CTR Special Projects Awarded To Theodor Sterling

Theodor Sterling is a university research professor at Simon Fraser University in Burnaby, British Columbia. In addition to receiving money through the university, Dr. Sterling also formed a private consulting firm that received funding through CTR special projects. Between 1973 and 1990 CTR special projects provided over $5 million to support Sterling's work, with additional funding through Special Account 4 (table 8.1). The focus of Dr. Sterling's tobacco research has been on examining factors that could potentially confound the association of tobacco smoke and adverse health effects. For example, he has studied the influence of occupational hazards and genetics on lung cancer. This work has been useful to advance the "constitutional hypothesis" of disease (i.e., that cancer is caused by genetic makeup, not smoking) favored by the tobacco industry and provides a distraction from the evidence on the adverse health effects of tobacco.

Documents from tobacco industry lawyers reveal that Dr. Sterling's work became increasingly important to the industry over time because it was used to dispute scientific findings about the adverse effects of tobacco. Dr. Sterling's long history of funding by the tobacco industry illustrates the scientific issues that were important to the industry at different times.

A February 27, 1980, letter {2020.06} from William Shinn of Shook, Hardy, and Bacon to the general counsels of the tobacco companies describes the way in which Sterling was funded both through the university and through his consulting firm, the range of his funded activities, the tobacco industry's use of his work, and the lack of a competitive review procedure to receive continued funding. The projects funded in 1979–80 were directed at refuting the evidence that environmental tobacco smoke is dangerous (see chapter 10). Dr. Sterling's projects were designed to critique published work on environmental tobacco smoke and to draw attention to occupational and other lifestyle factors that might confound an association between environmental tobacco smoke and disease. As described in the lawyer's memo, Dr. Sterling's work was presented at congressional hearings, at scientific meetings, and in scientific publications to support the industry's position that exposure to environmental tobacco smoke should not be regulated.

Dr. Sterling is presently quite busy in at least nine areas. These include: preparation of a review of health effects due to indoor combustion of organic material requested by the National Academy of Sciences; preparation of a paper to present to the American Lung Association on the possible relationship between occupation, smoking and lung disease; completion of work on familial disease among women whose husbands are exposed to irritating dust and fumes; an investigation of the change in employment patterns of women since the 1930's; a study of smoking habits and employment patterns among blacks; completion of an analysis of errors in the [Harold E.] Dorn/[Harold A.] Kahn Study [a study of smoking and mortality among US veterans]; analysis of the use of magnetic techniques to measure long-term lung clearance of particles in smokers and nonsmokers; and an examination of preliminary data from a study of indoor pollutants from gas stoves.

Dr. Sterling has continued to be helpful in frequent consultations about the smoking and health controversy. He testified at Congressional hearings on public smoking in October, 1978; has given several technical papers at professional meetings recently; and has prepared a number of manuscripts, some of which have been published.

...

He [Sterling] has offered to prepare a detailed proposal for the extension, but I am not too concerned about this since we could continue under the old agreement [emphasis added]. {2020.06, pp. 1–2}

One of the main purposes of CTR special projects funding was to attempt to discredit independent scientific findings about tobacco. A letter from William Shinn at Shook, Hardy, and Bacon to the counsels for the tobacco companies requesting their approval of Sterling's funding credits their funding arrangements with Sterling as enabling the companies to obtain fast responses from Dr. Sterling to dispute scientific results that were not favorable to the industry. In contrast to research grants, which usually focus on a specific topic, the lawyers' correspondence indicates that Dr. Sterling's special projects funding was used to criticize the work of other scientists, such as Cohen's study showing that smoking adversely affects people's ability to eliminate dust from their lungs (described below).

A February 4, 1981, letter from William Shinn of Shook, Hardy, and Bacon to the counsels for the tobacco companies states:

As in the past, Dr. Sterling has used the support received from his grant to develop proposals for other projects. The flexibility inherent in the current arrangement has also provided Dr. Sterling with the ability to respond quickly to new scientific developments.

... Dr. Sterling analyzed Cohen's article [8], which appeared in Science , May, 1979, and concluded that Cohen's claim that smokers have impaired long-term clearance capabilities compared to nonsmokers' is open to challenge because of his faulty experimental design. Dr. Sterling interested

Dr. Glicksman and colleagues at Brown University in this problem. Subsequently, both Dr. Sterling and Dr. Glicksman presented papers highly critical of Cohen's work at a recent conference. ... Dr. Sterling has been informed that Cohen and colleagues have apparently ceased this type of experimental work. In view of the many claims about the possible interaction of smoking and occupational exposures, Sterling's critical response to Cohen's work seems particularly important [emphasis added]. {2022.06, pp. 1–2}

Cohen and his colleagues (8) had human volunteers inhale a dust that could be traced because of its magnetic properties over a long period of time. They showed that after one year smokers had eliminated only half of the dust from their bodies, whereas nonsmokers had eliminated 90 percent of the administered dose. This work had potentially important implications for setting exposure limits to toxic dusts in occupational and in environmental settings.

Shinn's letter recommending approval of Sterling's funding contains a comment revealing the lawyer's interest in maintaining that Sterling was an independent scientist and not a representative of the tobacco companies:

Dr. Sterling is an independent scientist, of course, and as we have stated in earlier grant requests, there are to be no restrictions attached to his research work. Dr. Sterling's findings are his own, and we are free to agree or disagree with them. {2022.06, p. 3}

A March 1, 1982, memo from Patrick M. Sirridge at Shook, Hardy, and Bacon to the counsels for the companies requesting their approval for further funding of Sterling indicates that the lawyers were directly managing at least some of Sterling's work:

It is further recommended that the extension of Theodor D. Sterling, Ltd. commence May 1, 1982, because of unforeseen expenses due mainly to additional requests from our office [emphasis added]. {2037.04, p. 1}

Sirridge's acknowledgment that unforeseen expenses had been incurred by Sterling because Sterling was responding to additional requests from Shook, Hardy, and Bacon presents an ironic contrast with Shinn's insistence a year earlier that Sterling was an independent scientist. Sirridge repeats the point made by Shinn that the companies' funding arrangement with Sterling enabled him to respond quickly, apparently to requests from the lawyers. For example, one special request involved responding to publications on environmental tobacco smoke:

In January, 1982, Dr. Sterling prepared written comments in response to a paper presented by James E. Repace [of the US Environmental Protection

Agency] at the ASHRAE (American Society of Heating, Refrigeration and Air-conditioning Engineers) in Houston. ... Dr. Sterling's oral presentation at the Houston meeting and the written comments which will be published in the ASHRAE Transactions this summer provide the first public criticisms of the deficiencies in Repace's scientific methodology. Further, Dr. Sterling pointed out that Repace's reliance on studies such as Hirayama's [Takahishi Hirayama published a paper in 1981 demonstrating that environmental tobacco smoke increases the risk of lung cancer in nonsmokers] was misplaced and that his conclusions were at variance with many published reports and Dr. Sterling's own research on indoor air pollution.

The flexibility inherent in Dr. Sterling's ongoing project enables him to respond within a short time to scientific developments. His willingness to prepare written comments on Repace's paper with only a few weeks notice is a good example. Dr. Sterling also responded to the publication of Hirayama's article early last year with a highly critical letter to the British Medical Journal , a copy of which is enclosed as Appendix D. Most recently, Dr. Sterling has prepared responsive materials on the scientific aspects of legislative proposals (Waxman and Hatch bills) pending in Congress [emphasis added]. {2037.04, p. 2}

Sirridge then points out that Sterling's work will be useful for stimulating controversy about the health effects of environmental tobacco smoke:

[Sterling] has written an extensive critical review of the literature on indoor by-product levels of tobacco smoke which is scheduled for publication in March. This paper will serve as a useful critique of previous studies in this area, as it points out their deficiencies and emphasizes the need for more careful work ... [emphasis added]. {2037.04, p. 2}

In 1984, at the request of Ernest Pepples, B&W vice president for law, Sterling began to receive funding directly through the law firm of Shook, Hardy, and Bacon to continue his work reviewing epidemiological studies that demonstrated a link between smoking and disease {2037.01}. In a January 24, 1984, letter to Sirridge at Shook, Hardy, and Bacon, Pepples agrees that Sterling should be funded at the budget levels set forth but also states:

I do not think, however, that we should continue burdening CTR with such programs, and instead suggest that they be handled as law firm projects. {2037.01}.

Table 8.1 shows that in 1985 Sterling began to receive funding through Special Account 4, which was administered by the law firm of Jacob and Medinger.

In 1984, two years after Sirridge wrote the memo describing the usefulness of Sterling's work {2037.04}, that work continued to be useful to

the industry by stimulating controversy and refuting scientific findings about tobacco. A January 23, 1984, memo from Patrick Sirridge of Shook, Hardy, and Bacon to the general counsels of the tobacco companies summarizes some of Dr. Sterling's accomplishments for the tobacco industry:

He [Sterling] has also been concerned with selectivity in reporting in government reports such as the Surgeon General's. His conclusions have been presented at scientific meetings. ... Dr. Sterling and members of his staff have appeared before scientific and professional groups such as BOCA, ASHRAE [American Society of Heating, Refrigeration and Air-conditioning Engineers], and the California Energy Commission. ...

During the past year, Dr. Sterling attended international meetings in Geneva and Turin to present reports on environmental conditions in office buildings. Based on his research results, Dr. Sterling reported that there was no difference in the prevalence of complaints about health or environment among smokers and nonsmokers working in offices where smoking was permitted versus those where it was prohibited. Dr. Sterling continues to publish papers in scientific journals and make presentations at scientific meetings. ... Dr. Sterling has also provided assistance in responding to the 1982 and 1983 proposed legislation regarding new warning labels. He appeared before Congressman Waxman's Committee in 1982 and submitted statements in 1983. {2015.04, p. 2}

BOCA, ASHRAE, and the California Energy Commission are organizations involved in creating ventilation standards for buildings that are directly affected by environmental tobacco smoke. Sterling's presentations had the potential to influence regulation of environmental tobacco smoke exposure directly. The meeting in Geneva was a tobacco industry–sponsored symposium (9). Like those of other industry-sponsored symposia, the published proceedings of the Geneva conference featured the work of industry-funded scientists and contained articles that support the tobacco industry's position that tobacco smoke is not harmful (9). The industry-sponsored symposia are often cited by the industry as if they are peer-reviewed scientific journal articles that support the industry's position (1).

Sterling and Harold Perry were also funded under a CTR special project from 1978 through February 1982 to conduct an environmental study entitled "Retrospective Analysis of Environmental Contacts of Patients with Respiratory Cancer, Other Cancers, and Other Diseases" {2020.01}. In 1980 Sterling was funded under a CTR special project to conduct a study of indoor environments ("Feasibility Study on Office

Environments" {2022.10}). Robert Northrip (of Shook, Hardy, and Bacon), in a letter to the general counsels recommending funding, states:

It is our opinion that this work could be extremely useful in view of the intense activity we are witnessing in both legislatures and referendums to restrict indoor smoking. {2020.03, p. 2}

This study led to the development of a proposal entitled "Office Building Syndrome," with the purpose of examining

[the] dependence of this syndrome on building design and ventilation features, and investigating the syndrome's relationship, if any, to life-style factors, such as smoking. {2022.03, p. 1}

Theodor Sterling and his son, Elia Sterling, were coinvestigators on the $200,160 special project {2022.02}.

The documents show that Sterling has continued to receive funding through CTR and law firm special projects through at least 1993. The publication of Sterling's criticisms was part of a broad industry strategy to stimulate controversy about the adverse health effects of environmental tobacco smoke (1, 10, 11). Sterling's publications also gave the tobacco industry supportive material that could be cited in testimony before Congress, in court, in the medical literature, and in response to government documents in support of their position that the links between active and passive smoking and disease were "controversial."