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Tobacco Control: reflections on the first seven years
  1. RONALD M DAVIS, Editor 1992–1998

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As I announced in the Summer 1998 issue of Tobacco Control,1 I have stepped down as editor of the journal. Simon Chapman, deputy editor since its launch, is the new editor. In light of this transition, it is timely to review the first seven years of the journal’s life. The story of the journal’s development has not been told in print, so I will begin with that prologue.

Genesis of the journal

Why are there a half dozen journals in the field of alcohol abuse, but none for tobacco control? Why do we have several journals devoted to AIDS—a disease which has only been known since the early 1980s—but not one on tobacco and health? Those questions were vexing me when I worked at the Office on Smoking and Health, United States Centers for Disease Control and Prevention, in the late 1980s.

At a meeting of the World Health Organisation’s Technical Advisory Group on Tobacco or Health (TAG) in November 1989, I raised those questions and asked for the group’s support for the launch of a journal devoted to tobacco and health. The group responded favourably to the proposal, and suggested that “a platform for further discussion of the idea should be sought at the Seventh World Conference on Tobacco & Health, in Perth.”2

At the world conference in Perth in April 1990, I convened a meeting of 25 leaders in tobacco control, from a variety of countries, to discuss the proposal. There was a strong consensus that it should move forward, and the ensuing discussion focused on who might publish such a journal. One of the attendees was Pamela Taylor, then head of public affairs for the British Medical Association. She immediately called Stephen Lock, then editor of the British Medical Journal(BMJ), and reported back within 24 hours that the BMJ Publishing Group would be very interested in publishing such a journal.

In February 1991, the new editor of the BMJ, Richard Smith, met with me, Pamela, Martin Raw (deputy editor ofAddiction at that time), and David Simpson (then director of Action on Smoking and Health—United Kingdom), in London. At the meeting, Richard confirmed the BMJ Publishing Group’s interest in publishing a new journal on tobacco and health. Several months later, I accepted Richard’s offer to become editor of the journal.

Putting together the team, and choosing the name

Richard and I were delighted when Simon Chapman, a prolific researcher and writer in the field, agreed to become deputy editor. With the publisher in London, the editor in the United States, and the deputy editor in Australia, we had a good jump on our goal to develop a global reach for the journal.

Ken Warner and Judith Mackay, two of the most distinguished international leaders in tobacco control, agreed to serve as chair and vice chair of our editorial advisory board. Alan Blum, well-known in the tobacco control community as a writer, editor, speaker, and provocateur, served as our news editor for two years. David Simpson, another longstanding leader in international tobacco control, took Alan’s place in 1994 and has continued in that role since then. A dozen associate editors joined the team, assisting the senior editors in reviewing and making decisions on manuscripts. Seven regional editors were also appointed to help recruit papers and subscribers.

Now that the team was in place, we needed a name for the journal. After soliciting ideas from the tobacco control community, we choseTobacco Control. That name was favoured because it reflected our intention to focus on thecontrol of the problem, it subsumed the major interventions in this area (education, prevention, cessation, and policy), and it was pithy.3

From the very beginning we wanted the journal to be international in content and readership. To emphasise that point, we placed “An International Journal” on its masthead on the front and back covers. The associate and regional editors and members of our editorial advisory board represented more than 30 countries throughout the world. International organisations dedicated to tobacco control were invited to appoint representatives to the editorial advisory board, and most did so. Anti-smoking postage stamps from around the world were reproduced on the covers of the first six issues of the journal, again to emphasise the international scope of the journal. For several years we published Chinese, Spanish, and French abstracts of our research papers (this practice was ended because of the logistical difficulties in preparing the translations and because of the lack of evidence that the translated abstracts were being read and disseminated widely).

Plans to launch the journal were announced in theBMJ,4 and contributions were solicited. The first issue was published in March 1992,5just in time for distribution to all those attending the eighth world conference on tobacco or health in Buenos Aires, Argentina.

Content of the journal

The content of Tobacco Control has changed very little through the years (table), as the editors believe that the initial structure of the journal has served us—and our readers—well. The main changes that haveoccurred are that we are publishing more papers, we have added a few sections along the way, and we now include colour graphics and photography inside the journal.

Pages devoted to the various sections of “Tobacco Control”, 1992–1998

Perhaps the most striking feature of the journal is the colourful covers, accompanied by cover essays. We reproduce the covers from the first seven volumes of Tobacco Controlwithin this editorial, for two reasons: (a) to celebrate the first seven years of the journal, and (b) to ensure that the cover images appear in the permanent collections of libraries, which often remove the covers of journals before they are bound. Two of my favourite covers were those of the Spring 1996 and Spring 1997 issues, the first showing a photograph of a poor, malnourished child on the Pacific island of Vanuatu, holding a torn carton of Marlboro; and the second showing a photograph of “The Marlboro Man” of Indonesia, wearing pig-tusk nose rings, a penis gourd (not shown in the photo), and  . . . a Marlboro shirt. These two photos depict—in a gripping way—what the transnational tobacco companies are doing throughout the world.

News Analysis is where we feature stories about new developments in tobacco and health throughout the world. It is a section of the journal where we strive to cover events in developing countries, inasmuch as we receive few research papers from those countries. As a quarterly publication, Tobacco Control cannot report breaking news, so the focus of News Analysis is to report happenings that have received scant publicity, and to analyse the important news that has already been covered. Tobacco Control has been fortunate to have David Simpson as our news editor; his knowledge, wit, humour, and extensive contacts in the international tobacco control community have made this section one of the most informative and entertaining in the journal.

Original articles and other full-length papers (review articles, special communications) comprise the largest section of the journal, accounting for slightly more than half of the pages published from 1992 to 1998 (see table). Manuscripts are subjected to a rigorous peer-review process. That process has evolved and improved through the years, and revolves around an editorial committee (the “hanging committee”) which makes consensus decisions on papers that have been submitted. In a recent editorial, I explained in detail how that process works, and I recognised the contributions of the many peer reviewers who have participated in that process.6 During the past few years Mike Cummings and Ross Brownson have served with me on the “hanging committee”, reviewing large numbers of papers, participating in weekly conference calls, and corresponding with authors. Their knowledge and insight have greatly improved the quality of our manuscript reviews, and the huge amount of work they have performed has improved the timeliness of those reviews. Kudos also go to our three consulting editors for methods and statistics—Seth Emont, Todd Rogers, and Mike Siegel—who collectively review most of the papers submitted to Tobacco Control.

Ad Watch and Industry Watch are two sections which have been with the journal since its inception. They provide a forum for reporting on the activities of the tobacco industry in marketing, advertising, public relations, lobbying, and so on. Some of our most visually appealing articles have appeared in these sections. Like News Analysis, these sections allow us to report on developments in countries and regions of the world from which we receive few research papers. In fact, those very countries—whose populations are largely impoverished, illiterate, and unhealthy—are where some of the most outrageous activities of the industry are occurring.

Web Watch is a section we added beginning with the Summer 1997 issue.7 The explosion of information on the world wide web has included tobacco, and Web Watch columnist Jack Cannon has helped the journal track tobacco on the internet. Jack continually updates a page on his web site <http://www.gate.net/∼jcannon/webwatch/> which features links to all those sites covered in his past columns (totaling 123 as of 15 February).

From the beginning, Tobacco Control has published anti-tobacco cartoons, most of which appear in the section called The Lighter Side. Early on, we heard from a few sceptics that a journal with cartoons would not be taken seriously by the scientific community. We believe we have proven them wrong. Cartoons serve several useful purposes: (a) as mirrors of public opinion and media coverage, they help show how tobacco is viewed outside the confines of our research facilities; (b) they provide entertainment value, which is in very short supply in most scientific journals; and (c) they provide much-needed comic relief from the daunting and often depressing work in tobacco control.

Another section of the journal “on the lighter side” is Play It Again. As the introduction to this section states, it reproduces “quotes, gaffes, and immortal lines from both friends and foes of tobacco control”. Launched in the Spring 1995 issue, Play It Again usually comprises a potpourri of quotes on different subjects. A few editions, however, have been devoted to huge stories that provided a seemingly endless supply of priceless quotes—including the Philip Morris recall of cigarette brands contaminated with the chemical methyl isothiocyanate (MITC),8 the 1996 presidential campaign in the United States,9 and industry documents.10

A section called Speaking Personally was inaugurated in our March 1993 issue to allow contributors to reflect on some of the more personal aspects of what they do as they work to reduce tobacco use. Unfortunately we have received few submissions for this section. However, we are now publishing thoughtful articles in Speaking Personally in three consecutive issues of Tobacco Control—in the Winter 1998 issue, in this issue (see pages101–105), and in the next issue.

A variety of other sections (some regular and some occasional) have rounded out the content of the journal during its first seven years, including commentaries, letters to the editor, book reviews, obituaries, citations, calendar of events, reports from the WHO and the International Union Against Cancer, and “Special Reports”. Special Reports represent re-publication of the authoritative reports (or summaries thereof) from government agencies, academic institutions, and private health organisations.

Papers submitted and published

During 1992, the first year of the journal’s publication, 84 manuscripts were submitted. For the next four years, the number of papers submitted was remarkably consistent: 74 in both 1993 and 1994, 76 in 1995, and 75 in 1996. The number increased to 89 in 1997 and 83 in 1998. Data for acceptance rates and the length of time from submission to decision, submission to acceptance, acceptance to publication, etc., will be published soon.

American researchers have dominated as authors, writing 61.9% of the papers published in the first seven years (excluding the Winter 1998 issue). Next most published are Australian researchers (11.7%). Given Australia’s small population (18 million), Australian authors lead the world in “per capita publishing” in Tobacco Control. Authors from the United Kingdom (6.4%) and Canada (2.7%) are our next most published researchers, with all of Europe combined (excluding the United Kingdom) accounting for 8.7% of papers. We had hoped to attract publishable papers from developing nations, but so far that has not happened. In seven years we have published only eight papers from Africa and four from South America. The new editorial board will be actively encouraging authors from these regions to contribute further.

Recognition of the journal

Tobacco Control has enjoyed positive recognition in a variety of ways and from a diversity of sources. According to a review of Tobacco Controlpublished in the Journal of the American Medical Association (JAMA) after its first two years of publication, “Tobacco Control is a unique journal providing a synthesis of issues relevant to all who are interested in the political, economic, clinical, and epidemiologic aspects of tobacco control. This journal will be of value to practicing physicians as it heightens awareness of the magnitude of the problems caused by smoking and provides information on the effectiveness of cessation techniques. For physicians and others interested in taking an advocacy position in their states or local community, this journal will be invaluable in providing current information on the economics and politics of the issue.  . . . This well-written and professional journal should have an impact on the health of people worldwide.”11

INDEXING IN BIBLIOGRAPHIC DATABASES

Perhaps the most important achievement forTobacco Control was when the National Library of Medicine approved the journal for inclusion in its bibliographic database Index Medicus and its online counterpart, Medline, beginning in 1996.12 This ensured that articles published in the journal will be disseminated well beyond the journal’s subscribers and regular readers.

Starting with volume 7 (1998), issue 1, the Institute for Scientific Information <http://www.isinet.com> began to includeTobacco Control in several of its important databases: (a) Current Contents/Clinical Medicine; (b) Current Contents/Social & Behavioral Sciences; (c) Science Citation Index; and (d) Social Sciences Citation Index.

OUTSIDE FUNDING

Outside funding for Tobacco Controlprovides further evidence that others perceive an important role for the journal. The Robert Wood Johnson Foundation gave a three-year grant to Tobacco Control to support the dissemination of findings from tobacco policy research.13Bionax–Hong Kong and SmithKline Beecham have provided funding to pay for free subscriptions to the journal for tobacco control researchers and advocates in Asia, Africa, Eastern Europe, and Latin America and the Caribbean. SmithKline Beecham has contributed additional funding to pay for colour graphics and photography inside the journal.

SPECIAL SUPPLEMENTS

A variety of companies, organisations, agencies, and foundations have sponsored seven supplements to Tobacco Control published from 1992 to 1998. These include the proceedings of four national conferences in the United States,14-17 a compendium of working group reports on tobacco policy research needs,18 a collection of papers on policy research conducted in California,19 and a group of papers on research related to two large demonstrations in tobacco control funded by the National Cancer Institute.20 As an international, peer-reviewed, Medline-indexed journal,Tobacco Control is seen as an effective vehicle for disseminating information from conferences, consensus-development projects, and research programmes.

MEDIA COVERAGE

Media coverage of material in Tobacco Control provides yet another indication that the journal is publishing important information. Some of the articles in the journal have received substantial media coverage.

In the Spring 1995 issue, we published four articles and an editorial on the subject of nicotine manipulation in moist snuff products.21-25 That package of papers was very timely because their publication coincided with the United States Food and Drug Administration’s (FDA’s) investigation of the tobacco industry. With financial support from the Robert Wood Johnson Foundation,Tobacco Control and the American Medical Association convened a press conference in Washington, DC, at the National Press Club, and put out a video news release, to disseminate the findings of these papers. The press conference was scheduled more than a month in advance, and even though it was held seven days after the bombing of the Murrah federal building in Oklahoma City, it still attracted huge coverage in the media—on the four major national television networks (ABC, CBS, NBC, and CNN), on National Public Radio, on two wire services (Associated Press and Reuters), and in theNew York Times, Wall Street Journal, and USA Today.26-28 Several of these papers were cited by the FDA in the agency’s legal analysis supporting its assertion of jurisdiction over smokeless tobacco products.29

In the Spring 1997 issue, the journal published an editorial co-authored by eight leaders in tobacco control, entitled “What should be the elements of any settlement with the tobacco industry?”30 The editorial was published two months before the 20 June 1997 settlement agreement between the tobacco industry and state attorneys general who had sued the industry. It helped point out the shortcomings of that first settlement agreement, which was condemned by the health community and ultimately rejected by Congress. An article in the New York Timescited the editorial as follows: “Eight prominent anti-tobacco advocates from the medical and scientific community, in an editorial to be published by Tobacco Control, a journal of the British Medical Association, are calling for any negotiated settlement to be far tougher on the cigarette makers than the tentative terms that have been disclosed. For example, they called for a total ban on tobacco advertising and promotion, monetary damages as high as $32 billion a year to be paid by the industry, and the eventual removal of all nicotine from tobacco products.”31

The $32 billion figure came from another timely article published inTobacco Control.32

The Autumn 1998 issue of Tobacco Controlpublished a report from the American Medical Association’s Council on Scientific Affairs, calling for nicotine to be eliminated from cigarettes within five to 10 years.33 The British Medical Association (BMA) and the American Medical Association (AMA) held simultaneous press conferences in London and St Paul, Minnesota (where a large tobacco control conference was being held at the time) to call attention to the publication. In addition, health groups in Australia convened their own press conference at about the same time. The BMA, the AMA, and the Australian Medical Association each endorsed the recommendations of the Council on Scientific Affairs. The story was covered in leading newspapers in the United Kingdom34 and Australia,35 ,36 in the Reuters news service in the United States,37 and on several television stations in Australia. (See pages 106–109 for correspondence regarding the AMA report.)

RECOGNITION BY THE INDUSTRY

Recognition of Tobacco Control within the tobacco industry might be seen as confirmatory evidence that the journal is having an impact. When the journal was first launched, tobacco companies and their law firms signed up as subscribers. Representatives of the companies and affiliated organisations have sent us letters to the editor, a few of which we have published.38-40 Tobacco Control was hailed at an international tobacco industry conference as a symbol of the “coming of age” of the global tobacco control movement.41

Philip Morris documents made public in response to recent tobacco industry litigation included a memorandum aboutTobacco Control from Gerard A Wirz, Philip Morris Corporate Services Inc. (Brussels), dated 13 April 1992 (that is, shortly after publication of the journal’s first issue). The memo stated, in part: “[T]he articles contained in the journal deal with some of our most pressing issues. Judging by the names on their Editorial Advisory Board, this journal will certainly make an impact internationally. We should expect that anti-smoking groups will use the journal to lobby policy makers and to generate press coverage.  . . . Essentially, this journal offers a one-stop shopping guide for anti-smoking literature and other resources.”42

Three other Philip Morris documents on “the activist movement” and “our opponents” report on Tobacco Control.43-45

Finally, the industry has expressed an interest in seeing the internal files of Tobacco Control. I recently served as an expert witness in the case of Iron Workers Local Union No. 17 Insurance Fund vs Philip Morris Inc et al. Before my deposition, the law firm representing Lorillard Tobacco Company (Shook, Hardy & Bacon) requested “from Dr. Davis copies of all correspondence and other documents in his possession which relate to or reflect the launching, funding, mission and organization of his journal, Tobacco Control.”46That request was rejected by the law firm representing the plaintiffs in the case, because the requested documents were not materials upon which my testimony was expected to rely.47

Closing thoughts and acknowledgments

As seen above, the journal has accomplished a lot in a relatively short period of time. We have attempted to craft the journal into a publication that is scientifically sound, valuable to practitioners,and readable and entertaining. We hope we have accomplished our mission.

In my editorial in our very first issue, I also expressed the hope that the journal would “enhance the esteem of the movement, to help it attract a more abundant supply of educators, advocates, and researchers”.5 That outcome is more long term, and more difficult to measure, but I believe that Tobacco Control has indeed added legitimacy and credibility to the field.

The new team, under Simon’s leadership, will take the journal to “the next level”. I will enjoy watching the future growth and evolution of Tobacco Control—as a subscriber and reader, and perhaps as an occasional contributor. I will not stray far from the journal, as I have a new role with its parent publication—as North American editor of theBMJ.

I have been privileged to serve as editor ofTobacco Control for seven years. What made this role so much fun was the opportunity to work with colleagues who are so dedicated and talented. All that the journal has accomplished has been the product of a team effort. The chemistry among the members of that team has been remarkable. So forgive me for taking some space to acknowledge many of those who have contributed to the journal.

Of course our subscribers, contributors, and reviewers must be acknowledged up front, as the journal would not exist without them.

I have had five editorial assistants through the years: Elaine Beane, Paul Smyth, Sue Jackson, Jeff Pearsall, and Regina Yeckley. In addition, Helene Larson, Anne Bischoff, and Kim Raniszeski have provided clerical support for my work on the journal. I thank each of them.

Three technical editors in the United Kingdom have worked forTobacco Control—Sharon Davies, Sue Peter, and Anne Waddingham. Anne has served as technical editor of the journal for the past four years; I owe her a special debt of gratitude for her skill, hard work, sense of humour, and patience in dealing with an obsessive-compulsive editor.

Many other colleagues at the BMJ support the journal behind the scenes, and deserve recognition. Diane Harris and Julie Halfacre provide marketing support for the journal. Pete Christopher and his staff handle the production process. Alex Williamson (ably assisted by Carol Torselli) oversees all of the specialist journals published by the BMJ Publishing Group, includingTobacco Control; she has been the key advisor and trouble-shooter for the journal through the years, and her support has been an indispensable ingredient in the success ofTobacco Control.

Richard Smith, editor of BMJ, agreed to publish Tobacco Control, and gave me the opportunity to serve as editor. He also gave the editorial team the freedom to adorn the journal with a style quite unlike that of most other scientific journals. His leadership and mentorship have been invaluable to me and to Tobacco Control.

My co-editors deserve special mention. The associate editors have played important roles, as have the three consulting editors for methods and statistics (Seth Emont, Todd Rogers, and Mike Siegel). And I couldn’t ask for a better senior editorial team—Simon Chapman, Mike Cummings, Ross Brownson, David Simpson, Ken Warner, and Judith Mackay; their contributions have been critically important. I am very pleased that they will continue to serve the journal in the new regime.48 With their continued support, and with the creativity and energy that Simon is already bringing to the editorship, the future of Tobacco Control is very bright indeed.

Last, but certainly not least, I thank my wife, Nadine, and my three sons: Jared, Evan, and Connor. They have endured the eccentric work schedule of an overburdened journal editor. They have had to struggle for access to the home computer. And they have seen journal files encroaching on more and more floor space in our living quarters. I appreciate their support, patience, and understanding.

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