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Big Tobacco led throat doctors to blow smoke

Article / Review by on January 23, 2012 – 8:16 pmNo Comments

Big Tobacco led throat doctors to blow smoke

Big Tobacco led throat doctors to blow smoke

Tobacco companies conducted a carefully crafted, decades-long campaign to manipulate throat doctors into helping to calm concerns among an increasingly worried public that smoking might be bad for their health, according to a new study by researchers at the School of Medicine. Beginning in the 1920s, this campaign continued for over half of a century.

“Tobacco companies sought to exploit the faith the public had in the medical profession as a means of reassuring their customers that smoking was safe,” said , the Edward C. and Amy H. Sewall Professor in Otolaryngology.

“Tobacco companies dreamed up slogans such as, ‘Not one single case of throat irritation with Camels;’ then, to justify their advertising claims, marketing departments sought out pliant doctors to conduct well-compensated, pseudoscientific ‘research,’ which invariably found the sponsoring company’s cigarettes to be safe,” Jackler said. “The companies successfully influenced these physicians not only to promote the notion that smoking was healthful, but actually to recommend it as a treatment for throat irritation.”

Jackler is the senior author of the study, which was published in the January issue of The Laryngoscope. Hussein Samji, MD, a recent Stanford residency graduate, was his co-author.

Using internal documents from tobacco companies from the Legacy Tobacco Document archives, the study’s authors reviewed a wealth of correspondence, contracts, marketing plans and payment receipts that shed light on the industry’s multifaceted, highly effective campaign.

Jackler’s ongoing research into the history of tobacco company advertising has resulted in several published studies on the topic, sparked in part by his collection of thousands of historical cigarette ads exhibited online at, the originals now donated to the Smithsonian Institution. He also spearheaded a group called the Stanford Research into the Impact of Tobacco Advertising, which analyzes the effects of tobacco advertising, marketing and promotion.

In the new paper, the authors describe how tobacco companies regularly hosted “hospitality booths” at otolaryngology conventions from which they gave out free cigarettes, sometimes with packs embossed with the doctors’ names. In major cities all over America, throat specialists were taken out to elegant dinners at which they were implored to “prescribe” their brand of cigarettes to patients with sore throats or coughs.

When the government, through the Federal Trade Commission, tried to intervene against “hucksterish” advertising slogans promoting the healthfulness of their cigarettes, prominent otolaryngologists were recruited to defend the validity of the blatantly false claims.

“The list of recruitments who served as experts testifying on behalf of tobacco interests includes a virtual who’s who of leading otolaryngologists in the 20th century, including many leading head and neck cancer surgeons,” Jackler said.

In 1949, the average physician income was $11,058. In that era, a $5,000 payment — which was common from tobacco companies to otolaryngologists — represented a major inducement.

Even after the Surgeon General’s Report of 1964 definitively linked smoking with cancer of the voice box (larynx), the otolaryngology departmental chairs of four major universities testified before Congress in opposition to the findings.

“It was especially disappointing to discover that leading otolaryngologists took public positions exculpating tobacco even after the definitive Surgeon General’s report,” the study said.

The authors emphasized the importance of collaboration between doctors and industry for continued advances in medicine, but pointed to this study as a reminder to the medical community of the need to adhere to the “highest standards of scientific validity” and to remain vigilant in the advocacy for patients’ interests when working with industry.

“Ethically, a physician must always act on behalf of the well-being of patients,” Jackler said. “Responsible industries balance their need to maximize profits with a commitment to improve the health of their consumers.”

This research was conducted as part of the Stanford Research into the Impact of Tobacco Advertising. The school’s Department of Otolaryngology also supported the research.


Robert K. Jackler, MD

Robert K. Jackler, MD. Bio.

Robert K. Jackler, MD Professor, Otolaryngology (Head and Neck Surgery) Professor (By courtesy), Neurosurgery Professor (By courtesy), Surgery Otolaryngology – Head & Neck Surgery 801 Welch Rd MC 5739 Stanford, CA 94305

> Clinical Focus Acoustic Neuroma, Cerebellopontine Angle Meningioma Neurofibromatosis 2 Glomus Jugulare Tumor Ear Neoplasms Otosclerosis Cholesteatoma Facial Paralysis Facial Nerve Tumor Otolaryngology Otolaryngology – Head & Neck Surgery (Ear, Nose and Throat)

> Administrative Appointments Sewall Professor and Chair, Department of Otolaryngology-Head & Neck Surgery (2003 – present) Associate Dean, Postgraduate Medical Education, School of Medicine (2007 – 2011)

> Professional Education Board Certification: Neurotology, American Board of Otolaryngology (2004) Fellowship: House Ear Institute CA (1985) Board Certification: Otolaryngology, American Board of Otolaryngology (1984) Residency: UCSF Medical Center CA (1984) Internship: UCSF Medical Center CA (1980) Medical Education: Boston University School of Medicine MA (1979) MD, Boston Univ School of Medicine Medicine (1979) Residency, Univ California, SF Otolaryngology – Head/Neck Surg (1984) Fellowship, House Ear Institute Neurotology (1985)

> Graduate & Fellowship Program Affiliations Biomechanical Engineering Neurosciences Neurosurgery

> Current Research Interests

Stanford Research into the Impact of Tobacco Advertising (SRITA)

SRITA is a Stanford research group which analyzes the effects of tobacco advertising, marketing, and promotion. Participants in this interdisciplinary program include faculty and students from several Stanford School of Medicine departments as well as the departments History and Anthropology.

Resources for Study: • Digital collection of over 12,000 historical and contemporary magazine and newspaper tobacco advertisements (The original print advertisements were donated to the National Museum of American History at the Smithsonian Institution in 2/11) • Video advertising collection including hundreds of early TV tobacco advertisements ( • Compilation of tobacco industry web and social media based promotions ( • Collection of internal tobacco industry documents relating to advertising campaigns

Resource for Scholars: Thematically organized, annotated archive of print and video advertising collections available on the web. (

Research Priorities: 1. Use of medical and scientific themes to reassure a worried public about the health hazards of smoking 2. The marketing of “safer” cigarettes including filters, low tar and nicotine, and “lighter” smoke 3. Techniques used in targeting of specific populations including women, youth, African Americans 4. Endorsements by prominent movie and TV stars, athletes, and politicians 5. Use of cultural icons such as jazz music, religious symbols, patriotic imagery, and trusted professionals. 6. Use of social media (eg Facebook) in promoting tobacco use and as an educational tool communicating the dangers of smoking

Museum Exhibit The “Not a Cough in a Carload: Images from the Campaign by the tobacco Industry to Hide the hazards of Smoking” exhibit debuted at Stanford University in January 2007 subsequently displayed at the University of California, San Francisco, Harvard Medical School, the New York Public Library, South Station in Boston, Philadelphia, McCallen Texas, Louisanna State University, Washington University, St Louis, and Vanderbilt University. A second exhibit travelled to 3 major cities in Brazil.

Scholarship (selected publications) Samji HA, Jackler RK. “Not one single case of throat irritation”: Misuse of the of the image of the otolaryngologist in cigarette advertising. Laryngoscope 118: 415-427, 2008

Lum KL, Polansky JR, Jackler RK, Glantz SA. Signed, sealed, and delivered: Big tobacco in Hollywood, 1927-1951. Tobacco Control 2008 Oct;17(5):313-23

Jackler RK, Samji HA. The Price Paid – Mid 20th Century Tobacco funded research designed to obfuscate the emerging truth that smoking causes head and neck cancer. Laryngoscope Jan 2012

Lecture “Not a Cough in a Carload” by Dr Jackler:

On Stanford I Tunes U or Research Channel:

### * Stanford University Medical Center integrates research, medical education and patient care at its three institutions – Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital. **  The above story is adapted from materials provided by Stanford University School of Medicine


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