The Cigarette Century

by Allan Brandt

  It was apparently Hill who hit on the idea of creating an industry-sponsored research entity. Ultimately, he concluded, the best public relations approach was for the industry to become a major sponsor of medical research. This tactic offered several crucial advantages. The call for new research implied that existing studies were inadequate or flawed. It made clear there was “more to know,” and it made the industry seem a committed participant in the scientific enterprise rather than a detractor. The industry had, as noted, supported some individual research in recent years, but Hill’s proposal offered the potential of a research program that would both be controlled by the industry yet promoted as independent. This was a public relations masterstroke. Hill understood that simply giving money to scientists offered little opportunity to shape the public relations environment. The very nature of controlling and managing information in public relations stood in marked contrast to the scientific notion of unfettered new knowledge. Hill and his clients had no interest in answering a scientific question; their goal was to maintain vigorous control over the research program, to utilize “science” in the service of public relations. After tobacco executives proposed forming a “Cigarette Information Committee” dedicated to defending smoking against the medical findings, Hill argued aggressively for adding research to the committee’s title and agenda. “It is believed,” he wrote, “that the word ‘Research’ is needed in the name to give weight and added credence to the Committee’s statements.” Hill understood that his clients should be viewed as “embracing” science rather than dismissing it.

  Hill also advised the industry that continued competitive assertions about the health benefits of particular brands would be devastating. Instead, the industry needed a collective research initiative to demonstrate its shared concern for the public. Rather than using health research to create competitive products as they had been doing, the companies needed to express—above all else—their commitment to public well-being. Hill believed that the competitive fervor over health claims had harmed the industry’s credibility. No one would look for serious information about health from an industry that was making unsubstantiated claims about its product.

  The future of the industry would reflect its acceptance of this essential principle. From December 1953 forward, the tobacco companies would present a unified front on smoking and health; more than five decades of strategic and explicit collusion would follow.29 The industry pursued its strategy despite worries about recurring antitrust claims. Although its lawyers would later claim that the government was informed of and approved the Plaza Hotel meeting on December 14, it is worth noting that U.S. Assistant Attorney General Stanley Barnes advised that the industry support independent research by a third party. As Hill & Knowlton operative Carl Thompson explained, Judge Barnes told him that an independent approach “might be smarter,” both “to eliminate the question of getting involved in anti-trust difficulties” and “to lend authenticity to the case.”30 But the need to control the scientific message took precedence. By the time Thompson spoke to Barnes, the companies were already fully committed to the establishment of the Tobacco Industry Research Committee, an organization that would be shaped by Hill & Knowlton to serve the industry’s collective interests.

  Hill carefully outlined the plans for a research program before a single scientist was consulted. The utility of such a strategy was its apparent commitment to “objective” science and its search for the “truth.” As Carl Thompson argued, “A flamboyant campaign against the anti-smoking propagandists would unquestionably alienate much of the support of the moderates in both scientific and lay publics.” 31 Instead, tobacco companies had to respect the moral valence of science in American culture at mid-century. If science now threatened the industry, the industry must “secure” science.

  The companies’ first public action, under the direction of Hill & Knowlton, was to produce a public statement of their collective intentions. In the last weeks of 1953, Hill & Knowlton drafted “A Frank Statement to Cigarette Smokers” that sought to establish the industry as reliable, responsible, and fully committed to the public’s interest. The “Frank Statement,” as it would come to be known, brilliantly represented Hill’s essential strategy. It announced:We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business.

  We believe the products we make are not injurious to health.

  We always have and always will cooperate closely with those whose task it is to safeguard the public health.32

  The Frank Statement was a triumph of modern PR. It reassured smokers by promising them that the industry was absolutely committed to their good health.

  The statement went on to announce the creation of the collaborative research entity, the Tobacco Industry Research Committee (TIRC):We are pledging aid and assistance to the research effort into all phases of tobacco use and health. This joint financial aid will of course be in addition to what is already being contributed by individual companies.33

  Such reassurances became characteristic even as the scientific evidence indicting cigarettes grew in strength, sophistication, and professional acceptance. The Frank Statement represented the industry as serious, authoritative, and judicious—committed without exception to the public’s well-being. If there is a problem, it implied, the cigarette manufacturers would solve it, expeditiously and scientifically. The industry had seized the controversy and made it its own. In retrospect, it is especially impressive that less than three weeks after the initial Plaza Hotel meetings, Hill & Knowlton had not only devised a major new strategic approach, but announced it to the media. Signed by the top executives from the major tobacco manufacturers (except for Liggett & Myers), several smaller companies, and growers, the Frank Statement appeared on January 4, 1954, as an advertisement in 448 newspapers in 258 cities. This advertisement and the establishment of the TIRC, the industry hoped, would calm the crisis. Hill & Knowlton executive E. C. Read urged restraint in the days following the announcement, noting that there was “far more danger of fanning the flames by making too many statements. . . . Now that one good statement is out from the committee, I believe the controversy should be given every chance to die a natural death.”34

  The Frank Statement depicted an enlightened industry eager to fulfill its responsibilities to its patrons and the public. With obvious satisfaction, Hill & Knowlton staffers noted that editorials embraced the industry line as presented in the announcement. Through the meticulous interventions of Hill & Knowlton with editors, writers, and scientists, the Frank Statement received broad support in the public media. The Cleveland News saw the industry as “wisely answering the challenge of medicine” and exclaimed: “Good for the industry!”35 Leslie Gould in the New York Journal-American opined that the “tobacco industry has taken a proper step in finding out if there is any truth or not in the recent scares about cigarette smoking and lung cancer.”36 And the Jersey Journal called the formation of the TIRC “a brave approach to a fundamental problem . . . with a keen sense of public service as well.”37

  If the tobacco companies had but followed their own explicit commitments, the history of the cigarette might be distinctly different. But at the moment the Frank Statement was released, the industry had yet to take even the first step toward creating a research program.

  Many of the researchers who had spent the last years demonstrating the harms of smoking now anticipated that the companies would seriously invest in scientific research. John Hill understood that nothing would quiet the immediate storm like the notion of the need for more research—and the availability of new funding. Even as the findings mounted, Hill realized that the very culture of the scientific community compelled it to focus on the limitations of the research and the remaining uncertainties. The fact that science valued knowledge and honored skepticism opened a critical space for this campaign strategy.

  Some researchers were receptive to industry funding of their work. In late 1953, Ernst Wyn
der continued to hope that the industry might support independent tobacco research through programs, such as the Damon Runyon Fund.38 Others, including Evarts Graham, Wynder’s senior collaborator, doubted that the tobacco companies would provide funds for truly independent research; Graham cautioned Wynder on the matter, insisting “we must preserve our independence” and emphasizing “I should not like to enter into any agreement with any tobacco company to carry out research that might be colored a little by financial contribution.”39 Following the public announcement of the TIRC, Ochsner wrote to Graham. “Have any of the tobacco people offered to finance some of your research?” he asked. “I am in hope that they might finance some of ours, but I am afraid they will not, because I think they are accusing us of being prejudiced.”40 Ochsner naively believed that the TIRC might develop a program to explicitly address the health risks of smoking.

  But the TIRC, from its inception, was dominated by its public relations goals. Ochsner’s hopes for funding support faded as the TIRC’s research agenda quickly became clear. “Of course, the critical areas of investigation, as every research scientist knows, have to do with the problem of how to make smoking a less lethal agent in lung cancer incidence and a less deadly killer in heart disease,” he noted. “Yet it is precisely these areas that apparently have been declared out of bounds for the industry’s research committee.” 41 Industry assessments confirm Ochsner’s view. As one internal industry evaluation would conclude a decade later, “most of the TIRC research has been of a broad, basic nature not designed to specifically test the anti-cigarette theory.”42 From the outset, Hill & Knowlton exerted extensive influence over the industry’s collaborative research program. The TIRC administrative offices were even located at Hill & Knowlton.

  W. T. Hoyt, executive director of the TIRC, came to the position with no scientific experience whatsoever. Before joining Hill & Knowlton, he sold advertising for the Saturday Evening Post. At Hill & Knowlton, where he began work in 1951, he had run the Scrap Mobilization Committee for the Iron and Steel Industry. Now in early 1954, he assumed a dominant role in the day-to-day operations of the tobacco industry research program. Carl Thompson described how the PR firm had “loaned” Hoyt to the tobacco industry because he was “a proved administrator and organizer.”43 Ultimately, Hoyt would become a full-time employee, remaining integral to the TIRC until he retired in 1984.44

  Tobacco company leaders also played important roles in the organization. In the early months of operation, Paul Hahn of American Tobacco and Parker McComas of Philip Morris served as its acting chairs. The first full-time chairman of TIRC was Timothy Hartnett, the retired CEO of Brown & Williamson. The press release announcing his appointment explained:It is an obligation of the Tobacco Industry Research Committee at this time to remind the public of these essential points:1. There is no conclusive scientific proof of a link between smoking and cancer.

  2. Medical research points to many possible causes of cancer . . . .

  5. The millions of people who derive pleasure and satisfaction from smoking can be reassured that every scientific means will be used to get all the facts as soon as possible.45

  Hartnett and his successors would reiterate this message for the next forty years.

  Hill & Knowlton executives and industry scientists also carried out the search for the scientific director of the TIRC. They carefully sought out a leader who was skeptical of the emerging medical consensus. A three-man Industrial Technical Committee—H. R. Hanmer, research director at American Tobacco; Irwin Tucker, director of research at Brown & Williamson; and A. Grant Clarke, a William Esty advertising executive and director of the Medical Relations Division at R.J. Reynolds—followed an ambitious itinerary in search of a leader. Not just anyone could fill such an important and complex position.

  As this threesome made their rounds conducting interviews, they paid especially close attention to the candidates’ smoking habits. Leon Jacobson, they noted, “is a heavy smoker.” He was ultimately invited to join the Scientific Advisory Board (SAB). Lawrence Kimpton, chancellor at the University of Chicago, also smoked. Lowell Coggeshall, the dean of the Division of Biological Sciences at Chicago, they observed with some disappointment, did not. Coggeshall advocated giving the funds to an independent organization, a suggestion heard from many. After interviewing Clayton Loosli, who explained he had lost his taste for tobacco, Hanmer explained, “We gathered the impression . . . that he thinks there is a definite connection between smoking and lung cancer, based on the statistical association which has been established.” The search committee concluded that they “did not feel that Dr. Loosli was acceptable.”46 Dr. R. Harrison Rigdon, pathologist from University of Texas Medical Branch, advised the group “to shift the burden of guilt to smog, smoke, and automobile exhaust and other forms of air pollution,” a strategy that had already been widely noted by the Hill & Knowlton crew.47

  Finding a scientist of stature willing to serve as scientific director proved no easy task. In a culture that prized independence and autonomy, taking a high-salaried job with an industry-supported research entity was viewed with suspicion. Most of the candidates insisted they could be considered only if they could maintain their current academic affiliations. Such an arrangement was fine with Hill & Knowlton, which remained eager to oversee the day-today operations of the Tobacco Industry Research Committee.

  After failing to recruit three distinguished scientists, including Harold Stewart (the NCI’s chief pathologist) and McKeen Cattell (head of pharmacology at Cornell University), the industry decided to construct the SAB first, offering positions to nine scientists (seven accepted).48 They then offered the position of scientific director of the TIRC to biologist Clarence Cook Little, who had already agreed in early 1954 to serve on the SAB and had been elected its chair.49 In this appointment, Hill and his clients found precisely what they hoped for: the ultimate skeptic concerning the harms of smoking. As one Hill & Knowlton operative noted, “Little filled the bill perfectly.”50 He now emerged as the industry’s leading spokesman on the science of tobacco and health, a position he would hold for the next two decades. Gregarious, charming, combative, and arrogant, he was a seasoned fund-raiser and much-sought public speaker. His view of the relationship between smoking and disease would never change: there was “no proof ” that smoking caused lung cancer or, for that matter, any other health problems.

  By the time Little joined the TIRC in early 1954, he had already publicly declared his skepticism concerning the link between smoking and cancer. “If smoke in the lungs were a sure-fire cause of cancer,” he explained, “we’d all have had it long ago.”51 No doubt, such a statement enhanced Little’s candidacy for director. He explained at the press conference announcing his appointment that “I am an ultraconservative about cause and effect relationships.”52 Confidential reports of a TIRC meeting make Little’s agenda explicit:He [Little] declared that both he and the members of the board were aware of the attacks which had been made on tobacco for over 200 years, and wished to build a foundation of research sufficiently strong to arrest continuing or future attacks.53

  Such an approach was central to Hill & Knowlton’s overall PR strategy.

  Little’s personal commitments and a priori assumptions about cancer causality made him the ideal proponent of the industry’s singular goal of maintaining a “controversy” regarding smoking and health. His scientific beliefs about cancer corresponded directly to his belief in the importance of heredity for understanding the causes of disease. From his earliest scientific training, Little had been deeply committed to hereditarian notions of cancer and society. In 1936, as president of the American Birth Control League, he decried the “ill-advised and unsound policies of economic relief employed in the country,” which he maintained would only lead to the further propagation of the unfit, and he offered gratitude to “the gentlemen who rule Italy, Japan, and Germany for demonstrating that a program of stimulating population is a program of war.”54 Little’s eugenic scie
nce was closely tied to his politics. “Our political and sociological premise in America is based on the false premise that all persons are born free and equal. This is an absolute absurdity,” he wrote in 1936. “We must segregate men according to their standing.”55 Little also became a founding director of the National Society for the Legalization of Euthanasia and the Race Betterment Congress. He vigorously defended compulsory sterilization, urging the expansion of legislation mandating such policies. “When a sink is stopped up,” he wrote, “we shut off the faucet. We favor legislation to restrict the reproduction of the misfit. We should treat them as kindly and as humanely as is possible, but we must segregate them so that they do not perpetuate their kind.”56

  Such views—not uncommon throughout the first half of the twentieth century—provide insight into Little’s deep commitment to hereditarian causes of cancer. Cancer, he believed, resided in an individual’s genetic lineage. It was self-evident that most systemic, noninfectious diseases originated in the body and were fundamentally subject to genetic predisposition. If smoking “appeared” to cause disease, this was but an artifact of an intrinsic constitutional vulnerability. Environment and behavior could mask these internal causes but did not themselves “cause” disease. Moreover, following eugenic theory, social and behavioral interventions were at odds with evolutionary schema. The lung cancer-smoking connection threatened to topple Little’s rigidly held world view of biology, disease, and society.