"UNPRECEDENTED" TOBACCO INDUSTRY CAMPAIGN UNDERMINED REPORT ON SECOND-HAND SMOKE AND CANCER, RESEARCHERS FIND

A ten-year study conducted by the International Agencyfor Research in Cancer (IARC) examining the links between second-hand smoke andcancer was subverted by an unprecedented misinformation campaign co-ordinatedby the tobacco industry and resulting in misleading media reports of theEuropean scientific study even before it was published.

These are the findings of two UC San Franciscoscholars whose analysis of the fierce tobacco industry information campaign ispublished in the April 8 issue of the medical journal Lancet. Authors are Elisa K. Ong, BA, and Stanton Glantz, PhD, bothresearchers at the Institute for Health Policy Studies in UCSF's Department ofMedicine.

"The extent of tobacco industry money and effort spentto discredit a single study is unprecedented," said Glantz, professor ofmedicine at UCSF and long-time scholar and critic of tobacco industrystrategies. Ong is a medical student at Stanford University.

The reason the industry was so concerned about thepaper, he suggests, is that while scientific reports on second-hand smoke hadalready stimulated legislation on clean indoor air in the U.S., Europeancountries have been slower to change.

"Tobacco industry strategists were apparently tryingto head off the possibility of sentiment growing for similar restrictions intheir European markets, so they hit this report with all they had," Glantzsays. "There seems to be little regard for the truth in the information theytried to spread."

In their paper, Ong and Glantz describe how thetobacco industry worked to undermine the conclusions and potential impact ofthe largest European study of passive smoking, conducted by IARC, the researcharm of the World Health Organization (WHO).

Fearing that the IARC study (and a possible IARCmonograph summarizing all scientific evidence linking second-hand smoke todisease) would lead to increased European smoking restrictions, the PhillipMorris tobacco company spearheaded an inter-industry, three-pronged strategy inthe mid 1990s to subvert IARC's work, write Glantz and Ong.The scientific strategy attempted to undercut IARC's research andto develop industry-directed research to counter the anticipated findings; thecommunications strategy planned to shape opinion by manipulating the media andthe public; the government strategy sought to prevent increased smoking restrictions.

The IARC scientific study cost roughly $2 million overten years; Philip Morris planned to spend $2 million in one year alone and upto $4 million on research, the authors report. Part of Philip Morris' strategywas to use consultants sympathetic to the tobacco industry who were asked tofind out more about the IARC report, and did not always disclose their industrylinks while seeking information from IARC investigators. The documents andinterviews suggest that the tobacco industry continues to conduct asophisticated campaign against conclusions that second-hand smoke causes lungcancer and other diseases, "subverting normal scientific processes," theauthors conclude.

The IARC study demonstrated a 16% increase in risk inlung cancer to nonsmokers from second-hand smoke, a result consistent withearlier studies. Although the results were clear and comparable to those foundby others, the number of people in the study was too small to reach statisticalsignificance (at the 95 percent level).

As Ong and Glantz document, the tobacco industryexploited the degree of statistical uncertainty by providing selectednewspapers with the misinformation that the study had demonstrated "no risk" ofcancer from second-hand smoking clearly notthe study's finding. These incorrect conclusions were published in the Britishpress before the scientific study was published, and as an official Britishreport reviewing second-hand smoke's health effects was released.

To understand the tobacco industry's strategy regardingthe IARC study, Ong and Glantz interviewed IARC investigators and analyzedtobacco industry documents among 32 million pages released in 1998 as part ofthe settlement of the legal case, State of Minnesota and Blue Cross/Blue Shieldof Minnesota vs Phillip Morris, Inc.The documents are archived in Minneapolis.

The study by Ong and Glantz was supported by a grantfrom the National Cancer Institute.