"Sex, Lies, and Cigarettes"

Hello Everyone,

I've assembled a few links that I think you'll find informative, particularly on tobacco, following Michele's lecture this week on cancer and tobacco use.

First, this photo of the tobacco CEOs swearing to tell the truth before Congress was taken during a hearing lead by Congressman Waxman (D-Calif) on April 14, 1994 (20 yrs ago next week) on the dangers of tobacco. They swore that tobacco was "not addictive," knowing all the while their research showed it was, based on internal tobacco company memos dating to the 1960s.  Michele pointed me to this fascinating document published by WHO in 2008 that chronicles the tobacco companies' public relations efforts, beginning in the late-1990s,  to "re-invent" their corporate image, even admitting publicly, e.g., Phillip Morris, that nicotine is the addictive agent in tobacco.

The hearings came about thanks to an insider whistle blower, Jeffery Wigand, a former Vice President for Research and Development for Brown & Williamson Tobacco Corporation who learned early on in his career that the tobacco industry was manipulating nicotine levels in tobacco products to make them more addictive. Russell Crowe portrays Wigand in the Oscar nominated film "The Insider."

Second, the Waxman hearings fundamentally changed the way the US viewed cigarettes and tobacco use, eventually leading to the landmark settlement agreement of $368.5 billion between the tobacco industry and the state attorneys general.  These funds led to the creation of an archive of tobacco industry documents (revealed during trial discovery) and organizations like the American Legacy Foundation.  

Third, while the tobacco industry has been stymied in the US where tobacco use rates are declining (< 20% of Americans smoke), the industry is full steam ahead in the developing world, as described vividly in this 41 minute Vanguard documentary "Sex, Lies, and Cigarettes" which we watched after Michele's lecture.  

For example, in China less than 2% of women smoke, compared with nearly 53% of men.  For the tobacco industry, this means 98% of Chinese women are potential smokers. The challenge, from a marketing perspective, is how to convince young Chinese women that smoking is not for prostitutes (a longstanding cultural association) but for the modern Chinese woman.   Check out these cigarette ads to see how the industry conveyed this image to the 1960s woman, which is parodied in the film "Thank You for Smoking" about the tobacco lobby.  

Regarding electronic nicotine delivery devices (ENDs) or "e-cigarettes," unlike tobacco cigarettes, these products are not regulated by the FDA, as there is no health claim made by the manufacturers.  One argument in favor of e-cigarettes is that they are a reasonable alternative for smokers who want to quit smoking, much like other nicotine replacement products, such as gum or patches (which are regulated by the FDA because the manufacturer makes a health claim about the product).  Arguments against e-cigarettes are that the manufacturers, many of which are multinational tobacco industries, like Phillip Morris (aka Altria), British American Tobacco, and R.J. Reynolds, are marketing e-cigarettes towards youth, just like tobacco cigarettes (glamorous, sporty, youthful, sexy, etc.) with the intent that the youthful user will become addicted to nicotine (which is as addictive as cocaine) and switch to tobacco or use both.  A win-win for the tobacco industry, it seems.

Lastly, on cancer and environmental exposure, Sir Percival Pott studied and reported in 1775 on "chimney sweep's cancer" or "soot wart."  This was an occupational hazard (later identified as squamous cell carcinoma) of the scrotum in young boys who cleaned the soot and creosote from fireplace chimneys in England.  A dose-response relationship is demonstrated here, in that boys starting as early as age 6 would be exposed to soot that was not washed off for months at a time, allowing prolonged exposure to the carcinogens in soot to accumulate in the ridges of the scrotal skin, leading to a "soot wart," invasion of the testes, and eventually up the spermatic cord to the abdomen.

Eventually, England and other countries banned the use of child labor for this task (but not necessarily others, like weaving, servants, etc. until the 20th century.)

Qs for thought: If you look at tobacco companies' websites, it is clear that they now admit that nicotine is addictive and say people should quit smoking.  If this is true, why are they still in business?  What was the net profit of, say, Phillip Morris, last year?  Hint: not in the millions.  What about profits from e-cigarettes?  Does money speak to power in our democracy, thus obviating any potential for change?

Regarding environmental exposures and cancer, is more regulation of carcinogens likely to keep us safe from developing, say, lung cancer from radon (remember my earlier blog post on this element)?  What is the balance between imposed regulation and personal choice?  If so, how is this balance defined scientifically?

Hope you find this discussion informative.

Jim