Ashes to Ashes (88 page)

The cigarette makers, moreover, made such heavy use of print advertising throughout the ’Seventies that they succeeded in further diluting the health community’s message by simply buying off the message-bearers. In the January 1978 issue of the
Columbia Journalism Review
, R. C. Smith reported on a survey he had taken of press coverage of the smoking issue in periodicals during the seven years since the ban on broadcast advertising of cigarettes had gone into effect—a span during which the proportion of cigarette ads in magazines had doubled. Journalistic purists might have hoped that the press could keep its news columns fiercely independent of commercial considerations, thus allotting smoking the play it deserved among the pressing social concerns of the day. “Such simply has not been the case,” Smith wrote, noting that his survey revealed “a striking and disturbing pattern. In magazines that accept cigarette advertising I was unable to find a single article, in seven years of publication, that could have given readers any clear notion of the nature and extent of the medical and social havoc being wreaked by the cigarette smoking habit.” Neither
Time
nor
Newsweek
, to cite two of Smith’s examples of flagrant nonfeasance, “has published anything resembling a comprehensive account of the subject,” while carrying six to eight pages of cigarette advertising per issue. Smith was forced to conclude that “advertising revenue can indeed silence the editors of American magazines.”

The inadequate press coverage of the smoking issue inevitably had its effect on the public’s understanding of it, as FTC staff investigators learned when
they conducted a pair of surveys of their own and uncovered privately taken opinion samplings by the Gallup and Roper polling organizations involving more than 8,000 consumers. The combined findings were that many people in fact did not know just how dangerous smoking was and what specific diseases it was causally linked to: 20 percent did not know smoking caused lung cancer, more than 30 percent were unaware of its link to heart disease, 40 percent of smokers thought only heavy smoking was dangerous, half of those polled did not know smoking could be addictive, and 60 percent did not know it caused emphysema. Nearly half the college-educated subjects in the sampling did not believe the statement that in industrialized nations cigarette smoking was the greatest single cause of excess deaths
(i.e.
, beyond normal actuarial probability); twice as many believed traffic accidents were a greater killer than smoking as those who knew the truth.

The FTC investigation moved into high gear after a January 1979 U.S. district court ruling in the commission’s favor, giving it access to the tobacco companies’ market research documents. The commission was fully within its rights, the court held, and did not have to specify its purpose in seeking the documents; the industry’s cost of compliance, claimed to run into the millions, was minor relative to its financial position, the federal ruling added, “and when measured against the public interest of this investigation.” Most cigarette makers, unafraid that the documents would hurt them since their lawyers had long since instructed tobacco executives not to commit sensitive words to paper, complied with the court order, but Brown & Williamson, in a fit of pique over what it called reckless bullying by a federal agency, overcomplied. It delivered a seven-ton truckload with 750,000 pages of documents, hoping to smother the FTC staff with a blizzard of irrelevant paper. The company’s truculence was met by the commission staffs diligence; the most damaging evidence of the industry’s eagerness to enlist young smokers was uncovered in nuggets panned from the Brown & Williamson mother lode. Among these was a report by Marketing & Research Counselors, Inc., hired by B&W’s ad agency, Ted Bates, in 1975 to help plan the revitalization of the Viceroy brand and improve its appeal to youngsters. “For them, a cigarette, and the whole smoking process, is part of the illicit pleasure category … ,” the consulting firm advised Bates. “To the best of your ability (considering some legal constraints) relate the cigarette to ‘pot,’ wine, beer, sex, etc.
Don’t
communicate health or health-related points.” FTC investigators determined that many of the ideas in this report for Bates found their way into the 1976 campaign for Viceroy, including two basic premises as spelled out by Brown & Williamson group project director V. C. Broach, in a March 3, 1976, report entitled “Viceroy Strategy”. The campaign ought to provide consumers with a rationalization for smoking, Broach urged, and a “means of repressing their health concerns about smoking a full flavor Viceroy.”

Despite findings by FTC investigators that Brown & Williamson employed these strategies and ideas embodied in the research by Bates and its consultants over a six-month campaign in three test markets, the company denied that it had ever heeded such advice and insisted, as did every other cigarette manufacturer before, during, and since the FTC probe, that it did not direct its advertising toward young people in the hope of recruiting them to smoking. None of them, though, ever explained how an industry that lost hundreds of thousands of customers to death each year and several million more who quit using its product could afford
not
to try to enlist customers of any age.

The Heights of Arrogance

TWO-FACED
politicians, bent upon gaining and holding power and never spending it on risky causes, rarely beguile the electorate with a matched set of profiles in courage. The most they can manage, upon being unmasked, is to invite some laughter over the display of duplicity. So it was in August 1978 when Jimmy Carter, having publicly neither embraced nor disavowed his HEW Secretary’s antismoking crusade, traveled to the heart of tobaccoland to damage the Senate reelection campaign of Republican right-winger Jesse Helms and to advance the President’s own standing in the Tarheel State, thought to be pivotal to his own reelection prospects two years hence.

Carter told a crowd of tobacco warehousemen that he had planned to bring along that infamous former smoker, Joe Califano, until he discovered that North Carolina was not only the top tobacco-growing state “but that you produce more bricks than anyone in the nation as well.” Instead of summoning the courage to justify the national need to relieve the health peril that their leading crop carried with it, Carter waxed poetic about “the beautiful quality of your tobacco,” pledging his continued backing of the federal price support program for the crop and of the government’s research “to make the smoking of tobacco even more safe than it is today.”

That very day in Chicago, the American Medical Association’s Education and Research Fund released
Tobacco and Health
, a 369-page, lavishly printed report on its study, initiated in 1964 and carried out through the tobacco industry’s funding of 844 researchers at some one hundred institutions. The outcome of this prodigious labor proved to be nothing more than a grab bag of
abstracts of the mostly unrelated studies, with a two-page summation dated fifteen months earlier, a sign of the urgency level of the project. Instead of a digest of findings from a carefully structured investigation that one might have supposed to be the ambition of the nation’s largest medical organization, the summary noted merely that “the bulk of the research … supports the contention that cigarette smoking plays an important role in the development of chronic obstructive pulmonary diseases and constitutes a grave danger to individuals with preexisting diseases of the coronary arteries.”

This revelation added nothing whatever to the findings fourteen years earlier by the original Surgeon General’s committee on smoking and entirely skipped over any appraisal of the habit’s link to lung cancer—on the excuse that the National Cancer Institute was adequately funding research on that subject. Most of the AMA-ERF studies listed in
Tobacco and Health
were at best tangentially related to the smoking and health question.

President Carter, advised of the AMA report while still genuflecting in North Carolina, promised to “read about it” back in the White House; nothing further was ever said of the findings, which, soft-pedaled though they were, made plain that beneath tobacco’s “beautiful quality” lurked great danger. Nor was the AMA’s virtual whitewash subjected to a deserved lashing for dereliction of professional duty by the government’s little Office on Smoking and Health, whose director, John Pinney, recounted, “We didn’t have the option to criticize the report.” Such forthrightness would have plunged the Carter administration into deeper hot water in tobacco country, but the spirited band at the OSH was contemptuous nonetheless. “Why did it take them [the AMA-ERF] fourteen years to produce it? The whole thing was sinful,” said Pinney.

Two days later the tobacco industry had still further reason to smile when the press got hold of an article awaiting publication at the AMA’s flagship journal,
JAMA
. The author was Dr. Gio Gori, director and indefatigable hawker of the NCI’s smoking and health program, who, as if impervious to the undertow of criticism charging that his enterprise was riddled with cronyism, had collaborated on the
JAMA
piece, “Toward Less Hazardous Cigarettes: Current Advances,” with Cornelius J. Lynch, manager of NCI-funded smoking research at Enviro Control, Inc., of Rockville, Maryland, one of Gori’s main contractors. Gori and Lynch claimed that cigarettes with a “tolerable risk” level were at hand, thanks to major (but unspecified) strides that had been taken in the past eighteen months.

This sensational claim grew out of the authors’ calculations based on not only the tar (43 mg. on average) and nicotine yield of the average pre-1960 cigarette but also the dosages of four other known, major toxic components of tobacco smoke—carbon monoxide, nitrogen oxide, hydrogen cyanide, and acrolein—and their conclusion that two such cigarettes constituted the “critical
level” of smoking
(i.e.
, no greater risk than from no smoking at all). Gori and Lynch then measured the amount of these six destructive ingredients in the smoke of twenty-seven current so-called low-tar (15 mg. or less) brands and interpolated to determine how many of the latter were needed to deliver the same concentration of these substances as were contained in two pre-1960 cigarettes. Thus, for Benson & Hedges Light, with a rating of 10.1 mg. of tar, the equivalent number of cigarettes would he 8.5, producing the total of 86 mg. of tar yielded by two pre-1960, “tolerable risk” cigarettes. Other brands in the Gori-Lynch calculations produced spectacularly higher equivalency figures: You could smoke twenty-three Carlton menthol cigarettes, seventeen Nows, eighteen Trues, and seven Pall Mall Extra Milds at the “tolerable risk” level, they said. To be sure, the authors added a disclaimer: Their calculations were “based on the assumption” that the smoker of these current, apparently less lethal brands “will not change his smoking habits in terms of depth of inhalation, frequency of puffing, and butt length.” The article, when it appeared in the September 15, 1978,
JAMA
, concluded with the prescriptive comment that persuading the smoker “to wean himself to progressively less hazardous cigarettes may provide an alternative to smoking cessation that is perhaps more effective than the self-denial approaches of current antismoking messages”—like those (though the article did not cite him) by HEW Secretary Califano—“[and] reduce the current epidemic of smoking-associated diseases to a considerably less serious health problem.”

In remarks to the Washington
Post
of August 10, 1978, Gori said, “I am not calling any cigarette safe,” and noted that his calculations did not necessarily apply to any given individual’s risk. But he stressed that recent technological developments now made it possible to speak of “tolerable” levels of smoking “from an overall public health standpoint.” The
Post
accompanied its report on the Gori-Lynch findings with a double-column boxed listing of the twenty-seven low-tar brands tested and how many of each you could smoke at a “tolerable” risk. “We are not trying to endorse cigarettes or smoking in any way,” Gori contended. “We are only trying to put the facts before the public.”

But they were not facts; they were a theoretical hypothesis based on a set of untried assumptions. An angry Califano read about them and how the officer in his department charged with managing its smoking research program was saying things that seemed to cut the legs out from under his anticigarette drive. NCI director Arthur Upton remembered getting a phone call around midnight, soon after the
Post
had hit the street with the front-page headline,
“SMOKING
: Some Cigarettes Now Tolerable,’ Doctor Says”—and it was not just any doctor. “He was mad as hops,” Upton said, “and asking me who the hell Gio Gori is,” as well as whether the NCI chief had read the offending study by Gori and Lynch. Upton had not, because the article had been passed
on by an NCI reviewer some months before Upton had come to the institute and because Gori had not been astute or forthright enough to bring it to the new director’s attention.