Dr. Stanton Glantz

quitting smokingProfessor Glantz has been a long-time critic of tobacco and is a leader in the anti-tobacco public health community. In 1994, more than 4,000 pages of secret internal tobacco industry documents mysteriously arrived at Glantz’s office at the University of California. They were sent by a secret source, “Mr. Butts.” Dr. Glantz posted them on the Internet, as well as compiled them into a book, “TheCigarette Papers.” In California, Glantz has lobbied extensively for reform of cigarette laws and he and other local activists are responsible for the recent passage of the ban on cigarette smoking in bars. Glantz is opposed to a national settlement and believes that the cigarette industry can never be trusted to comply with any national deal.

Q. When the Brown and Williamson documents arrived, what was your reaction when you opened the box and started reading?

Glantz: Well, my initial reaction when I opened them was that I’m going to send these to Dick Daynard. Because I up until then had been working on issues around secondhand smoke and local clean indoor air laws, and was really not that interested in the litigation aspect of tobacco and nicotine pharmacology and cancer and all that. And, and so–I kind of knew what they were because they’d been floating around for some time and I’d heard about them. But my initial reaction was “well, I’ll look through these for a few minutes and ship them off to Dick because he’s the guy who’s really doing litigation.” But as I started to look through them I just got sucked in. I mean it was like an archaeologist stumbling into a new, you know, tomb or some kind of archaeological site. Because after working for years against the tobacco industry and listening to the absolutely ridiculous public statements that come out of the Tobacco Institute and their other spokesmen, to have a window into the industry and to see how they were really thinking–intelligent, motivated, sharp people–was just in, incredible and it sucked me in.

Q. Sucked you in how?

Glantz: I just realized I wanted to read all this stuff and I wanted to write about it. There was just an important story that needed to be written about and you know, I work in a university, it’s publish or perish. So I decided to publish something. Now we had no idea, or I had no idea when I started this that we’d end up writing a book. I was expecting writing maybe an article for a medical journal. But it just, it’s, it’s, it’s–I recruited some of my colleagues to work on the project and we got into it–the thing just grew and turned into, into the book we wrote.

Q. Now you say you heard about the documents, for a while some of your colleagues knew about the documents, but they wouldn’t go near them.

Glantz: Yeah what I had heard was there was a group of highly secretive internal industry documents that were floating around out there, that they’d gone to a variety of the health groups and other people and no one would touch them. That that was everything I knew till the story broke in May of 1994.

Q. What do you mean “no one would touch them”?

Glantz: I just heard that no one wanted them. I mean, I didn’t–I wasn’t paying that much attention. I mean I was working on secondhand smoke and trying to get local clean indoor air laws passed.

Q. Dick Daynard, Nader’s people, we understand through Merrell Williams he went to Daynard, he went to Nader’s people, he went to Morton Mintz and everybody acted like this is radioactive. Why would they do that?

Glantz: Well, the tobacco industry is very litigious, they’re very nasty, they have an infinite amount of money so they don’t need to have a good case. They’ll just bring a case to torture you. I mean they’re trying to do that to me at the University of California right now. And I mean it’s a baseless case but they’ll spend thousands of dollars just to keep us busy. And I think people just were frightened of them. I don’t know, I haven’t talked to them about why.

Q. Is this one of the reasons why Dick Scruggs and Mike Moore are important, that they weren’t scared?

Glantz: Yeah. I mean I think–when you look at what Dick Scruggs and Mike Moore and Humphrey and the others that came in to the Cerisi–the lawyers who come into this case have done the public a great service, because they’ve come in and had the courage and the wherewithal to take the industry on on its own terms. And I think that the activities of these lawyers really points to the really inadequate job that the public health community’s done on this issue for the last forty years. They’ve talked about tobacco a lot, but they’ve never been willing to put the resources into taking the industry out. If you go back and look at the–back to 1964 when the Surgeon General’s report first came out and read the Brown and Williamson documents and other things that have come out, the industry was terrorized of the public health groups, especially the Cancer Society, that they were just going to come in and squash them. And they didn’t, you know? Instead of coming in and smashing the tobacco industry they decided that they would keep kids from smoking. They’re making–the same mistakes they’re making now. It’s just right now you see history repeating itself. But if the public health community had been willing to demand the kind–and commit the kind of resources that it took, there–pardon me. If the public health community had been willing to commit the kind of resources that they, that they could have, they could have wiped out the tobacco industry in the sixties as a public health problem. But it wasn’t until Scruggs and Moore and, and all these other lawyers, Motley, uh, Humphrey, Cerisi, came along and started to take the industry on seriously. And you know, these guys are very sharp and they spend a moderate amount of money, but it’s not an astronomical amount of money, it’s not money that the health groups couldn’t have spent if they’d wanted to.

But the tobacco companies not only have worked hard at influencing government, they’ve worked hard at influencing the public health community and keeping them frightened, and trying to convince them that if you did anything meaningful your donations, uh, would go down and it would be controversial. And one of the things the industry understood very early on was groups like the Cancer Society and the Heart Association, the Lung Association , were terrified of controversy. So every–because they thought it would hurt their donations. And so any time those groups started to move toward doing anything effective, which generally meant something in the political arena, the industry would yell and scream and jump up and down, they would get their, their toadies to yell and scream and jump up and down, and these groups generally backed off. And it was a strategy that worked for years and years and years.

I mean the thing I’ve learned is that when the industry tries to make something controversial, you should run straight at it. Because that’s what matters, you know. You don’t see the industry complaining about reducing youth smoking because they know that the strategies aimed at just reducing youth smoking won’t hurt them in the long run. You don’t see the industry complaining about smoking cessation because they know it isn’t very effective. But clean indoor air, meaningful restrictions on advertising and promotion, things designed to hold them responsible for the costs they impose on society–those are the things the industry’s scared of. And those are the very things that these health groups have been very slow, to take up.

Q. So Moore, Scruggs, they were the father of Dr. Butts at least, or Mr. Butts, right?

Glantz: No one’s ever told me where it came from.

Q. You’ve never asked?

Glantz: No. why, what’s in it for me? Just make my life more complicated.

Q. If you knew who it was who changed you life for the last four years?

Glantz: I’ll find out when I get to a nursing home. It’s a lot simpler to just leave that door closed.

Q. When you first heard of this lawsuit in Mississippi, the idea of suing for Medicaid, the third party suits like that, what was your reaction?

Glantz: Oh, it was a great idea.

Q. Most people we’ve talked to said it was a crazy idea. Didn’t have a chance in the world.

Glantz: No, I thought it was a great idea. I mean, the taxpayers get stuck with these costs, the industry’s been lying to the public for decades, why shouldn’t they try?

Q. Were you suspicious of these personal injury lawyers? These guys with their jet planes and their big yachts and their swashbuckling attitude?

Glantz: No more than you should be. I mean, my attitude toward the lawyers was they had their lawyers and–they had their greedy lawyers on horseback and now the public health people had their greedy lawyers on horseback. And that was fine. The big problem that we’ve had with the lawyers has not been with the lawyers. The lawyers are acting like lawyers. The big problem that we’ve had is that the public health community and, and the politicians, who should be serving the public interest and keeping the lawyers under control, effectively being the clients, have tended to let the lawyers tell them what to do, and, and have tended to let the lawyers set the agenda. Rather than asserting the public interest and keeping the financial pressures on these lawyers in balance by the public interest.

I mean in the end the lawyers who brought these cases are going to make a lot of money, whether they settle, whether they go to trial, or whether Congress bails out the tobacco industry. And I frankly don’t begrudge them the money. I think they’ve done a–done the public a great service in getting this process going. But right now these same lawyers are pushing a deal in Congress which is not in the public interest. And, and I think that the interest of the lawyers and the public health community have to some extent diverged. And one of the things that I think the public health people never understood in the–as this thing unfolded was there was a period of time when the interests of the lawyers bringing these cases and the public health interests were quite congruent but they weren’t identical. And what’s happened in the last few months is those interests have diverged.

Q. Well let me take you back to 1996. By then you’ve got Wigand, you’ve got Merrell Williams, you’ve got Bennet LeBow, you’ve got a growing number of states suing.

Glantz: Right.

Q. And word is out that there is an attempt to develop a settlement. What was your reaction then?

Glantz: I thought it was horrible. I thought it was premature, I thought it was a sellout, I thought that this was the beginning of the divergence of the public interests and the interests of these lawyers, and that it was a mistake. Again, the power–the, the, the power to fight the tobacco industry, the proper place to fight the tobacco industry is not in the United States Congress. If you were the Starship Enterprise and you searched the entire universe for the place where the tobacco industry had the most power, it would be the United States Congress. Particularly this Congress, which was put there in no small measure by tobacco industry money and influence. So you want to stay away from that. If you’re in a war with a well-armed enemy you don’t rush into their citadel to fight with them; you try to get them to fight on your terms. And what’s happened with the tobacco control movement, particularly with regard to clean indoor air, is we’ve learned that the communities is where you can beat them.

And what the AG’s did with all of these suits is they distributed the problem all over the country into many different venues with different sets of rules, environments where the industry had not historically been so strong. And that’s where we should keep the fight because we can win there. We have won there. So I–so the idea of some big blowout settlement, of pulling the whole thing back into the United States Congress, never appealed to me. And if you go back–and I thought, and, and they were asking for way too little. I remember Dick Scruggs when the first proposals came out, I think it was four billion dollars or six billion dollars. He was going around saying “this is the best we’re ever going to do. This is the best we can do. You better take it. If you don’t take it now they’re going to take it away and we’re going to never get anything.” Well, that has only gone up by a factor of fifty or sixty since then. That the three hundred sixty eight billion dollars they’re talking about now is only about five cents on the dollar. So it’s still a great deal for the cigarette companies.

Q. What do you mean, five cents on the dollar?

Glantz: The tobacco industry costs America, just in health costs and lost wages, about a hundred or a hundred and ten billion dollars a year in just direct damages. The settlement would only produce about twelve billion a year. And it’s tax deductible so it’s really only five. So the deal that the AG’s made is something that would, if it had been implemented as written, would have reimbursed the states pretty nicely for their Medicaid expenditures, which was the original motivation for those suits. But the other ninety five percent of the smoking-related costs, which the industry should be held liable for, were just blown off. You know, the, the deal that was negotiated and released last June, it, it took great, it took good care of the tobacco industry, it took reasonable financial care of the states, in terms of their Medicaid expenses, and it left the public out in the cold.

Q. Up to that point, June twentieth, the tobacco industry had never admitted anything.

Glantz: Yeah.

Q. You didn’t see that as a great step forward?

Glantz: No, no. I think that the industry could read the handwriting on the wall. The history of this issue–and we’re having very much a replay of the sixties. In the sixties, when the original Surgeon General’s report came out, there was a tremendous amount of action against the tobacco industry going on all over the country. All over the country there was chaos from their point of view. And they went to the United States Congress and they pretended to compromise. And they gave a little bit on warning labels and later they gave a little bit on advertising restrictions, and got bailed out for thirty years. And that’s, and that’s what’s going on again here.

I think the way to beat the tobacco industry is to beat the tobacco industry. You know, it’s not easy but it’s possible, and you do it one step at a time. And the fact that these suits are distributed all over the country in many different venues under many different sets of rules and all the AG’s and the other lawyers are cooperating with each other–to me, that’s a recipe for long term disaster for the industry, which is what I’d like to see happen. I mean these people have killed ten million Americans since that 1964 Surgeon General’s report. And they should not be allowed to just go on.

The tobacco industry has killed ten million Americans since the 1964 Surgeon General’s report, and they should not be allowed to buy their way out of taking responsibility for their actions. I mean we have a civil and criminal justice system to impose reasonable conduct on businesses, and the tobacco industry should not be allowed to buy their way out of their responsibility for five cents on the dollar. Or for even a hundred cents on the dollar. I mean, they should have to take responsibility for what they’ve done. And I think we’re making very good progress in doing that. While I think the deal in Congress is, is a, almost complete victory for the tobacco industry, and particularly the June twentieth agreement was masterfully negotiated by their lawyers. Because they produced something that looked good, but when you get down and look at the nitty-gritty details of it on every little thing, on anything that mattered the industry won. And on anything that didn’t matter they gave. And they sure think–the reason is very simple. They, I mean they’d been planning on this showdown for thirty years. I mean you can find things in the Brown and Williamson documents where they were talking about what should we do if we start really facing the chance of losing these suits? And they said we should establish a superfund that will give us immunity. And that’s just what they’re trying to do.

Q. So they’ve outsmarted the public health community, they’ve outsmarted the Attorneys General.

Glantz: Yes, absolutely.

Q. Now, you say the devil’s in the details. Let’s go over a couple of details.

Glantz: Okay.

Q. You don’t like the immunity that the deal provides. Why not?

Glantz: Because the tobacco industry’s killed ten million people. Because they’ve committed a huge fraud on the American public. And because they should be held accountable for that. They should be held accountable to the same rules of corporate and individual behavior as everybody else. It’s very simple.

Q. The immunity issue threatens their survival. They wouldn’t want it unless they were worried about surviving.

Glantz: No, that’s correct. The issue of liability is what has driven this industry for the last fifty years. If you read the doc–the Brown and Williamson documents, if you read any of the documents that have come out, you’ll see that this is an industry who is–whose whole thinking and behavior has been dominated by avoiding responsibility for their actions. … They want to be released from responsible corporate behavior. And I think that’s a mistake.

Q. You know what the problem is when I’m listening to what you say it sounds like you want to wipe them out completely.

Glantz: Well that wouldn’t be a bad thing, to have the tobacco industry disappear. You know, if we go back to the, the–the tobacco industry as it exists in this hypermalignant form today, it, it always wasn’t that way. If you go back to about 1890 or 1900, per capita cigarette consumption in this, in the United States was a couple of cigarettes a day, maybe, if that. And it was only with the advent of mass marketing that we got, uh, this huge monstrosity we have today. And yeah, I’m a public health person. I’d like to get rid of tobacco. I’d like to get rid of cancer. I’d like to get rid of heart disease. And I think that if the industry were forced to accept the same kind of financial responsibility for its actions that any other business would have to take, that would force a radical restructuring of how it functions, in a way that would lead to less smoking. Now exactly how that would play out isn’t clear to me. [I]f they get stuck paying out billions and billions and billions and billions of dollars every year, then they’re–at the very least going to have to raise their prices, which will discourage smoking. But if they can–in doing that they also have to be looking over their shoulder for their continuing liability–for their fraud, for their anti-trust actions, for their deceitful marketing tactics, maybe they’ll change the way they do the marketing. Maybe Phillip Morris will decide they’d rather sell cookies and crackers and beer rather than cigarettes, and just get out of the business.

Q. So you’re basically a prohibitionist.

Glantz: No, no.

Q. You want to wipe them out?

Glantz: No, no, that’s different from being a prohibitionist. A prohibitionist says “I’m going to make it illegal for you to, to sell or smoke cigarettes. I’m not, I’m just saying I want them to have to play by the same rules as everybody else does. And that will force them to behave very very differently. Like when you say someone who wants to do this is a prohibitionist, that’s like saying the people who used the legal system to force to make cars where the gas tanks didn’t explode were prohibiting exploding gas tanks.

Q. There’s a difference. This is a product which, used as directed, will kill you.

Glantz: That’s right.

Q. So there is no way out. You will either–from your logic.

Glantz: Well I think that if the tobacco industry were forced to play by the same rules as everybody else, we would see a radically different tobacco industry.

Q. The reality is, though, Stan, that what you would minimally do, according to industry, according to economists and everyone else, is you would drive them into bankruptcy. And bankruptcy, as you know, doesn’t mean you’re going to get what you want.

Glantz: One thing that’s clear, one group that would definitely be worse off if the industry went into bankruptcy, are the private lawyers. Because they wouldn’t have a direct claim on any assets, and so they would be far down the list of people to get paid. So they would make less money. But whether the public health would be worse off if a bankrupt–if the industry went bankrupt, it’s hard to tell, but probably they would. Because if the industry goes into bankruptcy–and there’s one of two possibilities. One is what’s called the Chapter Seven Bankruptcy where they just dissolve. Well, if the industry just dissolves then we don’t have this huge malignant corporate entity out there pushing cigarettes. So that would be okay.

The other possibility is what’s called a Chapter Eleven Bankruptcy where the reorganize to try to manage their debt. But one of the things they have to do in such a reorganization is they have to be able to say that they will be financially solvent in the future. And you will get the other big corporate bankruptcies, like the asbestos bankruptcies, which were brought on by litigation. In every single one of those cases the company had to stop doing the things that generated the bankruptcy. And so while there’s a lot of uncertainties in bankruptcy, I think the downside for the industry in doing it is much larger than the potential downside for public health.

Q. But aren’t you ignoring the fact that there are fifty million people who are addicted to smoking, that other people will get in the act of supplying those cigarettes, and other companies will rise up either from the ashes of the bankrupt companies or substitute for them? And they won’t be liable for the damages of the past.

Glantz: They won’t be liable for the damages of the past. But they will be liable for their future behavior. And they’ll be forced to operate in a very different environment, in a very different political environment and legal environment than the existing companies are. And you know, it’s, if, if you’re a businessman looking out there and saying “oh, these huge multinational corporations just got stakes driven through their hearts selling this product,” I mean you don’t see people rushing out to sell asbestos or silicone breast implants because there’s a new market available. You know I think, you know, the other thing is, is that the kind of people who have been attracted to the tobacco industry are a special breed of people who can sleep at night knowing they’re killing a lot of people. And there aren’t a lot of people out there like that.

And you know maybe what we would end up with is a situation where the government would–you know, we had like Amtrak for smokers. Where the government was making available plain cigarettes in plain packages for people who just couldn’t stop smoking. I mean we’ve shown here in California that an aggressive anti-tobacco education campaign can triple the rate of decline of cigarette use. If Pete Wilson hadn’t come in and wrecked the campaign because of his pro-tobacco ties, we’d have taken the percentage of adults who smoked in California from about twenty eight percent to about five percent in under ten years. You know, if the tobacco industry was out of the way politically, and–what I would do is I would figure out some way to take care of the addicted smokers, to get them their cigarettes without any active marketing whatsoever, and run a big tobacco control program and in ten years we could be rid of the problem.

Q. [I]f the Congress of the United States says you paid the sixty billion dollars up front for punitive damages, so no one can sue you any more for punitive damages for the past (they could in the future), are you against that?

Glantz: Yes.

Q. Why?

Glantz: Because it’s not fair. ‘Cause it’s letting the industry off for pennies on the dollar.

Q. You’re against immunity for the industry.

Glantz: Yes.

Q. If in March of last year Dick Scruggs had called you up and said “Stan, come to Washington. I’ll send a jet to pick you up. We’re going to negotiate with these guys. They seem to want to give up.” Would you have gone?

Glantz: No. Because they won’t give up.

Q. You wouldn’t have listened.

Glantz: They won’t give up. They never give up. They don’t. I mean, I’ve fought these guys for twenty years. I’ve seen how they work all over the world. They may pretend to give up, but they don’t give up. They’re not stupid. And, and I don’t think you can negotiate with them, at least at that level–at that venue. Obviously the state settlements are the results of some negotiations. And those worked out, I think, reasonably well. But there was no immunity. The important thing about the state settlements is they settle those cases. They don’t take anybody else’s rights away. Which is what the immunity would do. They don’t foreclose anybody else’s options. And the state settlements represent, I think, reasonable and just compensation to the states that have settled, together with good compromised by the industry which are getting better with each of the state settlements. And in doing that, it doesn?t give–take anybody else’s rights away, and it doesn’t foreclose any options.

Q. Let’s get specific again about the issue of what you call immunity. In fact the state settlements settle the Medicaid suit. The state cannot sue any more, ever, in the future.

Glantz: On Medicaid. That’s correct.

Q. Okay, so that’s a settlement.

Glantz: Right. But the important thing is, if you look at what the states were suing for, it was for recovery of the Medicaid costs. And if you look at the amount of money that the states are getting, they’re getting essentially a hundred cents on the dollar or better. And so into, into perpetuity in the future. And so they’re reasonable suits. The state brought an action to recover its Medicaid costs; the industry is paying those costs. So the state doesn’t need to sue again.

Q. But the settlement, as I understand it, as proposed on June twentieth and also as getting tougher in terms of how it’s perceived in Congress or what’s going to be presented, only allows the industry off on punitive damages and class action suits.

Glantz: Right.

Q. You could still sue.

Glantz: No, but the point is when you look at why the tobacco industry–well, there’s a couple of problems. The first thing is the amount of money that the states got in the individual state settlements is what they’re owed. The amount of money that people are talking about in the national deal is about the same amount of money. But it covers everything, you see? Medicaid costs are about five percent of the total smoking-induced costs. And so if the state settles a Medicaid suit for the Medicaid costs that’s reasonable. But that still leaves the other ninety five percent.

Q. But your numbers are cooked.

Glantz: No they’re not.

Q. Well, people disagree about how much money it costs every year and?

Glantz: We’re using, the CDC’s numbers.

Q. Has anyone ever won a class action suit or gotten it certified in the United States against the tobacco industry?

Glantz: No one’s won one yet, but they did–oh wait, wait, but they did, they did the Mangini case here in San Francisco.

Q. It’s settled.

Glantz: It’s settled. But that’s okay, it was settled on very favorable terms.

Q. I’m asking you did anyone ever win one that went to trial?

Glantz: Not yet.

Q. Has anyone collected any punitive damages against the tobacco industry?

Glantz: Not yet.

Q. Has anyone got an award against the tobacco industry through trial that’s been upheld on appeal?

Glantz: Uh, yeah.

Q. An award at trial?

Glantz: The case, I believe–well, there was a case about the Kent Micronite Filter here in San Francisco that was won, and the industry agreed to pay the damages. Part of it’s being appealed. But we’re very early in this process. You know, we just, this is just getting going. And it’s going very well, and all the signs are very good and why stop?

Q. Tell us, once you had the documents, how did you get them out, and what impact did that have?

Glantz: When I started reading these documents, I mean, I just got sucked into them. And I mean it was an amazing story of the realities of the tobacco industry from the inside. And I realized we had to write something about this.’

And so I assembled a team of experts, and we started analyzing these documents, and writing about them. And that ultimately led to a series of papers in the Journal of the American Medical Association. Which happened to come out about the time Clinton was deciding whether to let the FDA move forward, which was just sheer luck. But that helped convince Clinton to let the FDA go forward.

And we subsequently wrote a book about them, called The Cigarette Papers. And that book has become the bible for all these lawyers. I mean, when we wrote the book, I did the index for the book, which was very tedious. But it, the book has three indexes. It has the document index. It has a subject index, and it has a name index. And that name index I wrote for the lawyers. Particularly for the Justice Department. You know?

And that book and the work we did in putting the documents up on the World Wide Web, despite a lawsuit brought by Brown & Williamson against the university, I think, helped us light the afterburners on this whole process.

But you know, when we did that, we knew it would be important. But I’ll tell you in hindsight, we did not appreciate how important it was. Or would be. And I don’t think we still understand how important what we did is.

And that’s why I say the one thing you should never do is foreclose the future. You’ve got to let this thing unfold. You’ve got to have some patience to solve the problem.

And you know, when the tobacco in — when I got the documents, and the word got out that I had them, and the tobacco industry sued the University of California to try to keep us from putting them up on the World Wide Web, the university didn’t try to cut a deal with the industry. Or look for some easy, fast way out. The university beat the tobacco industry.

And when the tobacco industry sued the university over our research which showed that smoke-free bar laws don’t affect revenues, and the industry sued the university trying to shut me up and to discredit our study, the university didn’t say, “Okay, we’ll only let Glantz talk to reporters on Saturday.” They beat the tobacco industry.

And that’s what we need to continue doing. One victory at a time. Are we going to win every case? No. But we’ll win more than we’ll lose.

Q. You said you had a name index in the book for the Justice Department. What are you talking about?

Glantz: Well, I think there’s been a lot of criminal activity on the part of the tobacco industry. I think that they’ve engaged in antitrust activities, fraud, covering things up. They’ve abused the legal system, abused the attorney-client privilege. I think there’s evidence in there of a whole variety of misbehavior on the part of the industry. And the Department of Justice has read our book very carefully. I’ve met with them several times.

Q. You’ve met with attorneys there?

Glantz: Yes.

Q. What have they said to you? What have they asked you?

Glantz: They asked me not to tell people what they asked me. But I can tell you they’ve asked very pointed, intelligent questions. They’re doing their homework. And I can’t wait for them to finish.


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