Denying nicotine's addiction potential: comments on Frenk & Dar

Abstract

Sir—In 1963, Addison Yeaman, general counsel to the US British American Tobacco subsidiary Brown & Williamson, wrote a memo to his colleagues stating: ‘Moreover, nicotine is addictive. We are, then, in the business of selling nicotine, an addictive drug . . .’ (Yeaman 1963) Seventeen years later, Paul Knopick from the United States Tobacco Institute put the implications of this very plainly for his industry: ‘Shook, Hardy and Bacon [tobacco industry lawyers] reminds us, I'm told, that the entire matter of addiction is the most potent weapon a prosecuting attorney can have in a lung cancer/cigarette case. We can't defend continued smoking as “free choice” if the person was “addicted”’ (Knopick 1980). Accordingly, in the years since, the international tobacco industry has given high priority to an international effort to deny publicly that nicotine is addictive. It has bank-rolled and stacked the attendance lists of apparently independent scientific pharmacological conferences with ‘industry positive’ scientists (Francis 1986) to lend them the ‘deep fragrance of academia’ (Roe 1987). Before finally admitting in 1999 under the weight of hundreds of embarrassing internal documents that nicotine was indeed addictive (Philip Morris 2001), it fought for well over a decade to prevent the inclusion of ‘addiction’ on pack warnings. Against this background, what are we to make of Frenk & Dar's account (Frenk & Dar 2002) of being commissioned by a mysterious, unnamed research benefactor to review the literature on nicotine addiction, their subsequent decision to not declare this in their book and their final resort to a ‘people in glass houses’ defence of their coyness? Thanks to the revelations contained in internal tobacco industry documents, we now know a great deal about the way the tobacco industry has selected, vetted and then often ‘managed’ ostensibly independent scientists to produce work that fits its strategic objectives (Wood 1992). As Addiction's editor asks (Edwards et al. 2002), why did the tobacco industry's lawyers select these two—who remind us that they had no research experience in nicotine studies? A 1988 report of an industry meeting on recruitment strategy notes that ‘consultants should, ideally, be scientists who have no previous association with tobacco companies and who have no previous record on the primary issues’. The memo explains how potential consultants are sounded out by tobacco industry lawyers and, if suitable, then commissioned (Chapman 1997). Once a scientist crosses over to the tobacco industry, the cheques can just keep coming. With regard to a British professor, the memo explains that the British Tobacco Advisory Council ‘should continue to support him because it could be problematic to withdraw support from a scientist who has been sympathetic to the industry’ (Chapman 1997). In Australia in 1998, the tobacco industry engaged Dale Atrens from my own university to run similar arguments against a legal claim by a smoker to recover the costs outlaid by her to try to stop smoking (National Dispute Centre 1998). Atrens, once a member of the tobacco industry supported ARISE (Associates for Research into the Science of Enjoyment) was paid ‘about $A10,000’ (Ragg 2000) and has subsequently published a lengthy review reiterating his arguments that nicotine is not addictive—and like Frenk & Dar, also without acknowledgement of his history of industry support (Atrens 2001). One is left with the indelible impression that Frenk & Dar are either disingenuous or profoundly naïve. They ask us to consider that their account of being commissioned by an anonymous third party to re-examine a politically and legally white-hot topic was so unremarkable that the propriety of declaring this upfront was not an issue to them. While they are of course correct to point out double standards, their evasive argument is that this whole business is merely hypocritical and that the only question worth debating is the quality of their review. But their scientific sanctimony fits comfortably with an ongoing industry strategy: for as long as a scientific ‘debate’ can be said to exist, the tobacco industry can argue that policies to inform and warn smokers or regulate nicotine are premature. With the sort of debate they invite destined to be tucked away in the pages of publicly inaccessible low-circulation specialist journals, accounts of the to and fro will be left to tobacco industry spin-doctors and the occasional investigative journalist. Significantly, despite the industry admission about addiction deep in the fine print of websites, few nations today require an ‘addiction’ pack warning.