The safer cigarette

What do government and industry do when something is toxic but massively profitable? Most of the time, says Devra Davis, they just invest in better class of PR…

In his book Propaganda, written in 1928, Edward Bernays, the founding father of today’s PR industry, argued that democracy depended on the successful control of public opinion: ‘The conscious and intelligent manipulation of the organized habits and opinions of the masses is an important element of democratic society. Those who manipulate the unseen mechanism of society constitute an invisible government which is the true ruling power of our country…’.

Nowhere are clever and complex strategies to manipulate the public mind more clear than in the prolonged, failed, costly and eerily relevant campaign to produce a safer cigarette.

The story of the rise – and fall – of tobacco has been widely told in broad brushstrokes, but one of the lesser-known chapters is how the industry tried to have it both ways. At the same time as assuring the public its product was safe, many in the tobacco industry in the UK and US used the cover of ‘trade secrets’ to carry out expensive, clandestine efforts to design a less harmful cigarette.

In 1957, the notion that tobacco smoking could be considered a healthful habit – as many contemporary ads promised – was beginning to come undone in many quarters. Doctors may have smoked Camels and other cigarettes, but growing numbers were beginning to grasp the absurdity of their dependence. That year, in two separate stories, the popular Reader’s Digest struck what appeared to be a fatal blow to the industry. The magazine revealed a set of ‘industry secrets’, including the allegation that tobacco bosses were holding out on a ‘safer smoke’.

The first Reader’s Digest story detailed laboratory tests proving the amount of nicotine and tar inhaled from the current crop of filter-tip cigarettes was no less – and was sometimes far greater – than that from plain smokes. In some cases, switching from a regular-size plain cigarette to a king-size filter actually increased the tars and nicotine inhaled. In fact, the filtered King and Hit Parade cigarettes contained 30 per cent more nicotine and tar than unfiltered Camels.

But in 1953, when filters were just beginning, the American Medical Association (AMA) tested three new types and found that one, used in the Kent brand, actually did remove 55 per cent of all tars and nicotine.

What was in these too-efficient Kent filters was disclosed in the second story. The Atomic Energy Commission had recently declassified a report about a remarkable aerosol filter that removed radioactive particles from the air in nuclear power plants. This extraordinary material was crocidolite – a bluish kind of asbestos. In 1952, the company making Kent cigarettes, PJ Lorillard, decided to use this new material to filter its brand-new cigarettes.

Nearly 12 billion of these asbestos-filtered cigarettes – 585 million packs – were sold in the US until 1956. Ads assured smokers these filters provided health protection. Laboratory tests using smoking machines to simulate human exposures, eventually published in 1995, proved this was not the case. A typical smoker would have inhaled considerable amounts of asbestos, known now to induce lung cancer and mesothelioma – a tumour of the lining of internal organs, which basically causes people to suffocate to death.

At the time, however, lots of smart money bet on selling the phallic elegance of filters as less harmful, cleaner and easier smokes. Before 1954, only one out of every 10 cigarettes sold was filtered. By 1957, close to 75 per cent of all cigarettes would be. In the US, revenues from tobacco advertising accounted for more than one in every four dollars spent in the booming business of shaping public opinion.

There was, however, a price to be paid for being an early adopter. Kent’s filters proved too efficient. Sales eventually tanked as smokers complained the cigarettes just didn’t have that tobacco taste. Nevertheless, people wanted to believe that filters would fix that problem. Until that time, the risks of lung cancer had been demonstrated in industrial nations by charting the health of those who had used plain, unfiltered cigarettes. So the battle of the filter-tips began: how to design a filter that looked as though it was doing the right thing, but didn’t really remove too much of whatever it was that made a cigarette a cigarette and kept people craving more?

By March 1957, research was underway at the British American Tobacco Company (BAT), in Southampton, UK. The programme looked into whether or not the amount of various carcinogens formed could be lowered by different shapes or designs of cigarette. At one point they tried to rebuild the cigarette itself, creating a coaxial design in which the tobacco core was completely blanketed by thicker, filter-like material. They also developed a wide variety and length of filters. Each variant was tested for the amount of carcinogens released. None worked completely.

At first reading, the articles in Reader’s Digest looked like a heavy hit on the industry. In fact, they were a set-up. The first article ended with a tantalising report on a trade secret nobody wanted readers to know: most companies had begun to use the pieces of tobacco they had been sending to landfills, blending stems with fine tobacco leaves.

Putting tobacco scraps in cigarettes proved to be useful on several fronts. It was cheaper for a start, but it also turned out the smoking machines employed by the US Federal Trade Commission to measure the amount of tar and nicotine, found cigarettes containing what was to be called ‘reconstituted tobacco’ looked ‘healthier’. By recycling its tobacco rubbish, the industry was producing smokes that looked better and contained less tar. It seemed a financial and public health triumph: less costly and less potent cigarettes could be created. As with so many of its promised advances, however, the industry was blowing more smoke than it was clearing.

Waging the tobacco wars

In truth, the great bulk of the tobacco ‘science’ that appeared in print was well-disguised public relations work. Public doubt as to the truth of the dangers of tobacco had long been nurtured under the aegis of various medical experts. The editor-in-chief of the Journal of the American Medical Association, Morris Fishbein, masterminded highly profitable strategies to advertise tobacco, boosting the coffers of the AMA over more than two decades, long after officials had pronounced the product a public menace. In a real sense, the modern field of epidemiology evolved in response to the doubt-provoking tactics of the tobacco industry. The need to establish proof that tobacco was harmful was held up as a perfectly reasonable demand by the highly profitable industry. The national economies of Britain and the US, already dependent on tobacco revenues to fund various public works, including health services, easily accepted this stipulation. A well-engineered campaign of actively collaborating or occasionally unsuspecting experts fomented doubt about what sort of evidence was needed to establish proof of human harm.

Occasionally, however, the truth crept out. Much to the shock of UK tobacco firms, in 1962 the Royal College of Physicians issued a report declaring that smoking damaged human health. Richard Doll, the man behind early British research on the dangers of tobacco, told me that the report was delayed close to five years because of the tremendous influence of the industry and its vital role for the recovering Cold War economy.

In truth, Doll and many others knew that German, US, Japanese and Argentinian scientists had proven the dangers of tobacco for health in the 1930s and 1940s, in both experimental work and some public health analyses. The tobacco manufacturers in Britain had long assumed that because the government depended so heavily on revenues from tobacco to fund the health system (to this day the NHS receives money from the tax on tobacco), among other national services, they could create impossibly high bars of evidence regarding what could be deemed proof of human harm. As long as uncertainty could be magnified about the science, the tobacco industry remained immune from direct government control.

When its report indicting tobacco finally appeared, the Royal College’s data sent the industry reeling. Immediately afterwards, a major powwow was held by BAT’s research and development leaders. One, Sir Charles Ellis, explained at a conference in July 1962 that the challenge was to come up with a basic change in the nature of cigarettes:
‘The board recognises this problem must be tackled from two sides, and the first being at [sic] medical research on the origin of lung cancer and bio assay on the biological effects of smoke, the second being the composition of smoke and the possibilities of modifying it.’

Sir Charles went on to promise that if any new toxicology research was found that was relevant to improving the health of its product, the board would share this information with other tobacco companies, rather than seeking any commercial competitive advantage. Whether this information would ever be shared with the public or health authorities was not even considered.

Not long after in the US, Kenneth Endicott, the four-packs-a-day, chain-smoking chief of the National Cancer Institute, became convinced there had to be a safer way to smoke, and embarked one of the more bizarre chapters in the history of the war on cancer. In 1967, five years after the Royal College of Physicians and three years after the US Surgeon General had declared smoking caused lung cancer, Endicott began a government programme that spent more than $30 million of taxpayer money to create a safe cigarette. Similar efforts were also mounted in Britain.

Perhaps the concept of making cigarettes safer has an inherent logic, but less bad does not mean good, as the world would eventually have to admit. To carry out the objective of crafting a safer cigarette, the industry tapped respected researchers at private institutions, including the University of London, the American Health Foundation in New York, the AMA and the American Cancer Society, as well as the US government. These groups not only worked with the tobacco industry to engineer a safer smoke, but also profited from coming up with methods by which the chemical engineering and epidemiological safety of the product could be evaluated.

It’s not clear what was more foolish: the idea that a healthy cigarette could be designed using filters and newly configured types of tobacco waste, or the notion that the government ought to pay to come up with it to benefit what was already a heavily subsidised, multi-billion-dollar, multinational industry. The decision to attempt to engineer a safe smoke must be one of the more perverse results of tobacco’s grip on public thinking. The notion that cigarettes could be made safer was fuelled in part by scientists such as Endicott and surgeons, more than half of whom were heavy smokers themselves, and by a naïve sense that a safe cigarette would be far easier to create than a major programme to discourage most men and growing numbers of women from smoking.

What makes this story so remarkable is that the tobacco industry knew all along that filters did not make enough of a difference and that in trying to engineer a safer smoke, the industry was in effect acknowledging the primary toxicity of its product.
Cutting through the smokescreen

Not all government officials, however, were spellbound by the PR spin. Joseph Califano, a Harvard-educated lawyer and skilled litigator who headed up the US Department of Health and Human Services during the administration of Democratic President Jimmy Carter at the end of the 1970s, didn’t accede to the tobacco-supporting programme of the administration he served. Like many in government, Califano had been a heavy smoker, but unlike most had kicked the habit. Not known for his diplomatic skills, Califano became no friend to tobacco.

On 11 January 1978, Califano proposed the most strident anti-cigarette programme ever to come out of a cabinet-level office. Calling cigarettes ‘Public Enemy Number 1’, Califano wanted schools in the US to teach children about the consequences of smoking. He wanted a higher federal excise tax on cigarettes and called on the Civil Aeronautics Board to ban smoking on all commercial flights.

The breadth of the proposals left the tobacco barons and their defenders seething. Senator Jesse Helms chided Califano for ‘callous disregard for economic realities, particularly for the economy of North Carolina.’ Governor Jim Hunt challenged Califano to visit to learn what tobacco meant to North Carolinians. Representative Charlie Rose,
a Democrat who represented tobacco farmers in the east of
the state, elevated the whole discussion when he said, ‘We’re going to have to educate Mr Califano with a two-by-four [plank], not a trip.’
German playwright Bertolt Brecht, who spoofed Stalinist policies, argued that if the government didn’t like what the people wanted it should elect another people. Califano’s efforts to get public authorities to tackle tobacco made it clear that he was one person who could not continue to be part of the tobacco-friendly government.

Later that year, when President Carter visited North Carolina – then the nation’s top tobacco-growing state – as part of his campaign for re-election, Califano was not with him. He joked to the crowd that he had planned to bring along that infamous former smoker, Secretary Joe Califano, but explained he changed his mind when he realised North Carolina not only produces more tobacco than any other state, but also made ‘more bricks than anyone in the nation as well’.

The same day the president was mocking and threatening Califano’s anti-smoking efforts, the AMA’s Education and Research Fund released a lavishly printed report on a study that took four years and a considerable amount of money to complete, with more than 800 researchers and untold numbers of lobbyists. Much ballyhooed, the report consisted of nothing more than a potpourri of mostly unrelated studies that reached the lame conclusion: ‘The bulk of the research supports the contention that smoking cigarettes played an important role in the development of chronic obstructive pulmonary diseases and constitutes a great danger to individuals with pre-existing diseases of the coronary arteries.’

It was 1979, nearly 15 years after the surgeon general’s report on lung cancer and smoking, and the AMA had finally decided to acknowledge that smoking was bad for the lungs. This costly AMA report ignored the issue of lung cancer on the flimsy pretext that the National Cancer Institute was already studying the problem. Within days, the Journal of the American Medical Association published an astonishing paper: ‘Toward Less Hazardous Cigarettes: Current Advances’, boasting that as a result of the government effort to make a safe cigarette, a major breakthrough was at hand. Modern filters, some of which they named by brand, could be smoked to yield a ‘tolerable risk’.

The truth, as scientists knew then and have repeatedly shown since, was quite the opposite. People smoking filtered cigarettes suck harder, breathe deeper and take in more tars, nicotine and cancer-causing chemicals than they do with plain smokes. With respect to tobacco science, however, truth has always been a rare commodity.

The lengthy battle to gain public acceptance of the dangers of tobacco lasted as long as it did for two reasons: tobacco is highly addictive and was made more so by physical manipulation of the cigarette by the industry. Tobacco advertising and sponsorship invaded every part of modern life, from comedy and drama hours to major sports contests. Smokers’ addiction to tobacco was chemical; for the rest of society it was economical.

Based on what now appears to have been at best misguided thinking, at worst delusional, the UK and US governments spent millions trying to help the tobacco industry come up with a safer cigarette. How so much money was spent on such a bad idea for such a long time offers a moral tale with relevance to other realms.

Goaded by a bevy of expertly expressed technical doubts, public opinion came to wonder whether proof could ever be developed that smoking was harmful.

Each time a report appeared showing that smokers faced increased risks of lung cancer or other diseases, experts were tapped to explain how the study had not quite got it right. Crucial evidence was missing. The groups looked into were not really the right ones. Some basic flaw kept the results from being deemed definitive proof. The costly, decade-long effort to craft a healthier cigarette can be seen as further proof of how scientists can be just like anyone else. If it makes their world a bit easier, they are happy to believe in what they know probably isn’t true – especially if they are well paid to do so.

The lessons of tobacco have broad contemporary relevance. It is not possible for any public health issue involving millions of dollars and lives – whether mobile phones, aspartame or the misuse or overuse of diagnostic radiation or psychiatric medications – to be resolved without a major press of public relations and cutting-edge scientific studies being funded by those who run the invisible government. As Bernays knew, the best public relations appear as impeccable science, presented by expert advisors.

The dreams of an open society, where the marketplace of ideas governs, look faint and ephemeral. On any of these suspect modern hazards, what information is permitted to get to the marketplace? Who decides when to release findings about public health threats? These things are not determined by unfettered scientific inquiry, but by the social and economic realities that constrain them.

Devra Davis is the director of the Center for Environmental Oncology at the University of Pittsburgh. This article is adapted from her latest book, The Secret History of the War on Cancer (Basic Books/Perseus, £16.99)

Read about other 'profitable pollutants' found in household goods here

This article first appeared in the Ecologist February 2008