Tuesday, 5 November 2013

Naked Smoking Guns: Inside Big Tobacco's 'Operation Whitecoat'

From the Vaults: this was the biggest investigative story I worked on in Hong Kong, and full credit goes to my former colleague and good friend Hedley Thomas for spotting the huge yarn lurking in the briefs column. It's this ability to sense a story that has made Hedley Australia's most awarded, respected and feared investigative ace. When a massive tranche of court documents were made public via the internet following a class action suit against 'Big Tobacco' in the US in the late 90s, we began sifting through the mountain of virtual papers looking for anything that might pertain to Hong Kong. Did we ever hit paydirt. This was the first piece in a series that dominated the front page and features section of the South China Morning Post for three days in a row.

"We are here to do something radical. To look at a problem. To achieve a solution. Nothing should be withheld." Thus begins a sprawling account of a high-powered brainstorming session organised by cigarette colossus Philip Morris and dubbed Project Down Under, for the June 1987 think-tank's antipodean provenance.

Details of the meeting are revealed in a once-confidential Philip Morris document, a minuted note of a top-level strategy, and among more than 30 million pages - some of which reveal the tobacco industry's darkest secrets - prised from the companies' own files and posted on the Internet as a result of litigation in the United States during the past 12 months.

The memo points to the genesis of an international scheme that has now blown up in the face of the tobacco industry like an exploding cigar. A scheme that involved the channelling of millions of dollars from the industry's war chest through a range of innocuous-sounding organisations in an attempt to procure helpful science, then merchandise the findings to ease fears over the effects of second-hand smoke and win major concessions from the public and private sector over bans.

The stakes were huge: this was the 1980s, when objections by non-smokers to other people's smoke were becoming increasingly strident. By drawing pie-charts showing when and where the average smoker lit up, the tobacco industry calculated bans in work places, aircraft, restaurants and other venues would result in a dramatic plunge in the number of cigarettes smoked. People would have less time to puff. And that would lead to billions of dollars in lost revenue.

Several key documents tell the story of how a coterie of tobacco big-wigs and American lawyers drew up a pan-industry plan to target scientists throughout Asia, the US and Europe in an effort to wrest back control of an issue on which they had decided to make a last-ditch stand. That issue was passive smoking, or, to use the industry-preferred euphemism, Environmental Tobacco Smoke (ETS).

According to the US Environmental Protection Agency (EPA), ETS is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It cites the possible health effects as eye, nose and throat irritation, headaches, lung cancer, and heart disease. It says children exposed to ETS face increased risk of lower respiratory tract infections, such as bronchitis and pneumonia, ear infections, build-up of fluid in the middle ear, increased severity and frequency of asthma episodes, and decreased lung function.

In January 1993, the EPA published a controversial report designating ETS as a human carcinogen more dangerous than asbestos, benzene or radon, and estimated passive smoking was responsible for about 3,000 American lung cancer deaths each year. The tobacco industry hit back hard, accusing the EPA of putting its own spin on statistics to justify a political vendetta against tobacco.

However, the battle lines in this international slugging match were drawn much earlier. In the early 80s, the big tobacco companies could see which way the winds of scientific and public opinion on ETS were blowing. By the mid-80s, they believed their position was becoming critical. By 1987's Project Down Under meeting, they had girded their loins for a multi-million dollar battle.

Asia was, and remains, crucial to the industry. While increased government regulation, litigation and public awareness of the implications of smoking were harming the traditional US and European markets, Asia was wide open and primed for exponential growth.

The upshot was a scheme hatched by the world's biggest tobacco company, Philip Morris, and supported by fellow giants RJ Reynolds, British American Tobacco/Brown & Williamson and Japan Tobacco Inc.

The once-secret memos reveal it was called the Asia ETS Consultants Programme or Project. It revolved around a drive to identify and recruit scientists to push the industry's line on ETS - namely, that its contribution to disease was virtually non-existent and that it was not a major indoor air pollutant. The programme thrived under the close supervision of industry stalwarts like the Harvard-educated lawyer John Rupp, of huge Washington DC firm Covington and Burling.

The contents of the documents - available on the Internet - hardly make edifying reading for the Asian scientists named as tobacco industry consultants. Indeed, the lawyers and tobacco executives' references to the scientists verge on the condescending; they were dubbed 'whitecoats', to be 'recruited', 'oriented', 'educated' and 'deployed'.

In conjunction with the programme, various loftily titled institutes and publications were set up - purporting to be independent though substantially or wholly backed by tobacco money, the documents reveal. They were packed with tobacco consultants and overseen by the industry's lawyers, who encouraged the scientists to attend international symposiums that were quietly sponsored by cigarette companies, then to provide studies used by the companies to further their cause.

In Hong Kong, the two scientists named in the memos as part of the Asia ETS Consultants Programme are well-known figures. Dr John Bacon-Shone inhabits the top echelons of government policy-making as a full-time member of the Central Policy Unit. He was seconded there last year from his job as director of the Social Sciences Research Centre at the University of Hong Kong. He is brilliant, articulate, a kind of academic renaissance man, with his finger in a mind-boggling array of research pies.

Dr Sarah Liao Sau-tung, a chemist, is the managing director of EHS Consultants. She has worked for many private and public organisations, including British American Tobacco (BAT), the Consumer Council, and the University of Hong Kong. She recently completed a $10 million indoor air study for the Environmental Protection Department.

Both vehemently reject the tobacco industry's assertions that they knowingly took tobacco money to work for cigarette company interests, and say descriptions of them as paid tobacco consultants are gross and shocking misrepresentations. (see page 19) Their comments are at odds with those of Mr Rupp and the tobacco industry. Mr Rupp, now based in Paris, Donald Harris, Hong Kong-based Philip Morris Asia vice-president, and Clive Turner, former Asian Tobacco Council head, all asserted to the Post that Dr Bacon-Shone and Dr Liao knew at the time that they were being paid to be tobacco industry consultants.

The documents also show the tobacco industry had a particular affection for the work of Dr Linda Koo Chih-ling, a former University of Hong Kong Department of Community Medicine researcher. Her research showing diet and other factors were more to blame for lung cancer in Chinese non-smokers than ETS was manna from heaven for the industry. She also collaborated closely in her research, the memos show, with the University of Gothenburg in Sweden's Professor Ragnar Rylander - revealed by the tobacco documents to be one of the brightest stars in the industry's galaxy of consultants, pulling in US$150,000 (about HK$1.16 million) a year in fees and research grants in the early 90s as one of the top consulting 'whitecoats'. Dr Koo was not regarded by the tobacco industry as a paid consultant.

Professor Rylander periodically reported to Philip Morris on the progress of his work with Dr Koo and his visits to Hong Kong to meet her. In one letter, dated August 14, 1986, he recounts meeting her in Hong Kong a month earlier, 'to review the present status of the [lung cancer] project and to suggest new approaches for analysis or additional research projects aimed at defining risk factors for lung cancers among non-smokers'. He says further analysis of the material is important, to learn about 'confounding factors', some of which 'may prove to be more highly associated with lung cancer among non-smokers than the ETS exposure itself.'

He goes on to say: 'I gave as much encouragement as possible as to the finalisation into a manuscript . . . If a new international workshop on the effects of ETS is to be held, it is strongly suggested that Dr Koo participates and presents a review of her data.' Dr Koo's star was well and truly on the ascent with the tobacco interests by 1987. In a letter from Shook, Hardy Bacon, another law firm used by Philip Morris, to their client, she was lauded for her 'outstanding presentation' to an International Conference on Indoor Air Quality in Tokyo. Even internal University of Hong Kong correspondence between Dr Koo and her boss at the time, Professor Anthony Hedley, somehow ended up in the Philip Morris files, and then on to the Internet.

As the now-retired Clive Turner, former head of the now-disbanded Asian Tobacco Council, recalled last week from London, ETS in the 80s became 'an issue the industry had to think about because it was a stick that critics used to beat us with'.

RJ Reynolds scientist Dr Guy Oldaker III put it another way in an internal memo: 'For our industry, the present and future effects of the ETS issue are clear. Smoking restrictions limit the time available for consumers to enjoy our products. Put simply, a cigarette not smoked is a cigarette not sold.' Dr Oldaker was a visitor to Hong Kong during the early stages of the Asia ETS Consultants Programme, which began in 1989, and in a memo he describes his role in helping to devise the protocol for a $1 million indoor air study by Dr Koo and Dr Bacon-Shone. The study was sponsored by the Centre for Indoor Air Research (CIAR) - a tobacco-funded-and-directed group set up by cigarette companies in 1988 - which has also paid for university studies by eminent scientists.

The CIAR says its funding source has not affected its independence, but critics like Boston law professor Richard Daynard charge: 'Their true purpose was to generate disinformation.' The tobacco industry's serious concerns over ETS are also reflected in the memo summarising Project Down Under. As recorded in the minutes of its 10am session on June 24, 1987, John Rupp summed up the situation succinctly: 'Where we are - in deep shit.' He went on to say the industry had a serious credibility problem on ETS, that it had been 'fixed on by the do-gooders'. Mr Rupp says the industry's position must be to show ETS is not a health hazard to the non-smoker. Outside the US, he notes, 'scientists on our side pretty good, we need more.

'Studies now funded: None a silver bullet. Somebody has to say ETS is no risk . . . bullets against us are lousy, but we don't have better bullets.' Another participant chimed in: 'ETS not solvable with deductive reasoning, sum up with something company can get behind with $ . . . ETS is focus because it's driving public policy. It is the LINK between smokers and non-smokers.' Mr Rupp, in a 1988 memo, also noted the industry 'has not yet adequately dealt with Hirayama's study'. (In a finding damaging to the industry, Takeshi Hirayama, chief of epidemiology at Tokyo's National Cancer Centre Research Institute, tracked almost 100,000 non-smoking women for 14 years, and reported in the early 80s that the incidence of lung cancer was significantly higher in those married to smokers.) A BAT internal document, titled 'notes on a special meeting of the UK industry on ETS', dated February 17, 1988, shows that moves towards loading the tobacco industry guns with scientific silver bullets had progressed apace since Project Down Under.

Penned by BAT scientist Dr Sharon Boyse, it begins: 'Philip Morris presented to the UK industry their global strategy on environmental tobacco smoke. In every major international area . . . they are proposing, in key countries, to set up a team of scientists organised by one national co-ordinating scientist and American lawyers, to review scientific literature or carry out work on ETS to keep the controversy alive. They are spending vast sums of money to do so . . .' She notes although action on ETS is becoming increasingly vital to the industry, the plan 'is perhaps questionable in some respects, eg involvement of lawyers at such a fundamental scientific level'.

The function of the US lawyers, she writes, is 'to act as intermediaries between the consultants and the industry and also to indicate 'areas of sensitivity' on ETS research'. Potential consultants would be contacted by the lawyers and asked if they were interested in problems of indoor air quality.

'Tobacco is not mentioned at this stage. CVs are scrutinised and obvious anti-smokers or those with 'unsuitable backgrounds' are filtered out. The remaining scientists are sent a literature pack containing approximately 10 hours reading matter and including 'anti-ETS' articles. They are asked for a genuine opinion as independent consultants, and if they indicate an interest in proceeding further a Philip Morris scientist makes contact.

'Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be 'filtered' by lawyers to eliminate areas of sensitivity. Their idea is that the group of scientists should be able to produce research or stimulate controversy . . . The scientists would not necessarily be expected to act as spokesmen for the industry, but could be if they were prepared to do so.' Another memo lauds how the 'Asian group has proved to be a successful offspring' of the European programme. It says: 'Just as we must continually eliminate unproductive consultants, so too we must continue to seek new consultants to satisfy new needs.' 

A Philip Morris memo dated July 11, 1989, summarises the progress of the consultant programmes. 'With the assistance of [law firm] Covington and Burling, approximately 70 scientists in the major international markets of concern to PMI have been recruited into the programme.' In the same memo, an assessment of Asia-Pacific operations, Philip Morris executive Andrew Whist writes to his boss Geoffrey Bible (now chairman and chief executive of the company): 'One of our consultants recently made a presentation to the Hong Kong Consumer Council that resulted in the council's disapproving proposed restrictions on tobacco advertising in Hong Kong and taking the position that the smoking restriction proposals advanced by the Hong Kong Council on Smoking and Health (COSH) could not be justified on health grounds.' 

Mr Whist reports eight scientists have been recruited in Asia. He says while no retainers were allocated, compensation was paid on the basis of time spent, at an average of US$15,000 to US$20,000 a year. Internationally, the 'total project cost' for two years is recorded as US$2.5 million. Total legal cost over two years is recorded as US$1 million.

In a 'privileged and confidential attorney's work product, February 14, 1990', Mr Rupp wrote: 'This report summarises the current status of the Asia ETS Consultant Project, which is now entering its second year. Much of the project's first year was consumed with the recruitment and orientation of consultants. While those activities will continue, the groundwork has now been laid for more of our attention and resources during 1990 to be focused on deployment of the consultants within the Asian markets of interest to supporting companies.

'. . . During the past year, consultant activities have been reviewed and approved on an ad hoc basis - primarily through occasional meetings of supporting company representatives . . . By the time of our October meeting, we had recruited a total of seven consultants in three markets - Drs Reverente and Somera in the Philippines, Drs Liao and Bacon-Shone in Hong Kong, Drs Kim and Roh in Korea and Dr Wongphanich in Thailand.

'. . . The key objective of the project has been to recruit and educate scientists who then would be available to testify on ETS in legislative, regulatory or litigation proceedings in Asia or elsewhere. This objective was based on recognition of the fact that there were essentially no local scientists with a background in ETS issues and that experience elsewhere has shown that it is essential to have credible, local scientists prepared to speak out when ETS becomes an issue, which often occurs on short notice. We have made considerable progress towards this goal, and now have a group of scientists who could provide testimony.' Mr Rupp writes that about 80 consultants around the world attended a tobacco-funded symposium at McGill University in Montreal in late 1989, including Drs Liao and Bacon-Shone. 'At the consultant meeting held in Hong Kong on January 19 and 20, we spent a substantial amount of time exploring appropriate avenues for distributing the published proceedings of the McGill symposium within Asia.' His memo says nearly all of the industry's current Asian consultants are working on papers for the tobacco-funded 'Indoor Air Quality and Ventilation in Warm Climates' conference to be held in Lisbon from April 23 to 26, 1990.

Mr Rupp's memo continues: 'Among other things, Dr Bacon-Shone's Lisbon paper criticises the unsophisticated statistical analysis appearing in Dr Hirayama's paper on ETS and non-smoker lung cancer in Japan, the cornerstone of the scientific literature relied upon by industry critics.' In the memo Mr Rupp then discusses the tobacco-funded Indoor Air International, 'a scientific society devoted to the study and discussion of issues relating to indoor air quality', and founded by tobacco companies.

'Beginning in January 1991, IAI will begin publishing on a monthly basis an indoor air quality journal, based in part on the McGill symposium proceedings. In addition, Drs Bacon-Shone, Ferrer, He, Kim, Liao, Liu and Reverente are serving on the IAI journal editorial board.' Mr Rupp moves on to describe what was a 'highly preliminary presentation' concerning the so-called 'Asia Cities Monitoring Project' at a tobacco industry meeting in Hong Kong in October 1989. This project, he writes, is aimed at collecting data on indoor air pollution in offices, shops and public transport facilities and comparing it with outdoor pollution in the same areas.

If approved, it was to begin in Hong Kong and then move to Manila, Seoul and possibly Tokyo. 'We expect the project to show that ambient air pollution . . . is a serious problem in the target Asian cities and that the much less serious indoor air pollution problems that exist in those same cities are, in turn, caused largely by pollutants that are generated outdoors. Such data would be of substantial value in discussing with Asian officials sensible priorities on air pollution and environmental issues.

'Our current plan is to begin the project in Hong Kong, under the direction of Drs Liao, Bacon-Shone and Linda Koo, who has agreed to consult on the project. A complete protocol, with proposed budget, for the Hong Kong phase of the project should be available within the next few weeks. If ultimately approved by the supporting companies, we would hope to begin field work in Hong Kong in May 1990 and to have the results ready for publication by early August. We expect the project to yield over its course several different scientific publications.' 

Under the heading 'Country Specific Activities: Hong Kong', Mr Rupp writes: 'Drs Liao and [Roger] Perry [of Imperial College in Britain] currently are preparing a list of government officials in Hong Kong who might be given a copy of the McGill publication. We must emphasise again, however, that the decision to circulate the McGill book in Hong Kong and the manner of its circulation lie with our supporting companies and the Hong Kong Tobacco Institute. We took the opportunity provided by the January consultant meeting in Hong Kong to meet with JP Lee [Lee Jark-pui] of the HKTI [Hong Kong Tobacco Institute] to explain the objectives of the Asia ETS Consultant Project. We invited Mr Lee at that time to alert us to any opportunities or threats in Hong Kong involving ETS to which our consultants might respond.

'. . . As we move into the second year of the Asia ETS Consultants Project we believe we can provide a much higher level of public consultant activity than occurred last year. Having now achieved a reasonable command of the relevant literature, and with a substantial level of enthusiasm for the project, our consultants are prepared to do the kinds of things they were recruited to do, which, in the final analysis, is the project's real test.' In another memo by Mr Rupp dated February 13, 1990, he sets out estimated costs for the Asia part of the programme for 12 months at US$800,000. This included US$420,000 for recruitment, orientation, training and administration, US$225,000 for the Hong Kong and Manila components of the Asia Cities Monitoring Programme, US$35,000 for 'review articles in Asian scientific journals', US$28,000 for 'publishable papers' and US$50,000 for 'review of papers, attending conference, travel and related expenses'.

Philip Morris Asia executive Donald Harris, in a memo on January 24, 1990, implores regional offices to make every use of the findings from the McGill symposium. 'We must use the material wisely and effectively to block attempts by governments to establish public policies against smoking based upon ETS,' he writes.

'The material and information can be of greatest value...when it is given to the 'right people', probably in a private situation and probably by non-tobacco person.' A 1990 memo from Covington and Burling on the 'Whitecoat Project', the European arm of the consultant programme, records how one of its consultants managed to infiltrate the respected medical journal The Lancet and the World Health Organisation's International Agency for Research on Cancer, and come up with 'factors other than passive smoking which cause lung cancer - for example, keeping pet birds'.

It details the exhaustive measures employed to distance tobacco companies from the research they were sponsoring, in codes worthy of a James Bond film: 'B functions as the executive arm of A to which it is directly accountable . . . B is the interface with the operating units (whitecoats, labs) except for those aspects A elects to manage directly. D has responsibility for the range of ETS activities in its given markets . . . D may be considered as being accountable to C.' It continues in this vein for several confusing pages.

Extensive searches by the Post of the tobacco company documents turned up little of note about the consultants' programme during 1993, apart from a letter Mr Rupp wrote on March 12 in which he refers to how the industry had used the work of Dr Liao and Dr Bacon-Shone to present to authorities when the 'Hong Kong Government was actively considering smoking restrictions in public places and in the workplace'.

By 1994, however, things are beginning to go awry. Donald Harris notes: 'For a variety of reasons, the Asia ETS Consultants Programme is in a state of significant transition - and, quite possibly, reeling towards an inelegant collapse. Some effort has gone into fixing both the problems and the programme, but at this point it is more damage control than anything substantive.' 

His concluding remark proved more prescient than even he probably realised: 'There is some time, but not much.' 

Millions of pages of once-confidential tobacco company documents have been posted on a range of web sites in recent months. Mostly from cigarette giants Philip Morris, RJ Reynolds, British American Tobacco and Lorillard, they range from lengthy scientific studies and sensitive correspondence to marketing plans and memos dating back to the 1950s. When written, the tobacco industry could not have imagined they would ever be publicly inspected. They are the result of a ground-breaking legal settlement between the tobacco industry and United States attorneys-general.

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