Legacy Tobacco Documents Library Research Articles

Tobacco company strategies to identify and promote the benefits of nicotine

BackgroundIn response to a changing regulatory and consumer landscape, tobacco companies developed new strategies to promote cigarettes and smoking. We examined one of these strategies: to fund and conduct scientific...

How effective is the plain packaging of tobacco policy on rates of intention to quit smoking and changing attitudes to smoking?

The aim of this study is to critically appraise the evidence for the effectiveness of the plain packaging of tobacco products policy. A systematic approach to a literature review was undertaken using five databases: PubMed, MEDLINE, Google Scholar, Global Health and Legacy Tobacco Documents Library. Quantitative and qualitative studies that evaluate attitudes towards smoking, starting smoking and quitting intentions when plain packaging use is compared with standard cigarette packaging use were included. A total of 1923 studies were identified. After inclusion and exclusion criteria were applied, nine studies were included in the review. The overall quality of the data was variable but a significant number of the studies had major methodological flaws. However, data analysed in the literature review suggest that exposure to plain packaging increases intention to quit amongst exposed individuals, increases negative attitudes to both smoking and starting smoking. Although the evidence for plain packaging of tobacco is not strong, the evidence that is available indicates that it is an effective tobacco cessation policy.

MA03.02 Lung Cancer in Women 1929 to 2016: Cold-Blooded Origins of an Epidemic

The epidemiologic profile of lung cancer mortality in the U.S. is highly unusual. Mortality in males began to rise rapidly early in the 1920s and continued to increase through the 1990s before leveling off. Mortality in women did not begin to rise until decades later and did not approximate mortality in men until the early years of the twenty first century. This unusual pattern of disease can be explained by review of tobacco industry documents and court records. A search was conducted in the Legacy Tobacco Documents library at the University of California, San Francisco, as well as review of testimony and legal reports from state and federal court decisions. The beginning of the epidemic of lung cancer in women in the U.S. can be reliably traced back to Easter Sunday in 1929. On that date, a publicity stunt crafted by Edward Bernays was reported in the New York Times as the “parade of torches” supposedly representing an expression of freedom by American women who would henceforward not be constrained from smoking in public. The public relations effort was supplemented by an advertising campaign orchestrated by Chicago marketing expert Albert Lasker. Female smoking rates began to rise after this date, culminating over the succeeding decades in a sharp increase in lung cancer cases and deaths among women. A second phase of marketing of cigarettes to women and girls in the U.S. began in the 1970s as Philip Morris executive Joseph Cullman collaborated with tennis star Billie Jean King to market a new “slim” cigarette to young women via the Virginia Slims tennis tournament under the slogan “You've come a long way baby.” A further contribution to the lung cancer mortality arose out of the efforts of the Council for Tobacco Research (CTR) and the Council for Indoor Air Research (CIAR) to manufacture controversy regarding the danger of smoking as well as involuntary second hand smoking to provide cover for legislators voting against tobacco control legislation. As a direct result, many thousands of non-smoking women have had major involuntary exposure to tobacco carcinogens in the workplace causing lung cancer. Lung cancer cases presenting today originated in deliberate campaigns by tobacco executives, marketers and public relations experts to convince women and girls to smoke, despite their clear understanding that the products they were aggressively marketing would inevitably result in hundreds of thousands of deaths.

Analysis of British American Tobacco's questionable use of privilege and protected document claims at the Guildford Depository

BackgroundTobacco companies have a documented history of attempting to hide information from public scrutiny, including inappropriate privilege claims. The 1998 Minnesota Consent Judgement created two depositories to provide public access...

‘Public enemy no. 1’: Tobacco industry funding for the AIDS response

This article analyzes the history of tobacco industry funding for the AIDS response – a largely ignored aspect of private donor involvement. Primary documents from the Legacy Tobacco Documents Library and AIDS organizations are analyzed, alongside existing literature on the tobacco control and AIDS responses. Research on the tactics of transnational tobacco companies has documented how they have used various charitable causes to subvert tobacco control efforts and influence public health policy. This raises questions, which this paper seeks to answer, about if donations by tobacco companies to AIDS organizations have been used for similar means, and if so how AIDS organizations have responded to tobacco industry overtures. Two examples illustrate how tobacco companies initially tried to use the AIDS response to counter tobacco control measures: (1) During the 1990s, Philip Morris, one of the largest corporate donors of the AIDS response in the USA, used its connections with AIDS organizations to create competition for health resources, improve its reputation, and market tobacco products to the LGBT community; (2) In both Latin America and sub-Saharan Africa, Philip Morris and British American Tobacco championed the AIDS response in order to delegitimize efforts to develop the World Health Organization’s Framework Convention on Tobacco Control. However, from the late 1990s onwards, AIDS organizations began to refuse tobacco funding and partnerships – though these policies have been not comprehensive, as many tobacco companies still fund programs in sub-Saharan Africa. The article concludes that tobacco companies aimed to exploit competition between health issues, and use the high-profile AIDS response to improve their reputation and market access. However, AIDS organizations, adhering to broader health goals and drawing on extensive resources and networks, were able to shut the tobacco industry out of much of the response, though pockets of influence still exist. This demonstrates the importance of co-operation and policy convergence across health sectors and suggests that tobacco control advocates, and other charitable sectors that receive funding from the tobacco industry, may be able to draw lessons from the experiences of AIDS organizations.

Identifying counterfeit cigarette packs using ultraviolet irradiation and light microscopy

ObjectivesDevelop a method that yields high rates of sensitivity and specificity for determination of counterfeit cigarette packs for three popular brands: Newport, Marlboro (‘Red’) and Marlboro Gold.MethodsUsing systematic keyword searches,...

Smoke Rings: Towards a Comprehensive Tobacco Free Policy for the Olympic Games.

BackgroundThe tobacco industry has long sought affiliation with major sporting events, including the Olympic Games, for marketing, advertising and promotion purposes. Since 1988, each Olympic Games has adopted a tobacco-free policy. Limited study of the effectiveness of the smoke-free policy has been undertaken to date, with none examining the tobacco industry’s involvement with the Olympics or use of the Olympic brand.Methods and FindingsA comparison of the contents of Olympic tobacco-free policies from 1988 to 2014 was carried out by searching the websites of the IOC and host NOCs. The specific tobacco control measures adopted for each Games were compiled and compared with measures recommended by the WHO Tobacco Free Sports Initiative and Article 13 of the Framework Convention on Tobacco Control (FCTC). This was supported by semi-structured interviews of key informants involved with the adoption of tobacco-free policies for selected games. To understand the industry’s interests in the Olympics, the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) was systematically searched between June 2013 and August 2014. Company websites, secondary sources and media reports were also searched to triangulate the above data sources.This paper finds that, while most direct associations between tobacco and the Olympics have been prohibited since 1988, a variety of indirect associations undermine the Olympic tobacco-free policy. This is due to variation in the scope of tobacco-free policies, limited jurisdiction and continued efforts by the industry to be associated with Olympic ideals.ConclusionsThe paper concludes that, compatible with the IOC’s commitment to promoting healthy lifestyles, a comprehensive tobacco-free policy with standardized and binding measures should be adopted by the International Olympic Committee and all national Olympic committees.

Translating Smoke Signals: West German Medicine and Tobacco Research, 1950-1970

The article examines West German medical discourse about smoking and lung cancer. Drawing on articles in medical journals and the press, books by physicians, documents in the Legacy Tobacco Documents Library and the German Federal Archive, it reconstructs the extent, sources and interpretation of tobacco-related knowledge. Medical writers, it finds, were well-informed about Nazi-era German and postwar international research. Researchers and physicians generally accepted the science of critical tobacco research by the 1960s. They did not, however, advance lung cancer and smoking to the status of a public-health crisis or call for state regulation of smoking. This response reflected a reaction against National Socialist health policies but was shaped, above all, by postwar conditions, institutions, and professional and corporate interests.

The Fag Lady, revisited: Margaret Thatcher's efforts on behalf of the tobacco industry

ObjectiveThe death of former British Prime Minister Margaret Thatcher has offered many opportunities to reappraise her career. However it is not widely known that she acted as a consultant for the tobacco industry following her resignation from office. The availability of evidence from tobacco documents archives offers the opportunity to explore her work for Philip Morris, and more generally to assess how industry seeks to influence and use elected and former public officials. Study design and methodsAnalysis of documents from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu). Memos, letters and other documents were sought which mentioned Margaret Thatcher or other key individuals. Documents (n = 151) were downloaded as PDFs. Of these 51 provided relevant information. ResultsMargaret Thatcher advised Philip Morris on issues including advertising bans, lowering of tobacco tariffs in EEC countries, reducing tobacco taxes, and anti-tobacco programs. She had previously been involved in moving two of her ministers from their posts in response to tobacco industry pressure. She advised Philip Morris to exert political pressure through the House of Commons by lobbying MPs against the Conservative government accepting ECOFIN, an European Union (EU) tax harmonisation agreement. Other activities included trips to Prague, Tokyo, Chicago, Geneva and Hong Kong on Philip Morris' behalf, or for meetings with Philip Morris executives. ConclusionsRelationships between politicians and industry remain relevant today, not least because Article 5.3 of the WHO Framework Convention on Tobacco Control includes the protection of public health policies from tobacco industry interference. The findings are consistent with findings from other studies which show tobacco industry attempts to influence governments, for example to attempt to weaken the WHO Framework Convention on Tobacco Control. They particularly point out the value of former senior politicians to industry, specifically their 'insider knowledge' which can be employed to gain access to and influence other policymakers on industry's behalf.

Transparency as a remedy against racketeering: preventing and restraining fraud by exposing Big Tobacco's dirty secrets

The 1990s state litigation that resulted in the tobacco industry's initial document disclosure obligations fully expired in 2010. These obligations have been extended and enhanced until 2021 through a federal...

Waiting for the opportune moment: the tobacco industry and marijuana legalization.

In 2012, Washington State and Colorado legalized the recreational use of marijuana, and Uruguay, beginning in 2014, will become the first country to legalize the sale and distribution of marijuana. The challenge facing policymakers and public health advocates is reducing the harms of an ineffective, costly, and discriminatory "war on drugs" while preventing another public health catastrophe similar to tobacco use, which kills 6 million people worldwide each year. Between May and December 2013, using the standard snowball research technique, we searched the Legacy Tobacco Documents Library of previously secret tobacco industry documents (http://legacy.library.ucsf.edu). Since at least the 1970s, tobacco companies have been interested in marijuana and marijuana legalization as both a potential and a rival product. As public opinion shifted and governments began relaxing laws pertaining to marijuana criminalization, the tobacco companies modified their corporate planning strategies to prepare for future consumer demand. Policymakers and public health advocates must be aware that the tobacco industry or comparable multinational organizations (eg, food and beverage industries) are prepared to enter the marijuana market with the intention of increasing its already widespread use. In order to prevent domination of the market by companies seeking to maximize market size and profits, policymakers should learn from their successes and failures in regulating tobacco.

The Role of Cocoa as a Cigarette Additive: Opportunities for Product Regulation

The 2009 Family Smoking Prevention and Tobacco Control Act prohibited the use of characterizing flavors in cigarettes; however, some of these flavors are still used in cigarettes at varying levels. We reviewed tobacco industry internal documents to investigate the role of one of these flavors, cocoa, with the objective of understanding its relationship to sensory and risk perception, promotion of dependence, and enhancement of attractiveness and acceptability. We used the Legacy Tobacco Documents Library to identify documents relevant to our research questions. Initial search terms were generated following an examination of published literature on cocoa, other cigarette additives, and sensory and risk perception. Further research questions and search terms were generated based on review of documents generated from the initial search terms. Cocoa is widely applied to cigarettes and has been used by the tobacco industry as an additive since the early 20th century. Cocoa can alter the sensory properties of cigarette smoke, including by providing a more appealing taste and decreasing its harshness. The tobacco industry has experimented with manipulating cocoa levels as a means of achieving sensory properties that appeal to women and youth. Although cocoa is identified as a flavor on tobacco industry Web sites, it may serve other sensory purposes in cigarettes as well. Eliminating cocoa as an additive from tobacco products may affect tobacco product abuse liability by altering smokers' perceptions of product risk, and decreasing product appeal, especially among vulnerable populations.

Understanding corporations to inform public health policy: the example of tobacco industry interests in harm reduction and reduced risk products

BackgroundCorporations selling products that are damaging to health should be researched as vectors of disease, but how can such research inform public health policy? On the basis of findings of increasing transnational tobacco company (TTC) investments in reduced risk products, we aimed to examine companies' interests in harm reduction, including smokeless tobacco and nicotine-containing products in Europe. Methods416 TTC documents released via litigation and dating from 1971 to 2009 were obtained via searching the online Legacy Tobacco Documents Library and analysed by hermeneutic and sociohistorical archival methods. Various materials were used to triangulate documentary findings, including media, relevant tobacco industry journal, and Euromonitor reports. We also systematically examined contemporary industry materials, including all TTC annual reports accessible online and via the British Library in October, 2012, all British American Tobacco (BAT; n=42) and Philip Morris International (PMI; n=47) investor presentations available online in September, 2012, and all BAT sustainability reports from 2001–02 (the first year of publication) onwards. FindingsFrom 1971, prompted by fear of declining cigarette sales, BAT began to explore opportunities in smokeless tobacco in Europe and the potential to create a new form of tobacco use for those no longer interested in taking up smoking. Young people were therefore a key target. Despite awareness of smokeless tobacco's substantially lower health risks from the 1970s, TTCs did not invest in the product until 2002, when European Union cigarette volumes started decreasing and the public health community began actively exploring smokefree legislation and harm reduction. All TTCs have now invested in snus (a form of smokeless tobacco) such that no major European snus companies remain independent of cigarette interests; yet snus test markets seem to have failed and we identified no evidence that snus is central to TTCs' business strategy. This finding suggests that TTC snus investments might have been intended to eliminate competition between snus and highly profitable cigarettes. Recently, TTCs have invested in nicotine-containing products, including e-cigarettes. The scarce corporate information on this issue suggests that concerns identified in relation to smokeless tobacco might apply to such products; for example, a BAT investor presentation (2011) stated that “new ‘would be smokers’ begin with and stay with low risk product categories”. Documents suggest TTCs adopted the term “harm reduction” from the US Institute of Medicine, which published a report on the topic in 2001. Thereafter, TTCs increasingly used the term. For example, BAT's use of the term “harm reduction” in its social reports increased from two in 2001–02 to 247 in 2010. Documents and interviews suggest harm reduction offered TTCs two main benefits: reputation enhancement and an opportunity to establish or re-establish dialogue with and access to policy makers, scientists, and public health groups. InterpretationThe main study limitation is that the document collections might not fully represent TTC interests in Europe because they mainly cover BAT and PMI. Nevertheless, the findings suggest that TTCs' harm reduction discourse signals a tactical adaptation to policy change rather than a genuine commitment to reducing harm. Public health must, therefore, continue to protect policies from TTC influence. TTCs' historic interest in smokeless tobacco might apply to nicotine-containing products. Furthermore, having eliminated any competitive threat from snus, TTCs are now investing in e-cigarettes, which needs careful monitoring because TTC control of this market would serve to maintain the dominance of the cigarette. FundingThe internal industry document work was supported by the Pricing Policies and Control of Tobacco in Europe project EC FP7 Grant AgreementHEALTH-F2-2009-223323; the collection and analysis of contemporary industry materials was supported by the National Cancer Institute, US National Institutes of Health (grant RO1CA160695).

Transnational Tobacco Company Interests in Smokeless Tobacco in Europe: Analysis of Internal Industry Documents and Contemporary Industry Materials

European Union (EU) legislation bans the sale of snus, a smokeless tobacco (SLT) which is considerably less harmful than smoking, in all EU countries other than Sweden. To inform the current review of this legislation, this paper aims to explore transnational tobacco company (TTC) interests in SLT and pure nicotine in Europe from the 1970s to the present, comparing them with TTCs' public claims of support for harm reduction. Internal tobacco industry documents (in total 416 documents dating from 1971 to 2009), obtained via searching the online Legacy Tobacco Documents Library, were analysed using a hermeneutic approach. This library comprises documents obtained via litigation in the US and does not include documents from Imperial Tobacco, Japan Tobacco International, or Swedish Match. To help overcome this limitation and provide more recent data, we triangulated our documentary findings with contemporary documentation including TTC investor presentations. The analysis demonstrates that British American Tobacco explored SLT opportunities in Europe from 1971 driven by regulatory threats and health concerns, both likely to impact cigarette sales negatively, and the potential to create a new form of tobacco use among those no longer interested in taking up smoking. Young people were a key target. TTCs did not, however, make SLT investments until 2002, a time when EU cigarette volumes started declining, smoke-free legislation was being introduced, and public health became interested in harm reduction. All TTCs have now invested in snus (and recently in pure nicotine), yet both early and recent snus test markets appear to have failed, and little evidence was found in TTCs' corporate materials that snus is central to their business strategy. There is clear evidence that BAT's early interest in introducing SLT in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales and social restrictions on smoking, with young people a key target. We conclude that by investing in snus, and recently nicotine, TTCs have eliminated competition between cigarettes and lower-risk products, thus helping maintain the current market balance in favour of (highly profitable) cigarettes while ensuring TTCs' long-term future should cigarette sales decline further and profit margins be eroded. Please see later in the article for the Editors' Summary.

Tobacco company efforts to influence the Food and Drug Administration-commissioned Institute of Medicine report clearing the smoke: an analysis of documents released through litigation.

Spurred by the creation of potential modified risk tobacco products, the US Food and Drug Administration (FDA) commissioned the Institute of Medicine (IOM) to assess the science base for tobacco "harm reduction," leading to the 2001 IOM report Clearing the Smoke. The objective of this study was to determine how the tobacco industry organized to try to influence the IOM committee that prepared the report. We analyzed previously secret tobacco industry documents in the University of California, San Francisco Legacy Tobacco Documents Library, and IOM public access files. (A limitation of this method includes the fact that the tobacco companies have withheld some possibly relevant documents.) Tobacco companies considered the IOM report to have high-stakes regulatory implications. They developed and implemented strategies with consulting and legal firms to access the IOM proceedings. When the IOM study staff invited the companies to provide information on exposure and disease markers, clinical trial design for safety and efficacy, and implications for initiation and cessation, tobacco company lawyers, consultants, and in-house regulatory staff shaped presentations from company scientists. Although the available evidence does not permit drawing cause-and-effect conclusions, and the IOM may have come to the same conclusions without the influence of the tobacco industry, the companies were pleased with the final report, particularly the recommendations for a tiered claims system (with separate tiers for exposure and risk, which they believed would ease the process of qualifying for a claim) and license to sell products comparable to existing conventional cigarettes ("substantial equivalence") without prior regulatory approval. Some principles from the IOM report, including elements of the substantial equivalence recommendation, appear in the 2009 Family Smoking Prevention and Tobacco Control Act. Tobacco companies strategically interacted with the IOM to win several favored scientific and regulatory recommendations.

The impact of cigarette pack shape, size and opening: evidence from tobacco company documents

To use tobacco industry documents on cigarette pack shape, size and openings to identify industry findings on associations with brand imagery, product attributes, consumer perceptions and behaviour. Internal tobacco industry research and marketing documents obtained through court disclosure contained in the Legacy Tobacco Documents Library were searched using keywords related to pack shapes, sizes and opening methods. The search identified 66 documents related to consumer research and marketing plans on pack shape, size and openings, drawn from 1973 to 2002. Industry research consistently found that packs that deviated from the traditional flip-top box projected impressions of 'modern', 'elegant' and 'unique' brand imagery. Alternative pack shape and openings were identified as an effective means to communicate product attributes, particularly with regard to premium quality and smooth taste. Consumer studies consistently found that pack shape, size and opening style influenced perceptions of reduced product harm, and were often used to communicate a 'lighter' product. Slim, rounded, oval and booklet packs were found to be particularly appealing among young adults, and several studies demonstrated increased purchase interest for tobacco products presented in novel packaging shape or opening. Evidence from consumer tracking reports and company presentations indicate that pack innovations in shape or opening method increased market share of brands. Consumer research by the tobacco industry between 1973 and 2002 found that variations in packaging shape, size and opening method could influence brand appeal and risk perceptions and increase cigarette sales.

A Historical Review of R. J. Reynolds’ Strategies for Marketing Tobacco to Hispanics in the United States

Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.

‘To quarterback behind the scenes, third-party efforts’: the tobacco industry and the Tea Party

BackgroundThe Tea Party, which gained prominence in the USA in 2009, advocates limited government and low taxes. Tea Party organisations, particularly Americans for Prosperity and FreedomWorks, oppose smoke-free laws and...

OP77 Type a Behaviour Pattern and Coronary Heart Disease: Philip Morris’ “Crown Jewel”

BackgroundThe Type A Behaviour Pattern (TABP) – characterised as individuals who are highly competitive, time-conscious and aggressive - has been the subject of research for over fifty years. The concept...

Tobacco industry manipulation of tobacco excise and tobacco advertising policies in the Czech Republic: an analysis of tobacco industry documents.

The Czech Republic has one of the poorest tobacco control records in Europe. This paper examines transnational tobacco companies' (TTCs') efforts to influence policy there, paying particular attention to excise policies, as high taxes are one of the most effective means of reducing tobacco consumption, and tax structures are an important aspect of TTC competitiveness. TTC documents dating from 1989 to 2004/5 were retrieved from the Legacy Tobacco Documents Library website, analysed using a socio-historical approach, and triangulated with key informant interviews and secondary data. The documents demonstrate significant industry influence over tobacco control policy. Philip Morris (PM) ignored, overturned, and weakened various attempts to restrict tobacco advertising, promoting voluntary approaches as an alternative to binding legislation. PM and British American Tobacco (BAT) lobbied separately on tobacco tax structures, each seeking to implement the structure that benefitted its own brand portfolio over that of its competitors, and enjoying success in turn. On excise levels, the different companies took a far more collaborative approach, seeking to keep tobacco taxes low and specifically to prevent any large tax increases. Collective lobbying, using a variety of arguments, was successful in delaying the tax increases required via European Union accession. Contrary to industry arguments, data show that cigarettes became more affordable post-accession and that TTCs have taken advantage of low excise duties by raising prices. Interview data suggest that TTCs enjoy high-level political support and continue to actively attempt to influence policy. There is clear evidence of past and ongoing TTC influence over tobacco advertising and excise policy. We conclude that this helps explain the country's weak tobacco control record. The findings suggest there is significant scope for tobacco tax increases in the Czech Republic and that large (rather than small, incremental) increases are most effective in reducing smoking.