A Not-So-Slippery Slope

Few issues have drawn such persistent and divisive debate in recent years as tobacco-industry funding of university research. Although a number of institutions have developed policies to prohibit such funding in the last few years, others have taken large grants from tobacco companies. At the same time, for example, that the McCombs School of Business of the University of Texas at Austin barred faculty and student groups from accepting funds from Altria (the parent company of Philip Morris USA), faculty members at Stanford University and the University of California rejected efforts to ban tobacco funding. While the University of Virginia accepted a $25 million grant from Philip Morris in 2007, other institutions were enacting total bans on such funding.

Today, a number of prominent hospitals, medical schools, and schools of public health have established policies prohibiting tobacco-industry research funding. These include MD Anderson Cancer Center, Brigham and Women’s Hospital, the Johns Hopkins Bloomberg School of Public Health, Emory University School of Medicine, and Harvard Medical School and School of Public Health. In banning such funds, these institutions typically have cited the dire health effects of smoking and the companies’ long-standing public denials of the science linking cigarettes to disease and death. Critics of tobacco-industry funding also point to the massive public-relations campaign mounted by the companies over the last half century to disrupt scientific inquiry into the harms of cigarette smoking and to create a scientific “controversy”—often spurred by industry-supported skeptics. Those critics have also argued that it is inconsistent for institutions committed to human health and the public good to conduct research supported by an industry whose principal product continues to cause extensive harm to human health around the globe.

But that view draws opposition within the academy. Even some who disapprove of the historic misdeeds of Big Tobacco defend the right of researchers and universities to continue to accept tobacco money. They typically point to two related arguments. First, academic freedom supports the right of faculty members to take funding from any “legitimate” source, even those in political disfavor. Second, banning a particular industry because it is held in low public esteem creates a “slippery slope” that threatens to subject universities to continuous debate about whether particular funders are appropriate and legitimate. According to this argument, bans on tobacco-industry funding will leave universities in a perilous position, subject to political correctness and the whimsy of ideological bias.

These are precisely the arguments that the American Association of University Professors has offered in establishing its policies about corporate funding, specifically addressing the tobacco-funding controversy: “The distinction between degrees of corporate misdeeds is too uncertain to sustain a clear, consistent, and principled policy for determining which research funds to accept and which to reject. An institution which seeks to distinguish between and among different kinds of offensive corporate behavior presumes that it is competent to distinguish permissible corporate wrongdoing from wrongful behavior that is acceptable. A university which starts down this path will find it difficult to resist demands that research bans should be imposed on other funding agencies that are seen as reckless or supportive of repellant programs.” On this basis, the AAUP has opposed efforts to restrict universities from accepting tobacco-industry funding. A subsequent policy statement on corporate funding of university research, adopted by the AAUP’s Council in 2004, acknowledged the controversy concerning tobacco funding without modifying the earlier position.

As a strong advocate for academic freedom and a historian who has devoted many years to studying the history of the tobacco industry and cigarette smoking, I find these arguments and policies deeply flawed. My own position is that academic institutions can discern tobacco companies’ motivation for funding research and can make considered judgments about whether to accept or reject the industry’s money. Making such judgments is at the heart of the academy’s collective responsibilities. Those responsibilities include affirming our values, maintaining public trust, and serving the public good. The AAUP errs on both arguments it uses as a foundation for its policy: the case of tobacco funding is not a slippery slope, nor is it an appropriate instance for affirming our commitment to academic freedom.

Cigarettes, Addiction, and Death

Today, academic science and research universally recognize the full dimensions of the harms caused by cigarette smoking. In the United States, more than one in five adults is currently a regular smoker, and more than 450,000 deaths occur each year as a result of cigarette use. Most new smokers are underage, and younger smokers are a group heavily targeted by tobacco-industry promotion and advertising. An estimated three thousand children become new smokers every day. Nicotine is highly addictive, and the companies have worked diligently over recent decades to enhance the addictive properties of their product.

As rates of smoking have declined in the United States and other Western nations over recent decades, the tobacco companies intensified their efforts to market cigarettes in the developing world. The World Health Organization estimates that one hundred million smokers died worldwide from smoking-related diseases in the last century; if current rates of smoking are merely maintained, ten times as many—one billion smokers—will die this century. Cigarette smoking is widely regarded as the most preventable cause of death throughout the world. Unlike many other dangerous products, there is no way to use a cigarette safely. On these grounds alone, universities might well decide that the tobacco companies are not appropriate “partners” for academic research. But there are several important additional arguments for forgoing tobacco research funding.

Fraud and Racketeering

Historically, the tobacco industry took advantage of university-industry connections in a complex scheme to undermine and distort scientific knowledge of tobacco’s harms. This is not the controversial claim of a single historian. Rather, it is based upon extensive access to the companies’ massive internal archives, which were made public as a result of industry whistle-blowers and litigation against the companies. Universities and their faculties cannot, of course, know everything they might like to know about donors, corporate sponsors, or other supporters of academic research. At the same time, we cannot ignore what we do know. In the case of tobacco-industry research funding, we have extensive knowledge of how tobacco companies behave.

In 2006, a federal district court—utilizing the tobacco industry’s internal archives—concluded in U.S. v. Philip Morris that the companies had violated the federal racketeering and fraud statutes by participating in a fifty-year conspiracy to deny the known dangers of smoking, to aggressively promote tobacco to underage smokers, and to manipulate the science of addiction and the health effects of secondhand smoke through its industry-sponsored research program. Judge Gladys Kessler wrote in her final opinion that “over the course of fifty years, defendants lied, misrepresented, and deceived the American public, including smokers and the young people they avidly sought as ‘replacement smokers,’ about the devastating health effects of smoking and environmental tobacco smoke.” Kessler concluded that the companies “suppressed research, they destroyed documents, they manipulated the use of nicotine so as to increase and perpetuate addiction . . . and they abused the legal system in order to achieve their goal—to make money with little if any regard for individual illness or suffering, soaring health care costs, or the integrity of the legal system.”

The Racketeer Influenced and Corrupt Organizations (RICO) statute requires compelling evidence that the fraud not only occurred in the past but also continues in the present. Kessler concluded that, in fact, the companies continued to make false claims about low tar and “light” cigarettes, about nicotine and addiction, and about the harms of secondhand smoke. As a result of this historic case—later sustained on appeal—we might simply conclude that universities should prohibit funding from companies that have been found to have violated federal racketeering laws.

"Good Science”

I served as an expert witness in the federal trial over which Kessler presided. My testimony on behalf of the government, as well as the extensive cross-examination by lawyers for the industry, centered on the history of the industry’s efforts to disrupt and distort the emerging science and the character and quality of the industry-university research program. I concluded in my testimony that much of the research that the industry sponsored through its Tobacco Industry Research Committee (TIRC) had little or nothing to do with the primary question at hand: the causal link between smoking and disease. I testified that the industry sponsored academic research for two reasons: first, to create the notion that there was a scientific “controversy,” despite research categorically demonstrating that smoking causes lung cancer and other diseases; and, second, to create a public-relations campaign that utilized scientific investigation to demonstrate that the companies were acting in the public interest. Critical to this strategy was the solicitation of university-based researchers through the TIRC. The companies could then assert that they were supporting important scientific investigation. They insisted, despite overwhelming evidence to the contrary, that there was substantial uncertainty about the harms of smoking and the cause of disease, that there was “more to know,” and that there was “no proof” that smoking caused lung cancer. As one industry document noted, “doubt is our product.”

During my cross-examination, an industry lawyer asked me if tobacco companies sponsored “good science.” The industry had offered grants primarily to scientists who would investigate questions unrelated to whether cigarettes caused disease. Elite scientists conducted some of these studies and published their results in noted peer-reviewed journals. At the trial, the industry sought to use the work of these scientists to demonstrate the integrity and importance of its research program. But we now know from industry documents that this research was intended to serve as a public-relations “cover” to deflect attention from the scientific findings that clearly implicated tobacco as a cause of death and disease. Much to my frustration, the industry lawyer asked, “Did the companies sponsor good science, yes or no?”

That is not the question that universities should ask themselves. Universities and researchers must understand the motivation underlying offers of research support. Even first-rate research can be used to support and sustain industrial interests that are highly suspect. I have no doubt that in some instances scientists have used the funds provided by the tobacco industry to conduct valid research. Some would argue that we must not ban such funding if “good science” has been produced under industry auspices and that we must rely on the good judgment of individual researchers to protect the independence, credibility, and autonomy of their own scholarship. But universities also must consider the broader context, motivation, and impact of such “gifts.” Currently, tobacco companies are eager to establish themselves as committed to “corporate social responsibility.” When tobacco-industry executives and their public-relations representatives invest in university-based research, they know precisely what they are purchasing. The industry has a long history of seeking such relationships, which offer much-needed credibility and authority to an industry that has consistently worked to undermine and obscure critical questions of medical science. For an industry that has come to be so powerfully associated with lies and deception, associating with institutions committed to knowledge and the public good offers a potential route to relegitimation. Furthermore, the industry is well aware that it can exploit the current need for external research support within universities through grants and gifts that strengthen industry-academic relationships.

If, as has been demonstrated in my research and that of many others, the tobacco industry uses such funding programs to burnish a deservedly tarnished image, to claim its social legitimacy while aggressively selling a deadly product, then universities accepting tobacco money have been co-opted to support activities that sharply conflict with their own missions. By helping to legitimize the tobacco industry, universities risk their integrity, values, and public trust. Making decisions about whether to accept tobacco-industry support demands more thoughtful collective debate of our faculties and administrations than has occurred. Such decisions affect the entire university community; they cannot be left to the vagaries of individual judgment when the reputation of our collective enterprise is at stake.

How Slippery Is the Slippery Slope?

If prohibiting tobacco-industry funding places universities on an untenable slippery slope, then the logical extension of this argument is that universities cannot make any assessment of the funds they might agree to take from any industry or other funding source. In no instance is the historical and public record of corporate wrongdoing and harm as clear as tobacco. In many instances, of course, we will not have the depth of knowledge about industries supporting university-based research that we have in the case of tobacco. But it violates our strongest norms and values to infer that we thus cannot utilize the knowledge that we do have. There is no evidence whatsoever that institutions that have taken steps to prohibit tobacco funding have had any difficulty distinguishing between a “rogue” industry and industry-academy relationships that support the larger goals of knowledge acquisition and human betterment. The threat to academic freedom has come not from university policies, but rather—as the AAUP has documented—from the tobacco industry itself as it has aggressively used the courts to harass researchers whose findings threaten its corporate interests.

We must be careful as we assess university-industry relationships to make critical distinctions that guide policy and practice. If we simply conclude that complex and difficult cases present slippery slopes, we risk losing our moral compass and our most cherished values. University-industry relationships, and the real and perceived conflicts of interest that they engender, present tough and complicated choices that universities must carefully negotiate and adjudicate. In order to do so, however, there must be clear markers and boundaries. The issues surrounding tobacco-industry funding can help us to clarify our core principles and commitments and offer policy options that sharpen our mission and priorities. The ultimate protection of our academic freedom depends on such collective good judgment and the notion that universities can take collective action to ensure that we never serve corporate needs and strategies that are inconsistent with our own ethics and values.

Allan M. Brandt is dean of the Graduate School of Arts and Sciences at Harvard University, where he is Kass Professor of the History of Medicine. He is author of The Cigarette Century. That book’s Web site, www.cigarettecentury.com, contains additional resources on the tobacco industry. His e-mail address is [email protected].

Comments

Allan Brandt is an estimable scholar and superb historian of the health discourse in American culture.  So it's surprising to read, in "A Not-So-Slippery Slope" (Nov-Dec 2010), an argument from him that counters the slippery slope argument by invoking an even more suspect trope:  the one drop rule.

Prof. Brandt does make a stand for universities' liberty to make unfettered decisions about what sorts of research to permit.  He implies that those decisions might go either way, even when the research is funded by tobacco companies:  "Academic institutions can discern tobacco companies' motivation for funding research," he writes, "and can make considered judgments about whether to accept or reject the industry's money."  At the same time, he indicts institutions that do allow tobacco-sponsored research for undercutting the aims of higher education. "Universities accepting tobacco money have been co-opted to support activities that sharply conflict with their own missions [of producing knowledge and furthering public good]," Prof. Brandt holds.

Prof. Brandt's scholarship is unimpeachable. He is the author of the authoritative history of tobacco companies' infiltration of American culture -- including American science.  So he is to be believed when he says that even when tobacco companies sponsor research on areas other than smoking-associated harms, they do it for public relations purposes. Tobacco companies want their research programs to look scientifically sound and catholic in their aims, but that's all utterly cynical, he says.  It's just a way for corporations to look respectable.

Funders' motivation, Brandt says, is all.
 
The problem with Prof. Brandt's argument is that what he wants is tantamount to the old one-drop rule about race:  no research can be trusted if it has been touched -- contaminated, in essence -- by tobacco money.  It might seem to be methodologically sound, it might be carried out by practiced and unbiased researchers, its conclusions might pass scientific scrutiny.  But its funding source, Big Tobacco, will reveal the research's pervasive inner taint.  Universities must not be fooled by a research project's appearance or comportment; only by attending to its funding pedigree can the real nature of a project be discerned.

As a consequence of this one-drop rule, all sorts of research that really would produce knowledge and might serve the public well must be quashed.  Research into alternatives to cigarettes for people who are habituated to (or who just greatly like) nicotine, such as smokeless tobacco, won't be funded by government agencies in the U.S.; when public health professionals' smoking-cessation zeal turned into a holy and wholesale anti-tobacco crusade, they made sure of that.  Under the Brandt plan, those researchers would have to reject tobacco-company funding, and we would know less about how to help smokers to quit cigarettes.  Agricultural research, for instance on plant pathogens, although not similarly non grata to federal agencies, might suffer, too. Surely our society wants more, not less, research on ways to improve health and welfare.

In a sense, what's at stake here isn't the matter of the liberty accorded to academic institutions.  Universities make all sorts of decisions about what to sanction and what to forbid, for all sorts of reasons.  Rather, it's science.  I mean, the question is whether individual researchers have the moral probity to exercise good judgment in deciding what sorts of research to undertake -- and the responsibility of universities to back up their own faculty members' research choices.  I'd rather not have blanket rules about funding sources, because those rules get in the way of responsible judgment by researchers and the intellectual security that universities should provide to faculty.

P.A.

Of course there is fraud, bad science, a waste of time and money etc.  But I would like to think that there are a few first rate scientists who know how to disprove the empty theories and are already working on it  We know that tobacco smoke contains a number of carcinogens including polycyclic aromatic hydrocarbons and their derivatives.  A failure to agree on a satisfactory theory of how hydrocarbons produce cancer in humans and experimental animals, after 80 years of chemical and biological experiments, is a failure to disprove the empty theories.

J. L.