by Allan Brandt
They responded with a new and unprecedented public relations strategy. Its goal was to produce and sustain scientific skepticism and controversy in order to disrupt the emerging consensus on the harms of cigarette smoking. This strategy required intrusions into scientific process and procedure.5 The production of uncertainty in the face of the developing scientific knowledge required resources and skill. The industry worked to assure that vigorous debate would be prominently trumpeted in the public media. So long as there appeared to be doubt, so long as the industry could assert “not proven,” smokers would have a crucial rationale to continue, and new smokers would have a rationale to begin. Equally important, the industry would have cover to resist regulation of its product and the basis of a defense against new legal liabilities. The future of the cigarette would now depend on the successful production of a scientific controversy.
Reports in the medical literature rarely drew public notice, but given the huge popularity of cigarette smoking—which had grown by 1950 to some 2,500 cigarettes per person each year—journalists now reported the results of the new studies to an increasingly anxious public. One article, in particular, by journalist Roy Norr, touched off widespread concern. 6 Appearing first in the Christian Herald in October 1952, the article translated the Wynder and Graham findings into ominous layperson prose, noting that “what gives grave concern to public health leaders is that the increase in lung cancer mortality shows a suspicious parallel to the enormous increase in cigarette consumption.”7 The piece drew little attention until it was reprinted two months later in Reader’s Digest, the most widely circulated periodical at the time, under the title “Cancer by the Carton.”
Other prominent magazines and newspapers followed with related scientific findings. Time reported on the Wynder, Graham, and Croninger mouse-painting studies in an article entitled “Beyond Any Doubt” in November 1953. The article quoted Graham as saying that the experiments “show conclusively” that a substance in cigarette smoke could produce cancer. “This is no longer merely a possibility,” Graham concluded. “Our experiments have proved it beyond any doubt.” Time noted that rates of lung cancer in the United States had quadrupled for men and doubled for women since 1933.
Following this spate of publicity, the nature and meaning of cigarette smoking, so carefully constructed over the last half-century, would never be the same. After decades of successfully manipulating the media regarding the cigarette, the industry now found that it had lost its mastery of the public perception of its product. The wide coverage of successive medical findings generated intense pressure for the industry to respond. Alton Ochsner told Time: If the tobacco people are smart—as I am sure they are because they have been enormously successful—they will support research to find out what the cancer-producing substance is, and then take steps to remove it.
Graham concurred, noting, “It is certainly the moral obligation and common sense on the part of the manufacturers to support research.”8
In late 1953, the tobacco industry began to draw its wagons together. As the evidence of the harms of smoking accrued, the tobacco industry first attempted to continue its aggressive and reassuring marketing.9 One approach was to simply deny the problem. The entertainer Arthur Godfrey—who promoted Chesterfields on television—touted studies that he claimed exonerated Chesterfields from the rising health concerns. In early 1953, Godfrey announced during his weekly variety show, “I smoke two or three packs of these things every day. I feel pretty good. I don’t know, I never did believe they did any harm, and now, we’ve got the proof.” Godfrey went on to explain the Liggett & Myers research program:This doctor and specialist and some of his assistants, have been conducting experiments for 8 months, and they—people had been smoking Chesterfields for 10 years, some of ’em, and they smoked Chesterfields and nothing but Chesterfields for the last 8 months—it’s a little more than that now, and they have discovered that to date, he can’t find any adverse effects in the nose, the sinus, the ears or throat, or wherever else you smoke ’em.10
R.J. Reynolds ran similar campaigns, urging smokers to take a thirty-day test for Camels’ mildness. In the July 1949 issues of several local and national medical journals, Reynolds ran an ad asking “How mild can a cigarette be?” In answering this question, the ad juxtaposed a “Doctors Report” illustrated with a physician, cigarette in hand and head-mirror strapped around his brow, and a “Smokers Report,” illustrated with smiling Sylvia MacNeill, secretary. Physicians, the ad explained, had concluded after scientific investigation that there was “not one single case of throat irritation” from smoking Camel cigarettes. “Noted throat specialists” had conducted “weekly examinations” of patients in making this determination.11
The ad went beyond medical authority, however, to assert that smokers didn’t even have to take their physicians’ word for it. They could take their “own personal 30-day test,” as Sylvia MacNeill had done. She concluded that she “knew” that “Camels are the mildest, best-tasting cigarette I ever smoked.” Ads in popular magazines took this theme even further; for example, Elana O’Brian, real estate broker, gushed that “I don’t need my doctor’s report to know Camels are mild.” The ad showed six other smokers, from various walks of life, under the heading “thousands more agree!”12 In another example, Anne Jeffreys, a stage and screen star, insisted, “The test was fun and it was sensible! ” Still other ads called on Camel smokers to “Prove it yourself! ” and even offered a money-back guarantee for dissatisfied customers. 13 These ads attempted to subvert the emerging population-based epidemiologic findings by appealing to smokers’ individual judgment.
But in the face of those findings, such claims were now seen as drawing attention to the problem—in particular, the attention of government and consumer agencies. In February 1953, the national Better Business Bureau wrote to Liggett & Myers:Although cigarette advertising, as such, has been widely and justly criticized in recent years, we believe that your current advertising represents a particularly flagrant disregard of the public interest. Your advertising will not only deceive some members of the public to the detriment of their health but it will, in addition, tend to impair the integrity of advertising and lessen public confidence in it. . . . Godfrey’s free translations of the carefully worded copy theme clearly assure any listener that smoking Chesterfields is harmless. If one as close to the advertiser could draw such inferences from the copy theme, it is apparent that others may likewise be misled.14
Despite these critiques, Chesterfield and Camel ads (as well as others) continued during these years to attempt to quiet rising public concerns about the health impact of smoking. Decades later, the health warranties clearly implied in these ads would come back to haunt the industry in litigation. Cigarette apologist Arthur Godfrey died of emphysema in 1983, after surviving removal of the cancerous part of a lung in 1959.15
The pressure on company executives to respond rose with each new public report. Would the industry rely on its extensive advertising and public relations expertise, or would the companies collaborate and participate in the ongoing scientific assessments? Recognizing that bold claims for specific brands would not resolve the crisis and might in fact heighten popular concerns, the industry began to explore other options. In particular, it was becoming clear that it required a strategy for addressing the new peer-reviewed medical findings appearing in important medical journals. The crisis revealed the severe limitations of the companies’ own research programs. Many researchers now advocated that the industry give funds to the National Research Council, the American Cancer Society, or the National Cancer Institute (NCI) to investigate—intensively and independently—the relationship of smoking to disease. Ultimately, it was argued, the industry would need a detailed knowledge of the problems with the product if they were to be fixed.
The tobacco company CEOs tended at first to view the new findings as “attacks” by a small group of misguided researchers. As studies were reported in the popular press, they felt c
ompelled to come to the defense of their product and the integrity of their companies. In November 1953, American Tobacco President Paul Hahn took the offensive against “loose talk” about the now widely reported scientific findings. In a press release issued by the company, he wrote that “with all the research being conducted in the field, no one has yet proved that lung cancer in any human being is directly traceable to tobacco or to its products in any form.” He noted that American Tobacco was supporting independent scientific research (through the Damon Runyon Fund of the ACS), and concluded that “we are confident that long-range, impartial investigation and other objective research will confirm the view that neither tobacco nor its products contribute to the incidence of lung cancer.”16
There was no scientific basis for such optimism, nor had the companies conducted research into the question. To the contrary, emerging independent research now cast an ominous shadow over the cigarette’s future. Hahn nevertheless understood the need to respond to public fears. He explained:Believing as we do that cigarette smoking is not injurious to health, I feel that a statement of reassurance to the public should be made. What the public wants to know about is whether it is true that smoking has been proved to contribute to the incidence of lung cancer. The fact, of course, is that it has not been so proved.17
As Hahn’s statement made clear, “proof ” and how it was constituted became the critical issue. The industry would soon make explicit its approach to seizing the ambiguities in this question.
Hahn realized that such statements of reassurance—denying that cigarettes were harmful—would have little value if there was not a full-scale, industry-wide commitment to addressing the rising tide of medical and public concern about its product. The new findings demanded a new strategy of collaboration. Common interests now displaced the tobacco companies’ long history of rivalry. If any company sought to use health concerns against a competitor, the entire industry could descend in a downward spiral. He therefore called for an unprecedented meeting of the CEOs of the major companies to develop a unified public relations strategy in response to the new scientific evidence implicating cigarette use as a cause of cancer. When the executives met together at the Plaza Hotel on December 14, 1953, in New York City, it marked the first time since 1939 that the group had come together.18 Concerns that working together would invite another antitrust investigation following their 1941 conviction for price-fixing were now overwhelmed by the mounting crisis over the emerging scientific findings.
T. V. Hartnett, president of Brown & Williamson, summarized the problem in an internal memorandum following the initial meeting. “Excessive care,” he warned, “must be used at this time in the methods we use to counteract these claims. . . . The problem is to challenge these findings ethically and effectively without rancor—to win friends rather than create enemies.” Hartnett went on to outline the two approaches that would dominate the industry’s strategy:Cancer research, while certainly getting our every support, can be only half an answer. . . . The other side of the coin is public relations . . . [which] is basically a selling tool and the most astute selling may well be needed to get the industry out of this hole. It isn’t exaggeration that no public relations expert has ever been handed so real and yet so delicate a multi-million dollar problem. . . . Finally, one of the roughest hurdles which must be anticipated is how to handle significantly negative research results, if, as, and when they develop.19
The next day, representatives of the tobacco companies met with John W. Hill, president of the public relations firm Hill & Knowlton. Hill had already had a series of talks with tobacco executives and had started his staff on evaluating strategies for addressing what all agreed was a monumental public relations crisis. The industry executives now agreed to retain Hill & Knowlton to help shape their response.20
By the time Hill & Knowlton took on the tobacco industry in 1953, it was already the most influential public relations firm in the United States, with a client list that included the steel, oil, and aircraft industries. John W. Hill had cultivated close relationships with executives in these fields since the 1930s. And his firm had also worked with the liquor and chemical industries, areas where the health risks of products had emerged as issues in the past. He shared his clients’ strong opposition to government intrusion into business. “The role of public relations in the opinion forming process is to communicate information and viewpoints on behalf of causes and organizations,” Hill later wrote. “The objective is to inform public opinion and win its favor.”21 He had quit smoking in the early 1940s for health reasons, but such concerns would not affect his work on behalf of his tobacco clients.22 For Hill, the tobacco industry had a public relations problem that his firm could effectively manage.
The tobacco industry had successfully used public relations since the 1920s to shape the meanings and cultural contexts of tobacco use. It was not surprising that in a moment of crisis, the industry would again deploy public relations as the antidote. But now these techniques were used not to change mores and social convention, but to distort and deny important scientific data. In the winter of 1953-54, the industry crossed a legal and moral line by entangling itself in the manipulation of fundamental scientific processes. There would be no easy route back to legitimacy.
Hill immediately recognized that the principal public relations approach of the industry would require strict collaborative action. Even as the companies continued to vie for market share among their respective brands, it was imperative that their in-house public relations offices present a united front in the critical domain of health and science. Hill & Knowlton’s operatives expressed particular skepticism about the role of advertising in addressing the industry’s crisis. “Some bright boy from Madison Avenue,” one staffer noted, could “spoil the confidence building.”23 Hill’s skepticism concerning advertising reflected two central insights. The public confidence the industry sought could not be achieved through advertising, which was self-interested by definition. Second, it would be crucial for the industry to assert its authority over the scientific domain; science had the distinct advantage of its reputation for disinterestedness.24
Hill’s work for the industry marked the most significant public relations interventions on its behalf since those of Edward Bernays. The two men shared a skepticism about the role of advertising in influencing the public perceptions of tobacco. To those deeply schooled in public relations, advertising ran the risk of exposing corporate self-interest. Good public relations relied on the scrupulous behind-the-scenes management of media. As Bernays had demonstrated in the 1920s and 1930s, the best PR work left no fingerprints.
Hill and his colleagues set to work to review a full range of approaches open to them. Dismissing as shortsighted the idea of mounting personal attacks on researchers or simply issuing blanket assurances of safety, they concluded instead that seizing control of the science of tobacco and health would be as important as seizing control of the media. It would be crucial to identify scientists who expressed skepticism about the link between cigarettes and cancer, those critical of statistical methods, and especially those who had offered alternative hypotheses for the cause of cancer. Hill set his staff to identifying the most vocal and visible skeptics. These people would be central to the development of an industry scientific program in step with its larger public relations goals. Hill understood that simply denying the harms of smoking would alienate the public. His strategy for ending the “hysteria” was to insist that there were “two sides.” Just as Bernays had worked to engineer consent, so Hill would engineer “controversy.” This strategy—invented by Hill in the context of his work for the tobacco industry—would ultimately become the cornerstone of a large range of efforts to distort scientific process in the second half of the twentieth century.
Individual tobacco companies had sought to compile information that cast doubt on the smoking-cancer connection even before Hill & Knowlton got involved. A. Grant Clarke, an Esty advertising employee on loan to R.J
. Reynolds, announced to other industry executives in November 1953 that the company had formed a “Bureau of Scientific Information” to “combat the propaganda which is being directed at the tobacco industry.”25 At the same time, American Tobacco began to collect the public statements of scientists who had expressed skepticism about the research findings indicting tobacco. The company’s public relations counsel, Tommy Ross, understood that it would be critical to create questions about the reliability of the new findings and to attack the notion that these studies constituted “proof ” of the relationship of smoking to cancer.26 The resulting “White Paper” was a compendium of statements by physicians and scientists who questioned the cigarette-lung cancer link. When Hill & Knowlton started to shape and implement its PR strategy, the White Paper became fundamental to those efforts.
Following the December 15 meeting that formally brought Hill & Knowlton into the picture, its executives spent the next two weeks meeting with various industry staff. During this time, Hill & Knowlton operated in full crisis mode. Executives and staff cancelled all holiday plans as they worked to frame and implement a full-scale campaign on behalf of the industry. 27 They apparently made no independent attempt to assess the state of medical knowledge; nor did they seek informed evaluations from independent scientists. Their role was limited to serving the public relations goal of their client.
During these meetings, both Hill & Knowlton staffers and tobacco executives continued to voice the conviction that the industry’s entire future was threatened by the medical and scientific findings linking cigarette smoking to lung cancer and the consequent widespread public anxieties about smoking and health. “Because of the serious nature of the attack on cigarettes and the vast publicity given them in the daily press and in magazines of the widest circulation, a hysteria of fear appears to be developing throughout the country,” Hill wrote in an internal memo. “There is no evidence that this adverse publicity is abating or will soon abate.” According to his media intelligence, at least four additional major periodicals (Look Magazine, Cosmopolitan, Woman’s Home Companion, and Pageant) were currently planning articles on smoking and health.28