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During the past couple of weeks, newspapers around the country have carried a colorful, glossy insert, prepared by Philip Morris, which purports, among other things to offer "information on...the serious health effects of smoking, quitting smoking, and cigarette ingredients."
Is this effort on behalf of the world's largest cigarette manufacturer evidence that the tobacco industry is doing an about-face on questions related to smoking and health and is finally 'fessing up to the health consequences of using their products?
The answer here is a mixed one, about 5% "yes" and 95% "no."
What They Said
Yes, in the sense that this a change, since Philip Morris and other cigarette manufacturers have either flatly denied or equivocated about the dangers of their products since l954, speaking with one voice about what they referred to as the "health controversy" over smoking. Clearly, there is a major difference between the posture of the industry on health issues in l954 — or l964 or even l995 — and the statements made in this month's Philip Morris insert.
"We agree," the PM section on cigarettes and disease begins, "with the overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema, and other serious diseases in smokers."
It goes on to note that "smokers are far more likely to develop serious diseases, like lung cancer, than non-smokers. There is no 'safe' cigarette."
Thus, some fifty years after smoking was identified as a major cause of premature death in the United States, Philip Morris has finally decided to abandon its stonewalling strategy. While other manufacturers, including Brown and Williamson, have in recent years tiptoed around the link between smoking and disease (noting that "health authorities" maintain that smoking causes disease and death), Philip Morris has walked the extra mile here and used the first person plural, "we agree." (A notable exception to their use of this grammatical construction is their commentary on secondhand smoke and disease, which reverts to "Public health officials have concluded," revealing that the industry is not yet willing to accept that reality.)
When an industry has been lying for more than half a century, then announces it is going to tell the truth but only tells a fraction of the truth, the impact can be as bad as or worse than the original lie. Philip Morris wants you to believe that it is now open and candid, allowing customers to make fully informed decisions, but in reality they have cleverly muddied the waters further. This advertising insert communicates the barest minimum of information about the negative health effects of smoking and contains misleading, ambiguous references. When links for "more information" about health effects, addiction, and quitting are offered, the links are to highly obscure, consumer-unfriendly sources.
What They Could Have Said
Philip Morris was very careful not to give an overview of the horrors of cigarette-related disease in the United States. For example:
—Nowhere did they mention the fact that cigarette smoking is the leading cause of preventable death in the United States, causally linked to one in every four deaths daily — one in every two premature deaths.
—The text did not even consider the topic of "dose" as it related to disease risk. How many cigarettes do you have to smoke before you increase your risk of disease? Many pack-a-day smokers might well assume, "Well, I don't smoke that much," unaware that smoking in excess of four cigarettes per day increases the risk of disease.
—The publication didn't address the concept of relative risk, ignoring the unique status of cigarettes as the only legally available product that is hazardous when used as intended. In these times when the media reports to us about the "carcinogen du jour" in our food, air, or water, for Philip Morris to say that "cigarettes cause cancer" is hollow unless they note that it is the leading preventable cause of cancer death in the United States.
—Nowhere was there a mention in the text of the deadly synergism of cigarette smoking and alcohol use in the causation of esophageal cancer.
—The text completely omitted reference to the grim reality that some effects of smoking are irreversible. For example, after decades of smoking, an ex -smoker will continue to have a substantially elevated risk of lung cancer compared to a never-smoker.
This minimalist disclosure attempt is further proof that cigarette companies are subject to different legal standards than are any other companies. Full disclosure for tobacco products would probably require an "insert" the size of the New York City phonebook. But if Philip Morris really wanted to come clean, they could have presented a synopsis of the health devastation caused by smoking — as was done in an advertisement in the science section of the New York Times this month.
In that half-page ad entitled "Smoking Spells Trouble — Here's Why," there was a clearly understandable overview of smoking's relationship to cancer, cardiovascular disease, lung disease, vision loss, multiple sclerosis, digestive diseases, reproductive health, bone health, oral health, and more. In their "educational insert," Philip Morris did not even attempt to describe the totality of the health consequences of smoking. And it obfuscated further by including links to hard-to-access supplementary material.
An Industry Held to Different Standards
Pharmaceutical manufacturers — or makers of ladders, baby carriages, or automobiles — must declare in detail and in understandable lay language all the potential risks of their product. If they do not, they will be held liable in court should a consumer suffer adverse effects. But because the tobacco industry lobbied for and successfully pushed through legislation to require a government warning label in l964 (the so-called "Surgeon General's Warning," although the Surgeon General and his office had nothing to do with it), the industry claims that it is "pre-empted" from disclosing risks themselves. Disingenuously, Philip Morris tell us here that they "support the law that requires cigarette manufacturers to place health warnings on packages and in advertisements." Of course they support it! It has protected them in court for years as they argued "cigarettes don't cause disease, and if they do, which they don't, consumers are fully warned by the government label."
Exactly why did Philip Morris elect to venture, every so gingerly, into disclosure territory? By doing so, they leave themselves vulnerable to the question "why did it take you fifty years to do this?" One can only conclude that consumer sentiment these days is so anti-tobacco-industry that attitudes toward the industry could only improve among the general population — and among potential jurors — if it appeared that the industry was moving toward more responsible behavior.
And "responsibility" is what it is all about. According to the mission statement on their website, PM's goal "is to be the most responsible, effective, and respected developer, manufacturer, and marketer of consumer products, especially products intended for adults." But the quandary here is: How can a company responsibly market a product that is inherently life-threatening?
Dr. Whelan, President of ACSH, holds doctoral and master's degrees in public health. | 
