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Editor,—In the early summer of 1996, Philip Morris Europe launched a European campaign: “Secondhand smoke in perspective” to counter the growing public concern about the health effects of environmental tobacco smoke (ETS). In recent years, several governments in Europe had banned or restricted smoking in public places and in workplaces.1 Philip Morris wanted to put a stop to these regulations by demonstrating that all concerns about ETS were unfounded.
Advertisements appeared in the main Dutch newspapers. These tried to place the relative risk of lung cancer from living with a smoking spouse in the context of risks associated with other, everyday activities. According to Philip Morris, scientific data demonstrate that ETS does not present a meaningful health risk to non-smokers; the relative risks of lung cancer from passive smoking are lower than the risks of serious diseases from drinking chlorinated tapwater, or eating a biscuit or a pepper. The campaign was based on a report of a European Working Group,2 funded by Philip Morris, BAT, and Rothmans. The advertisements cited the relative risk of ETS for lung cancer produced by the Environmental Protection Agency in the United States.3 The health risks of the other activities were based on single studies.
Reactions to the campaign
Immediately after Philip Morris started their campaign, Stivoro (the Dutch Foundation on Smoking and Health) issued a press statement. Stivoro claimed that the campaign was highly misleading, in that the purported relationships between the foodstuffs mentioned and serious diseases were based only on single studies, and that ETS causes more diseases than just lung cancer, as was implied in the Philip Morris campaign.
The Dutch Union of Epidemiologists issued a fierce attack on Philip Morris’ interpretations of scientific research: “Data on risk factors for chronic diseases are interpreted in an unjustified manner. The campaign makes light of the health risks of ETS. We earnestly object to the way in which the campaign uses scientific research data.”
Leading experts in the field of cancer research and epidemiology, alerted by Stivoro, added to these condemnations. From the start, the campaign met with fierce criticism, not only from the health lobby, but also from media commentators and journalists.
In the first days of publicity, the Dutch participant in the industry-funded European Working Group, Professor PHM Lohman, from Leiden University,4 dissociated himself from the report.
Soon after the start of the campaign, a number of complaints were lodged with the Advertising Control Board, a self-regulating body of the Netherlands advertising community that seeks to prevent misleading campaigns. Complaints were lodged by the Asthma Foundation, the non-smokers’ union, CAN (Club actieve niet-rokers), the federation of tapwater companies, a spice producer, and several private citizens. These complaints were publicised and generated a lot of negative publicity for Philip Morris. Although Philip Morris’ goal was to open public debate on ETS, they refused nearly all invitations to respond to criticisms of their campaign in the media. Most importantly, the minister for health, Mrs Els Borst, condemned the campaign as being “really misleading”.5
The Advertising Control Board found the campaign to be misleading and formally recommended that it be ended. Philip Morris stopped the campaign prematurely, with the pretext of having reached their goal: “We have created enough discussion about this issue”.6
Effect on public opinion
By coincidence, in early 1996, a few months before the Philip Morris’ campaign, Stivoro had commissioned an opinion poll by the Dutch survey institute NIPO about ETS.7 To measure the influence of the Philip Morris campaign on public opinion we repeated this survey in the last quarter of 1996, three months after the campaign was withdrawn. A random sample (n = 6244) of the adult population was interviewed face to face.
The table shows that Philip Morris succeeded in one respect: the number of people who said that ETS is harmful to health had fallen after the campaign, although not significantly, by 1% to 73%. Ten per cent of the Dutch population thought that ETS was not harmful. Fewer people thought that ETS can cause lung cancer. This is a significant change.
However, the ultimate goal of the campaign failed in the Netherlands: more people said that separate areas for smokers and non-smokers in public places are needed; that smokers should ask permission before lighting up; and that employees should be able to work without being bothered by cigarette smoke.
Philip Morris’ purpose in running the campaign was to calm serious concern about ETS and forestall more smoking restrictions from the government. They tried to influence public opinion and the decision making process, so that state regulations to protect non-smokers would not be introduced in Europe. Philip Morris failed to achieve its goal of convincing the public that ETS does not warrant more regulation.
Tobacco control lobbyists in the European Union experienced great satisfaction when their hard work bore fruit in May 1998, when the European parliament voted in favour of a proposed directive which bans all tobacco advertising and sponsorship, and which will come into force in all member states of the European Union during the period July 2001 to July 2006.
In the final analysis, the Philip Morris campaign should probably be applauded for its role in facilitating the advertising ban. The campaign antagonised the Dutch government and the Commission on Health of the European parliament. As the commission was debating the advertising ban at the time Philip Morris launched its ETS campaign, it is likely that the campaign probably helped to reduce the tobacco industry’s political and public support.
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