Politicians and Their Attitude to Smoking

14.3 Scientists and the Tobacco Industry

One฀perennial฀important฀issue฀is฀whether฀scientists฀should฀accept฀money฀from฀the฀tobacco฀ industry฀for฀their฀work.฀Ignaz฀Semmelweis,฀director฀of฀the฀Gynaecology฀Clinic฀in฀Budapest฀ in฀the฀mid-nineteenth฀century,฀once฀made฀the฀famous฀statement,฀on฀being฀asked฀whether฀ he฀had฀accepted฀money฀from฀a฀condom฀irm,฀which฀was฀after฀all฀immoral:฀“This฀is฀no฀ cause฀for฀reproach:฀I฀have฀a฀machine฀into฀which฀I฀put฀dirty฀money฀at฀the฀top฀and฀take฀out฀ clean฀money฀at฀the฀bottom.”฀But฀it฀is฀surely฀evident฀that฀a฀scientist฀cannot฀take฀the฀view฀ that฀it฀is฀not฀where฀money฀comes฀from฀that฀counts,฀but฀only฀what฀it฀is฀used฀for. In฀1954,฀the฀US฀tobacco฀industry฀founded฀the฀Council฀for฀Tobacco฀Research฀CTR,฀ which฀provides฀large฀sums฀of฀money฀for฀research฀work:฀US฀83฀million฀for฀865฀research฀ projects฀ in฀ 279฀ medical฀ facilities฀ at฀ universities,฀ hospitals฀ and฀ research฀ institutes฀ [29] .฀ While฀initially฀the฀funding฀was฀given฀for฀work฀on฀the฀subject฀of฀“smoking฀and฀health,”฀a฀ research฀group฀was฀formed฀which฀was฀devoted฀to฀biomedical฀research฀without฀any฀refer- ence฀ to฀ smoking.฀ The฀ inluence฀ of฀ the฀ CTR฀ on฀ research฀ projects฀ has฀ been฀ variously฀ assessed,฀with฀no฀bias฀being฀found฀in฀many฀instances.฀In฀these฀cases,฀the฀aim฀of฀the฀CTR฀ was฀to฀appear฀as฀a฀donor฀of฀equal฀standing฀with฀the฀American฀Cancer฀Society,฀the฀National฀ Science฀Foundation,฀the฀National฀Institutes฀of฀Health฀and฀other฀leading฀research฀bodies฀ [29] ,฀and฀in฀this฀way฀to฀acquire฀equal฀status฀with฀them฀by฀riding฀“piggy-back,”฀as฀it฀were.฀ It฀is฀ultimately฀a฀question฀of฀conscience฀whether฀money฀can฀be฀accepted฀from฀an฀industry฀ which฀is฀responsible฀for฀1,000฀smoking-related฀deaths฀a฀day฀in฀the฀USA฀alone. In฀Germany,฀the฀“Smoking฀and฀Health”฀research฀council,฀the฀“Rauchen฀und฀Gesundheit฀ mbH”฀ research฀ company฀ in฀ Hamburg฀ and฀ the฀ “Verum”฀ Behaviour฀ and฀ Environment฀ foundation฀in฀Munich,฀advised฀by฀the฀physiologist฀K.฀Thurau฀andor฀the฀clinical฀medical฀ specialist฀F.฀Adlkofer,฀have฀sought฀to฀do฀scientiic฀work฀in฀this฀ield฀ [30,฀31] .฀Their฀results฀ have฀been฀the฀subject฀of฀very฀severe฀criticism฀ [30] .฀The฀Danish฀physician฀T.฀Voss฀was฀paid฀ US฀3,500–6,500฀a฀month฀by฀Philip฀Morris฀for฀speaking฀publicly฀against฀anti-smoking฀ groups.฀The฀Swedish฀physician฀T.฀Malmfors฀of฀the฀Karolinska฀Institute฀also฀worked฀for฀ Philip฀Morris,฀presenting฀the฀risks฀of฀passive฀smoking฀as฀unproven,฀for฀which฀they฀received฀ the฀equivalent฀of฀DEM฀60,000฀ [32] . Around฀the฀year฀1990,฀INFOTAB,฀a฀think฀tank฀supported฀by฀the฀tobacco฀industry,฀pub- lished฀“A฀guide฀for฀dealing฀with฀anti-tobacco฀pressure฀groups”฀ [33] ,฀in฀which฀an฀early฀ warning฀system฀was฀established฀for฀setting฀up฀WHO฀bureaux฀and฀for฀holding฀regional฀ workshops฀of฀anti-smoking฀groups฀and฀non-smoker฀organisations฀and฀coalitions.฀These฀ initiatives฀were฀accompanied฀by฀activities฀aimed฀at฀delaying฀the฀establishment฀of฀anti- tobacco฀programmes.฀After฀BATCo฀had฀studied฀the฀WHO฀programmes,฀scientists฀were฀ enlisted฀and฀paid฀by฀BATCo฀who,฀acting฀as฀private฀persons,฀cast฀doubt฀on฀the฀WHO฀pro- grammes.฀These฀scientists฀included,฀for฀instance,฀Paul฀Dietrich,฀at฀that฀time฀president฀of฀ the฀Institute฀for฀International฀Health฀and฀Development,฀and฀Bob฀Tollison฀from฀the฀Centre฀ for฀Study฀of฀Public฀Choice.฀The฀former฀played฀down฀the฀tobacco฀issues฀in฀a฀publication฀ planned฀for฀the฀New฀York฀Academy฀of฀Sciences,฀and฀the฀latter฀wrote฀similar฀articles฀for฀ the฀International฀Herald฀Tribune.฀The฀essence฀of฀these฀articles฀was฀that฀the฀WHO฀should฀ concern฀itself฀more฀with฀combating฀infectious฀diseases฀malaria฀and฀cholera฀in฀the฀Third฀ World,฀rather฀than฀with฀issues฀such฀as฀safety฀belts฀or฀cigarettes฀and฀alcohol฀ [34] .฀If฀these฀ misrepresentations฀of฀the฀WHO฀are฀repeated฀internationally฀often฀enough,฀they฀come฀to฀be฀ accepted฀as฀facts. The฀questionable฀sponsoring฀of฀researchers฀at฀universities฀for฀studies฀sympathetic฀to฀ the฀tobacco฀industry฀should฀be฀reconsidered.฀Also฀in฀the฀USA,฀readers’฀letters฀on฀the฀low฀ or฀non-existent฀risks฀of฀passive฀smoking฀have,฀according฀to฀the฀journal฀Science,฀been฀paid฀ for฀with฀sums฀up฀to฀US฀10,000฀and฀evidenced฀on฀the฀payrolls฀of฀the฀tobacco฀industry฀ [35] .฀ The฀Munich฀medical฀journal฀Münchner฀Medizinische฀Wochenschrift฀carried,฀in฀a฀supple- ment,฀ a฀ study฀ on฀ passive฀ smoking฀ by฀ the฀ well-known฀ statistician฀ K.฀ Überla,฀ entitled฀ “Liberty฀and฀responsibility฀–฀discussed฀with฀special฀reference฀to฀passive฀smoking,”฀which฀ was฀funded฀by฀the฀Peutinger-Collegium,฀a฀body฀closely฀afiliated฀to฀the฀tobacco฀industry฀ [35] .฀This฀institute฀has,฀since฀its฀foundation,฀been฀run฀by฀G.฀B.฀Gori,฀an฀adviser฀to฀the฀ tobacco฀ industry,฀ who฀ also฀ acts฀ as฀ its฀ adviser฀ in฀ public.฀ In฀ the฀ years฀ 19921993,฀ Gori฀ received฀over฀US฀20,000฀for฀ive฀letters฀to฀scientiic฀journals฀J฀Natl฀Cancer฀Inst฀and฀ daily฀newspapers฀Wall฀Street฀Journal฀ [36–39] . Critical฀notice฀has฀also฀been฀drawn฀to฀the฀University฀of฀Nottingham,฀which฀opened฀an฀ International฀Centre฀for฀Corporate฀Social฀Responsibility฀with฀inancial฀support฀from฀BAT฀ [40] .฀This฀decision฀by฀the฀university฀aroused฀considerable฀protest฀and฀controversial฀discus- sion฀in฀scientiic฀quarters฀and฀raised฀the฀question฀as฀to฀whether฀an฀action฀of฀this฀kind฀was฀ ethically฀ and฀ morally฀ justiiable฀ in฀ view฀ of฀ the฀ major฀ damage฀ to฀ health฀ caused฀ by฀ the฀ tobacco฀industry’s฀products฀ [41,฀42] .฀It฀ought฀to฀be฀impossible฀for฀physicians฀to฀conduct฀ research฀work฀with฀the฀aid฀of฀subsidies฀from฀the฀tobacco฀industry฀see฀Sect.฀ 14.1

14.4 “Subsidised” Tobacco Growing

The฀ cultivation฀ of฀ tobacco฀ as฀ a฀ lucrative฀ business฀ for฀ farmers฀ is฀ shown฀ by฀ a฀ US฀ list฀฀ of฀income฀that฀can฀be฀obtained฀by฀the฀cultivation฀of฀various฀agricultural฀products฀see฀฀ Fig.฀ 14.1 ฀ [12] . The฀world’s฀best฀tobaccos฀are฀grown฀outside฀of฀Europe;฀in฀the฀European฀Union,฀only฀ Greece฀3฀share฀is฀able฀to฀produce฀tobacco฀of฀superior฀quality฀ [43] .฀The฀EU฀subsidises฀ the฀ tobacco฀ industry฀ to฀ the฀ tune฀ of฀ 1฀ billion฀ annually,฀ including฀ 25.6฀ million฀ for฀ the฀ German฀tobacco฀growers฀ [44] .฀In฀1997,฀European฀tobacco฀farmers฀earned฀approximately฀ 4,090฀ per฀ hectare,฀ a฀ price฀ which฀ is฀ below฀ the฀ average฀ income฀ for฀ European฀ farmers.฀ However,฀as฀this฀production฀is฀subsidised,฀it฀nevertheless฀continues.฀In฀the฀Greek฀part฀of฀ Macedonia,฀the฀farmers฀used฀to฀grow฀wheat,฀but฀because฀of฀the฀subsidies฀they฀switched฀to฀ tobacco,฀especially฀as฀the฀annual฀subsidies฀in฀Greece฀rose,฀between฀1986฀and฀1995,฀to฀409฀ million฀ [43] ,฀i.e.฀approximately฀ive฀times฀the฀market฀value.฀The฀costs฀of฀smoking฀to฀the฀ national฀economy฀health฀care,฀social฀security,฀illness-related฀loss฀of฀production,฀on฀the฀ other฀hand,฀are฀about฀three฀times฀higher฀than฀the฀proit฀earned฀from฀tobacco฀growing฀ [43] . Altogether,฀the฀tobacco฀industry฀employs฀some฀200,000฀people฀in฀the฀EU,฀whereby฀the฀ tobacco฀processing฀plants฀are฀also฀located฀in฀rural฀regions฀and฀support฀the฀economy฀there.฀