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An interview with Allan M. Brandt

In the United States, cigarette smoking is well past its heyday. In 1964, nearly half of all adult Americans smoked. Today that proportion has dropped to 1 in 5, but tobacco still kills more than 435,000 Americans each year—more than HIV, alcohol, illicit drugs, suicide and homicide combined.Allan M. BrandtClick to Enlarge Image

Harvard health historian Allan M. Brandt has spent 25 years studying Big Tobacco, and in The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America (Basic Books, 2007) he chronicles the United States' peculiarly involved struggles with the "evil weed."

"It seems striking that a product of such little utility, ephemeral in its very nature, could be such an encompassing vehicle for understanding the past," he writes. "But the cigarette permeates twentieth-century America as smoke fills an enclosed room."

American Scientist Online Managing Editor Greg Ross interviewed Brandt by e-mail in June 2007.

You describe the tobacco industry's deceit as "the crime of the century." Why?

Because of the powerful impact on health and disease that Big Tobacco had through its acts of fraud and deception. This view of the companies' actions is not simply my view. In the fall of 2006 a federal district court judge ruled that the companies had violated federal racketeering statutes, laws devised to combat organized crime. It is now estimated that more that 100 million people worldwide died of tobacco-related diseases over the last hundred years. Although it could be argued that for the first half of the century the industry was not fully aware of the health effects of cigarettes, by the 1950s there was categorical scientific evidence of the harms of smoking. The companies chose to disparage these risks and reassure smokers despite the fact that their own scientists were well aware of both the carcinogenic and addictive properties of the product.

How did they do this?

The companies responded to the development of peer-reviewed science implicating the cigarette as a cause of lung cancer, heart disease and other serious ailments by developing a sophisticated public relations campaign to disparage these findings and call for "more research." Engineered by the leading PR firm of Hill & Knowlton, these efforts contended that there was "no proof" that smoking caused cancer. They established a group known as the Tobacco Industry Research Committee (overseen by Hill & Knowlton), which promised to explore the health question but, in reality, worked to obscure and contest the scientific data implicating cigarettes as a cause of disease. At the same time, the companies aggressively promoted new filtered cigarettes, offering false reassurances about the harms of their product.

How have cigarette makers manipulated science?

The companies understood that "controversy" and "uncertainty" would delay regulation and encourage smokers to continue using their product. As a result, they emphasized the notion of further research as a strategy to negate what was known. They attacked the epidemiological studies as "junk science" while sponsoring research that had little to do with their product.

Do you see parallels to other issues?

In many ways, the recent debates about global warming are similar to the "controversy" about cigarettes in the middle of the twentieth century. As many industries understood, as long as they could disparage the emerging science and focus on "uncertainties," they could delay regulatory action and policies that the companies hoped to avoid. This type of scientific disinformation campaign was invented by Big Tobacco.

What's the future of tobacco?

The tobacco industry remains quite strong despite losing lawsuits and enhanced public regulation. As a result, more people across the globe are smokers today than perhaps at any time in human history. As rates of smoking have declined in Western developed nations, the industry has aggressively sought new smokers in developing and poorer nations. It is now expected that in the coming century there will be one billion tobacco-related deaths. This despite the fact that we know such a great deal about the health effects of cigarette use.

What can be done?

There is much that could be done to further reduce cigarette use, both in the United States and around the globe.  There could be much better labeling and restrictions on advertising and promotion; higher taxes (which discourage youth sales); and strategies for ensuring that individuals who seek to quit get the most appropriate combination of counseling and new pharmacologic treatments. The World Health Organization has promulgated its first-ever public health treaty, the Framework Convention on Tobacco Control, which has now been ratified by more than 140 nations.  But the United States has not ratified the treaty, which calls for the intensification of public health efforts.

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