527 



RoBk PnfcrFv^ 



AiTKTxaa Medical Assocuooc EJuaooo 

 and Resevdi Foundibon (AMA-ERF) 

 for a major study of smotong and dotase, 

 injuaied in 196A and culmmaong in a (inai 

 repon puNished in 1978.' The tndusiry 

 irumpeis lh« magnitude of its restarch ef- 

 fon by emptusizirg ihat, "In many years, 

 industry awards exceeded that [sic] of any 

 govemmeni department. They have al- 

 ways far exceeded the smoking aixl health 

 research funding of all voluntary health 

 assooauons. . ."' In Congressional tes- 

 tirtxxiy in 1982. the (hen-president of R J. 

 ReyTX>lds Tobacco Company suted that 

 "the lobacxzi industry is recognized as a 

 leader in seeking ihe answers lo the ques- 

 uons regarding smoking and health."' 



Also illustrating the indusny's use of 

 the CTR program is a recently coiKluded 

 CTgarene product liability tral in .Missis- 

 sippi.'" During the trial, the attorneys for 

 the .American Tobacco Company placed 

 large charts before the jury identifying 

 pror Tent uruversiues supported by CTR 

 grants. The anomeys emphasized that 

 many of the supported research projects 

 were also funded by the .Ajnencan Cancer 

 Society, National Cancer Insurute. and 

 other major voluntary and governmental 

 research-granting agencies. The tobacco 

 attorneys specifically identified the mem- 

 bers of the SAB by name and institutional 

 affiliation, asking witnesses whether or 

 not these were reputable scientists. 



At no time did the attorneys state ex- 

 plicitly that the research at issue dealt with 

 the health consequences of smoking; nor 

 did they stale expliatly that any of the 

 advisors or funded saentists questioned 

 that smoking was dangerous to health. But 

 the intent of the tactic was dear to estab- 

 lish "innocence by assoaation," to create 

 at least a modicum of doubt lo jurcjrs' 

 minds that the relationship between snx)k- 

 ing and disease i in this case, lung cancer) 

 was definiuvely established; and to do so, 

 in part, by associating the reputable SAB 

 saentists with a search for the "as yet 

 unknown" truth about the role of smoking 

 in lung cancer monality. 



This courtroom experience typifies 

 the industry's broader use of the CTR pro- 

 gram. Mentioned nowhere in any industry 

 public relations document is the faa that 

 only a minority of industry-funded re- 

 search addresses the relationship between 

 sjTKJking and health. Nor has the industry 

 ever acknowledged that the vast majonty 

 of Its funded research that does relate to 

 smoking and health has identified the 

 same disease relationships identified in 

 lens of thousands of studies funded by 

 other sources. ' ' This indudes the findmgs 



ol the AMA-ERF siudy, which produced 

 aeaiy 900 research rrporo aixl indiacd 

 snoiang as a cause of lung cartcer, chronic 

 otsDucxrvr pulmonary disease, and coro- 

 nary disease. • 



To many knowledgeable observers, 

 the tobacco industry's funding of scientific 

 research represents an uivestmenl not in 

 soence. but rather in public relations. This 

 was ifie conclusion of US Dismci Court 

 Judge H Lee Sarokin, who presided over 

 a prominent cigarette product liability 

 lawsuit in New Jersey. Judge Sarokin 

 wroce thai, based on the evidence pre- 

 sented at tnal, "the jury could reasonably 

 conclude that the creation of [the Tobacco 

 Industry Research ComrruttetCouixal for 

 Tobacco Research) and the work per- 

 formed was nothing but a hoax created for 

 public relations purposes with [the mdus- 

 uy having) no intention of seeking the 

 truth or publishmg it." He concluded, 

 also, that there was suffiaent evidence for 

 the jury to find that "the industry ... en- 

 tered into a sophisticated conspu^cy . . . 

 organized to refute, undermine, and neu- 

 trakze information coming from the scien- 

 tific and medical community and, at the 

 same time, to confuse and mislead the 

 consuming pubUc m an effon to encourage 

 ex3sting smokers to continue and new per- 

 sons to commence smoking."'^ 



The CTR program IS part of a broader 

 public relations campaign that has 

 achieved notable success in misleadmg 

 and decervtng the public. Survey research 

 has consistently found that while Amerv 

 cans recognize smoking as hazardous to 

 health, they greatly underestimate the 

 dangers of smoking, both in absolute 

 terms and relative to other health haz- 

 ards." In one poll, for example, lay re- 

 spoodents placed "not smoking" tenih 

 anxng the nation's health and safety pn- 

 onoes. (Health professionals placed it 

 firsL ) The lay respondents ranked "having 

 smoke detectors in the home" six prior- 

 ities higher in fourth position.' despite tlie 

 faa that home fires claim about 6,000 lives 

 per year, while cigarenes annually kill 

 400.000 Amencans. Ironically, the most 

 imponani cause of home fire deaths is the 

 CTgarette.''' 



Shon of a universal rejection of CTR 

 funding by researchers — an outcome that 

 certainly cannot be antiapated — tfie sa- 

 enofic community has limited optioos with 

 which to combat the cynical tobacco in- 

 dustry campaign. A clear exception, how- 

 ever, lies within the ready grasp of the 

 CTR Scientific Advisory Board. Woven 

 into the very fabric of the industry re- 

 search funding process, the Board has itie 



abdity— some would uy obliptioD — to 

 (xiMidy distaiKe iseV (aod tbeieby tbe 

 soenufic community, whch it represents 

 in the public mind) from the mdustry'i 

 persistent assenion thai doubt rerruOTS as 

 to whether smokiog is dangerous to 

 health. 



Is the CTR Soeniific Advisory 

 Board, through its coUecttve silence on 

 the health consequences of smoking ii>- 

 advertently conin'buting to misleading ifie 

 public'' A L'S Senator suggested iho pos- 

 sitiility nearly 30 yean ago. In 1963, Sen- 

 ator Maunne Neubeijer charaaenzed de- 

 velopment of the Tobacco Industry 

 Research Comrrunee as follows: 



The CTtaijon of the TIRC. the brM«3uk! 

 of [a) resourceful public relauons fins 

 . . . was a stroke orf tn^nuity By offer- 

 ing as bill miUiom of dollars of ioniy 

 needed rnearch funds, the industry «'^s 

 able to anracT soesosts of uoLT.peactv- 

 able iniegnty 10 seTN« on a . Soenufic 

 Advisory Board. As responsible u 

 these . . . men wot- ;hey never.he«5S 

 servttj the mduscy^s purpose of asso- 

 ciating eminent saeausis wiih the .n- 

 dustry position iflai 'Jie relationship 5e- 

 tween smoking and disease had rxx >et 

 been pruved.'* 



Recognizing this possibility, the Aus- 

 tralian equrvaleni o( ;.he Scientific -XdMs- 

 ory Board recently dosociaied its«L' from 

 the industry positioD, publicly and collec- 

 tively. Wnting in the Medical /ouna/ of 

 Australia, the pand of saentific advisors 

 to the industry-funded Australian To- 

 bacco Research Foundation stated, un- 

 equrvocally, that 



The membeis of the Soeniv/ic Advisory 

 Committee are uoannous in believing 

 thai smoking is an tnponani causaovc 

 factor in several major diseases . . . 

 [W)e strongly endorse the view thai iKe 

 public should be hifly informed about 

 the nsk in smokers, and we fully support 

 any measures, wtich are consistent 

 with the li^rry of nx mdr^ual, tfiai are 

 (designed to reduce snoking.'' 



Qearty, there musi be considerable 

 sympathy for this sceniific position within 

 the Amencan Scientific Advisory Board. 

 Among the six SAB members who have 

 individually gone oo record through their 

 responses to my query or thrtjugh their 

 published work, there is unanimous agree- 

 ment that cigarette smoking causes lung 

 cancer. But seven of their SAB colleagues 

 have not expressed thetr scientific judg- 

 ments through either of these vehicles, 

 and the Board as a whole has never n'^ucd 

 a statement about whether or not ii •-up- 

 ports the "party Ime" of the industry to 

 which II provides saentific advice. 



July 1991. Vol. 81, No. 7 



Amencan Jouial o( Public Health SJI 



