Philippe Boucher's Rendez Vous with . . . with Alan Blum (part 2)
Rendez-vous with NAME
By Philippe Boucher
Rendez-vous with Alan Blum (part 2)
DO YOU THINK THAT PERHAPS IF YOU HAD BEEN LESS CRITICAL OF OTHER HEALTH GROUPS OVER THE YEARS, THEN DOC WOULD HAVE RISEN TO THE FOREFRONT OF THE ANTI-SMOKING MOVEMENT?
That may be true, and it certainly would have been a lot safer to pretend that the health community is one big happy family. But when you consider that, at least in the US, virtually every major health group and government agency from the American Cancer Society (ACS) and the AMA in the private sector to the National Cancer Institute (NCI) and the Food and Drug Administration (FDA) in the public sector has had to be shamed into taking a stronger position against tobacco use and promotion, then I don't regret a thing. I took my inspiration from labor organizer Saul Alinsky, self-taught media guru Tony Schwartz, and Mad Magazine. The fact is, we don't need more epidemiologists, nicotine addictionologists, smoking cessation specialists, and professional grant writers. We do need more creative, unconventional, innovative people-artists, comedians, historians, film-makers’Ķand trouble-makers.
In Miami in 1978, the ACS and the American Heart Association gave virtually no financial or other support to the nation's first county-wide referendum on a clean indoor air measure, which lost by only a few hundred votes out of more than 200,000. GASP had to go it alone and still almost beat Goliath.
It was not until 1983 that the ACS even began to address the subject of cigarette advertising and not until 1985 that the AMA proposed a cigarette advertising ban. Until the 1980s, the major effort by the NCI on smoking was to find a safer cigarette! In the early 1990s the head of the NCI called us to ask if he would be sued by RJ Reynolds if he were to publish a picture of Joe Camel in an NCI report. He thought it was an act of courage to mention a brand name! The FDA had flunked every test on tackling tobacco and was about to be castigated in an ABC-TV news report for having done nothing when Dr. Kessler, who had been commissioner for several years, suddenly announced he would be looking more closely into nicotine.
In the mid-1990s, the release of tobacco industry documents, many of which were actually available a decade or more earler in the Cippolone trial and other litigation, seems to have provided the perfect excuse for health groups to explain away their minimal activity against tobacco for more than 40 years. For people in some major health organizations to suggest that for decades their leadership had been duped by the industry, unaware of the addictiveness of nicotine, or ignorant of the attempts to attract a youthful market is contemptible. The question I think should be asked is why are the organizations that not too long ago were content to sit on the sidelines and look down their noses at the activists literally marching in the streets against the tobacco industry now talking so tough about "Big Tobacco"? And how is it that these folks got control of the pursestrings?
I'm afraid the grand tobacco settlement (which has taught me that lawyers go for settlements, seldom for victories) has in some ways spoiled and corrupted us. Almost all the news we read is about chasing the settlement dollars.
It's no longer about people who have died from tobacco-related diseases or the taxpayers who helped pay the bills. It's not even about fighting tobacco.
Rather, it's about fighting over the money to fight tobacco, like the same old Beltway Bandit institutes who keep hauling down the grants to write policy papers that are carbon copies of what the activists were calling for 20 years ago. And while some revile Philip Morris for its youth anti-smoking campaign, I fail to see anything much more creative on our side of the fence.
I think the paid counter-advertisements that DOC did 20 and 10 years ago on a shoe-string budget, with true brand-name ridicule (including Barfboro, Fartboro, Emphysema Slims, and "Dakota, Dacough, Dacancer, Dacoffin" and our radio ads with Tony Schwartz) are still far better than most of the slick "award-winning" multi-million dollar ad agency stuff today. However self-serving that sounds, I'll still match our ads any day with any others on cost-effectiveness and popularity among the target audience.
For too long, government and voluntary health agency tobacco control functionaries have measured progress in terms of the establishment of coalitions and the publication of policy papers to promulgate such unrealistic goals as the reduction of smoking by "50% by the year 2000" or the creation of a "smoke-free generation" by that time. And there has been an unfortunate presumption in some circles that successful action in reducing tobacco use cannot occur without enormous amounts of money. I disagree.
Accountability for how funds are spent would be the obvious way to judge the biggest bang for the buck. Ironically, although the jobs of tobacco industry personnel depend on increased sales, I have yet to meet anyone in tobacco control whose job depends on there being a decline in tobacco consumption.
YOU'RE NOT REALLY SUGGESTING THAT THE TOBACCO SETTLEMENT OR TOBACCO LITIGATION IN GENERAL IS A BAD THING?
Tobacco litigation is a bad thing only when the truth has been distorted or when used for personal financial gain. Unfortunately, as evil as the tobacco industry was and is, some people on our side have simply climbed on the litgation bandwagon. Although I haven't been invited back to speak at a Tobacco Product Liability Project (TPLP) meeting in several years (after having spoken at the first nine) after I challenged the commitment of one of the newly arrived Rolls-Royce-driving plaintiffs attorneys to put HIS money where his mouth was by supporting the anti-smoking activists in exchange for the support he was seeking to oppose tort reform legislation, I credit Professor Dick Daynard with convincing people on the need for tobacco litigation. In this vein, I would say that among the handful of people who really changed the world of tobacco litigation the key individuals are attorney Marc Edell, who won the initial round of the Cippolone case against the tobacco industry, and attorneys Stanley and Susan Rosenblatt, who took on the seemingly impossible odds of bringing a class action suit against the industry in Florida. These lawyers were willing to search out the truth and tell the whole story, including naming the collaborators in the media, politics, and the health community that helped the industry get away with their deceptive practices for so long.
The downside of the litigation, in my opinion, are cases brought by the Blue Cross health insurors or the US Justice Department. Blue Cross did nothing whatsoever to discourage smoking for decades in spite of knowing about its terrible health and economic costs. And the US government was, by virtue of its tobacco support programs and weak educational efforts, a veritable accomplice of the tobacco industry. Somehow the victims are no longer the people who have become sick from tobacco products, but rather governments and private agencies that are basing claims on economics---essentially asking for reimbursement for their own mistakes in not accounting properly for the enormous health and economic toll taken by tobacco, which has been well known for the past half-century. (In refusing to endorse the concept of warning lables on cigarette packages in 1964, the AMA testified in Congress that the public had been well-informed for at least a decade on the hazards of smoking!)
WHAT DO YOU SEE AS THE BIGGEST STRENGTH AND THE BIGGEST WEAKNESS OF TOBACCO CONTROL?
Our strength is that working to reduce demand for tobacco products is based on arguably the most extensive body of scientific evidence of any health problem of the twentieth century. For that matter, we really didn't need the tobacco industry's documents to tell us what for the most part we already knew. Another strength is the integrity, decency, and longterm commitment of so many individuals working on this problem.
Our weakness has been too often confusing our own press clips with progress.
There is a definite danger, especially among those who have little knowledge of or interest in the history of the anti-smoking movement, of a herd mentality regarding tobacco control policy, such as the assumption that nicotine regulation by the FDA or any law regulating tobacco use, purchase, promotion, or price, is, per se, a good thing. Nor am I comfortable with the trend toward creating a kind of smoke police to enforce the many laws. We sometimes can't decide whether to demonize the tobacco industry or the person who smokes. Is everyone who uses any form of tobacco in any form truly a hopeless, helpless addict? Can we admit that anyone could possibly enjoy tobacco? We are oblivious to the backlash that comes with prohibition. We have not forged strong alliances with health advocates in other issues, such as those working to curb alcohol use and promotion.
My research colleague for the past decade, Eric Solberg, and I presented a paper at the World Conference in Paris in 1994 entitled, "Revisionism, Magical Thinking, and Hokey-Pokey Objectives in the Anti-Smoking Movement,"
which was probably the first critique of tobacco control from within. We called for 1. a setting of priorities (as opposed to the politically correct practice of equating in importance every single aspect of tobacco control
[eg, occasional cigar smoking, candy cigarettes, clove cigarettes, and the notion that some cigarette ads are worse than others]), 2. for a division of responsibilities to avoid the inordinate duplication of activity and squandering of resources, and, above all, 3. for accountability to gauge the success or failure of our efforts. Eric and I knew we would ruffle some feathers within the establishment health agencies, and were not surprised by the hostility from a handful of bureaucrats, perennial grant-recipients, and other insiders. But we were gratified by the positive comments we received from many individuals in developing nations who felt that what activist groups like DOC had set in motion and accomplished on a shoestring budget is a more realistic model than a set of lofty policy goals handed down by a global health agency or an industrialized country.
Another problem we have to acknowledge is our penchant for trying to fit our findings to our predetermined biases. As one who has tracked tobacco advertising daily for more than 20 years with the initial hope of getting rid of it entirely, I've come to the conclusion that a goal of a total advertising ban is an illusion. The creativity of the industry and the expanding global electronic media means it is likely we will continue to chase our own tail as we keep spending enormous time and effort on incremental advertising restrictions. Ubiquitous counter-advertising is a far better use of resources than paying people to count the number of Marlboro signs on storefronts. And having been sued (unsuccessfully) by Philip Morris for spoofing one of its ad campaigns, I've come to appreciate all the more the protection the First Amendment of the US Constitution offers those of us who choose to buy ads to make fun of drug pushers. Believe me, the tobacco industry hates counter-advertising far more than it hates laws that purport to ban ads or regulate nicotine.
WHAT ARE YOUR PLANS FOR ALL OF THE ADVERTISEMENTS, BOOKS, DOCUMENTS, AND OTHER MATERIALS YOU HAVE COLLECTED? ARE THESE BEING INCORPORATED IN THE UNIVERSITY OF ALABAMA CENTER FOR THE STUDY OF TOBACCO AND SOCIETY?
Although several universities over the years have asked to host the collection, the University of Alabama was the first to offer a no-strings opportunity to establish a center to explore the tobacco issue from all vantage points. In other words, this is a sociocultural resource that will document and analyze the evolving worldwide story of tobacco not only from the health advocacy viewpoint but also from the historical, agricultural, anthropological, archeological, and economic perspectives, among others. I call it scholarly activism. The Center will become, in effect, the first true international tobacco museum. It's a nice fit for a university that already operates several museums and is one of the few to offer courses in museum studies. Incidentally, Dr. Luther Terry, who as Surgeon General in 1964 published the original report on smoking and health, was from Alabama, as was Congressman Claude Pepper, who along with Senator Dick Durbin was the mastermind behind the ban on smoking on airlines.
We have a space for exhibitions, such as "When More Doctors Smoked Camels: A Century of Health Claims in Tobacco Advertising," which I originally created for the first US conference on tobacco in Houston in 1988 and which has been displayed in various medical schools in the US. Another major exhibition will be a history of tobacco in the 20th century as seen through the eyes of political cartoonists. With the assistance of the Departments of Computer Science and the School of Library and Information Studies, we'll be developing a website to provide access to our more than 30,000 slides of tobacco advertising and promotion. We are cataloguing hundreds of antiquarian tobacco books and hundreds of thousands of advertisements, original newsprint reports, and tobacco industry publications. Many of these have been contributed by colleagues from around the world. Among our special collections are Dr. Koop's original memoranda and notebooks on tobacco when he was Surgeon General. He has been our leading supporter for the concept of a museum and center on tobacco and society.
We have thousands of videotapes and audiotapes, as well as an ongoing oral history project. And we plan to publish periodic monographs on tobacco history, as well as to invite guest speakers and sponsor debates. Numerous colleagues from around the world will be contributing in a variety of other ways. Lastly, we are looking to hire at least one full time creative scholarly activist, probably from outside the field of public health, and we welcome the inquiries of others who might wish to collaborate on research projects utilizing our material.
So, after being a full-time tobacco activist and reading at least six newspapers a day for the past 25 years-performing in essence a daily biopsy on tobacco and studying Philip Morris like a parasitic disease, I hope to provide a fuller context through The University of Alabama Center for the Study of Tobacco and Society for the proper consideration of scientific research on the one hand and tobacco industry documents on the other.
Perhaps we can turn this century's greatest public health failure into a triumph in the next one.
THANK YOU, ALAN. AND "BONNE CHANCE" WITH THE CENTER.
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to all of the globalink members our best wishes for a happy new year!
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P.S: THE UNIVERSITY OF ALABAMA CENTER FOR THE STUDY OF TOBACCO AND SOCIETY, 26 PINEHURST DRIVE, TUSCALOOSA, ALABAMA 35401.
TEL: 205-348-1372.
EMAIL: ablum@cchs.ua.edu
Prepared by Philippe Boucher mailto:IslandErsk@aol.com
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