Tobacco Explained: 2. Nicotine and addiction

ASH/ Industry conduct/ Tobacco Explained: 2. Nicotine and addiction

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Tobacco Explained

2 Nicotine and addiction

"…the entire matter of addiction is the most potent weapon a prosecuting attorney can have in a lung cancer/cigarette case. We can't defend continued smoking as 'free choice' if the person was 'addicted'." ¹

The Tobacco Institute in 1980, revealing why the industry consistently refuses to accept that nicotine is addictive - its legal defences would be wrecked and its 'freedom to smoke' arguments would be defeated.

2.1 Summary

Beginning in the early sixties, industry documents discuss the addictive nature of nicotine, and recognise that the primary reason for people to continue smoking is nicotine addiction. The documents show that the industry believes nicotine to be a drug. "We are in the business of selling nicotine - an addictive drug" one lawyer wrote as far back as 1963. The documents are peppered with statements about the pharmacological or psychopharmacological effects of nicotine - its effect on the brain or central nervous system.

Publicly the industry has maintained that nicotine is not addictive – culminating in Congressional hearings in 1994 when seven Chief Executive Officers of American tobacco companies all testified that nicotine is not addictive. The industry has always said publicly that nicotine was important for taste or flavour – not addiction.

By the early seventies, industry lawyers were worried that the "free choice" argument the industry was using to defend smoking was being negated on the grounds of addiction, and could have implications for litigation against the industry.

In the seventies and eighties, industry researchers investigated the addictiveness of nicotine, on, amongst others, monkeys and rats. In the experiments, animals became dependent on nicotine – but the lawyers normally took over the control of the results.

In the US, the industry, knowing that without nicotine cigarettes would not be a viable product, became terrified that the Food and Drug Administration would regulate cigarettes as a drug, and hence regulate tobacco and nicotine content. In the early eighties BAT at least, was considering becoming involved in the marketing of other nicotine delivery systems, but decided against the move because it feared that it might heighten the chances of FDA regulation.

In the late nineties, as many internal documents showing that cigarettes are addictive reach the public domain, the companies have responded by trying to fudge and change the definition of addiction - which they now apply to such activities as shopping or the Internet. In 1997, Liggett broke ranks and became the first company to admit that "smoking is addictive". Many companies still openly deny that nicotine is addictive.

2.2 What is known - key facts about nicotine addiction

A UK Government scientific committee said in March 1998: "Over the past decade there has been increasing recognition that underlying smoking behaviour and its remarkable intractability to change is addiction to the drug nicotine. Nicotine has been shown to have effects on brain dopamine systems similar to those of drugs such as heroin and cocaine." (SCOTH, 1998) ²
"Dependence on nicotine is established early in teenagers' smoking careers, and there is compelling evidence that much adult smoking behaviour is motivated by a need to maintain a preferred level of nicotine intake…" (SCOTH, 1998, Ibid.)
Withdrawal from smoking can be observed as causing irritability, difficulty in concentrating, anxiety, restlessness, increased hunger, depression and a pronounced craving for tobacco. The fact that this can be attributed to nicotine, rather than behavioural aspects of tobacco use is shown by the consistent finding that withdrawal symptoms are relieved by nicotine replacement (patches, gum etc) but not by a placebo (patches, gum etc that do not contain nicotine) ³.
Despite a high proportion (c. 70%) of smokers that say they would like to quit, cessation rates are low - two studies showed less than 5% of those attempting to stop maintained complete abstinence for 6 months. Only a third managed to abstain for 2 days. Nicotine replacement therapy approximately doubles the chance of successful cessation ⁴.
There is no universally accepted definition of addiction and the scope of characteristics included varies, but the WHO gave a reasonable definition in 1969: "A state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterised by behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present." ⁵

Smokers are compelled to smoke by addiction to nicotine but the harm is largely done by the 4,000+ other chemicals in the tar and gases produced by burning tobacco. It is this combination that makes tobacco so deadly.

2.3 What the industry said and what it knew

2.3.1 Early to mid 1960s:
What the chief scientist said	Sir Charles Ellis, from BAT "…smoking is a habit of addiction …nicotine is … a very fine drug." ⁶(BAT, 1962)
What the lawyers said	17 July: Addison Yeaman from Brown and Williamson: "Nicotine is addictive. We are, then, in the business of selling nicotine, an addictive drug." ⁷ (B&W, 1963)
Tobacco industry scientists	"The habitual use of tobacco is related primarily to psychological and social drives, reinforced and perpetuated by the pharmacological actions of nicotine on the central nervous system." ⁸ (Research for BAT, 1963)

2.3.2 Mid-late 1960s:

What the BAT scientists said

"It may be useful, therefore, to look at the tobacco industry as if for a large part its business is the administration of nicotine (in the clinical sense)." ⁹ (BAT, 1967)

"Smoking is an addictive habit attributable to nicotine and the form of nicotine affects the rate of absorption by the smoker." ¹⁰ (BAT, 1967)

What the Philip Morris scientists found and said

RD Carpenter from Philip Morris writes a report on "RJ Reynold’s Biological Facilities" stating that:

"Reynolds has developed an inhalation smoking device [which] is being used to expose rats to cigarette smoke …the rats have become habituated to the smoke." ¹¹ (Philip Morris, 1969)

The Vice President for R&D explains 'why one smokes':

"the primary motivation for smoking is to obtain the pharmacological effect of nicotine. In the past, we at R&D have said that we’re not in the cigarette business, we’re in the smoke business. It might be more pointed to observe that the cigarette is the vehicle of smoke, smoke is the vehicle of nicotine, and nicotine is the agent of a pleasurable body response." ¹² (Philip Morris, 1969)

2.3.3 Early-Mid 1970s:

What the scientists said at their conferences	"Sir Charles [Ellis of BAT] started the meeting by saying that he had first brought out the concept that we are in a nicotine rather than tobacco industry." ¹³ (BAT, 1971) William Dunn Jr. of Philip Morris: "The cigarette should be conceived not as a product but as a package. The product is nicotine …Think of the cigarette pack as a storage container for a day’s supply of nicotine …Think of a cigarette as a dispenser for a dose unit of nicotine. Think of a puff of smoke as the vehicle of nicotine ..Smoke is beyond question the most optimised vehicle of nicotine and the cigarette the most optimised dispenser of smoke." ¹⁴ (Philip Morris, 1971)
Scientists recognise that without nicotine there is no industry	"If, as proposed, nicotine is the sine qua non of smoking, and if we meekly accept the allegations of our critics and move toward reduction or elimination of nicotine in our products, then we shall eventually liquidate our business. If we intend to remain in business and our business is the manufacture and sale of dosage forms of nicotine, then at some point we must make a stand." ¹⁵(RJR, undated)
Lawyers warn that free choice arguments may be undermined	February: Ernest Pepples, B&W’s counsel: "Addiction - Some emphasis is now being placed in the habit-forming capacities of cigarette smoke. To some extent the argument revolving around "free choice" is being negated on the grounds of addiction. The threat is that this argument will increase significantly and lead to further restrictions on product specifications and greater danger in litigation." ¹⁶ (B&W, 1973)
Industry scientists find more evidence	"Monkeys can be trained to inject themselves with nicotine for its own sake, just as they will inject other dependence-producing drugs e.g. opiates, caffeine, amphetamine, cocaine …. The absorption of nicotine through the lungs is as quick as the junkie’s ‘fix’." ¹⁷ (B&W's research review, 1973) Experiments on rats showed that: "dependence of nicotine is related to the stressfulness of the situation." ¹⁸ (B&W, 1974)

2.3.4 Mid –late 1970s:

What the marketing people worried about	August: An advertising conference undertaken for B&W examines the goals of how to "market an ADDICTIVE PRODUCT in an ETHICAL MANNER." ¹⁹ (1977)
‘Socially acceptable’ replacements for tobacco must be addictive	A 1979 BAT document assesses the role of addiction and its importance in any search for a product that would replace tobacco: "We are searching explicitly for a socially acceptable addictive product involving: a pattern of repeated consumption a product which is likely to involve repeated handling the essential constituent is most likely to be nicotine or a direct substitute for it the product must be non-ignitable (to eliminate inhalation of combustion products and passive smoking)." ²⁰ (BAT, 1979)
High profits arise because the customer is dependent on the product	"We also think that consideration should be given to the hypothesis that the high profits additionally associated with the tobacco industry are directly related to the fact that the customer is dependent upon the product." "Looked at another way, it does not follow that future alternative 'Product X' would sustain a profit level above most other product/business activities unless, like tobacco, it was associated with dependence."
Ethical problems of addiction recognised	"That being the case, one must question the ethics and practical possibilities of society/medical opinion permitting the advent of the new habituation process." (BAT, 1979)

2.3.5 Early-Mid 1980s:

What the scientists said

Dr Green, from BAT:

"It has been suggested that cigarette smoking is the most addictive drug. Certainly large numbers of people will continue to smoke because they can’t give it up. If they could they would do so. They can no longer be said to make an adult choice." ²¹ (BAT, 1980)

A memo by BAT scientists:

"BAT should learn to look at itself as a drug company rather than as a tobacco company." ²²(BAT, 1980)

What the industry scientists found

Victor DeNoble of Philip Morris undertook experiments on rats who had nicotine injected directly into their hearts. The results showed that the rats would administer a further dose of nicotine by pushing a lever.

"Nicotine has properties of a drug of abuse. It has properties of drug addiction ...This [The results] was completely contradictory to the industry’s position that nicotine is in cigarettes for taste. We know they [the rats] pressed the lever because of the drug effects on the animals brain. We also know from studies that if the substance was cocaine or morphine or alcohol the rates would continue to press the lever. We found the same in nicotine." ²³(Philip Morris, quoted on Dispatches, Channel 4, 1996)

2.3.6 Mid to late 1980s:

Too uncomfortable to quit

"Why do people smoke?….to relax; for the taste; to fill the time; something to do with my hands. […] But, for the most part, people continue to smoke because they find it too uncomfortable to quit." ²⁴ (Philip Morris, 1984)

What the US Surgeon General declared

The US Surgeon General officially declares that:

"cigarettes and other forms of tobacco are addicting". The pharmacological and behavioural processes are "similar to those that determine addiction to drugs such as heroin and cocaine." ²⁵ (1988)

Industry responds with denials

The Tobacco Institute argues: "claims that cigarettes are addictive contradict common sense … An escalation of antismoking rhetoric … without medical or scientific foundation." ²⁶ (TI, 1988)

2.3.7 The 1990s

What the industry said privately	"Different people smoke for different reasons. But the primary reason is to deliver nicotine into their bodies. Nicotine is an alkaloid derived from the tobacco plant. It is a physiologically active, nitrogen containing substance. Similar organic chemicals include nicotine, quinine, cocaine, atropine and morphine." ²⁷(Philip Morris, circa. 1993)
Publicly, nicotine adds taste and feel	Brennen Dawson, Vice President, Tobacco Institute says "Nicotine is essential. It has taste. It has what’s called a mouth feel." ²⁸ (1994)
Tobacco CEOs say it's not addictive under oath	US tobacco CEOs testify under oath before Congressional Health and Environment Subcommittee: Thomas Sandefur, Chief Executive of Brown and Williamson says: "I do not believe that nicotine is addictive." William Campbell from Philip Morris: "I believe nicotine is not addictive." James Johnston, RJ Reynolds:"And I too believe that nicotine is not addictive." ²⁹ (1994)
…but once free the obvious may be stated	After stepping down, Ross Johnson, ex-Chief Executive of RJ Reynolds, is asked by the Wall Street Journal whether nicotine is addictive: "Of course it’s addictive. That’s why you smoke the stuff." ³⁰(Cited in Wall Street Journal 1994)
But the industry keeps up its outward pretence…	Martin Broughton, Chief Executive BAT: "We have not concealed, we do not conceal and we will never conceal … we have no internal research which proves that smoking … is addictive." ³¹ (1996) A Philip Morris Position Statement: "Those who term smoking an addiction do so for ideological -- not scientific -- reasons." ³²(1996)
…until the weight of evidence is too great and a fudge must be found…	To an editorial in the Observer, which argued that nicotine is addictive, Dr Chris Proctor from BAT responded: "Addiction is an emotive subject and it is certainly possible to define the term broadly enough to include smoking….the public’s understanding has changed significantly over recent decades….the current definition is more colloquial, reflected in terms like ‘chocaholic’ and ‘Addicted to love’ as in a recent movie. This colloquial definition is all inclusive and certainly applies to the use of many common substances that have familiar pharmacological effects to cigarettes, such as coffee, tea, chocolate and cola drinks." ³³(BAT, 1998)
…everything's addictive!	When asked in a magazine interview, John Carlisle of the TMA (UK) adopts the new fudging approach: Question: "Is nicotine addictive? Carlisle: The definition of addiction is wide and varied. People are addicted to the Internet. Others are addicted to shopping, sex, tea and coffee. The line I would take is that tobacco isn't addictive but habit forming." ³⁴ (TMA, 1998)

References

Memo from Knopick to Kloepfer, Tobacco Institute, 9 September 1980. {Minn. Trial Exhibit 14,303}.

Report of the Scientific Committee on Tobacco and Health (1998) UK Government, Department of Health, March 1998. Para 1.30, Page 23.

I. P. Stoleman, M. J. Jarvis, The scientific case that nicotine is addictive. Psychopharmacology (1995) 117:2 2-10.

Stoleman and Jarvis, op cit.

WHO (1969) Technical Report Series No 407, Geneva. Cited in Stoleman and Jarvis, op cit.

A. McCormick, Smoking and Health: Policy on Research, Minutes of Southampton Meeting, 1962 {1102.01}

A. Yeaman, Implications of Battelle Hippo 1 & 11 and the Griffith Filter, 1963, 17 July, Memo {1802.05}

C. Haselbach, O Libert, Final Report on Project Hippo, Battelle Memorial Institute for BAT, 1963, {1211.03}

S. Green, Note to Mr. D.S.F Hobson, 1967, 2 March

BAT, R&D Conference, Montreal, Proceedings, 1967, 24 October {1165.01}; BAT R&D Conference Montreal, 1967, 24-27 October, Minutes written 8 November {Minn. Trial Exhibit 11,332}

R.D. Carpenter, Memo Re: RJ Reynolds Biological Facilities, 1969, 3 October {Minn. Trial Exhibit 2545}

Philip Morris Vice President for Research and Development, Why One Smokes, First Draft, 1969, Autumn {Minn. Trial Exhibit 3681}

R. R. Johnson, Comments on Nicotine, Notes of a meeting held on 30 June, 1971

W. Dunn. Motives and Incentives in Cigarette Smoking, Philip Morris Research Centre, 1971, {Minn –www.tobacco.org}

Quoted in Report of Special Master: Findings of Fact, Conclusions of Law and Recommendations Regarding Non-Liggett Privilege Claims, Minnesota Trial Court File Number C1-94-8565, 1998, 8 March, {Minn. Plaintiff’s Exhibit 43 (1), RJR 500915683, p688}

E. Pepples, Memo to J. Blalock, 1973, 14 February

B&W, Secondary Source Digest, ~1973 {Minn. Trial Exhibit 13,809}

C. Morrison, Effects of Nicotine and Its Withdrawal on the Performance of Rats on Signalled and Unsignalled Avoidance Schedules, Psychopharmacologicia, 1974, No 38 [L&D UK Ind 25]

Hawkins, McCain & Blumenthal, Inc, Conference Report, 1977, 28 July {Minn Trial Exhibit 13,986}

BAT, Key Areas for Product Innovation Over the Next 10 Years, Minnesota Trial Exhibit 11,283.

Dr S J Green, Transcript of Note By SJ Green, 1980, 1 January [Pollock 129]

BAT, Brainstorming 11, What Three Radical Changes Might, Through the Agency of R&D Take Place in this Industry by the End of the Century, 1980, 11 April {Minn. Trial Exhibit 11,361}

Quoted on Channel 4, Big Tobacco, Dispatches, 1996, 31 October

Philip Morris, internal presentation, 1984, 20 March

Quoted in R. Kluger, Ashes to Ashes - America’s Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris, Alfred A. Knopf, New York, 1996, p 672

The Tobacco Institute, Claims That Cigarettes are Addictive Contradict Common Sense, 1988, 16 May {Minn Trial Exhibit 14,384}; {Minn Plaintiff’s Exhibit 22(1), TI 00125189, p189}

Philip Morris, Draft Report into "Table", Undated but using data from 1992

B. Dawson, Face the Nation, 1994, 27 March [L&D BAT file 4]

S. A.Glantz, J. Slade, L. A. Bero, P. Hanauer, D. E. Barnes, The Cigarette Papers, University of California Press, 1996, p100

Quoted in the Wall Street Journal, 1994, 6 October, p1 quoted in P. J. Hilts, Smokescreen - The Truth Behind the Tobacco Industry Cover-Up, 1996, Addison Wesley, p64

T. Stevenson, BAT Denies Smoking Claims, The Independent, 1996, 31 October, p20

Philip Morris, Position Statement On A Wide Range of Issues, Believed to be 1996

Dr. C. Proctor, BAT Industries - Smoking Gun?, Statement in the Observer, 1998, 1 March, p13

Quoted in an interview in Punch magazine, 1198, 11 April.

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