Robert Proctor

Tuesday, June 22 , 1999

Thank you  Robert for accepting our " rendez-vous ". May I ask you to introduce yourself ?

I am professor of the history of science at Penn State University in University Park, Pennsylvania. I specialize in the history of scientific controversy and what I call the 'social construction of ignorance,' since ignorance and impotence seem to me more common even than knowledge or power.

I have written on the history tobacco and cancer policy, but also on racial theory, environmental policy, and Darwin's life and work. I'm spending this year in Germany, finishing up a book on agates and a book on human origins and paleoanthropology.

1. In "Cancer Wars" (Basic Books, NY 1995) you underline the "poverty of prevention" compared to the budgets devoted to cure and cure oriented research.
Do you think there is still the same imbalance today? If so, what could bring changes and where to put the "blame"?

Cancer prevention has always been a trivial part of cancer research, and probably always will be. Cancer research organizations are not really set up for prevention, and you could argue that this should not be their job. They do research, and for most preventive work, research is not what is needed.

The pretence that ever more research is needed can even slow the implementation of genuine preventive measures, since what is really needed is political intervention.
We don't need more research to show that taxation will reduce youth smoking, or more research to show that the tobacco companies are engineering an unprecedented global epidemic of heart and lung disease.

I guess I''d start by blaming the tobacco companies, but I'd move on to blame those politicians who've let the industry get away with murder, along with the research organizations that pretend that research is all we need to control tobacco.
Cancer is a political disease and needs political solutions.

2. Antismoking proposals are not new: there was an active "hygienist" movement in the late 19th century but it did not really succeed against the tobacco lobby and the first world war wiped it out when cigarettes were distributed to soldiers even by the YMCA. What does history teach us about tobacco and tobacco control?
The tobacco industry sometimes portrays history with pendulum like cycles going from business with little constraints to tight regulations and back the other way. Is it wishful thinking?

The tobacco industry does seem remarkably resilient. Many of the earliest complaints against tobacco were based on moralistic grounds, since good solid evidence of the health hazards was lacking. The industry was able to cast its detractors as puritanical prudes, equating opposition to tobacco with opposition to masturbation, playing cards, etc.
Liberals like John Dewey lumped antitobacco advocates with the illiberal lot that gave us Prohibition, and the industry of course was delighted.
It was not until the 1930s, in fact, that you get unimpeachable evidence that tobacco was responsible for devastating health effects--esp. cancer and heart disease.
A consensus on such effects is established in Germany around 1940, and in the US in the early 1950s. 
The timing is important, since the industry now wants us to believe that people have always known about the hazard, from Columbus to King James Counterblast.
They want to forget, of course, their role in denying the hazard for more than 40 years, and even now when it suits them. 
The impact of their denials should not be underestimated, esp. the impact on the public knowledge of the hazards. 
I recently served as an expert witness in a tobacco trial (the Ohio class action suit), where several jurors inquired whether pollution might not in fact be the major cause of lung cancer.
That of course was a major thrust of the industry's propaganda: industry officials in the 1960s admitted privately that 'doubt is our product'--that they could only continue to manufacture cigarettes as long as there was doubt about the hazard of that product.

3. You are a specialist of Germany. In "The nazi war on cancer" (Princeton University Press, 1999), you look at how Nazi Germany scientists studied cancer and how eventually some public health measures were taken against smoking. Some people think the tobacco control proposals are slow to gain momentum in today's Germany because they stir bad memories. What is your opinion and how would you describe the relationship between Reemstsa (the powerful German cigarette maker) and the Nazi regime?
(Sometimes the government says one thing and does another in an apparent contradictory way).

The Nazi government organized the most powerful antitobacco campaign in the world at that time, including bans on smoking in many public spaces, limitations on women and teenagers smoking in public, restrictions on the kinds of themes that could be included in advertising (no athletic or sexual imagery, for example, and no depictions of women or girls).
Most striking, perhaps, is that Nazi scientists pioneered the world's most sophisticated tobacco health research, including the first case control epidemiological studies, concluding unequivocally that tobacco was the major cause of lung cancer. That research was ignored after the war, perhaps from the taint of Nazism, perhaps from other several other reasons one could name.
What is also interesting, though, is that Reemtsma pioneered many of the antiantitobacco strategies later (re)developed by America's Tobacco Institute. In 1941, for example, the industry established the Tabacologia medicinalis to combat the antitobacco movement, arguing that antitobacco activists were irrational 'fanatics,' antiscientific, etc. Helmuth Aschenbrenner was active in this, and later went on after the war to attack the authors of the Surgeon General's report as paranoid pyrophobes, fearing what he called 'the big fire' (nuclear war). There is also reason to believe that US tobacco authorities may have studied the German (Nazi) experience:
we know there were high-level meetings with Reemtsma in the early 1950s and that cancer was discussed. More research on this is needed, since we are probably talking about an international conspiracy with far reaching implications.
I do think the Nazi experience has been important in stunting the German antitobacco movement, since antitobacco efforts are easily cast as antiliberal. On the question of Reemtsma's relationship to the Nazi regime, I describe in my book how the company collaborated with many Nazi policies, paid Goering millions of marks to call off his SA dogs, tried to curtail Nazi antitobacco efforts, etc.
The company was involved in taking over tobacco properties from conquered territories, and many other questionable and illegal activities.

The only good to come of it, from my perspective, is that the only surviving son, Jan Phillip Reemtsma (kidnapped in a sensational crime a couple of years ago), took the two billion marks he inherited and founded the Hamburger Institut f¸r Sozialforschung, a leading social research unit still active today (they organized the widely acclaimed expose of Nazi military atrocities, and funded some of my own research).

4. The tobacco industry has been very apt at "manufacturing ignorance" and fighting regulation. How do you assess the situation now? In 1995 you thought "much remains to be done: stiffer taxes, financial support for tobacco counteradvertsing, support for litigation" etc.
("Cancer Wars", p. 268).
Beside, considering the worldwide presence of the US multinationals it seems that what they would eventually lose in the US they will recoup abroad?

In Cancer Wars, I showed that manufacturing doubt was a central strategy to popularize cigarettes and deflect legal attacks on the industry. That continues, albeit with different emphasis: a central strategy is now to equate the right to smoke with freedom of speech. That strategy has been effective, and fits conveniently with the strategy of equating smoking with modernization and 'the West' more generally (esp. in developing nations).
Working on the Ohio class action suit I developed a new strategy to fight the industry, calculating how many deaths have occurred in consequence of the industry's duplicity--figuring that 8 trillion cigarettes would not have been smoked in America if the industry had come clean about what it knew when it knew it.
The math is easy because you know that it takes about 4 million cigarettes in a society to generate a lung cancer, etc. There are many industry pronouncements from the mid 1950s to the effect that the industry would `cease production tomorrow' if it believed there were health hazards associated with the product; we used this to argue that the industry was irresponsible and breaking its own promise in continuing production. I am hoping that legal and economic measures can be developed to stop the industry abroad, international trade and health authorities should play an important role in this regard.
There are already good rules limiting the international sale of e.g., asbestos, and more could certainly be done against tobacco.

American consumption today accounts for less than five percent of domestic tobacco production, so I imagine the industry has virtually 'written off' the domestic market.

5. I know this is a strange question to ask an historian but how do you imagine tobacco and tobacco control in 20/50 years from now? Do you think people will wonder why it took so much time to regulate tobacco products and tobacco use or do you think the situation will still be pretty much what it is now?

It is not of course a strange question, unless you expect historians to deny themselves the hopes and fantasies that any other human is entitled to! I expect world tobacco consumption to peak some ten or twenty years from now, following which time we should see a gradual fall-off lasting most of the next century.
I imagine historians of the future will find it astonishing that governments were so willing to encourage smoking--from short-sighted greed to fill their treasuries.
The implicit disregard for life and suffering is truly remarkable, and there will have to be an accounting (that is one thing historians do).
I hope to see advertising banned in many parts of the world within my lifetime (I'm 44), and I expect to see smoking increasingly relegated to a private past-time. I'd say that China will play the major role in curtailing smoking in Asia, though probably not until the health costs are taken seriously by the top brass and commercial authorities are instructed to combat the habit, perhaps as part of a renewed respect for the elderly (the coincidence of the rise of the habit in China with the erosion of filial piety should not be missed). I think economic stability will be a precondition for effective anti-smoking efforts in many other countries. I would predict that limits on public spaces allowed for smoking will become the major means for combating smoking, along with increased taxation and limits on the cultivation or sale of tobacco products.

Do you have anything else you would like to add?

There are some funny stories about tobacco in my book, The Nazi War on Cancer, which only tobacco experts will be in a position to appreciate.

Perhaps I can also end by inviting anyone with further insights into the history of German tobacco use or policy to email me with comments or questions, since I will be in Germany until June of next year (2000).

[email protected] (Robert Proctor)

Thank you  Robert for taking the time to be with us today.