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Editor,—Lisa Bero’s review of the above report1 is generous, but contains, apart from a number of minor inaccuracies, two specific points which we think should be challenged.
(1) “More documentation of the futile search for a ‘safer’ cigarette”. The reviewer makes much of the fact that “internal tobacco company research . . . had already demonstrated by the early 1980s that the production of a safer cigarette was not feasible for a variety of practical and legal reasons.” However this view was never apparent to the trust and only came into the public domain in the mid-1990s, when the trust’s programme was terminating, with the delving into the Brown and Williamson papers.2 She also discounts the points that (a) the search for a “safer” cigarette (after the collapse of tobacco substitutes) by “product modification” required properly funded and planned studies to monitor the programme’s effectiveness (or lack of it) and this formed the basis of the constrained terms of reference of the trust; and (b) that the final industry decision on monies to the trust was made in 1984 (with the last agreed payment in 1987), well before the alleged discoveries by Brown and Williamson. The continuance of the trust until 1996 was due to the pace of the trust’s agenda rather than to continued payments from the industry. The reviewer concedes that trust-sponsored studies showed an independent effect of tar yield on certain smoking-related diseases but surprisingly seems to consider that lower tar cigarettes, after discounting the effect of compensatory smoking, would not be “safer” than higher tar ones.
(2) Independence of the trust from the tobacco industry. The reviewer, by statement and innuendo, suggests that the trustees were not working free from the influence of the tobacco industry. This is not so. The trust was created by the Independent Scientific Committee on Smoking and Health (ISCSH) to administer research funds obtained from the tobacco industry (via the Tobacco Advisory Council (TAC)) for the Committee as part of the voluntary agreements (of 1980 and 1984) between government and the TAC which (to the reviewer’s clear disappointment) did not obviously include research related to smoking prevention and cessation! The legal status of the trust and the independence and objectivity of the trustees ensured that the responsibilities were discharged at arms-length from specifically, but not exclusively, the contracting and interested parties—the tobacco industry and government.3 The reviewer’s statement that the “tobacco companies participated in meetings and advised the [Tobacco Working Group] on the direction of research, just as they did for the [Tobacco Products Research Trust]” (our italics) may have been true for the Tobacco Working Group, a federally supported initiative launched in 1973 by the National Cancer Institute in the United States, but is certainly not true for the trust.
In reply,—(1) More documentation of the futile search for a “safer” cigarette. The key point in Cheryl Swann and Peter Froggatt’s response to the contrast I make between internal tobacco company research and research funded by the trust is that the tobacco company research was not in the “public” domain until the 1990s. As I stated in my review,1 the report on the trust, as well as Swann and Froggatt’s response to the review, begs the question of why the tobacco industry was supporting research on a “safer” cigarette when it already knew that a cigarette that was both safe and addictive could not be developed for a number of legal and practical reasons. As described in the trust’s own report, low-tar cigarettes are not “safer” than higher tar ones because smokers puff on them more frequently, increase the depth and duration of smoke inhalation, smoke more cigarettes per day, and smoke cigarettes to a shorter butt length.1
(2) Independence of the trust from the tobacco industry. I was disappointed that the entire £8 million spent by the trust was spent with the aim of maintaining use of a harmful product, rather than on prevention and cessation research that could potentially decrease use of a harmful product. The Tobacco Working Group is not identical to the trust. For example, as stated in my review, the Tobacco Working Group was not funded by tobacco companies.1 However, there were striking similarities between the Tobacco Working Group in their research agendas (which were set by the tobacco companies) and non-traditional peer review processes.4