The Emperor of All Maladies: A Biography of Cancer (100 page)

242
“the cigarette century”
: Allan M. Brandt,
The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America
(New York: Basic Books, 2007).

The Emperor’s Nylon Stockings

243
Whether epidemiology alone can:
Sir Richard Doll, “Proof of Causality: Deduction from Epidemiological Observation,”
Perspectives in Biology and Medicine
45 (2002): 499–515.

243
lung cancer morbidity had risen nearly fifteenfold:
Richard Doll and A. Bradford Hill, “Smoking and Carcinoma of the Lung,”
British Medical Journal
2, no. 4682 (1950): 739–48.

243
“matter that ought to be studied”:
Richard Peto, “Smoking and Death: The Past 40 Years and the Next 40,”
British Medical Journal
309 (1994): 937–39.

243
In February 1947, in the midst of a bitterly cold:
Ibid.

243
One expert, having noted parenthetically:
British Public Records Office, file FD. 1, 1989, as quoted by David Pollock,
Denial and Delay
(Washington, DC: Action on Smoking and Health, 1989); full text available through Action on Smoking and Health, www.ash.org.

243
Yet the resources committed for the study:
Medical Research Council 1947/366 and Ibid.

244
In the summer of 1948:
Pollock,
Denial and Delay
, prologue. Also see Sir Richard Doll, “The First Report on Smoking and Lung Cancer,” in
Ashes to Ashes: The History of Smoking and Health
, Stephen Lock, Lois A. Reynolds, and E. M. Tansey, eds. (Amsterdam: Editions Rodopi B.V., 1998), 129–37.

244
“The same correlation could be drawn to the intake of milk”:
Ernst L. Wynder, letter to Evarts A. Graham, June 20, 1950, Evarts Graham papers.

245
Wynder and Graham’s trial:
Ernst L. Wynder and Evarts A. Graham, “Tobacco
Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of Six Hundred and Eighty-Four Proved Cases,”
Journal of the American Medical Association
143 (1950): 329–38.

245
When Wynder presented his preliminary ideas:
Ernst L. Wynder, “Tobacco as a Cause of Lung Cancer: Some Reflections,”
American Journal of Epidemiology
146 (1997), 687–94. Also see Jon Harkness, “The U.S. Public Health Service and Smoking in the 1950s: The Tale of Two More Statements,”
Journal of the History of Medicine and Allied Sciences
62, no. 2 (2007): 171–212.

245
Doll and Hill’s study: Doll and Hill, “Smoking and Carcinoma of the Lung.”

246
When the price of cigarettes was increased:
Richard Peto, personal interview. Also see Virginia Berridge,
Marketing Health: Smoking and the Discourse of Public Health in Britain
(Oxford: Oxford University Press, 2007), 45.

246
By May 1, 1948, 156 interviews:
David Pollock, “Denial and Delay,” collections from the public record office files deposited in the Action on Smoking and Health archives, UK. Also see the Action on Smoking and Health Tobacco Chronology, http://www .ash.org.uk/ash_669pax88_archive.htm (accessed January 21, 2010).

247
In the early 1940s, a similar notion had gripped:
R. A. Fisher and E. B. Ford, “The Spread of a Gene in Natural Conditions in a Colony of the Moth
Panaxia diminula
L.,”
Heredity
1 (1947): 143–74.

248
And
the notion of using a similar cohort:
Stephen Lock, Lois A. Reynolds, and E. M. Tansey, eds.,
Ashes to Ashes
(Amsterdam: Editions Rodopi B.V., 1998), 137.

249
Doll and Hill’s study of smoking habits and lung cancer in doctors: Richard Doll and A. Bradford Hill, “The Mortality of Doctors in Relation to Their Smoking Habits: A Preliminary Report,”
British Medical Journal
1, no. 4877 (1954): 1451–55.

“A thief in the night”

250
By the way, [my cancer]:
Evarts Graham, letter to Ernst Wynder, February 6, 1957, Evarts Graham papers.

250
We believe the products that we make:
“A Frank Statement to Cigarette Smokers,”
New York Times
, January 4, 1954.

250
Cigarette sales had climbed:
See, for instance, Richard Kluger,
Ashes to Ashes
(New York: Vintage Books, 1997), 104–6, 123, 125. Also see Verner Grise,
U.S. Cigarette Consumption: Past, Present and Future
, conference paper, 30th Tobacco Workers Conference, Williamsburg, VA, 1983 (archived at http://tobaccodocuments.org).

250
cigarette industry poured tens, then hundreds:
For a succinct history of postwar advertising campaigns of cigarette makers see Kluger,
Ashes to Ashes
, 80–298.

251
“More doctors smoke Camels”:
See, for example,
Life
, October 6, 1952, back cover.

251
At the annual conferences of the American Medical Association:
See Martha N. Gardner and Allan M. Brandt, “‘The Doctors’ Choice Is America’s Choice’: The Physician in US Cigarette Advertisements, 1930–1953,”
American Journal of Public Health
96, no. 2 (2006): 222–32.

251
In 1955, when Philip Morris:
Katherine M. West, “The Marlboro Man: The Making of an American Image,” American Studies at the University of Virginia website, http://xroads.virginia.edu/~CLASS/marlboro/mman.html (accessed December 23, 2009).

251
“Man-sized taste of honest tobacco”:
Ibid.

251
By the early 1960s, the gross annual sale:
Estimated from U.S. Surgeon General’s
report on per capita consumption rates for 1960–1970.

251
On average, Americans were consuming:
Jeffrey E. Harris, “Patterns of Cigarette Smoking,”
The Health Consequences of Smoking for Women: A Report of the Surgeon General
(Washington, DC: U.S. Department of Health and Human Services, 1980), 15–342. Also see Allan Brandt,
The Cigarette Century
, 97.

251
On December 28, 1953, three years before:
“Notes on Minutes of the Tobacco Industry Research Committee Meeting—December 28, 1953,” John W. Hill papers, “Selected and Related Documents on the Topic of the Hill & Knowlton Public Relations Campaign Formulated on Behalf of the Tobacco Industry Research Committee,” State Historical Society of Wisconsin, http://www.ttlaonline.com/HKWIS/12307.pdf (accessed December 23, 2009).

252
The centerpiece of that counterattack:
“Frank Statement,”
New York Times.

253
In January 1954, after a protracted search:
Brandt,
Cigarette Century
, 178.

254
In a guest editorial written for the journal:
C. C. Little, “Smoking and Lung Cancer,”
Cancer Research
16, no. 3 (1956): 183–84.

254
In a stinging rebuttal written to the editor:
Evarts A. Graham, “To the Editor of
Cancer Research,
”
Cancer Research
16 (1956): 816–17.

254
“We may subject mice, or other laboratory animals”:
Sir Austin Bradford Hill,
Statistical Methods in Clinical and Preventative Medicine
(London: Livingstone, 1962), 378.

254
Graham had invented a “smoking machine”:
Ernst L. Wynder, Evarts A. Graham, and Adele B. Croninger, “Experimental Production of Carcinoma with Cigarette Tar,”
Cancer Research
13 (1953): 855–64.

255
Forbes
magazine had famously spoofed the research:
Forbes
72 (1953): 20.

255
Bradford Hill’s nine criteria for epidemiology: Sir Austin Bradford Hill, “The Environment and Disease: Association or Causation?”
Proceedings of the Royal Society of Medicine
58, no. 5 (1965): 295–300.

256
“Perhaps you have heard that”:
Letter from Evarts Graham to Alton Ochsner, February 14, 1957, Evarts Graham papers.

257
In the winter of 1954, three years before:
Alton Ochsner,
Smoking and Cancer: A Doctor’s Report
(New York: J. Messner, 1954).

“A statement of warning”

258
Our credulity would indeed be strained:
Eva Cooper v. R. J. Reynolds Tobacco Company
, 256 F.2d 464 (1st Cir., 1958).

258
Certainly, living in America in the last half:
Burson Marsteller (PR firm) internal document, January 1, 1988. Cipollone postverdict document available at the UCSF Legacy Tobacco Documents Library.

258
In the summer of 1963, seven years after:
See Richard Kluger,
Ashes to Ashes
, 254–55.

258
Auerbach’s paper describing the lesions:
O. Auerbach and A. P. Stout, “The Role of Carcinogens, Especially Those in Cigarette Smoke, in the Production of Precancerous Lesions,”
Proceedings of the National Cancer Conference
4 (1960): 297–304.

259
Auerbach’s three visitors that morning:
See Kluger,
Ashes to Ashes
, 254.

259
In 1961, the American Cancer Society:
“The 1964 Report on Smoking and Health,” Reports of the Surgeon General, Profiles in Science: National Library of Medicine, http://profiles.nlm.nih.gov/NN/Views/Exhibit/narrative/smoking.html (accessed December 26, 2009); U.S. Surgeon General. “Smoking and Health,”
Report of the
Advisory Committee to the Surgeon General of the Public Health Service
, Public Health Service publication no. 1103 (Washington, DC: U.S. Department of Health, Education, and Welfare, Public Health Service, 1964).

260
“a reluctant dragon”:
Lester Breslow,
A History of Cancer Control in the United States, 1946–1971
(Bethesda, MD: U.S. National Cancer Institute, 1979), 4: 24.

260
he announced that he would appoint an advisory committee:
U.S. Surgeon General’s report:
Smoking and Health
, 1964.

261
Data, interviews, opinions, and testimonies:
Ibid.

261
Each member of the committee:
Ibid. Also see Kluger,
Ashes to Ashes
, 243–45.

262
“The word ‘cause,’” the report read:
U.S. Surgeon General’s report:
Smoking and Health.

262
Luther Terry’s report, a leatherbound, 387-page:
“1964 Report on Smoking and Health.”

262
“While the propaganda blast was tremendous”:
George Weissman memo to Joseph Cullman III, January 11, 1964, Tobacco Documents Online, http://tobaccodocuments.org/landman/1005038559–8561.html (accessed December 26, 2009).

263
the commission’s shining piece of lawmaking:
Annual Report of the Federal Trade Commission
(Washington DC: United States Printing Office, 1950), 65.

263
In 1957, John Blatnik, a Minnesota chemistry teacher:
“Making Cigarette Ads Tell the Truth,”
Harper’s
, August 1958.

263
The FTC had been revamped:
“Government: The Old Lady’s New Look,”
Time
, April 16, 1965.

264
A week later, in January 1964:
Federal Trade Commission, “Advertising and Labeling of Cigarettes. Notice of Rule-Making Proceeding for Establishment of Trade Regulation Rules,”
Federal Register
, January 22, 1964, 29:530–32.

264
they voluntarily requested regulation by Congress:
“The Quiet Victory of the Cigarette Lobby: How It Found the Best Filter Yet—Congress,”
Atlantic
, September 1965.

264
Entitled the Federal Cigarette Labeling and Advertising Act:
Cigarette Labeling and Advertising Act, Title 15, chap. 36, 1965; “Quiet Victory of the Cigarette Lobby.”

265
In the early summer of 1967, Banzhaf: John F. Banzhaf III v. Federal Communications Commission et al.
, 405 F.2d 1082 (D.C. Cir. 1968).

266
“The advertisements in question”:
Ibid.

266
“a squadron of the best-paid lawyers in the country”:
John Banzhaf, interview with author, June 2008.

266
“Doubt is our product”:
“Smoking and Health Proposal,” 1969, Brown & Williamson Collection, Legacy Tobacco Documents Library, University of California, San Francisco.

266
In 1968, a worn and skeletal-looking William Talman:
A video of the ad is available at http://www.classictvads.com/smoke_1.shtml (accessed December 26, 2009).

267
The last cigarette commercial:
See Brandt,
Cigarette Century
, 271.

267
He had already died:
“William Hopper, Actor, Dies; Detective in ‘Perry Mason,’ 54,”
New York Times
, March 7, 1970.

267
cigarette consumption in America plateaued:
U.S. Department of Agriculture,
Tobacco Situation and Outlook Report
, publication no. TBS-226 (Washington, DC: U.S. Department of Agriculture, Economic Research Service, Commodity Economics Division, April 1994) table 2; G. A. Glovino, “Surveillance for Selected Tobacco-Use Behaviors—United States, 1900–1994,”
Morbidity and Mortality Weekly Report CDC Surveillance Summaries
43, no. 3 (1994): 1–43.

267
“Statistics,” the journalist Paul Brodeur once wrote:
Paul Brodeur,
Outrageous Misconduct: The Asbestos Industry on Trial
(New York: Pantheon Books, 1985).

267
She represented the midpoint:
See “Women and Smoking,” Report of the U.S. Surgeon General 2001, and prior report from 1980.

268
“[It’s] a game only for steady nerves”:
See, for example,
Popular Mechanics
, November 1942, back cover.