Clinical Question: How did the tobacco industry enlist otolaryngologists in support of efforts to reassure consumers that cigarettes were safe?
Background: To counter emerging scientific evidence in the mid-20th century showing the link between smoking and cancer, the tobacco industry needed more than advertising to create doubt about the scientific facts. Supported by generous payments, some of the country’s foremost physicians were recruited to obfuscate the emerging truth.
Explore this issue:January 2012
Study design: Literature review and search of the Legacy Tobacco Document Archives.
Setting: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
Synopsis: Material studied included contract agreements, payment receipts, research solicitations, marketing campaign plans, financial reports and press clippings, as well as testimony by otolaryngologists in court proceedings and before congressional committees and the U.S. Federal Trade Commission (FTC). The material showed that as early as the 1930s, Philip Morris began a campaign to pay for research that supported its product.
For decades, the tobacco industry, in general, gave large sums of money to prominent researchers. Examples were cited of research that was not published when it showed a link between cigarettes and cancer. In the 1940s, several otolaryngologists, named in this article, received compensation to speak before the FTC in support of the tobacco industry.
In a 1962 lawsuit, otolaryngologists testified on behalf of the tobacco industry. Mid-century advertising by the tobacco industry featured otolaryngologists supporting cigarette smoking.
Otolaryngology journals received regular and substantial payments from the industry, and efforts were made to influence community otolaryngologists in private practice. On the other hand, the authors noted otolaryngologists who spoke about and/or published research on the link between smoking and cancer.
Bottom line: This article demonstrates another example of the impact of industry—tobacco at the time, but more recently, pharmaceutical—can have on the medical profession. The statements made by physicians identified in the article must be put in context of the lack of scientific evidence about the role of tobacco as a cause of head and neck cancer at that time. Additionally, the standards of declaring any relationship between researchers and industry were quite different at the time of this study.
The lesson of the tobacco industry marketing campaign to manipulate medical opinion is that physicians need to adhere to high standards and advocate patient interests.
Reference: Jackler RK, Samji HA. The price paid: manipulation of otolaryngologists by the tobacco industry to obfuscate the emerging truth that smoking causes cancer. Laryngoscope. 2012;122(1):75-87.