Ashes to Ashes (150 page)

Even assuming a widened antismoking educational campaign, point-of-sale vigilance against underage purchases, the end of sampling and vending-machine sales, and insistence that cigarette ads be made far less alluring, merchandising with brand logos halted, and sponsorship of sports events and rock concerts be stopped, the best hope for cutting smoking’s immense toll in human life remained a rigorous FDA program to reduce over time the potency of cigarette yields. Just what those maximum permissible levels should be and how to measure them will require fresh scientific calculations in light of recent findings that, despite the reduction in average toxic yields over the past three decades as measured by FTC-approved smoking machines, the rate of lung-cancer deaths has not declined, even among lifetime smokers of filter-tip brands. Investigators led by Steven Stellman at Ernst Wynder’s American Health Foundation have clinically observed that smokers, besides probably
consuming more lower yielding cigarettes as they “smoke down” and underreporting their use, take bigger, more frequent puffs and hold them down longer “to achieve a desired physiological response to the pharmacoactive nicotine. We postulate that such a … change in smoking behavior has led to an altered deposition pattern of particulate matter within the lungs.” As a result, about half of the smaller particles that characterize the aerosol intake in filter cigarette smoke is taken far deeper into the lungs and trapped in the alveolar region, chief incubator of adenocarcinomas, which are decidedly on the rise. The FTC protocol for machine-measured yields is now “decades out of date,” according to Stellman.

In short, to be made markedly less deadly, cigarettes of the future will have to be blended and processed so that they contain significantly reduced dosages of harmful ingredients. It will no longer suffice to engineer the product in ways, such as with complex filter devices and porous paper, that can easily be compromised by smokers insistent on poisoning themselves. In the end of course, government cannot save those who—whether through smoking or any other way—have a suicidal bent, but it can do far more to frustrate the process than the tobacco companies concede—and without shutting down their grim business.

R.K.
May 1, 1997

Afterword to the Vintage Edition

No epochal event or stunning disclosure in the eighteen months since the original edition of this book went to press has caused the author to revise his basic judgments or the thrust of the narrative on the preceding pages. Still, one has the sense that a climactic moment is approaching in the tobacco wars and that an accommodation among the belligerents, roughly approximating the sort of negotiated settlement prescribed at the close of the text, may—amazingly enough—be in the offing.

The most telling recent event in this sorry history was the reelection of Bill Clinton in 1996 as the first antismoking President, after he had put into effect FDA regulations declaring cigarettes to be—whatever else they are—a drug-delivery system and therefore requiring oversight by federal public health officials. The scientific evidence supporting such a step had been in place for twenty years; what was missing was a show of political spine by an executive branch willing to challenge antiregulatory sentiment in a Congress long lubricated by heavy campaign contributions from flush cigarette makers.

Clinton’s shrewd political instincts were manifest in his couching the FDA initiative as essentially, a program to discourage teenage smoking, which, surveys showed, was sharply on the rise in the 1990s despite government intervention programs. More than four out of five voters polled said they favored the FDA regulations aimed at curbing youth access to cigarettes. So great was the appeal of this approach that a powerful new tobacco control champion, retion
of materials in order to craft a coherent social narrative about an industry that was, after all, a thriving enterprise well before a conclusive scientific consensus on the hazards of its products was achieved. My intent throughout has been to bring an unpremeditated approach to a subject that has historically generated a good deal more heat than light.

Of particular value to the book was the access kindly and cannily granted the author by the Philip Morris Companies, Inc., whose growth from the smallest of the six chief competitors in the U.S. cigarette business to its present dominance as the world’s leading private-enterprise purveyor forms a prominent strand of this history. The company allowed me to interview sixty of its past and present executives, some on more than one occasion, with the understanding that the book would fairly convey their views on the health question without necessarily embracing all or any of them. Most of the interviews were conducted with house legal counsel present; a list of questions for each session was submitted in advance, but the exchanges themselves were not limited to those topics about which prior notice had been given. House counsel, during hundreds of hours of discussion, intervened on only two occasions, claiming that the topic raised was pending before the courts or Congress. Not surprisingly, other interviews with former Philip Morris officials arranged beyond the company’s purview were more productive. In large part my purpose was to try to understand better how the company prospered, especially as the news from the scientific community grew worse and worse. That irony is one of the central themes of this work.

To have freighted the text with sourcing for all of its assertions would have required a companion volume perhaps equally forbidding in size. Instead, attribution of some of the main sources is given within the narrative itself, along with the place and date of publication of some of the most important scientific findings; a limited number of other sources, including books not listed in the Selected Bibliography, are cited in the Chapter Notes. Quoted comments, unless otherwise indicated, are drawn mostly from the author’s interviews, as suggested by the attributive verbs “recalled,” “recounted,” “remembered,” and the like.

The authority relied on in chronicling the comparative sales performances of the cigarette companies is John C. Maxwell, Jr., the veteran financial analyst and unofficial tollkeeper for the tobacco industry, a member of the Richmond-based brokerage and investment firm of Wheat, First Securities, Inc., who generously allowed me use of his data without revealing exactly how he had come by it—apparently a combination of tax revenue stamp reports, company-provided figures, and wholesaler corroboration. Maxwell’s numbers have generally held up as the most reliable gauge of the industry’s shipments, if not net sales figures. I was also courteously provided with many of the Tobacco Institute’s publications, quoted herein. The Federal Trade Commission’s annual reports
to Congress, as mandated by the 1965 cigarette labeling law, on the advertising and promotional expenditures and practices of the tobacco industry are the best source for this information, though they necessarily rely on the hard-to-verify claims of the companies themselves. The readiest source of information on the activities of antismoking lawmakers and litigants is the
Tobacco Products Litigation Reporter
, published since December 1985 with personnel based at Northeastern Law School; its contents, though, are often excerpts rather than complete texts and sometimes skewed by an avowed anti-industry perspective.

Some of the most noteworthy material in the book is derived from documents produced in the course of the discovery process for
Cipollone
v.
Liggett et al.
, which came to trial, during the early stages of my research. In many cases the documents are cited by plaintiffs exhibit number in the Chapter Notes.

My interview notes and other research materials are to be on permanent file in the Manuscripts and Archives Section of Sterling Memorial Library, Yale University.

* * *

Many people lent me assistance in this undertaking, which consumed six and a half years, in part due to a rash of unfolding events on the legal, political, and financial fronts, all affecting the status of the cigarette. My principal aide and sorely tried sounding board throughout this wearing process was Phyllis Kluger, who gathered and initially evaluated most of the scientific documents consulted. Susan S. Angelí prepared skillful memoranda on the political and legal aspects of the book. Michael Pertschuk of the Advocacy Institute and Donald Shopland of the National Cancer Institute were founts of wisdom on the modern history of the tobacco control movement. John C. Maxwell, Jr., of Wheat, First Securities (see above) kindly provided me with industry marketing data, and Joe Tye of Stop Teenage Addiction to Tobacco shared materials on the marketing and advertising practices of the industry. Attorney Marc Edell, chief plaintiffs counsel in
Cipollone
, and his associate Cynthia Walters and legal aide Nelson S. T. Thayer, Jr., were generous with time, insights, and materials. Alexander Holtzman, associate counsel of Philip Morris, and his assistant, Anne Doherty, were unfailingly courteous in response to many inquiries. Elizabeth Whelan of the American Council on Science and Health allowed me early access to her own research files. Anne Mintz,
Forbes
librarian, and Linda Smith of the Lexington, Kentucky,
Herald-Leader
helped me obtain highly useful clippings. Joan Garb of Buckingham, Pennsylvania, undertook often tiresome readings on the historical background of the subject. My old friend James C. Freund offered insights on some of the late-breaking corporate takeover maneuvers within the tobacco industry. Lisa Bero and Dr.
John Slade provided instructive and valuable scientific scrutiny. Others who helped in various ways were Clifford Douglas, Mark Pertschuk, Janet Holt, Morton and Anita Mintz, Carole Nebiolo, Andrew Mytelka, Daniel Kornstein, Jolie Goodman Khalsa, Fraser Lewis, Molly Ivins, Victor Navasky, and the late John Bogart. Without their invaluable collective help, my want of expertise would have made the project unthinkable. Finally, I am grateful for the editorial acumen applied to this book by Jonathan B. Segal of Alfred A. Knopf, Inc.

R. K.
Skillman, New Jersey

Selected Bibliography

American Medical Association/Education and Research Foundation.
Tobacco and Health. AMA/ERF, 1978.

Badger, Anthony J.
Prosperity Road: The New Deal, Tobacco, and North Carolina
. University of North Carolina Press, 1980.

Borgatta, Edgar F., and Robert R. Evans, eds.
Smoking, Health and Behavior
. Aldine, 1968.

Brecher, Ruth and Edward,
et al. The Consumers Union Report on Smoking and the Public Interest
. Consumers Union, 1963.

Burrough, Bryan, and John Helyar.
Barbarians at the Gate: The Fall of RJR Nabisco
. Harper & Row, 1990.

Calfee, John E.
Cigarette Advertising, Health Information and Regulation Before 1970
. Bureau of Economics, Federal Trade Commission, 1985.

Califano, Joseph A., Jr.
Governing America: An Insider’s Report from the White House and the Cabinet
. Simon & Schuster, 1981.

Coles, L. B.
The Beauties and Deformities of Tobacco-Using
. Ticknor, Reed & Fields, 1853.

Corina, Maurice.
Trust in Tobacco: The Anglo-American Struggle for Power
. London: Michael Joseph, 1975.

Corti, Count.
A History of Smoking
. London: George A. Harrap, 1931.

Cox, Edward,
et al
, eds.
The Nader Report on the Federal Trade Commission
. Richard W. Baron, 1969.

Diehl, Harold S.
Tobacco and Your Health: The Smoking Controversy
. McGraw-Hill, 1969.

Doron, Gideon.
The Smoking Paradox: Public Regulation in the Cigarette Industry
. Abt Books, 1979.

Dunn, William L., Jr., ed.
Smoking Behavior: Motives and Incentives
. V. H. Winston, 1973.

Eysenck, H. J.
Smoking, Health and Personality
. London: Weidenfeld & Nicholson, 1965.

———.
Smoking, Personality and Stress: Psychosocial Factors in the Prevention of Cancer and Cardiovascular Disease
. New York: Springer-Verlag, 1991.

Farnum, Henry W.
Our Tobacco Bill: A Tentative Social Balance Sheet
. Unpopular Review, 1914.

Festinger, Leon.
A Theory of Cognitive Dissonance
. Stanford University Press, 1957.

Finger, William R., ed.
The Tobacco Industry in Transition: Policies for the 1980s
. D.C. Heath/Lexington Books, 1981.

Fink, Bruce.
Tobacco
. Abingdon, 1915.

Fisher, Ronald A.
Smoking: The Cancer Controversy
. London: Oliver & Boyd, 1959.

Ford, Henry.
The Case Against the Little White Slaver
. Privately published, 1916.

Fritschler, A. Lee.
Smoking and Politics: Policymaking in the Federal Bureaucracy
. Prentice-Hall, 1969.

Gahagan, Dolly D.
Smoke Down and Quit: What the Cigarette Companies Don’t Want You to Know About Smoking
. Ten Speed Press, 1987.

Gerstein, Dean R., and Peter K. Levison, eds.
Reduced Tar and Nicotine Cigarettes: Smoking Behavior and Health
. National Academy Press, 1985.

Goldstein, Tom.
A Two-Faced Press?
Twentieth Century Fund, 1986.