A Frank Statement to Cigarette Smokers," which appeared Jan. 5, 1954, in 448 newspapers with a cumulative circulation of 43 million. The ad was followed in April with "A Scientific Perspective on the Cigarette Controversy," a booklet quoting 36 scientists questioning smoking's link to health problems.
" (The booklet) was sent to 176,800 doctors, general practitioners and specialists . . . (plus) deans of medical and dental colleges . . . a press distribution of 15,000 . . . 114 key publishers and media heads . . . . days in advance, key press, network, wire services and columnist contacts were alerted by phone and in person . . . and . . . hand-delivered (with) special placement to media in Los Angeles, Chicago, Cleveland, Pittsburgh and Washington, D.C. The story was carried by hundreds of papers and radio stations throughout the country . . . . staff-written stories (were) developed with the help of Hill & Knowlton, Inc. field offices." (Hill & Knowlton memo, May 3, 1954.)
"The proposed Argosy piece, by Dick Reddy, is now scheduled for the August issue and the latest revision we have seen in proof form shows that it will be an extremely positive piece." (May 25, 1955.)
Next, a June press conference introduced the committee's new scientific director, Dr. Clarence Cook Little, a cancer researcher.
" (The press conference) was covered by Dave Garroway's NBC-TV program, Today. Delos Smith, UP Science Editor, filed a very complete story of 600 words. AP filed two stories, one 80 words and the other 120 words . . . . AP radio to 1,400 stations . . . UP-Movietonews to 80 some TV stations; MGM-Telenews to 80 some TV stations . . . ." (Hill & Knowlton memo, June 18, 1954.)
" (The research committee) now has the basis needed for carrying on a long-range plan of public relations . . . establishing the (research committee) in the public mind as a constructive force in scientific research . . . . research should be carried forth on . . . current scientific opinion holding that no case has been proved against tobacco . . . . how the public is carried away by over-simplified reading of scientific experiments." (Hill & Knowlton memo, June 21, 1954.)
"Although the industry has been bedeviled by sensational headlines generated often by publicity seeking researchers . . . the trend is beginning to turn . . . . The bulk of editorial comment now appearing approves and, at times, applauds the action of the industry . . . . Advance knowledge was obtained of a story on smoking by Bob Considine for Cosmopolitan Magazine. Information was supplied resulting in seven revisions . . . to the story which was already in type. . . . One negatively aimed program (WNBT) . . . was postponed after discussion (with us). Another TV program (ABC-TV, Martin Agronsky) . . . ended on a favorable note after conferences (with us) . . . . Assistance was provided to the New York Times for a Sunday magazine piece . . . . Special conferences are held with AP, UP and INS science writers." (Hill & Knowlton secret memo, July 17, 1954.)
Hill & Knowlton documents describe sit-down sessions with the New York Times, AP, UP, INS, Coronet magazine, the New Yorker, New York Post, Time, Newsweek, U.S. News & World Report, Business Week, Cosmopolitan, the New York Daily News, the New York World Telegram & Sun, Real magazine, Redbook, Bluebook, Harper's, Look Magazine, Life and Reader's Digest.
According to an Oct. 7, 1954, memo, TIRC researchers pitched tobacco's case in private meetings with Arthur Hays Sulzberger, president and publisher, New York Times; William Randolph Hearst Jr., president and publisher, Hearst Consolidated Publications; Mrs. Helen Rogers Reid, chairman of the board, New York Herald Tribune; Jack Howard, president, Scripps-Howard Newspapers, and Roy E. Larsen, president, Luce Publications. Hill & Knowlton reported that the publishers felt that "the sessions had been most helpful in clarifying the Tobacco Industry Research Committee program."
" (We have compiled) a cross indexed card file . . . on medical and scientific papers regarding smoking and health . . . in some 2,500 medical journals . . . . a cross indexed card file on medical opinions . . . as noted in press, radio and other popular media is compiled . . . ." (Hill & Knowlton report, "considered highly confidential . . . . no additional copies be made . . . this copy not be placed in files," Aug. 17, 1954.)
Tobacco's strategy was reflected in newspaper headlines: "Lung Cancers Found in Non-Smoking Nuns," "Air Pollution Blamed for Lung Cancer," "New Survey Disputes Tobacco-Cancer Link," "Finnish Doctor Challenges Cigaret-Heart Ill Link," "Lung Cancer Linked To Auto Exhaust," "Japanese Research Finds No Link Between Lung Cancer, Cigarettes," "Heavy Smokers With Low Mortality," "Cigaret Theory of Cancer Hit," "Three Scientists Raise Questions About Cigarette-Cancer Theory."
Research committee publicists nurtured such pro-smoking articles as "Go Ahead and Smoke Moderately" in Pageant magazine; "Phony Lung Cancer Scare," in People Today; "Who Says Smoking Gives Men Lung Cancer?" and "Smoke Without Fear," published by True magazine.
"The first big scare continues on the wane . . . . the lynching party seems to have been called off, at least temporarily. Treatment of the cigarette-health issue in public media continues to improve from the Tobacco Industry Research Committee's point of view. Even adverse stories now tend to carry modifying statements. Positive stories are on the ascendancy . . . . The research program . . . has won wide acceptance in the scientific world as a sincere, valuable and scientific effort.
"On the other side of the ledger . . . . Anti-tobacco crusaders continue to ride the health issue." (Hill & Knowlton memo, April 28, 1955.)
Then the other shoe dropped. In 1960, U.S. Surgeon General Dr. Luther L. Terry announced the "need for a new look . . . that smoking has adverse health effects." A committee that Terry formed in 1962 delivered its report in January, 1964, and forever changed the country's view toward cigarettes. Drawing on studies of 1.2-million smokers and thousands of animals exposed to tobacco, the 387-page report declared that smoking can cause cancer of the mouth, larynx, esophagus and lung, plus chronic bronchitis, emphysema, heart disease, stunted babies and other ills.
In response, the Tobacco Industry Research Committee was reorganized, expanded and renamed the Council for Tobacco Research (CTR).
Hill & Knowlton ended its relationship with the council in 1968. "The Council for Tobacco Research has served no public relations function since that time," says Dr. James F. Glenn, who is currently chief executive officer of the CTR.
To date the council has handed out $242 million in research grants to institutions in 44 states and 12 countries. Among them were Harvard, Dartmouth, MIT, Rutgers, Columbia, Cornell, Yale, Notre Dame, Stanford, USC, the University of Texas, Houston, and six schools in the University of California system.
After the 1964 surgeon general's report, the research council began recruiting and funding scientists to debunk anti-smoking research.
". . . the industry must somehow find a way to make an effective technical rebuttal to the arguments of the anti-cigarette forces. Only in this way will the present burden be lifted from us. . . . Our philosophy is not to start a war, but if war comes, we aim to fight well and to win." (Philip Morris internal memo, Oct. 28, 1964.)
" (The Council for Tobacco Research is) the best and cheapest insurance the tobacco industry can buy and without it the Industry would have to invent (it) or would be dead." (CTR official's handwritten note, mid '60s.)
" (The Council for Tobacco Research) provides (the tobacco industry) with its own scientific experts who may also serve as scientific spokesmen . . . (to) disprove the allegations that smoking is a primary etiological factor in some diseases . . . . If we are satisfied . . . we could encourage its publication." (CTR memo, Oct. 18, 1965.)
Favorable studies were summarized in the research council's annual reports until 1976 and publicized in press releases. Here is a representative sample:
" (Test) results lend little to support the hypothesis that cigarette smoke can act as a direct contact carcinogen in the human lung." (CTR annual report, 1964-65.)
"Association between lung cancer and smoking is 'incomplete.' " (CTR annual report, 1965-66.)
" (The increase in lung cancer) has been exaggerated considerably by the progressively increasing skill of clinicians in diagnosis . . . leading to overdiagnosis." (CTR annual report, 1966-67.)
"Many experiments . . . have failed completely to produce lung tumors . . . with cigarette smoke . . . in lungs of ducks, hamsters and mice." (CTR annual report, 1968-69.)
"Vital statistics for the past 15 years do not show a significant rise in reported cases of bladder cancer. Hence, the reported statistical association (between smoking and bladder cancer) has lacked rational explanation." (CTR annual report, 1968-69.)"
Heart Disease and Hypertension: "Persons who stopped smoking showed significantly LESS cardiovascular disease incidence than those who had never smoked at all." (CTR annual report, 1964-65.)
". . . studies suggest that the physiological act of eating sugar prevents the cardiac effects of smoking." (Research council scientists' abstract, 1964.)
"Rabbits or hens . . . did not show any convincing differences in the condition of their arteries if given nicotine regularly." (CTR annual report, 1964-65.)
"An entirely unexpected finding was the higher prevalence of coronary heart disease among non-smokers than among ex-smokers, a paradox which casts doubt upon the alleged role of smoking in the genesis of coronary heart disease." (Research council scientists' abstract, 1965-66.)
"There have been reports claiming a relationship between smoking and hypertension, but, paradoxically, it has been found that men who are heavy smokers generally have lower blood pressure than non-smokers." (CTR annual report, 1968-69.)
Pregnancy: "A significant question that remains unanswered is whether the decreased birth weight of infants born to smokers is detrimental." (Research council scientists' abstract, 1965-66.)
"While this report clearly indicates that nicotine modifies uterine function in the rat . . . the authors emphasize that the results cannot be extrapolated to women who smoke." (Research council scientists' abstract, 1978.)
SMOKERS DO IT BETTER
Nicotine. The bottom line.
"We need to stress the benefits that sixty million smokers derive from the use of our products." (Philip Morris memo, February, 1971.)
"Nicotine stimulates the learning process, more particularly among the animals that are originally relatively slow learners." (CTR annual report, 1966-67.)
"In short, the chronic administration of nicotine appeared to stimulate the brains of the rats, making the animals function more effectively." (CTR annual report, 1970-71.)
"Without nicotine . . . there would be no smoking. No one has ever become a cigarette smoker by smoking cigarettes without nicotine. Smoke is beyond question the most optimized vehicle of nicotine and the cigarette the most optimized dispenser of smoke. Think of the cigarette pack as a storage container for a day's supply of nicotine. Think of the cigarette as a . . . dose unit of nicotine." (Confidential Report, Research Council Conference, St. Martin Island, the Caribbean, 1972.)
"Habitual smokers proved more efficient and better able to sustain performance when they smoked than when they did not." (Research council scientists' abstract, 1975.)
"Under (nicotine's) influence there is greater retention of learning . . . . It would appear to be the perfect tranquilizer. (Research council scientists' abstract, 1977.)
BLAME THE SMOKER
Research committee scientists scavenged other explanations for smoking's growing disrepute.
". . . inherited or genetic make-up causes predisposition to smoking and lung cancer. To prove this is the industry's best hope." (Handwritten council memo, March 21, 1975.)
". . . A number of factors . . . that differ in smokers and nonsmokers and may be predictors of early heart and artery disease. Still another researcher has found a significant difference in basic brain wave patterns of smokers and nonsmokers." (CTR annual report, 1968-69.)
"Heavy smokers are characterized by features of: defiance, impulsiveness, danger seeking, neurotic lability, and oral preoccu- pation . . . . relationships with their fathers were more disturbed." (Research council scientists' abstract, 1970.)
". . . heredity and smoking probably contribute about equally to the likelihood of developing (lung) disease." (Research council scientists' abstract, 1970.)
"The earlier death of those that smoked more and those that smoked cigarettes was due to the fact that they were born later and lived at a time when there was more smoking, rather than because smoking was life-shortening . . . . Individuals die essentially at a single point in time, one cannot precisely measure the effect of smoking on longevity since the probability of a given individual being a cigarette smoker or non-smoker is related to the birth year!" (CTR annual report, 1970-71.)
DON'T TREAD ON ME
Punch and counterpunch became tobacco's strategy.
"In this area (of lung disease), the statistics are even more confused and of more dubious accuracy than they are in the case of cancer or (heart) diseases, by reason of problems of diagnosis and nomenclature." (CTR annual report, 1966-67.)
". . . changes in the popularity of such terms as 'emphysema,' may have resulted in a fictitious increase in reported prevalence rates." (CTR annual report, 1969-70.)
"We need to call attention to the exaggeration and lies of the anti-cigarette zealots . . . ." (Philip Morris report, 1971.)
". . . Any assumption that the results (of painting mice with cigarette tar) can be extrapolated directly to other species, especially man, is highly presumptuous." (CTR annual report, 1973.)
"We have gone over from . . . the 'vigorous denial' approach, the keep quiet and take it on the chin attitude, to the strongly voiced opposition and criticism . . . . this counter-propaganda is a better stance . . . . We need to give the scholarly reply to the improper studies." (Philip Morris internal report, 1981.)
"Attacking bad research . . . attacking researchers themselves, where vulnerable." (Philip Morris memo, March 24, 1981.)
Dr. Freddy Homburger, a scientist funded at the time by the research council, scheduled a press conference at a scientific convention in Atlantic City in April, 1974, to accuse the tobacco industry of attempting to suppress important findings about the harmful effects of smoking.
"Got press conference killed without (Homburger) knowing why or how. . . . He came into the press room . . . and nicely hastened out the door. . . . I doubt if you or Tom will want to retain this note." (A confidential memo from Leonard Zahn, a long-time research council publicist, April, 1974.)
AND THE BEAT GOES ON
In 1990, fifth grade students at Willow Ridge School in Amherst, N.Y., wrote R. J. Reynolds Tobacco Co. about smoking advertisements and health. A company publicist replied:
"Dear Sir or Madam:
"A number of your fifth grade students have written (about smoking advertisements and) . . . about the controversies surrounding cigarette smoking. The tobacco industry is also concerned about the charges being made that smoking is responsible for so many serious diseases. Long before the present criticism began, the tobacco industry in a sincere attempt to determine what harmful effects, if any, smoking might have on human health, established The Council for Tobacco Research--U.S.A.
"Despite all the research going on, the simple and unfortunate fact is that scientists do not know the cause or causes of the chronic diseases reported to be associated with smoking. . . . We would appreciate your passing this information along to your students."
Science Bought and Sold
A hand-scrawled note from the 1960s rated 44 scientists as to "which ones might be the greatest benefit to the (tobacco) industry." The note was written by an official of the Council of Tobacco Research, which funds scientists with tobacco money. The note ended: "Use (the ratings) for what you think they might be worth and throw the paper away."
On of the 44 was Dr. Gary Friedman, now 60, of the Kaiser-Permanente Medical Care Program in Oakland. "I needed support for research back then," he explains. "They were very interested in how smokers differed from nonsmokers in health and mortality." Friedman worked with Carl C. Seltzer, a Harvard anthropologist, whom the research council considered a favored scientist who has consistently criticized anti-smoking research. Friedman now says that at first he "compromised" with Seltzer on their early studies.
After a further study convinced him that "quitting smoking really seemed to do some good," Friedman says, Seltzer and the research council "disassociated themselves" from those findings. Friedman published his results in the New England Journal of Medicine in February 1979. Seltzer wrote the to Journal: "These authors conclude that stopping smoking appears to result in a substantial reduction in coronary mortality. I find the procedures used in their article to be questionable and the conclusions to be unjustified . . . ."
"Just as well," Friedman reflects. "There's a feeling in this building today of the wish we had never taken that money."
Seltzer, now retired, insists that Friedman "wanted to continue getting money from the council but didn't want me to have an equal say. His link to smoking and mortality was two or three times more than anybody in the country. Sure, the council gave me and Harvard a lot of money . . . maybe a million or so. I was at it for a great many years. The council liked my research. I also showed there was no relationship between heart disease and smoking. And this business of secondary smoke, passive smoke, is absolute nonsense . . . nonsense. I don't care what the surgeon general says! What does the surgeon general know! He only knows what he is told!"
In fairness, Seltzer and others argue that many research council grants have little to do with smoking or are sometimes critical of it. But there's little disagreement that the research council's influence on anti-smoking scientists went beyond money.
"Scientists by their very nature are very cautious," adds Michael Cummings, a senior research scientist at the Roswell Park Cancer Institute in Buffalo. "That's one of the things the tobacco industry has exploited. They look for people to run counter. If the tobacco industry can find a person or two to expound the opposite view, it creates controversy, casts doubt on the other scientists. They won't say what they believe. It's science by intimidation. Controversy means no grants, no funding, no tenure. Money is something scientists must have and the tobacco industry and the research council have plenty of it."
"The tobacco industry trained anti-smoking researchers to be irresponsibly cautious," says Stanton Glantz, a professor of medicine at UC San Francisco. "Tobacco industry intimidation causes the health community to apply a standard of proof so high on smoking dangers it consistently has understated the risks of smoking and has historically delayed actions year after year. The tobacco industry jumps up and down and screams controversy! It gives cigarette companies their best asset--credibility. It's a fig leaf for the politicians."
After the release of the 1964 surgeon general's report, the Council for Tobacco Research bombarded anti- smoking studies with a thesaurus of skeptical words, phrases and clauses.
"Fails to support . . . tenuous and inconclusive . . . still quite obscure . . . little evidence at present . . . no clear picture has emerged . . . lacked adequate controls . . . misdiagnosis . . . still no assurance . . . lend little to support . . . did not sustain any claims . . . suggest attention to the smoker rather than the smoke . . . speculative . . . baffling . . . superficial . . . unanswered . . . masked . . . overdiagnosis . . . fictitious . . . does not duplicate real life situations . . . still little is understood . . . many anomalous and contradictory aspects . . . no firm evidence . . . problems of diagnosis and nomenclature . . . misstated or overstated . . . an impressive failure . . . still remain to be explored . . . cannot be concluded . . . dubious accuracy . . . confusion of contradictory findings . . . welter of fragmentary, confusing and inconclusive observations."
The story draws from three main sources:
Documents reported by Richard W. Pollay, curator of The History of Advertising Archives, University of British Columbia, Vancouver. They include personal papers donated to the State Historical Society of Wisconsin by John W. Hill of Hill & Knowlton, Inc., the public relations giant hired by the tobacco industry.
Court exhibits and transcripts compiled by the Tobacco Products Liability Project, School of Law, Northeastern University, Boston.
Annual reports of the Council for Tobacco Research, 1964 to 1993.