Cigarettes: they provide no nutrition and quench no thirst. They serve no purpose other than being an excuse to take a break from the grind before getting right back to it. And on top of that, they’re deadly. As far as American vices go, they might be at the top of the list. So how did they get and stay popular for so long? And why are they making a comeback?
This two-part episode dives into the rise of this quintessential American product, the science that proved it was dangerous, and the eventual reckoning that came from a mysterious box of documents—one delivered with the return address of an iconic cartoon character. Along the way, we’ll uncover what has driven so many Americans to risk their lives to light up despite what the science has told us.
Credits
Host: Alexis Pedrick
Executive Producer: Mariel Carr
Senior Producer: Rigoberto Hernandez
Sound Design: Seth Samuel
Fact-Checking: Alexandra Atiya
Resource List
ABC News. Surgeon General’s Report on Smoking. May 16, 1988.
Brandt, Allan M. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America. Basic Books/Hachette Book Group, 2007.
CBS News. Smoking: “A health hazard of sufficient importance”
CBS News Extra. “On Smoking and Health” 1964.
Chesterfield Cigarette Commercial with Mason Adams.
C-SPAN. Congress Investigates: Tobacco Industry. 1994.
DOLL, R, and A B HILL. “Smoking and carcinoma of the lung; preliminary report.” British medical journal vol. 2,4682 (1950): 739-48. doi:10.1136/bmj.2.4682.739
Frontline, PBS. Tobacco on Trial. 1986.
Glantz, Stanton A., John Slade, Lisa A. Bero, Peter Hanauer, and Deborah E. Barnes.The Cigarette Papers. Berkeley: University of California Press, 1996.
Glantz, Stanton A., “Stanton Glantz: Putting Cardiovascular, Epidemiological, Economic, Political, and Policy Research into Action at UC San Francisco and Beyond.” UC San Francisco Oral History Project. Interviews conducted by Paul Burnett in 2021 and 2022
Hoffman, David “How Americans Got Sold on Cigarettes”
Inside Edition. “Are Cigarettes Cool Again?” Inside Edition, 2026.
River of Gold-Tobacco. British Pathé, 1969
Showdown on Tobacco Road. UCSF Industry Documents Library, Truth Tobacco Industry Documents Library, Philip Morris Records, Master Settlement Agreement, November 1987
Smoother, Cooler Cigarette Commercials (1950s & ’60s)
Tobaccoland, USA. Produced by Liggett & Myers Tobacco Company, 1949.
Truth Tobacco Industry Documents Library, University of California San Francisco.
“Wild Stallions” Marlboro advertisement. 1970
Wynder EL, Graham EA. Landmark article May 27, 1950: Tobacco Smoking as a possible etiologic factor in bronchiogenic carcinoma. A study of six hundred and eighty-four proved cases. By Ernest L. Wynder and Evarts A. Graham. JAMA. 1985;253(20):2986-2994. doi:10.1001/jama.253.20.2986
Yeaman, A.. Implications Of Battelle Hippo I & II And The Grifffith Filter. UCSF Industry Documents Library, Truth Tobacco Industry Documents Library, UCSF Brown & Williamson Collection, 1963 July 17. Accessed: Sep 14, 2026. https://www.industrydocuments.ucsf.edu/docs/hrwh0097/.
1955 Lucky Strike Cigarettes Commercial, “LIGHT UP A LUCKY – ITS LIGHT UP TIME”
1963 Viceroy Cigarette Commercial, “Swingers”
Transcript – Part 1 (The Rise)
Alexis Pedrick: From the Science History Institute, I’m Alexis Pedrick. Welcome to the new season of Distillations: American Vice. Over the next eight episodes, we’re diving into stories about our appetite for risk, how science plays a role in it, and how it’s shaped the American experience.
First up, a story about the most American vice of all. It provides no nutrition. It quenches no thirst. It serves no purpose other than being an excuse to take a break from the grind and then get back to it.
Light Up a Lucky Ad: Relax, It’s light-up time…
Alexis Pedrick: I’m talking about the cigarette.
1963 Viceroy Ad: Shared a court with a couple we met, then took time out for a cigarette. Viceroy? That’s right!
Chesterfield Ad: Make your pleasure long, pleasure true, pleasure filter-free. Chesterfield…
Alexis Pedrick: We can laugh at these old ads now, because we’ve come a long way from being so happy-go-lucky about cigarettes. We know they’re poison now. You can’t smoke in restaurants or on airplanes or elevators. Americans just aren’t lighting up like they used to. At least that’s what we thought. But then we started noticing something.
Inside Edition: “Are Cigarettes Cool Again?”: Are cigarettes cool again? Sabrina Carpenter takes a drag in this music video…Jeremy Allen White’s character smokes up a storm in The Bear and Zendaya puffs on a cig in Euphoria. There’s even an Instagram account called “cigfluencers.”
Alexis Pedrick: And then there was this Instagram post that made our jaws drop.
Instagram Post – We Need to Smoke Again: We need to smoke again. If you’re young, you don’t understand this, but in the nineteen hundred and nineties, we smoked. We smoked all the time. We smoked cigarettes behind the school in our cars, at coffee shops. This was our stimulation.
Alexis Pedrick: And look, as someone who was a teenager in the 90s, I can confirm she’s not wrong. But does she not remember why we stopped smoking? Oh wait, she does.
Instagram Post – We Need to Smoke Again: The death thing is a problem. I acknowledge it being an obstacle here to my plan, but like, I mean, surely there’s a way around that, right? Like we can figure this out. We’re smart, we’re capable. How do we bring back a cigarette that doesn’t kill us?
Alexis Pedrick: Trying to wrap your head around that question? Same. So how did we get here? How did we go from cigarettes being a niche product when they debuted in the late 1800s to becoming the quintessential American product by the end of the 20th century? How did that happen despite the fact that cigarettes are poison? What was the thing that finally brought their rise crashing down? And why, why are they getting popular again?
Chapter One: How Do You Sell a Poison?
Alexis Pedrick: Before there were cigarettes, there was just a plant.
Tobaccoland USA: The aromatic annual called tobacco.
Alexis Pedrick: Humans started using tobacco shortly after they arrived in the Americas. Archaeologists have recovered seeds from an ancient hearth that are a little over 12,000 years old. And while we don’t know exactly what those Paleolithic campers were doing, researchers believe that the plant could have been smoked or put behind the lip and sucked. But that wasn’t the only early use. For centuries, indigenous Americans have used the plant for medicinal and spiritual purposes. And then, when Europeans arrived to colonize the Americas, they quickly turned it into a lucrative cash crop.
River of Gold: Tobacco is a crop that calls for care. From early spring, when the seeds are sown, to the time of harvesting the luscious leaves.
Alexis Pedrick: People smoked the leaves in pipes, or they rolled them into cigars and smoked those. And though it had many fans, tobacco also had critics from early on. In 1604, King James I described smoking tobacco as a custom “loathsome to the eye, hateful to the nose, harmful to the brain, and dangerous to the lungs.” Still, by 1670, half the men in England smoked it daily. Cigarettes, which literally just means little cigars, didn’t come along until the middle of the 19th century. They started taking off after inventor James Bonsack patented his game-changing cigarette rolling machine in 1880. Production remained pretty small-scale at first, but by the time we got further into the 20th century, things changed.
Allan Brandt: And people went from being able to produce a few thousand cigarettes in a day to being able to produce hundreds of thousands.
Alexis Pedrick: This is Allan Brandt, a historian of science and the author of The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America.
Allan Brandt: And that led the leaders of the tobacco industry to say, how are we going to sell this many? How can we invent and expand demand?
Alexis Pedrick: Before cigarettes, smoking was mostly relegated to just one part of 19th-century American society.
Allan Brandt: It was very much an elite male practice and behavior.
Alexis Pedrick: But when the mass production of cigarettes made tobacco cheaper and more accessible, suddenly, working-class boys started smoking, too. Still, despite the growing popularity of smoking in the U.S., there continued to be pockets of strong opposition. In the late 1800s, the cigarette was loathed by the same people fighting for the prohibition of alcohol. To them, both vices trafficked in the same evils: wastefulness, indulgence, and the willful poisoning of oneself and others.
Allan Brandt: Religious organizations made the case very strongly that smoking was a sign of bad character, and it was very bad for your health, and boys should really be restricted from it. And that’s kind of the eve of the 20th century.
Alexis Pedrick: Even though America had come a long way from its puritanical roots and the pastime of frowning upon worldly pleasures, the concept of leisure was still taboo.
Allan Brandt: The worst thing you can say about somebody, I think, in the late 19th century is that they were, you know, idle and pleasure-seeking. And here you had something with no purpose except for the enjoyment of individuals and groups.
Chesterfield Ad: You’ll find a man stops and takes big pleasure when and where he can. Chesterfield.
Oasis Ad: Oasis takes you away…welcome to sunny California! Oasis, fresh as a sunlit day…Oasis, cool as the sparkling spray…Oasis takes you away.
Alexis Pedrick: This struggle between cigarette-lovers and cigarette-haters continued through the first decade and a half of the 20th century, and there was real momentum behind banning or limiting the sale of cigarettes. By 1909, Kansas, Minnesota, South Dakota and Washington had all passed some sort of prohibition measure. But everything changed in 1917 when the U.S. entered World War One.
US Merchant Ship Archival: It came at last: war. Overnight, the cry was for ships and men, a bridge of ships across the Atlantic and the men to sail them.
Allan Brandt: And when the risk and divisions of our society become greater, and we’re living in a period of violence, division, uncertainty—that’s a better environment for selling tobacco and encouraging people to use it.
Alexis Pedrick: Suddenly, the risks of smoking paled in comparison to the risk of dying in a trench.
Allan Brandt: There was this idea like, there are so few pleasures, and smoking produces a short, immediate sense of pleasure and relaxation. Obviously, we’re in a time of great anxiety and violence.
Alexis Pedrick: Suddenly, it was a small comfort in an otherwise chaotic and scary world.
Allan Brandt: And so, for example, the Young Women’s Christian Association, which had always worked very stringently to prohibit smoking, suddenly starts collecting cigarettes and sending them to the American troops in France.
Alexis Pedrick: Buying cigarettes for troops became a patriotic act. The federal government even got in on the game at one point, claiming Bull Durham’s entire output for the military. By this point, if you were still an anti-cigarette crusader, you just seemed petty. As one 1919 opinion piece put it, “as for the poor fellows lying mangled in shell holes…with life slowly ebbing away from a body soon to become dreamless dust, who would be heartless enough to prohibit this last and only solace?”
Allan Brandt: I’ve always felt that that kind of 180 shift from, you know, essentially smoking being banned and prohibited in so many places to smoking being seen as positive, cool, manly.
Marlboro Wild Stallions Ad: You don’t see many wild stallions anymore… No, he’s one of the last of a wild and very singular breed. Come to where the flavor is. Come to Marlboro country.
Allan Brandt: Many American men came back from the First World War, you know, habitual addicted smokers.
Alexis Pedrick: War made smoking ubiquitous among American boys and men, but it took a more coordinated effort to get women hooked. It had long been a taboo for women to smoke, but cigarette companies realized they were missing out on half of the American market, so they decided to change the culture. In 1929, Lucky Strike tapped a man named Edward Bernays to do just that. Bernays was an early pioneer in public relations. Some call him the father of the field. He was crafty. He also happened to be the nephew of Sigmund Freud, which might have had something to do with why he consulted a psychoanalyst about his project.
Showdown on Tobacco Road: I went to Doctor Brill, and I said, can you tell me what cigarettes mean to women?
Alexis Pedrick: This is Bernays in a documentary called “Showdown on Tobacco Road.”
Showdown on Tobacco Road: He said cigarettes to women are torches of freedom. And they titillate the erogenous zones of the lips.
Alexis Pedrick: He also told Bernays that if he could find a way to connect cigarettes to the idea of challenging male power, then women would smoke because they—insert big sigh here—would have their own representation of an appendage. You get the idea.
Showdown on Tobacco Road: So I left and wondered what to do with that information.
Alexis Pedrick: Bernays hired a group of young women, specifying that they be good-looking but not “model-y”—according to his notes—to march in the New York Easter Parade. At his signal, they were to start smoking cigarettes. Bernays acted like the whole thing was completely spontaneous. And that’s how newspapers around the world reported it the next day.
Showdown on Tobacco Road: Within six weeks, smoking became an accepted pattern for women throughout the United States.
Alexis Pedrick: Bernays called this tactic the “engineering of consent.” The goal was to make it seem like the consumer had come up with the idea on their own, but really, he was in the background, pulling the strings. Cigarettes’ social acceptance and popularity continued to grow until, by the middle of the 20th century, cigarettes were everywhere. Even if we had the sense they weren’t great for us, there was no clear evidence to point to confirming that. But proof was coming.
Chapter Two: The Proof and the Conspiracy
Alexis Pedrick: There had always been people, especially doctors, who thought of course, smoking can’t be good for you.
Allan Brandt: But it’s very hard to separate that from the moral categorizations. Like, is it bad for you because we think it’s wasteful, you know, it makes your teeth yellow, or it smells in a funny way? But is this bad for everyone?
Alexis Pedrick: Before 1950, if a patient complained to their doctor of a chronic cough, it was common to be told that for some people smoking wasn’t healthy.
Allan Brandt: And that’s a radical difference than saying smoking causes lung cancer.
Alexis Pedrick: But then in 1950 two studies came out, one after the other, showing that cigarettes likely caused lung cancer. The first was co-authored by an American surgeon and a medical student in Saint Louis, Evarts Graham and Ernst Wynder. By necessity, they had to take a creative approach.
Allan Brandt: It’s almost certainly unethical to say to two groups of, you know, 12-year-olds: half of you are going to become smokers, half of you are not, and in 30 years, we’ll see what your health is like.
Alexis Pedrick: Yeah. No one was going to sign up for a study like that. So they had to figure out another way. And that other way turned out to be looking backwards.
Allan Brandt: And so they would find people with lung cancer, and they would say: you know, did you smoke or didn’t you smoke?
Alexis Pedrick: Graham and Wynder collected extensive data on 684 lung cancer patients across the United States. And it turned out that smokers made up a large percentage of the group. Not only that, but the sharp increase in lung cancer rates also followed the same line as the increase in smoking. The second study was conducted by two British medical statisticians, A. Bradford Hill and Richard Doll. And it also had a unique approach.
Allan Brandt: They were really interested in statistics, and they were really prepared to build a model for how we think about causality, not just for cigarettes, but for other environmental toxins for other products.
Alexis Pedrick: But there was a problem with both of these studies. They were really different from how we studied infectious diseases. This wasn’t like looking at tuberculosis, for example, where you could isolate a bacterium under a microscope. These studies couldn’t be conducted in a lab, and they didn’t address what in cigarettes was causing lung cancer.
Allan Brandt: And so, a lot of people would say: well, you know, all of the statistics are really pretty meaningless. We don’t really know, and we won’t know until we know what it is in the cigarette that changes the cell.
Alexis Pedrick: It was a convenient argument for cigarette companies who wanted to keep selling cigarettes. But Allan Brandt argues that the evidence of danger was clear, and that should have been enough.
Allan Brandt: I sometimes compare this to taking the pump off the handle during the cholera epidemics of the 1850s. You know, you could say: we don’t know what’s in the water, but we better stop drinking that water now because we understand that cholera is coming from this particular well. And you know, how much information do you need? But there were people who said: this kind of information is faulty to begin with. And of course, that’s the essential argument that the tobacco companies took for many, many years.
Alexis Pedrick: Wynder and Graham were aware of the merely statistical critique of their study. But it didn’t stop their work. In fact, they backed up their claims with a lab study where they spent a year painting mice with tobacco tar. In the end, 44% of the mice developed cancer. They went public with the results on November 30th, 1953. TIME magazine wrote that the case against tobacco had now been proven beyond any doubt. A couple of weeks later, on December 13th, their landmark study was published in the journal Cancer Research.
The response from cigarette companies was immediate, but also secret. You see, the very next day, CEOs from the six largest tobacco manufacturers in the U.S. met at the Plaza Hotel in New York City, where they privately freaked out, and then made a plan. Beneath the Plaza’s chandeliers, in a scene straight out of a mobster movie, the most powerful tobacco tycoons in the world hatched a conspiracy to publicly deny smoking’s hazards and defraud the American people.
Allan Brandt: They hire a really great public relations expert, one of the giants of the 20th century named John Hill. And he essentially says to them: you know, you don’t like the science that’s coming out, and it’s going to hurt your industry across all the companies. If you don’t like their science, get your own science.
Alexis Pedrick: And believe me, they tried, but their own science didn’t say anything different.
Allan Brandt: So the companies did something very clever. They said: we need more research. This is unresolved. And so people were able to use uncertainty as a defense for continuing to smoke.
Alexis Pedrick: From this point forward, the industry would focus on one word: doubt. After that Plaza Hotel meeting, the tobacco CEOs decided to form the Tobacco Industry Research Committee, or TIRC. Publicly, it was advertised as a research arm of the tobacco companies trying to get to the bottom of the issue.
Smoking: A Health Hazard of Sufficient Importance: If there are bad elements, through our laboratories, through acts of God and luck, we hope we may find them. And if they are found, they will be removed.
Alexis Pedrick: But the TIRC was really a PR machine spinning the wheels of uncertainty.
Smoking: A Health Hazard of Sufficient Importance: But at this point we do not know.
Alexis Pedrick: As the years went on, cigarette companies repeated this claim over and over again, despite a growing mountain of evidence that said otherwise. In 1964, the Surgeon General gave his damning report on the dangers of cigarettes.
1964 Surgeon General Report: Cigarette smoking is a health hazard of sufficient importance to the United States to warrant remedial action. Cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.
Alexis Pedrick: The reaction was immediate. The following clip is from an interview with a man who was in the audience.
How Americans Got Sold on Cigarettes: Smoking in auditoriums was universal in those days. In fact, there were ashtrays on the back of each seat. But as the two hours wore on, you could see cigarettes going out all over the room. Cigarette smoking declined immediately and abruptly, and this was a worldwide phenomenon. It was the Great Forswearing, which was followed a week or two later by the Great Relapse, and cigarette sales went right back to where they had been before.
How Americans Got Sold on Cigarettes: There was this assumption, I think, at the time of the ’64 report: let’s tell people it’s dangerous. People are intelligent. They’ll quit.
Alexis Pedrick: This is Allan Brandt from that same documentary.
How Americans Got Sold on Cigarettes: What we found at that moment when we really said smoking causes harm was that it was very difficult to quit. And this led to a full reevaluation of what was the nature of cigarette smoking. Was it a habit? Was it an addiction?
Alexis Pedrick: It was an important distinction, because a habit is a choice, but an addiction, by definition, is not. So you can guess which one the cigarette companies went with. They did everything in their power to make sure cigarettes embody what is arguably the most American of values: personal freedom. And personal freedom’s flipside: personal responsibility. And so, the quintessential American industry used the quintessential American value as a shield to protect itself from accusations that cigarettes were killing people.
Allan Brandt: The tobacco industry was quite effective at talking out of at least two sides of its mouth for a very long time. So they sort of say, first, we want you to know—and we’ve been investigating this—we know of nothing in cigarettes that could cause cancer. If they admitted that it was harmful, that would be the end of the industry, okay? And then they say, you should also know it’s entirely up to you whether you smoke or not.
Alexis Pedrick: Cigarettes are safe. But even if they aren’t, you can’t blame us if you get sick because it was your own choice to smoke. It was a nice accompaniment to doubt. So even when we get to the 80s and there was a consensus that cigarettes were addictive because of nicotine—
1988 Surgeon General Report on Smoking: The Surgeon General’s report released this morning is the 20th dealing with the health effects of smoking. One: tobacco is addictive. Two: nicotine is the ingredient in tobacco that causes addiction. And three: tobacco addiction is similar in many respects to addiction to alcohol, heroin, and cocaine.
Alexis Pedrick: Publicly, the companies described nicotine like an afterthought—it just happened to be in tobacco. Or they said it helped with flavor. But no cigarette executive ever openly admitted the truth that nicotine was the drug that cigarettes deliver—that it was the whole point of smoking. In 1994, the CEOs of seven tobacco companies testified under oath on the question of nicotine and addiction before Congress.
1994 Tobacco CEOs Testify before Congress: I’d like to just go down the row, whether each of you believes that nicotine is not addictive. Just yes or no. Do you believe nicotine is not addictive?
1994 Tobacco CEOs Testify before Congress: I believe nicotine is not addictive. Yes.
1994 Tobacco CEOs Testify before Congress: Mr. Johnston.
1994 Tobacco CEOs Testify before Congress: Congressman, cigarettes and nicotine clearly do not meet the classic definitions of addiction. There is no intoxication.
1994 Tobacco CEOs Testify before Congress: We’ll take that as a no. And again, time is short. If you could just, I think each of you believe nicotine is not addictive; we just would like to have this for the record.
Alexis Pedrick: One by one they answered in the negative:
1994 Tobacco CEOs Testify before Congress: I believe nicotine is not addictive.
Alexis Pedrick: Nicotine is not addictive. Case closed. But—and there is a but—we told you the story was about the rise and fall of cigarettes. Something was about to turn all those wins for the cigarette industry into liabilities. And we’ll get into it in part two dropping on September 22nd.
Alexis Pedrick: When a mysterious box was delivered to an office at the UC San Francisco Medical School—
Stanton Glantz: The return address was Mr. Butts, the Doonesbury cartoon character.
Alexis Pedrick: One unlikely man found himself on the front lines of the war against Big Tobacco.
Stanton Glantz: They said, boy, you have just the perfect credentials if you had a decent suit, because at that point the only suit I had was orange. And they didn’t think that would play too well on television. So they went out and picked out a suit for me, and that’s how my career got launched.
Alexis Pedrick: And the dominoes would start to fall.
Stanton Glantz: The thing that was most important overall was that it was the industry speaking in its own words. You know, when I first got the box and looked through it, the thing that struck me just immediately was that, boy, you know, all these things we thought about these guys are true. In fact, it was even worse than a lot of the things we thought.
Alexis Pedrick: Tune in next week to Cigarettes in America, Part Two: The Reckoning.
Alexis Pedrick: Distillations podcast is produced by the Science History Institute and recorded in the Laurie J. Landau Digital Production Studios. Our executive producer is Mariel Carr. Our senior producer is Rigoberto Hernandez. This episode was produced by Mariel Carr. It was fact-checked by Alexandra Atiya, and the sound design was done by Seth Samuel.
Support for Distillations has been provided by the Middleton Foundation and the Wyncote Foundation.
You can find all of our podcasts, as well as our videos and articles, on our website at sciencehistory.org, and you can follow us on social media @scihistoryorg for news about our podcast and everything else going on in our free museum and library.
For Distillations, I’m Alexis Pedrick. Thanks for listening.
Transcript – Part 2 (The Reckoning)
Alexis Pedrick: From the Science History Institute, I’m Alexis Pedrick. Welcome to the new season of Distillations, American Vice. We’re diving into stories about our appetite for risk, how science plays a role in it, and how it shaped the American experience. This is Cigarettes in America, Part Two: The Reckoning. If you haven’t listened to the first part, go back and start with Cigarettes in America, Part One: The Rise.
Alexis Pedrick: Chapter Three: Mr. Butts.
Alexis Pedrick: Ever since those first cancer studies in the early 1950s, people had been suing cigarette companies. In fact, hundreds of liability lawsuits had piled up against them, seeking damages for smokers who had gotten lung cancer. But the decades went by, and by the 1980s, not a single plaintiff had yet to win.
Frontline: Tobacco on Trial: Tonight on Frontline, if you get sick from smoking cigarettes, can you sue the tobacco companies? Is it right to pay damages to someone for their having engaged in an activity which they knew carried with it claimed risks? Is it fair to let them turn around and say, give me money for that? Although I made my choice? Tonight: Tobacco on Trial.
Allan Brandt: As I started to study this more and I would be meeting with lawyers who wanted to sue the companies, I mostly would say to them in those days, you’ll never win. It was very hard to convince a judge or jury that the companies were responsible for the decisions that an individual had made.
Alexis Pedrick: This is Allan Brandt, a historian of science and the author of The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America.
Allan Brandt: Because American culture is so committed to the idea that individuals must and should take responsibility for their health. And we rely on that in a self-protective way. When we say, well, so and so got sick, they did something they should not have done, you know, so and so is a drug addict. Whose fault is that?
Alexis Pedrick: But there is a bit of a silver lining as the cases piled up. Each one went through a process called discovery, where two sides in a trial hand over evidence. This means that each case resulted in documents being squeezed from the tobacco companies. Document by document, a slow and steady drip until—
Stanton Glantz: It was about eleven o’clock in the morning. I remember because I was getting ready to go teach Statistics. My name is Stanton Glantz. I’m a retired professor of medicine at the University of California, San Francisco.
Alexis Pedrick: On the morning of May 12th, 1994, a mysterious box showed up in Stanton’s office. He didn’t think much of it at first. It was just a nondescript cardboard banker’s box. But then he noticed the label.
Stanton Glantz: The return address was Mr. Butts, the Doonesbury cartoon character.
Alexis Pedrick: Mr. Butts was a talking cartoon cigarette that appeared regularly in the Pulitzer Prize-winning comic strip. Now, the character was a personification of the tobacco industry. His naive personality was meant to be a satirical takedown, and Stanton was intrigued, and he opened the box to find, well, a mess.
Stanton Glantz: You know, these were all just papers thrown in a box, and they were. They were not organized. They were not clipped together in separate documents.
Alexis Pedrick: But gradually the return address started to make sense. There were about 4000 pages dating back as far as the 1950s. Memos, scientific reports, meeting minutes, and letters, all from a company called Brown & Williamson, which at the time was the third largest cigarette maker in the U.S. Its brands included Kool, Capri, and Viceroy. There were also documents from Brown & Williamson’s parent company, British American Tobacco. And interestingly, most of the memos were labeled confidential or privileged.
Stanton Glantz: As I started looking through them, it was like I just got sucked into them. I tell people it was like an archaeologist finding a new tomb.
Alexis Pedrick: Whoever this Mr. Butts was, they were clearly a tobacco industry insider, a whistleblower who wanted the world to see what the cigarette companies were up to behind closed doors. The documents revealed things that those companies would have never admitted publicly, and they threatened to bring a carefully constructed facade crumbling down.
Stanton Glantz: The thing that was most important overall was that it was the industry speaking in its own words, and how frank they were about it. That was the thing that struck me just immediately was that, boy, you know, all these things we thought about, these guys are true. In fact, it was even worse than a lot of the things we thought.
Alexis Pedrick: Mr. Butts’s real name was Merrell Williams Jr. He was a paralegal working for the law firm Brown & Williamson hired because they were being sued several times over. He was working out of the law firm offices in Louisville, Kentucky, going through the company memos and internal documents day in and day out.
Stanton Glantz: And he saw all kinds of outrageous stuff. You know, other people have said he just was appalled by what he was reading and decided it needed to be liberated.
Stanton Glantz: And he saw all kinds of outrageous stuff. You know, other people have said he just was appalled by what he was reading, and he just was bothered by it and decided it needed to be liberated.
Alexis Pedrick: We know that tobacco companies that were being sued would often try to purge incriminating documents before they handed them over in discovery, but that wasn’t so easy.
Stanton Glantz: The problem was in doing that, that these companies are, among other things, giant bureaucracies. And what do people in bureaucracies do? They write memos, and they cc people, so even if they were trying to get rid of something, usually there were so many copies floating around that it was very hard to do.
Alexis Pedrick: There was plenty of juicy material to leak, but it wasn’t as simple as putting papers in a briefcase and walking out the door. There were security protocols. These were sensitive documents connected to an important client. Merrell Williams Jr. had to get creative.
Stanton Glantz: What he did was he built a little harness [that] fit under his shirt, and he put the documents in and snuck them out. Because they were crinkling, he would eat potato chips as he was going past the armed guard. And then he would smuggle them back in. And he made copies of about four or five thousand pages.
Alexis Pedrick: There were a lot of people he could have sent the box to—lawyers, journalists. But ultimately it went to Stanton Glantz.
Stanton Glantz: Because I had a reputation of having a backbone, and people thought I would do something with them.
Alexis Pedrick: Stanton was actually pretty well known in this arena already. In the late 1970s, he had been researching secondhand smoke and heart disease. It was an important issue because people smoked almost anywhere.
Stanton Glantz: I mean, you could smoke on airplanes. You could smoke in elevators, in a lot of places.
Alexis Pedrick: He got into politics, volunteering with a group that was working on an initiative called Proposition Five in California.
Stanton Glantz: To put in place, by today’s standards, ridiculously mild restrictions on smoking.
Alexis Pedrick: When Stanton showed up, he asked what one of the group’s organizers would later describe as “the dumbest question I’ve ever heard.” He wanted to know if there was anything he could do to help. Stanton Glantz, the guy who was becoming the foremost scientific authority on the cardiovascular effects of secondhand smoke. Of course, he could help.
Stanton Glantz: When the people running the campaign found out I was a scientist with a PhD minor in economics, they said, boy, you have just the perfect credentials to play an important role in this campaign, if you had a decent suit. Because at that point, the only suit I had was the one I got married in, which my wife made for me, which was orange, which is my favorite color. And they didn’t think that would play too well on television. So, they went out and picked out a suit for me. And that’s how my career got launched.
Alexis Pedrick: Secondhand smoke was a relatively novel way to go after big tobacco. Like addiction, it chipped away at the whole personal freedom argument. Maybe the person smoking had made a choice, but the people next to them in elevators and restaurants? They hadn’t consented to smoking. And yet here they were, inhaling away. The campaign had some wins and some losses, but they got secondhand smoke on the radar.
Stanton Glantz: While we were trying to reduce secondhand smoke as air pollution, indoor air pollution, we inadvertently undermined the social acceptability of smoking. It wasn’t because more people got convinced that smoking was bad for you; it was just that they got worried that it was bad for other people. And, you know, I mean, very, very few smokers—while they’re willing to rationalize the fact that they’re hurting themselves—very, very few smokers can rationalize hurting somebody else.
Alexis Pedrick: Cigarette companies were not fans of Stanton Glantz. They tried to discredit his research, intimidate him, but he didn’t stop.
Stanton Glantz: There have been some very, very hard times, and some of this stuff has been very scary. But, you know, you just have to deal with it. It’s not fun, but it’s just part of the cost.
Alexis Pedrick: Stanton turned out to be the perfect person to send the box to.
Stanton Glantz: I just realized within a, you know, a short time, I mean, before I had to go off to class at noon, that I wanted to write something about these and just decided that that’s what we were going to do. And I figured we’d get sued at some point, but I wanted to get something written before we had to deal with the lawyers. And so, while I was off teaching statistics, I got a couple of the staff in cardiology to Xerox the whole box. And we burnt out two Xerox machines, xeroxing all those documents. And then we sent them, or I sent them to people out of state.
Alexis Pedrick: Stanton described their reporting as a “keyhole” into the tobacco industry. It was just a small window into one company, but still, there was a lot to see. Glantz and a handful of his colleagues frantically got to work. They started writing articles that described the documents in detail.
Stanton Glantz: We were like, really, really working our butts off to get this done. And I just spent so many hours typing on this that I ended up getting weakness in one hand from all the typing.
Alexis Pedrick: Meanwhile, Brown & Williamson learned about the leak, but thought the documents had been sent to someone else: a lawyer named Dick Daynard.
Stanton Glantz: He was kind of the Stanton Glantz of litigation. Now, he knew I had the documents because I had told him I had the documents, and he was a very good sport about it, in that he let them sue him for months so they would be busy chasing after him so I’d be talking to him at home, and his wife would get on and say, “How’s your book coming?” Because she wasn’t totally enjoy[ing] being sued.
Alexis Pedrick: Stanton and his colleagues wrote six articles and submitted them to the Journal of the American Medical Association, or the AMA.
Stanton Glantz: And it ended up comprising most of the July 19th, 1995 issue.
Alexis Pedrick: Not everyone was happy or as chill about being sued as Dick Daynard.
Stanton Glantz: This was done kind of over the dead body of the AMA’s lawyer. He was very unhappy with them for doing this. And I remember before the press conference, he came in and gave me this speech that, you know, I needed to watch my language and, you know, not call the tobacco companies [expletive] or something like that, which I was a little offended by because, I mean, by then I had a lot of media experience and I knew you shouldn’t do that. I told him I would really work hard not to. But you know, they are [expletive].
Alexis Pedrick: Brown & Williamson argued that the documents had been stolen, which was true. And that anyone who published them was also breaking the law—also kind of, sort of technically true. But given the First Amendment protections for journalists exposing information that serves the public interest, the courts quashed their subpoenas. And so the documents made their way out into the world. Congressman Henry Waxman even read parts of them directly into the Congressional Record. Stanton Glantz gave the original box to the UCSF library, but by this point, it was 1995, so there was something else they could do.
Stanton Glantz: The deputy director of the library came to me and said, you know, I have this idea. Why don’t we put them on the internet? To which I said, what’s the internet?
Alexis Pedrick: They put them on the World Wide Web, and they’re still there, along with an expansive collection from other industries at industrydocuments.ucsf.edu, free and accessible to everyone. The cat was out of the bag, and Stanton and his colleagues edited the documents and their analysis into a book called The Cigarette Papers. But aside from some bad publicity, was there anything in the box that could really make a difference? The answer is yes.
Alexis Pedrick: Chapter Four: Secret Science.
Alexis Pedrick: Remember when all those industry execs got up and testified that nicotine was not addictive? The timing was hilarious, if you like dark humor, because the proof that they were liars was delivered to Stanton Glantz in the Mr. Butts box less than one month later.
Stanton Glantz: I can tell you the most quoted line in the documents was “we’re in the business of selling nicotine, an addictive drug.”
Alexis Pedrick: That line is from a memo written by Brown & Williamson’s vice president and general counsel in 1963, 25 years before the Surgeon General said nicotine was addictive and 31 years before those tobacco CEOs testified before Congress. They lied about it for decades. Meanwhile, the documents showed that the company’s scientists had done sophisticated research into the pharmacology of nicotine and how it creates and reinforces addiction.
Stanton Glantz: That was done to develop products to figure out how do you design a cigarette to make it more addictive? They did very detailed studies of what’s called smoking topography, which is like, how do you puff? How frequently do you want to make the nicotine hit? How hard should it be? And how do you develop different products to get somebody new drawn in and then working them up to a really heavily addicted state? And all that stuff. If you look at it, the science was extremely well done.
Alexis Pedrick: Done to nefarious ends, but well done nonetheless.
Stanton Glantz: They did not screw around with that stuff. They did not spin it. They did not try to avoid it because that was informing product development and profits. And they wanted those decisions to be based on the best evidence.
Alexis Pedrick: And that memo wasn’t the only explosive document. Remember that meeting at the Plaza Hotel in 1953 after all those studies came out showing that cigarettes cause lung cancer? Well, the cigarette companies conspired to publicly say that they didn’t believe it, but privately, their own scientists were confirming it was true. This is Allan Brandt.
Allan Brandt: You know, on the one hand, you’re following the public record where they say: we don’t know if it’s cancer-causing or not. And then you come across a document that’s, you know, from like 1962 and it says: we have now identified 17, you know, known carcinogens in tobacco smoke.
Alexis Pedrick: Brown & Williamson’s memos used code words. Lung cancer was referred to as “zephyr,” as in “…tobacco smoke contains a substance or substances which may cause zephyr.” That line is from a 1957 memo. There was also “hippo.”
Stanton Glantz: Hippo is the hypothalamus, which nicotine, among other things, acts on.
Alexis Pedrick: Once it was clear that cigarettes did indeed cause lung cancer, cigarette companies did the next business-savvy thing. They tried to engineer themselves out of the problem with a tech fix. Secretly, of course.
Stanton Glantz: And the idea back then is, well, okay, cigarettes are, you know, causing diseases. And, you know, there’s lots of bad things in cigarettes, or there’s some bad things in cigarettes. And if we could just identify what they are, we could re-engineer the product to get rid of them.
Alexis Pedrick: In other words, they tried to make a safe cigarette, just like our friend from Instagram suggested.
Instagram Post – We Need to Smoke Again: The death thing is a problem.
Alexis Pedrick: And you can just imagine the cigarette executives thinking, how hard could it be, right? Well, have a safe cigarette in no time.
Instagram Post – We Need to Smoke Again: Like we can figure this out. We’re smart. We’re capable.
Stanton Glantz: They worked on that for about 20 years, and I think it was a genuine effort to, you know, by them to say: okay, well, let’s find the one or two or three or five or ten bad things in cigarettes and re-engineer the cigarettes to get rid of that stuff. And they failed.
Alexis Pedrick: Sure, they could re-engineer the cigarette to reduce the amount of benzopyrene, one of the carcinogens they identified early on. But when they reduced that, they unintentionally increased something else.
Stanton Glantz: It was like trying to shove a balloon into a box that isn’t quite big enough. And so, making a cigarette that was substantially less toxic than the average cigarette just turned out to be impossible. And then by the 70s, their lawyers were saying to them: you know, this is very dangerous because, legally, because let’s say you do make a cigarette, which is safer than other cigarettes, then product liability lawyers, if you don’t stop selling everything else, they’re going to jump on you for that. And even if you do, they’re going to say: well, why didn’t you do this sooner? And so, the lawyers pulled the plug on the safe cigarette research.
Alexis Pedrick: Do you hear that Instagram lady? They tried. They couldn’t do it. The documents also revealed the inside scoop on secondhand smoke, which got personal for Stanton Glantz.
Stanton Glantz: I mean, it was interesting because publicly they were just always trashing my work and saying it was flawed, and I didn’t know what I was doing. But internally they thought it was pretty good.
Alexis Pedrick: So good, in fact, that they were worried. And they even tried to make a cigarette that produced less smoke. But that created a PR problem, as well as the same legal trouble as making a less toxic cigarette. How do you make something safer when you’ve been clinging to a narrative that there’s nothing dangerous about the original product? So, they bagged that too. And there was one more thing.
Allan Brandt: We know cigarettes were really pitched towards kids and very young kids.
Alexis Pedrick: Listen, the production team here at Distillations is old enough to remember the infamous Joe Camel. As children, we knew him as well as we knew Mickey Mouse. He was cool, and he was everywhere. And now we know why.
Allan Brandt: More and more evidence came out that the industry knew that if they didn’t get you using their product by the time you’re 17 or 18, their chance of making you a smoker was very, very low and getting lower all the time. So, they denied that they’d pitched towards kids, but they had to, to preserve their industry.
Alexis Pedrick: It’s one thing to say that grownups can make their own decisions. If they want to poison themselves, that’s up to them. But children are different.
Allan Brandt: We think of kids as, you know, needing protection, not adequately educated yet, developmentally unable to always act in their best interests. But if the industry is going after them, you know, through like Joe Camel ads, which was a famous legal case, then the industry had done something wrong that compromised their arguments about individual autonomy.
Alexis Pedrick: The damning evidence was piling up, and cigarette companies’ luck was about to run out.
Alexis Pedrick: Chapter Five: The RICO Case
Alexis Pedrick: The Mr. Butts box was an explosion of evidence that made it clear how corrupt the tobacco companies were, and how all of their arguments were a house of cards ready to fall. But it still seemed impossible for individuals to go up against them.
Stanton Glantz: The industry had a very good track record at defeating those cases. They just made the plaintiff miserable, just chasing after them, harassing them, just dragged the litigation on forever by, you know, endless fights about discovery and motions and appeals and stuff. It basically bankrupted the lawyers who were bringing the plaintiff’s case.
Alexis Pedrick: Something had to change, and it did.
Stanton Glantz: Well, what happened in the 90s was [that] a new set of legal theories emerged—and this is something [Dick] Daynard actually had quite a lot to do with—and that was moving from the individual to looking at large numbers of people.
Alexis Pedrick: Private cases merged into class action suits. Then a group of state attorneys general started grouping similar cases.
Stanton Glantz: But the theory wasn’t tort, wasn’t injury. It was fraud.
Alexis Pedrick: Fraud. You know, like if you had lots of evidence that a company had lied to you repeatedly over the course of decades? The argument was that the cigarette companies had defrauded large numbers of people and should pay Medicare costs that the states had borne as a result. And by 1998, all 52 states and territories had signed the master settlement agreement with the four biggest tobacco companies. It settled dozens of other lawsuits, and the company also agreed to a number of conditions, including restrictions on advertising, targeting youth using cartoons, and promoting smoking in TV and films.
Alexis Pedrick: And then the Department of Justice bought their own case against cigarettes. The United States v Philip Morris. And the DOJ handpicked none other than Allan Brandt to be an expert witness. Which was good, because, if you can believe it, the cigarette companies had their own historian of medicine expert witnesses. Allan was determined not to let them speak for the entire field.
Allan Brandt: I became alarmed that people would say: oh, that group of medical historians, you know, even though they don’t like smoking, they side with the industry’s argument that this should be any individual’s assumption and that the tobacco companies did not behave badly.
Alexis Pedrick: Allan challenged the argument that the cigarette companies had been relying on since the very first studies came out: that the evidence was inconclusive. And he brought a visual aid with him up on the stand.
Allan Brandt: I had drawn a chart that had public health, science, and medicine, I think, a basic Venn diagram and sort of the idea of what you know, how you know it, and when you act.
Alexis Pedrick: He used the cholera story as an example, noting that we didn’t wait until more and more people got sick. We looked around, said there’s something in the water, so we’d better stop drinking it.
Allan Brandt: You know, how much information do you need? There’s accumulation of scientific knowledge, and at certain points you could act on that knowledge with confidence, even if there were things about it you didn’t know with the goal of saving lives and restoring a community from deathly disease to health. So I asked the question: you know, what did we know? And when did we know it?
And what would have been the appropriate time to say we don’t know everything about this risk, but we know a lot about it, and we’ve demonstrated it. And the character of these scientific demonstrations were highly persuasive, and a company had worked to undermine public and scientific knowledge about this. And how many lives could we save if there hadn’t been, you know, this cover-up, these deceptions, these lies?
Alexis Pedrick: His testimony was an important counter to the defense’s argument. The case was litigated before a judge without a jury. And in 2006, the judge found the companies guilty of the Racketeer Influenced and Corrupt Organizations Act, otherwise known as the RICO Act, which should sound familiar if you’ve ever watched The Sopranos. It’s the law that goes after organized crime, as in the Mafia. The judge didn’t go so far as to punish them financially beyond a few small penalties for destroying documents, which was a blow to the DOJ.
Allan Brandt: But a legal ruling like this that confirmed what the companies had done and the outcome for the government was, you know, really very good because the judge found that the companies had acted criminally and that they should be punished. And the companies were required to put up ads that acknowledged, you know, that smoking was addictive, that it was harmful, that they had known about it.
NBC – Big Tobacco Finally Tells the Truth: Speaker 7: Smoking kills, on average, twelve hundred Americans every day. There is no safe level of exposure to secondhand smoke. All cigarettes cause cancer, lung disease, heart attacks, and premature death. There is no safe cigarette.
Allan Brandt: And so, you know, the case is widely cited. And I think it’s been influential in public health and public policy. But did it, you know, end the tobacco industry as we know it? No.
Stanton Glantz: They’re still there, you know, which is too bad. But, you know, there’s no question that fewer people are smoking, fewer people are using tobacco products. The tobacco companies have less power. And a lot of people are alive today that would be dead if the documents weren’t out there. And they’re still bouncing around, affecting public perceptions in the public debate all over the world.
Alexis Pedrick: We asked Allan Brandt if he’d noticed cigarettes getting popular again and how he felt about it.
Allan Brandt: Yeah, I haven’t really been surprised by it because I think that, first of all, the industry is there waiting for opportunities, and what the industry has done is similar in some ways to World War One. We’re living in a period of violence, uncertainty, and you sort of say, you know, I could get killed in a car accident or a protest or, you know, and so it’s a very hard time to feel like you have control, and smoking purports to be something that you can decide to do. But what that often has failed to reveal is that there’s somebody who wants us buying those cigarettes.
Alexis Pedrick: Americans have always gone to extreme lengths to uphold our values of personal freedom. We want to believe that we’re in charge of our own destinies, even when it’s not in our best interests. Even when the science points us in another direction. Because a myth can be more powerful than science, a myth can make us think it’s our own choice to take a risk. But what happens when science is the one taking the risk? Is it okay if we think it’ll save lives? Join us for our next episode when we get into it.
Michael McGuire: There was this fear of chemicals in drinking water, and nobody wanted to do anything, even though they knew it was causing typhoid fever and killing people. So they were very untrusting—the citizens were. But the water utilities, I mean, as long as nobody ever found out about it, they could do anything pretty much they could get away with.
Alexis Pedrick: Distillations podcast is produced by the Science History Institute and recorded in the Laurie J. Landau Digital Production Studios. Our executive producer is Mariel Carr. Our senior producer is Rigoberto Hernandez.
This episode was produced by Mariel Carr. It was fact-checked by Alexandra Atiya, and the sound design was done by Seth Samuel.
Support for Distillations has been provided by the Middleton Foundation and the Wyncote Foundation.
You can find all of our podcasts, as well as our videos and articles, on our website at sciencehistory.org, and you can follow us on social media @scihistoryorg for news about our podcast and everything else going on in our free museum and library.
For Distillations, I’m Alexis Pedrick. Thanks for listening.
