[This is an ABC podcast]

Dr Karl:

Last time, I talked about the history of smoking, and how the tobacco companies had managed to make smoking a common and mainstream activity. But in the 1920s, the previously unknown disease of lung cancer began to appear, and to increase with each passing year. So the tobacco companies came up with new strategies.

Back in the late 1920s in the USA, the Lucky Strike brand of cigarettes was the first to incorporate medical doctors in their ads, such as "20,679 Physicians say 'LUCKIES are less irritating'". By the mid-1930s, Philip Morris, then a newcomer to the tobacco industry, was claiming that after smoking their cigarettes, "every case of irritation cleared completely, and definitely improved". This helped Philip Morris transition into a major tobacco company.

By the 1930s, tobacco advertisements first began appearing in prestigious medical journals. Cigarette smoking was now widespread and common in society, and the majority of medical doctors also smoked. Of course, the tobacco companies gave free cigarettes to doctors, especially at medical conferences.

But then the science began rolling in.

By 1939, the first proper case-control study showed that people with lung cancer were far more likely to have smoked cigarettes.
After World War II, more and more medical studies appeared, showing the harmful effects of cigarette smoking. And the tobacco advertisements changed - they showed more doctors apparently endorsing various brands!

By 1950, five major statistical studies from the USA and UK confirmed that practically all cases of lung cancer happened in smokers.

In 1953, both Life and Time magazines devoted many pages saying that the ability of cigarettes to cause lung cancer was now proven "beyond any doubt". The Journal of the American Medical Association even stopped accepting cigarette advertisement.

So on December 14 of that year, the six biggest cigarette manufacturers in the USA met in a single room at the Plaza Hotel in Manhattan. They had to overcome their normal competitiveness, to work out an overall combined plan. This was a real crisis.

Cigarette sales, and their share prices, were actually dropping. They had to do something different. So they cancelled all Christmas holiday plans and engaged the USA's leading public relations company, Hill & Knowlton. It turned out to be incredibly successful.

The giant PR firm quickly realised that simply denying the torrent of scientific facts wouldn't work. So rather than simply deny the science, the key strategy was to control the science. They messed around with the information getting to the public. They claimed the real story was that there was lots of controversy over the "findings" about cigarettes being harmful to health. They just plain lied, and said that there were still two sides to the "hysteria linking smoking to cancer", so the issue (they claimed) was still in doubt.

They called for new research. Brilliant strategy. Just making this simple statement suggested both that they were open to new results and that the existing research wasn't good enough.

For this new approach to work all the tobacco companies had to join in, to provide a united front. The PR firm actually created and funded a fake research organisation to sponsor medical research into tobacco.

In 1954, Big Tobacco set up the TIRC, the Tobacco Industry Research Committee. Shortly after, they released a full-page advertisement in more than 300 newspapers across the USA, known as the "Frank Statement". This advertisement claimed that it had not been proven that smoking had bad effects on health, and that the tobacco industry would do some proper research, but overall, the tobacco industry would look after the health of its customers.

The first director of the Tobacco Industry Research Committee was the noted geneticist, Dr Clarence Cook Little. He held a very minority view that smoking was not linked to lung cancer. Little reckoned lung cancer was not caused by smoking, but by your unfortunate genetics, with maybe a little help from hormonal and emotional factors. Having such a prestigious academic as a Figure Head certainly helped add weight to Big Tobacco's statements.

The Tobacco Industry Research Committee was very successful at muddying the minds of the general public for decades, but they didn't succeed as well with the medical profession.

Doctors began to quit smoking.

In 1954, in Massachussetts, about 52 percent of physicians were smokers. Some 30 percent of these were smoking a packet or more each day. Within five years, by 1959, only 39 percent of doctors were smokers, and only 18 percent smoked at least a pack per day. So doctors were quitting smoking, and those who did smoke, were smoking less.

But it took a while even for this most educated health profession to fully accept the research about smoking.

In 1960, only one third of all US doctors accepted that the case against cigarettes had been fully established. Eventually the science prevailed, and by 2006, only 4 percent of US physicians smoked cigarettes.

So back in the early 20th Century, when the medical profession allowed itself to be associated with Big Tobacco it hadn't yet been fully proven that cigarettes were bad for your health.

But the lessons of how to successfully sway public opinion turned out to be a goldmine for Big Tobacco -- and others. The core message was "Doubt is our product".

Big Tobacco was just the first to effectively use this tactic.

It's since been successfully used by various governments to justify invasions, by pharmaceutical companies, and by many other organisations trying to put a spin on the truth.

Don't even let me start with climate change denialism ...

But it's safe to say that the merchants of doubt are doing a roaring trade.

- Dr Karl Kruszelnicki

 

Australian Broadcasting Corporation (2019)