Becauseofitshugeproits,thetobaccoindustryisabletosupportawiderangeofsport- ingandculturalactivitiesofthestate.Itremainsquestionablewhetherthestateorother
bodiesshouldacceptsuchmoney,forwhicha“return”isnaturallyexpectedfrompoliti- ciansandstateinstitutions.In2002theGermangovernmentreachedanagreementwiththe
tobaccoindustry,underthetermsofwhichthelatteristomakea“nostrings”paymentof 12.6milliontothegovernmentoveraperiodof3yearsfortheimplementationofpreven-
tionprogrammesamongchildrentodiscouragethemfromtakingupsmokingatanearly age.Thisformofcollaborationisalwayssuspect:thescientistsengagedinfutureworkof
thiskindarefreeonlytoalimitedextentbecausetheyare“takingtobaccoresearchEuros.” AnanalogoussituationexistedwhenBATannouncedthatitwouldfundanInternational
CentreforCorporateSocialResponsibilityatNottinghamUniversityintheUKforthe soberingsumof£3.8million
[9,10] seeSect.
14.3 .
Afewyearsago,averyfar-reachinglaw,theso-called“TobaccoDeal,”wasplannedin theUSA.Thislawproposedtoincreasetobaccodutyfrom1to10perpackovera
periodof5years,toimposesharprestrictionsontobaccoadvertising,andtosetupa specialfundforthetreatmentofsmoking-relateddiseases20billionperyear.Inreturn,
the tobacco industry would be “sheltered” by the state from individual legal actions. However,inconnectionwithelectionsintheyear1998,thetobaccoindustrygave50
millionincampaigndonationstotheRepublicans,whoatthattimeheldamajorityin Congress,andatthesametimerananadvertisingcampaignontelevision,allofwhichhad
thedesiredeffect.ThelawwasbroughtdownbythevotesoftheRepublicans [11]
. AccordingtointernaldiscussionsoftheGermanCigaretteIndustryAssociationVdC,
thetobaccoindustryispursuingseveralstrategicgoalstosecureitssalesmarkets [12]
.One ofitsprimarygoalsistopreventabanontobaccoadvertisingworldwide,intheEUand
Germanyby,forinstance,obstructingthediscussionandpassageofbillsintheEuropean Parliamentandorpreventinglawsfromcomingintoforcethroughcourtaction.Todothis,
thetobaccoindustryconductstalkswithpoliticiansofallpartiesandalsoseekstoexert pressure, through business and trade union representatives, on the members of the EU
Parliament,withtheaimofbringing314membersoftheEuropeanParliament“ontothe tobaccoindustry’sside.”Theostensibleargumentusedagainstabanonadvertisingwasthe
“freedom of advertising information,” backed by large-scale placard and advertising activitiespriortothevote
[13] .
Inarecentlypublishedcomprehensivereport [14]
,theWHOhasdocumentedindetail thatthetobaccoindustry
•
Isseekingtodistractattentionfromtobaccoabusethroughsidetrackingactivities
•
HastriedtoreducetheWHO’stobacco-relatedbudgetsandmobiliseotherUNorgani- sationsagainsttheWHO
•
HassoughttoconvincedevelopingcountriesthattheWHO’santi-tobaccoprogramme wouldbeattheirexpense
•
Hasmisrepresentedtheresultsofimportantscientificstudies [14]
Thetobaccoindustryhasalsolaiddownastrategyinaconidentialdocumentposition paper–thoughthishasnowbeenpublishedontheInternet–onwaysofinluencingthe
activitiesoftheWHO [15]
.
14.2 Politicians and Their Attitude to Smoking
Smokingisseenbymanypeopleasademonstrationofstrengthandsuperiority,andcigars evenasasymbolofpowerasevidencedbycaricaturesofcapitalists.Sometypicalexam-
plesofcigarsmokersareChurchill,Clinton,ErhardandSchröder.Politiciansaresupposed tobeindependentpeoplewhodecidesolelyaccordingtotheirconscience;infact,however,
theyareusuallyembeddedinsociallobbygroups,whoalsogeneratethevoterpotentialfor futureelections
[16,17] .Moststudiesonsmoking,andthestatementsmadeinthemonthe
“moreorlesssigniicantrisks”causedbysmoking,comefromthelaboratoriesandadver- tisingagenciesofthecigaretteindustry,whichintermsofinluenceonpublicopinionhave
evenmoreimportanceintheUSAthaninGermany [18–20]
.Despiteanappealbythe MedicalAdvisoryBoardoftheBonnorganisationstotheGermanchancellortoabandon
thegovernment’soppositiontotheEUdirectivebanningcigaretteadvertising,thegovern- mentfeltitnecessarytoightthe“resolutionsoftheEUCommissionastheywouldput
jobsatrisk”andtoputabrakeonthe“witchhunt”againstadvertisingbythetobacco industry
[21] .
In1998,theBritishgovernmentlaunchedanationwide“Smokingkills”campaign, withtheaimofreducingsmokingamongjuvenilesfrom13to9,amongadultsfrom
28to24,andespeciallyamongwomenfrom23to15,withinaperiodof10years [22]
.Fortheirst3yearsofthiscampaign,theBritishgovernmenthasmade£60million available
[22] .
InGermany,asinmanyotherEUcountries,thereisstillakindof“stalemate”situation, with“powerless”politiciansandjournalists–alotofwhomsmoke–ontheoneside,and
the social security contributors, who ultimately have to pay for-the costs of smoking- relateddisease,ontheotherside,includingapotentialmajorityofthepopulationwho
wouldvoteinfavouroftoughmeasurestoprotectnon-smokersandforacompletebanon cigaretteadvertising.Thisscenarioindicatesfailureonthepartofmanypoliticians
[23] .
Dependingonwhethertheydecide“for”or“against”abanonadvertisingandtheprotec- tion of non-smokers, politicians stand to lose credibility among their respective voter
groups.Therefusalofpoliticianstotakeaclearstandontheseissuesisamisrepresenta- tionofthewillofthepeople
[24] .Thepoliticiansprefertoaccepttheprovendamageto
healthcausedbysmoking,whichcanadduptobillionsinonlyafewyears,ratherthan makeacleardecision.Also,thepoliticiansinGermanyhavesofaradoptednoeffective
measurestoprotectchildrenathome.Atpresent,theremightexistsomeimprovement concerningpublicprotectionfornon-smokers,butresearchintothisieldstillreceives
hardlyanysupport. Wherespecialistadviceiscalledinpriortotakinglegislativedecisions,thecigarette
industryisalwaysabletopresent“experts”fromarangeofdisciplineswhocastdoubton theindingsofstudies,generatingageneralatmosphereofuncertaintyandinthisway
ultimatelyexercisinganinhibitingeffectontheintendedlegislativemeasures [25–27]
. Thetobaccoindustryisalsoable,bythreateningtoclaimfordamages–includingcourt
costsrunningintomillions–toparalyseanyactivity,ashappenedinthecaseofCBS,the radioandTVbroadcaster,intheUSA
[28] .
14.3 Scientists and the Tobacco Industry
Oneperennialimportantissueiswhetherscientistsshouldacceptmoneyfromthetobacco industryfortheirwork.IgnazSemmelweis,directoroftheGynaecologyClinicinBudapest
inthemid-nineteenthcentury,oncemadethefamousstatement,onbeingaskedwhether hehadacceptedmoneyfromacondomirm,whichwasafterallimmoral:“Thisisno
causeforreproach:IhaveamachineintowhichIputdirtymoneyatthetopandtakeout cleanmoneyatthebottom.”Butitissurelyevidentthatascientistcannottaketheview
thatitisnotwheremoneycomesfromthatcounts,butonlywhatitisusedfor. In1954,theUStobaccoindustryfoundedtheCouncilforTobaccoResearchCTR,
whichprovideslargesumsofmoneyforresearchwork:US83millionfor865research projects in 279 medical facilities at universities, hospitals and research institutes
[29] .
Whileinitiallythefundingwasgivenforworkonthesubjectof“smokingandhealth,”a researchgroupwasformedwhichwasdevotedtobiomedicalresearchwithoutanyrefer-
ence to smoking. The inluence of the CTR on research projects has been variously assessed,withnobiasbeingfoundinmanyinstances.Inthesecases,theaimoftheCTR
wastoappearasadonorofequalstandingwiththeAmericanCancerSociety,theNational ScienceFoundation,theNationalInstitutesofHealthandotherleadingresearchbodies
[29] ,andinthiswaytoacquireequalstatuswiththembyriding“piggy-back,”asitwere.
Itisultimatelyaquestionofconsciencewhethermoneycanbeacceptedfromanindustry whichisresponsiblefor1,000smoking-relateddeathsadayintheUSAalone.
InGermany,the“SmokingandHealth”researchcouncil,the“RauchenundGesundheit mbH” research company in Hamburg and the “Verum” Behaviour and Environment
foundationinMunich,advisedbythephysiologistK.Thurauandortheclinicalmedical specialistF.Adlkofer,havesoughttodoscientiicworkinthisield
[30,31] .Theirresults
havebeenthesubjectofveryseverecriticism [30]
.TheDanishphysicianT.Vosswaspaid US3,500–6,500amonthbyPhilipMorrisforspeakingpubliclyagainstanti-smoking
groups.TheSwedishphysicianT.MalmforsoftheKarolinskaInstitutealsoworkedfor PhilipMorris,presentingtherisksofpassivesmokingasunproven,forwhichtheyreceived
theequivalentofDEM60,000 [32]
. Aroundtheyear1990,INFOTAB,athinktanksupportedbythetobaccoindustry,pub-
lished“Aguidefordealingwithanti-tobaccopressuregroups” [33]
,inwhichanearly warningsystemwasestablishedforsettingupWHObureauxandforholdingregional
workshopsofanti-smokinggroupsandnon-smokerorganisationsandcoalitions.These initiativeswereaccompaniedbyactivitiesaimedatdelayingtheestablishmentofanti-
tobaccoprogrammes.AfterBATCohadstudiedtheWHOprogrammes,scientistswere enlistedandpaidbyBATCowho,actingasprivatepersons,castdoubtontheWHOpro-
grammes.Thesescientistsincluded,forinstance,PaulDietrich,atthattimepresidentof theInstituteforInternationalHealthandDevelopment,andBobTollisonfromtheCentre
forStudyofPublicChoice.Theformerplayeddownthetobaccoissuesinapublication plannedfortheNewYorkAcademyofSciences,andthelatterwrotesimilararticlesfor
theInternationalHeraldTribune.TheessenceofthesearticleswasthattheWHOshould concernitselfmorewithcombatinginfectiousdiseasesmalariaandcholeraintheThird