US Court orders tobacco companies to "tell the truth"

In June 2014, U.S. District Judge Gladys Kessler of the District of Columbia issued a final order in a long-standing case detailing how the major U.S. tobacco companies must publish court-ordered "corrective statements" to atone for decades of deception of the American public about their deadly products. The order by Judge Kessler includes a list of newspapers and TV networks in which the corrective statements must run, website announcements, and cigarette package “onserts” (information affixed to the packaging or cellophane wrapping).

Judge Kessler in November 2012 finalized the text of corrective messages that are to be made public.  United States v. Philip Morris USA Inc. et al., No. 99-CV-2496 (GK), 2012 WL 5928859 

Earlier this month, tobacco companies filed an appeal claiming that the phrasing in the proposed statements would "punish and humiliate" them, objections that rest largely on matters that were already decided by the D.C. court in 2009.

Below is the text of the five court-ordered Corrective Statements:

Adverse Health Effects of Smoking

A Federal Court has ruled that Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria deliberately deceived the American public about the health effects of smoking, and has ordered those companies to make this statement.

Here is the truth:
• Smoking kills, on average, 1200 Americans. Every day.
• More people die every year from smoking than from murder, AIDS, suicide, drugs, car crashes, and alcohol, combined.
• Smoking causes heart disease, emphysema, acute myeloid leukemia, and cancer of the mouth, esophagus, larynx, lung, stomach, kidney, bladder, and pancreas.
• Smoking also causes reduced fertility, low birth weight in newborns, and cancer of the cervix.

Addictiveness of Smoking and Nicotine

A Federal Court has ruled that Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria deliberately deceived the American public about the addictiveness of smoking and nicotine, and has ordered those companies to make this statement.

Here is the truth:
• Smoking is highly addictive. Nicotine is the addictive drug in tobacco.
• Cigarette companies intentionally designed cigarettes with enough nicotine to create and sustain addiction.
• It's not easy to quit.
• When you smoke, the nicotine actually changes the brain - that's why quitting is so hard.

Lack of Significant Health Benefit from Smoking “Low Tar,” “Light,” “Ultra Light,” “Mild,” and “Natural” Cigarettes

A Federal Court has ruled that Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria deliberately deceived the American public by falsely selling and advertising low tar and light cigarettes as less harmful than regular cigarettes, and has ordered those companies to make this statement.

Here is the truth:
• Many smokers switch to low tar and light cigarettes rather than quitting because they think low tar and light cigarettes are less harmful. They are not.
• “Low tar” and filtered cigarette smokers inhale essentially the same amount of tar and nicotine as they would from regular cigarettes.
• All cigarettes cause cancer, lung disease, heart attacks, and premature death - lights, low tar, ultra lights, and naturals. There is no safe cigarette.

Manipulation of Cigarette Design and Composition to Ensure Optimum Nicotine Delivery

A Federal Court has ruled that Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria deliberately deceived the American public about designing cigarettes to enhance the delivery of nicotine, and has ordered those companies to make this statement.

Here is the truth:
• Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria intentionally designed cigarettes to make them more addictive.
• Cigarette companies control the impact and delivery of nicotine in many ways, including designing filters and selecting cigarette paper to maximize the ingestion of nicotine, adding ammonia to make the cigarette taste less harsh, and controlling the physical and chemical makeup of the tobacco blend.
• When you smoke, the nicotine actually changes the brain - that’s why quitting is so hard.

Adverse Health Effects of Exposure to Secondhand Smoke

A Federal Court has ruled that Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria deliberately deceived the American public about the health effects of secondhand smoke, and has ordered those companies to make this statement.

Here is the truth:
• Secondhand smoke kills over 38,000 Americans each year.
• Secondhand smoke causes lung cancer and coronary heart disease in adults who do not smoke.
• Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, severe asthma, and reduced lung function.
• There is no safe level of exposure to secondhand smoke.

Clearly, the tobacco industry is not a legitimate stakeholder in tobacco control

http://blogs.bmj.com/tc/2013/01/31/a-letter-to-the-us-fda-from-tobacco-control-editor-ruth-malone/

Reposting this excellent response of Ruth Malone to the US FDA explaining her decision to decline their invitation to join a discussion panel that includes the tobacco industry.

A letter to the US FDA from Tobacco Control Editor, Ruth Malone

31 January 2013

This post from editor Ruth Malone is a response to an invitation from the US Food and Drug Administration to participate as a speaker on a panel with the tobacco industry focused on the topic of industry-funded research.

I was very surprised to be invited to present as part of an FDA-sponsored “Facilitated Dialogue” panel also featuring tobacco industry representatives, which would be focused on the topic of industry-funded research. This very type of industry engagement with senior public health figures is straight out of the tobacco companies’ public relations “corporate social responsibility” playbook and was something that at least one tobacco company anticipated as a favorable result of FDA legislation. [1, 2] Such “dialogues” have long been part of this and earlier industry public relations campaigns. Public health authorities and scientists – to say nothing of the federal agency charged with regulating this industry — should not lend their legitimacy to the tobacco companies’ efforts to position themselves as socially responsible.

I would be very willing to come to Rockville and share my perspectives with the FDA on the issue of third parties and tobacco products research. However, I cannot in good conscience participate as a panelist in this “Facilitated Dialogue” with the tobacco industry. Further, I strongly urge that other researchers from the public health community decline participation on such panels. The FDA should consider other means of determining a suitable framework for addressing the many issues related to industry-funded research. While this is clearly an issue about which I have thought and written extensively, I think this meeting as currently envisioned is a very bad idea.

My reasons are:

First, involving the tobacco companies as “stakeholders” on a panel with the public health community in this way suggests that all parties share a common or at least congruent goal. This is a flawed assumption. Public health advocates (and presumably the FDA) have a stake in saving lives. Tobacco companies have a stake in protecting profits. The research evidence has repeatedly demonstrated that they will do whatever it takes to continue to promote the use of cigarettes, their single most deadly product. While the companies may have an interest in reducing the numbers who die prematurely from using their products (so that they will live to purchase more of them), they have never indicated any willingness to pull from the market the products that kill half their longtime users and continue to be sold. Absent such willingness, the practical goals of public health and the tobacco industry are in direct conflict. No “dialogue” will change that.

Second, any such discussion among “stakeholders” would require a minimal level of mutual understanding about the nature and purpose of science. However, a large body of academic research based on the industry’s own internal documents, as well as federal Judge Gladys Kessler’s extensive findings of fact in the successful U.S Department of Justice racketeering case against the major tobacco companies, [3] demonstrates that research is an arena in which the tobacco industry is particularly untrustworthy. This fact was also repeatedly noted in the Institute of Medicine (IOM) Report on Scientific Standards for Studies on Modified Risk Tobacco Products.[4] As the Kessler decision found, the tobacco industry engaged in a conspiracy to cover up and distort the evidence of their products’ harmfulness, and they have a long track record of egregious manipulation of science. The courts also found that this behavior is continuing and likely to continue in the future; I see no reason to differ with this conclusion. For this very reason, Tobacco Control, the journal that I edit, and other reputable scientific journals including PLoS Medicine no longer publish tobacco industry-funded research. [5, 6] To engage the industry as a legitimate partner in the discussion of how to deal with industry science is to ignore this large body of evidence.

Third, as noted briefly above, such engagements have long been envisioned by tobacco companies as facilitating their image reform efforts while creating divisions within the tobacco control community. As we demonstrated in our papers examining Philip Morris’s support for FDA regulation of tobacco products [1]and its development of Project Sunrise, which sought to create and exploit divisions within tobacco control, [2]engagement with public health organizations allows tobacco companies to position themselves as reasonable and responsible, and position those who refuse to engage as extremists. In fact, shortly after the failure of a previous bill giving FDA authority to regulate tobacco, top Philip Morris executives were exploiting public speaking opportunities in which they falsely claimed to have “partnered” with leading public health organizations in supporting regulation. This is precisely the type of mileage tobacco companies can achieve from engaging in “facilitated dialogues” such as those envisioned by FDA.

Fourth, tobacco industry denormalization is a key part of successful tobacco control efforts. Convening a meeting of this sort undermines those critically important efforts by creating a forum for re-legitimation through association with respected public health agencies and leaders. Lending the FDA imprimatur to a public meeting featuring tobacco company speakers suggests that something has indeed changed and the industry is no longer harming people through its promotion of deadly products. But this is patently untrue. And, as we recently showed in an extensive review, a robust body of evidence supports tobacco industry denormalization as an effective population-level tobacco control strategy that contributes to reduced smoking prevalence among young people, reduced youth smoking initiation, increased intentions to quit and reduced perceived peer smoking prevalence. [7] It is very puzzling that the FDA would act in a way that undermines this important work.

The FDA may be required to interact with the industry for the purposes of discussing proposed regulation of tobacco products and what tobacco companies must do to comply. The FDA is not, however, required to “facilitate” dialogue as though it were acting as a neutral mediator between two parties with equally valid but divergent interests. In positioning itself as some sort of neutral party, FDA is unwittingly acting as an agent for the tobacco industry’s public relations initiatives and undermining a strong tobacco control strategy. This is very problematic and to those of us who have spent more than a decade researching industry strategies, enormously naive.

For these reasons I am declining to participate in this meeting and urging my colleagues to do the same.

[1] McDaniel PA, Malone RE. Understanding Philip Morris’s pursuit of US government regulation of tobacco. Tobacco Control. 2005;14(3):193-200.
[2] McDaniel PA, Smith EA, Malone RE. Philip Morris’s Project Sunrise: weakening tobacco control by working with it. Tobacco Control. 2006;15:215-23.
[3] United States District Court for the District of Columbia. Amended Final Opinion, U.S. Department of Justice versus Philip Morris et al. Civil Action No. 99-2496 (GK). http://publichealthlawcenter.org/sites/default/files/resources/doj-final-opinion.pdf 2006.
[4] Institute of Medicine Committee on Scientific Standards for Studies on Modified Risk Tobacco Products. Scientific standards for studies on modified risk tobacco products. Washington, DC: Institute of Medicine; 2012.
[5] Malone RE. Changing Tobacco Control’s policy on industry-funded research. Tobacco Control. 2013;22(1):1-2.
[6] PLoS Editors. A new policy on tobacco papers. PLoS Medicine. 2010;7(2):e1000237.
[7] Malone RE, Grundy Q, Bero LA. Tobacco industry denormalisation as a tobacco control intervention: A review. Tobacco Control. 2012;21:162-70.