If It's Good for Philip Morris,
Can It Also Be Good for Public Health? 

JOE NOCERA / New York Times 18jun2006

"We don't make widgets," Steve Parrish likes to say, and that acknowledgment strikes me as a good place to start this story. Parrish, whose title is senior vice president for corporate affairs, is a highly paid executive at Altria Group, a New York-based holding company that is the 10th-most-profitable corporation in America. If the name of the company doesn't strike you as terribly familiar, that's because a few years ago the company changed its name. It used to be called Philip Morris, a name that still attaches to two of its holdings, Philip Morris USA and Philip Morris International. (Altria also owns Kraft Foods.) So, yes, let's stipulate right up front: Steve Parrish represents the country's leading tobacco company, whose best-known brand, Marlboro, is so dominant it accounts for 4 out of every 10 cigarettes smoked in the United States. Last year, Philip Morris USA alone made $4.6 billion in profits. What was it that Warren Buffett once said? "You make a product for a penny, you sell it for a dollar and you sell it to addicts." They most certainly don't make widgets.

Let's stipulate a few other things. First, despite everything — the universal knowledge about the dangers of tobacco, the warnings on cigarette packaging, the antismoking public-service ads — lots of people still smoke, and one of every two long-term smokers will die from the habit. In all, more than 400,000 smokers in the U.S. will succumb this year to heart disease, lung cancer, emphysema or other diseases because they smoked. Although the trend has gone steadily downward over the past two decades, some 20 percent of the adult population smokes — that's about 48 million people. John Seffrin, C.E.O. of the American Cancer Society, calls tobacco-related diseases "the single-most-preventable cause of death in the world." Who can disagree?

You'll no doubt recall that in the mid-1990's, there was a huge public outcry about the behavior of the tobacco industry, and efforts were made to bring the cigarette companies to heel. State attorneys general sued the big tobacco companies, and private class-action suits were mounted; Congress held hearings excoriating Big Tobacco, while Dr. David Kessler, the commissioner of the Food and Drug Administration at the time, tried to claim regulatory authority over the industry; whistle-blowers leaked damning documents to the press. It was a moment when the cigarette companies were exceedingly vulnerable, and serious reform could have been imposed by the federal government. But that didn't happen. A reform effort failed in Congress, and 46 states and the industry wound up settling their litigation with something called the M.S.A. — the Master Settlement Agreement — which imposed marketing and advertising restrictions on cigarettes, financed an antismoking ad campaign and transferred a staggering sum of money ($206 billion over 25 years) from the big tobacco companies to the state governments. (Four states settled separately for an additional $40 billion.)

And then the body politic moved on. So, a final stipulation: Cigarettes aren't going away. Nobody is about to ban tobacco, nor is anybody about to put the cigarette companies out of business, much as they might like to. These days, although Philip Morris USA loses the occasional lawsuit, the litigation threat that once seemed so onerous has become quite manageable. And though the M.S.A. has done some very good things — it's the reason you no longer see cigarette billboards — it has both limits and unintended consequences. For one, it has resulted in the rise of about 100 small cigarette companies — with names like Liberty Brands and Virginia Brands — that now undercut the big boys on price. And it has given the states a rooting interest in the continued prosperity of the tobacco companies, because they now depend on M.S.A. money to balance their budgets. All the while, cigarettes remain exactly what they've always been: the most dangerous unregulated legal product in the country.

When you talk to Steve Parrish about all of this, though, he doesn't use the language tobacco executives once used. He doesn't talk about "individual choice," nor does he pretend that cigarettes aren't addictive. On the contrary: "Cigarettes are addictive and cause the disease and death of hundreds of thousands of people every year," he said in one of our conversations. "When you set tobacco on fire and inhale it into your lungs, bad things happen." In another conversation, he said, "If fewer people died from smoking, that would be good for Altria's shareholders." He says that it is important to keep kids from starting to smoke and freely concedes that tobacco can never be viewed as just another product because it is so deadly. It can be quite startling the first time you hear him say these things.

Most amazing of all, Parrish says that tobacco needs to be regulated by the Food and Drug Administration. The industry has long fought such efforts; it waged legal war, for instance, against Kessler's claim of jurisdiction, finally winning in the Supreme Court, which ruled that only Congress could give the F.D.A. the authority Kessler had sought. Yet since 2000, thanks in large measure to Parrish, Philip Morris USA has been calling for the regulation of cigarettes. Two years ago, Altria made a serious, sustained effort to have such a law enacted, which was strongly backed by the country's leading anti-tobacco lobby, the Campaign for Tobacco-Free Kids, as well as all the other big public-health groups, and fiercely opposed by the rest of the industry, including archrival Reynolds American. Although the measure twice passed the Senate, it died in a conference committee.

Among anti-tobacco advocates, Parrish's words are treated with varying degrees of skepticism. "Parrish is different from other tobacco executives in many ways," says Matthew Myers, president of the Campaign for Tobacco-Free Kids. "He is exceptionally bright and skillful. He has been the catalyst for Philip Morris taking a number of positions that surprise public-health advocates and that on their surface are consistent with what public-health advocates have long supported. But having said that, the jury is still out on what he really intends." Myers was quick to add, "One can look at the history here and wonder whether what Philip Morris is doing today is nothing more than a sophisticated version of what they've always done."

Paul Billings, of the American Lung Association, says: "I think Philip Morris is aggressively trying to demonstrate it is changing, but its words don't match its deeds. In Marlboro, they still have the No. 1 brand for kids. I think they are just as despicable as the other tobacco companies."

David Kessler, now the dean of the medical school at the University of California, San Francisco, says: "I believe that Steve believes 100 percent in what he is saying. Steve is genuine. But our job is to decrease the number of people who smoke to the lowest possible level. I'm not sure that's Steve's agenda yet."

But in the months I spent talking to him and others at Altria, I came to a different view. In his own way, Steve Parrish really is trying to solve the cigarette problem. Without question, he is doing so in a way that will allow Altria and Philip Morris USA not just to survive but also to thrive — and there are many in the public-health community who view any such solution as abhorrent. But that doesn't mean that his central idea is wrong. When you dig into it, you discover there are good public-health reasons to embrace regulation — and compelling business reasons for Philip Morris USA to embrace it, too. "This isn't social work," says Michael Szymanczyk, Philip Morris USA's chief executive.

I also came to believe that Parrish has another motivation. He is 56 years old. He has been with the company for 16 years. He's not going to be doing this all that much longer. And before he moves on to the next phase of his life, he'd like a little redemption — for his company, and for himself.

his is not the first time Steve Parrish has been featured in this magazine. Twelve years ago, Philip Morris made a decision to cooperate with an article by the writer Roger Rosenblatt that examined what it was like to work for a tobacco company. The article ran in March 1994. The cover read, "How Do They Live With Themselves?" The opening photograph was of Parrish, wearing a double-breasted suit and looking warily into the camera.

Parrish no longer smokes, but he did then, as Rosenblatt pointed out. He noted that Parrish grew up in the small town of Moberly, Mo., the son of a railroad cop, and wanted to be a Democratic politician before veering off into law. As a lawyer in the late 1980's, he defended Philip Morris in the Cipollone case, famous as the first trial in which a tobacco company was ordered to pay damages to a smoking victim. (The judgment, later overturned, was against another cigarette company, Liggett, not Philip Morris.)

Parrish explained to Rosenblatt that when he was approached about working for Philip Morris, he didn't have any big moral qualms; having represented the company in the highly publicized trial, he knew the issues, and he also knew he liked the people who worked there. He conceded that it was painful to be described as "a merchant of death," and he sometimes worried that he rationalized what he did for a living because of his "nice salary." ("I don't think I do," he concluded.) None of these thoughts were terribly different from the ones I heard recently when I plowed the same ground in my own interviews. Parrish is a thoughtful and articulate man, but there are clearly places he doesn't want to go.

He also said this to Rosenblatt: "A year or two ago, my daughter came home from school and said: 'I have a homework assignment I need you to help me with. Tomorrow we're going to talk about drugs like marijuana, cocaine and alcohol. We're also going to talk about cigarettes and whether they're addictive. I want to know what you think about cigarettes.' And I told her that a lot of people believe that cigarette smoking is addictive, but I don't believe it. And I told her the surgeon general says some 40 million people have quit smoking on their own. But if she asked me about the health consequences, I would tell her I certainly don't think it's safe to smoke. It's a risk factor for lung cancer. For heart disease. But it's a choice. We're confronted with choices all the time. Still, I'd have to tell her that it might be a bad idea. I don't know. But it might be."

His daughter was 11 at the time of that conversation, and when I asked him not long ago about that quote, he seemed stricken that I had brought it up. In fact, he told me, that is not what he had said to his daughter. "As long as I can remember," he says now, "I thought smoking caused lung cancer, and I said that internally. And I said it was addictive and we should say that." But when Rosenblatt asked him what he said to his children about smoking, he used the opportunity to lapse, as he puts it, into "corporatespeak." "It was one thing to convey the company's position, even if I didn't agree with it. But to do it through a conversation with my daughter — that was awful." He adds: "I said a lot of things back then that make my blood curdle now. But of all the things I did and said back then, that's the one I'm most ashamed and embarrassed about."

Rosenblatt's article was one of the early markers of the tobacco wars of the mid-1990's. A few weeks earlier, the ABC newsmagazine "Day One" accused the big tobacco companies of adding nicotine to cigarettes. (Nicotine, of course, is the ingredient that addicts smokers.) Five days after the article, Kessler testified before Congress that he believed that he had the authority to regulate cigarettes as "nicotine-delivery systems." A few weeks later, the chief executives of the seven largest tobacco companies went before a Congressional committee and famously denied that smoking was addictive. And a month after that, the attorney general of Mississippi filed the first of the states' multibillion-dollar lawsuits against the big tobacco companies.

What role did Parrish play in the tobacco wars? In the beginning, he led the charge against tobacco's enemies. In the wake of the "Day One" broadcast, Parrish was put in charge of something called the Action Team to orchestrate the company's response to its mounting problems. The first decision the company made was to sue ABC for libel. Philip Morris documents from that era include a draft of a presentation Parrish made to the board describing a Tobacco Strategic Attack Plan that included lawsuits and aggressive ad campaigns. He also commissioned polls and focus groups to figure out which countermessages would work best.

And more often than not, he delivered the message himself. For instance, after Kessler asserted jurisdiction over tobacco, Philip Morris and the other companies quickly filed their lawsuit to block him. Parrish then did a video presentation for the company's employees to denounce the F.D.A. commissioner. His language was strident and unapologetic. "Dr. Kessler has asserted that nicotine is addictive," he said, his jaw clenched angrily. "It has been called addictive because the concept of addiction has been expanded to include sex and exercise. We believe that it does not meet the common-sense notion of addiction. We believe that Dr. Kessler has described nicotine as addictive to further his own political agenda, so that he can regulate and possibly ban cigarettes." In other appearances, Parrish routinely described Kessler as a "neo-prohibitionist" — a description he says he also now regrets.

Strange as this may sound from the previous paragraph, Parrish is a likable man, with an easy laugh, a gracious manner and a desire to be liked by others. Lashing out did not come naturally, he told me. He mentioned several times how struck he is now, looking at old tapes of himself engaging in angry debates with tobacco's enemies, at his own body language. He appears distinctly uncomfortable. But of course, he was saying things he didn't believe, denying the terrible toll cigarettes take.

But why? Why didn't he just quit and find work at a company that sold something besides cigarettes? Parrish told me that he never thought seriously about quitting. But no matter how often I pressed the point, his reasons always struck me as pat and unsatisfying; this was one of those places, I wound up thinking, where he could go only so far. He still thought of himself as an advocate, just as he'd been during his career as a defense lawyer, he told me. He thought Philip Morris was a great company full of good people and felt a duty to help them. He respected the people within the company who were insisting that cigarettes weren't addictive, and he understood their reasoning even if he disagreed with it. He figured he had a better chance of changing their minds by staying than by walking away. And, of course, the longer he stayed at Philip Morris, the more his own career ambitions were tied up with the company itself, where, it must be said, he has done very well for himself. (Last year, for instance, Parrish's compensation package, including salary, bonus and restricted stock, was valued by the company at more than $14 million.) To the outside world, nothing could be more obvious than the fact that cigarettes were addictive; John Reed, a former C.E.O. of Citibank and an influential Altria board member, recalls one of his own sons telling him that the industry had its head in the sand. But if you were in the tobacco bunker, it was easy to feel misunderstood, beleaguered, unfairly attacked. Parrish felt that, too.

Eventually, his role in the tobacco wars changed: he helped bring them to an end. By the spring of 1997, the tobacco industry had begun secret negotiations with the states' attorneys general. It did so not because it suddenly saw the light about the evils of cigarettes, but because it had no choice. The state suits posed an enormous threat to the companies, and the documents coming to light repulsed the country. "Today's teenager is tomorrow's potential regular customer," began one 1981 Philip Morris memo, "and the overwhelming majority of smokers first begin to smoke while still in their teens." By the mid-1990's, Reed and several other board members were telling Philip Morris management that if it continued to stay in the bunker, it risked "having society take away our license to operate."

Parrish played a key role in the negotiations with the states, and it was the turning point of his career. Once he got in the room, his essential self kicked in; he liked the people on the other side of the table, and he wanted them to like him. As he listened to what the attorneys general and their negotiators were saying, he saw how wrong Philip Morris — and he — had been in fighting the obvious: "All we knew was our own rhetoric." The people in the room weren't neo-prohibitionists; they were trying to solve a terrible public-health problem, and they were justifiably angry with the tobacco industry's historic tactics of denial, obfuscation and trench warfare. They believed the industry needed to be punished for its behavior. To his surprise, Parrish found himself agreeing with much of what they said. He also began to feel ashamed about his earlier role in the tobacco wars.

Parrish became the tobacco executive most committed to ensuring that a deal was cut, and he took huge risks to make it happen. Matthew Myers, of Tobacco-Free Kids — the one public-health advocate involved in the secret talks — was also taking a giant risk; when word leaked out that he was one of the negotiators, he was roundly condemned by many anti-tobacco advocates, who insisted that their side should never sit at the same table as Big Tobacco. There was one moment, Myers would later recall to Michael Pertschuk, who wrote a book about the settlement talks, when he felt that negotiations had nearly reached a stalemate. "Don't quit," Parrish pleaded with him, his hands shaking. "There are people on our side of the table who have staked their careers on these talks succeeding, who don't agree with the position the industry is now taking."

The deal, announced on June 20, 1997, should have been one of the great public-health triumphs in American history. The industry agreed to be regulated by the F.D.A., which could, among many other things, set manufacturing standards that could include the lowering of nitrosamines, an established carcinogen; mandate bigger and bolder warnings on cigarette packages; virtually eliminate tobacco marketing and advertising; and take other measures that might reduce the long-term harm tobacco causes. It agreed to pay financial penalties if youth smoking didn't decline by a certain percentage. And it agreed to pay $368.5 billion, over 25 years, to the states and the federal government, some of which would be earmarked for smoking-cessation programs, antismoking research, antismoking advertising and other national programs to reduce cigarette consumption and, over time, perhaps eliminate the culture of smoking. In return the industry received an explicit guarantee that the F.D.A. would not ban cigarettes outright. And it was granted relief from most liability — not just the state lawsuits but private litigation as well. At long last, the country would have a national tobacco policy.

But it wasn't to be. Both the F.D.A. and liability-relief provisions required that Congress pass a new law, and once the settlement reached Capitol Hill, all hell broke loose. Even though the agreement embodied far more than public-health advocates had ever dreamed of, once they saw how much they had gotten, they wanted more. The money figure starting climbing, until it exceeded $500 billion. And the liability relief was gradually stripped away. Many of the deal's opponents believed that the industry needed to be punished further by the courts. But once the liability relief was out of the bill, the tobacco industry, including Philip Morris, withdrew its support, and the deal died. After which, the two sides went back to the drawing board and came away with the Master Settlement Agreement. Without the federal government's involvement, though, the new deal no longer represented a national tobacco policy; it was merely a contractual settlement with a group of aggrieved plaintiffs.

One way to think about what Parrish has been doing ever since is trying to get to back to that place he and Philip Morris were on June 20, 1997, a place that could both reduce the harm caused by smoking — and rehabilitate his company.

Shortly after the tobacco wars ended, Kessler contacted Parrish through an intermediary. Kessler left the F.D.A. in early 1997, but he remained a powerful anti-tobacco voice; he was a key opponent of the 1997 deal, in large part because of the liability-relief provision, which he maintained should not be a quid pro quo for a public-health measure. Now, as he was preparing to write a memoir of his time at the F.D.A., he wanted to interview Parrish. Parrish quickly agreed.

"We were supposed to just meet and say hello that first time," Parrish recalls. "But we sat and talked for hours. And I had the same reaction I'd had during the negotiations: this guy I always thought was a fire-breather was really a pretty neat guy. I remember talking to him about how it felt for him when we were calling him a neo-prohibitionist. And as we talked, I started to understand a lot better why he had done the things he'd done."

Sure enough, a relationship developed. "I consider David Kessler a friend," Parrish says now; Kessler, for his part, agrees that they became close. Kessler, who had become the dean of the Yale University Medical School, invited Parrish to speak at Yale. Parrish apologized for all the invective he had once hurled at Kessler. They had a number of long talks about the past. And as Philip Morris began to change its long-held positions, Parrish made a point of getting in touch with Kessler, to apprise him personally and solicit his input. He became a one-man outreach program to anyone on the other side willing to talk to him.

source: http://www.nytimes.com/2006/06/18/magazine/18tobacco.html?_r=1&oref=slogin 17jun2006

Tobacco Industry:
Smoking Isn't Bad For Your Health*

SOPHIE GOODCHILD & MARTIN HODGSON / The Independent 18jun2006

*Or at least not as bad as everyone says, according to pro-smoking campaigners who even claim it can fight disease. Now American tobacco giant Philip Morris says it need not damage fertility.

Tobacco companies are funding research into infertility in a bid to counter widespread evidence that smoking drastically undermines the chances of conceiving.

Philip Morris, one of the world's largest cigarette firms, is being accused by the anti-smoking lobby of attempting to deceive smokers into believing they can improve their chances of having children if they take vitamin supplements.

Campaigners such as the anti-smoking charity Ash say that tobacco giants have turned their attention to treatments which may boost fertility in a "cynical" attempt to change their image.

The criticism is in response to the publication of a Philip Morris-backed study this week which concludes that taking supplements of the mineral selenium, which is found in shellfish, as well as vitamin E tablets can boost fertility in men who have low-quality sperm.

However, the study, carried out by experts in Montreal in Canada, fails to make any mention of the fact that smoking drastically undermines sperm quality and that any benefits of vitamin and mineral supplements would be cancelled out by the effects of cigarettes.

The research comes as changing attitudes to smoking in the West have forced tobacco companies to seek out new markets in the developing world.

Cigarette sales in western Europe and North America have collapsed amid tougher anti-smoking laws, higher tobacco taxes and a growing awareness of the health implications. In Britain the number of smokers has fallen dramatically over the past 30 years or so. Where half the male population smoked in 1974, by 2003 that figure was down to 28 per cent; numbers of women smokers have fallen from 41 per cent to 24 per cent over the same period.

In turn, cigarette manufacturers are focusing their attention on eastern Europe, Africa and the Far East.

Tobacco companies have also been accused of turning a blind eye to cigarette smuggling in order to flood new markets with their product. And they have faced criticism for launching aggressive marketing campaigns, which would be banned in the West, linking tobacco with sex, youth and glamour.

Health workers say that the tobacco firms are taking advantage of looser trading restrictions and lower levels of health education to ensnare a new captive market of nicotine addicts.

"By funding research they create the impression that there is an ongoing debate about the health impact of smoking," said John Britton, professor of epidemiology at Nottingham University.

"They fund research in the developed world which affords a certain credibility, but all the time they carry on pushing the product in poor countries."

The new research is the latest in a series of studies used by the tobacco lobby in an attempt to downplay the potential health hazards of smoking.

In 1999, research carried out by the Parkinson's Institute in California showed that smoking may lessen the risk of Parkinson's disease. The study of 161 pairs of twins suggested that smokers were apparently protected from Parkinson's and was seized upon by pro-smoking campaigners.

But the doctors who carried out the research said that it was not possible to say which chemicals were responsible for the lower rate of disease, and stopped short of recommending cigarettes to prevent Parkinson's. Other studies quoted by pro-smoking campaigners have suggested that smoking may reduce the risk of hypertension and certain forms of cancer. They have also suggested that smokers' children may suffer from lower levels of eczema and asthma.

Dr Sinead Jones, who recently authored a report on smoking and reproductive health for the British Medical Association, said that the tobacco industry was more interested in maintaining its market than deepening medical knowledge. "The links between smoking and lung cancer were first detected in the 1950s, and since then the tobacco companies have been very active funding research, to increase their credibility in the scientific community and to confuse people about the risks of smoking," she said

"The real reason they invest in research is to increase their profits."

And a spokeswoman for Ash said it was "ludicrous" to urge people to take vitamin supplements to improve fertility if they are smokers. "They are very good at masking contradictions. It is bizarre when smoking is one of the most important causes of infertility problems and the first thing a GP would advise is to quit."

This is not the first time that the benefits of selenium have been highlighted by research which is either funded by or has links to the tobacco industry. The mineral has already been shown to lower the incidence of lung, colorectal and prostate cancer.

The power of tobacco companies to plug their products has been greatly reduced since the introduction of worldwide bans on overt advertising of cigarettes.

Since December 2004, all cigarette advertising in the UK has been banned apart from small images of products on vending machines, and tomorrow the House of Lords will vote on measures to restrict smoking in public places.

In response, tobacco companies have become increasingly inventive in finding new ways of raising awareness and marketing their products.

Smoking is one of the major causes of infertility in both men and women. Some studies have found that substances in cigarette smoke are toxic to the testes and ovaries. Smoking also reduces the quality of sperm. Women smokers also take longer to conceive, while the rate of miscarriage is substantially higher.

But Philip Morris denied that its motives were cynical in helping to fund the fertility research, which was carried out by researchers at the Hospital Saint-Luc du Chum, in Montreal.

A spokesman said that the company's aim was to improve public health and that it had no influence over the research that it funded.

"We make a product that is addictive and causes disease and one of our goals is to reduce the harm," he added. "There is no attempt to hide the fact we are funding research. This is always made clear so that the findings are transparent and independent."

Additional reporting by Hazel Francis

source: http://news.independent.co.uk/world/americas/article1090210.ece 17jun2006