Un-regulation of Big Tobacco

The cigarette has loomed large in the history of public health in the 20th century. The invention of mass marketing led to cigarettes being emblazoned in advertising and film, deeply tied to modern notions of glamour and sex appeal. No product has been so heavily promotion or has become so deeply entrenched in American consciousness, and no product has received such sustained scientific scrutiny. But while perhaps no other product has undergone so significant transformation in its image—no longer symbolizing aroma and pleasure, but stench and death—Big Tobacco remains securely positioned to expand into new global markets. The implications for the future are vast: 100 million people died of smoking-related diseases in the twentieth century; in the next 100 years, we expect 1 billion deaths worldwide. The development of new medical knowledge demonstrating the dire harms of smoking ultimately shaped the evolution of evidence-based medicine. In response, the tobacco industry engineered a campaign of scientific disinformation seeking to delay, disrupt, and suppress these studies. Using a massive archive of previously secret industry documents, I show how the industry pioneered these campaigns, particularly using special interest lobbying and largesse to elude regulation. The history of efforts to regulate the cigarette – and their relative ineffectiveness – demonstrated the power of the industry to disrupt public health, just as it disrupted science. Not only did the tobacco industry effectively thwart tobacco regulation, it also shaped the public meanings of smoking to its benefit. Even as the health risks of smoking came to be more widely recognized and understood, it was still possible to argue that to smoke or not to smoke was simply an issue of personal agency.