Introduction

Tobacco has been controversial at least since its introduction into Europe shortly after Columbus reported that North American natives used its dried leaves for pleasure (1, 2). The first medical report of tobacco's ill effects dates to 1665, when Samuel Pepys witnessed a Royal Society experiment in which a cat quickly expired when fed "a drop of distilled oil of tobacco." In 1791 the London physician John Hill reported cases in which use of snuff caused nasal cancers. Not until the late 1940s, however, did the modern scientific case that tobacco causes disease begin to accumulate rapidly. Epidemiological and experimental evidence that smoking causes cancer led to the "cancer scares" in the 1950s and, ultimately, to the 1964 Surgeon General's report on smoking and health, which concluded that smoking causes lung cancer (3). By responding to these challenges from the scientific community with aggressive legal, public relations, and political strategies, the tobacco industry has been largely successful in protecting its profits in spite of overwhelming scientific and medical evidence that tobacco products kill and disable hundreds of thousands of smokers and nonsmokers every year (1, 4).

What did the tobacco industry actually know about the addictive nature of nicotine and the dangers of smoking? How did the industry develop its successful legal, public relations, and political programs? Until now, the public's understanding of these questions has been based largely

on observation of the industry's behavior and suppositions by a few journalists and public health professionals. This situation changed abruptly in mid-1994, when several thousand pages of internal documents from the Brown and Williamson Tobacco Corporation (B&W) and its parent, BAT Industries (formerly British American Tobacco) of the United Kingdom, became public. These documents reveal that the tobacco industry's public position on smoking and health has diverged dramatically not only from the generally accepted position of the scientific community but also from the results of its own internal research (see table 1.1, p. 15). While even these documents do not provide a complete picture, they offer a candid look at the tobacco industry's internal workings during the smoking and health "controversy" during the last half of the twentieth century.

BAT is the second-largest private cigarette manufacturer in the world. In 1992 the company sold 578 billion cigarettes (5), 10.7 percent of the total world output and more than were consumed in the entire US market that year (6). Its wholly owned US subsidiary, B&W, is now the third-largest cigarette maker in this country. Its US sales increased from about 10 percent of the market during the 1960s to about 18 percent in the 1970s, then fell back to about 10 percent in the 1980s (7). In 1994 it had an 18 percent share of the $48 billion US market, including the domestic cigarette business of American Brands, which B&W purchased in 1995 (8). B&W's domestic brands (before buying American Brands) include Kool, Viceroy, Raleigh, Barclay, Belair, Capri, Fact, and Richland, as well as GPC generic cigarettes.

The tobacco industry has used three primary arguments to prevent government regulation of its products and to defend itself in products liability lawsuits. First, tobacco companies have consistently claimed that there is no conclusive proof that smoking causes diseases such as cancer and heart disease. Second, tobacco companies have claimed that smoking is not addictive and that anyone who smokes makes a free choice to do so. And, finally, tobacco companies have claimed that they are committed to determining the scientific truth about the health effects of tobacco, both by conducting internal research and by funding external research.

These arguments have been essential to the industry's success in claiming that its products should not be subject to further government regulation and that it should not be held legally responsible for the health effects of its products. By refusing to admit that tobacco is addictive and that it causes disease, the tobacco industry has been able (so far) to

resist efforts to regulate its products. In addition, the industry has been able to argue that cigarette smoking is a matter of "individual choice," thereby essentially blaming its customers for the diseases they contract by using tobacco products. Finally, the industry's stated willingness to support health-related research has added credibility to its claim that the health effects of smoking have not been scientifically proven, thus helping to allay public fears about its products.

This book analyzes internal documents from the files of Brown and Williamson—documents that were delivered to us, as well as other related documents that have been released to the public during the past year. The documents consist primarily of internal memoranda, letters, and research reports related to B&W and BAT. Many of them are marked "confidential" or "attorney work product," suggesting that the authors never expected them to be released outside the corporation, not even for legal proceedings. These documents demonstrate that the tobacco industry in general, and Brown and Williamson in particular, has engaged in deception of the public for at least thirty years. They show that other cigarette manufacturers participated in some of these activities. The documents are listed at the back of the book under the heading "List of Available Documents" and are cited in the text in curly braces (e.g., {1234.56}). Copies of the actual documents are deposited in the Archives and Special Collections Department of the Library at the University of California, San Francisco, where they are available to the public. They are also available over the Internet at World Wide Web address http://www.library.ucsf.edu/tobacco. The library also has a CD-ROM version of the Documents for sale.

In the documents nicotine is routinely seen as addicting and is always treated as the pharmacologically active agent in tobacco. There is no question that B&W and BAT regarded nicotine's pharmacological (drug) effects as key to the intended smoking experience. The documents also demonstrate that the tobacco industry's professed public-spirited approach to pursuing the truth about smoking and health has been a sham. Its purported willingness to engage in and disseminate health-related research was, in reality, always subservient to commercial and litigation considerations. Initially, the companies' researchers tried to discover the toxic elements in cigarette smoke so that a "safe" cigarette, which would deliver nicotine without also delivering the toxic substances, could be developed. When that objective proved to be unattainable, largely because of the number of toxins involved, decisions about health-related research passed almost exclusively to lawyers. The documents show that

lawyers from B&W and other tobacco companies played a central role in research decisions, both within B&W and BAT and also in industry-sponsored research organizations.

The principal aim of this lawyer-controlled research effort was not to improve existing scientific or public understanding of the effects of smoking on health but, rather, to minimize the industry's exposure to litigation liability and additional government regulation. Where the goals of determining and disseminating the truth conflicted with the goal of minimizing B&W's liability, the latter consistently won out. In particular, even after B&W's research had shown that cigarettes cause disease and are addictive, under its lawyers' direction B&W sought to avoid generating any new results reconfirming that smoking causes disease or that nicotine is addictive. B&W sought to avoid affiliation with, or even knowledge of, such research results, for fear they could be used to show that B&W believed that smoking causes disease or that nicotine is addictive. B&W also sought to prevent the dissemination or disclosure of such results, either in court or in any public forum—apparently to the point of removing some relevant documents from its files and shipping them offshore.

Many of the documents are correspondence among company lawyers. In addition to providing insight into B&W and BAT's legal thinking, the lawyers effectively serve as candid witnesses for what the company actually believed at any particular time about disease causation and addiction. The lawyers appear to have accepted the causation and addiction hypotheses about smoking. The 1970s–1980s documents from lawyers specifying what could and could not be claimed in company public relations and advertising show that some lawyers regarded those hypotheses as so well established that they could not be denied directly without risking liability.

The documents show that by the 1960s the tobacco industry in general, and B&W and BAT in particular, had proven in its own laboratories that cigarette tar causes cancer in animals. In addition, by the early 1960s BAT's scientists (and B&W's lawyers) were acting on the assumption that nicotine is addictive. BAT responded by secretly attempting to create a "safe" cigarette that would minimize dangerous elements in the smoke while still delivering nicotine. Publicly, however, it maintained that cigarettes are neither harmful nor addictive. The tobacco industry's primary goal has been to continue as a large commercial enterprise by protecting itself from litigation and government regulation. To this day, despite overwhelming scientific evidence and official govern-

ment reports, the tobacco industry contends that tobacco products are not addictive and do not cause any disease whatsoever.