frontlinesmoke in the eye

interview: stanton glantz


Professor of medicine at the University of California, San Francisco and anti-tobacco researcher.
Glantz: The Brown & Williamson documents give the public the first really clear and comprehensive view inside the tobacco industry during the period in which the evidence that nicotine was addictive became available, that smoking caused cancer, heart disease, and other diseases, and shows us that at least this tobacco company and its multinational parent, British American Tobacco, fully understood that nicotine was addictive, fully understood that smoking caused cancer and other diseases, and was actively working to try and reduce those dangers. At the same time that they had a massive and high quality scientific enterprise underway in secret, their public posture was that the case wasn't proven, that there was nothing wrong with smoking, that it was controversial and the documents show how they developed a bevy of legal strategies and public relations strategies to keep this information away from the public, away from the courts, away from the government, to keep people smoking.

And other documents have come to light since then. For instance, Congressman Henry Waxman got hold of a bunch of documents from Philip Morris which he put into the public record. I've read those documents, and they're not nearly as complete and comprehensive as what we have from Brown &Williamson, but the important thing is that they are completely consistent with the kinds of things we see in the Brown &Williamson documents. And so the industry, for 40 or 50 years has succeeded in building an incredible wall between itself and the public, and running a completely separate reality inside and outside, and I think many millions of people have died as a result. And that, I think, is going to be much harder for them to continue getting away with when the public has a chance to look at these things and understand them. It's going to generate a tremendous amount of public pressure. It think it's going to make it much easier for the courts to deal with them, for the federal government to deal with them. And the kinds of subterfuges and ridiculous statements that they've gotten away with for years, are just going to be much harder to do.


Glantz: I was really looking at it more as a scientist than a campaigner really. I've obviously been involved in tobacco control for years because when you know what I know about the science, you have no choice in the matter. I mean there's an ethical imperative on you. But really when these documents arrived on my doorstep, the things that sucked me into them was not their potential political or legal import, it was the documents as history, the documents as science. It as just an unbelievable find. As a professor, it would be like an archaeologist finding a new tomb in Egypt or something. And in fact, historically, I hadn't really been that interested in the issues these documents deal with. My work had been on passive smoking, and tobacco policy work, not on nicotine pharmacology and cancer. And I'd actually read about the documents in the New York Times a week or so before I got them. Phil Hilts had run a story. But, and you know, and I thought it was very interesting, but I...was very interesting, and I went about my business. But when the documents first arrived and I realized what they were, my initial reaction was, well, these are very interesting, and I'll make them available and somebody can deal with them. But spending 20 minutes looking at them, you just get sucked into the story that they tell. I mean it's an amazing, amazing story of what was going on inside these cigarette companies during this crucial period. I mean I dropped what I was doing, or piled this on top of the other things I was doing, because it was such a compelling story. That's not exactly answering your question.

Now to answer your question, I think that the thing this shows to journalists is how they've been duped all these years, you know. And it outlines the tremendously effective public relations campaign that the industry has used, and how cleverly they've manipulated the press in terms of keeping the public confused about the actual dangers of tobacco use. They've had a tremendously sophisticated public relations campaign underway, which has not only used public relations firms and all those standard things, but made use of high level executives, the...lobby high level executives of media outlets, which is involved in the sub rosa funding of scientists, who were so called independent experts, that the media could then be referred to. It involved hiring people or underwriting the costs of writing articles critical of the Surgeon General and other anti-tobacco forces. And that continues to this day.


Glantz: Yes. There was never any question about publishing it with me. I mean that's what you do at university. And it was very clear to me very shortly after I started looking at these documents that we were going to write something about them. I didn't have a clue that we were going to write as much as we ended up writing. I thought we'd write a paper and send it to a scientific journal, which is what you're supposed to do when you are a professor. And as I got...assembled the research team and got into was very clear that this was turning into a very major project, so then we thought we were going to write a couple of papers, and then we ended up writing a book and 5 papers, which were published in JAMA which took a tremendous amount of guts on their part. And my hope had been that, as it is in anything we do, whether it's this or the research I do in my laboratory on how hearts work, was that the quality of the work we could produce would overcome the fear of the tobacco industry, and I think when you are dealing with the academic community, there is a very strong commitment in that community to the truth, and that commitment, I think, carried the day in helping to get these papers published, because of the commitment to have information out there. I mean, that's one of the core values of the university. And I...when these documents was very clear to me that sooner or later the shit was going to hit the fan. The tobacco companies, the kind of seige warfare that they run against everybody, it was just a matter of time before they started doing that against the university and against me. And I went down and informed the attorney at U.C. that these had arrived, and that I intended to use them as research materials. And I'd been told, I'm not to talk about exactly what was said, but the university was obviously very supportive, and have not wavered, and it's been from the highest level down. And the chancellor of this campus, people in the General Counsel's office, have just been very strong and very supportive.

And I have to say there were periods when Brown & Williamson came in and started threatening the library, and it was obvious, threatening to sue the university, and I figured this is where the rubber hits the road. And I remember being called down to a meeting with people from the General Counsel's office, Chris Patti and others, and I remember riding down the elevator thinking, this is the time to walk the plank, this is my little adventure, it's going to hit a wall. That's not at all what I was told. What I was told was, this is what the University of California is for. The university is here to bring the truth to people, to write about things, to do scholarly research, and we'll defend you. And they did, and they did spectacularly well. And I think the lesson for that is that these guys, the tobacco companies, can be beaten, they can be stood up to if you are willing to do it. And the university did a superb job, and I think the contrast between the behaviour of the University of California as a public institution, standing up to the tobacco companies, at a time when our Governor's campaign for President was being run by Philip Morris, Craig Fuller, the Vice-President of Philip Morris was running his governatorial campaign, and he's been destroying the voter mandate for tobacco education programs, when our legislature has been dominated by tobacco interests, when the big networks were caving in to them, when a lot of other publications--newspapers, magazines--would rather not do tobacco stories, to not be bothered, really makes me proud to be affiliated with this institution. Because not only did they do the right thing, but they did it for the right reasons. They did it for the right reasons, they did it because of a commitment to the public interest and to the truth.

I didn't mean to be ranting and raving along. I mean I feel quite strongly.


Glantz: Well, I think the situations at ABC and CBS were a bit different. I think at ABC, I mean, they were similar and they were different. I mean from my point of view they were both driven by basic greed and cowardice. The situation at ABC was they did what I thought was a superb piece of journalism. They took a fairly complicated issue and explained it in very clear and concise terms to the public. The tobacco industry did then what they do best. They seized on one little word, spiking, which when you talk about reconstituted tobacco, I don't even know what the word spiking means. When you're talking about a manufactured product, it is like saying, this mouse is spiked with plastic. I mean a cigarette is a manufactured product, you know. There is no such thing as a natural cigarette that you go buy from the tobacco company. It's a very carefully engineered product where every aspect of that cigarette is controlled to very high standards, quality control standards. And so when Philip Morris was complaining about the word 'spiking' I mean it's crazy. My initial reaction to the suit against ABC was that it was purely a public relations device. For one thing, under Kentucky law, pardon me, or under Virginia Law they couldn't sue them for 10 billion dollars. There were very severe limitations on the actual exposure that the company had. So it was all just hot air. And ABC's initial response was a very very aggressive and well mounted defence. I was actually contacted by their lawyers to see if I would be willing to serve as an expert, and I just didn't have time. I was buried in the Brown & Williamson documents, and also working with O.S.I.A. at the time, and also I didn't want to sign a non-disclosure agreement. I felt that that was something I just won't do. And, but, it was clear to me from talking to the people I talked to and what they were allowed to tell me, that the lawyers and the technical experts they had brought in were mounting this superb defence. The other thing that was very true from the material that Congressman Waxman had put into the public record was that all the same kinds of things that were going on in the Brown & Williamson, appeared to be going on inside Philip Morris. If anything Philip Morris had more sophisticated work going on than Brown & Williamson did. And my feeling was that Philip Morris would never actually let the case go to trial, because I think that for the kind of materials that one can reasonably expect to see introduced into the public record at the trial, that would have been a legal disaster for Philip Morris, it would have had huge implications in the products liability actions that are pending, and it would have provided a gold mine of material for the Food and Drug Administration. As the case proceeded, Philip Morris was actually dropping a lot of its own complaints, and when ABC management capitulated, basically to grease a merger, was the way it looks to me, I think they did a huge public disservice, and they did a huge disservice to the journalists working for them, who I think, had put together an absolute first rate piece of journalism, and a very important piece of journalism.


Glantz: The situation at CBS is a bit different, and in some ways, even worse, because there they weren't even sued. Basically it looks to me like there was a big merger or buy-out going on. Key CBS management were standing to make big bonuses if that buy-out went through by a certain date. And they just didn't want to be bothered. And that's part of what the tobacco companies do. If you deal with them, you know they are going to hassle you. And you know they're going to do all kinds of things just to make your life miserable, and they didn't want to be bothered. And so they didn't even wait to be sued. we had the media making up theories under which they can be sued for suppressing or not suppressing information. It was just outrageous. But I think it's very much to the credit of the producers and the other people at 60 Minutes that that piece did get on the air, and the subsequent stories that ran recently with Jeff Wigand, the two part piece, which I thought were very well done, and that, I think showed, that within CBS the journalists were able to ultimately force the corporate interests to let the story run. And that, I think, a lot of people inside the news division at CBS deserve a lot of credit for pulling that off.

One other thing about this, I think in the end though, the bullying tactics of the tobacco industry against the media are beginning to backfire, because after ABC caved in, and after CBS pulled the original story, I started getting calls from major reporters saying, what can you tell us. My editors want to do a tobacco story to show that we're not like ABC. We're not like CBS. I mean here, you're doing the story. And I think in the short run it was very chilling. In the intermediate term, it has actually increased the level of interest in tobacco. What the long run implications are, you know, time will tell.


Glantz: Well, the tobacco companies had been after me for years. The work I've done on passive smoking and heart disease, and showing that second hand smoke kills 53,000 people a year. This work has done them a huge amount of damage in terms of promoting the enactment of smoke-free workplace, and other environments, other kinds of smoking restrictions. So, they have had their front groups--smoker's rights groups--they set up that publish magazines and newsletters. They are constantly attacking me, and after every barrage of personal attacks against me in the American Smoker's Journal or the American Smoker's Alliance or these other publications from these groups, I then get a series of hate mail. I have had hate mail, hate faxes, hate phone mail, hate e-mail, hate phone calls. I mean the police department here intercepts some of my mail now, and it's a drag. I mean I can sympathize with Jeff Wigand. They're after him much harder than they've ever been after me. They sued the University of California because of the documents being here in the library. My personnel records get frequent subject to Freedom of Information Act requests from time to time. My grants, just one of them was just recently (Unclear) by a concerned citizen who in the letter says, I have no ties to the tobacco industry, but in fact has been working with a group called California for Smoker's Rights, which was set up by our R.J. Reynolds. And probably the most serious assault was working through the American Smoker's Alliance which was set up by Philip Morris and something called the One Thirty Ten Club, which operated out of a post office box, in a small town in Kentucky. But it turns out the guy who runs it, his address is Central Park West, New York City, orchestrated a major campaign to working through the Republican Congress to get...NCI forced to terminate the funding of my research grant, part of which paid for our analysis of Brown & Williamson documents.


Glantz: One of the things you do when you are a professor is that you apply for research grants which are then given to the university to support your work, and the National Cancer Institute has given me a grant to study how the tobacco industry works to protect its interests and to keep people smoking. And that's legitimate cancer control research, because the leading form of cancer is lung cancer, almost all of which is caused by tobacco. Well, working through front groups like the American Smoker's Alliance where it was established by Philip Morris and the One Thirty Ten Club which operated out of a post office box in a little town in Kentucky, but turned out to be run by a guy whose address was on Central Park West in New York City. A whole campaign was orchestrated in conjunction with the Republicans in Congress, and particularly in the House of Representatives, to force the National Cancer Institute to terminate the funding of my National Cancer Institute research grant. And that grant, among other things, was paying for the costs associated with our analysis of the Brown & Williamson documents. There was a huge fight that dragged on for months and months where, and this was unprecedented to terminate an already funded grant, gone through peer review, was rated in the top 10% of all grants awarded by NIH, but I'm happy to say that because the health groups rallied, and particularly the American Cancer Society, the tobacco industry was pushed back and the grant is continuing. But it seriously disrupted my work. I mean at one level, the tobacco industry failed in their efforts to terminate what I was doing, but they did hassle me mightily. They caused a lot of effort to be spent by people in the health community, in the academic community, defending the grant, and disrupted the work for several months while we were trying to keep the thing alive. And that's what they do to everybody. I mean that's what they do to journalists. If you are a journalist and you do a story on tobacco that they don't like, you'd know your editor's going to get a letter from some big shot at the cigarette company. You may be demanded to prove certain things. There are a lot of things you can do short of suing somebody. And people know, if you do a tobacco story you are going to get hassled. And given that there's ten million other things out there to do, it's human nature for a lot of people to just go do something else. In addition to the work I do on tobacco, I have a laboratory, and we do research on cardiovascular function, on your pericardium, you probably don't even [know you have a pericardium. No one's ever hassled me about that work. The tobacco companies don't care about that. It's good science. I enjoy doing it. I think it's making a contribution, but it's much easier to do that work, than to do the tobacco work.


Glantz: Well in 1988, the voters of California passed an initiative called Proposition 99, which increased the tax on tobacco and said that some of the money was supposed to go for anti-smoking education. And much to my astonishment, the State Health Department developed an incredibly intelligent and aggressive campaign. And the cornerstones of this campaign were 3 messages: Nicotine is addictive, second-hand smoke is dangerous for non-smokers, and the tobacco companies are out to get you. And these are the 3 most powerful messages for dealing with kids. And our previous governor took a hands off posture towards this campaign, and let the Health Department do his job. Pete Wilson has been much more meddling, and particularly since he decided to run for President, and with his Presidential campaign chaired by Craig Fuller, the Vice-President of Philip Morris. Well Philip Morris makes Marlboro cigarettes, the cigarettes two-thirds of all kids who smoke, smoke. And it is not in Philip Morris's interest to have an effective tobacco control program run by the State of California. And so the governor has started messing with the campaign, and the old ads which went after the industry, which talked about nicotine addiction have been disappearing. And in fact, there were 2 very important ads that have simply been banished. One of them is called nicotine (unclear). And what the State did was it took the very famous hearing, the defining moment at the Waxman Hearings where the 7 dwarfs, the 7 tobacco executives stood there and said, 'Nicotine is not addictive,' and they turned that into a 30 second spot, which combined these three messages: that the tobacco companies are out to get you, nicotine addiction, and passive smoking, into probably the most effective tobacco control spot ever made, particularly for reaching kids.

Well, that was on the air for a while. The tobacco companies complained. The Director of Health Services who used to work for the tobacco industry, who actually campaigned on behalf of the tobacco industry against Proposition 99, shocked everybody by writing back a very strong letter defending the ad. He was called on the carpet by the governor's office for doing that, and a bit later the ad was simply pulled off the air and the department has been told, never, never to allow that ad to be aired again. It is the kind of thing you'd expect in Stalinist Russia. The most recent incident is another ad called Insurance which points out that 2 of the biggest insurance companies in California are owned by tobacco companies, and they give non-smoker discounts. It is a brilliant ad, again, a very effective ad for reaching both the general public and children in particular. That ad was submitted for final approval to the governor's office, well probably 8 or 9 months ago. It has never been approved. And the ad was simply killed to avoid offending the tobacco industry.

And if you look at the kind of junk that the state is now producing, it looks like Philip Morris did it. You know, it looks like, if you go down the street here and look at the material they are putting out on youth access, and don't sell cigarettes to kids, it looks like the Philip Morris Action on Access campaign. And I think that there are many ways that the tobacco industry keeps the public from being adequately informed. One is trying to intimidate the media. The other is buying politicians the way they've bought the Governor of California.


Glantz: And other politicians? He's not the first. No. And I think against that backdrop, Bill Clinton's willingness to allow the FDA to move forward and to try to impose some meaningful regulations on tobacco products as nicotine delivery devices, is a tremendously courageous thing to do. And you know, to bring the whole thing full circle, and it's been reported in the press that our work helped convince Clinton to do that. It happened just at the time that he had been deciding to go with some rinky-dinky voluntary agreement, or to allow Kessler to move forward, our papers came out, and I've heard from several people that he actually read them and was very moved by them. And I think it's an example of how knowledge is power.


Glantz: The Brown & Williamson documents show that by the early 60's they recognized nicotine as an addictive drug, that cigarettes were devices to deliver nicotine to the brain very efficiently in metered doses, and that smoking caused cancer. Later they recognized that smoking caused heart disease and other diseases, and that this information was withheld from the public and that complicated legal and public relations subterfuges were developed to keep this information away from the proper authorities and to keep the public smoking. At the same time that they had huge experiments under way internally to try to find out what it was in the cigarettes that were causing cancer so they could try to do something about it, they were denying that smoking caused any disease whatsoever to the public.


Glantz: The emergence of Jeff Wigand, I think is probably the most important development that's happened in tobacco probably in the last 30 years. Because, when I got the Brown & Williamson documents and read them it confirmed what we thought. And it showed that over a period of many years, the industry knew smoking caused disease, knew nicotine was addictive, but the documents end in 1985, about. And Brown & Williamson has been saying, as the tobacco companies always say, well they're not representative or it's cherry picking or, misrepresentation of this, that or the other thing. But Wigand can come speak in the first person. He was there, he dealt with these people, he was the object of the kind of league lawyer manipulation of the scientific process that the documents show. And his ability to get up there and say, I know this because it was said to me, I know this because it was told to me, I know this because I did it is something that the industry is simply not going to be able to do anything about. I fear for the guy , he's been given death threats and I think the industry is running a psychological warfare campaign against him, trying to drive him into a mental hospital. But if he lives through this, he's gonna save millions of lives, I think. I mean, I think the guy is a hero.

Brown & Williamson says that the often-quoted statement by Addison Yeaman that we're in the business of selling nicotine, an addictive drug, is just one kind of out-of- context, weird statement. Well, if you look at the documents here, you'll see that there's hundreds of documents in here dealing with nicotine and very sophisticated issues of nicotine pharmacology: the effects of nicotine on the central nervous system, how do you control the delivery of nicotine to the brain. I mean what they're doing is typical of the industry, whenever any document leaks out that shows they knew smoking was addictive or that it caused disease, or that advertising research showing they're trying to appeal to kids, the answer's always the same, it's that, well, that was a rogue scientist or a rogue advertising consultant or a rogue executive or a rogue lawyer and that isn't really what we mean. Well, the strange thing and the bizarre thing about this is that if you look at the research they did on nicotine it was superb science, it was 20 years ahead of what's going on in places like UCSF and you'd think they'd be proud of it, but instead they repudiate it and they say this was somehow all screwed up. Well if that was the case, and given that their scientific work fit with what the larger community learned later, I'd like them to produce all the research they did that showed nicotine wasn't addictive and not their phoney baloney special projects and CTR stuff, but y'know Brown & Williamson has said that somehow these documents are cherry-picked or not representative. Well, when I look at them they tell a story, they all fit together, they make scientific sense. If this is somehow not representative they've got the keys to the vault, let them release all of their scientific research. And we'll see how typical or atypical this was, my guess is this is very highly reflective of what they did, and had I been one of their scientists at the time I'd have been proud to have done this work.


Glantz: Right here, we have document 1102.01, it's the minutes of a research conference that was held, and we have Sir Charles Ellis who was the chief scientist of British American Tobacco saying smoking is a habit of addiction.

I mean if you read Ellis's work, if you read the work of most of their scientists, they're very straightforward. The other thing you have to appreciate is that in the 60's when all this was done, this was before the war on drugs. And the whole addiction didn't have the kind of social stigma it does today and in fact one of the big concerns that the tobacco industry had back then was new drugs were appearing on the scene like resurping and the anti depressants and new psycho active drugs and they were afraid those were gonna compete with cigarettes. That motivated a lot of the research, in fact.


Glantz: No. I mean why, for one thing, if they're preparing a brief for the surgeon general, didn't they send the surgeon general, y'know they withheld the information on nicotine research from the surgeon general. So I mean the argument -- it's stupid. I mean how could they say they were preparing some kind of brief for the surgeon general, that they never gave the surgeon general. The whole debate, in fact, was over withholding the information from the surgeon general, which they did.

The other thing is, when you read the Yeaman memo, it's consistent with the whole rest of this material. Another thing that's very important about these documents is there's a lot of them. And y'know they fit together, they tell a story. And when we went through them, the Yeaman memo was one document out of many, many, many documents and it had a role and it said some important things but it didn't say anything that was inconsistent with the whole rest of the documentary record and in fact it was quite consistent with it. So I mean for them to somehow say that this was some out of control person writing some strange view, it repudiates the whole rest of the scientific record that they had built.


Glantz: Well I mean I don't know, you'd have to ask them but I mean they, that's the kind of thing. I mean years ago when the federal trade commission got a hold of research on how to get --one of the companies had, in fact, I think it was Brown & Williamson-- and how to attract young smokers, Brown & Williamson's response was, well that was some out of control marketing research guy and it wasn't the company position. When Victor DeNoble talked about his work on nicotine analogs for Philip Morris and how that research was shut down they said well that was just one guy, he wasn't doing, that wasn't what we really meant. I mean that's always their answer and y'know just because these guys can wear expensive suits and hire big public relations firms with fancy dancy lawyers, that doesn't make ridiculous statements not ridiculous. And the things that they're saying are simply stupid.

And, y'know one of the things they do through all of their fancy public relations experts, lawyers and the fact that everybody's afraid of them, is they can say stupid things and get treated respectfully rather than somebody simply saying this is stupid. I mean for them to get up there, to have the temerity to go before Henry Waxman and say nicotine is not addictive, I mean that was a defining moment in the history of this issue. That's why it was, it was such a great idea for the California department of health services to make the nicotine soundbite spot and that's why Governor Wilson caved in to Philip Morris's friends and Philip Morris pulled the ad.


Glantz: Well, there's a couple of reasons. The first reason is that an addiction has come to have a strong social stigma associated with it, people don't wanna be addicted. The second reason is because it's a very important message for dealing with kids. Kids smoke to rebel, kids smoke to try, to take control of their lives away from grown ups and if you say to them you're gonna get addicted to this product and end up turning control of your body over to some cigarette company, that discourages kids from smoking. And finally it has tremendous legal implications in terms of all the products liability and medicaid suits that are pending now. It goes to the whole issue of free choice which the industry loves to make.

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