Doctors Who Grow Tobacco Questioned
Hundreds of doctors across the country own and profit from tons of tobacco, despite decades of health warnings, scolding from peers and in some cases their own ethical reservations.
They’re family practitioners who warn teenagers not to smoke, psychiatrists who treat addiction, oncologists who identify malignant tumors and surgeons who remove them.
One tobacco-owning doctor was a longtime regional medical director for the American Cancer Society. Another runs a public health department. A third writes a newspaper’s health tips column.
Almost none smoke themselves.
“I won’t smoke,” says Stephen Jackson, an orthopedic surgeon in Paducah, Ky., who co-owns the government rights to grow 1,400 pounds of burley tobacco a year. “I mean, it will kill you.”
All tell their patients not to smoke or chew tobacco.
“I get mad with them, fuss at them every day,” says Richard Rush, a family practitioner from Conway, S.C., with more than 11,000 pounds of flue-cured tobacco allotted to his farm.
Nonetheless, they are among at least 760 doctors and other health care workers who own valuable federal tobacco-growing rights, known as allotments or quotas, according to a computer analysis by the Associated Press. They practice in 23 states, from Florida to Alaska, Georgia to Wisconsin.
Some of the doctors own minuscule government rights, as little as 21 pounds annually; one in South Carolina has 932,000 pounds.
All told, these doctors control production of more than 7 million pounds of tobacco--enough to make 193 million packs of cigarettes a year. They also grow nearly 290,000 pounds of the varieties of leaf used in chewing tobacco and cigar wrappers.
At last year’s sales prices, their leaf would be worth $13 million-- although a large portion of that goes to family members, sharecroppers and those who lease much of the crop.
For professionals who have taken an oath not to do harm, those numbers are “shocking and disappointing,” medical ethicist Arthur Caplan says.
“I think you just cannot argue that you’re going to make money on the back of this obvious health menace,” says Caplan, director of the Center for Bioethics at the University of Pennsylvania. “To own and farm and produce tobacco as a doctor, especially in small communities, sends a resoundingly wrong message.”
The fact that many of these doctors grew up in those small communities is often their reason for being involved in tobacco. Even so, some are uneasy about it.
Dr. Edwin Norris has no doubt that a three-pack-a-day habit hastened his father’s death at age 53 from coronary disease. And the Mountain City, Tenn., general practitioner and cosmetic surgeon has little doubt that tobacco produced under his 1,925-pound quota is harming other people’s fathers.
“Even though it’s legal,” Norris says, “we’re still responsible for some of the effects of it.” His explanation for keeping the tobacco: Neighbors who actually raise it for him need the poundage to make a living.
Other physicians bought their farms as investments and acknowledge that tobacco proceeds contribute to their wealth.
Although they may only get a nickel to 15 cents a pound for leasing their tobacco rights to farmers, quotas help pay mortgages and add to the land’s assessed value. With talk in Washington about possible $8-a-pound federal tobacco buyouts someday, the leaf could constitute an even more valuable asset.
“I’m too greedy,” George Burrus, a cardiovascular surgeon in Nashville, Tenn., says when asked about his decision to keep his 6,500-pound quota, even though he says he knows tobacco is “killing people.” He clears about $4,000 a year from leasing his leaf.
“I don’t worry about it enough to [sell out] since I don’t feel like, say, the guy that’s raising dope.”
The AP identified these doctors by cross-checking a federal farm database with medical rosters from tobacco states. To verify matches, the AP contacted scores of physicians by telephone.
Some hung up when they heard the word “tobacco.” Most who stayed on the line expressed ambivalence.
“Absolutely schizophrenic” is how Dr. William Grigsby described the notion of physicians growing tobacco.
“It’s crazy, but I’ll tell you why we do it,” says the general surgeon from Kingsport, Tenn., who owns about 3,700 pounds of quota. “Almost the only doctors who raise tobacco have grown up on the farm and have the kinfolks there.”
One is Richard Calhoun. He was raised on a tobacco farm, and tobacco money helped put him through college and medical school.
On Wednesdays, when other doctors hit the golf course, Calhoun dons bib overalls and a baseball cap and drives a beat-up red flatbed truck around his mountainside farm in western North Carolina. He raises hay, cattle, Christmas trees and about 7,000 pounds of burley.
“Tobacco is a proud heritage for North Carolina,” says Calhoun, who practices in Jefferson, near the Tennessee line. “I want to maintain that part of my heritage.”
So while he lectures his three children--ages 9, 11 and 13--on the ills of smoking, he makes sure they help out on the farm.
“They’re still young, but they know what it is to work in the dirt--and that this is actually a cash crop that can be grown for farm income.”
He knows the links between the crop he grows and diseases he treats, from cancer to heart disease. Is that inconsistent?
“I do feel that tobacco is harmful to one’s health,” Calhoun replies. “But more importantly than that, I feel that, as citizens of the United States, we have the freedom of choice. And I don’t think that governmental regulation should infringe upon one’s ability to make choices in this regard.”
Dr. Wendell Levi Jr. agrees. In 45 years as a thoracic surgeon, he has removed cancer-ravaged lungs, but he has little sympathy for smokers.
“If they’re stupid enough to smoke, that’s [their] business, I suppose,” says Levi, a Sumter, S.C., tobacco owner. “I’ve never had time to feel guilty about something like that.”
Yes, he urges patients to quit smoking. “But it’s not very effective.”
Given the addictiveness of nicotine, quitting may not really be a choice, as even some tobacco-owning physicians acknowledge.
William Gause, a family practitioner in Columbia, S.C., says he quit cigars shortly before the U.S. surgeon general first warned against smoking’s health hazards. But he knows how hard it is for others to stop.
“It’s easier for me to get somebody off of, say, cocaine, than it is to get them off of tobacco,” Gause says.
Still, he says he never gave much thought to how his 3,000 pounds of allotment, passed down through the family for three generations, might be fueling that addiction.
“I’ve so many other things going right now,” Gause says. “I’ve never really sat down to think about it. I may feel that way when I do--if I do.”
Others have thought about it--a lot.
John Patterson, family practitioner and owner of a 900-pound quota in Irvine, Ky., has reached a moral bargain with himself.
He is the Kentucky Medical Assn.'s liaison with two farm health groups and says the $230 a year he earns from tobacco pays for the gasoline he uses traveling the state trying to help farmers diversify from burley.
“I think the question is: What is that doctor doing with that base?” Patterson says. “That is the way I’ve dealt with my ethical dilemma.”
Elizabeth Ward feels as if she’s a hostage of tobacco.
Ward, a physician’s assistant in Wilmington, N.C., watched two years ago as her father slowly succumbed to smoking-related emphysema 15 years after he’d quit.
Around the same time, Ward bought a farm from her aunt because it adjoins her mother’s property. The farmer who rents her mother’s tobacco allotment says he can continue doing so only if he can also continue renting the tobacco on Ward’s property.
“I’m a crusader against tobacco,” Ward says between patients. “Every day, all day long, I talk to sick people, and a lot of their problems come from their bad habits--and bad habits I indirectly promote.”
But her mother wants to live out her days on a working farm. So Ward keeps her connection to the industry and takes her $300 annual share of the tobacco lease money.
Many physicians make more than that on their tobacco.
Dr. Pickens Moyd answers several questions in a phone interview, but when the issue turns to how much the Hartsville, S.C., surgeon earns from his 2,000 pounds of tobacco, irritation creeps into his Southern accent.
“I’ll tell you what,” he tells a reporter. “You send me a check for half of what I’ll lose, and I’ll eat the other half. . . . You’re not going to cough it up to stop this cigarette thing.”
Frank Sessoms, a family practitioner in Pittsburgh who owns 2,200 pounds of allotment on a North Carolina farm that’s been in his family for generations, also voices indignation. He’s not part of some social problem, he says.
“I have a lot of patients, man, who always make excuses for themselves, for their behavior, whether it’s alcohol, cocaine, tobacco, food,” says Sessoms, one of 10 children of a steel mill worker.
The income that oncologist Stanley Sides of Cape Girardeau, Mo., makes from 3,200 pounds of tobacco grown on his farm, four hours east in Kentucky, is shared with a now-elderly neighbor who has helped tend the crop for 25 years.
But he resents being singled out as a physician.
“You could argue that the farmers in South and North Dakota that raise barley [for beer companies] are also contributing to a product that . . . hurts the lifestyle of many families. The issue is how far we take it.”
AP news data manager Drew Sullivan performed computer analysis for this report.
(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)
The federal government grants people the right to grow tobacco in specified amounts, known as quotas and allotments. The Depression-era program was established to restrict annual production and stabilize prices.
The program is supported largely by a fee that farmers pay per pound. There are penalties for nonparticipation or exceeding one’s quota/allotment.
Quotas are the allowed poundage that can be raised by growers of burley, an aromatic tobacco cured on the stalk. Allotments measure the pounds and acreage apportioned to growers of the other main variety of U.S. tobacco, flue-cured.
These two varieties go into American blend cigarettes, along with lesser amounts of other leaf.
Both varieties must be farmed by the owner or rented out two of every three years or the quota/allotment lapses. A lapsed flue-cured allotment goes back into a county pool, but a burley quota that lapses is lost forever.
Both can be bought, rented or inherited. Some families treat the tobacco rights as a sort of bond or asset.
(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)
How Survey Was Done
The Associated Press cross-checked two primary sources to find at least 760 doctors and other health care workers who own tobacco-growing rights:
* A U.S. Department of Agriculture database of tobacco owners.
* Medical licensing records from the following 12 states where the government administers tobacco price-support programs: Florida, Georgia, Indiana, Kentucky, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Virginia, West Virginia and Wisconsin.
Apparent matches were confirmed through checks of property and other records, and phone interviews. Because of incomplete data, hundreds of other likely matches could not be confirmed.
Doctor data was not obtained for Alabama, Arkansas and Kansas because so little leaf is grown there--although some tobacco-owning doctors were found in those states. Tobacco is grown without price supports in Connecticut, Illinois, Maryland, Massachusetts and Pennsylvania; ownership records for those states were not publicly available.