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

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The Tobacco Files

Science for hire

 Cigarettes for sale at convenience store
A convenience store in Lima, Peru, offers single cigarettes for sale for about 15 cents (U.S.) each to smokers who cannot afford the $1.50 purchase price for a pack.
In the early 1990s, the issue of secondhand tobacco smoke came to the fore in the United States as scientific evidence mounted concerning its harmful effects on health. The U.S. Environmental Protection Agency (EPA) and the National Institute of Occupational Safety and Health (NIOSH) both issued reports confirming that so-called passive smokers were at significantly increased risk of disease.

These reports, issued by U.S. government agencies, put new pressure on the tobacco industry to counter the science

linking environmental tobacco smoke (ETS), or secondhand smoke, to disease and in particular to preempt growing tobacco control efforts in this area in Latin America and the Caribbean.

A 1992 proposal by the tobacco industry law firm Covington and Burling outlines the industry's response:

The ETS Consultants Project in Central and South America ("Latin Project") was initiated in early 1991. The Latin Project currently includes 13 consultants from seven countries: Argentina, Brazil, Chile, Costa Rica, Ecuador, Guatemala and Venezuela. The consultants represent a wide variety of scientific disciplines, including chemistry and biochemistry, epidemiology, oncology and pulmonary and cardiovascular medicine. The Latin Project currently receives 40 percent of its funding from Philip Morris International [and 60 percent from BAT]. The Latin Project is managed by Covington and Burling.

Unlike many other regional ETS consultant programs sponsored by the industry, the Latin Project was initiated in anticipation, rather than in reaction to, the full-force arrival of the ETS issue to Central and South America... Critical to the success of the Latin Project is the generation and promotion of solid scientific data not only with respect to ETS specifically but also with respect to the full range of potential indoor and outdoor air contaminants. This approach encourages government agencies and media in Central and South America both to resist pressure from anti-smoking groups and to assign ETS its proper place among the many potential indoor and outdoor air contaminants found in these regions.

In addition to funding research by the consultants, the industry deployed them as presenters at scientific seminars and symposia and used their influence to obtain co-sponsorship of such events by some of the region's most prestigious academic bodies. Among these were the Argentine National Academy of Sciences and National Academy of Medicine, the University of São Paulo in Brazil, the Chilean Academy of Sciences, the Catholic University of Chile and the Faculty of Medicine of the University of Chile.

Although the purported goal of the Latin Project was to produce and disseminate "solid scientific data" to counter "extremist" tobacco control efforts, the links between the consultants and the industry were to be strictly concealed. A 1991 letter by BAT's Boyse to Edgar Cordero of Republic Tobacco in Costa Rica makes this point clear:

I cannot stress strongly enough the absolute necessity for the industry to have no direct contact with these scientists that are part of the program.… If one scientist in the group is perceived by anyone to be associated with the industry, then we run the risk, by association, of this happening for the rest of the group and the whole exercise will become pointless. All contact, as previously explained, must be carried out through Covington and Burling.

 Cigarettes for sale at convenience store
A giant pack of Ducal "American Blend" cigarettes greets drivers along the Pan American Highway south of Lima, Peru. The ad promises "flavor that brings people together."
A key strategy of the Latin Project was to shift the focus of public debate from the health effects of passive smoking to broader issues of air quality in the region, suggesting that secondhand smoke was a minor contributor to indoor air pollution. Toward this end the project proposed original research on these issues, including a study in Central America that would "acquire data on levels of various gas and particulate phase airborne substances in offices and restaurants in Costa Rica, Guatemala, Panama, El Salvador, Nicaragua and Honduras. Levels of outdoor air pollution will be determined simultaneous to the indoor air measurements." The results of the study, published in the journal Ciencias Ambientales (Environmental Sciences) of the National University of Costa Rica, showed predictably that smoking was not a significant contributor to poor-quality indoor air.

Similar findings were presented at a 1993 industry-sponsored seminar at the International Center for Higher Studies in Communications (CIESPAL) in Quito, Ecuador. Latin Project consultant Carlos Alvarez told dozens of assembled journalists that there was no statistically significant relationship between passive smoking and cardiovascular disease and that, "even assuming a worst-case scenario, the problems presented in Latin America by ETS exposure pale in comparison by those caused by outdoor air pollution, malnutrition, cholera, diarrhea, illiteracy, poor housing and marginalization." This is despite an overwhelming body of established scientific research indicating a causal link between secondhand smoke and heart disease.

Tobacco industry documents show that events such as the CIESPAL seminar were a favorite public relations tactic in Latin America and the Caribbean. Similar symposia sponsored jointly by BAT and Philip Morris throughout the region targeted journalists with proindustry messages on the issues of smoking and health, secondhand smoke, freedom of speech and WHO activities and priorities. For speakers, the companies drew heavily on Latin Project and other ETS consultants but also relied on allies in advertising and related industries. Only when addressing the core issue of smoking's direct effects on health—which the industry has subsequently conceded to its critics—was it forced to rely on its own PAHO paid staff. "We do not have any external consultant willing to do this, let alone a Spanish speaker," as Boyse put it in a 1994 memo.

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