Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 8, Number 1, 2003

Editor’s note: The release of internal tobacco industry documents as part of antitobacco litigation in the United States in the 1990s provided a treasure trove of evidence of the industry’s attempts to confuse and deceive consumers and undermine public health efforts in the United States and abroad. To find out what these documents show about tobacco industry activities in Latin America and the Caribbean, the Pan American Health Organization (PAHO) in 2001 commissioned a research project focusing on the two market leaders in the region, British American Tobacco (BAT) and Philip Morris International (PMI). The result, drawn from more than 10,000 pages of documents, is Profits Over People: Tobacco Industry Activities to Market Cigarettes and Undermine Public Health in Latin America and the Caribbean (PAHO, 2002), by Stella Aguinaga Bialous and Stan Shatenstein. The full text of the report is accessible online at www.paho.org. Printed copies can be requested by e-mail fromHeather Selin at selinhea@paho.org.

It was 1990, and the two leading multinational tobacco companies in Latin America and the Caribbean were concerned that antitobacco sentiment was spreading from North America and Europe to their fast-growing markets south of the U.S. border.

Sharon Boyse, then a public affairs specialist with British American Tobacco (BAT), described the situation in a memo to officials of her company’s affiliates in Argentina, Brazil, Chile and Venezuela: "The main issue facing the industry in South America, now and in the future, is ETS [environmental tobacco smoke]/public smoking restrictions/social unacceptability of smoking ... The influence of anti-smoking stories in international media (particularly those emanating from the U.S./England) and of WHO [World Health Organization]/PAHO [Pan American Health Organization] must not be underestimated in this context."

Boyse’s concerns were echoed in a presentation that same year by Marc Goldberg, Latin America manager for Philip Morris International.

"Legislation efforts have been intensified by governments to restrict smoking in public places and further limit advertising," he said, according to the transcript. "We have been able to challenge successfully anti-smoking proposals in Costa Rica, Guatemala, and Paraguay, but it is clear that the tendency to restrict smoking in public places will continue to prompt legislation throughout the region."

Goldberg’s notes make it clear that the industry would not just watch these growing threats to some of its most lucrative developing markets. Instead, it would enlist the help of one of the region’s most prestigious medical organizations to counter them.

"Under the guidance of Shook, Hardy and Bacon [a U.S. law firm] and under the sponsorship of the Interamerican College of Physicians and Surgeons, a survey is being conducted to determine the health priorities of the region according to the deans of medical schools," Goldberg reported.

"We expect the results of the survey will demonstrate that the concern with smoking in Latin America as a public health hazard is the result of outside pressure and not a primary item of concern among the medical community. If the study confirms our suspicion, we expect the Interamerican College of Physicians and Surgeons to amply publicize these findings."

He added: "We are continually developing lobbying strategies and coalitions with those who share an economic interest with us, and plan to stay one step ahead of our adversaries."

According to insider documents released by the tobacco industry since 1998 and reviewed at the request of PAHO,

this wasn’t the first or the last time that the industry would enlist the help of respected medical and scientific professionals to undermine tobacco control efforts in Latin America and the Caribbean. In one such effort, tobacco companies recruited the dean of the Graduate Program in Health Sciences of the Catholic University of Argentina, a friend of then Argentine President Carlos Menem, to lobby against legislation that would ban advertising and restrict smoking in public or enclosed areas.

In addition, according to insider documents, tobacco companies:

• Secretly hired medical and scientific researchers throughout the region to misrepresent the science linking secondhand smoke to disease in nonsmokers;
• Courted the media with expenses-paid junkets and cosponsored proindustry conferences with journalists’ associations;
• Designed "youth smoking prevention" campaigns primarily as public relations tools while simultaneously targeting young smokers in their marketing strategies;
• Actively participated in smuggling networks to increase market shares and sales volumes, while publicly opposing illegal cigarette sales.

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