Authors: Richard Kluger
But the cigarette industry did not leave it at that. Instead, it proceeded during the last half of the ’Fifties to dispute, distort, minimize, or ignore the unfolding evidence against it. Throughout, the companies reassured the smoking public that they were hot on the trail themselves and more anxious than anyone to settle the health question.
Their chosen instrument to do so was the Tobacco Industry Research Committee, which geared up in the last half of the ’Fifties under its scientific director, Clarence Little. That he fully understood the dual nature of his charge was disclosed in an April 1955 memo in which he wrote, “Essentially, the major purposes of the T.I.R.C. are Research and Public Relations. Our job is to maintain a balance between the two.” To facilitate the balancing act, the TIRC offices were moved to Rockefeller Center in quarters separated by just a few floors from the lair of Hill & Knowlton, the tobacco industry’s public-relations counselors. Back in the limelight now, Pete Little, that mercurial extrovert, with his social charms very much intact, had logged many years studying and fighting cancer and in the process had gained a healthy respect for that relentless adversary. To get anywhere on the subject of tobacco and health, Little argued, science would first have to unravel the mysteries of the human cell; only then could it begin to understand the basic causes of cancer and try to devise ways to come to grips with them.
The scientific enterprise he headed, Little wrote in the March 1956 issue of
Cancer Research
, was left “completely free from suggestions or pressure by the industry in any form whatsoever” and could initiate as well as respond to requests for study grants—the tobacco companies had set up a kitty of about $1 million a year for these purposes. The TIRC had but “one objective,” Little asserted, “namely, to find the whole truth and to see that it is made known as quickly and effectively as possible.” But what if “the whole truth” was incorrigibly elusive in an age when science was opening up many more questions with every answer it uncovered? In the TIRC’s 1956 annual report, Little displayed the rhetorical usefulness of his Utopian “one objective,” writing, “We have learned much in the past two years, but perhaps the most important thing we have learned is how much more must be done before definite answers can be given” on the relationship of smoking to health. The next year his report began, “Progress of medical research is slow and painstaking. Many promising avenues must be followed before finding one that opens the way to new and useful knowledge … .” Here was rapturous music to the ears of Little’s tobacco industry patrons: while science inched ahead, you could sell one helluva lot of cigarettes.
Was the TIRC program a serious scientific effort or an elaborate exercise in temporizing, an industry-sponsored masquerade funded by a fistful of conscience money—and as tight a fist as the manufacturers could get away with, at that? For every dollar spent on its joint research effort in those early years of the program, the industry spent nearly $200 on advertising and promoting its product. Certainly the TIRC was not, despite Clarence Little’s claim in his 1956 report, listing grants to fifty-five investigators, “a carefully planned, well integrated scientific endeavor to help in the solving of important questions.” There was nothing structured or programmed about it. And it initiated practically nothing in the way of a sustained or substantive inquiry, preferring to dispense funds for scattershot studies sometimes only remotely connected to smoking or devoted to tilling fields already overharvested.
The TIRC did have, though, an aura of plausibility in the form of competent and, in some cases, distinguished scientists contributing to the effort. Chosen as Little’s full-time assistant in running the TIRC’s Scientific Advisory Board (SAB) was MIT Professor Robert C. Hockett, an expert in sugar chemistry. A short, shy, gentle man lacking Little’s magisterial manner and appearance, Hockett had a serviceable, encyclopedic, and somewhat plodding mind and played the dutiful Sancho Panza to his superior’s Quixote and his quest for “the whole truth.” Among their early recruits for the SAB, whose main business was to meet periodically to evaluate grant applications for research somehow related to smoking and health, were McKeen Cattell of Cornell Medical College, a distinguished pharmacologist; Julius Comroe, a cardiovascular expert from the University of California; Leon Jacobson of the University
of Chicago Medical School, who directed the Argonne Cancer Research Hospital; and Kenneth Lynch, dean of South Carolina Medical College at Charleston.
A pioneer member of the SAB was a young pathologist from the University of Southern California—Paul Kotin—whose motives for serving at the behest of a highly suspect industry suggest the shrewdness of the enterprise. Having previously acted as a consultant to Ford, Sears, and Standard Oil of New Jersey (now Exxon), Kotin felt that private industry had contributed more to the understanding of carcinogenesis than the scientific academy had and so he did not dread Mammon’s money. More to the point regarding tobacco dollars, “You weren’t going to change their policies by calling them murderers,” Kotin reasoned, “but as an advisor, you could work from within.” As the only SAB member deeply involved in lung cancer research, he was able to direct funds to investigators who otherwise would not have been kindly disposed to accept tobacco industry money. The material rewards for his services—an honorarium of several hundred dollars per day for the grant review meetings plus travel expenses—were hardly an inducement to “sell out” to a rogue industry, but its invitation represented a different kind of seduction for Kotin. As an associate professor at USC, a liberal in a profession dominated by conservatives, and a poor boy from an unfashionable neighborhood in Chicago, he found it irresistible to be asked to sit among the scientific elite at collegial sessions presided over by the genial Pete Little and afterward drink and socialize and listen to Little’s second wife mock Ernst “Vynder” and his German accent. After an initial period of uncertainty about tobacco’s role in causing cancer, Kotin liked to think of himself as something of a subversive on the SAB, but he nevertheless served for a dozen years, by the end of which he had become a ranking official at NCI and found it professionally untenable to keep taking the cigarette makers’ money.
Less defensive about his SAB membership was Richard J. Bing, a St. Louis heart surgeon on the Washington University medical school faculty and experimental cardiologist, who served more than three decades as a tobacco industry advisor. Bing said he was drawn by the intellectual challenge of the smoking questions because of “the terrible discrepancy between the epidemiological data” and the ambiguous chemical findings of only traces of carcinogens in the cigarette smoke. Fascinated by Clarence Little, whom he found to be “an artist, a truly great man,” Bing nevertheless was eventually convinced that cigarette smoking was causal for bronchitis and compounded the health perils of anyone already stricken With a heart ailment, but he claimed never to have been persuaded of tobacco’s role as an instigator of cardiac disease. A latter-day SAB member, Harvard biochemist Manfred L. Karnovsky, explained that he was inclined to believe that heavy cigarette smoking “increases the possibility of lung cancer, but I don’t know why. … It’s a very complex thing.” He was
deeply suspicious of the validity of skin-painting experiments and animal inhalation studies due to “the forced level” of the dosage, which unnaturally sped up organic processes, while “we don’t know what the true pace of these changes is in the human lung.” As to the TIRC sponsorship, the Harvard professor said he had “no fear of taint. If this was a group of gangsters from New York, that would be a different thing, but I feel that smoking is a thing that people do voluntarily—like driving—and that’s their business.” In acknowledging that much of the funding by the TIRC and its renamed but otherwise identical successor, the Council for Tobacco Research (CTR), went for studies at best remotely related to the smoking question, Karnovsky said the CTR might better have been named the Biochemical Research Council. But, he added, “no one ever said to us that we should in any shape, manner or form defend the tobacco industry.”
Yet there were many in academia and the public-health community who faulted both the TIRC’s scientific advisors and the recipients of their largesse for legitimizing the tobacco industry’s position, even if there were no visible strings attached to the funding. A representative expression of disapproval of such consorting with an industry that had a clear vested interest in the exoneration of its product by respectable scientists from distinguished institutions was offered by Lester Breslow, former director of the California State Department of Public Health, dean of the UCLA School of Public Health, and longtime advisor to NCI. “Do not impute villainy to them,” Breslow said of well-intentioned scientists who accepted tobacco money to conduct their research, “but they do not understand how the industry uses them—it’s terrible.”
While some of the early TIRC grants, like those for the Leuchtenbergers’ smoke inhalation studies and Kotin’s work in ciliary toxicity, helped shed corroborative light on the health issue, these were exceptions to an unfocused program that implicitly ran the risk of closing itself down if it discovered too much; Even the industry’s own scientists recognized early on the shortcomings of the TIRC effort. Philip Morris research director Robert DuPuis called in 1958 for an improved and enlarged effort by the SAB, with its grants better targeted. Frederick Darkis, research chief of Liggett & Myers, which had chosen to remain outside the TIRC and pursue strictly smoking-related research on its own and through the Arthur D. Little laboratory, was quoted as saying in a 1963 publication of Consumers Union that the TIRC was “mostly a publicity organization. They have given millions to various research analysts, but it is very difficult to know what purpose the money has served.”
Despite Clarence Little’s insistence that the TIRC research was entirely free of the industry’s oversight, there were early signs that studies too critical of the product would not be encouraged. Officials of the Rand Development Corporation in Cleveland, who had received a grant to study tobacco for carcinogens, testified at the 1957 Blatnik hearings in Congress that after their investigation
had found benzpyrene in burned cigarette paper and, to a lesser extent, the tobacco—and after they had then been visited by Clarence Little, who praised their facilities and research effort and agreed that benzpyrene ought to be removed from the product—their research grant was not renewed. A similar experience was disclosed by Boston University investigator Peter Knapp, who in 1962 with a TIRC grant wrote a paper he titled “Addictive Aspects in Heavy Cigarette Smoking.” Knapp recalled that TIRC officials “were very sensitive about not putting pressure on us, but they definitely did not want that word ‘addictive’ to be used in the title—it was a low-key but unambiguous request. We said no—there were real withdrawal symptoms and a morphine-like effect from smoking.” Knapp published his paper after reading it at the 1962 American Psychiatric Association meeting; his grant was not renewed.
VIII
OF
far more public prominence than the health research funded by the tobacco industry were the statements by its hired scientists and less qualified officials, ceaselessly denigrating or trivializing every new study and report by truly independent investigators who found cigarette smoking to be mortally perilous.
Apparently unchastened by the public-relations counsel he got from Hill & Knowlton, the TIRC’s president, nonscientist Timothy Hartnett, served as the industry’s lead attack dog. For example, after the second interim report in the huge, ACS-sponsored prospective study by Hammond and Horn had disclosed in 1956 that quitters improved their life expectancy compared to that of continuing smokers, Hartnett asserted that it would be “tragic if an overpublicized allegation that lacks scientific support were to divert and impede public or private support of sound research in such an important field of health.” Clarence Little’s approach was, by contrast, simply more cautioning, except when he chose to carp at emerging evidence that he found to be gravely flawed. After the final Hammond-Horn report in 1957, for example, Little objected because the investigators’ questionnaire had not probed beyond the subjects’ age, residence, smoking habits, and cause of death and because it would amount to “a scientific gymnastic feat” for smoking to serve as a prime causal agent in all the diseases claimed in the study. That same year, when Surgeon General Burney issued his first tepid statement that excessive smoking was
a
likely cause of lung cancer, Little answered that the TIRC’s funded studies had so far produced nothing to justify such a claim and that most of the “statistical studies,” as he styled the epidemiological surveys, had “so far failed to consider adequately many variables in human habits, environments and constitution … .” And writing in the December 1957
Atlantic
, Little sounded his
anthem in declaring that since even cynics would admit the tobacco industry could not afford as a practical matter “to offer products which have been so definitively attacked without making every effort to find out the whole truth,” he and his patrons “claim merely the right to pursue knowledge through scientific research, the right to hold our point of view, and the right of the public to be aware of it.”
But Little and his backers did more than pursue the truth in their fashion; what they continued to exercise most strenuously was their First Amendment right to degrade the findings of others at least as dedicated and far more disinterested. Thus, when in 1958 the NCI’s Harold Dorn published the results of his massive investigation of the mortality rates of smokers who as veterans had bought life insurance from the U.S. government, Little remarked only that “statistical association does not prove cause and effect.” And when Oscar Auerbach reported at the AMA’s annual convention in Dallas in 1959 on his findings after reviewing more than 20,000 slides from 402 cadavers for cell changes common in smokers and exceedingly rare in nonsmokers, Little’s chief aide, Robert Hockett, said that these highly suggestive findings were merely more of the same sort of thing Auerbach had reported earlier and that they “had not since been accepted by many other pathologists”—a dismissive slur devoid of substantiation and disregarding the fact that Auerbach’s papers on the subject had been published in the
New England Journal of Medicine
and other top peer-reviewed journals.