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Tobacco industry dying? Not so fast, says Stanford expert

Smoking is not going away. Worldwide, says Stanford historian Robert Proctor, the tobacco industry continues to create toxic products that cause not just lung cancer but also cataracts, ankle fractures, early onset menopause, spontaneous abortion and erectile dysfunction, among other maladies.

Steve Fyffe and L.A. Cicero

'The industry has spent tens of billions designing cigarettes since the 1940s – that's from the industry's own documents,' Robert Proctor said.

BY CYNTHIA HAVEN

The cigarette industry is not dying. It continues to reap unimaginable profits. It's still winning lawsuits. And cigarettes still kill millions every year.

So says Stanford's Robert Proctor, author of the new bombshell study, Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition, a book the tobacco industry tried to stop with subpoenas and hundreds of thousands of dollars in legal fees.

Proctor, the first historian to testify in court against the tobacco industry (in 1998), warns that the worst of the health catastrophe is still ahead of us: Thanks to the long-term effects of cigarettes, "If everyone stopped smoking today, there would still be millions of deaths a year for decades to come."

"Low-tar" cigarettes? "Light" cigarettes? Better filters? Forget it, he said. They don't work. Today's cigarettes are deadlier even than those made 60 years ago, gram for gram.

Half the people who smoke will die from their habit. A surprising number will die from stroke and heart attacks, not cancer.

Moreover, he asks, "How many people know that tobacco is a major cause of blindness, baldness and bladder cancer, not to mention cataracts, ankle fractures, early onset menopause, ectopic pregnancy, spontaneous abortion and erectile dysfunction?"

Six trillion cigarettes are smoked every year – that's 6,000,000,000,000. Proctor said that's "enough to make a continuous chain from Earth to the sun and back, with enough left over for a couple of round trips to Mars."

L.A. Cicero Robert Proctor with collection of cigarette ads and packages

'There's hundreds of things people don't know about smoking,' Robert Proctor said.

His 750-page book, a decade in the making, has already earned high praise, with terms like "a real page-turner," "a must-read," "the most important book on smoking in 50 years."

"This book is a remarkable compendium of evil," wrote Columbia's David Rosner, an author of Deceit and Denial: The Deadly Politics of Industrial Pollution. "It will keep you spinning from page one through the last. … It is the type of book that makes you wonder how, in God's name, this could have happened."

According to Donald Kennedy, Stanford president emeritus and former editor of the journal Science, the book "unpacks the sad history of an industrial fraud. [Proctor's] tightly reasoned exploration touches on all topics on which the tobacco makers lied repeatedly to Congress and the public."

The hefty book has not only won him accolades, but it's personally cost Proctor $50,000 in legal fees to defend himself against the industry, which subpoenaed his email and unpublished manuscript.

According to an article in The Nation last year, Proctor is one of only two historians who currently testify on behalf of smokers injured by tobacco products; 50 have testified on behalf of the industry. Academics from virtually every discipline have been collaborating with the Marlboro Men – and made big money doing so.

"This is the biggest breach of academic integrity since the Nazis," he said, and "certainly the most deadly."

Such language is typical for Proctor. When it comes to cigarettes, he speaks in provocative superlatives, pulling no punches.

Cigarettes are "the deadliest artifact in the history of civilization" – more than bullets, more than atom bombs, more than traffic accidents or wars or heroin addiction combined. They are also among "the most carefully and most craftily devised small objects on the planet."

"The industry has spent tens of billions designing cigarettes since the 1940s – that's from the industry's own documents," he said.

Old ad of two famous women promoting a brand of cigarette

He also marshals evidence to show that smoking contributes substantially to environmental damage, even global warming: "When we finally decide to take seriously the problem of global climate change, cigarettes will come under increasing scrutiny. Tobacco agriculture and cigarette manufacturing have heavy carbon footprints – think deforestation and petrochemical pesticides – and cigarettes are leading causes of fires and industrial accidents. There's not much room for cigarettes in an environmentally conscious world."

For the industry, though, the cigarette represents the perfect business model. "It costs a penny to make. Sell it for a dollar. It's addictive," says investment guru Warren Buffett. Proctor notes that "by artfully crafting its physical character and chemistry, industry scientists have managed to create an optimally addictive drug delivery device, one that virtually sells itself."

"There's hundreds of things people don't know about smoking," said Proctor. Myths have instead lulled the public into complacency. He listed a few of the most common:

Myth #1. Nobody smokes anymore. If you read the media, smoking sounds like a dying habit in California. That's far from true, said Proctor. Californians still smoke about 28 billion cigarettes per year, a per capita rate only slightly below the global average.

So why do we have this illusion? "We don't count the people who don't count. It's not the educated or the rich who smoke anymore, it's the poor," said Proctor.

Also, look at popular social trends – the recent trendiness of cigars, for example. Or the current fad for hookah parties. He recalled one such event at Stanford: "They would never have a Marlboro party. But hookah is just as addictive, and just as deadly."

Myth #2. The tobacco industry has turned over a new leaf. "The fact is that the industry has never admitted they've lied to the public or marketed to children or manipulated the potency of their project to create and sustain addiction," Proctor said. "A U.S. Federal Court in 2006 found the American companies in violation of RICO racketeering laws, and nothing has changed since then. And the same techniques used in the past in the U.S. are now being pushed onto vulnerable populations abroad."

Myth #3. Everyone knows that smoking is bad for you. Proctor pointed out that most people begin smoking at the age of 12 or 13, or even younger in some parts of the world. "Do they know everything?" Proctor asked rhetorically. "And how many people know that cigarettes contain radioactive isotopes, or cyanide, or free-basing agents like ammonia, added to juice up the potency of nicotine?"

Old cigarette ad with a dentist promoting a brand of cigarette

Myth #4. Smokers like smoking, and so should be free to do it. And the industry has a right to manufacture cigarettes, even if defective. Proctor called this "the libertarian argument."

"It is wrong to think about tobacco as a struggle between liberty and longevity; that tips the scales in favor of the industry. People will always choose liberty, as in 'Give me liberty or give me death.' What people don't realize is that most smokers dislike the fact they smoke, and wish they could quit. Cigarettes are actually destroyers of freedom."

There are tobacco industry documents, he noted, in which smoking is compared not to drinking but rather to being an alcoholic. Proctor also points to how we handle other forms of toxic pollution: "We don't allow kids to play with toys coated with lead paint. We don't drive cars that don't meet safety standards."

The upshot: "People should be free to smoke wherever it harms no one else, but cigarettes as now designed are too dangerous to be produced or sold."

Myth #5. The tobacco industry is here to stay. Global tobacco use would be declining were it not for China, where 40 percent of the world's cigarettes are made and smoked. Proctor has a bet with a colleague, though, that China will be among the first to bar the sale of cigarettes, once their financial costs are recognized. Governments throughout the world have benefited from tobacco taxes, which he calls "the second addiction." The costs of paying for diseases caused by smoking are high, however – especially when you count lost productivity – and governments will start winding down on tobacco, he says, once this is taken seriously.

Proctor also said that in the United States, a "Kafkaesque world" divides smokers and non-smokers. The industry has computerized databases of virtually all smokers and spends over $400 per smoker per year on special offers, coupons, sign-ups and other direct mail approaches – an unseen world to non-smokers. "This is precisely how the industry wants it; a fungus always grows best in the dark," he writes.

Proctor admits to a personal motivation for his research. Three of his grandparents died from smoking – one from emphysema, another from lung cancer and a third from a heart attack in his mid-50s. The family blamed the last death on eating too many eggs. "That's the story," said Proctor, "but he smoked nonstop."

For Proctor, then, his engagement with Big Tobacco is more than just research: "It's part of my sense of what it means to be an ethical human being, using my expertise to do what's right for humanity on the planet."

Media Contact

Robert Proctor, History: (650) 269-4495, (650) 323-6346, rproctor@stanford.edu

Dan Stober, Stanford News Service: (650) 721-6965, dstober@stanford.edu