Philip Morris is committed to domestic violence.
PHILIP MORRIS COMPANIES INC., “DOMESTIC VIOLENCE FACT SHEET,”
Tobacco companies have sometimes claimed it is not possible to make a “safe” or even a “safer” cigarette, though the basis for that argument has shifted somewhat in recent years. The claim used to be there was no point to making cigarettes “safer,” since they had never been shown to be unsafe. In the late 1990s this argument was given a bizarre twist, as the companies began characterizing cigarettes as inherently risky. The hope was to glide safely through the collapse of the denialist project, using the reassuring rhetoric of “risk”: Isn’t life, after all, inherently risky? So isn’t the cigarette very much like life in this respect?
Smoking, then, entails certain “risks.” We are also reassured, though, that the companies are trying to reduce those risks through research. That is one reason Philip Morris built a new $350 million research facility in downtown Richmond, Virginia. One of the main goals of this high-tech “Life Sciences Park,” staffed by three-hundred-odd research scientists, is to explore “reduced harm” tobacco products, using nanotechnology and metagenomics and other state-of-the-art science fashions. “Harm reduction” has become the industry’s new mantra; the companies now want us to believe that less hazardous products can be and are being made and marketed—in the form of cigarettes, of course, but also chewing tobacco, oral snuff, and that sexy spittle-soaked item known as Swedish “snus,” which causes mainly tooth loss and mouth tumors.
Unquestioned in all of this is the ideology of consumer sovereignty: the presumption is that consumers should have unlimited choices when it comes to what kinds of products they might consume. It is the myopia that leads us to encourage cessation of consumption while ignoring opportunities in the realm of cessation of production. Consumers are encouraged to stop consuming, but producers are never discouraged from producing. Applied to harm reduction, the presumption is that we should only think of “safer” cigarettes in terms of products added to those already on the market. Harm reduction is envisioned in terms of inventing new products rather than restricting or banning those already being sold.
But first: Can cigarettes be made less lethal? Of course they can! Cigarettes are highly engineered artifacts and can be made in a thousand different ways—and some will obviously be less deadly than others, depending (partly) on how they are used. Tobacco control advocates have often been leery of making this point, not wanting to seem to be helping the industry find ways to “improve” cigarettes—which might well discourage people from quitting (or never starting). Health advocates are, in fact, divided over whether it is good for cigarettes to be made “more safe,” and for interesting reasons.
On the one hand, there are those who ask: How could anyone not want cigarettes to be less hazardous? If people are going to smoke, shouldn’t they be able to smoke in ways that are less likely to kill them? Comparisons are made to the use of drugs such as heroin: so long as people are going to shoot junk into their veins, shouldn’t they at least be able to use clean needles? Such has been the basis for needle-exchange programs in various parts of the world, and the tobacco industry has worked hard to piggy-pack onto at least part of this rhetoric—the “harm reduction” part. People are always going to smoke, so shouldn’t we at least make cigarettes as safe as possible?
There are good reasons to be skeptical of harm reduction, however. I tend to agree with those who sense that as most commonly imagined “harm reduction” may end up causing even greater harm, by dangling false or even true hopes in the market. Quitting (or never starting) is really the only way to prevent harm, and if products touted as “safer” make smokers less likely to quit, then harm reduction could do more harm than good. There is the added legal twist that a tobacco manufacturer might have trouble obtaining approval for a novelty that might provide, say, only a 10 percent chance of killing you—compared with the 50 percent of traditional cigarettes (over a lifetime of smoking). Cigarettes made in the conventional (= super-deadly) way have been “grandfathered in” by the health and safety myopia of times gone by, but imagine a world in which cigarettes had never been invented, and the question were posed de novo: is the cigarette an acceptable drug or consumer product? Patent offices would presumably refuse it; regulators would bar it. That is why new tobacco products, even those that are marginally less lethal, may not be welcomed with open arms. A California law (Proposition 65) defines a “significant risk level” as anything that would result in more than one excess cancer in 100,000 individuals exposed over a seventy-year lifetime; cigarettes are thousands of times more deadly, so even a thousandfold improvement wouldn’t pass the Golden State’s test of “significant risk.” Hence the difficulty. Of course given how low the bar is for cigarette safety, almost anything will appear “safer” by comparison. Talk of “safer cigarettes” is rather like talking about safer terrorism, or safer smallpox, or safer forms of drowning: it’s oxymoronic.
Again, it would not be hard to make a “safer cigarette” or even one that is perfectly safe, so long as we are willing to stretch our definitions. A cigarette made entirely of solid wood or stone could not be smoked, for example, and therefore would be quite safe. The same would presumably be true for any cigarette that does not deliver toxins into the body. Cigarettes of this sort are not made, of course, because no one would buy them. People buy cigarettes because they have a craving for nicotine, and if cigarettes don’t deliver “the goodies” they won’t get bought.
The law also has a say in this matter. Cigarettes are regulated for purposes of taxation—and now in the United States by the FDA—which means we have legal definitions of a cigarette. In the United States a cigarette has traditionally been a smokable tobacco product wrapped in paper. How important, though, is the paper to this definition, or the smokability, or the tobacco? What if we are talking about a nicotine delivery device that emits no smoke, or is not wrapped in paper, or contains no tobacco, or is not burned but rather heated—is that still a cigarette? The question is not an academic one, since regulators have to decide whether a particular device is or is not a cigarette, in order to know how or even whether to regulate it. This was one problem encountered by Premier and Accord in the 1980s and 1990s: the devices were introduced as cigarettes but didn’t so much burn as warm and release a kind of flavored nicotine steam. The industry called these “cigarettes” and included tobacco to have them grandfathered into the FDA’s regulatory neglect (since the agency was barred from regulating cigarettes), but not everyone agreed they were enough like cigarettes to ignore.
There is an ugly irony here: cigarettes that are not deadly enough may not be classified for regulatory purposes as cigarettes—especially if they don’t contain (and burn) tobacco. Electronic cigarette manufacturers often include some small amount of tobacco in their products, just to guarantee these will be classed as cigarettes and not as inhalers or some other kind of drug device. Nicotine inhalers have to be approved by the FDA, whereas cigarettes generally speaking do not (though that is now beginning to change). And drug delivery designs that stray too far from traditional cigarettes may not be approved even if—and in a sense because—they are less deadly. Designs that well might kill fewer people may not be classed as cigarettes and might not obtain regulatory approval. Cigarettes get grandfathered in as sacrosanct, while devices that might kill fewer people get barred as unsafe.
From the industry’s point of view, of course, it would be great to be able to make less deadly cigarettes, so long as profits could be kept high. The companies are not in the business to kill people; that is more of a side effect and one they would surely rather avoid, everything else being equal (“unattractive side effects,” is how Brown & Williamson once described lung cancer and heart disease from smoking.)1 The companies have tried from time to time to make cigarettes less deadly, albeit always within the confines of maximizing profits and fending off lawsuits. Many of these efforts were kept quiet, since the industry didn’t want to admit that cigarettes were at all unsafe.
And most such efforts involved little more than tinkering. Scientists working for Reynolds once summarized ten different ways that cigarettes had been redesigned to offer “safer smoking,” following the arguments of Gio Gori, their ally at the National Cancer Institute. These included use of high-porosity cigarette paper; air-dilution filters; use of reconstituted tobacco and stems, along with inert fillers (“tobacco extenders”) such as clay or dolomite; novel methods of cultivation and curing; and reductions in machine-measured tar, nicotine, nitrogen oxides, carbon monoxide, and hydrogen cyanide to “appropriate” levels.2
The industry now likes to display such efforts as proof of good-faith efforts to make cigarettes safer, but the fact is that none of these are anything but minor tinkerings. High-porosity paper helps the companies control the oxygen flow to the burning rod, affecting the temperature and rate of burn. Tar and nicotine look lower to smoking robots because the cigarettes burn up faster. Air dilution is just ventilation, a trick overcome by compensation and “lipping behavior.” Recon is primarily a way to save on factory costs and to fine-tune composition, and inert fillers make smoking safer if you believe that a few glass marbles in a bottle of soda will lower its calorie count. The industry’s principal stabs at creating “safer” cigarettes ignore—or sometimes even capitalize on—the reality of compensation and can even cause more harm by delaying quitting. Untold millions of smokers have continued to smoke, imagining that by switching to extra longs, filters, menthols, low tars, or lights they were smoking safer.
There are two chief problems in this “safer cigarette” business. The first is that no matter how you modify the product, repeated inhalation of smoke is going to cause disease. The second is more of a legal nature, having to do with the fact that so long as cigarettes in their super-deadly form are legal, there really is no incentive for a manufacturer to make less deadly cigarettes. Think about it from a (rather misanthropic) marketing point of view: why bother selling a “safer” cigarette when no one is stopping you from selling your unsafe brands? That was the problem with Lorillard’s “little cigars,” launched with the brand name Madison in 1958. These were basically cork-tipped cigarettes made with brown instead of white paper and a smoke pH so high—on a par with cigars—they would not be inhaled (“You Need Not Inhale to Enjoy Them”), which would have been a genuinely less deadly tobacco product. A few people even outside the industry realized this and grasped the underlying rationale: as Consumer Reports put it in 1959, “cigar smoke is too strong and irritating for most people to want to inhale it, and smoke which merely is taken into the mouth does not, so far as is now known, cause or aggravate lung cancer.”3 “Little cigars” never met with much commercial success, however, despite a burst of popularity following the 1964 Surgeon General’s report. The companies never made any serious effort to advertise these as less lethal and never withdrew cigarettes with more easily inhalable smoke.
The lawyerly complications stem from the fact that once you start saying your new version of Luckies, Marlboros, or Virginia Slims will kill fewer people, this would seem to be an admission that your old-school brands have not been on the up and up. Lots of “safer” cigarettes marketed or proposed for marketing have bitten the dust on these grounds—Liggett’s palladium cigarette, for example.
In Liggett’s case the company had launched this effort jointly with the Arthur D. Little company in the 1950s, spraying palladium nitrate onto cured tobacco leaves to achieve a more complete combustion.4 The idea was that the metal would act as a catalyst, helping to burn up some of those nasty polycyclic aromatic hydrocarbons thought responsible for causing cancer. Catalytic converters were known to have done something similar for cars: automobile exhaust is basically forced past a reactive catalyst at a high temperature, which breaks up some of the uglier complex molecules into softies like carbon dioxide and water. The afterburners attached to jet engines work on a similar principle, albeit with the goal being not to reduce emissions but rather to extract more energy from the fuel. Catalytic conversion might well have “worked” in cigarettes—preliminary tests showed a lessening of carcinogenic potency—but the idea seems to have foundered on legal shoals.
Everything else being equal, it could well be that switching from, say, Marlboro Reds to a cigarette with a palladium nitrate catalyst might make you less likely to die from smoking. Liggett in the 1960s and 1970s put quite a few eggs into this basket, spending $15 million over about twenty years on projects with code names like Project Tame and Project XA. Smoke from such cigarettes caused fewer tumors when condensed and smeared on the backs of experimental animals, and the company purchased 200,000 ounces of the precious metal—at $52.50 per ounce—from Engelhard Minerals. But legal fears eventually caught up with and snagged the cigarette, which was never sold commercially. This was a great disappointment to the program’s chief architect, the chemist James D. Mold, who wanted very much to see this “safer cigarette” marketed. Liggett’s attorneys realized this would be difficult without admitting that cigarettes cause cancer; there was also the worry that the Federal Trade Commission might not even allow any mention of such additives in advertising. Mold has testified that the company hoped for help from the White House; Jimmy Carter was president when the cigarette was being readied and was friendly enough to promise North Carolina growers help with making smoking “even more safe than it is today.”5
Liggett would later claim that its palladium cigarette was dropped because it had a “metallic taste” and failed marketing tests. Testimony from the project’s researchers, however, reveal that the company came under pressure from some of the larger manufacturers, who didn’t want to hear anyone in the business conceding that smoking caused cancer. According to Mold, the company worried that the sale of palladium cigarettes “would seriously indict them for having sold other types of cigarettes”; he also recalls Liggett’s president and CEO, Kinsley Van R. Dey, talking about a threat from Philip Morris that the Marlboro men would “clobber” Liggett if it were to market such a product. Shortly after announcing the new cigarette, Liggett researchers got word from the company’s lawyers that the device could put them in legal jeopardy.6
Liggett’s low-cancer palladium cigarette was announced in the fall of 1978, with a press release by Arthur D. Little identifying Liggett as “the first cigarette maker to acknowledge tobacco produces cancer in laboratory animals.” A Liggett spokesman immediately rejected this conclusion, stating that the admission pertained only to certain animal experiments using smoke condensate—which were flawed by virtue of using “the wrong substance on the wrong tissue, on the wrong species in the wrong amounts.” A Liggett press release of September 26, 1978, reaffirmed that the company and the cigarette industry as a whole “continue to deny . . . that any conclusions can be drawn relating such test results on mice in laboratories to cancer in human beings.” The company’s acquisition of a patent on the palladium process was not to be considered an admission of a cancer link:
Liggett has made no such admission; the fact is that for more than two decades scientific researchers have produced tumors on mouse skin by the application of enormous dosages of smoke condensate. Neither the industry nor Liggett has denied these results. Liggett and the cigarette industry continue to deny, as they have consistently, that any conclusions can be drawn relating such test results on mice in laboratories to cancer in human beings. It has never been established that smoking is a cause of human cancer.7
Plaintiffs’ attorneys later had a field day with the confusion, after learning that Liggett had spent $15 million over twenty-four years to research a project whose relevance to human smoking they now repudiated. Had Liggett really spent so much money just to save the lives of a few shaved mice?8
The palladium cigarette is remarkable as a case of product suppression, regardless of whether it would have actually saved lives. It was suppressed for legal and PR reasons, but it is certainly not the only instance of tobacco-related product suppression. Another example took place in the 1980s, when Philip Morris pressured Merrell Dow Pharmaceuticals to rein in its marketing of Nicorette chewing gum. Nicorette was a nicotine replacement therapy developed by the Swedes in the 1960s and approved for use in Switzerland in 1978 and in the United Kingdom in 1980, by which time Merrell Dow was readying it for sale in the United States. FDA approval didn’t come until 1984, but in 1981 the company had launched the Smoking Cessation Newsletter to publicize the virtues of nicotine replacement therapy. Philip Morris was furious at Merrell Dow for publishing “anti-smoking propaganda” and called a meeting with the company to demand that it “cease further publication.” Philip Morris also threatened to stop buying humectants from the company’s parent, Dow Chemical, which by 1982 was doing $8 million in business with the cigarette manufacturer. Merrell Dow bent under the pressure, and the Smoking Cessation Newsletter was canceled after only one issue.9
Philip Morris continued to pressure Merrell Dow on other matters, including the pharmaceutical manufacturer’s support for the National Interagency Council on Smoking and Health, a distinguished group of representatives from the American Heart Association, the American Public Health Association, the American Cancer Society, and other public health agencies. Philip Morris didn’t like the council’s support for scholars who refused tobacco industry money, its urging of athletes to renounce tobacco sponsorship, or its call for “a Smoke-Free Society by the year 2000.” Merrell Dow also continued to promote Nicorette gum, prompting Philip Morris to honor its threat to halt all purchases of glycerine, glycol, and other humectants from Dow Chemical (in May 1984). Philip Morris explained in internal correspondence that Dow had apparently decided that Nicorette was “more important” than its trade with tobacco manufacturers; indeed Dow was engaged in an audacious program “to motivate Philip Morris customers to stop smoking.” Philip Morris expressed its disappointment that a loyal customer (itself) would spend millions of dollars purchasing materials from a company (Dow Chemical) whose profits would then be used “to attack that customer’s product and perhaps reduce the customer’s sales.” Dow protested that it was not in fact trying to combat smoking, but the cigarette maker was rightly skeptical. Philip Morris warned that future relations between the two companies would be “predicated” on “the course of the Nicorette program.”10
Philip Morris continued with its effort “to eliminate, or at least tone down,” Dow’s marketing of Nicorette but eventually realized that the cigarette maker was as dependent on Dow as vice versa. Philip Morris resumed purchasing from Dow but only after the chemical company had withdrawn its support for the Interagency Council.11 By pressuring Dow in this manner and by helping to quash the Smoking Cessation Newsletter, Philip Morris may well have delayed the spread of effective methods of smoking cessation in the United States. Which of course was precisely its intent.
Bhavna Shamasunder and Lisa Bero at UCSF have shown that tobacco manufacturers have pressured pharmaceutical manufacturers in other ways—to limit the marketing of nicotine transdermal patches made by Merrell Dow and CIBA-Geigy (Nicoderm and Habitrol), for example. Philip Morris here again was worried about patches cutting into its cigarette business and actually calculated a loss of sales to the industry on the order of 11.2 billion cigarettes per year by 1996, based on a market for patches predicted to reach $1 billion per year by 1995. Philip Morris “took offense” at CIBA-Geigy’s marketing of Habitrol and used its position as a major buyer of pesticides to pressure the company to rein in its “anti-tobacco” advertising. Intimidation of this sort resulted in CIBA-Geigy revising its marketing of Habitrol, with a “Groundrules” agreement between the company’s agricultural and pharmaceutical divisions requiring that the drug maker target only those people already “committed to quitting.” Habitrol was not to be considered “a substitute for smoking” or to violate “the freedom of choice for smokers.” Philip Morris was apprised of all these changes and appeared satisfied that CIBA-Geigy would “remain sensitive to the concerns of the tobacco grower organizations and the rest of the tobacco industry.”12
There are many other examples of the industry flexing its muscles to suppress products, policies, or programs perceived as obstacles to the continued sale of cigarettes. In an earlier chapter we saw how dependence on tobacco advertising revenue made it hard for popular magazines to criticize cigarettes; this same influence worked to encumber cessation advertising. Consumer Reports as early as 1959 noted how hard it was for the manufacturers of Bantron, a prescription pill designed to help smokers cut down on smoking, to get magazines to take their ads, given the risk of offending cigarette makers. The New York Times cautioned that magazines wanting to publish such ads would have to “think twice” before risking their lucrative cigarette accounts. Shamasunder and Bero compare this to the industry’s use of its considerable financial might to pressure airlines not to enact smoking bans.13
These are only tiny slivers from the industry’s larger history of political machinations, much of which has been designed to keep radical tobacco exceptionalism alive. Tobacco managed to have itself excluded from regulation by the FDA for more than a century, just as it was excluded from regulation by the Consumer Product Safety Commission when that body was founded in 1973. The commission has always had the power to rein in dangerous cigarette lighters, for example, but has never had any authority over tobacco products. It has the power to require furniture makers to design upholstery to withstand ignition from cigarettes but no power to demand a reduction in the ignition propensity of cigarettes themselves.14 A medievalist colleague once remarked on how the government of the United States is byzantine with political fiefdoms and legal exceptions, and I cannot think of a better example than the parochial exceptionalism granted to Lord Tobacco.
“Safer” cigarette designs number in the hundreds if not the thousands. What we’ve mainly seen from manufacturers, however, are illusions of safety, conveyed by intimations of health via branding categories like “lights,” “low tars” and “milds,” along with healthy-seeming additives such as menthol, with its medico-bogus implication of sanitation. (For the tuxedoed “Dr. Kool,” complete with black bag and stethoscope, see Figure 34). King-sized cigarettes (Pall Mall, introduced in 1939) were also supposed to offer protection by virtue of “traveling the smoke” farther, and even “toasting” (Lucky Strike) was heralded as removing poisons. Filters were all the rage in the 1950s, forcing smokers to pull somewhat harder on their cigarettes but doing little to change the quantity inhaled or its carcinogenic character. Selective filtration was supposed to be the next big hope, though here, too, the difficulty was that while one kind of compound might be partially trapped (say, hydrogen cyanide or phenols), others were as likely to be augmented (carbon monoxide or nitrosamines, for example). Cigarette makers found themselves faced with a chemical hydra, with new poisons cropping up when old ones were vanquished. Smokers were then urged to switch to “low tar” and eventually “light” cigarettes—concocted by blending tricks and ventilation and hand waving—though here, too, the benefits were illusory. Smokers tended to adjust their smoking behavior, drawing harder to maintain their accustomed level of “satisfaction.” “Lights” became the main new branding concept in the 1970s, formalizing this low-tar subterfuge. With Lights this suggestion of a benefit from “stepping down” in tar was built into the very brand name, a novelty in the history of marketing. Competition for the “worrier” or “concerned segment” prompted brand extensions into ever lower tar regimes, with the late 1970s seeing the invention of “Ultra Light” and “Lowest Tar” brandings—all bogus.
Additives were another great hope. Dozens if not hundreds of substances were tested to see whether specific poisons might be destroyed: to eliminate benzpyrene, for example, companies tried adding metal nitrates of various sorts, hoping these would act as catalysts to break down carcinogenic polycyclics. Absorbents were added, along with chemicals to lower the burning temperature (to reduce polycyclics), or even hemoglobin to gobble up carbon monoxide.15 Carbon was added to filters to capture ciliastats, and while American companies were toying with Parmesan cheese and kitty litter, the Japanese were patenting a bovine milk protein that was supposed to adsorb onto a carbon surface.
The problem with almost all such manipulations is that tobacco smoke is a complex and chemodynamic brew, with many interacting components. David Townsend, director of product development at R. J. Reynolds, saw a certain amount of humor in the situation:
You know, we—we joke a lot in the laboratory about it, all the heads are tied to all the tails. If you change one thing, in fact, everything changes because it’s such an interactive system . . . it’s technically very difficult to go into something complex—complex like cigarette smoke with a scalpel and carve out one compound or one group of compounds.16
Which is also why so few of these manipulations offered anything in the way of genuine safety. All were essentially gimmicks, as was revealed to the outside world when cancer rates failed to fall as many scholars had hoped. Per-cigarette cancer rates today remain about what they were in the 1950s and 1960s, with no real benefit from the shift to lights and low tars. Indeed since there is significantly less tobacco in cigarettes, on a per-gram basis cigarettes are actually more deadly now than ever before—as we have seen.
One new and radical step taken in the 1980s and 1990s was to try to make a nonburning cigarette—basically a smoke-free nicotine delivery device that would release some kind of warm nicotine steam with flavors. The idea here again was that smokers should be able to obtain their requisite nicotine fix without all that nasty admixed tar. Reynolds spent hundreds of millions of dollars along these lines: the goal of Projects Spa, Q, and Y, for example—which eventually yielded the Premier cigarette—was to develop a device heated by a battery or chemical reaction of some sort that would emit no secondhand smoke and near-zero tar while still delivering nicotine “satisfaction.”
Reynolds announced its Premier cigarette in the summer of 1988, but the brand was a flop from the get-go. The new cigarette never sold, despite a massive marketing campaign encompassing one-on-one briefings with university presidents, medical school deans, science writers, and medical organizations, along with politicians and “opinion leaders” throughout the world. The plan included cultivation of academics as spokespersons and witnesses—including Stanford’s Nathan Rosenberg, who was hired to testify on “technology policy” for the company—along with more traditional use of hot lines, sampling vans and kiosks, and “very elegant cigarette girls to sample product in trendy restaurants and clubs.” And contacts with key friendlies in the House and the Senate. The new device—basically a nicotine steam dispenser with a hollow, pellet-filled, metal heating element running through the center—was clumsy to light, hard to dispose of, and had a pretty wretched taste. Test panels reported flavors reminiscent of “burnt biscuits” and “glue made from fish or horses,” with the remnant heating element left after smoking looking rather like “the heating rods in nuclear reactors—very industrial.” One user described the smell as redolent of “a grave opened on a warm day.”17 And while tar deliveries were lower, “gas” yields were actually higher, including classic nasties like carbon monoxide and hydrogen cyanide, released by the smoldering of the charcoal tip (which you lit to get the thing fired up). So it was never even clear that a shift to such a cigarette would be an overall plus, even if it didn’t stink (which it did). Smokers found the thing disgusting, but there was also the legal/PR rub that devices such as this could not be advertised as “safer,” so long as no one was willing to admit that ordinary cigarettes were dangerous. Critics charged that the only reason it contained tobacco at all was to exempt it from regulation as a new kind of drug delivery device—to which Reynolds responded by launching a series of investigations forcing baboons to smoke crack cocaine.
The stimulus here was the complaint that Reynolds’s Premier cigarette could be used to deliver other kinds of drugs—like cocaine. Jack Henningfield and Edward Cone from the National Institute of Drug Abuse had replaced the nicotine in Premier with 200 milligrams of crack cocaine and found that the contraption functioned tolerably well as a crack pipe. Reynolds ridiculed the suggestion (“They call Premier a ‘drug delivery device’: well, so is a spoon”) but was forced to respond, prompting a series of Reynolds-financed experiments in which baboons were taught to smoke cigarettes laced with crack cocaine. The goal was to see whether this new “smokeless” cigarette could be used “as an efficient system for the delivery of ‘crack’ or free-base cocaine.” Reynolds in January 1989 had at least nine baboons smoking crack (or controls), with laboratory analyses farmed out to the University of North Carolina in Chapel Hill and the crack-addicted baboons lodged at the Southwest Research Institute in San Antonio, Texas—which at that time had the world’s largest baboonery. A psychiatrist by the name of Mario Perez-Reyes was the company’s point man at UNC, with Walter R. Rogers doing the dirty work in San Antonio. The cocaine was provided by the Georgia Bureau of Investigation. The experiments went on for several months, with mixed results. Perez-Reyes for a time was worried that the baboons had not been properly trained and might only be “puffing” without inhaling. Researchers did find evidence of compensation: “As in humans, baboons are very sensitive to draw resistance. They can learn to modify their puffing to compensate.”18
There is much we cannot know about such experiments: the document just cited, for example, begins with a redacted section censored as “Privileged material.” We do know, though, that Southwest Research by the mid-1970s already had thirty- five baboons hooked on cigarettes: Walter Rogers had trained them to smoke by depriving them of water and then allowing them to drink only through a tube through which smoke was also introduced. Helmut Wakeham led a Philip Morris team to San Antonio to observe the creatures, several of whom by 1975 had already been addicted for more than two years. Operant conditioning had turned them into precision instruments for the study of smoking behavior, with their carefully timed puffs resulting in “the buildup of a heavy pall of smoke about the animal’s head.”19
As for the baboons: we don’t yet have a good study of experimental animal abuse in the tobacco industry. Tens and probably hundreds of thousands of animals have been sacrificed for no good purpose. We also need further study of human experimentation in the industry. Philip Morris in 1969, for example, launched a series of experiments titled “Smoking under Conditions of Shock Produced Anxiety” to see whether college students would become more or less interested in smoking after exposure to electric shock. Virginia Commonwealth University students were jolted with electric current to show that smoking “is more probable in stress situations than in nonstress situations.” Shock intensity was to be adjusted for each subject “according to the subject’s pain threshold,” and the protocol explained that “the shock will be painful.” This particular series was abandoned in October of 1972, when Philip Morris psychologists realized that “fear of shock” was “scaring away some of our more valuable subjects.” Industry employees have also been subject to human experiments, testing experimental cigarettes or even experimental pesticides with little or no regulatory oversight.20
Premier’s failure was, in a sense, both pre- and overdetermined. Quite apart from being awkward, unpleasant, and a bigger emitter of carbon monoxide even than ordinary cigarettes, protests were also voiced that this was just another effort by the industry to keep people hooked on nicotine. Trenchant criticism also came from those who realized that the “safety” offered was trivial at best: Arnold M. Katz, head of cardiology at the University of Connecticut Health Center, noted that to market such a product as preventing disease would be like urging us to sleep with rattlesnakes because they are less toxic than cobras.21
Criticism of this sort seems not to have been much of a deterrent, however. Philip Morris’s Project Advance (from 1984) was yet another effort to investigate “nonburning pleasure articles,” quasi-cigarettes that would deliver an aerosol of “nicotine, flavors and other satisfying components” with “very low biological activity” and little or no sidestream smoke. The goal was to avoid combustion, with alternate heat sources ranging from electric batteries to chemical power (photoflash or thermite). The same company’s Project Vanguard expanded this to include cold unpowered vapor devices, flashbulb heating mechanisms, piezoelectrics, and mechanical devices for atomization, along with devices incorporating whistles, capillaries, and something called “packed beds-pulsed power.” A common idea behind the “electric cigarette” was that a battery of some sort would heat a nichrome wire, warming and vaporizing the nicotine (developed under the company’s Project Leap). Philip Morris also worked with General Electric “to provide additional expertise in developing the electric cigarette concept.”22 Efforts along these lines—supported by $200 million in development costs—culminated (in 1997) in the debut of Accord, an “ultra low tar” cigarette that could be smoked only while inserted into a large, handheld, battery-powered Puff Activated Lighter™, complete with a microprocessor to indicate how many puffs remained. This, too, was an instant flop: the electronic lighter alone cost $50 and required a recharge of batteries after every pack smoked. Richard Daynard called it a “weird contraption,” and the New York Times likened it to smoking a kazoo. The device also failed when test marketed in Germany as the “Heatbar.”23
Other companies developed similar designs. Brown & Williamson in 1991 filed for a patent on a cigarette that would generate a warm tobacco-flavored liquid, and Imperial Tobacco patented a cigarette that would burn only while the smoker was inhaling. But most projects of this nature during the development phase at least were kept quite confidential. The companies usually didn’t want it known that they were trying to make (some) cigarettes less dangerous, and the dilemma continued even after new products were announced. It was hard to advertise such innovations: the companies couldn’t really say they were “safer,” without admitting their other brands were less than safe. The solution was a kind of doublespeak, in which Premier and the like were offered only as reducing “many of the controversial compounds” in cigarette smoke. And smokers just didn’t buy it. Why should they, when the manufacturers were not even admitting any harms from plain old regular smokes?
Reynolds in the 1990s retreated to a less radical redesign with Eclipse, which was more like a traditional cigarette with reduced (visible) secondhand smoke emissions. Eclipse was introduced in the United States in 1996 but also simultaneously in Germany as Hi.Q and in Sweden as Inside. None of these were popular, however. The cigarette was supposed to yield fewer smoke solids and to be “safer” from the point of view of starting fires (since it wasn’t really burning the tobacco so much as just heating it to produce a flavored nicotine aerosol). But the taste again was foul: not as “sweet and sickly” as Premier but still unpleasant with “fungal” and “metallic/toxic” taste overtones. And hard to light and hard to tell how far down you’d smoked, since the tubular outer casing never went away. Test panels judged it overall “a good cigarette to smoke if you want to quit”—mainly because it was so disgusting.
The hard lesson learned through such misadventures was that while cigarettes could be made that might well be less likely to kill you, they weren’t likely to attract much of a following. And in a smug sort of way the companies must have welcomed this, since it could be used to blame the victim—that is, the consumer. The companies could basically say, “Look how hard we tried to make safer cigarettes, but people don’t want to smoke them! What more can we do? If smokers don’t want safety, then it’s not our fault.”
Recent years have seen renewed efforts to produce “less hazardous” cigarettes, most of which use batteries to provide some kind of flavored nicotine steam. Electric or “electronic” cigarettes, for example, warm a soup of nicotine fluid, which then vaporizes and can be sucked into the lungs. Many such devices are now being produced in China—the Ruyan cigarette, for example, which can be bought on various Internet sites or through eBay, or competitors like the Ploom (a pipe) or Njoy. The idea is for these to be used (“vaped”) in places where traditional cigarettes cannot—on airplanes, for example, or in bars where smoking is banned. None of these devices have been tested for safety, however, and since all deliver nicotine, sometimes accompanied by a propylene or diethylene glycol mist, we can assume they will all cause addiction. Electronic cigarettes have been banned in Australia and in Hong Kong and are restricted in many other countries. Regulatory oversight is likely to depend on whether they are imagined for use as cigarettes, cigarette substitutes, or smoking cessation instruments. Some are being promoted as quasitherapeutic—like Vapir One, a “revolutionary” vaporizer designed to “intoxicate your senses” by inhaling “the essence” from various herbs, spices, or tobacco. Vapir’s inhaler is advertised as useful in the treatment of asthma, congestion, or anxiety, eliminating “all of the discomfort” associated with traditional cigarettes. Users are invited to “inhale the future.”24
Most such devices have been greeted with skepticism from the medical community, since the long-term consequences of inhaling nicotine or glycol steam or herbal “essences” are not at all clear. There is also the worry that such devices will be used in combination with smoking or to avoid quitting. The U.S. Food and Drug Administration in 2009 barred the import of electronic cigarettes into the United States, though a federal court shortly thereafter lifted this ban, classifying the devices as cigarettes and therefore subject to the new regulatory authority of the FDA. Electronic cigarettes have been banned in many countries—Brazil, Australia and Canada, for example—where cigarettes themselves (for now) remain legal.
There is no such thing as a “safe” or even a “safer” cigarette, judging purely from the intrinsic physical properties of some smoking article. Cigarettes are more or less lethal, depending on how they are used. The tarriest Lucky Strike from the 1950s wouldn’t be so bad if you just puffed once on it lightly without inhaling and then tossed it (fireless) into the trash. And the “healthiest” ultralight is a tumor tube if you suck on it like a vacuum pump to the bitter end. All those numbers printed on packs for so many years were virtually meaningless—and highly deceptive—and the fact is that a cigarette advertised as delivering 20 milligrams of tar could be smoked to deliver 2 milligrams and vice versa. The only really safe cigarettes are those you never smoke.
That being said, it is important to realize that the industry easily could have designed and manufactured cigarettes that would have been inherently less deadly—by virtue of being difficult to inhale. Cigars, for example, cause far less damage to the lungs than cigarettes, because they are harder to inhale. They are harder to inhale because the tobacco is cured in such a way as to make the resulting smoke quite alkaline. Alkaline smoke (anything above pH 7) is harsh and if pushed higher than about pH 8 becomes almost impossible to inhale without coughing. Tobacco manufacturers have been manipulating the pH of cigarette smoke for more than a century, and it would be easy for them to redesign cigarettes—back to the uninhalable form that existed prior to that time and still exists today in most pipe and cigar tobaccos. Cigarettes would once again become little cigars and lose part of their deadly force. Cigarettes would still cause mouth and throat cancer and heart attacks and just as many deaths from secondhand smoke, but the total burden of death would still be significantly less than we have at present. The FDA’s new Center for Tobacco Products—charged with regulating cigarettes—should consider this fact: if cigarette manufacturers were barred from making products with a smoke pH less than 8, there would be significantly less inhaling and significantly less lung cancer. It’s a no-brainer.
Tobacco manufacturers have realized this for quite some time, and some have even tried to capitalize on it. In the 1970s, for example, the Consolidated Cigar Corporation marketed “little cigars” delivering nicotine with a sufficiently high pH that they did not have to be inhaled. (Recall that high-pH nicotine easily penetrates the mucosal membranes of the mouth and so needn’t reach the lungs to deliver “satisfaction.”) In testimony before the U.S. Congress in 1973, Consolidated’s president defended his company’s Dutch Treat cigars by claiming that their goal had been to develop “a little cigar that would be acceptable to the consumer and to the authorities as a safer alternative to cigarette smoking.” The claim was that cigar smoking presented “reduced, if not negligible health risks.” This is one of the few concessions at this time by a tobacco manufacturer of the reality of “health risks.” Consolidated kept the pH of its cigar smoke around 7—but if it had been elevated to 8 or above and smokers had no access to “milder” smokes of the more traditional sort, this would have dramatically reduced the lung cancer risk.25
Cigarettes could easily be redesigned to be difficult to inhale. There is no iron law saying that cigarette smoke must be inhalable; indeed as late as the 1930s it was fairly common for cigarette smoke not to be taken into the lungs. Inhalation was promoted to facilitate nicotine delivery; there is no more effective way to administer such a drug. (Recall also that we are not talking here about “taste”; there are no taste organs in the lungs.) The modern inhalable cigarette is the product of decisions that could have been reversed at any time during the past century—or today for that matter. Had a decision of this sort been taken in the 1950s, cigarettes would not be causing the 160,000 annual lung cancer deaths we now have in the United States. Millions of lives could have been saved.
Tobacco companies could also have produced cigarettes that were not addictive, simply by reducing the amount of nicotine in the rod to less than about 1 milligram per cigarette. Manufacturers like to keep the nicotine up around the io-milligram mark—even in cigarettes marketed as “light” or “low tar”—and reducing the absolute (rather than machine-measured) nicotine in the rod by a factor of ten or more would make it virtually impossible for smokers to sustain their addiction. Manufacturers have sometimes made such cigarettes—Merit Free or Next, for example—but they have never been commercially successful. The companies realize that people smoke for the nicotine and that without nicotine people will not smoke. Not tobacco at any rate.
Safety has never been a high priority for the industry—except when it comes to their own self-preservation. An immense amount of money is spent by the companies to defend themselves in court—close to a billion dollars per year in the United States. Yet another strategy has been to diversify into products such as candy, food, and alcohol, to secure for themselves a future in a post-tobacco, or at least a post-cigarette, world.
This was shrewd, given that it has never been clear when the bottom might drop out of the cigarette market—as a result of consumer revolt, litigation, or regulation. Liggett & Myers began the trend in 1964 by acquiring the Allen Products Company, makers of Alpo dog and cat food, for $15 million. American Tobacco shortly thereafter bought Sunshine Biscuits and Sara Lee, and Lorillard in 1965 acquired the Golden Nugget Candy Company. Reynolds that same year bought My-T-Fine Desserts and Vermont Maid Syrup by acquiring Pennick and Ford. Philip Morris bought Miller Beer in 1969, prompting a move into the liquor business by Liggett, which by the 1970s was making not just cigarettes but also Bombay gin and vermouth, Grand Marnier liqueur, and J&B scotch. And popcorn and vacuum cleaners. Imperial Tobacco did something similar in England and by the end of the 1960s was supplying 10 percent of the country’s turkeys and a quarter of its chickens. Reynolds then bought Nabisco (in 1985, for $4.9 billion), forming RJR Nabisco, a conglomerate cranking out Camel cigarettes alongside Oreo Cookies, Fig Newtons, Saltine Crackers, and Planters Nuts.
The biggest deal of this sort was Philip Morris’s purchase of Kraft Foods in 1988. The company had earlier bought Miller Beer and a Canadian brewery, and by the 1970s was holding American Safety Razor (makers of Personna razors) and Clark Gum (makers of chewing gum). The Kraft acquisition launched Philip Morris big time into the food business, which continued in 2000 with its acquisition of Nabisco Holdings, a spin-off from RJR Nabisco, for $18.9 billion. This turned Philip Morris into the largest food producer in the United States, controlling products such as Altoids, Maxwell House Coffee, Lifesavers, Planters peanuts, Oscar Mayer wieners, Jell-O, Boca Burgers, Kool-Aid, and all Nabisco and Post cereals. The thinking was that if tobacco ever went down the tubes, then the people who brought you the Marlboro cowboy and millions of deaths from cardiac arrest could fall back on quality foods like Velveeta Cheese, Cool Whip, and Oreo Cookies. Ordinary consumers who bought such products probably had no idea they were enriching the coffers of the tobacco magnates.
Nor, I suspect, did they realize they were helping the world’s largest cigarette maker mobilize support for the industry. Philip Morris on a number of occasions used its subsidiaries to do its political dirty work, to protect its core cigarette market. In 1994, for example, the tobacco maker sent Corporate Affairs reps to its food divisions to urge employees to write to their congressmen to oppose an increase in federal cigarette taxes. The “Talking Points” prepared for these agents offered samples of what kinds of resistance might be encountered and how best to deal with it:
Anti: |
“You people should pay for health care. Your cigarettes kill hundreds of thousands of people a year.” |
You: |
“We could debate tobacco issues all day. But that’s not why I’m here. I’m here to tell you that if it’s tobacco today, it will be pickles tomorrow. Did you know they tried a snack tax in California a couple of years ago?” |
The company had earlier organized focus groups to find out what kinds of arguments would be most persuasive, identifying “slippery slope,” “fairness,” and “jobs” as the “most involving.” So the argument to these makers of hot dogs and cookies was to go something like this: “Look, if they get cigarettes this year, they’re going after beer and gasoline next, and then it will be everything else—baked goods, fast food, sports equipment, boats, anything they think you like enough that you’ll keep using it, even if you have to pay an increased tax.” The company also organized a “Beat Federal Excise Tax Week” (starting March 21, 1994), with letters mailed to each of Philip Morris’s 150,000 employees urging them to act to defeat the tax. The company also shut down its Richmond plant to bus its entire staff to Washington, D.C., to meet with a congressional delegation and rally at the Capitol. Philip Morris used similar tactics to fight FDA regulation: in 1995, when the Clinton administration began making noises along these lines, Philip Morris mobilized its Oscar Mayer employees to write letters opposing any such move. Philip Morris’s venture into foods thus had a political value over and above its economic worth.26
Marlboro’s diversification was not achieved without a struggle, however. When William Farone was hired by the company in 1976 he had two principal duties: to develop “safer” cigarettes and to ease the company away from tobacco and into foods. As he tells the story, this was a time of titanic struggle within the firm, with two chief factions: “Hercules” versus “Atlas.” Farone was on the Hercules side, believing cigarette making to be a kind of labor the company had to endure before emerging as a producer of some more socially acceptable product, like food. The Atlas faction, by contrast, held that cigarettes were a burden the company must bear forever, just as Atlas shouldered the earth. The Atlas faction had triumphed by the time Geoffrey C. Bible was named president and CEO in 1994; Bible retrenched the company and continued to deny all health effects from smoking, even as late as 1998. Altria—the friendly-sounding new name for Philip Morris as of 2003—spun off its Kraft shares in 2007, becoming once again a pure tobacco play.
Smokeless tobacco is another direction in which the industry has recently diversified, part of its ongoing hope for “reduced harm” products. Oral snuff, snus, and chewing tobacco have all been revived, principally because the companies now see this as one solution to the problem of secondhand smoke. The hope is also to co- brand with cigarettes, helping thereby to keep people smoking. (That may be one reason Marlboro Snus has been designed to deliver so little nicotine: the hope may be to supplement rather than supplant cigarette use.)27 Global tobacco manufacturers have invested heavily in smokeless products, imagining these as a “safer” business bet given current threats to the cigarette enterprise. Reynolds in 2006 bought Conwood Sales, maker of Kodiak and Grizzly smokeless, for $3.5 billion. Philip Morris in 2007 test-marketed Marlboro Snus, a tobacco pouch that you basically suck on as you might a tea bag, swallowing whatever juices mix with your saliva. This so-called Swedish experience has become a bright hope for several of the transnationals, imagining that snus will prove more socially acceptable than cigarettes. And while it is probably true that gram per gram oral snuff won’t kill as many people, this is by no means a benign indulgence.
Chewing tobacco has long been associated with cancers of the mouth and jaw. Baseball players are notoriously vulnerable, given their historic preference for a salivated plug bulging from inside the cheek. Chewing tobacco was banned from American collegiate sports in 1994, but the practice quietly continues, and Major League Baseball to this day has refused to take a stand against the drug. So in summer 2007, when Barry Bonds was creeping up on Hank Aaron’s home run record, television cameras revealed the telltale circle in his back right pocket, the signature impression of the tobacco tin. It is unclear whether Bonds was paid for such a display, but it wouldn’t be the first time an athlete has taken money to promote tobacco. Thousands of athletes have contracted cancers of the mouth, lips, and throat—Baseball Hall of Famer Tony Gwynn is one recent victim, following in the footsteps of Babe Ruth and numerous other baseball greats—and vivid pictures of such tumors can now be found on tobacco products in many parts of the world. And will appear in the United States before very long.
Some cigarette critics hope that smokeless will “reduce harm,” but we don’t really know what the long-term consequences might be. Sweden is held up as an example, but there is actually a huge variability in the constituents of chewing tobacco. In some parts of Africa, where oral snuff is widely used, smokeless tobacco is quite high in deadly nitrosamines. And in Sweden itself many health professionals are horrified that the “Swedish experience” is being used to promote this new form of drug use. Margaretha Haglund, head of tobacco prevention at Sweden’s National Institute of Public Health, debunks the “myth” of using smokeless to quit smoking and notes that few of Sweden’s former smokers—only about 5 percent—quit with the help of snus. While snus use itself has skyrocketed. Twenty-two percent of Swedish men use snus on a daily basis, up from about 9 percent in the mid-1970s. Swedish Match sells 250 million cans per year, and nearly 40 percent of Swedish users still smoke cigarettes. Only about a quarter of these are former smokers. Snus may well help some smokers quit, but it also seems to be promoting a kind of “dual use”—allowing cigarette users to get a nicotine fix where they are no longer allowed to smoke (on long airplane flights, for example). Snus and other new forms of “spitless” tobacco are perhaps best regarded as the flailing grasp of an industry thrown off-balance by successful campaigns to make offices, restaurants, bars, and an increasing variety of outdoor spaces smoke-free.28
The industry’s overarching goal, of course, is to create and sustain addiction, which is also why other kinds of smokeless articles have been introduced in recent years—including flavored “dissolvable tobacco” in the form of Camel Strips, Sticks, and Orbs, which are meant to be sucked or chewed while still delivering a nicotine punch. Greg Connolly has commented on how the new cinnamon- and mint-flavored Camel Orbs look like Tic Tac candy and contain about a milligram of nicotine in a highly freebased form (pH 7.9). The danger of appealing to kids is not farfetched, given the 13,705 reported cases of poisonings from tobacco products from 2006 to 2008, most of which (90 percent) involve children. Connolly in a recent interview with the New York Times described making nicotine look like candy as “recklessly playing with the health of children.”29 Of course the real purpose of Reynolds et al. may be just to tie up the new FDA with trivial pursuits while business goes on as usual in the big-killer cigarette market.
Talk about “safer” cigarettes is often misinformed. We might as well talk about safer ways to inhale asbestos, or safer forms of drowning. The word safer itself is mischievous in this context, since talk of making something “safer” implies it is already “safe.” (Think “safe,” “safer,” “safest.”) Cigarettes could certainly be made less lethal, but there is always the chance that in doing so we end up causing more harm by delaying quitting—and encouraging starting. A safe cigarette is one that cannot be smoked, or one you leave unsmoked in the pack. Cigarettes are less deadly when fewer of them are smoked, however they are made. The industry has tried to make cigarettes that yield less smoke, and while some of these might well cause less death per cigarette—ceteris paribus—they have never been introduced coincident with any kind of plan to withdraw the more obviously deadly. Smokers are often given a “choice,” but the industry’s own choices remain invisible, as if sacrosanct. Which is why still today you can go out and buy Camels, Marlboros, 555s, Mild Sevens, or Panda or Chunghwa cigarettes that if smoked as intended by the manufacturers will increase your chances of contracting cancer by several thousand percent. Half of all regular smokers will die from the habit, and all will show evidence of pathology at autopsy. The industry seems never to have removed a product because of evidence it was killing people. It is hard to name another business with so little regard for its customers. Viewed from afar, one would almost think that cigarette makers have been granted a license to kill.