Strategies and tactics used by transnational tobacco companies are revealed in the article by Yussuf Saloojee & Elif Dagli included in this issue of the Bulletin (1). The article draws heavily upon once-secret documents intended for internal circulation within the industry. Saloojee & Dagli show that documents dating back to the mid-1950s prove beyond doubt that the industry had known for decades that tobacco causes death, that it is addictive and has been manipulated to make it more addictive, that getting more teenagers and women to smoke and expanding into new markets is crucial to company profits, and that this knowledge had been covered up (2). The revelations are clear -- the tobacco industry has consistently obscured the truth about smoking from governments, the media and smokers themselves.
The 1998 Minnesota lawsuit in the United States against the tobacco industry was settled on terms highly favourable to the plaintiffs. The lawsuit's most significant result was not the large financial settlement or the banning of all advertising and promotion within Minnesota but the disclosure of millions of pages of previously confidential tobacco industry documents exposing decades of subterfuge regarding the health risks of smoking, the addictive nature of nicotine and its manipulation by the industry, and marketing to children (3).
The documents are available in warehouses in Minnesota, USA, Guildford, England, and at the Brown & Williamson Collection at the University of California in San Francisco.(2) Some of the material has been published in a book (4) and the documents are also available on tobacco industry web sites and several health sites dedicated to making the documents more user-friendly.(3)
The documents are a collection of letters, memos, studies, reviews of studies, marketing plans, statements of policy, article reprints and news clippings, on a wide range of topics such as smuggling, science, youth, denigration of tobacco control personnel, infiltration of the World Health Organization and the International Agency for Research on Cancer, addiction, tobacco-industry front groups, lobbying tactics, women, tobacco industry lawyers, public relations and advertising companies, and tactics to encourage voluntary agreements in preference to tobacco control legislation. Millions of pages remain unexamined and more revelations will be forthcoming.
Obstacles to tobacco control that were once puzzling may now be understood. Government employees who resisted pro-health measures have been shown to have acted in liaison with the industry. The industry infiltrated some of the most respected scientific institutions, and scientists who argued against the scientific evidence on the damaging effects of tobacco are now known to have been paid to do so. The authors describe how the industry singled out scientists whom they believed could be persuaded to work with, and for, the tobacco industry (5). They would then pay them well to criticize the scientific methods used by others, to dispute findings of studies performed on secondhand tobacco smoke, to concoct contrary articles and appear as `expert witnesses' for their side against clean indoor air measures at government hearings.
Not only did the tobacco industry subvert science, but the authors point out that it also presented distorted economic arguments, attempted to hijack the moral high ground on "freedom" issues, and used its corporate muscle to convince governments not to take strong measures against tobacco.
These tactics of the industry have, in general, been highly successful. In spite of decades of knowledge, World Health Assembly resolutions, World Health Organization plans for action, conferences and declarations, the number of smokers is increasing, more smokers are dying, children are still taking up the habit, more girls and women are smoking, and the economic costs are escalating (6) (Table 1). …