Use Of Research From Special Projects

Although CTR's publicly stated purpose was to conduct scientific research, it actually served purposes related to public relations, politics, and litigation.

Producing Good Publicity

The tobacco industry used CTR to create a public image as a benevolent funder of science. In "Cigarette Smoking and Health: What Are the Facts?" TIRC-funded research is touted as contributing "to the fund of knowledge about lung cancer and other diseases" {1903.02, p. 4}. The document also boasts that "300 papers have been published in medical and scientific journals and societies which credit TIRC for support in whole or part" {1903.02, p. 4}.

A "Report to CTR Annual Meeting," dated January 31, 1975, describes 1974 as a "good year" for CTR because the work of its grantees was covered favorably in the lay press {1908.01}. The report specifically mentions that a paper published by Carl Seltzer (a special projects researcher, discussed earlier in this chapter) on the effect of smoking in lowering blood pressure "was reported on the front page of the Chicago Daily News and moved on CDN [Chicago Daily News] newswire" {1908.01}. The report also describes CTR's reaction when it did not receive credit for its sponsored research:

A CTR grantee last month had an article in an AMA journal that did not credit CTR for support. The article was brought to the attention of certain writers who were told of CTR's sponsorship. There was some followup on my part [the unnamed person who wrote the memo] and the science writer of the Pittsburgh Post-Gazette interviewed the scientist and wrote a nice piece. {1908.01}

Supporting The Industry's Public Policy Positions

An undated, unsigned document labeled "Privileged Attorney Work Product" and entitled "CTR Special Projects" shows that CTR and Special Account 4 special projects were used to fund researchers to testify at legislative hearings.

Dr. LGS Rao also received Special Account 4 money for testifying in the Hatch-Packwood, Waxman hearings. {2005.01, p. 1}

Rao's research, funded, in part, from 1977 through 1984 from Special Account 4, supported the tobacco industry's position that poor fetal outcome is associated more with poor nutrition than with smoking (table 8.1).

[Dr. Henry Rothschild] also testified at Hatch-Packwood, Waxman Hearings and probably received Special Acct 4 money. {2005.01, p. 2}

Rothschild's work, discussed above, was funded as a special project from 1977 through 1984, and was designed to support the tobacco industry's position that cancer is genetically determined (table 8.1).

Dr. [Gerhard] Schrauzer also testified in hearings re: Comprehensive Smoking Prevention Act of 1982. {2005.01, p. 3}

The memorandum does not specifically say whether Schrauzer was paid for this testimony. Schrauzer received support through CTR special projects to study selenium in tobacco and tobacco smoke (1981–83) and to conduct statistical and epidemiological studies on lung cancer (1983–85). He also was paid on a date not revealed in the documents through a Special Account 4 consultancy to prepare a statement on public smoking (table 8.1).

The undated, unsigned document described above summarizes studies that support alternate hypotheses for disease (e.g., the constitutional and genetic hypotheses):

CONCLUSION : Low protein intake (poor nutrition) associated with poor fetal outcome more than smoking habits. (NUTRITIONAL HYPOTHESIS ) [From a summary of L. G. S. Rao's Special Project through Account 4.] ...

SALVAGGIO/LEHRER PROJECT : All studies deal with rebutting contention that ETS [environmental tobacco smoke] aggravates allergies. ... [These investigators were funded through CTR special projects from 1981 to 1983 and from 1985 to 1988 (table 8.1).]

RESULTS : Challenge studies showed that exposure to cigarette smoke did not cause a significant decline in lung function among "smoke sensitive" individuals. Found that ETS did not impair lung function in asthmatics. ...

RESULTS : Preliminary clinical [trials] suggests that there are little, if any, human allergens in tobacco smoke. {2005.01, pp. 1–4}

This same document also cites a special project that could actually suggest positive health benefits of tobacco:

INVESTIGATORS : Drs. Henry and Linda Russek (Father and daughter) [They received funding through a CTR special project between 1979 and 1981 (table 8.1).]

SUBJECT : Relationship between psychological factors and disease. ...

Henry and Linda Russek have long investigated the link between stress and heart disease using prospective epidemiological studies. Have also found that smoking may be an effective means of coping with stress . ...

RESULTS : Proposal approved, and expected results to show that cigarette smoking is the best mechanism for smokers to cope with stress. Expect to show benefits of smoking (i.e. to reduce risk of stress-related heart disease) [emphasis added]. {2005.01, p. 3}

Creating A False Controversy Among Scientists

The tobacco industry's strategy of perpetuating controversy about the adverse effects of tobacco took place on two levels. One was to generate controversy among the lay public as discussed above. The other was to generate controversy among scientists. The controversy among scientists could then be publicized in the lay press. As mentioned in the previous sections of this chapter, special projects were often used to support scientists to prepare talks for conferences and to send scientists to conferences.

Sponsoring scientific conferences was identified early on as a way of publicizing results favorable to the tobacco industry's position. Support "in conducting conferences of scientists" is first mentioned in a document describing the formation of TIRC in 1954 {1903.03, p. 2} Sponsoring and publishing the results of scientific conferences has been used as a strategy by both the pharmaceutical and the tobacco industries to publicize research that supports their interests (9, 12). For example, the tobacco industry has sponsored at least six symposia on ETS. These symposia present research articles that are primarily unbalanced reviews of the medical literature, rather than original work. In general, the symposia articles, many of which are authored by industry-affiliated individuals, suggest that ETS is not harmful or that other factors contribute more to health problems than ETS does (9). Furthermore, once the symposia articles are published, they can be cited in a misleading fashion by the industry as if they were peer-reviewed medical or scientific journal articles. For example, articles from symposia proceedings were cited frequently by tobacco industry—affiliated individuals who reviewed the EPA risk assessment of ETS (1).

The tobacco company lawyers encouraged industry-supported scientists to attend scientific meetings in order to counter the results presented by the general scientific community. In 1978 William Shinn, an attorney at Shook, Hardy, and Bacon, wrote in a memo that it "may also be important to evaluate the desirability of increased attendance at scientific meetings" {1910.05}. Shinn then summarized the work of four non-industry-funded scientists who would be presenting data unfavorable to the industry at meetings, such as evidence that smoking is an addiction. The memo then notes that Dr. Gary Huber, then director of the CTR-supported research facility at Harvard University, will conduct a session at another meeting:

Dr. Huber has agreed to conduct a two-hour presentation at an American Thoracic Society/American Lung Association meeting in May. There will be

several participants, who will discuss the status of tobacco research in the fields of cancer, cardiovascular disease and chronic obstructive pulmonary disease. Dr. Huber also contemplates a section on the nonsmoker and tobacco smoke. {1910.05, p. 2}

Shinn's letter spends six paragraphs reporting on various aspects of Dr. Huber's work, including that Huber was concerned about the appearance that he had become closely identified with the tobacco industry:

Sometime ago Dr. Huber asked that a committee be formed at Harvard to critique the scientific aspects of the smoking and health programs. Dr. Huber, as you know, is very proud of the caliber of work done and wanted to lay to rest any accusations (completely unfounded) that the industry had control over the research. {1910.05, p. 3}

The lawyers also monitored the performance of industry-supported researchers at scientific conferences. It may be fairly inferred that if an industry-supported researcher presented data that were unfavorable to the industry, his or her chances for future industry funding would decrease. For example, an April 22, 1981, letter from attorney William Shinn to the counsels for the industry describes a meeting attended by special projects grantee Theodor Sterling:

At a meeting on occupational health, held earlier this month, he gave a presentation titled "Job Discrimination Based on Exposure Consideration and Smoking." This meeting was monitored by one of our research analysts ; she felt that Dr. Sterling's manner of presentation put his potentially hostile audience in a receptive mood and that the audience paid close attention to what Dr. Sterling had to say. He reviewed published evidence contrary to the idea that smoking heightens the risk of disease by interacting with certain substances to which workers are occupationally exposed. He also stated that the questions of whether other people's tobacco smoke is hazardous to non-smoking workers, and whether smoking workers represent an additional cost to industry, are not settled and that the published reports in these areas are based on data which can be questioned on sound scientific grounds [emphasis added]. {2022.03, pp. 2–3}

Researchers supported through special projects also reported back to the law firms and tobacco companies on the scientific conferences they attended. A January 19, 1978, memo from Donald Hoel at Shook, Hardy, and Bacon to Ernest Pepples states:

I enclose herewith a copy of a program for the International Symposium on Mechanisms of Airways Obstruction to be held in South Africa during March 28–31 of this year. You will note that Dr. [Domingo] Aviado [who was funded through special projects] is making a presentation at this symposium. I am

sure that upon his return, Dr. Aviado will be giving us a general report on the papers and presentations given at the symposium. {2007.03}

The tobacco industry sometimes sponsored conferences through an independent foundation, so that its sponsorship of the conference would not be disclosed. For example, in 1972 Dr. Theodor Sterling wrote to William Shinn asking for $5,000 to fund a panel on "Effects of Pollutants on Human Health at the International Meeting of the Society of Engineering Science in Tel Aviv, Israel." Sterling also suggested that the grant be awarded to the ALEPH Foundation, to "enable us to manage the arrangement of support in a proper and desirable manner" {2002.02}. It is advantageous for the tobacco industry to hide its sponsorship of scientific conferences because it makes the results that are presented at the conferences appear independent of the industry. In a memo to other industry lawyers, Shinn recommends that Sterling's request be approved and that it be funded through a "special project non-CTR" {2002.05}. Shinn believed that the conference proposed by Sterling would be valuable for advancing the industry's position that ETS is not dangerous because Sterling had been effective in this way in the past:

The work which Dr. Theodor Sterling has been doing in connection with air pollution became unusually valuable following the President's transmission on January 31 of an air pollution message to Congress, which you have received, that attempted to implicate cigarette smoking in 95% of lung cancer and 90% of chronic obstructive lung disease. {2002.05, p. 1}

Sterling's work was used to criticize this message.

The tobacco industry continues to fail to disclose its sponsorship of conferences; of the six conferences on ETS known to be sponsored by the tobacco industry, only four openly mentioned industry funding (9).

Reacting to "Undesirable" Results

According to the principles of academic freedom, researchers who work at universities are free to publish the findings of their research in the scientific literature regardless of the outcome of the research. Although tobacco industry—sponsored research organizations have maintained publicly that they do not restrict publication by their researchers, the documents show that they actually did attempt to influence scientific publication.

A document (undated) describing the organization and policy of TIRC, and later CTR, contains the following statement about scientific publication:

Recipients of Tobacco Industry Research Committee grants are assured complete scientific freedom in conducting their investigations and reporting the results of their research in the accepted scientific manner through medical and scientific journals and societies. The investigators receiving grants from the Committee are alone responsible for publishing or reporting their research results [emphasis added]. {1920.01, p. 6}

CTR's behavior regarding publication of results unfavorable to the tobacco industry, however, did not always follow these ideals.

When CTR-sponsored research that was unfavorable toward the tobacco industry was published, CTR had to defend the research to the tobacco companies. In a 1977 memo from Robert C. Hockett, assistant scientific director of CTR, to Addison Yeaman, president of CTR, Hockett attempts to undermine the conclusion of a paper published by C. G. Becker in the Journal of Experimental Medicine (13). Becker's paper concluded that glycoproteins isolated from tobacco leaves produce a substance known to cause allergic reactions and blood clotting. In his memo Hockett claims that Becker did not provide evidence showing that tobacco contains glycoproteins. Therefore,

[A]ll their work on rutin [a glycoprotein] has an obscure and doubtful relevance to the effects of smoke exposure on human subjects. ...

I regard the Becker-Bauer publication, as it appeared, to be very unfortunately premature.

Some of the observations might have been reported legitimately, in a different form, if the extensive speculations had been modified appropriately. {1910.01, p. 2}

Hockett also notes that CTR cannot be held responsible for the publication of Becker's results:

The present paper was seen here [at CTR] only after its submission to and acceptance by the journal. It represented a wide digression from the subject of the grant as we understood it. Our request that credit lines to The Council and to individual persons be deleted was reported to be 'too late' and the paper, with press releases, was published shortly thereafter, to our discomfort. {1910.01, p. 3}

CTR also attempted to turn a CTR-sponsored publication that was unfavorable to the industry into a public relations advantage. When such a publication came out, the tobacco industry publicized the fact that it had encouraged the author's research; it also prepared a response to the work. For example, in response to a paper on smoking as a cause of heart disease, published by CTR grantee Gary Friedman in

the New England Journal of Medicine (14), CTR issued the following public statement:

Grantees are always encouraged to publish their findings. This study reports relationships between various factors and death rates. There isn't any suggestion of cause-and-effect. ... This and so much else in the medical literature just shows that we have a great deal more to learn before we can reach any solid conclusions about smoking. It may or may not be hazardous, and that's where we are. {1916.01}

Influencing Government Policy

The documents reveal at least one instance where a CTR contract monitored by industry lawyers funded work that attempted to directly influence future publication of government documents on public policy related to tobacco and health. In 1967, the US Public Health Service published a study on the health effects of tobacco entitled Cigarette Smoking and Health Characteristics . The documents contain corre-spondence among industry lawyers in which the CTR contract is described as calling "for recommendations concerning the feasibility of a review and public analysis of the PHS report [emphasis added]" {2001.02, p. 1} that would criticize the methods used to collect the data for the PHS report. According to the documents, Theodor Sterling, then at Washington University, convened an "Advisory Panel" to for-mulate such recommendations, funded by a CTR contact to Washington University.

A December 26, 1968, letter from David R. Hardy of Shook, Hardy, and Bacon to the counsels for the tobacco companies describes a letter from Sterling and enclosures. (Neither the letter from Sterling nor the enclosures are among the documents.) Referring to the advisory panel, Hardy states: "I believe that this is perhaps the best work that Professor Sterling has done and it appears that we now have several other distinguished scientists who were members of the panel and who concur in our long held position that the Government's work in these various surveys is not reliable" {2001.01}.

One of the enclosures with Sterling's letter described by Hardy is a summary of the advisory panel's analysis of the PHS study. Sterling states:

It is worth quoting the concluding paragraph in [the summary of the advisory panel's analysis]:

There can be no doubt, however, that the claims made by Cigarette Smoking and Health Characteristics cannot be justified. Neither are the

data of adequate validity and reliability, nor is the analysis of these data properly designed and executed. The problems raised by these unjustified claims ought to be reviewed with the authority of a public body, properly constituted to do so, behind it.

Final recommendations of the [e]valuation group were delayed because of an apparent loss in the mail of comments from one member. These have just been received by me and are enclosed. ... It contains (a) the actual recommendations of the "Advisory Panel", (b) the principal justifications for such recommendations (Cigarette Smoking and Health Characteristicsand PHS claims based on it are examples used to demonstrate why a review procedure is needed ) and (c) minutes of the group's discussions ("not to be distributed outside the sponsoring agency") which bear on many problems in the health area.

The group which Dr. Sterling convened saw little use in going forward with a "definitive evaluation" of the morbidity study, preferring, in the words of the "Status Report" enclosed, to recommend that "a permanent commission needs to be formed for the purpose of establishing a consensus on the results of various studies and what they mean ."

This is an extremely ambitious undertaking and is not dissimilar to other recommendations made in the past. Dr. Sterling feels, however, that simply attacking the morbidity study alone would not cause the Government to withdraw the report nor make any headlines. Sterling believes that a top level advisory group (perhaps working with the [US] President's Science Advisory Committee or under its auspices, for example) would have the necessary prestige to prevent the future publication of documents such asCigarette Smoking and Health Characteristics [italic emphasis added]. {2001.02, pp. 1–3}

Hardy's description makes it clear that the CTR contract was not funded simply to critique the PHS morbidity study; it was intended to stimulate a "public analysis" of the PHS study—an analysis with a government imprimatur. Judged against this goal, Hardy's assessment of Sterling's success is understandable—Sterling's panel went beyond recommending a public analysis of the PHS report, and instead (apparently justifying the recommendation on the basis of alleged flaws in the PHS study) recommended the creation of a high-level government agency (perhaps in the White House) that would divert scientific efforts in an attempt to establish a "consensus on the results of various studies and what they mean" {2001.02, p. 2}. It was Sterling's judgment that such an agency would prevent the publication of future studies on tobacco and disease like the PHS study.

Although Hardy was enthusiastic about the boldness of the advisory panel's recommendation, he was also concerned that creation of a high-level agency could have adverse repercussions for the industry. He stated:

Obviously, there are problems involved in setting up any advisory group where conclusions might be binding on industry. There would certainly be implications involving the present industry-government dialogue. In any event, the very recommendations by Sterling's panel appear to be a condemnation of publication quality control at PHS. {2001.02, p. 3}

The advisory panel's recommendation that the process by which the report was generated be criticized, as well as the data in the report, is similar to a strategy that the tobacco industry has used to criticize the EPA's risk assessment of ETS (15). Seven tobacco industry-affiliated individuals who reviewed the risk assessment criticized the government procedure used to assess risk. In contrast, the independent EPA Science Advisory Board concluded that the risk assessment of ETS was "fully consistent with the risk assessments that [the EPA has] done for many other carcinogens" (1).