Tobacco Companies Forced to Admit That Smoking Is Deadly

Roxanne Nelson, RN, BSN

November 28, 2017

Major US tobacco companies are finally having to admit that they have been deceiving the public about the dangers of tobacco.

Tobacco companies have been ordered by the courts to begin publishing "corrective statement" advertisements in major news outlets based in the United States.

The advertisements, which began running on November 26, will have to explain the adverse health effects of smoking and second-hand smoke, along with other topics.

However, the statements not only will focus on the health problems associated with tobacco use but will also require companies to admit that they "intentionally designed cigarettes with enough nicotine to create and sustain addiction."

These "corrective" statements must be disseminated via television and newspaper advertisements, and a schedule for the topic and dates of presentation has been set up.

"The most important thing about these ads is that they remind the public and policymakers that the tobacco industry is a rogue industry, build on a mountain of lies," said Vince Willmore, vice president of communications at Campaign for Tobacco-Free Kids. "They are a reminder that the horrific toll that cigarettes have taken did not happen by accident and are the result of the illegal and deceitful practices of the tobacco industry."

In an interview, Willmore told Medscape Medical News the hope is that the corrective statements will spur elective officials to take strong corrective action.

"The main goal is to inform the public about health harms related to cigarette smoking and to inform them of the behavior of the tobacco industry and then start a conversation," he said. "There has been a lot of coverage about these statements, and that in and of itself is very beneficial in informing the public."

Long Court Process

The proposed ads are the culmination of a long-running lawsuit that the US Department of Justice filed against the tobacco companies nearly 20 years ago, in 1999. A landmark 2006 judgment and opinion by US District Judge Gladys Kessler ruled that tobacco companies had violated civil racketeering laws (RICO) and engaged in a decades-long conspiracy to deceive the public about the health effects of smoking and their marketing to children.

In her 2006 verdict, Judge Kessler ruled that the tobacco companies "have marketed and sold their lethal products with zeal, with deception, with a singleminded focus on their financial success, and without regard for the human tragedy or social costs that success exacted…. Over the course of more than 50 years, defendants lied, misrepresented and deceived the American public, including smokers and the young people they avidly sought as 'replacement' smokers about the devastating health effects of smoking and environmental tobacco smoke."

Despite their internal knowledge, the tobacco companies (from 1964 onward) continued to deny and distort the serious health effects of smoking, said Judge Kessler. Even as recently as 2005 (the year before the judgment), they still refused to admit that smoking was linked to serious health problems.

The tobacco industry was also well aware that smoking and nicotine are addictive, but they publicly denied it and "continue to do so," she ruled. They have "concealed and suppressed research data and other evidence that nicotine is addictive."

In 2006, Judge Kessler ordered the tobacco companies to publish corrective statements on the five topics about which they deliberately mislead the public:

  • The adverse health effects of smoking;

  • The addictiveness of smoking and nicotine;

  • The lack of significant health benefits from smoking "low tar," "light," "ultra light," "mild," and "natural" cigarettes (which have been deceptively marketed as less harmful than regular cigarettes);

  • The manipulation of cigarette design and composition to ensure optimum nicotine delivery; and

  • The adverse health effects of exposure to secondhand smoke.

However, during the 11 years since the ruling, the tobacco companies have repeatedly filed appeals and have tried to modify and delay publication of the corrective statements. The US Supreme Court declined to hear their appeal in 2010, and the appeal process finally ended this year, with the result that the tobacco companies were ordered to begin running the corrective statement ads.

The new court-ordered advertisements for television must contain one of the five corrective statements and run five times per week for 1 year, for a total of 260 spots. The ads must run during prime time (7 to 10 pm) and on one of the three major networks.

For newspapers, tobacco companies must purchase five full-page ads in the first section of the Sunday edition of the 50+ newspapers specified by the court. These include papers published in the Hispanic media and African American/community papers. Each of the ads will contain one of the five corrective statements.

Reacting to the news, the University of Texas MD Anderson Cancer Center in Houston issued a statement applauding the action, noting that it will be a significant step toward informing Americans about the addictive power of cigarettes and the harms of tobacco use.

"Although we have made tremendous progress in terms of reducing tobacco use, the CDC [Centers for Disease Control and Prevention] recently reported that 20% of adults in the U.S. still use tobacco products," Ernest Hawk, MD, vice president and chair, Division of Cancer Prevention and Population Sciences at MD Anderson, said in a statement.

"It's clear that we must continue to educate the public about the dangers of tobacco use, and these statements will be an important part of that process," added Dr Hawk.

Big Tobacco Changing Its Stripes?

The ads are coming at time when tobacco companies are resorting to a variety of measures to thwart progress in smoking cessation and reduction.

Philip Morris International, for example, is trying to rebrand itself as part of the solution by funding the Foundation for a Smoke-Free World, as reported previously by Medscape Medical News. Philip Morris will provide $80 million annually over the next 12 years, and the foundation will focus on funding critical research and finding ways to speed up science-based solutions to the current public health crisis involving 1 billion smokers worldwide.

While some have applauded the measure, many experts are skeptical at what appears to be an apparent conflict of interest. In a Lancet editorial commenting on Philip Morris putting up the funds for this Foundation, Martin McKee, CBE, MD, DSc, from the Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, United Kingdom, and colleagues wrote: "Anybody who believes that they really do want to see a smoke-free world is, we argue, living in a fantasy world." In its reaction to the announcement, the American Cancer Society commented that the involvement of Philip Morris in this endeavor was just "a continuation of a decades-long effort to paint over tobacco's role in spreading death and misery around the globe." The company has the power to make a difference, they noted: It should "stop selling cigarettes."

At the same time, while government health policies to control tobacco use are gaining strength globally, the tobacco industry is not about to back off that quickly.

Instead, it has produced new products to replace conventional cigarettes ― electronic cigarettes (e-cigarettes), electronic nicotine delivery systems (ENDS), and novel "heat not burn" (HNB) devices. Although these products claim to be less toxic than cigarettes, no epidemiologic data are yet available on lung cancer or other diseases.

The tobacco companies "lie and pretend to be reformed…and say that they want to see people stop smoking cigarettes," commented Willmore. "But at the same time, they are trying to interfere with efforts to control the use of tobacco, and continue to aggressively market and promote their products."

More Steps Needed

In July, the US Food and Drug Administration unveiled a new comprehensive plan for regulating tobacco and nicotine that will "serve as a multi-year roadmap to better protect kids and significantly reduce tobacco-related disease and death."

Included in their plan is to begin a public dialogue about lowering nicotine levels in combustible cigarettes to nonaddictive levels. Given that 90% of smokers begin before they are 18 years old, lowering nicotine levels could decrease the likelihood of addiction as well as helping current smokers to quit.

"That would help prevent kids from getting addicted," said Willmore, "And there are a lot more steps we would like them to take, such as banning menthol cigarettes and putting graphic warnings on cigarette packs."

Smoking rates are still high in parts of the United States, he added, and in some specific populations. "We need to reduce smoking and the death and disease it causes, in all states and for all Americans."

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