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Big Tobacco Undermined Report on Secondhand Smoke (2000)
Thursday, April 6, 2000
A ten-year study conducted by the International Agency for Research in Cancer (IARC) examining the links between second-hand smoke and cancer was subverted by an unprecedented misinformation campaign coordinated by the tobacco industry and resulting in misleading media reports of the European scientific study even before it was published.
These are the findings of two UC San Francisco scholars whose analysis of the fierce tobacco industry information campaign is published in the April 8 issue of the medical journal Lancet. Authors are Elisa K. Ong, BA, and Stanton Glantz, PhD, both researchers at the Institute for Health Policy Studies in UCSF's Department of Medicine.
""The extent of tobacco industry money and effort spent to discredit a single study is unprecedented,"" said Glantz, professor of medicine at UCSF and long-time scholar and critic of tobacco industry strategies. Ong is a medical student at Stanford University.
The reason the industry was so concerned about the paper, he suggests, is that while scientific reports on second-hand smoke had already stimulated legislation on clean indoor air in the U.S., European countries have been slower to change.
""Tobacco industry strategists were apparently trying to head off the possibility of sentiment growing for similar restrictions in their European markets, so they hit this report with all they had,"" Glantz says. ""There seems to be little regard for the truth in the information they tried to spread."" In their paper, Ong and Glantz describe how the tobacco industry worked to undermine the conclusions and potential impact of the largest European study of passive smoking, conducted by IARC, the research arm of the World Health Organization (WHO).
Fearing that the IARC study (and a possible IARC monograph summarizing all scientific evidence linking second-hand smoke to disease) would lead to increased European smoking restrictions, the Phillip Morris tobacco company spearheaded an inter-industry, three-pronged strategy in the mid 1990s to subvert IARC's work, write Glantz and Ong. 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 scientific study cost roughly $2 million over ten years; Philip Morris planned to spend $2 million in one year alone and up to $4 million on research, the authors report. Part of Philip Morris' strategy was to use consultants sympathetic to the tobacco industry who were asked to find out more about the IARC report, and did not always disclose their industry links while seeking information from IARC investigators. The documents and interviews suggest that the tobacco industry continues to conduct a sophisticated campaign against conclusions that second-hand smoke causes lung cancer and other diseases, ""subverting normal scientific processes,"" the authors conclude.
The IARC study demonstrated a 16% increase in risk in lung cancer to nonsmokers from second-hand smoke, a result consistent with earlier studies. Although the results were clear and comparable to those found by others, the number of people in the study was too small to reach statistical significance (at the 95 percent level).
As Ong and Glantz document, the tobacco industry exploited the degree of statistical uncertainty by providing selected newspapers with the misinformation that the study had demonstrated ""no risk"" of cancer from second-hand smoking clearly not the study's finding. These incorrect conclusions were published in the British press before the scientific study was published, and as an official British report reviewing second-hand smoke's health effects was released.
To understand the tobacco industry's strategy regarding the IARC study, Ong and Glantz interviewed IARC investigators and analyzed tobacco industry documents among 32 million pages released in 1998 as part of the settlement of the legal case, State of Minnesota and Blue Cross/Blue Shield of Minnesota vs Phillip Morris, Inc. The documents are archived in Minneapolis.
The study by Ong and Glantz was supported by a grant from the National Cancer Institute.
- Alice Trinkl, News Director
- Source: Wallace Ravven (415) 476-2557=20
- E-mail: wravven@pubaff.ucsf.edu
THE LANCET'S PRESS RELEASE:
Issued 08 April 2000
Tobacco Industry Campaign Undermined Cancer Research into Passive Smoking
(pp 1197, 1253)
""The tobacco industry continues to conduct a sophisticated campaign against conclusions that second-hand smoke causes lung cancer and other diseases, subverting normal scientific processes', states an article published in this week's issue of THE LANCET.
Scientific reports on second-hand smoke (""passive smoking') have stimulated legislation on clean indoor air in the USA, but less so in Europe. Elisa Ong and Stanton Glantz from the University of California, San Francisco, USA, describe how the tobacco industry worked to undermine the conclusions of an International Agency for Research on Cancer (IARC) report on passive smoking.
The IARC study demonstrated a 16% increase in risk in lung cancer for non-smokers, a result consistent with earlier studies. Although the results were clear and comparable to those found by others, the number of people in the study was too small to reach statistical significance (at the 95 percent level). The findings were thus supportive of earlier studies showing that passive smoking increases cancer risk, but taken alone would not have been conclusive.
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, Ong and Glantz 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. Part of Philip Morris' strategy used consultants, sympathetic to the tobacco industry, who were asked to find out more about the IARC report, but did not always disclose their industry affiliations. The investigators conclude that the documents and interviews suggest that the tobacco industry continues to conduct a sophisticated campaign against conclusions that second-hand smoke causes lung cancer and other diseases, subverting normal scientific processes.
In an accompanying editorial (p 1197), THE LANCET comments that the dirty war of misinformation in academic and more public settings is likely to continue. It states: ""Journal editors are especially vulnerable to being duped since we have limited powers to discover sources of funding support other than merely inviting disclosure from authors. Tobacco is not the only aspect of medicine open to twisted corporate communications strategies. A 1998 study reported that published opinions on safety of calcium-channel blockers were related to the financial rewards bestowed by pharmaceutical companies on those giving such opinions. All policymakers must be vigilant to the possibility of research data being manipulated by corporate bodies and of scientific colleagues being seduced by the material charms of industry. Trust is no defence against an aggressively deceptive corporate sector"".
- Contact:
- Wallace Ravven,
- News Services,
- University of California,
- San Francisco, USA;
- T) +1 415 502 1332;
- F) +1 415 476 2557;
- E) wravven@pubaff.ucsf.edu tobacco
http://www.thelancet.com/
Tobacco Industry Interference with World Health Organization's Research on Passive Smoke and Cancer
Smoking is now generally recognized as the most important preventable cause of human cancer and responsible for more than 230,000 new cases in North America and more than 420,000 cases annually in Europe. Passive smoking carries a lower risk and the tobacco industry has made considerable efforts to dispute the lung cancer risk associated with environmental tobacco smoke (ETS) since it is the scientific basis for legislation protecting the non-smoker at the workplace and in public spaces.
In the issue of The Lancet dated 8 April 2000, researchers from the University of California at San Francisco report the results of a review of internal documents from Philip Morris and other tobacco companies. The documents provide evidence that the tobacco industry has closely monitored and tried to actively interfere with the conduct of an international epidemiological study on lung cancer in non-smokers following exposure to passive smoking.
The study was co-ordinated by the International Agency for Research on Cancer (IARC) in Lyon, France, a research institute of the World Health Organization (WHO). The results were published in the Journal of the National Cancer Institute (Boffetta et al., J Natl Cancer Inst 90: 1440-1450; 1998) and showed that exposure to passive smoking at the workplace or through spouse results in an increased relative risk (RR) of 1.16, a small factor when compared to the RR of more than 20-fold associated with active cigarette smoking.
However, given the large populations exposed to passive smoking, it has been calculated that in the USA 3000 and in Europe up to 2500 cases of lung cancer annually are caused by passive smoking.
Among the actions undertaken by the tobacco industry were the establishment of a task force to react to the publication of the results, the use of consultants to contact the IARC investigators to obtain confidential information on the study, and plans to influence the scientific policy and financing of IARC.
Two years ago, the IARC study was the object of a strong diffamation campaign in the media orchestrated by the tobacco industry through a lead article in the Daily Telegraph (London). Although these attacks did not pre-empt the publication of the report in the medical literature, they created confusion and controversy on the interpretation of the results.
The documents reviewed in The Lancet's article suggest that this media campaign was part of a broader long-planned strategy of the tobacco industry on passive smoking.
The existence of a carcinogenic risk from passive smoking adds a new dimension to the debate on health effects of tobacco since in contrast to the diseases affecting the active smoker, it represents a health damage imposed on people who have chosen not to smoke.
This difference has great implications in terms of regulation of smoking in public settings, and may, in the long run, be a major factor towards the decrease in tobacco consumption. This explains the strong interest of the tobacco industry to monitor and discredit studies, including the one from IARC, that contribute to establishing the causal link between passive smoking and cancer.
More information on the IARC study of passive smoking and on the activities of the tobacco industry to interfere with it can be obtained from Dr Nicolas Gaudin, Public Relations Officer (gaudin@iarc.fr)
- Nicolas Gaudin, Ph.D.
- Public Relations Officer/Responsable des Relations publiques
- International Agency for Research on Cancer/Centre international de
- Recherche sur le Cancer
- 150, cours Albert-Thomas
- 69008 Lyon
- France
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