What if this time they’re serious?
Philip Morris International’s call for a smoke-free world echoes cigarette makers’ past efforts to burnish their nicotine-stained image, but what if this time they’re serious?
“We allow science to be politicized and polarized at our peril.”
This comment, in a full-page advertisement in 2017 in The Wall Street Journal signed by former Philip Morris International (PMI) chief executive officer Andre Calantzopoulos, may be the most honest observation in recent memory by the head of a cigarette company.
It’s unfortunate that it wasn’t made by one of his predecessors 60 years ago on Jan. 11, 1964 when Dr. Luther Terry released “Smoking and Health: Report of the Advisory Committee to the Surgeon General of the U.S. Public Health Service,” the landmark document that indicted cigarettes as the principal cause of the rising epidemic of lung cancer.
“Cigarette smoking is causally related to lung cancer in men,” the report concluded. “The magnitude of the effect of cigarette smoking far outweighs all other factors.”
Instead, for the next half-century Philip Morris and the other cigarette manufacturers did everything possible to cast doubt on the report, to prevent the federal government from taking the “appropriate remedial action” against smoking called for by Dr. Terry, to continue making implicit health claims in cigarette advertising, and to wage war on science.
The tobacco industry would release a torrent of misinformation, sophistry, casuistry, and spin to debunk the growing evidence of the deadly dangers of smoking. It would continue to hire academics and government health officials to chant the industry’s mantra, “We just don’t know enough about smoking and health. We still need more research.”
Although the 10-member, multidisciplinary Advisory Committee to the Surgeon General, selected from a list of more than 150 public health and medical authorities generated by the Public Health Service and approved by the tobacco industry, would base its conclusions on a review of 7,000 published studies on smoking, the industry dismissed the findings as “statistical” and lacking clinical proof.
In addition, two months before the release of the report, the tobacco industry had quietly arranged with the American Medical Association (AMA) for it to retreat from its pledge to defer to the Committee’s findings on smoking’s role in disease. Instead, the AMA’s Education and Research Foundation (AMA-ERF) would conduct its own “independent” research on smoking and health—funded by $5 million from the cigarette manufacturers, a figure that would balloon to $18 million over more than a decade.
Incredibly, three members of the Surgeon General’s Advisory Committee agreed to serve on the AMA-ERF’s committee, and researchers at 54 US medical schools (plus 13 in other countries) would wind up accepting the tobacco industry largesse.
The AMA-ERF did not publish its own conclusions until 14 years later, and although they concurred with the Surgeon General’s findings from 1964, the industry had achieved its goal of buying the silence of America’s largest medical organization in the crucial years following publication of the landmark report. In a further setback, by 1967 the role of the Surgeon General had been reduced from directing the entire US Public Health Service to that of a figurehead, doubtless in retribution for the black eye Dr. Terry had inflicted on the almighty tobacco industry.
Koop: Charisma, but no cigar
Flash forward to 1982, by which time the American Cancer Society’s most visible effort against smoking was its three-year-old, one-day-a-year Great American Smokeout. Meanwhile the tobacco industry hadn’t skipped a beat in its forceful denial of smoking’s many harms.
Through its Council for Tobacco Research (CTR) and its public relations and lobbying operation, The Tobacco Institute disseminated statements by hirelings from academia that even the case against smoking as a cause of lung cancer was unproven.
“Lung cancer, like many other human cancers, remains a biological mystery,” said pathologist Sheldon C. Sommers, MD, scientific director of the CTR in testimony before a U.S. House of Representatives subcommittee hearing on proposed new cigarette health warnings in 1982. “The biomedical experimentation does not support the smoking causation hypothesis.”
Sommers was one of more than 30 scientists and physicians enlisted by CTR to submit testimony opposing the warnings.
By 1985, in response to the tobacco industry’s unending denial that smoking caused lung cancer (even as it introduced filters and other gimmicks to allay consumers’ fears and implicitly make cigarettes safer), Surgeon General Dr. C. Everett Koop used his bully pulpit to rally public support for anti-smoking measures, such as in these remarks at a press conference:
If you look at the biomedical literature of the past 30 years, you have to be impressed with the extraordinary amount of evidence that has been generated to prove the causal relationship between cigarette smoking and some two dozen disease conditions. The medical literature now holds an inventory of more than 50,000 studies regarding smoking and health. The overwhelming majority of them clearly implicate cigarette smoking either as a contributing cause or the primary cause of illness and death.
Now these are facts. They are part of the case built by medical researchers here and the world over for the past three decades, a case that is scientifically conclusive. And the verdict is clear: Smoking is the leading preventable cause of disease and death in this country.
But as with Dr. Terry’s entreaties for government action to deter and reduce cigarette smoking a generation earlier, even a plea from a charismatic surgeon general was not enough to dissuade Congress or state legislatures (mindful of huge cigarette tax revenues) and the mass media (covetous of cigarette advertising) from giving the tobacco industry the final say: “the science is inconclusive”; “Dr. Koop just wants a nanny state”; “we need more research.”
Alan Blum, professor and Gerald Leon Wallace, MD, Endowed Chair in Family Medicine at the University of Alabama, as well as the director of the Center for the Study of Tobacco and Society, is serving as a guest editor for the Cancer History Project this January to commemorate the 60th anniversary of the Surgeon General’s Report.
An interview with Blum and former HHS Secretary Louis Sullivan appears in this issue. More interviews and virtual exhibits on this topic are available through The Center for the Study of Tobacco and Society, on the Cancer History Project.
This column features the latest posts to the Cancer History Project by our growing list of contributors.
The Cancer History Project is a free, web-based, collaborative resource intended to mark the 50th anniversary of the National Cancer Act and designed to continue in perpetuity. The objective is to assemble a robust collection of historical documents and make them freely available.
Access to the Cancer History Project is open to the public at CancerHistoryProject.com. You can also follow us on Twitter at @CancerHistProj, or follow our podcast.
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