A historian's indictment of the US tobacco industry

Abstract

As unlikely as it sounds, the US tobacco industry funded the work of more than 50 historians during the past several decades. This largesse was not motivated by any commitment to disinterested historical scholarship. The industry supported historians who would testify in ways that would help it evade legal liability for the harms caused by the tobacco industry's promotion of cigarettes over the past 50 years. As Robert Proctor documents in his Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition, these historians provided support for two contradictory claims: that, since the 1950s, smokers had been well informed about the harms of tobacco smoking; and the tobacco industry was fully justified in publicly denying any connection between smoking and these harms for as long as possible. The historians who were prepared to provide this support often did so without acknowledging that they had taken industry money. Proctor—author of Cancer Wars and The Nazi War on Cancer—was one of only three historians who testified against the tobacco industry. Given the book's provenance, readers should not expect a disengaged scholarly narrative of the discovery of the harms of tobacco smoking and the behaviour of the industry that denied them. Golden Holocaust is not a cool historical analysis that avoids making moral judgments about the key participants in the narrative. Proctor's morally engaged historical analysis represents a damning indictment of the US tobacco industry and its well-paid accomplices. Proctor explains why US Judge Gladys Kessler found in 2006 (in an action brought under the Racketeer Influenced and Corrupt Organizations Act) that the US tobacco industry had engaged in a criminal conspiracy for more than 50 years. Proctor describes how Judge Kessler found that various US tobacco companies had conspired to: deny the addictiveness and harmfulness of cigarette smoking; coordinate “research” and public relations efforts to manufacture a spurious “controversy” about the adverse health effects of smoking and falsely reassure smokers about the safety of cigarettes; design cigarettes that delivered nicotine in ways that would addict new smokers and make cessation difficult; promote filtered and “light” cigarettes that it knew from its own research would falsely reassure smokers without reducing risk; and promote cigarettes to the adolescents who were needed to replace older smokers who quit or died. The amoral conduct of tobacco industry executives and corporate lawyers who managed these events is well known to readers of Lisa Bero, Alan Brandt, Stanton Glantz, David Kessler, and many others. Proctor gives a forensic account of how the conspiracy was abetted and facilitated by various co-conspirators outside the industry. These were putatively “independent” researchers in epidemiology, cancer biology, statistics, and history from leading US and British universities who were paid to publish peer-reviewed articles and give legal testimony favourable to the tobacco industry. They argued, for example, that: the health case against smoking was still open; that cigarettes were not addictive; and that second-hand tobacco smoke was not harmful. They usually did not disclose their research funding and consultancy payments from the tobacco industry. Proctor maintains that tobacco industry misbehaviour has not stopped since the US industry belatedly “came clean” about the health risks of smoking in 1998. He argues that the industry continues to protect its market share in the USA, subvert the Master Settlement Agreement, and, most importantly from the perspective of global health, promote tobacco sales in developing countries where public awareness of smoking risks is low and government regulation of tobacco is weak or friendly because of governmental tobacco monopolies. Proctor describes the efforts of US governments to compel reluctant countries to accept imports of US tobacco or risk legal action for infringement of free trade agreements. Proctor also draws a parallel between the US Government's stance on trade laws and the promotion of tobacco and the way that the British Government used “free trade” to justify the use of military force to open China to imports of Indian opium in the early 19th century, a story well told in Julia Lovell's recent The Opium War. Proctor is not content to merely interpret the world. As the subtitle of his book indicates, he wants to abolish cigarette smoking. He urges the US Food and Drug Administration to use its new powers to ban the production of cigarettes that sustain smoking; Proctor proposes increasing the alkalinity of tobacco smoke to make inhalation unpleasant and reducing nicotine levels below that needed to sustain addiction. Although this proposal seems unlikely to attract wide support, it certainly deserves discussion. Whatever its reception by historians, Golden Holocaust is likely to be welcomed by the public health community as an invaluable resource in making smoking history.