Elsevier

The Lancet

Volume 355, Issue 9211, 8 April 2000, Pages 1253-1259
The Lancet

Public Health
Tobacco industry efforts subverting International Agency for Research on Cancer's second-hand smoke study

https://doi.org/10.1016/S0140-6736(00)02098-5Get rights and content

Summary

Scientific reports on second-hand smoke have stimulated legislation on clean indoor air in the USA, but less so in Europe. Recently, the largest European study, by the International Agency for Research on Cancer (IARC), demonstrated a 16% increase in the point estimate of risk in lung cancer for nonsmokers, a result consistent with earlier studies. However, the study was described by newspapers and the tobacco industry as demonstrating no increase in risk. To understand the tobacco industry's strategy on the IARC study we analysed industry documents released in US litigation and interviewed IARC investigators. The Philip Morris tobacco company feared that the study (and a possible IARC monograph on second-hand smoke) would lead to increased restrictions in Europe so they spearheaded an inter-industry, three-prong strategy to subvert IARC's work. The scientific strategy attempted to undercut IARC's research and to develop industry-directed research to counter the anticipated findings. The communications strategy planned to shape opinion by manipulating the media and the public. The government strategy sought to prevent increased smoking restrictions. The IARC study cost $2 million over ten years; Philip Morris planned to spend $2 million in one year alone and up to $4 million on research. The documents and interviews suggest that the tobacco industry continues to conduct a sophisticated campaign against conclusions that secondhand smoke causes lung cancer and other diseases, subverting normal scientific processes.

Section snippets

Data sources

The tobacco industry documents are among 32 million pages made public as part of the settlement of the 1998 legal case of State of Minnesota and Blue Cross/Blue Shield of Minnesota vs Philip Morris Inc, et al. These documents are deposited in Minneapolis and each tobacco company has a searchable website archive. Search terms included IARC, IEMC, WRA, GEP, TASSC, NHANES (see glossary), “confounders,” and the names of key players. Most of the documents referred to here are on PM's website.* We

Initial fears and organisation

The 1992 US Environmental Protection Agency (EPA) report4 provided a comprehensive evaluation of secondhand smoke's health effects that stimulated clean indoor air laws in the USA.6 As similar legislation increased worldwide, PM began monitoring research internationally to prevent further restrictions. By 1993, Philip Morris Corporate Services in Brussels expressed concern that the IARC study would become “Europe's EPA”. PM also feared that IARC would produce, for tobacco smoke, one of its

IARC study

In early 1993 PM had asked Covington and Burling “through their consultants, to try and uncover as much information as possible on the current status, etc, of the IARC study” and requested “all those who receive a copy of this memo to use whatever internal and external resources they may have or may know about to help us get more information on the IARC study as quickly as possible”. Covington and Burling, the industry's Washington, DC based law firm, had established a network of sympathetic

Communications strategy

PM planned a variety of programmes to deliver and reinforce the industry's perspective on second-hand smoke, described in the September, 1993 “Action Plan” (panel 4).

The industry implemented these programmes before the IARC study's release. Besides the programmes that were internally conducted, PM used third-party vehicles that recruited other participants and funders and expanded its “sound science” discussion to issues beyond second-hand smoke, masking the industry's role as the initiator or

Government relations strategy

In September, 1993, PM planned to develop a lobbying plan before and after the IARC study's release. PM sought “key international government influence points” in the IARC donor countries for “generating pressure for reorientation/reprioritisation of IARC priorities/budget allocations”, and planned to lobby regulatory bodies and secure preemptive legislation against smoking restrictions. In 1994, PM developed a “briefing book” about the IARC study for the industry's messengers, allies, and

Discussion

The massive effort launched across the tobacco industry against one scientific study is remarkable. Whereas over ten years (1988–98) the IARC study is estimated to have cost $1·5–3·0 million, PM alone budgeted at least $2 million for “IARC” plans for just one year (1994) and proposed $4 million for studies to help discredit IARC's work. The elaborate plans were developed by PM's top management, implemented by an elite task force, and designed to coordinate the international tobacco industry.

Glossary: Abbreviations

BAT
British American Tobacco
CIAR
Tobacco industry's Center for Indoor Air Research
EPA
US Environmental Protection Agency
ESEF
European Science and Environment Forum
ETS
Environmental tobacco smoke
GEP
Good Epidemiological Practices
IARC
International Agency for Cancer Research, Lyon, France
IEMC
International ETS Management Committee
NHANES
National Health and Nutrition Examination Survey
PM
Philip Morris tobacco company
PMCS
Philip Morris Corporate Services
RJR
R J Reynolds tobacco company
TASSC
The Advancement of

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