Ashes to Ashes

Reviewed by Steve Snyder.

There may still be a few people in America, besides major tobacco company executives, their employees and their hired legal guns, who argue that there is no demonstrated causal link between smoking and cancer and that nicotine is not addictive.

Yet, these companies’ own research departments knew of some of the health problems 40 years ago and more. And for those who may have heard the basics of the tobacco companies stonewalling, some of the details can still paint a callous picture. Thirty years ago, Lorillard was making the first efforts at a deliberately "safe" cigarette, using a burning catalyst and an additive, partly as a way to break out of its No. 4 position among cigarette companies. But company legal counsel said "no," worried about liability over conventional cigarettes it sold.

That and more can be found in Ashes to Ashes, for those still wondering about all the details of Big Tobacco. Ashes to Ashes, by Richard Kluger, is a detailed look at the history of tobacco, beyond that, the history of the cigarette and above all, the history of the major American tobacco companies, including their deceptive marketing strategies and their half-century of willful denial and obfuscation over the clear causal links between cigarettes and lung cancer, first in the research history, then cigarettes and cardiopulmonary disease, cigarettes and other cancers, and cigarettes and emphysema.

For nonsmokers, Ashes to Ashes has other importance. It details research on environmental tobacco smoke (ETS), commonly known as second-hand smoke. Over the last decade, studies by the Environmental Protection Agency, as well as various heath research centers, have detailed a moderate connection between second-hand smoke and lung cancer and a stronger connection, with greater likelihood of adverse health conditions, between ETS and cardiopulmonary disease.

Since Ashes to Ashes is a 1996 book, it doesn’t include details about the Medicaid lawsuit filed in the later 1990s by a number of states, which resulted in multibillion-dollar settlements by the tobacco companies, and which further exposed those companies’ decades of deceit on the danger of cigarettes.

But, up to the mid-1990s, this is all presented in detail, including:

• 1940s-1960s ads which made borderline health claims, including when cigarette filters were first introduced, without doing anything that might provoke a then-toothless Federal Trade Commission.
• Advertising graphics, such as beach scenes, which underscored these hints at healthfulness.
• Details of marketing to children, including cigarette giveaways to youth outside concerts into the 1970s.
• Aggressive efforts to expand U.S. cigarette sales abroad, including using federal government muscle on trade deficit issues to push American cigarette sales in Japan and other Asian countries as a key part of reducing trade deficits.
• How tobacco companies bought and funded the research of outside scientists, including some on government study panels who leaked information back to them. In other cases, particularly with British psychologist Hans Eysinck, the Tobacco Institute, Big Tobacco’s lobbying and PR front group, paid for years for him to continue studies and reports on cigarettes as being purely a psychological habit and not physiologically addictive.
• The American Medical Association’s unconscionable actions, especially in trading southern tobacco states’ Congressional votes against Medicaid and Medicare in exchange for not supporting the first Surgeon General’s report in 1964. The political timidity of the American Cancer Society is also reported in detail.
• How federal smoking legislation, after the first Surgeon General’s report, was usually written on a "lowest common denominator" base of what Big Tobacco would accept without too much of a fight.
• Cynical arguments that tobacco companies actually saved the government money, with smokers being less of a drain on Social Security through their earlier deaths.
• How state and local efforts, such as nonsmoking areas, became the primary fighting ground.
• How, already in the late 1970s, the Food and Drug Administration was being urged to put cigarettes on its list of controlled toxic substances and regulate cigarettes as a drug delivery device.
• And, finally, part of why the FDA hasn’t done this – or simply outlawed cigarettes – and why the various states haven’t taken more restrictive action. Governments, too, are hooked – on the millions and millions of dollars annually at the level of the various states and more than 10 billion a year in federal excise taxes. Other countries, with cigarette taxes even higher, are more hooked. And, in America, tobacco state Congressmen still have power on Capitol Hill, as well as Republicans generally not being of a mind to further regulate tobacco.

However, at the end of the book, Kluger offers his personal plan to induce Big Tobacco to step into the 21st century and to begin to step away from its deadly product, especially as lawsuits mount up.

Kluger says Washington should offer tobacco companies blanket liability from further suits, except for contaminated products. In exchange, the excise tax would be pegged at half of wholesale cigarette prices, the FDA would have the power to regulate maximum tar and nicotine yields, cigarette packs would advertise total chemical content, not just tar and nicotine yields, and federal price supports to tobacco growers would be phased out.

Even with recent lawsuits like the one in Florida, it’s not a bad prescription. However, with the current national political leadership, it’s, sadly, not likely to happen.

Part fascinating history, part science story, part akin to a detective story and part morality play, Ashes to Ashes, by Richard Kluger, is published by Alfred A. Knopf.