In a barely-reported but seismic event in public health history, Britain's esteemed medical journal Lancet this week called on Tony Blair to ban tobacco. That's quite a shift from the days when tobacco companies could still issue propaganda like the so-called "Frank Statement," which flatly denied that cigarette smoking had been shown to cause lung cancer. The fiftieth anniversary of that pronouncement arrives on January 4, 2004.
As ACSH's president, Dr. Elizabeth Whelan, put it in her 1984 book A Smoking Gun:
History might designate Monday, January 4, 1954 as the day that the Tobacco Industry officially became dishonest. On that day, newspapers around the United States carried a full-page advertisement that began "A FRANK STATEMENT TO CIGARETTE SMOKERS." The ad claimed that:
(1) Medical research of recent years indicates many causes of lung cancer.
(2) There is no agreement among the authorities regarding the cause.
(3) There is no proof that cigarette smoking is one of the causes.
(4) Statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of the many other aspects of modern life. Indeed, the validity of the statistics themselves is questioned by numerous scientists.
The companies who paid for the ad all of the major firms except Liggett and Myers, who thought it was a bad idea to get into debates with physicians and research scientists announced formation of the Tobacco Industry Research Committee (TIRC), funded but supposedly not controlled by the tobacco industry. A few days later, it was announced that Dr. Clarence Cook Little, a geneticist and cancer specialist, had accepted the scientific directorship. Although he had been managing director of the American Society for the Control of Cancer (now the American Cancer Society), Dr. Little served as a vigorous spokesman for the tobacco interests. One of his most frequent lines was that the tobacco-disease link was "premature and oversimplified." He passed off the eighteen major epidemiological studies demonstrating the link as "the opinion of a few statisticians." And he suggested that the problem lay not in tobacco but in the type of individual who smokes. Perhaps something in the smoker's physical or emotional make-up causes a bad cancer risk with or without the cigarette habit.
The TIRC announcement and advertising campaign were a way of saying "We care about your health, American smoker," a message designed by Hill and Knowlton, the public relations firm that still works with the tobacco companies today. The companies did distribute unrestricted money for research a fraction of their advertising budget but they ignored the resultant negative medical findings!
One still hears echoes from time to time of the old tobacco industry position, in obfuscatory or merely ignorant claims that the risks from smoking are simply too complex to calculate or are comparable to countless other risks in everyday life. And many are inclined to cut the industry some slack as smokers feel themselves increasingly hemmed in by anti-smoking regulations.
But the risks are clear, as is the main reason the industry has lied about them for so many decades: not simply to stymie regulation but to prevent potential customers from thinking clearly about taking up a potentially lethal habit. There is nothing admirable in the industry's actions. If they sometimes lie to bureaucrats and busybodies, they are just as happy to lie to innocent customers.
Basic economics would suggest that industries would tend not to knowingly kill their customers and that means that highly unsafe products ought to be a rare phenomenon in the marketplace but a highly-addictive and (usually) very slow-killing product is an exception to that pattern. You can make a lot of money off customers who take years to die, especially if their complicity in their own deaths (their partial awareness, however murky, of the risks they're taking) makes it difficult for them to sue the seller of the product.
Should the Lancet suggestion be followed and this most unusual of products be outlawed? It would be nice to find voluntary solutions instead of using the force of law, but let us never pretend that the cigarette companies are angels in all of this. They live by tempting others to risk death, and British doctors are right to remind people of that fact loudly and frequently.
Far from thinking of the tobacco companies as comparable to free spirits who flout regulations against dancing or public nudity, think of them as comparable to the cannibal recently brought to trial in Germany. He ate another human being but not, he argues, against that other person's will. Through an Internet search, he managed to find someone who, for whatever perverse reasons, wanted to be eaten. The two of them apparently even videotaped the whole meal, providing prosecutors with some two hours of damning footage. Perhaps cannibals shouldn't be put in jail when their victims come to them voluntarily. But the rest of us would do well to be wary of them, should not pretend they are admirable, should worry that they prey upon the weak-willed and ignorant, and should not be too quick to denounce anti-cannibal statements as Puritanical or anti-fun.
The tobacco industry's efforts to tempt people to their deaths have been going on far too long to record on a two-hour videotape, so they don't inspire the same sort of visceral outrage in most people. But they are ghoulish.