EMPLOYEE HANDBOOK
ON
SMOKING AND HEALTH
M-G. Cannon
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BATCo document for Province of British Columbia I
November 1999


INTRODUCTION
A; I of us who work for the tobacco industry are
aware cf
the controversy that surrounds our products.
Tnere is a substantial body of scientific and
med:cal
opinion that links smoking to various diseases.
While
we obviously respect this opinion, there is
another side
to the case and some scientists have not acceoted
these
allegations. The tobacco industry is deeply
concerned
that our knowledge about smoking and its effects
cn peopple
is extended and last year alone funded independent
research
with more than E5 million.
Outside the scientific debate public concern is
fuelled by
an active and skilled lobby of pressure groups who
devote
all their efforts to the campaign against smoking.
Ir contrast, the tobacco industry in the U.K. has
been
very restrained in defending itself. The use of
unreasonaDty
excessive pressure by the anti-smoking lobby
requires the industry
tc state the case in a balanced way.
B.A.T feels that its first responsibility is to
explain to
employees the issues that surround smoking and
present a
reasoned, balanced view. In doing so it is hoped
that the
o-.ner side of the smoking argument will be aired;
giving you
the information needed to make up your own mind
about smoking.
We have tried to make this leaflet as factual as
we can;
there is no resort to the sensationalism that our
adversaries
use. In doing so the arguments may appear less
convincing
than the bold stateme nts you see in some sections
of the
med;a. The opposite is true; convincing argument
is based
on demon strable fact not loudly repeated
assertions. C:)
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This leaflet is designed to help you in your role
as a private
citizen who works for a tobacco company.
Statements on the
company's views, particularly to the media or
public audiences,
must remain the responsibility of designated
members of the
company.
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Part I
SMOKING AND HEALTH
However complex the arguments surrounding smoking
and its
effec:s on health become the real issue is about
one word
only. That is the word "cause".
There is a large body of opinion which states that
smoking
causes such diseases as lung cancer, bronchitis
and emphysema.
The ---:)acco industry disputes the accuracy of
the word "cause"
in tne context of smoking and disease.
There is certainly a relationship between smoking
and the
incicence rate of some diseases. It is accurate to
say
that smokers are, on average, more likely to
suffer from these
diseases than non-smokers but not to say that
smoking is the
cause of that disease because many other complex
factors may be
in~o'-ed.
This cifference of opinion is not just a
hair-splitting argument
abo~;-.,~ords. It is fundamental to the entire
debate that
sur.-c-.snds smoking.
To say that smoking causes a particular disease
implies that
there is medical and scie6tific proof that this is
the case.
There is not. Neither is there proof that smoking
does not
cause disease.
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Lung Cancer
The alleged assQciation between smoking and lung
cancer is perhaps
the most widely known issue in the smoking
controversy.
Here the evidence pointing to smoking as a cause
of lung
cancer is primarily based on statistics: in other
words more
smokers develop lung cancer than non-smokers. That
in itself
does not prove that smoking is the cause. The
causal accusation
also ignores the facts that a substantial number
of non-smokers
develop lung cancer; the majority of smokers do
not develop lung
cancer; and that the cause of lung cancer has not
yet been established.
Experiments wi-th animals were also used, but
while cancers
have been produced the incidence has been too low
to demonstrate
that there is any more than random association.
Nevertheless, the accusation of "causing cancer"
is still
levelled at smoking. As long as the causes of
cancer are not
known smoking may still be used as the scapegoat,
diverting
attention from other possible factors such as
environment, occupation
and heredity.
Again the tobacco industry believes that the
question is an
open one and more research is called for. We
should also
bear in mind that:
lung cancer was an established disease long before
cigarettes became popular;
most smokers do not develop lung cancer, while
some non-
smokers do.
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Heart Disease
Coronary heart disease is a growing affliction for
20th Century
man. Doctors have sought to discover the cause of
heart
disease and have identified a number of possible
risk factors
such as stress, diet. obesity, fitness.
Somedoctors have included
smoking as one of these possible risk factors.
Some researchers have a] so found I inks between
heart di sease and
the type of people we are. For example, ambitious,
aggressive
people are statistically more prone to heart
problems and they
also tend to be smokers. Other scientists have
concluded that the
disease is hereditary. And in one study scientists
have found
that deaths from coronary heart disease were
actually lower in
ex-smokers than non-smokers.
It is misleading, therefore, to call smoking the
cause of heart
disease when doctors suggest so many possible risk
factors may
be involved.
What is also ignored are the benefits of smoking:
if stress is
a risk factor in heart disease and smoking helps
relieve stress,
then smoking might arguably be beneficial.
Obstructive Lung Disease
The medical situation concerning smoking and lung
disease,
such as chronic bronchitis and emphysema is
nowhere near as
clear cut as the opponents of smoking would have
us believe. As
with some of the other associated diseases no
positive evidence
has emerged from scientific enquiry that
demonstrates smoking
causes these lung disorders.
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6
Many smokers never develop these diseases but
individuals who
have never smoked do. Neither is there any
consistent relationship
between the levels of cigarette consumption and
the development
of the diseases and the number of deaths from
them.
Animal research has again been cited as
justifica:ion for the
link between smoking and lung disease. But it is
dangerous
to base human medical diaonosis on results
obtained from animals.
This is particularly true, as animals' respiratory
systems have
significant structural differences from humans.
Because
of this the validity of these experiments has been
questioned
by other scientists.
The role of environmental and occupational
factors, such as
air pollution and the type of jobs we do, has been
identified
as a possible contributory factor. Even the type
of person we are may
have its effects: studies in the United States,
for example,
have shown that black people have a lower rate of
bronchitis
and emphysema than white even when smoking habits
were the same.
Preonancy
One of the most emotional allegations against
s,-noking is that it can
effect the unborn child. Many people are prepared
to accept
the adults right to smoke, because they have a
freedom of choic-e.
But this freedom "Obviously does not apply to the
unborn
child.
Once more the emotional allegations are based on
statistics, and
a close look at these illustrates the dangers of
trying to use
statistics as a basis for proof.
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Certain statistical studies suggest that
on average the babies of mothers who smoke during
pregnan cy
tend to be born at a lower birth weight. That
sounds bad as we often
think of a heavy baby being a healthy baby. But it
is not always
the case; indeed,.one American researcher found
that the lower
weight babies of smoking mothers' were, in fact,
"healthier" than
babies of the same weight of non-smoking mothers.
Further research showed that some women produced
lower weight
babies even before they started to smoke, and then
had babies
of lower weight after they had begun to smoke.
Despite claims, too, that smoking causes increased
still birth
during pregnancy and malformation of children,
none of the
available scientific evidence has established any
proof to
support this. In fact one study on malformation
indicated
precisely the opposite.
Many doctors advise that a modification in smoking
habits during
pregnancy is a sensible part of pre-natal
behaviour and is
similar to the advised reduction in drinking
alcohol or the
taking of substances such as aspirin.
SMOKING AND HEALTH: Conclusions
Conclusions is perhaps a wrong heading for this
section as
there are few definite conclusions in the Smoking
and Health
debate. There is certain.ly controversy
surrounding smoking,
which is continually fanned by the protestations
of anti-smoking
groups. Their arguments, are not however, always
totally
factual. What is certain is that in the climate of
uncertainty
r.-~ore research is needed to reach definite
conclusions.
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Smoking is enjoyed regularly by 20 million people
in the U.K.
alone. Obviously these people have legitimate
concerns about
the habit when so much of what they read and hear
is mis-informed
comment by anti-smoking activists.
The other side of the coin, the tobacco industry
vie.point, is
heard far less frequently. This is because the
industry cannot
express an opinion on smoking and health whilst
the
evidence is inconclusive on either side. If the
bodies
opposed to smoking treated the medical and
scientific evidence
available to them in the same balanced way, they
could not
lustifiably say that smoking has been proved
harmful.
Rhe question of smoking and health remains
unrescl~e~. B.A.T,
and the entire tobacco industry, devotes millions
of pounds
each year to fund independent scientific research.
In the
many years of this research not one (or any
combination) or
the thousands of substances as found in cigarette
smcke has been
identified as the cause of any disease.
Smoking must therefore remain a matter for
individual decision.
In the unresolved controversy, the individual can
apply common
sense to smok i ng that a I lows h i m to make up
h i s own mi nd based
cn t he evi dence that has been fu I I y pub I i
ci sed. From this the
individual smoker will be able to establish for
himself if he
considers the benefits to be greater than the
alleged risks.
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Part
SMOKING AND SOCIETY
Introduction
Smoking tobacco has been a social custom in many
societies
for centuries and was first brought to European
attention
in the 1490's by a sailor with Christopher
Columbus.
Walter Raleigh did not therefore discover it, but
was
responsible for the introduction and
popularisation of
tobacco to the English Court in the late 1500's.
Since then tobacco has been a source of pleasure,
controversy
and revenue for governments. It was not until the
1880's
that the cigarette began to emerge as the most
popular, mass
produced method of smoking tobacco.
The great popularisation of the cigarette was made
possible
by the introduction of machinery and its growth
has matched
the growing industrial isation and urbanisation of
our world.
Since the health controversies of the 1960's and
70's the
growth of smoking has slowed in the developed
world. Even so
nearly half of all adults in the U.K. are smokers
of at least
one form of tobacco. In the world as a whole
smoking still
continues to grow.
Why do people smoke?
It is sometimes easy to forget that people smoke
because they
find it enjoyable. After all, 20 million people in
the U.K.
would hardly continue smoking if they didn't like
it.
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As well as the pleasure of smoking and the
enjoyment of the
taste and flavour of tobacco there are many other
reasons.
For some it helps them to relax; for others it
assists
concentration or relieves boredom.
Smoking can help combat nervousness or help a
social meeting
cet off to a friendly start.
Other smokers enjoy the ritual of smoking, and
this can be
seen particularly amongst pipe smokers.
Tobacco smoke also contains nicotine, which has an
extremely
complex action within the human system. Nicotine
in the
levels gained by smoking is thought to be the
reason why
smoking can relax or stimulate a person's
activity.
Whatever the reason for smoking, and it is a very
personal
activity, it is a decision to be taken by adults
and their
decision should be respected.
Public Smokinc
Public smoking or passive smoking is a term that
has been
coined to describe the intake of tobacco smoke by
non-smokers
from the air around them.
It has been aroued thqt this constitutes a health
hazard to
the non-smoker. much has been made of this
argument in the smoking
controversy and the "rights of the non-smoker"
have been
championed on trains,buses, aeroplanes and in
other public
places.
The argument that the non-smoker's health is at
risk just
does not hold water. Even if aH the alleged
dangers of smoking
were accepted, the amount of smoke inhaled by a
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In fact, it would take the non-smoker more than
100 consecutive
hours spent in a crowded bar to inhale the
equivalent of one
cigarette.
A recent study has alleged that tHere seems to be
a link between
passive smoking and respiratory disorders but this
research has
been questioned by experts and more work will be
needed before a
positive view is reached.
Smoking may cause annoyance to non-smokers; in
some extreme
cases a very few people may have an allergic
reaction. That
is very different fron saying that non-smokers'
health is
at risk.
Common courtesy and a respect for the views of
others, both
non-smokers and smokers, is sufficient to resolve
any problems
of passive smoking.
Under age smoking
Millions of adults smoke. It is quite
understandable therefore
that children become aware of smoking from an
early age and
in some cases want to copy adult behaviour.
Because of this there is a strong pressure on
smokers to discourage
the habit in order to prevent chi ldren starting.
There are many activities in our society which
adults wish to
pursue but consider inappropriate for children to
take up
until they have reached a certain age. These vary
from sex, drinking
alcohol, driving motor cars or voting.
However, when a responsible age of adulthood is
reached the
individual has a right to make up his own mind
based on information
which he is capable of evaluating for himself.
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This is exactly the attitude advanced by the
tobacco industry,
which has formally adopted a policy of not
promoting its products
to children nor make them attractive to young
minds.
Several researth studies have examined what makes
people start
smoking; none of them demonstrated that
advertising was responsible.
In fact one major study concluded that advertising
had no
link at all with the amount of cigarettes sold.
Social Attitudes
Social attitudes are constantly changing. What was
unacceptable
behaviour at the beginning of the century is
commonplace now-
Our attitudes to smoking are also changing. Som.
years ago,
for example, smoking was considered a masculine
preserve, and
somehow slightly dashing. With sexual equality
developing it
became less of a masculine pursuit - indeed
smoking was often
used as a symbol of the sexual revolution. Often
film makers
and dramatists used smoking as a visual shorthand
to imply
sophistication.
That type of attitude is rather dated now and
so:iety has moved
to treating smoking much more as a matter of
individual
choice, without any social statements being made.
The anti-smoking group want to take this natural
progression
even further and create a climate where smoking is
socially
unacceptable - or at least where the smoker is
made to feel
that it is.
This programme is all part of the campaign against
smoking and
the wider concept that some small yet influential
groups
want to decide what is best for us.
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The tobacco industry believes that information on
smoking is
so widely avaiLable that everyone is aware of the
controversy.
As there is no re!;olution to that controversy the
decision to
smoke or not must be left to the rational
decis-ion of adults.
Having made their decision they should not be
hounded by
campaigning do-gooders.
The Role of the Government
Successive Governments around the world have
worked to reduce the
.inc.idence of smoking in their countries.
They-have taken the view that
smoking may be harmful to some smokers. While
the'tobacco industry obviously
does not concede this, it recognises that any one
or any group
can legitimately reach that conclusion while the
smoking
controversy contLnues.
However with hundreds of millions of smokers
around the world it would
be impractical to ban smoking - America's
experience with prohibition
gives some idea of what could happen. The role of
government
in a free society where legal products are
concerned is to
provide information and allow individuals to
decide.
To resort to legislation to interfere with adult
choice would
be wrong. It is also wrong for governments to
legislate in
order to restrict arbitrarily, comrZrcial
competition by
restraint of advertising or promotion.
We believe that the Tobacco Industry has acted
responsibly in their relations with Governments
and that
the voluntary codes of practice are by far the"
better ay
of operating, than resorting to legislation.
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Part 3
SMOKE AND ITS COMPONENT PARTS
Introduction
In any debate on smoking attention is often
directed to the
component parts of smoke: "tar", nicotine, carbon
monoxide and
so on. Despite considerable research comparatively
little is
known about the complex nature of tobacco smoke
and this has
allowed many misleading statements to be made
about the content
and the effect of tobacco smoke.
In this section we will take a look at some of the
more
familiar substances that are referred to in the
smoking debate.
Tar
Tar has been singled out by some governments, with
the suppoct
of medical authorities, as the "harmful" component
of smoke.
Unfortunately this is misleading as "tar" as such
does
not exist in a cigarette as smoked by a human.
Tar is the substance composed of the millions of
tiny liquid
droplets that make up part of the visible smoke.
It is collected
in laboratory conditi.ons e'ither by passing
cigirette smoke through
a cold trap, rather like a condenser or by passage
through
a highly efficient filter.
Constant interest in "tar" has produced a demard
for lower tar
cigarettes and the industry has responded by
producing
many lower tar brands and accepting a policy of
supporting them
with greater advertising expenditure than their
volume sales
would normally justify.
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Ni cot i ne
Nicotine is the principal active ingredient in
smoke and is
the substance that stimulates or relaxes the
smoker.
It is a substance that is readily absorbed by the
blood
stream and is also readily eliminated from the
body and so has
very little cumulative effect.
It is generally acknowledged that nicotine does
not present a
health problem and indeed one aid to giving up
smoking - a
chewing gum that is available from doctors on
prescription -
contains nicotine.
Carbon Monoxide
Carbon monoxide is present in the body naturally
and this is
increased slightly by such things as traffic fumes
and smoking.
The level of increase for smokers has not been
shown to be
harmful and the one experiment which linked carbon
monoxide
in tobacco smoke with the blocking of coronary
arteries in
animals has never been repeated. The scientist
concerned has
since withdrawn his claims.
However it is accepted that increased levels of
carbon
monoxide in the blood can put a greater load on a
damaged heart
and anything that increases this level , such as
smoking, should
be avoided by anyone with heart disease.
Oxides of Nitrogen
Nitrogen dioxide is a component of smog and this
has
been linked with emphysema. Because cigarette
smoke contains
minute amounts of nitric oxide - v..,hich on
contact with air can
slo%41y c~~anqe to nitrogen dioxide - it has been
argued that C)
smoking can cause lung disorders.
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No reliable evidence backs this claim and it seems
that the change
is far too slow for it to be of any significance
to the smoker.
Nitrosamines
These substances, which have been associated with
the development of
cancers occur in a wide range of products such as
beer, fish meal, bacon,
hamburger and sausages as well as in minute
quantities in
tobacco and tobacco smoke,
So far the levels of these substances taken in by
individuals
from all sources have not been established as
harmful. It is
also important to note that filter :ips remove
nitrosanines more
effectively than other smoke components.
Conclusion
Many substances in the food and drink that are a
normal part of
our lives have been accused of being dangerous but
sometimes
this is as a result of research using massive
doses which are
unrepresentative of normal intake.
in the absence of firm scientific proof the only
reasonable
view can be if all the "scares" were true life
would be virtually
impossible.
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Part 4
SMOKING AND THE INbIVIDUAL
Introduction
We have stressed that the decisions to smoke or
not should
be left to individual adult choice. In this
surr-ary chapter
we wil I look at smoking and its effects on the
collection of
individuals that work for B.A.T ... you.
Should I work for a tobacco company?
Presumably you have made that decision already.
But perhaps
it was made before the current high level of
controversy or perhaps
you have never really considered the question.
As we have said the smoking controversy is
unresolved. It 'is
tnerefore up tc the individual to make his or he-
own choice
based on a balanced view of the facts.
However, it is worth re-stating the tobacco
incustry does meet
a legitimate consumer demand by the supply of
lecal products
which are enjoyed by millions of people.
It spends millions of pounds each year funding
independent
research into the effects of smoking.
In the U.K. alone, it employs more than 40,000
people directly
and some 250,000 people derive some or all of
zneir living
from involvement in the sales and distribution of
tobacco.
It contributes nearly E3 bil lion (three thousand-
million) to
government each year in taxation. C)
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. . 18
It contributes some E250 million each year to our
balance of
payments.
It has a record of responsibility in the smoking
and health
debate and has always demonstrated its readiness
to cz-operate
with the reasonable demands of government.
Does tobacco have a secure future?
We believe that smoking will continue for the
foreseeazie
future and is as secure as any industry. Growth
for :~-Ie overall
market in countries like the U.K. is not likely
and one of the
reasons why tobacco companies like B.A.T have
invested in other
businesses is because of that limitation of
growth. That is not
to say that we are getting out of tobacco, our
presence will remain
substantial, but there are o0er areas whose growtn
potential is
greater.
Should we really carry on making cigarettes when
so manv doctors
say it is bad for us7
Some doctors and scientists also say that the case
against smoking
is not proven; that there is no scientific proof
that s-mcking causes
disease. The manufacture and sale of cigarettes
therefore xeets a
legitimate consumer deman'd.
I'm sometimes critiCsed for working for a tobacco
conDan~.
What do I say?
Obviously you have to say what you believe. We
have produced
this booklet to give what we hope is a balanced
view of some of
the major areas of controversy. CD
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19
In summary:
Smoking is a legitimate social custom enjoyed by
millions.
Tobacco companies are perfectly right in marketing
a product to meet a clearly expressed consumer
demand.
The allegations against smoking are not conclusive
and
the industry does much to advance scientific
knowledge
of the issues.
In the face of scientific and medical controversy
the
industry has consistently acted responsibly anc
has
met government requirements for promotional
restraint
and the modification of its products.
Tobacco is a legitimate business that meets
consumer
demand, provides employment and contributes to the
economy
of the country.
This is not comprehensive because the subject is
extremely complex,
but we hope it has given the answers to some of
your questions
and the questions that you may be asked.
What is B.A.T doing about the smoking and health
controversy?
We fund independent research to the tune of E5
million annually
and we are active members of the Tobacco Advisory
Council.
This association of tobacco manufacturers
maintains close liaison
with government , researchers and other
international bodies
and puts the industry case to the widest possible
audience.
Why are tobacco comoanies producinq low tar
ciqarettes?
The tar content of cigarettes has been the subject
of niuch investi-
gation by government and scientists. It is used as
a measurement
of the SErenct-) of a particular brand and a body
of scientific
opinion has argued that tar is one of the harmful
constituents
cf s."noke. While the tobacco industry does not
accept this
conclusion it does take account of scientific
opinion and produces
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... 20
cigarettes of lower tar deliveries which consumers
are demanding
tecause of the information published.
iz is often stated th-at smoking kill* 50,000
people a year in
:ne U.K. Is that true?
No. The figure of 50,000 deaths is from diseases
which are associated
.ith smoking. It has not been established that
smoking
causes these diseases.
,he use of statistics like this is typical of the
misleading claims
.2 y the anti-smoking lobby. Sir George Young, a
committed anti-smoker
and junior health minister, has admitted in
Parliament that it is
i.-.oossible to attribute this figure to deaths by
smoking.
In. a written reply to a parliamertary question he
said: "The precise
csntribution of smoking to mortality is not known,
but the annual
number of premature deaths due specifically to
smoking-related
diseases has been estimated at 50,000 in the
United Kingdom. This
cives an approximate rate of 900 per million
population.
T'his supports the industry's consistently stated
position that causation
has not been established.
'.,nat aDOUt each cigarette taking 5i minutes off
your li`e?
ff the argument that cigarette smoking causes
disease is accezted
as proven, and this booklet has made clear that
the tobacco industry
coes not accept this, then it is possible to
calculate the ancunt
of time that a cigarette can "take off a life."
:5 viously it is a very emotive statement and
captured many headlines,
as it was designed to do. Bu: it is only a
statistical calc,--Iation
mat depends on the acceptance of smoking as a
cause of disease.
Using the same method of calculation you can work
out that driving
a car for one mile will take 31 seconds off your
life!
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This is rez-*Iy using statistics in a totally
sensational way. If
you look a: :he 50,000 deaths figure more than
half of them are
people ove- 70 anyway. ~ut in order to get to the
"51 minutes''
accusation cu look at the number of yeats less
than the average
that people ,iith these diseases live, multiply it
by the number
of deaths and divide it by the average number of
cigarettes they
smoke. The result is the 51 minutes figure. That
is a statistic
based on va-ious, averages, it is not valid from
that to say that
anyone who smakes a cigarette lessens his life by
that time,
or any ot-e- time.
Why is it --at most smokers say they would like to
give up?
What smoke -s mean by that i s tha t they mi ght I
i ke to g i ve up
if it were easy. Smoking fulfills complex needs
and people find,
for example. that they become irritable when they
give up smoking,
or that the, become more tense. Obviously smoking
has helped
these peo:'a to alleviate tension and that is one
of the reasons
they smoke. Giving up becomes difficult and people
have not recognised
their reas::~s for smoking. Cost is also a factor
and most of us would like
to save mo-ey in theory, but when it comes to a
clear choice carry on
smoking.
kA
CZ)
00
BATCo document for Province of BritiSh Columbia I
November 1999