FWO Fellow at Ghent University, Ghent, Belgium
In this third and final chapter on the history of the tobacco industry and its product, I discuss the role the Hill & Knowlton marketing company played in creating a deception of the general public. The Frank Statement, the Tobacco Industry Research Committee, the Tobacco Institute, mass-marketing techniques, and extensive lobby-work were all part of a strategy to lead the American public to believe that there still existed a scientific controversy on smoking despite the fact that the tobacco companies’ own scientists had convincing evidence to the contrary. These tactics by the tobacco industry are key elements of the testimony of expert historians in tobacco litigation today.
Doubt is our product, since it is the best means of competing with the “body of fact” that exists in the mind of the general public.
Brown & Williamson Tobacco Company (1969)
The discovery by medical scholars of a clear causal link between smoking and disease alarmed the tobacco industry. In the decades following 1950, tobacco companies devised strategies that would question the health impact of smoking. These elaborate tactics allowed the industry to escape liability while continuing its destructive business. In the following chapter, I address two particular strategies: The first was the construction of a scientific controversy by hiring industry-friendly scientists who would produce research funded by the tobacco industry, which questioned the causal link between smoking and disease. I discuss the legacy of the tobacco industry’s incentivized “scientific research.” For decades the tobacco companies have used science to further a myth of controversy surrounding cigarette smoking and lung cancer or other respiratory diseases. A second strategy of the tobacco industry has already been referred to in the previous chapters: that of mass-marketing. I discussed it as one of the seven essential steps taken in the rise of the cigarette.1 To further defend their product, the industry added a third tactic to their scheme. Tobacco companies reinforced their marketing relations strategy with huge lobbying networks. This powerful system was well funded and influenced politicians, news reporters, legislators, jurors, advocates, doctors, and the general public on a national, state, and local level. The Tobacco Institute and its influence has already been referred to in the previous chapter.2 Both of these strategies have been active components in the construction of the cigarette controversy.
This chapter focuses on the creation of and the efforts to maintain a scientific controversy on smoking by the tobacco companies while simultaneously conducting an enormous marketing campaign and lobbying strategy to convince the public of the controversy’s existence. Furthermore, this is a very important issue in tobacco litigation and the expert testimony of historians.
12.1 The Tobacco Controversy: A Careful Construction
In the early 1950s, the tobacco industry was faced with a serious threat to its future. Scientific research that linked smoking and cancer created a potential disaster for the tobacco companies.3 However, the tobacco companies were determined to offer a collective response to save its industry. They had succeeded in constructing the best possible image of their product for over half a century, and now that fragile creation was at risk. The tobacco industry mounted an unprecedented public relations campaign, which claimed to be supported by “scientific research.”4 This strategy “required intrusions into scientific process and procedure.”5 The tobacco companies hired scientists of their own to counter the results from medical research, which reported at an augmenting rate that smoking cigarettes was unhealthy. Titles like “Smoking a Cause of Cancer.”, “Cigarettes and Cancer.”, “Cigarette Hangover.”, “Beyond any Doubt.” and “Fresh Hope but Hard Reality: Cubebs or Coffin Nails.” fuelled public anxiety that smoking was dangerous.6 In 1952, Reader’s Digest, the most widely circulated American periodical at the time, published a piece under the title “Cancer by the Carton.” The article referred to numbers disclosed by Dr. Alton Ochsner, a former president of the American Cancer Society, who did research on the health effects of smoking. His figures indicated that in only one decade, from 1938 to 1948, the number of lung-cancer deaths had increased by 144 %.7 The industry tried to appease rising public concerns with health warranties in advertisements. Eventually, these assurances would come back to haunt the tobacco companies in litigation decades later.8
On December 14th 1953, the CEO’s of the tobacco companies attended a meeting in the Plaza Hotel in New York City. Representatives from the tobacco industry felt the growing pressure from health advocates and the general public. On top of these problems, several industry scientists had confirmed in internal documents that there was a causal link between smoking and cancer.9 The meeting at the Plaza Hotel was organized to handle these dangers collectively.10 Rivalry was put aside for the sake of common interest, even at the risk of being faced with another antitrust investigation.11 Paul Hahn, president of the American Tobacco Company in 1953, responded in a press release to the American public: “I feel a statement of reassurance to the public should be made. What the public wants to know about is whether it is true that smoking has been proved to contribute to the incidence of lung cancer. The fact, of course, is that it has not been so proved.”12 The definition of “definitive proof” would remain a very important issue in the cigarette controversy.13 T.V. Hartnett, president of Brown & Williamson at the time, stated in an internal memorandum the importance of “challenging these findings [scientific research that argued there was a link between smoking and cancer] ethically and effectively without rancour-to win friends rather than to create enemies.” Hartnett further outlined two approaches that would dominate the industry’s strategy for the coming years: cancer research and public relations would make up both sides of the same coin. The public relations offices of the tobacco industry had to anticipate handling “significantly negative research results, if, as, and when they develop”, according to Hartnett in 1953.14
The next day –December 15th 1953-, executives from tobacco companies met with John W. Hill. As president of the public relations firm Hill & Knowlton, Hill already had a long and lucrative relationship with the tobacco companies. Hill worked with the tobacco industry since the 1930s. He had also been involved with liquor and chemical industries, who had also faced health issues with their products in the past. Until then, mass-marketing had been tobacco’s tool to bend social convention and mores on cigarettes. Hill now also used it to distort and deny important scientific data.15 Hill himself had stopped smoking in the 1940s due to health reasons. The tobacco industry decided to enlist the services of Hill and his company in order to help shape their collective response.16 Hill argued that the final result would depend on strict collective and collaborative action from the tobacco companies. He also identified two key elements of the industry’s response. (1) Public confidence could not be achieved by advertising, which is by definition self-interested. (2) Secondly, and crucial to the whole scheme, the tobacco companies had to assert authority over the scientific research on the health hazards of cigarette smoking. Science had the distinct advantage that it had a reputation of disinterestedness.17 The moral value of science in American culture had to be used by the tobacco companies. Since the industry was now threatened by science, the tobacco companies had to ‘secure’ science.18 The public relations work could leave no fingerprints in its scrupulous behind-the-scenes management of media.19 Simply conducting ad hominem attacks aimed at researchers or full-out denial of the statistical coincidence would only alienate the public, Hill realized.20 Therefore, Hill’s strategy concentrated on engineering a controversy, which questioned the causal link between smoking and disease. The industry’s own tobacco research would insist that there were always two sides to a story and further research was needed for conclusive evidence.21
The following weeks, Hill’s company and tobacco executives acted in crisis mode in order to further shape the strategic answers on the current threat. Hill concluded that the tobacco industry had to become a major sponsor of medical research. This offered several advantages. The tobacco companies could control research agendas and the results could be presented as independent scientific work. Science and the information it produced were to meet the goals of the public relations strategy.22 With the assistance of Hill, the tobacco industry reacted to the health issue as a united front. Their collaboration would persist for almost five decades after 1953.23 This understanding amongst tobacco companies is also known as “the Gentleman’s agreement.”24
On the 4th of January 1954, the tobacco industry published a “Frank Statement.” The statement was published as an advertisement in 448 American newspapers in 258 cities. Hill and his team offered the American public a first taste of the tobacco industry’s new public relations strategy. The text read as follows:
We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business.
We believe the products we make are not injurious to health.
We always have and always will cooperate closely with those whose task it is to safeguard the public health. 25
The Frank Statement also questioned the validity of the scientific research linking cancer to smoking cigarettes. To clarify the controversy, the tobacco companies announced the creation of the Tobacco Industry Research Committee (TIRC). This independent institution funded by the industry would contribute to the “scientific research” already underway at individual tobacco companies.26 The immediate goal of the Frank Statement was to silence the criticism on the industry and its product. In the long run, the statement served as a guide for industry scientist and advocates. Reactions to the statement, and thanks to expert scheming by Hill & Knowlton, were fairly positive. The industry was credited by several newspapers for creating the TIRC.27 In an article from 2002, health advocates assessed the promises made by the industry in the Frank Statement from 1954. They convincingly showed that the tobacco industry had failed to inform the public about the health risks of their product.28 Brandt concludes: “[i]f the tobacco companies had but followed their own explicit commitments, the history of the cigarette might be distinctly different.”29 All the internal memos, documents, and records which show the strategies used by the tobacco companies to create the controversy would later be used against the industry in tobacco litigation.
The TIRC was, since its creation, devoted to Hill’s public relations goals.30 Proctor assigns several purposes to the TIRC. First and foremost the TIRC was used to provide “reassurance research.” It gave the impression that the industry was concerned about the health of its consumers. In reality, the TIRC had no projects directly relating to research on smoking and lung cancer.31 In April 1954, the TIRC distributed a paper titled: “A Scientific Perspective on the Cigarette Controversy.”32 The document was sent to over 200,000 persons in the medical community and to the general media. The paper was extremely well referenced and touched every argument that could be made against the causal relation between lung cancer and smoking. The arguments that were made in the paper included: the inconclusiveness of research up until that moment, the dangers of attributing much value to observations made in research of mice and tobacco tars, the invalidity of autopsy results, etc.. This and other published documents were everything but scientific; they were part of the marketing strategies of the TIRC. These publications were accompanied with widespread and fair media coverage, thanks to the well-oiled relations of the Hill & Knowlton marketing company.33 Accordingly, the TIRC was led not by scientists but by business men, who wished that the TIRC supported the claim that there was no conclusive evidence to link smoking and disease.34 In its recruitment of researchers, the TIRC actively looked out for known sceptics of the link between lung cancer and cigarette smoke. The scientific advisory board of the TIRC was filled with scientists who held a priori assumptions on the evidence.35 The TIRC was a major propaganda weapon in service of the tobacco industry.36 Until this day, “[t]he TIRC marks one of the most intensive efforts by an industry to derail independent science”, according to Brandt.37
Meanwhile, the tobacco companies also continued their own research. Claude Teague, a researcher at R.J. Reynolds, concluded in February 1953, after reviewing epidemiologic studies and animal studies, that: “[s]tudies of clinical data tend to confirm the relationship between heavy and prolonged tobacco smoking and incidence of cancer of the lung.”38 In September 1953, the American Tobacco Company had also started experiments on mice. The tar-painted mice were reported to show, what the industry described as “biological activity.” In other words, the mice developed tumours. The company’s president was informed of the results, but they were never made public.39 Another scientist at R.J. Reynolds confirmed Teague’s findings several years later in 1964. In an internal report, tobacco scientist Rodgman wrote: “[s]ince it is now well-established that cigarette smoke does contain several polycyclic aromatic hydrocarbons, and considering the potential and actual carcinogenic activity of a number of these compounds, a method of either complete removal or almost complete removal of these compounds from smoke is required.”40 Other former secret documents show that the industry had accepted that there were dangerous carcinogens in cigarette smoke and sought ways to eliminate them from tobacco smoke.41 One confidential memo from 1954 stated that “[o]ur objective is to determine all chemical constituents of smoke, and to develop means of removing any which are considered harmful.”42 By acknowledging the existence of these harmful carcinogens in cigarette smoke and by researching strategies to remove them, the tobacco industry did in fact acknowledge that smoking was harmful, although they never went public with this information.43 On the contrary, despite the worrying results of their own research, tobacco companies continued to give reassurances about the safety of their products to consumers by claiming that the scientific evidence was inconclusive.44 Proctor remarks that were it not for the forced release of internal industry documents by recent litigation, these pertinent facts would probably still be hidden from the public.45 By hiding the results of their own research from the general public, the tobacco industry kept the scientific controversy on smoking alive.
Wakeham, another industry scientist at Philip Morris, led a research-project on medically acceptable cigarettes. His aim was to develop a cigarette without the cancer-causing effects of cigarette smoke but with the same psychological effects of nicotine.46 The development of this low-health risk cigarette would require: “[t]ime, money and unfaltering determination.”47 While industry scientists like Teague, Rodgman, and Wakeham had accepted and noted, in multiple internal industry documents, that there was a causal link between smoking and cancer, the TIRC continued to send out press release after press release denying any sound scientific proof of such causality.48
The TIRC had a special interest in influencing doctors through their propaganda. By sending physicians all over the country pamphlets, like the one from April 1954, the TIRC tried to convince physicians that there was a tobacco controversy. A periodical distributed by the TIRC, Tobacco and Health Research, was mailed free of charge to 340,000 American doctors, scientists, surgeons, dentists, and medical school faculty staff.49 Each of these brochures were designed for public-relations purposes, not for scientific information. Insufficient evidence remained the industry’s main argument. Rendering doubt about the dangers of smoking cigarettes was its main goal. The tobacco industry maintained that evidence was “scant.”50 The importance of influencing doctors lay in the fact that the opinion of one doctor could potentially influence the opinions of an exponential number of patients.51 With rising health concerns, slogans as “[m]ore doctors smoke camels”, tried to reassure consumers about the safety of cigarettes.52
Other articles, meant for a more lay public, were widely distributed in popular magazines. Proctor lists some titles of pamphlets that appeared around the mid-1960s: “Lung Cancer Rare in Bald Men.”, “Rare Fungus Infection Mimics Lung Cancer.”, “28 Reasons for Doubting Cigarette-Cancer link.”, and “Nicotine Effect is Like Exercise.” Some tens of thousands of copies were going out to the media, opinion leaders, tobacco industry suppliers, tobacco farmer groups, and others with an interest in the industry.53 In January 1968, True Magazine published an article titled “[t]o smoke or not to smoke, that is still the question.”54 Its author, Stanley Frank, stated that there was “absolutely no proof that smoking causes human cancer.”55 Frank did not disclose that he was working for Hill & Knowlton and the TIRC.56 After being republished several times, the article was reported to have reached over three million Americans. Free copies had been sent out to scientists, educators, government officials, and opinion makers. None of these editions mentioned that its author had been paid by the tobacco industry.57 As I already mentioned in the previous chapter, the controversy also succeeded in dividing the PHS, the FTC, and AMA into a kerfuffle on professional boundaries.58 Jack Anderson and Drew Pearson, two journalists, called the AMA-tobacco connection: “the weirdest lobbying alliance in legislative history … The doctors were more concerned about Medicare, which they fancied as a threat to their fees, than about the threat to the nation’s lungs.”59 The TIRC continued to fuel the feud and succeed in driving potential allies apart.
The TIRC also tried to influence members of the Surgeon’s General Advisory Committee.60 Members were invited to meetings and corresponded with staffers of the TIRC for advice and counsel. Little, head of TIRC, tried to gain influence on an informal basis with some members of the committee. One member, Peter Hamill, was very impressed by Little and argued that Little should be admitted to help the committee. Hamill was put on medical leave when the Surgeon General’s Report was nearing its completion. Little and Hamill met again afterwards in the TIRC headquarters in New York. Hamill expressed his disappointment in the final report and declared that he did not believe in any specific effect of tobacco use in causation of various diseases.61 Little concluded later in a confidential TIRC note: “I have a strong feeling that this is a man of whom we probably can and should make use.”62
A second Frank Statement was circulated within the tobacco industry by 1958. Although never published, its very existence proves the continued use by the industry of the idea that there was “not enough research.”63 The document candidly proclaimed that: “[t]he cause of cancer remains as much a mystery as ever.”64 Although medical evidence was piling up and was increasingly convincing, Hill & Knowlton were relentless in their quest to create a controversy.65 The TIRC had echoed the same declarations for over a decade. There was need for more research, before anyone could conclude with full certainty that smoking caused lung cancer.66
By the 1960s, the industry had succeeded in creating and firmly establishing the “cigarette controversy.”67 This had prompted some historians to claim that there was a real controversy on the relation of smoking and lung cancer.68 The controversy and its creation are important subjects for historians who testified in tobacco litigation. Central questions in court to determine possible fraud by the tobacco industry were: “[h]ow independent was the research done by the TIRC?”, and “[h]ow real was the tobacco controversy?”69