My apologies to those whom we in the public health field usually refer to as “sex workers”, but who are more commonly referred to by one of the words in the title of this post. I don’t mean to insult them by comparing them to tobacco industry prostitutes, but I couldn’t think of more appropriate words to describe tobacco industry prostitutes.
Epidemiologist tobacco prostitutesMy first exposure to big tobacco prostitutes came when I was an epidemiology student at the Berkeley School of Public Health in the late 70s. We students were asked to review several “scientific” articles that argued – pro and con – regarding whether or not cigarette smoking causes lung cancer. Without exception, every “scientific” article that argued that the causal link was not proven was written by an epidemiologist prostitute.
At the time that these articles were written the causal link between cigarette smoking and lung cancer had been unequivocally established through thousands or tens of thousands of research studies published in peer reviewed scientific journals. The results of the combined evidence from these studies met ALL of
the criteria that are accepted as indicating a causal link: The average study that looked at the incidence of lung cancer found the incidence to be 14 times higher in cigarette smokers than in non-smokers; that result was consistent throughout the thousands of published articles on the subject; every known or suspected
potential confounding variable had been statistically controlled for in these studies; laboratory experiments on animals clearly demonstrated
how tobacco exposure to living cells turned them from normal to cancerous; and nobody ever offered a plausible explanation for these findings. There was lots more, but that’s the gist of it.
The only weakness in the evidence supporting a causal link was that no randomized clinical trial had been conducted on the subject. There was a very good reason for the lack of randomized clinical trials: conducting a randomized clinical trial with respect to an exposure that was widely regarded as being highly fatal would have been criminally illegal and grossly unethical.
The
best argument used by the tobacco prostitutes for refuting a causal link went something like this: that it is
possible that there is some unknown factor (which epidemiologists refer to as a confounding variable) that causes lung cancer AND also causes people to smoke cigarettes; that this factor causes the rate of lung cancer to occur at minimum at14 times the rate found in the general population AND also causes people to smoke cigarettes at minimum at 14 times the prevalence found in the general population; AND that despite thousands of scientific studies on the subject, no researcher had ever been able to indentify or even come close to identifying this factor.
Is it possible that this argument could have, in reality, explained the association between cigarette smoking and lung cancer? Yes, it is
possible. Just as it is possible that I will vaporize while I’m writing this post. But if arguments such as that are allowed to refute causal links that are as abundantly supported by scientific evidence as is the tobacco-lung cancer link, then no causal links would ever be considered to be proven in the absence of multiple randomized clinical trials.
METHODS USED BY THE TOBACCO INDUSTRY TO FIGHT LAWSUITSThere is a very good reason why the tobacco industry has been so aggressive in their efforts to fight off lawsuits: Their survival depends on it. Unlike other dangerous products, which result in the death, illness, or injury of an occasional person who is exposed to them, cigarette smoking results in the death or illness of a huge proportion of people who engage in it on a regular basis.
Typical of the epidemiologic studies that demonstrate this is one conducted by the U.S. Public Health Service
that showed 16% of all deaths in New Hampshire to be attributed to cigarette smoking. That means that if, for example, approximately one third of New Hampshire adults were chronic cigarette smokers, that about 48% of deaths of cigarette smokers in New Hampshire would have been attributable to cigarette smoking (If less than a third of adults were cigarette smokers, the percent of smoker deaths attributable to cigarette smoking would have been calculated to be even higher). And in addition to deaths, cigarette smoking results in a tremendous burden of disease – primarily cardiovascular disease, cerebral-vascular disease (stroke), respiratory disease and cancer – and hospital costs. If even a minute fraction of these deaths and illnesses were successfully prosecuted, the tobacco industry would die.
So let’s consider the methods they use to survive potential lawsuits:
Primary arguments – extreme mental gymnasticsTheir first line of argument, as discussed above, was that there is no proof that cigarette smoking causes lung cancer – or any other disease.
An article published in
Tobacco Control vividly documented this history:
Analysis of public statements issued by the tobacco industry sources over the past five decades shows that the companies maintained the stance that smoking had not been proven to be injurious to health through 1999. The public statements of the tobacco industry are in sharp contrast to the private views expressed by many of their own scientists. The tobacco documents reveal that many scientists within the tobacco industry acknowledged as early as the 1950s that cigarette smoking was unsafe. The sincerity of the industry’s promise to support research to find out if smoking was harmful to health and to disclose information about the health effects of smoking can also be questioned based upon the industry’s own documents which reveal… that research findings implicating smoking as a health problem were often not published or disclosed outside the industry.
But by the late 1990s it gradually became no longer possible for the tobacco industry to maintain that stance – perhaps largely due to
the efforts of Food and Drug Administration (FDA) Commissioner David Kessler to bring cigarettes under FDA purview.
So the tobacco industry switched to a different argument – an argument that was virtually the opposite of their previous claim of no proof that cigarettes are harmful. They began
claiming that everyone always knew that cigarettes were harmful. Thus, they had their expert historians:
re-narrate the past, creating an account for judges and juries that makes it appear that “everyone has always known” that cigarettes are harmful, meaning that smokers have only themselves to blame for their illnesses.
In other words, they now claim that during all those decades that they were aggressively arguing that there is no proof that cigarettes cause illness, nevertheless “everyone knew” that they do.
Harassment of hostile witnessesTherefore, the tobacco industry must distort history in order to support their claims. A recent article in
The Nation by Jon Wiener, titled “
Big Tobacco & the Historians – A Tale of Seduction and Intimidation”, notes that there are only three historians that have testified
against the tobacco industry in the past fifteen years, whereas forty have testified in their favor during that time. How were they able to limit those testifying against them to three?
Stanford Professor Robert Proctor is currently one of the two historians who testifies against tobacco companies. In line with his interest in the subject, he e-mailed a colleague at the University of Florida, inquiring about graduate students who had been hired by the tobacco industry. For doing that:
The next thing Proctor knew, tobacco attorneys were telling a court in Florida that Proctor, simply by e-mailing his colleague, had engaged in an “unethical” campaign of “intimidation,” seeking “to malign and harass graduate students who serve as research assistants.” … Proctor’s e-mail, they told the court, constituted an “improper” effort to “influence, interfere with or intimidate” a witness for the defendants.
A judge ordered Proctor to hand over the incriminating e-mails – all ten of them. Nothing improper was found, and the case was dismissed. But the harassment continues. The goal is to make it so that no historian will be able to – or would
dare to – testify against the tobacco industry.
Use of prostitute historians – The distortion of historyWiener asks in his article how the tobacco industry is able to get so many historians to testify in their behalf. The good majority of historians whom he approached refused to interview with him. But one of them, Michael Parrish, agreed to talk with Wiener. The answer was simple:
For doing research, I charged $110 an hour… If I was deposed, it was $250 an hour. If it went to trial, $400 an hour… I didn’t do it out of love for the tobacco industry.
Similarly with Stephen Ambrose, famous for his best-selling books about D-Day and other history:
Ambrose was asked in a deposition why he was testifying for the companies. His answer was brief: “for compensation.” Tobacco companies paid him $25,000 for just one case in 1994.
Is it possible that the “expert” historians who testify in behalf of the tobacco industry do so honestly? That seems quite unlikely. Wiener explains how they manage to distort history:
Given the deception practiced by Big Tobacco, how are the historians who work for tobacco attorneys able to blame the smokers? As they admit under cross-examination by plaintiffs’ attorneys, in their “research,” they fail to examine the most important source of information on the history of smoking: the archives of the tobacco manufacturers and their public relations firms, which are readily available online at tobaccodocuments.org, as required by the 1998 settlement in the state attorneys general lawsuit. These materials document industry efforts to suppress information about cancer and smoking and to secretly sponsor disinformation.
Louis Kyriakoudes, one of the three historians to testify against the tobacco industry in the past fifteen years, examined the testimony of 18 “experts” who testified for the industry and found that they uniformly failed to examine the industry archives.
He concluded that this behavior “fails to meet basic professional standards of scholarship”.
This point was made more vividly by Richard Abrams, who
refused to testify for the tobacco industry:
He said that when tobacco attorneys… approached him fifteen years ago, “I told them that tentatively I was sympathetic to their position… I needed to get into their records to see what they were telling the public. They said, ‘You can’t see our archive, but we’ll send you stuff.’ I said, ‘If you’re going to put me on the stand as an expert witness, I can’t say I had access only to what you chose to send me.’ They still wouldn’t let me see their archives, so I said forget it.”
Endless appealsThere are so many injustices embedded in our legal system. One of the biggest is that the deep pockets of the wealthy enable them to delay justice for what seems like indefinite periods of time. Here is one example from Wiener’s article. With regard to the death of a woman’s mother from lung cancer:
The jury awarded her an awesome $28 billion. That set a record as the single largest judgment against Philip Morris. The company appealed, and the court reduced the $28 billion to $28 million. The company appealed that too, but a California appeals court concluded in 2006 that “Philip Morris’s misconduct was extremely reprehensible” and that “the vast ‘scale’ and ‘profitability’” of the misconduct justified an award of $28 million – to Betty Bullock’s daughter Jodie, since Betty had died of smoking-related causes in 2003. The company appealed again on another issue and won a retrial in 2009, which ended recently with an award of $13.8 million. Philip Morris attorneys have said they will appeal that verdict as well.
CONCLUSIONThe importance of this issue goes way beyond the ability of the tobacco industry to get away with murder. Similar issues apply to any legal case that pits adversaries against each other who are highly unequal in the wealth and power that they wield.
When we are young we are told that all Americans have the right to equal justice under the law. I believed that – when I was young.
Our
Fourteenth Amendment to our Constitution explicitly – though in theory only – guarantees equal justice under the law:
nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
But when one party in a legal case has so much wealth and power that it is able to intimidate witnesses from testifying for the other side, and pay huge sums of money to encourage its own witnesses to prostitute themselves, justice cannot be served. That is not “equal protection of the laws”.
Furthermore, the idea of paying expert witnesses huge sums of money to testify in one’s behalf makes a mockery of the idea of justice. If that doesn’t constitute a conflict of interest then the phrase “conflict of interest” has no meaning. Paying people a reasonable sum of money for their time and effort is one thing. Paying them so much that are sorely tempted to perjure and prostitute themselves is entirely something else. Unfortunately, wherever and whenever that kind of thing is legal, witnesses will tend to shade the truth or outright lie in favor of their masters, and justice will not be served. There are few better examples of this than the way that the tobacco industry has manipulated our legal system in pursuit of its own selfish interests for the past several decades.
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