Special Projects Awarded To Henry Rothschild

Henry Rothschild, M.D., Ph.D., has been a professor of medicine at Louisiana State University, New Orleans, since 1972. Between 1977 and 1988 Dr. Rothschild was awarded grants of approximately $250,000 to conduct research on the role of genetics in the causation of cancer (table 8.1). In 1976 Henry Rothschild wrote a letter addressed to "Dear Mister" and sent it to B&W suggesting that his research implicating factors other than tobacco smoke in the causation of lung cancer would be of interest to the tobacco industry {2009.19}. Subsequent correspondence indicates that the tobacco companies were interested in Dr. Rothschild's work and began funding him through CTR special projects in 1977. A 1977 memo from lawyer Timothy Finnegan (at Jacob, Medinger, and Finnegan) to William Shinn (at Shook, Hardy, and Bacon) recommends that Dr. Rothschild be funded to conduct a pilot study "to explore the possibility that peculiar genetic and environmental factors are responsible for this unusual lung cancer pattern [in Louisiana]" {2009.15, p. 1}.

In his progress report about the work conducted in 1977, Dr. Rothschild asks for continued support and states that his work has shown that autopsy and lung biopsy are confirmed in only about 20 percent of deceased patients {2008.04, p. 1}. This finding would be important to the tobacco industry because the industry argues that lung cancer is diagnosed more often than it actually occurs (1). Rothschild also notes that his data will be useful to the industry because "it will allow us to raise several interesting questions concerning the validity of many epidemiologic studies based on Mason and McKay's data" {2008.04, p. 2}.

A 1982 memo from Timothy Finnegan to the counsels for the tobacco companies recommends that Dr. Rothschild be funded through a CTR special project to continue his work related to the genetic aspects of cancer {2015.02}. The 1982–83 funding enabled Dr. Rothschild to complete his work on the association between sugar cane farming and lung cancer. This work did not relate to genetic aspects of cancer, but it supported the tobacco industry's position that environmental factors other than tobacco cause lung cancer. In 1983 Timothy Finnegan again recommended renewing Rothschild's funding for another year to "discover possible genetic markers associated with lung cancers" {2034.02, p. 2}. Rothschild's work was useful to the tobacco industry because it suggested that environmental and genetic factors are associated with lung cancer, thereby shifting attention away from the health dangers of smoking.

The documents contain an example of how Rothschild's work was used by the tobacco industry. First, the work was used for congressional testimony. In the "Statement of Henry Rothschild, M.D., Ph.D. in response to S.772, the 'Smoking Prevention Health and Education Act of 1983'" (cited by Finnegan as a reason for funding Rothschild), Rothschild said that his work "indicates that genetic factors may play a significant role in this excess mortality from lung cancer" and "If we can isolate such genetic markers, it will be a major step toward unraveling another aspect in the mystery of lung cancer causation" {2034.03, pp. 1, 6}.

The documents on Rothschild show that he kept tobacco company lawyers informed about his work, even offering to let them review scientific manuscripts before the manuscripts were submitted for publication. In an April 17, 1979, letter, for example, Dr. Rothschild asks Timothy Finnegan to review a scientific paper:

Enclosed is a summary of our accomplishments during the past year. A copy of our proposal for the coming year, including the budget, and a preprint of a next to final copy of the paper we would like to submit to the New England Journal of Medicine is also enclosed. (I say the penultimate copy because I await your comments prior to submission ) [emphasis added]. {2034.18}

The paper in question never appeared in the New England Journal of Medicine; the documents do not indicate why. The document demonstrates that a tobacco company lawyer was involved in commenting on a scientific paper before its publication.

In 1979 Rothschild published an article entitled "The Bandwagons of Medicine" (2) in the scientific journal Perspectives in Biology and Medicine . The article's basic premise is that physicians "jump on the bandwagon" of whatever therapies are popular and use these therapies even though there is little scientific evidence of their validity. The article criticizes the overwhelming acceptance of unproven but popular ideas—"the bandwagons of medicine." Historical bandwagons cited in the paper include leeches, homeopathy, tonsillectomy, and anticoagulants. When the article was submitted for publication, it contained the sentence:

Exercise, vitamins, high fiber diet, and the complete elimination of cigarettes are all rapidly gaining acceptance among physicians, though at present time there is no definitive evidence to support their value [emphasis added]. {2009.06, p. 13}

Deletion of the phrase referring to cigarettes was suggested by one of the peer reviewers who read the article for the journal that published it. In

the published article the phrase "and the complete elimination of cigarettes" was deleted (2). The editor's acceptance letter stated:

We will be pleased to publish "The Bandwagons of Medicine". The reviewers and I have only one strong suggestion. We are convinced that it would be wise to eliminate the comment on cigarettes (p. 13). Since smoking is known to be harmful, your qualification 'complete elimination' will not be carefully noted [emphasis added]. {2009.07}

Rothschild apparently sent the manuscript and the editor's comments to Timothy Finnegan, who, in turn, circulated the editor's acceptance letter and page proofs of the article to the counsels for the tobacco companies. Finnegan evidently believed that the statement about cigarettes was an important part of the paper, even though the reference to cigarettes was the only one in the seventeen-page paper.

Of particular interest is the reviewer's comment about 'complete elimination of cigarettes' on page 13 of the manuscript, which makes the point of the paper [emphasis added]. {2009.05}

Thus, the documents reveal that Rothschild cooperated closely with the lawyers in allowing opportunity for editorial input and in reporting on professional editing that affected references to tobacco in Rothschild's work submitted to scientific journals on scientific subjects and that lawyers at the highest levels followed Rothschild's work closely.