Tobacco Industry's Growing Power: Bad Acts, Lessons Learned, and New Tricks
At the recent American Public Health Association conference in San Francisco, veteran public health advocates warned that the war on tobacco is not over. Here's an overview and some ideas for your work.
Sharon Eubanks, the RICO lawyer who successfully tried the tobacco industry for fraud during the Clinton administration said that, for many people, it is hard to believe that "fifty years of lying" occurred, and to grasp the lengths to which the tobacco companies are willing to go.
In response to the historic case, the tobacco industry used extensive lobbying efforts, including attempts to have the litigation’s budget cut, Eubanks said. The industry tried to prevent the use of many of their own documents based on attorney-client privilege, despite the fact that the documents were readily available online. The industry used attorneys extensively to "cloak" information, with attorneys being present during research and "science" discussions to allow for claiming attorney-client privilege.
Tobacco regulations are still not being enforced, said Eubanks, who exhorted regulatory agencies like the FDA to use existing laws to more effectively regulate tobacco.
Did the L.A. Times Singlehandedly Defeat Prop 29?
Tobacco control researcher Dr. Stan Glantz highlighted how an uncertain origin, heavy industry lobbying, "lazy media" and the failure of a major newspaper to take a stand ended up killing California's Proposition 29, a $1 tobacco tax increase that failed in the June 2012 election.
Glantz, a supporter of Prop 29, said that the ballot proposition originated not with scientists or public health advocates, but with former California state lawmaker Don Perata, who was, at the time, Senate President Pro Tem. Perata originally wrote Prop 29 to benefit construction, Glantz said, "for reasons that were not clear."
Health groups revised Prop 29 so that 70 percent of the revenue it generated would go towards cancer prevention. The measure lost by only "four-tenths of one percent," Glantz noted.
The tobacco industry spent approximately $40 million dollars to defeat it, compared to $12 million spent by Prop 29 advocates. While supporters' money came in late, Glantz said, a lack of money wasn't a reason that Prop 29 failed.
The "yes" side framed the argument as a tax to cure cancer, while the "no" campaign portrayed the proposition as "flawed" and that the state's budget issues were too pressing to be distracted by trying to cure cancer.
The most effective ad against Prop 29 featured Dr. Ladonna Porter. As Glantz said, Porter was "a very appealing spokesdoctor" with a three-part message: there is no money for cancer treatment in Prop 29, that the money would be sent outside the state of California, and that it was opposed by several taxpayer groups.
Glantz, who got involved with the Yes on 29 campaign at this point, said he was astonished that supporters did not aggressively rebut Porter's argument. He said he was very frustrated with their "soft-focus" message of curing cancer, and by the campaign's lack of response to Porter.
Glantz pointed out Dr. Porter’s past history on his blog, specifically about her track-record of testifying against cleaning up the rocket-fuel contamination of a water supply. At that point, Dr. Porter was removed from a state regulatory board and her No on 29 ads were pulled -- but "it was too late."
Glantz also said that the tobacco industry also tried to stay "invisible" by "hiding behind third parties," a frequent tactic. Quotes in the media were almost always attributed to taxpayer groups, or the Republican Party, despite the fact that the industry was massively bankrolling the opposition. Dr. Glantz also said that the campaign suffered from the L.A. Times not endorsing Prop 29. The lack of endorsement was "heavily advertised" by the No campaign. Given Prop 29's narrow margin of defeat, Glantz believes the measure would have passed with the newspaper's endorsement.
The lessons for public health advocates? Glantz said health groups need to be more pro-active. The public is much more likely to support legislation if it is seen as "doing something about tobacco," rather than "taxing smokers in order to do something in general for the public."
Is Tobacco The New Medical Marijuana?
Dr. Robert Proctor, a professor of science history at Stanford University, argued the case for tobacco abolition, an emerging approach to limiting tobacco's public health consequences. Abolition would ban the sale of cigarettes, not their use, he said; if you wanted to grow and cure your own tobacco, you could. Among his arguments for abolishing tobacco:
* Tobacco is "the deadliest object in the history of humanity," killing millions.
* Tobacco is dangerous "by design" – cigarettes are addictive on purpose
* The tobacco industry has sponsored fraudulent research and lied about the dangers of tobacco
* Tobacco agriculture and waste products harm the environment, and tobacco companies have funded research denying the existence of global warming
Proctor said one of the biggest arguments in favor of abolition is that smokers do not like their habit. "Smoking is not like drinking, it’s rather like being an alcoholic," is a quote from a tobacco executive provided by Proctor.
So would tobacco abolition result in organized crime involvement, or become another failed War On Drugs? Proctor said the tobacco industry has been promoting this argument. But he noted that, historically, laws to ban cigarettes have been allowed to stand, even when challenged.
These laws were only rescinded by local communities in response to a desire for tobacco revenues, and because of persuasive arguments at the time from the tobacco industry. Every community in America still has the legal right to ban the sale of tobacco, Proctor said. Abolition is not a radical idea. As Proctor points out, "it would only help the industry to live up to its long-held promise."
Zombie Tobacco Industry Tricks
Anti-smoking activist Cynthia Hallett of No Smoke spoke about the resurrection of some of the tobacco industry's oldest tricks. Deja vu seems to be the norm for those who are working in tobacco control, she said, citing these examples:
1. Ventilation as a solution for allowing smoking, especially in casinos. Ventilation, however, only deals with temperature and comfort, and does not mitigate the health effects. Hallett noted that 19 states include casinos in their smoke-free work-place laws, but, in general, the states that do are not the "heavy-hitters" such as Atlantic City, where the laws say, for example, that three-fourths of the casino floor must be smoke-free. Local governments are getting push-back when they try to pass these laws, with industry saying that only the state has the right to regulate these issues. Local governments do have this right, but they are wary of getting into a battle with industry, Hallett said.
2. Lawsuits or legal threats. She noted that the industry has gotten aggressively involved in blocking both Graphic Warning Labels (FDA), and Corrective Statements (RICO remedy).
3. New products. Hallett said that the tobacco industry is promoting e-cigarettes in smoke-free environments. These products are not regulated by the FDA. Other tobacco products are also being pushed. Diversification is the new approach.
4. Attacks on successful tobacco programs, including claims of illegal lobbying, as well as attacks on successful measures. In response, the World Health Organization held a recent global No Tobacco day to highlight tobacco company intimidation.
Hallett noted that these intimidation tactics lead to self-censorship. As a result, anti-tobacco legislation is stalling; there have been no new state laws since 2009. "How long are we going to allow these convicted racketeers to have a voting or even non-voting role in these issues?" asked Hallett, who strongly cautioned against "working with" industry.
Emerging Anti-Tobacco Policies
New policy approaches highlighted by the APHA panelists include such emerging issues as pushing for smoke-free apartment or condominium units. Successes include 132 communities which have smoke-free beaches, 231 communities and 6 states/commonwealths have smoke-free parks. Now, 825 college campuses are smoke-free, and many also are completely tobacco-free. She emphasized that the industry is losing "the battle of smoking acceptability," but the pushback from industry may threaten this progress.
Finally, Glantz talked about issues on a national level where, as he put it, at the FDA "the lawyers are running the science." He states that laws are not being implemented, including banning menthol, or going to color-coded labeling of products. He states that health groups may need to sue, or get more involved because, as he noted, "the bad guys often win because the good guys didn’t show up."
Will you show up? Check out the local tobacco issues in your area.
Photo credit: Julie Bocchino via Flickr