10.12 The tobacco industry's revised stance on health issues

Corporate admission that smoking causes ill-health and death is at the heart of the tobacco industry's metamorphosis into socially responsible corporate citizens. From the earliest days, the tobacco industry robustly countered any claims that smoking caused disease. Discovery of internal tobacco industry documents in the wake of several US court cases in the late 1990s (discussed in Chapter 10, Section 10.10) proved what health advocates had long suspected—that the tobacco industry was indeed aware that its product was a major cause of death and disease, and that several decades had been spent deliberately colluding in covering up, denying, confusing and questioning the issues of smoking and health.1 Even well into the 1990s, spokespeople for the tobacco industry in Australia denied that tobacco use was a cause of disease, citing, for example, a perceived lack of causal proof, and the vagaries of genetics.i It is highly probable that this legacy of denial, maintained consistently and persuasively for more than half a century, still has residual effects on smokers today.2

10.12.1 Smoking, health and addiction

Historically, the industry denied that smoking was addictive, despite conducting research and developing products that enhanced and increased the uptake of nicotine.3, 4 Today, a visit to any one of the websites of Philip Morris International,5 British American Tobacco Australia6 and Imperial Tobacco Group7 provides the reader with a number of carefully crafted statements about the effects of tobacco on health. Perhaps reflecting the litigation concerns of a company with strong US connections, Philip Morris International states its acceptance of the views of major health authorities with the statement: 'Smoking causes many serious diseases including cardiovascular disease (heart disease), lung cancer, and chronic obstructive pulmonary disease (emphysema, chronic bronchitis). Smokers are far more likely to become sick with one of these diseases than non-smokers. Smoking is also addictive and can be extremely difficult to stop'.5 British American Tobacco Australia states that, 'With smoking comes a real risk of serious and fatal diseases such as lung cancer, respiratory disease and heart disease. We also recognise that many people find it is difficult to quit smoking'.6 Less forthcoming, Imperial Tobacco Group (ITG) makes a general statement about smoking and health, stating that, 'no cigarette is safe, and that it operates its business on the basis that smoking may cause human disease. ITG does acknowledge that 'smoking can be characterised as addictive as the term is commonly used today'.7

It can safely be assumed that all of the above statements have been thoroughly vetted by industry lawyers to ensure that they will adequately serve the companies' needs in the event of litigation. Meanwhile, it has been observed by some commentators that in reality, the tobacco companies have not made substantial strides towards a consensus with public health interests on smoking and health. In her analysis of evolving language on tobacco, health and addictiveness on Philip Morris's website, Friedman comments that Philip Morris's wording in fact concedes little and is deliberately constructed to leave open options for Philip Morris's defence in the event of litigation.8 Another study on the use of language on Philip Morris's website found many contradictions and omissions that may undermine public health messages, including confusing information about addiction, tar and nicotine, a lack of motivational messages to quit smoking, and silence about tobacco-related mortality.9

Henningfield et al have studied courtroom testimony and other related statements made by tobacco companies regarding the addictiveness of tobacco.10 This report concluded that industry strategy has evolved to redefine and trivialise the term 'addiction', likening nicotine to substances such as caffeine and chocolate but distinguishing it from hard drugs like cocaine and heroin. The World Health Organization has published an extensive report, Evolution of the Tobacco Industry Positions on Addiction to Nicotine, that provides a detailed outline of the tobacco industry's public and internal views on addiction.11 It concludes that, 'the industry's current position on addiction as a complex of social, behavioural and pharmacological factors potentially allows the company to develop a so-called "safer" cigarette that manipulates behavioural and chemical properties related to addiction, but without necessarily changing the potential for addiction at all'.11

10.12.2 Secondhand smoke

As with active smoking, each of the tobacco companies operating in Australia addresses secondhand smoke (SHS) on its website in different, but equally meticulously constructed, statements. Philip Morris International's website offers a list of health consequences declared by 'public health officials' to be caused by SHS, and recommends that the public should be guided by these conclusions (Philip Morris International itself neither confirming nor denying any connection between SHS and disease).12 Philip Morris International also accepts that it is reasonable to restrict smoking in public places, with the exception that it does not support bans in 'restaurants, bars, cafes, discos and other entertainment establishments, as proprietors should be free to decide whether to permit, restrict, or prohibit smoking. If signage is posted communicating the smoking policy, and includes the public health view that exposure to smoke is harmful to non-smokers, then an individual can make an informed decision about whether or not to enter an establishment'.13 Less acquiescent, British American Tobacco Australia cites conclusions by the World Health Organization and the National Health and Medical Research Council on SHS, but goes on to cast doubt on the strength of the epidemiological research upon which these conclusions are based. British American Tobacco Australia only supports 'regulation that accommodates the interests of both non-smokers and smokers and limits non-smokers' involuntary exposure to [environmental tobacco smoke] ...such as the creation of smoke-free areas, combined with adequate provision for smokers'.14

Imperial Tobacco takes a very different position, acknowledging that SHS can be an annoyance, but declaring that 'it is our view that the scientific evidence, taken as a whole, is insufficient to establish that other people's tobacco smoke is a cause of any disease', and asserting that 'bans on smoking in public places are disproportionate and unnecessary'.15 Imperial reiterates the industry's standard arguments from earlier decades that issues regarding SHS can be resolved through common sense, courtesy, improved ventilation, and the introduction of smokefree areas in the workplace, restaurants and other public places.15

In Australia and internationally, the tobacco industry continues to lobby against measures to protect non-smokers from tobacco smoke, to dispute and undermine findings by medical and health bodies16-18 and to fund, directly and indirectly,19-22 research that supports its position on the health effects of secondhand smoke.

i A collection of public statements made by tobacco industry executives and officers from the Tobacco Institute of Australia dismissing the impact of smoking on health is available at: http://tobacco.health.usyd.edu.au/front-groups-and-spokespeople/ and http://tobacco.health.usyd.edu.au/diary-of-denial/

Recent news and research

For recent news items and research on this topic, click here  (Last updated May 2017) 

 

References

1. Francey N and Chapman S. 'Operation Berkshire' - the international tobacco companies' conspiracy. British Medical Journal 2000;321(7257):371-4. Available from: http://www.bmj.com/cgi/reprint/321/7257/371.pdf

2. Carter S and Chapman S. Smoking, disease, and obdurate denial: the Australian tobacco industry in the 1980s. Tobacco Control 2003;12(suppl. 3):23iii-30. Available from: http://tc.bmjjournals.com/cgi/content/abstract/12/suppl_3/iii23

3. Stevenson T and Proctor RN. The secret and soul of Marlboro: Phillip Morris and the origins, spread, and denial of nicotine freebasing. American Journal of Public Health 2008;98(7):1184–94. Available from: http://www.ajph.org/cgi/content/abstract/98/7/1184

4. Wayne GF and Carpenter CM. Tobacco industry manipulation of nicotine dosing. Handbook of Experimental Pharmacology 2009(192):457–85. Available from: http://www.springerlink.com/content/p620645230641214/

5. Philip Morris International. Smoking and health New York: Philip Morris International, 2011, [viewed 12 August 2011] . Available from: http://www.pmi.com/eng/tobacco_regulation/smoking_and_health/pages/smoking_and_health.aspx

6. British American Tobacco Australia. Cigarettes and smoking. Maroubra, New South Wales: British American Tobacco Australia, 2010, [viewed 12 August 2011] . Available from: http://www.bata.com.au/group/sites/BAT_7WYKG8.nsf/vwPagesWebLive/DO7WZEPS?opendocument&SKN=1

7. Imperial Tobacco Group. Tobacco and health. Bristol, UK: Imperial Tobacco Group, 2011, [viewed 12 August 2012] . Available from: http://www.imperial-tobacco.com/index.asp?page=40

8. Friedman LC. Philip Morris's website and television commercials use new language to mislead the public into believing it has changed its stance on smoking and disease. Tobacco Control 2007;16(6):e9. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/16/6/e9

9. Smith E and Malone R. Philip Morris's health information web site appears responsible but undermines public health. Public Health Nursing 2008;25(6):554–64. Available from: http://www3.interscience.wiley.com/journal/121473560/abstract

10. Henningfield J, Rose C and Zeller M. Tobacco industry litigation position on addiction: continued dependence on past views. Tobacco Control 2006;15(suppl. 4):iv27-36. Available from: http://tobaccocontrol.bmj.com/cgi/reprint/15/suppl_4/iv27

11. Hirschhorn N. Evolution of the Tobacco Industry Positions on Addiction to Nicotine. Tobacco Free Initiative. Geneva: World Health Organization, 2008. Available from: http://www.who.int/tobacco/publications/evolution_tob_ind_pos_add_nicotine/en/index.html

12. Philip Morris International. Secondhand smoke. New York: Philip Morris International, 2011, [viewed 12 August 2012] . Available from: http://www.pmi.com/eng/tobacco_regulation/smoking_and_health/Pages/secondhand_smoke.aspx

13. Philip Morris International. Regulation of public place smoking New York: Philip Morris International, 2011, [viewed 12 August 2011] . Available from: http://www.pmi.com/eng/tobacco_regulation/regulating_tobacco/pages/public_place_smoking.aspx

14. British American Tobacco Australia. Second-hand smoke. Maroubra, New South Wales: British American Tobacco Australia, 2010, [viewed 12 August 2011] . Available from: http://www.bata.com.au/group/sites/BAT_7WYKG8.nsf/vwPagesWebLive/DO7WZEWB?opendocument&SKN=1

15. Imperial Tobacco Group. Environmental tobacco smoke (ETS) and smoking in public places. Bristol, UK: Imperial Tobacco Group, 2011, [viewed 12 August 2012] . Available from: http://www.imperial-tobacco.com/index.asp?page=37

16. Trotter L and Chapman S. 'Conclusions about exposure to ETS and health that will be unhelpful to us: how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking. Tobacco Control 2003;12(suppl. 3):iii102-6. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/12/suppl_3/iii102

17. Muggli ME, Hurt R and Repace J. The tobacco industry's political efforts to derail the EPA report on ETS. American Journal of Preventive Medicine 2004;26(2):166-77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14751332

18. Ong E and Glantz S. Tobacco industry efforts subverting International Agency for Research on Cancer's second-hand smoke study. Lancet 2000;355(9211):1253–9. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140673600020985/abstract

19. Tong EK, England L and Glantz S. Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry. Pediatrics 2005;115(3):e356-e66. Available from: http://pediatrics.aappublications.org/cgi/reprint/115/3/e356.pdf

20. Tong EK and Glantz SA. Tobacco industry efforts undermining evidence linking secondhand smoke with cardiovascular disease. Circulation 2007;116(16):1845-54. Available from: http://circ.ahajournals.org/cgi/reprint/116/16/1845.pdf

21. Bero LA, Glantz S and Hong M-K. The limits of competing interest disclosures. Tobacco Control 2005;14(2):118-26. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/14/2/118

22. Kummerfeldt CE, Barnoya J and Bero LA. Philip Morris involvement in the development of an air quality laboratory in El Salvador. Tobacco Control 2009;18(3):241–4. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679184/

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