Authors: Richard Kluger
Wynder was also among the first and surely the loudest of the voices in the health community to argue that smokers would not abandon their habit en masse no matter how grave the medical evidence against it, and since government could never, as a practical matter, outlaw tobacco use, it behooved academia and federal officials to join with the cigarette companies in pursuit of the least hazardous cigarette human ingenuity could devise. As one veteran industry lawyer recalled, “Here was the guy with the longest list of publications in the field saying in effect that cigarettes could and should be made safer. This gave encouragement to the manufacturers, who hung on his every suggestion.” What did it matter, from the companies’ standpoint, if they were pressured into marketing what the medical community judged to be a more acceptable sort of cigarette so long as the modified types sold? And if a new breed of cigarette were certified by government imprimatur to be authentically safer, smokers
were less likely to quit and youngsters more likely to take up the habit. So the industry was cordial to Wynder, and he, in turn, ever eager to build his edifice, accepted research assignments from several cigarette companies so long as he was free to publish the findings.
As a self-appointed lobbyist for the less hazardous cigarette, Wynder stalked three prime targets in Washington during the ’Sixties—Senate Commerce Committee chairman Warren Magnuson’s chief of staff, Michael Pertschuk; anyone who would listen at the FTC; and the National Cancer Institute. While lung cancer was by then recognized at the NCI as the most prevalent form of the disease, the institute’s mission was not viewed as translating new knowledge into cancer control or prevention programs; it existed mainly for the best brains available to undertake basic research into the nature of the disease. Under John Heller, who directed the NCI throughout the 1950s with marked deference to the tobacco industry’s defenders in Congress, the accumulating findings on smoking were viewed at the institute as so many scattered data points that did not register very heavily. Even in the early ’Sixties, some strategically placed NCI people were not sold on the need for urgency in addressing the smoking peril. But the 1964 report to the Surgeon General set off a warning gong at NCI. The head of its etiology research program, Carl G. Baker, recounted, “Most of our clinicians had not thought this thing through on causation and the chemistry of carcinogenesis.” The Surgeon General’s panel, in Baker’s words, “woke up a lot of people,” among them the new NCI director, Kenneth M. Endicott, a serious smoker who doubted that addicts like himself would ever be motivated to quit, however persuasive the health charges.
But it was precisely that conviction that made Endicott, a warm and somewhat rough-hewn man, innovative scientist, and hands-on administrator, ready prey for Wynder. Though many who enjoyed NCI’s rarefied climate thought participation in a nuts-and-bolts endeavor like the development of a less hazardous cigarette was beneath their dignity, Wynder argued to Endicott that in view of the rising lung cancer toll, it was essential that NCI’s mission be extended to include saving lives as well as discovering pristine truths. To the argument that development of a less dangerous smoke might serve only to condone continued use of the product and give would-be quitters an easy out, Wynder insisted that the dose-response data was still more persuasive and Utopian dreams of mass abandonment of smoking served only to exacerbate the public-health peril.
Not everyone at NCI was smitten by Wynder’s proposition. Among the serious doubters was Paul Kotin, then director of NCI’s division of environmental health studies. “I thought the idea was … scientifically an absurdity,” Kotin recounted. Reducing the toxic yields of a cigarette did not necessarily make it less hazardous, he told Endicott and Carl Baker, whom the NCI director
named to explore the idea. “You can’t tell what will happen by projecting a given level of carcinogenic material or promoters,” Kotin contended, while insisting that there was no true threshold of safety for cancer since “any one molecule can react with another.” It was a view shared by Endicott’s deputy, Jesse Steinfeld, who noted that no given dosage was a surefire predictor of carcinogenesis: “It’s a random hit”—which was to say that if the carcinogen did not assault that part of a cell’s genetic material concerned with reproduction, the damage might be minimal, or even if the injury was serious, too much was and remained unknown about the DNA splicing process and how readily a given cell could repair itself.
Kotin, who knew the industry better than anyone else at NIH because he had worked with its people for fifteen years by then, wondered what made public-health officials think the tobacco companies would yield their sovereignty to NCI and actually market a cigarette blessed as less hazardous by government scientists. Why undertake that massive research effort when it was the industry’s responsibility in the first place? The rank-and-file scientists below the policymaking level at NCI were equally dubious. Most of the benchmen had seen the ravaging effects of lung cancer and knew there was a far simpler and less costly way to reduce the peril: to educate the public not to smoke—and that was a job not for scientists at NCI but for the publicists at the institute’s sister organization, the American Cancer Society.
In the end, the judgment had to rest on the relative merit of the proposition. No one was claiming that it was possible to produce an absolutely safe cigarette. The goal was to reduce the risks of smoking, not eliminate them, so that the bulk of the objections were beside the basic point Wynder was making. On reflection, Endicott was persuaded to go along with the less hazardous project at least in part because he recognized a politically viable proposition when he saw one. Jesse Steinfeld, deputy NCI director at the end of the ’Sixties, remembered accompanying Endicott to congressional appropriations sessions where they were confronted by tobacco-state lawmakers who demanded to know just how much the institute—and the HEW Department overall—was spending on “antismoking propaganda.” To Steinfeld, “the covert, if not overt, message was that if you wanted your budget passed, you’d better go easy on smoking and health.” But a program to develop a less hazardous cigarette seemed to have the dual virtue of engaging public-health concerns yet not threatening the tobacco industry. The task might more nearly resemble an engineering project than a venture on the cutting edge of science, but for Endicott it was a way simultaneously to promote and protect his domain, and he took it.
V
THE
Less Hazardous Cigarette Working Group, as it was formally known, began its work in March 1968—the most promising idea to emerge from the presidentially created Lung Cancer Task Force, set up the year before under Kenneth Endicott to combat a disease by then assuming epidemic proportions. The working group, soon headed by NCI’s Carl Baker, was composed of some of the brightest minds in the U.S. to address the smoking and health issue, including Ernst Wynder and Paul Kotin. What soon became apparent was the mundane nature of the scientific labor.
It was always possible that a startling breakthrough might occur—a particularly virulent form of carcinogen would be identified as the prime villain and a way found to filter it out of the smoke. But the reality was a painstaking regimen of separating the complex compounds in smoke and testing them for carcinogenicity and other toxic effects by skin-painting and other kinds of bioassay. As the more knowing minds at the industry’s Council for Tobacco Research had long been aware, it was hard to attract top-flight scientists to research on smoking; much of the work was irksome, involving smelly smoking machines, the endless painting of mouse backs and tracking of tumors, and similar repetitive tasks that required more patience than insight. And there were few laboratories around the nation with the competence and experience to do such work well, among them Wynder’s American Health Foundation and the Arthur D. Little lab in Cambridge, where Charles Kensler had long presided over the tobacco research done for Liggett & Myers. Thus, it was hardly a coincidence that both Wynder and Kensler were members of and key players on the less hazardous task force.
To make it work, then, Carl Baker knew that he could not wait for qualified applicants to ask for the assignment; he had to contract for the work with outside laboratories and let NCI personnel oversee their output. It was precisely the sort of coordinated, targeted effort that the tobacco industry’s own designated body, the CTR, had never undertaken. The chief value of the NCI effort was precisely its focus and coordination, even if many within the institute looked down their noses at it. As Frank Rauscher, who headed the national cancer program in the mid-1970s, put it, “Though we didn’t know how to do that sort of work, it was necessary science, and it couldn’t be left to the tobacco industry, or it wouldn’t get done.”
And so it happened that the nation’s leading cancer investigators found themselves in bed with the tobacco industry. The foreplay proved awkward in the extreme. While the industry had, on the face of it, little to lose from the affair, it was entered into with wariness and uncertainty about where it might
lead. Philip Morris Chairman Joseph Cullman recalled his view of the government’s less hazardous cigarette program as a possible form of product improvement: “We were happy to cooperate and hopeful something positive would emerge.” But the industry could hardly have boycotted the effort without arousing a public outcry and congressional ire. If, on the other hand, it was too avid in its participation, the industry would appear to be conceding the need for such a modified cigarette. It was hard for the tobacco companies, moreover, to know how they would market such a product even if the government was a partner in its development. When Liggett developed a charcoal filter in the early ’Sixties which somewhat reduced the ciliatoxic gases in the Lark and American Tobacco tried a similar approach with Tareyton and Philip Morris with its Saratoga brand, the sales results had been unimpressive. It was a no-win situation for the manufacturers, in the view of Charles Kensler, whose ADL laboratory had played a significant role in the creation of Lark: “How do you know when you’ve taken everything [hazardous] out?” How, that is, could the industry ever claim it was selling a totally safe cigarette without massive exposure to liability suits? And how could any company boast of a less hazardous product without admitting in the same breath that all of its earlier offerings were
more
hazardous?
Still, the industry had to show up or forfeit the opportunity to affect the course of the federal program. From the opening session in 1968, there was tension in the air as thick as the smoke from Charlie Kensler’s cigar and the cigarettes prominently brandished by the industry scientists. The latter seemed at first to be treading on eggshells, unwilling to concede the degree of the health peril claimed by the academics and government scientists in attendance. The company scientists’ principal contribution in the early sessions was to insist that the name of their body be changed because of the implications of the term “less hazardous cigarette;” after that, the ad hoc committee was known simply as the Tobacco Working Group (TWG).
At first, according to TWG member Steinfeld, “the industry guys sat around saying not one word but taking notes feverishly.” Their purpose, the non-industry people there assumed, was to report back in detail to their superiors and to assure them that the industry was not about to be bushwhacked by the public-health community. The industry scientists surrendered information highly selectively, none of it dealing with any biological findings that their own research had already yielded. The one area in which the company men were forthcoming was the chemistry of tobacco. As TWG Chairman Carl Baker recalled, “They were willing to tell us what they knew about what made up the smoke, the techniques they used to determine it, the size of the particles—nuts-and-bolts stuff they would share. … They were … useful—so long as you didn’t ask them about biology. [And] I could never get the company people to admit that a lowered nicotine level would lead to reduced consumption.
They got itchy—I could sense their uneasiness—on the addiction question.”
Even by 1971, when Thomas B. Owen joined NCI as a contract administrator in what had come to be known as the Smoking and Health Program (SHP), there was still a palpable “Them Against Us” feeling in the air between the two sides. “The industry crowd wasn’t telling us much about what they knew,” Owen recounted. “I knew damned well we were talking about problems they had worked on two years earlier … . It took quite a while for our people to interface with them and understand that these guys wanted to prevent deaths, too, but couldn’t afford to say so.” One company scientist who participated in the ten-year program, Thomas Osdene of Philip Morris, recounted with delicacy, “It was rather a cumbersome situation—one put in one’s expertise as one knew it—the politics could be rather horrendous.” Too much of the research was carried out poorly, Osdene believed, “and there were never any clear-cut answers.” For the industry scientists, “being there was like having one hand tied behind your back.” They were there, during the life of the program, “to try to be helpful on the technical aspects … and not to let the government go down any blind alleys.” Others, though, believing the whole enterprise to be a hopeless labyrinth, suspected that the longer government-paid investigators lingered within it, the better for the industry.
VI
RUNNING
the Smoking and Health Program’s less hazardous cigarette research effort was not a chore that delighted NCI’s brainy overseers. The sort of person needed was ideally half diplomat, half detail-man, who was good at dealing with commercial laboratories, scrutinizing contracts, monitoring budgets, sweet-talking politicians, and riding herd on the prima donnas who made up the Tobacco Working Group. Unfortunately, Carl Baker had no one like that on his staff, and few at NCI aspired to the grinding assignment.
But Baker knew a journeyman microbiologist in his late thirties, Gio Batta Gori, a native of Italy, who had been educated at an uncelebrated medical school in his homeland and had worked with varying degrees of success at commercial and corporate labs in the Washington area, hoping to land a spot somewhere within the NIH complex. Personable and attractive, with smooth manners and quick wits, Gori was brought in as Baker’s assistant in 1969 and viewed from the first as something less than a sterling addition to the institution. His medical training had been at a backwater school, he had no scholarly publications to speak of, and he brought no depth of knowledge on the nuances of cancer. But Baker, who was a far better scientist than a personnel manager, was willing to look past skepticism over Gori’s credentials. “He had a broad
grasp of the issues on the scientific side and of the political realities,” Baker recounted, “as well as a good managerial sense … . I found him a useful guy.”