Swaying Public Opinion

The documents show that Brown and Williamson—and probably the other tobacco companies—was not above using its significant economic clout to try to sway public opinion. Several documents from the 1970s and 1980s describe discussions about, or actual involvement in, manipulating corporations, the media, and physicians.

Influencing Corporations

As the tobacco industry faced increasing government regulation, it turned to the corporate world, particularly the corporations with which it had business ties, for assistance. Such corporate friends could obviously be useful to the industry in various ways, but, if nothing else, they could at least refrain from taking actions that were detrimental to the industry. A memo from the late 1970s discusses a proposal to use B&W's economic relationships to convince various corporations to maintain a more fa-

vorable attitude toward smoking and the tobacco industry. The memo, dated February 3, 1977, was sent from Ernest Pepples to C.I. McCarty.

A question has arisen in different forms about approaching companies we do business with who are prominent in association with the American Cancer Society or with other forces against the tobacco industry, or who happen to be involved in some other way with aspects of the anti-smoking campaign. Three examples: the Chairman of the St. Regis Paper Company is lending his name to the anti-smoking press release put out by the American Cancer Society; TWA [Trans World Airlines] would not let their premises be used by persons who were seeking petition signers in support of the industry's position before the CAB [Civil Aeronautics Board]; and the Chase Bank in New York is permitting a stop smoking clinic on their premises.

I favor the idea of raising with our friends in such companies the points which we consider are being used unfairly and falsely against tobacco and giving our side of the story.

It is imperative that we do not apply overt economic pressure in carrying our message. It is also essential that we operate this program solo. If it is done in collaboration with other companies or through the [Tobacco] Institute, in my opinion a serious question arises under various trade regulation laws which prohibit boycotts and other joint economic action.

Just as a rule of thumb, we have considerably greater latitude in deciding who [sic ] we will deal with than we do in deciding when we will stop dealing with someone. Both areas must be approached with great caution.

If properly structured, however, Brown & Williamson can certainly tell its side of the story in the smoking and health controversy and refute the false claims made against cigarettes. It goes without saying that communications to our friends in other industries should be done deliberately, carefully and tactfully in order to have maximum impact. If we follow that common sense approach, we will not stray off the path into the thicket of unfair trade practices and boycotts [emphasis added]. {2116.01}

In view of the industry's consistent public posture that smokers can quit if they so wish, it is hard to understand Pepples's concern over the existence of a stop-smoking clinic at the Chase Bank. In any event, the memo was written just as an initiative campaign was being launched in California to limit smoking in workplaces and public places (see chapter 10), and the tobacco industry in fact did exert enormous influence on restaurants and small business associations, as well as other corporate entities, to oppose that initiative. However, although the industry was able in the early days of the nonsmokers' rights movement to wield great influence with corporations, it gradually lost much of its corporate support as the dangers of secondhand smoke and the costs of smoking to employers became more evident. For example, when a law

to regulate smoking in the workplace was proposed in San Francisco in 1983, it was supported by the Bank of America.

Influencing The Media

Like any other industry whose products are the subject of public debate, the tobacco industry has always attempted to curry favor with the media. As discussed in chapter 5, during the "safe" cigarette era of the 1960s, the industry enjoyed some strong support in the media. However, by the 1980s much of that support had eroded, and the industry often had to struggle to find a sympathetic media voice. As several memos from the early 1980s indicate, the industry attempted to influence media coverage of proposed legislation on cigarette labeling and advertising by Congressman Henry Waxman (D-CA) and Senators Orrin Hatch (R-UT) and Robert Packwood (R-OR).

On February 8, 1983, Horace Kornegay, chairman of the Tobacco Institute, wrote to Ernest Pepples at B&W stating:

First, the project to determine in each company who is personally acquainted with the publisher, editor or business manager of any of the newspapers on the list which was distributed at the meeting of the Executive Committee and to set up a meeting with the publisher, editor or business manager for the purpose of informing him of the great dangers contained in the Waxman-Hatch-Packwood bills. I would urge you to move as soon as possible on this undertaking inasmuch as the Congressional committees could begin action on these bills within the next few weeks. {2131.02, p. 1}

This project appears to have been part of an industry-wide effort to approach all major media. Thus, a letter dated February 8, 1983, from C.H. Judge, who was in the office of the president of Lorillard Tobacco, to Samuel D. Chilcote, Jr., president of the Tobacco Institute, states:

Have met with Dick Monroe, Chief Executive and Cliff Grum, Executive V. P. of Time, Inc. Agreement reached for presentation to Editor-in-Chief of Time, Inc. and Managing Editors of all Time, Inc. Magazines. Presentation to be mainly rebuttal of upcoming Surgeon General's Report and a plea for fairness and objectivity.

...

cc: TIEC [Tobacco Institute Executive Committee] Members. We need help. Key city newspapers (eg. NY Times, LA Times, Wash. Post, Houston Chronicle, etc., etc.) key. If you can set up and attend a similar meeting, please let Sam [probably Sam Chilcote] know. {2131.03, p. 1}

In a memo to Dr. I. W. Hughes, B&W chairman and CEO, also dated February 8, 1983, Tom Humber, B&W assistant director of corporate

affairs, discusses the possible pitfalls involved in attempting to influence the media:

I have persistently criticized the industry and TI [Tobacco Institute] for not taking a pro-active stance with regard to article placement in what I call, for lack of a better umbrella term, the popular press. By that I mean the mass circulation magazines, ranging from Ladies Home Journal to Playgirl . That, I believe, is where the attack is headed. Having lost our advantage of positive pursuit during relative quiet, we must now fight a rear-guard action with limited hopes.

...

Given the proclivities of several companies, I believe there is significant danger of pressure tactics that could easily backfire and make matters worse. If we've got what we say we've got, then the authoritative, coherent presentation of information is the best course. The seminar approach is substantive and clean; it can, to some extent, be better controlled. It can provide more information to more people in a shorter time. We will be attacked for whatever we do, but the open approach has a better chance of being regarded as honest and straightforward, even gutsy, than private meetings in parking garages [perhaps a reference to "Deep Throat" of Watergate fame] or French restaurants.

Our message should be simple: We shall not use our advertising dollars to influence editorial material. In fact, we believe that the smoking and health controversy mandates more public discussion, not less, just as it mandates increased research. But the discussion should be informed, balanced and accurate, not based on anyone's propaganda. To that end, here are scientists, here are films, here are documents, here are resources for you to call on when you have questions [emphasis added]. {2131.04, p. 2}

Some of the same concerns are expressed in a February 14, 1983, "restricted" memorandum from Pepples to Dr. Hughes, regarding "industry contacts with editors":

The gist of what I said was as follows. While contacts to media by CEO's do make sense in the present circumstances, they need to select the ground carefully and coordinate with the appropriate advisers. I suggested that the better ground was the Waxman-Hatch-Packwood legislation on cigarette labeling and advertising because it presents First Amendment concerns which are so dear to the heart of publishers. I further suggested that the footing would not be as good on the alternative ground, heart disease and the Surgeon General's Report. [The 1983 Surgeon General's report dealt with smoking and heart disease.]

...

Finally, a concern was mentioned to [Arthur] Stevens about a potential backlash, legal and otherwise, if the publishers see our contacts as either solo or jointcoercionto influence news and editorial content. I mentioned the Wall Street Journal article of some several weeks back as well as the recent

contact from a Milwaukee reporter, raising the issue of advertising dollars and the press' freedom to express antismoking views. This is merely a caveat, not a bone-breaker. The industry has a good, respectable position to present. It is just a matter of keeping it in mind and saying it to the publishers. No company uses its advertising dollars in a coercive way. Indeed, the industry urges that the public deserves more not less discussion of the smoking and health controversy. But the discussion should be balanced and accurate and it should be free of the rhetoric and one-sided propaganda which sees no good in cigarettes and only great harm.

...

Curt [Judge] then informs his listener that if such legislation [providing for rotational warnings on cigarette packs] passes, litigation will wipe out the cigarette industry and the publishers will not have a customer for their advertising space. Arthur [Stevens] indicated that Curt Judge would use this approach as part of his presentation to the editors of Time Magazine . Stated another way, he would get into the Waxman/Hatch/Packwood situation even though it is extraneous to the central subject of heart disease and the Surgeon General's Report [italic emphasis added]. {2131.01, pp. 1–3}

That both Humber and Pepples would state that the industry does not use its advertising dollars in a coercive way is remarkable. Not only does the industry apply pressure through its advertising clout to forestall criticism in the media, but, as was discussed in chapter 5, the industry occasionally buys favorable media coverage by paying people to write articles supporting the industry without disclosing their ties to the industry.

Influencing Physicians

The tobacco industry's efforts to influence physicians began with the publication in 1954 of a booklet entitled A Scientific Perspective on the Cigarette Controversy (5). The booklet was merely one part of a large-scale public relations campaign being organized on behalf of the industry by the firm of Hill and Knowlton to counteract the emerging evidence of the health dangers of smoking (see chapter 2). According to a May 3, 1954, memorandum from Hill and Knowlton to the Tobacco Industry Research Committee (TIRC), the publisher of the booklet, it was released on April 14, 1954, and 205,000 copies were printed. It was sent to 176,800 doctors (general practitioners and specialists as well as the deans of medical and dental colleges), members of Congress, and 15,000 members of the press. As noted in a "Confidential" memorandum from Hill and Knowlton to the TIRC on August 17, 1954 (reporting the firm's activities through July 31, 1954), the booklet contained quotations from three dozen research and medical authorities, culled from both domes-

tic and foreign sources. The booklet "was held necessary and urgently timely to present to leaders of public opinion the fact that there was no unanimity among scientists regarding the charges against cigarettes" (5).

The documents contain evidence of continuing efforts by the tobacco industry to influence physicians over the next few decades. An untitled and undated document, apparently from about 1970, summarizes various proposed advertising strategies for the tobacco industry and B&W's analysis of them (see chapter 5); one item relates to "Communications with Physicians":

The need was felt for directing printed material to MDs on research efforts and studies which cast doubt on anti-smoking theory. Talk centered on reinstituting the [Tobacco] Institute's "Tobacco and Health Research" publication [which was distributed quarterly to more than 100,000 physicians in the late 1950s and early 1960s]. Our [i.e., B&W's] opinion was that a better approach would be to run a paid insert in some medical journals (particularly the well-read "Medical Economics" [a "throw-away" journal that focuses on how physicians can increase their incomes]) rather than direct mail pieces, which would probably end up in wastebaskets. We were in favor of a pilot study to determine the best method and, indeed, the feasibility of this type of communications. {2112.04, p. 2}

Thus, as in 1954, the tobacco industry was not content to influence physicians by passively responding to inquiries or communicating with them through the media. Rather, the industry was considering proactive steps, at substantial expense, to communicate directly with physicians.

Brown and Williamson also studied physicians' attitudes about cigarette smoke, to see what physicians were telling their patients and what their attitudes toward a safer cigarette would be. In March 1979 Dugan/Farley Communications Associates presented a report to B&W on a series of interviews with physicians {2127.01}. The emphasis the interviewers placed on "gasses" suggests that this was a marketing study for the Fact brand, which B&W had on the market at that time (see chapter 4). The interviewers found that doctors generally had poor success encouraging people to quit smoking, and that virtually all physicians were aware of conditions besides lung cancer linked to cigarette smoking. Despite this knowledge, fewer than one-third were aware that carbon monoxide is a problem or that other gases are linked with other diseases. Dugan/Farley's report concludes:

The "concept" of a cigarette that is low in tar and nicotine with a filter that greatly reduces known deleterious gasses was exposed to them [the doctors]. It was generally well received.

...

At this early stage in our research there seems to be hope for an educational program that would lead to acceptance by the medical profession of a "safer" cigarette. {2127.01, pp. 10, 11}

Medical textbooks at the time advised physicians to recommend low-tar cigarettes if a patient was not able to stop smoking. The marketing company's interviews with physicians introduced them to the concept of toxic gases in cigarette smoke, a problem they had not usually considered. Once confronted by this new problem with tobacco smoke, physicians responded favorably to the idea of a low-tar cigarette that also reduced "deleterious gasses." As it happened, B&W had such a product already on the market, Fact cigarettes, and the competition did not. However, B&W apparently was unable to capitalize on this insight, since Fact never attracted enough sales to warrant continued support. Indeed, this marketing study may have been part of a last-ditch effort to revive the brand. Nonetheless, the vignette well illustrates the underlying health benefit B&W promised in a low-delivery cigarette and, if the market research was, indeed, for Fact, it also shows that, with the Purite filter of Fact, the company made an additional health claim: that lower levels of certain toxic gases are better for the consumer.

Two years later, on April 29, 1981, G. E. Stungis, B&W's director of marketing research services, sent a "Limited" memorandum to Dr. I. W. Hughes, J. Alar (president and chief operations officer), and Ernest Pepples. In this memo Stungis discusses the possibility of marketing low-tar cigarettes through a Medical Communications Program {2129.01}. First, Stungis presents some background:

Up to now we have bits/pieces of how "Medical Communications Program" (MCP) may operate. Several optional and indeed variations within options exist ... all with cost structure implications.

Currently a number of assumptions exist ... by necessity at this stage. In this document Benefits Research will not be dealt with directly; consequently, we take as a given that:

There is [sic ] indeed benefits associated with smoking along the lines of stress/mastery.

There is a stable , sound and controllable benefits research team that is operative.

The output of the Benefits Research is technically sound.

Appropriate information channels with associated controls are indeed "assets in place".

Opposition counter measures developed [emphasis in original]. {2129.01, p. 1}

Using a communications diagram and an explanatory text, Stungis next describes an "MCP Model." In both the diagram and the text, he distinguishes between the "General Smoking Public" and "Extreme Concerned Smokers." The diagram pictures communications running among "Health/Medical," "Benefits Research Program," "Extreme Concerned Smokers," and "General Smoking Public." The text, which is written in shorthand form, reads as follows:

Benefits Research conducted in conjunction with credible asset . Results of Benefits Research are communicated through two controlled information channels ... devices for physician[s] and extreme concerned smokers. Physician community, accepts/refers in an interactive sense with smoking public and initiates information diffusion or so-called word of mouth process. To operate, the entire system must be continually driven. At introductory stage (time period?) referred smoking product would be only distributed through outlets associated closely with Health/Medical System [emphasis in original]. {2129.01, p. 2}

In conjunction with the model, Stungis notes that the following assumptions operate:

However, these assumptions are far from exhaustive:

Our earlier work (qualitative) with physicians provided clues ... no more, no less. We should pursue fairly rapidly to tighten up loose points above as well as uncover latent issues. Suggested further research work is:

Quantitative Study among Physicians ... primary objective would be to determine willingness on part of physicians to consider alternatives to consumables that affect patients' health and well being ... eg., cigarettes, coffee, etc. ... Properly designed study should confirm/refute assumption 1 through 3.

Qualitative Studies—Peripheral Health/Medical Systems (Pharmacist[s], Nurses, etc.) ... primary objective is to determine attitudes toward alternative risk/benefit consumables. This phase similar to early qualitative physician study. Would in all probability require quantitative follow up.

Consumer Qualitative Study ... primary object would be to obtain clues as to how effective physicians would be in convincing patients to use alternative products for improving his/her lifestyle management. Would require quantitative follow up [emphasis in original]. {2129.01, pp. 3–4}

Finally, Stungis outlines the cost estimates of the proposal {2129.01, p. 4}.

By 1981 several epidemiological studies had demonstrated that the tar reductions of the previous generation did not markedly reduce the risk of lung cancer (6), and internal BAT studies beginning around 1974 had shown that smokers of low-tar cigarettes compensate for the weaker smoke by smoking more intensively, in order to maintain their accustomed nicotine levels, and thereby lose much of the supposed benefit of low-tar brands (see chapter 3). Despite these findings, B&W apparently continued its efforts to sell low-tar cigarettes through the medical profession. Stungis's proposed Medical Communications Program may have been organized around the Barclay brand, B&W's "99% tar free" cigarette. Whatever specific brand, though, the concept belies any pretense that low-tar cigarettes are not about health. The MCP was organized to influence physicians to recommend certain types of cigarettes, if not specific brands, on the basis of their perceptions of health benefits.

These documents corroborate the impression that low tar and "low gas" were intended as a health benefit and demonstrate that B&W at least considered marketing these benefits to physicians. The documents do not indicate whether the MCP was ever actually put in practice. Its existence as a concept and the physician survey about "deleterious gasses," however, reveal that B&W, at least internally, considered marketing particular types of cigarettes as intended to prevent disease. This intent to provide health benefits (whether or not the products actually provided any), in turn, would have made the brands that were to be detailed through the MCP, as well as the "low gas" brand (probably Fact), drugs under the Food, Drug and Cosmetic Act.

Buying Friends

The Brown and Williamson documents include the confidential budget for state and local activities performed by the Tobacco Institute for 1987 {2229.01}. The proposed budget allotted $10,096,000 for state lobby-

ing activities, including campaign contributions and donations to a wide variety of organizations that play a role in determining public policy (table 9.2, p. 385). In many cases the connection to tobacco is not obvious; the industry simply seems to be opening doors and buying friends who can be called on to oppose controls on tobacco sales and use, taxation, and other issues handled politically.