The Light Begins To Break Through II
By Norman E. Kjono, January 16, 2007
"The deeper we dig into anti-tobacco, the dirtier it gets. The more we look for plausible explanations, the more rationalizations to justify an agenda of intolerance we find. . . . There are so many good things that we could be doing to help us all grow together in spirit. Why do we waste such enormous energy and resources on the agenda of a few activists? Now that we are beginning to understand what is wrong with anti-tobacco, can we please get on with making things work for everyone? Is there anyone out there in the mainstream press willing to pick up this gauntlet?" (Underline added.)
Norman E. Kjono, Columnist Forces.org
February 20, 1998
February 8, 2007 the Wall Street Journal published an interesting and informative article, "Nicotine Fix Behind Antismoking Policy, Influence of Drug Industry." The Journal's article was written by its Pulitzer prize winning chief of the Chicago Bureau, Kevin Helliker. Mr. Helliker shares his Pulitzer for Explanatory Reporting with Thomas M. Burton, also with the Wall Street Journal. In his February 8, 2007 Mr. Helliker wrote:
"Michael Fiore is in charge of revising federal guidelines on how to get smokers to quit. He also runs an academic research center funded in part by drug companies that make quit smoking aids, and he personally has received tens of thousands of dollars in speaking and consulting fees from those companies. Conflict of interest? No, says Dr. Fiore, who has consistently declared that doctors ought to use stop-smoking medicine. He says his opinion - reflected in current federal guidelines - is based on scientific evidence from hundreds of studies. . . . At stake is one of the most important issues in the nation's public health-policy. Cigarettes kill an estimated 440,000 American each year. Helping America's 45 million smokers kick the addiction could save untold numbers of people. . . . Dr. Fiore and other members of the Society for Research on Nicotine and Tobacco refuse to accept any and funds from the tobacco industry, even unrestricted research grants. . . . Reflecting the view of many in the antitobacco camp, Harry Lando, a University of Minnesota nicotine researcher, says 'I view the pharmaceutical industry as our ally.' . . . Pressure may be growing for doctors to follow the federal guidelines. An article in the December issue of the journal Tobacco Control argued that failure to follow the guidelines could be deemed medical malpractice."
The full text of Mr. Hilliker's article is highly recommended reading. His report about financial conflicts of interest for tobacco control advocates is worthwhile reading and the focus on Dr. Michael Fiore is illuminating.
The Journal's report raises an important question, however. Why would Dr. Fiore or other anti-tobacco activists be interested in taking tobacco company money when anti-tobacco grants of at least $446 million have been distributed by the Robert Wood Johnson Foundation-among the top five institutional shareholders of NicoDerm CQ Manufacturer Johnson & Johnson-and NicoDerm CQ distributor GlaxoSmithKline is doling out millions more each year? But even that transparent logic begs the question. As discussed below, some nicotine researchers accept money directly from tobacco companies, too.
What is the moral imperative of those already awash in millions from pharmaceutical allies that compete with tobacco companies for nicotine market share refusing to take money from both sides of the agenda? Tobacco control researchers also receive funding from tobacco companies through the 1998 tobacco Master Settlement Agreement (MSA), which cost cigarette consumers 45 cents per pack to fund. In addition, many states use MSA revenues to fund anti-tobacco programs and advocates. The MSA becomes a moral laundry for some, converting tobacco company dollars into less odious deposits garnered from consumers through tobacco settlement coffers.
The strident refusal to accept tobacco company money is akin to claims that funding is accepted from Robin Hood but not the Sheriff of Nottingham. The facts about nicotine dollars reveal, however, that Robin Hood becomes the pharmaceutical sheriff in disguise, funding anti-tobacco troops to scour the countryside for peasants to tax and ban. That's some moral high ground, indeed.
I first wrote about Dr. Fiore and his connection to Nicotine Replacement Therapy (NRT) distributors such as GlaxoSmithKline in my March 16, 1998 commentary "Glaxo Wellcome and SmithKline Drug Marketing." GlaxoSmithKline was created by the merger of British pharmaceutical giant Glaxo Wellcome and American SmithKline Beecham in 2000. In that commentary I wrote:
"New York NY - The Wall Street Journal, February 27, 1998, an article by Suein L. Hwang, headlined 'Drug Makers See a Risky New Role for Nicotine:'
"The drug makers' new strategy [long term use of smoking cessation products] has some obvious advantages. `There will be less environmental smoke,' says Neal Benowitz, a nicotine expert at the University of California at San Francisco who was one of the scientific editors of the landmark surgeon general's report of 1988 that concluded that nicotine is addictive. `I'd much rather see people dependent on nicotine than on tobacco,' he adds."
An interesting shift in the anti-tobacco story. Drug companies are exploring FDA approval for long term use of "Smoke Free" nicotine delivery products. I set that on the back burner, to see how it developed. It didn't take long for the unseen hand to start writing on the wall. Today, I believe this is one of the most important pieces to the anti-tobacco puzzle. Less than two weeks later, I was following a story about a public hearing in Madison, Wisconsin. The hearing was as usual for smoking bans, with well-organized antis out in force to express their spontaneous outrage at smoking and tobacco companies. . . . Then a stray fact came across my desk. Dr. Michael Fiore from the University of Wisconsin Center for Tobacco Research and Intervention testified at the Madison hearing, in support of the smoking ban. There was an interesting twist, however: a professorship in Nicotine Dependency at the University of Wisconsin was funded by a grant from the drug company Glaxo Wellcome, according to a March 5, 1998 article in the Madison, Wisconsin Capital Times. The headline for the article by staff writer Gwen Carelton is 'Grants to UW Would Fund Asthma, Smoking, Leukemia Research.' Is Dr. Fiore's paycheck dependent on a drug company? There sits Dr. Fiore, extolling the virtues of a "Tobacco Free" and "Smoke Free," but not a "Nicotine Free," work environment in Wisconsin." (Underline added.)
Dr. Neal Benowitz is a former officer of the Society for Research on Nicotine and Tobacco (SRNT). Dr. C. Everett Koop-who, as surgeon general, released the 1988 report that declared nicotine to be as addictive as heroin or cocaine-was also a SRNT member in the 1990s, as were representatives of RJ Reynolds at the time. SRNT is noted for its remarkable 2001 study, co-authored by nicotine delivery device patent holder Dr. Jed Rose at Duke University, that stated smoking "De-Nicotineized" cigarettes such as Philip Morris' NEXT brand in conjunction with (while also using) nicotine replacement gum or patches may be a "fruitful" approach for smoking cessation. I interviewed Dr. Rose and wrote about that SRNT study published in commentaries published by Forces.org during the summer of 2001. The lead for those articles is:
"THE DUKE OF NICOTINE - June 14, 2001 - Professor Jed E. Rose of Duke University responds to Norman Kjono's commentaries "Will The Real Nicotine Addicts Please Stand Up?" (May 24, 2001) and "Nicotine Free Smoke" (May 26, 2001). Not only does Prof. Rose have a vested interest in nicotine patch royalties, but he also accepts research money from tobacco companies as well. And, according to Duke's Web site, Prof. Rose's colleague, Dr. Eric C. Westman, has now developed a nicotine solution that can be added to soft drinks. Why is it not a surprise that Duke University concludes in its recent study, "Individual Differences In Smoking Reward From De-Nicotinized Cigarettes," that people could smoke to quit smoking, while using nicotine patches or gums?
Shortly after "The Duke of Nicotine" was posted to Forces.org my Op-Ed SMOKE SCREEN: ANTI-NICOTINE ACTIVISM BENEFITS BIG TOBACCO, PHARMACEUTICAL COMPANIES was published by the Los Angeles Daily Journal (www.dailyjournal.com) July 27, 2001. I also wrote about medical malpractice lawsuits and smoking cessation guidelines in That's Ridiculous! published by Forces.org November 30, 2006.
I believe that Mr. Helliker's article adds much to the debate about tobacco control. His fine work adds more confirmation of facts about tobacco control advocacy reported by Forces.org nine years ago, shortly after Ms. Hwang's February 1998 article was published by the Wall Street Journal.
As is evident from comparing Mr. Helliker's February 8, 2007 article and my March 16, 1998 commentary, Dr. Fiore's financial interests in tobacco control advocacy date back at least nine years. Indeed, his paycheck as Chair of Nicotine Dependency at University of Wisconsin appears to be dependent on pharmaceutical grants. Why was that aspect of the story not reported by Ms. Hwang in her February 1998 article "Drug Makers See a Risky New Role for Nicotine"? Tobacco control advocate conflicts of interest were certainly on point with the subject of that 1998 article, its focus was about distribution of smoking cessation products and the strategy for long-term use of those products by consumers. In addition, Ms. Hwang quoted a person associated with the Society for Research on Nicotine and Tobacco, Dr. Henningfield; Mr. Helliker reports about SRNT member Dr. Fiore and quotes Harry Lando with the University of Minnesota in that context. The same elements of the story reported by Mr. Helliker in 2007 were in place when Ms. Hwang's article was published in 1998. Both the Wall Street Journal and Forces reported about tobacco control advocates in early 1998. Forces March 1998 report included disclosure of tobacco control conflicts, the Wall Street Journal's February 1998 report did not.
The only material difference between 1998 and 2007 is the ever-expanding magnitude of economic, political, ethical, and cultural devastation imposed in the interim by tobacco control on consumers, taxpayers, small business owners, and states. Would that devastation have occurred, had the Wall Street Journal reported in 1998 what it now reports in 2007? As this is written, tobacco control advocates' clarion calls for job discrimination, discriminatory taxes on legal tobacco products, imposing increased premiums for health insurance, discriminatory housing, intrusion into parental rights and custody, and ostracization through bans ring through the halls of Congress, state legislatures, and county offices. Adding to the devastation is the call for malpractice law suits against doctors who may not impose the prescribed pharmaceutical nicotine agenda on patients and prohibitions that eliminate small business owners' ability to serve the lawful clientele they choose. Meanwhile, $84 million Robert Wood Johnson Foundation grantee, the Campaign for Tobacco-Free Kids, crows about a "WIN, WIN, WIN" in its January 9, 2007 publication, "Higher Cigarette Taxes," as average state "Target Group" taxes on cigarettes reach a benchmark $1 per pack, up from 43.4 cents per pack in 2002.
What is the economic impact of at least $9 billion per year in new cigarette taxes-more than tobacco company payments under the 1998 MSA-on 46.5 million cigarette consumers in a scant five years? What are the ethical implications of the fact that those who aggressively target selected consumer groups for higher costs and discriminatory taxes on tobacco also aggressively peddle pharmaceutical nicotine delivery devices that compete for market share with tobacco products? What moral issues are raised by those who engage in such advocacy sitting comfortably in department chairs and taxpayer financed offices-their salaries, health care, and pensions financed by special-interest grants and tax sharing revenue-while they push for new rules that would exclude their "Targets" of choice from employment, housing, medical care, social discourse and parental rights? What legal questions are raised by special-interest advocates being paid to systematically exclude from gainful employment and housing those who choose "inappropriate" nicotine delivery devices that do not produce new revenues for their political and economic sponsors? What public policy considerations rise from the facts that tobacco control has not accomplished the results it touted during the 1990s, its programs cannot produce the widely-promoted results without eliminating the market for its financial sponsors' products, and its agenda is often advanced by promoting the worst of negative labels and unfavorable stereotypes about one's fellow citizens? What do we the people accept about those issues when we consider that tobacco control advocates often present the lowest of Junk Science as pretense for public policy that predictably lines Tobacco Control Enterprise participant's pockets with new sales and tax revenues?
The economic, moral, ethical, legal and public policy questions raised by tobacco control advocacy could fill volumes. The foregoing, however, are sufficient to present a simple concept with stunning clarity: neither program performance nor observable negative impacts justify continued operations of the Tobacco Control Enterprise. Which raises the core issue toward which this commentary is focused: Is Mr. Helliker's interesting and informative February 8, 2007 article published by the Wall Street Journal the beginning of credible and meaningful mainstream media reporting about tobacco control? Time will tell, of course. One profoundly hopes that that such is the case. We need only read next week's daily newspapers and watch the evening news a month from now to determine if that is true. Such is the case because it is also evident that consumers, employees and constituents do get it about tobacco control, as evidenced by the contrasting reports published by Forces.org and the Wall Street Journal cited above. The alternative-that operation of the Tobacco Control Enterprise continues to be regarded as legitimate and proper public policy by mainstream media-is at once frightening and unthinkable. Since when were American citizen rights to employment and housing, not to mention medical care and one's ability to manage a medical practice or hospitality business, contingent on approval by a special-interest political agenda dedicated to mandating public policy to suit pharmaceutical mercantile interests?
Considering the above, I prefer to think of Mr. Helliker's article as a mainstream media breakthrough work that discloses important conflict of interest issues about tobacco control advocacy. Whether that view is confirmed as to The Journal or mainstream media in the future matters naught at this moment. We tend to live the consequences of our beliefs and expectations. It therefore seems appropriate to establish the highest expectations about reporting on special-interest advocacy if we are to salvage remaining value from this most unfortunate and damaging phenomenon. Should those higher expectations be proved false, it is certain that we will have much greater problems to deal with as a people than wetting our collective pants over the possibility that there may be a smoker behind every tree or wisps of secondhand smoke wafting from beneath every bed in this great land.
Accordingly, I believe that current events and disclosures concerning tobacco control advocacy create an unprecedented opportunity. Why not combine the in-depth research capabilities of Web journalists who have covered the tobacco control beat for years with the investigative reporting prowess of major newspapers and networks? It seems to me that together we could quickly get to the bottom of tobacco control and produce credible investigative reporting information with which the public can make up its own mind about that agenda. Isn't that what democratic public discourse and credible journalism is all about, in the first place?
That decision about collaborative and cooperative reporting on important public health issues is influenced by several factors, not the least of which is the fact that it's a competitive world. Concerning competition, I bring to mainstream media's attention an excerpt from Time Magazine's Person of the Year award for 2006:
"But look at 2006 through a different lens and you'll see another story, one that isn't about conflict or great men. It's a story about community and collaboration on a scale never seen before. . . . It's about the many wresting power from the few and helping one another for nothing and how that will not only change the world, but also change the way the world changes. The tool that makes this possible is the World Wide Web." (Underline, italic added.)
It is important to contrast Time Magazine's views with that of the George H. W. Bush administration about mainstream media as published when tobacco control began its public policy interventions in the early 1990s. From page 22 of "Planning for a Tobacco Free Washington:"
"Social change requires that people receive persistent and consistent messages from sources they trust. To this end ASSIST resources will be use to generate a variety of media messages that will foster and strengthen public support for proposed policy changes."
So there we have it, two clear and contrasting definitions of end results to which media is applied. The above-referenced booklet was published under federal contract in April 1993 as a guide to implementing the George H.W. Bush administration's 1991 to 1998 $135 million American Stop Smoking Intervention Study (Project ASSIST). The nationwide manager for ASSIST, announced October 4, 1991, was the American Cancer Society.
Media, according to Bushites and the American Cancer Society, is to be used to generate "persistent and consistent messages" crafted to "foster and strengthen support public support" for proposed policy/regime change. Such neocon uses of media are how we get television images that portray "Shock and Awe," based on a drumbeat of false and willfully misleading information about Weapons of Mass Destruction. Why should we be at all surprised that the Son of Anti-tobacco applies the same tools of negative labeling, unfavorable stereotypes and distortion of facts to achieve his policy objectives, when such processes were apparently learned on daddy's knee decades ago when tobacco control's precursor to Project ASSIST, test intervention COMMIT, was launched?
Fundamental to that choice for credible, collaborative reporting is a choice by journalists about the purposes of media: is mainstream media merely a non-thinking, catatonic conduit for the current agenda that keeps special-interest advertising revenues flowing, or does it's purpose extend to challenging agendas that are transparent as to their mercantile motivations and conflicts of interest? Does mainstream media still have a place reporting about community and collaboration, or has it reduced itself merely crafting sound bites read from teleprompters by talking heads who have no clue as to the relevance and import of "the news" they broadcast?
We leave addressing the preceding questions to talking heads. As Time Magazine astutely points out, other folks are working together through the Web to not only constructively change our world for the better but to also change the way our world changes. When employing today's communications technology those engaged in earnest endeavor to report about special-interest agendas require neither the permission nor the resources of mainstream media. Web columnist often reach audiences equal to or greater than those of major daily newspapers. Regardless of the number of hits on a Web site during a given day, one thing is certain: it will be read by someone; facts and information will be communicated. Consequently, the minds of normal, everyday folks will increasingly change from that defined by sound bites on the evening news to views expressed by those who take the time to dig out the facts and share them with others. Accordingly, whether mainstream media chooses to lift itself from self-imposed dark ages of sending persistent and consistent messages to support political agendas is of little consequence in the greater scheme of things. The choice is not whether credible, honest reporting to the best of one's ability will occur because a vast number of people are already doing that every day through the Internet. The choice for mainstream media is whether it will change its approach to what is included in the news and how it is reported, thereby surviving in this new and highly competitive information age.
Whatever the outcome, it is certain that those who have covered the beat for years about a host of important subjects will not only continue to do so but their numbers will expand. We'll continue at our desks, patiently digging out the facts and reporting them as we see it. What's more, increasing numbers of readers begin to view "the news" as a mere checklist of issues to explore for credible information through their preferred Web site sources. It is in such a competitive environment that mainstream media now confronts its choice.
We should be pleased that newspapers with the stature of the Wall Street Journal and credible, highly-skilled reporters such as Mr. Helliker are beginning to publish important articles about tobacco control advocates' conflicts of interest. That is an encouraging and welcome turn of events. One hopes that large circulation dailies will continue in their footsteps, to report about this important subject with increasing depth. Kudos to The Journal and Mr. Helliker for their fine effort. Now where's the first media network that's willing to follow that lead?
I close with a brief excerpt from "Glaxo Wellcome and SmithKline Drug Marketing," published by Forces.org March 16, 1998:
"Public health policy must be something more than a useful tool employed by influential drug companies to develop market share for their products, chemicals from which they profit. . . . Enough. It's time to start aggressively addressing the drug companies' latest market expansion ploy, using anti-tobacco as a front for "Smoke Free" nicotine dependency. I am not employed by any tobacco interest, nor is my work supported by tobacco companies. Needless to say, I also am not an employee of any drug company, nor am I supported by any anti-tobacco federal grant or revenue. Those who have an interest in my personal background, and my four years of effort opposing anti-tobacco, should access and review "Let's Really Save The Kids", at www.forces.org." (Underline added.)
Note: "Let's Really Save the Kids" was later published by Lucent Books/Greenhaven Press in its 2000 anthology "Teen Smoking" under the title "A Better Way to Talk to Teens About Smoking."
Norman E. Kjono