Smoke Screen: Anti-Nicotine Activism Benefits Big Tobacco, Pharmaceutical Companies - By Norman E. Kjono

In 1984, two of the most powerful lobbies in America, pharmaceuticals and tobacco, were confronted with a shared mercantile crisis: The market for their nicotine products was evaporating. Special-interest policy intervention that stabilized and expanded the consumer base for nicotine products thus began in 1984.

The stabilization of adult smoking and the expansion of youth smoking that occurred under tobacco-control programs are not a theory, they are a historical travesty; a travesty that says mercantile interests appear to have superseded honest public health.

On June 7, the Seattle Times reported, "Jury Hands Smoker Record $3 Billion; Philip Morris Promises To Fight 'Outrageous' Sum." A California jury rendered the verdict for plaintiff Richard Boeken on six counts of fraud, negligence and the making of a defective product.

The Times quoted Boeken's attorney: "Piuze [Boeken's attorney] said his client once was addicted to heroin and alcohol; he was unable to stop smoking." From that statement, one infers that nicotine is as addictive as heroin, or more so, a fact asserted by anti-tobacco activists for years. The addictiveness of nicotine and the behavior associated with that addiction - that consumers continue to smoke, despite health hazards of doing so - is, therefore, central to nicotine product liability.

Today the United States has completed 17 years of tobacco-control programs. Anti-smoking interventions began in 1984, through the National Cancer Institute's COMMIT program, and were expanded under its 1991 Project ASSIST. The stated purpose for those programs was to reduce tobacco use, presumably to eliminate the medical consequences of smoking, such as Boeken's lung cancer.

1984 marks the beginning of tobacco-control interventions through public policy. Given the importance of that year to anti-tobacco intervention, it is helpful to establish a baseline of youth and adult smoking rates at the time. The University of Michigan's "Monitoring the Future Study" and the Centers for Disease Control's "National Health Interview Surveys" provide reliable information about youth and adult smoking rates.

According to University of Michigan data, in 1984, 69.7 percent of our children tried cigarettes and 18.7 percent were daily smokers. Those statistics create a smoking persistence ratio of .2682, that is, 26.8 percent of youth who tried cigarettes continued and became daily smokers. Centers for Disease Control data say that in 1984, 32.1 percent of adults currently smoked and 21.8 percent were former smokers. 

To the preceding benchmarks one can add basic trend analysis to see where smoking rates were headed at the time tobacco-control intervention began. From the beginning of youth-smoking data in 1975 to 1984, children who tried cigarettes declined from 73.6 percent to 69.7 percent (minus 5.3 percent), youth daily smokers declined from 26.9 percent to 18.7 percent (minus 30.4 percent), and youth-smoking persistence decreased from .3654 to .2680 (minus 26.6 percent).

Adult smoking also showed marked improvement from the beginning of those statistics in 1965 to 1984. During that 19-year period, adult current smokers declined from 42.4 percent to 32.1 percent (minus 24.3 percent) and former smokers increased from 13.6 percent of adult populations to 21.8 percent (plus 60.3 percent). 
Whatever else those statistics may say, one fact is abundantly clear: Adults who smoked in the 1960s did not believe they were addicts because 60.3 percent more of them quit smoking.

As discussed in the white paper, "The Mangini Paper," published by the firm Milberg, Weiss, Bershad, Hynes & Lerach (see <http://www.milberg.com>www.milberg.com) about the California Joe Camel litigation, the preceding benchmarks and trends created a crisis for tobacco companies. Adult smoker franchises were aging, and precipitous declines in youth smoking indicated the market for nicotine products would not recover or be self-sustaining in the future.

The market for any product where current consumers decline by 24.3 percent and former consumers increase by 60.3 percent is not viable in the long term. Such a market cannot be salvaged when more youth consumers also refuse to use the product (where youth daily smokers decrease 30.4 percent, and youth smoking persistence decreases 26.6 percent).

Had 1965 to 1984 trends continued, tobacco use would be a small fraction of what it is today. And, judging by what anti-tobacco says about the deadly consequences of tobacco use, fewer adults would find themselves in Boeken's unfortunate circumstances if 1965 to 1984 trends had continued.

The above observations raise a compelling question: Why intervene in 1984? Historical data clearly say that the nicotine market was contracting at the time, and in the foreseeable future, the smoking problem would solve itself. Why would government, university researchers, activists and politicians launch what has become a now-multibillion-dollar jihad in 1984 to reduce tobacco use when adult current smoker populations had decreased 24.3 percent and youth daily smokers had declined 30.4 percent?

Another event that occurred in 1984 may explain why we have never seen such declines in smoking rates since that time. 1984 was also the year that nicotine gum was introduced. Because nicotine gum is a smoking-cessation product, its exclusive source consumer base is people who smoke. Dramatically declining youth and adult smoker populations at the time showed that the market for smoking-cessation products was contracting. It is also clear that such products were not required for millions of smokers to quit.

Why would pharmaceuticals invest millions in research and market development for unnecessary smoking-cessation products at a time when sales alarm bells were going off at tobacco companies due to fewer people smoking?
A plausible reason to invest in new product research and development is that one believes a presently contracting market will expand in the future. One way to turn around a market for nicotine products is to raise the threshold of difficulty for people to quit smoking. New consumer beliefs that they have a habit that they cannot quit, that they have a permanent addiction that requires medical therapy, would increase the difficulty in stopping smoking.

Were tobacco consumers to adopt new addiction beliefs, it would serve the interests of both tobacco and pharmaceutical nicotine because more people would continue to smoke and would believe that they had to use nicotine gum to quit. Addiction beliefs also encourage consumer price tolerance, which allows higher prices without materially decreasing demand for nicotine products.

The theme that nicotine is as addictive as heroin is created by anti-tobacco activists and policy-intervention specialists who were financed with more than $200 million in cash grants from pharmaceutical nicotine during the 1990s. Creating that new consumer belief began with the publication of Dr. C. Everett Koop's report in 1988, which declared nicotine to be addictive.

Although it failed to produce more new youth smokers nationwide, the Joe Camel campaign was also launched in 1988. In effect, Joe Camel said "Here kiddie, kiddie!" and Dr. Koop proclaimed "Gotcha, addict!" 

The theme that nicotine is as addictive as heroin has been a cornerstone of tobacco-control programs. During the COMMIT program, youth smoking persistence stabilized, and adult quit-smoking rates leveled off. During Project ASSIST, dramatic increases in youth daily smokers and youth smoking persistence occurred. And during Project ASSIST, adult current smokers stabilized, while adult former smoker populations began to decline. ASSIST "Action Plans" for intervention to begin in 1993 were written in 1992, the year that nicotine patches were introduced.

In 2001, we now observe a stabilized adult smoker nicotine-consumer base, and the market will expand in the future through increased youth smoking realized under Project ASSIST. Whether it occurred by default or design, today we experience what the doctor would prescribe to cure the ills of an anemic and consumptive nicotine market in 1984.

Today, tobacco and pharmaceutical nicotine interests share revenues from a stabilized and expanding nicotine consumer base through the November 1998 tobacco Master Settlement Agreement. And tobacco-control activists are now funded by tobacco companies through the settlement, in addition to grants and payments received from pharmaceutical nicotine.

Do the above observations absolve Philip Morris of the $3 billion verdict? I do not believe so. Juries do their duty as they see it based on the facts presented. It just seems to me that all partners who now enjoy the benefits of a stabilized and expanding nicotine consumer base should share equally in the liability that such an enterprise creates.

Who is more culpable: tobacco companies who sold a product with known health risks or pharmaceutical companies who used public-health influence to elevate a habit to an addiction and financed activists who presided over a 40-percent-plus increase in youth smoking during the 1990s?

A legal question should be explored: Does promoting new public beliefs that consumers are addicted to financial sponsors' products give rise to liability for medical consequences of using the products?

Good for the lawyers who fought Philip Morris for Richard Boeken. Now where are the lawyers who will fight pharmaceuticals and activists just as hard on behalf of our children? Perhaps it is time for trial lawyers to send an invoice for another $3 billion to the other half of the nicotine equation - pharmaceuticals.

Norman E. Kjono has served as an expert witness in securities fraud cases, on behalf of both plaintiffs and defendants, since 1979.

> BACK TO FORCES MAIN PAGE <