"The Doctors’ Choice Is America’s Choice”: The Physician in US Cigarette Advertisements, 1930-1953

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Citation Gardner, Martha N. and Allan M. Brandt. 2006. “‘The Doctors’ Choice Is America’s Choice”: The Physician in US Cigarette Advertisements, 1930-1953. American Journal of Public Health 96(2): 222-232.

Published Version http://dx.doi.org/10.2105/AJPH.2005.066654

Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:3372909

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o Hoctars' Choice Is America's Choice'' The Physician in US Cigarette Advertisements, 1930-1953

In the 1930s and 1940s, smoking be- Martha N, Gardner, PhD, and Allan M, Brandt, PhD came the norm for both men and

women in the llnited States, and a ma- IN 1946, THE RJ REYNOLDS cigarette brand of choice just after In retrospect, these advertise- jority of physicians smoked. At the Tobacco Company initiated a being provided complimentary ments are a powerful reminder same time, there was risingpubli c anx- major new advertising campaign cartons of Camels.' of the cultural authority physi- iety about the health riskso f cigarette for Camels, one of the most popu- Even without the suspect na- cians and medicine held in smoking. One strategic response of to- lai- brands in the United States, ture of the data used in the "More American society during the mid- bacco companies was to devise ad- Working to establish dominance Doctors" campaign, the frequent 20th century, and the manner in vertising referring directly to physi- in a highly competitive market appearance of physicians in ad- which tobacco executives aligned cians. As ad campaigns featuring Reynolds centered their new cam- vertisements for cigarettes in this their product with that authorily, paign on the memorable slogan, and many other ad campaigns is Even before modem epidemi- physicians developed tfirough the early "More doctors smoke Camels both striking a:id ironic fromth e oiogicaJ research would demon- 1950s, tobacco executives used the than any other cigarette," This vantage point of the early 21st strate the health risks of smok- doctor image to assure tiie consumer phrase would be the mainstay of century. Any association between ing at mid-century, there had that their respective brands were safe. their advertising for the next 6 physicians and cigarettes—the already arisen considerable con- These advertisements also sug- years. Touting surveys conducted leading cause of death in the cem about the health impact of gested that the individual physicians' by "three leading independent re- United States—is jarring given our cigarette use,' Questions of the clinical judgment should continue to search orgajuzadons," one typical cuirent scientific knowledge moral and health consequences be the arbiter of the harms of ciga- advertisement proclaimed that ac- ahout the relationship of smoking of cigarette smoking that bad rette smoking even as systematic cording to "nationwide" surveys to disease and the fact that fewer been prevalent at the beginning health evidence accumulated. How- of 113 597 doctors "from every than 4% of physicians in the of the 20th century still lin- ever, by 1954, industry strategists branch of medicine." Camel was United States now smoke,^ gered. Although many physi- the brand smoked by most re- cians were unconvinced by this deemed physician images in adver- In 1930s and 1940s, how- sprondents. It also asserted that older research, some had begun tisements no longer credible in the ever, smoking had become the this statistic was an "actual fact" to recognize a disturbing in- face of growing public concern about norm for botli men and women not a "casual claim," crease in lung cancer, and some in the United States—and a ma- tbe health evidence implicating ciga- had also started to consider the In realit>', this "independent" jority of physicians smoked,'' At rettes. {Rm J Public Health. 2006; respiratory and cardiovascular surveying was conducted by RJ the same time, however, rising 96:222-232. doi:10.2105/AJPH.2005. effects of smoking. A common Reynoids's advertising agency, the public and scientific anxiety 066654} theorj' held that cancer resulted William Esty Company, whose existed about cigarettes' risks ftxjm chronic irritation to the af- employees questioned physicians to health, creating concern fected tissue, and many won- about their smoking habits at among the tobacco companies. dered whether cigarette smoke medical conferences and in their The physician constituted an "irritated" lung tissue in this offices. It appears that most doc- evocative, reassuring figure to tors were surveyed about their include in their advertisements.

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Well aware of these concerns— Strikes tobacco underwent de- and their impact on cigarette creased throat irritation.'' In fact, sales—the tobacco companies de- Lucky Strikes' curing process did American Tobacco, We leader vised advertising and marketing not significantly differ from that in the splashy ad campaigns strategies to (1) reassure the pub- of other brands. that had made its Lucky Strike lic of the competitive health ad- Related campaigns empha- vantages of their brands, (2) re- sized that "Luckies" would help brand dominant by the cruit physicians as crucial allies consumers—especially women, late 1920s, was the first in the ongoing process of market- their new market—to stay slim, to mention physicians ing tobacco, and (3) maintain the since they could "Reach for a salience of individual clinical Lucky instead of a sweet." ;\long in advertisements. judgments about the health ef- with these persistent health fects of smoking in the face of categorical scientific findings. These elements would be of growing importance as the healtli effects of smoking came to be more fully elucidated. One aspect of these promotional strategies was to refer directly to physicians in botb images and words. We explored how physicians were depicted in these advertisements and how the ad campaigns devel- oped as health evidence implicat- ing cigarette .smoking accumu- lated by the early 1950s.

EARLY MEDICAL CLAIMS

American Tobacco, the leader in the splashy ad campaigns that had made its Lucky Strike brand dominant by the late 1920s, was the first to mention physicians in advertisements. The physician was just one piece of a much claims, a ^ical advertisement larger campaign on bebalf of from 1930 boldly stated that ing firm had "checked and certi- FIGURE 1—Advertisement: American Tobacco. As cigarette "20,679 Physicians say 'LUCK- fied" this number, independently "20,679" physicians say 'LUCKIES sales grew exponentially in the are less irritating.'" IES are less irritating'" and fea- validating the claim.** Their ad- Source. Magazine of Wall Street. United States in the early 20th tured a white-haired, white- vertLsing agency. Lord, Thomas July 26, 1930. century. Lucky Strikes had be- coaled doctor with a reassuring and Logan, had sent cartons of come the preeminent brand smile (Figure 1).' cigarettes to physicians in 1926, largely because of its massive In this manner, American To- 1927, and 1928 and asked them promotional elTorts. Company bacco advertisements refiected to answer whether "Lucky Strike president George Washington an awareness of ongoing public Cigarettes ... are less irritating to Hill worked with ad man Albert concern about the potential sensitive and tender throats than Lasker to develop a "reason why" health effects of cigarette smok- other cigarettes." consumers should purchase their ing. Referring to a large number Ibuting the toasting process in brand. With no real scientific evi- of physicians who they claimed the accompanjong cover letter, dence to back their claims, backed up the superiority of adveitising executive Thomas American Tobacco insisted that Lucky Strikes, the ad text noted Logan pointed out the virtues of the "toasting" process that Lucky in small print that their account- Lucky Strikes and claimed that

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they had heard from "a good referring directly to research con- 1943 advertisement in the Satur- many people" that they could ducted by physicians. Both in day Evening Post proclaimed, smoke Lucky Strikes "with perfeet magazines targeted to the general Philip Morris provided "[fjull re- comfort to their throats." Ameri- public and in medical journals, ports in medical journals by men, can Tobacco used the physicians' Philip Morris claimed tbat their higb in their profession—regularly responses to this survey to vali- cigarettes were proven to be offered to physidans on request."' date their claim that Lucky Strikes "less irritating." For example, in These advertisements used were "less irritating," claiming it a 1937 Saturday Evening Post ad- physicians and science to make confirmed their enduring asser- vertisement, Philip Morris's ball- their particular brand appeal to tion that their "toasting" process mark spokesman, bellhop Johnny the broader public while at the made cigarettes less irritating. Roventini, announced that accord- same time they curried favor with Toasting, the advertisement went ing to "a report on the findings of physicians. Company operatives on to explain, was "your throat a group of doctors ... when appeared at medical conventions protection against irritation— smokers changed to Philip Morris, and in physidans' private offices, against cough."^ Although there every case of irritation cleared providing pbysidans with free dg- was no substantive evidence that completely and definitely im- arettes and reprints of sdentific this process of curing tobacco was proved" (Figure 2). The text re- articles on the subject. As a 1936 superior to the methods tised by ferred specifically to faithfijl doc- Portune Magazine profile of Pbilip other companies, American To- tors "day after day... [keeping] a Morris & Company made clear: bacco made the bold claim and record" to "prove conclusively" the decrease in irritation."^ tied it to physicians. TTie object of all this pmpa- By the mid-1930s. Philip These "findings" resulted from ganda is not only to make doc- tors smoke Philip Morris dga- HGURE 2—Advertisement: "A Morris, a newcomer to the mar- an aggressive pursuit of physi- rettcs. thus setting an example report on the findings of a ket took the use of health claims cians and focused on the concept for impressionable patients, but also tn implant tbe findings of group of doctors.*" a step ftirther, designing a cam- that adding a chemical to their Mtilmos so strongly in tlie med- Source. Saturday Evening Post. paign that used a new strategy of cigarettes, diethylene-glycol. made October 16,1937. ical mind tbat tbe doctors will them moister and less irritating actually advise their coughing, than other brands. As Alan Blum, rtieumy, and fur-ttingut'd pa- tienLs to switcli to Pbilip Morris REPORT ON THE FINDINGS editor of the New York State Jour- on the ground that Ihey are less )F A GROUP OF DOCTORS* nal of Medicine, explained in bis irritating." 1983 assessment of cigarette advertisements that had appeared With careful, deferentiiil ap- in the journal from 1927 to peals to physicians, Philip Morris 1953, Philip Morris—armed with aimed to gain tbeir approval. The papers written hy researchers that spedfic positive references to clin- the company bad sponsored— ical evidence tbat had appeared attempted to use "clinical proof in medical journals helped to es- to establish the superiority of tablish and maintain this connec- their brand." Specifically, Colum- tion between physicians and to- tiocror kcpr a r«wd .f ..,,, bia University pharmacologist bacco companies, and between Michael Mulinos and physiologist health and dgarettes. Frederick Flinn produced findings (on the basis of tbe injection of TOBACCO INDUSTRY diethylene-glycol into the eyes of COURTS DOCTORS rabbits) that became the center- piece of the Philip Morris claim According to a number of ac- that diethylene-glycol was less irri- counts, medical professionals- tating, although other researchers having themselves joined the not spoasored by Philip Morris ranks of inveterate smokers- disputed these findings. ^ doubted the connection between Thi.s highly successful campaign smoking and disease after made Philip Morris into a major 1930."' Although hygienic and brand for tbe first time.'"* As a physiological concerns continued

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to be voiced, clinical medidne medical organizations and jour- doctors in a 1942 advertisement claimed that individual assess- nals, including the New England that appeared in medical journals ment and judgment was re- Journal of Medidne and the Journal describing the MHD. Declaring quired.'^ During this era, there of the American Medical Associa- that "[tlhe most significant med- was a strong tendency to avoid tion (JAMA), as well as many ical data is derived from the altogether causal hypotheses in branches and bulletins of local every-day records of practising matters so clearly complex. medical associations.''' [sicj physicians," the text asserted There was—and would remain— Coming during the Great De- "your office record reports in stich a powerful notion that risk is pression, the placement of adver- cases should prove interesting to largely variable and thus, most tisements in medical journals study."^' appropriately evaluated and helped to keep medical organiza- The MRD, induding its long- monitored at the individual, clini- tions financially solvent when re- time director. A. Grant Clarke, cal level."* sources were scarce. Philip Morris was in fact a part of RJ Reynolds's According to this logic, some praised physidans in these adver- advertising firm, rather than any people could smoke without risk tisements with taglines like "Every kind of professional scientific to health, whereas others appar- doctor is a doubter" and "Doctor division of the company. The ently suffered untoward and as judge" as they appealed to MRD's mailing addmss was tbe sometimes serious consequences. physicians' expert ability to evalu- side door of tbe William Hsty Ad- As cigarette smokiiig became in- ate the evidence, referring them vertising Company.^' The work creasingly popular in the early to scientific articles that they of the MRD focused on promot- decades of the 20th century, daimed illtistrated the superiority ing Camels mainly through find- medicine offered no new insight of their brand. As one sudi adver- ing and courting researchers to into how best to evaluate such tisement explained in its entirety belp suKstantiate the health vaiiabiiity other than on an indi- in 1939, "If you advise patients claims RJ Reynolds made in theii- vidual post hoc basis. If, and on smoking—and what doctor does advertisements. when, an individual developed not—you will find highly impor- In the late 1930s and early symptoms, a physician might ap- tant data in the studies listed 1940s, Clarke—wbo had no propriately advise restricting or below. May we send you a set of medical or scientific training- eliminating tobacco. As a restilt, reprints?""'^ corresponded with many re- rather than being located within Not only, then, did physidans' searchers who were pursuing the sphere of public health, ciga- findings help to make the Philip questions relating to smoking rette use remained within the Morris brand appear superior in and health. The MRD financed domain of clinical assessment the eyes of the public, but the research tbat Reynolds then and prescription. The tobacco in- company also turned to physi- referred to in advertisements. dustry would actively seek to dans with great effect Physicians Rather than emphasizing claims keep cigarettes within this clinical became, through this process, an of moistness as Philip Morris domain. increasingly important conduit in had done, RJ Reynolds foctised For the tobacco companies, the marketing process. on nicotine absorption, insisting physicians' approval of their prod- that Camels were the slowest uct could prove to be essential, RJ REYNOLDS'S MEDICAL burning of all cigai-ettes. The especially since patients often RELATIONS DIVISION safety of nicotine—like the issue brought smoking-related symp- of chronic irritation—was a toms and health concerns to the Althou^ Philip Morris may source of ongoing concern; attention of their doctors. Through have created this strategy—and Reynolds maintained that nico- advertisements appearing in the gained a leg up in tbe competitive tine was "the chief component p^s of medical journals for the cigarette mai'ket-Rj Reynolds be- of pharmacologic and physiolog- first time in the 1930s, tobacco came the leading force in solicit- ical significance." Camels' slow companies worked to develop ing physidans. Reynolds created a burning rate, their advertise- close, mutually benefidai relation- Medical Relations Di\Tsion (MRD) ments now asserted, decreased ships with physicians and their in the early 1940s that became nicotine absorption; as a result, professional organizations. These the base of their aggressive physi- Camels offered smokers an advertisements became a ready cian/health claims promotional advantage over other, faster- source of income for numerous sti-ategy. They directly solicited burning ^^

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their products and brands. To- precursors to the "More Doctors" AT THE A. M. A. COiXVE-VnOX bacco companies' participation in slogan, Rj Reynolds spedfically medical conventions provided a featured dedicated physidans

SC'8 deal- example of their efforts to serving their country and its sol- appeal to physidans. For example, diers during World Wai' 11. As a sodal commentator Bernard 1944 advertisement that ap- Devoto described tbe exbibit hall peared in Life Magazine entitled of the 1947 American Medical "Doctor of Medicine ... and Assodadon (AMA) convention in Morale" illustrated, doctors on the Atlantic City, where doctors front received hero status: "lined up by the hundred" to receive iree cigarettes.^^ At the He wears the same uniform.... MmlLv (he He shares the same risks as Ihe 1942 AMA annual convention, man with (he giin, , , , Yes, the Philip Morris provided a lounge in medical man in the service your Club which doctors could relax and so- today is a figlitiiig man ihroiigh and through, exeept he fights Ot-'LL Ei« i[ m iht Aliulir I'll) Ainfihv,).!!. uis i^ dalize. The lounge, an advertise- YnhiMl tHT . . . in^il li» law onlvl Dnf i> without a gun. . . . [Hit's a ment explained, was "designed for trusted fnend to every fighting i* .Ilk .-, <«pjB'>I. f^ .«- > your conifort. Drop in. Rest... man,. . IHjc well knows the •Jmvuuil r-JV LJ« hj** jpwe IHW comfort and eheer Ihnre Ls read ... smoke ... or jtist chat"^^ in a few moments' relaxation (Figure 3). with a goixl cigarelle , , . like Camel ... the Favorite dgarette Philip Morris Besides welcoming physidans with men in atl the serviecs."" to the convention, Reynolds touted their scientific research With this and similar advertise- into dgarcttes. In an advertise- ments, the positive place that physicians held in American cul- FIGURE 3—Advertisement: As they made this claim, RJ ment that appeared in medical "Philip Morris invites you to Reynolds also asked physicians to journals across the country in the ture was both exploited and un- the... Doctor's ^^ use the infomialion when advis- weeks before tbe 1942 AMA derlined by RJ Reynolds's adver- ing their patients. They referred meeting, Reynolds reiterated their tising scribes. Linking physicians to "a number of reports from claim tliat 'Tt]he .smoke of slow- to wartime patriotism further ele- physicians who recommend burnmg CAMELS contained less vated their status and, with it, Camels" and called on those read- nicotine than that of die 4 other Camel dgarettes. ing the advertisement to send in largest-selling brands tested," and their own ctimcal experiences and condnued to direct its health THE "MORE DOCTORS- to request copies of medical jour- theme at doctors. The advertise- CAMPAIGN nal articles from the MRD that ment also referred to "the inter- proved their assertions, llse ofler esting features of the Camel ciga- When the "More Doctors" served to legitimate R] Reynolds's rette exhibit," including "the campaign began in January 1946, claims. The main article dted diti dramatic visualization of nicotine it also focused on die respected not in fact address Camels specifi- absorpdon from dgarette smoke and romandc image the medical cally, although it did make the in the human respiratory tract" profession had achieved in Ameri- claim that slow-burning cigarettes and "giant photo-murals of Camel can sodety.^" Featuring 6 illustra- were superior.^"* With no deai- laboratory research experiments." tions of physidans with patients— knowledge about whether nico- At a dme when laboratory sd- in the laboratory or sitting back tine absorption was even an area ence had garnered espedal admi- with dgarette in hand—this first that should concern smokers, and ration, the advertisement linked advertisement personalized the with very little data showing clinical medicine to the authority physidan for the readers of such Camels' slower absorption, the of invesdgadve science. ' popular magazines as Ladies' scientific basis for Reynolds's Along with directly solidting Home journal-And 7ime.'"'Pref- claim remained obsnire. physidans, the tobacco advertise- aced with the bold statement that Nonetheless, such health claims ments portrayed a glowing image "Every dodor in private pracdce would become the basis for tbe of physicians in both medical was asked:—family physidans, aggressive recruitment of physi- journals and popular magazines. surgeons, spedalists ... doctors in cian.s as allies in the promotion of In advertisements that were eveiy branch of medicine," the

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advertisement touted the thor- Beyond the questionable meth- "an honored profession ... his oughness of their survey and in- ods used to gather data. Reynolds professional reputation and his sisted that "yes, your doctor was was also careful how they de- record of service are his most asked ... along with thousands scribed the survey findings in ad- chenshed possessions,"'*' The im- and thousands of other doctors vertising copy, making sure to portance of professional autonomy from Maine to California." avoid conflating doctors' choice of loomed large, and tlie industry By linking their depiction of a dgarette with any belief on their was eager to sustain this view. As physicians to the consumer's own part that Camels were healthier. physidans geared up to fight(h e physician. Reynolds brought im- In theii- advertisements, Ihey as- Truman administration s national mediacy to their claims. Any fears serted, "Doctors smoke for pleas- health insurance proposals, their that smoking might be harmful ure just like the rest of us."''^ In- image as loyal and deserving of were also easily contradicted by ternally, Reynoids's advertising respect was especially important"^ the physician's being a smoker executives cautioned William Along with providing images himself. Admirable, forthright Esty. their advertising company, of professional trustworthiness physicians—including the con- to be careful of what they and dedication, the "More Doc- sumer's own—had "named their claimed, insisting that "in no way tors" ad campaign also exploited choice," and that choice, the ad- [shotiid] the copy.., intimate that the popular faith and admiration vertisement insisted, was Camels, doctors recommended smoking of of medical science and technol- hands down. CAMELS, [or] that CAMELS are ogy. In one such "More Doctors" good for health." '"* This caution- Even though a few of these ad- ad. a 5-year-old girl sits next to FIGURE 4—Advertisemerrt from ary approach reflected the grow- vertisements did appear in print, her mother in a doctor's office the Camels "More Doctors" ing industry concern about poten- series: "I'm going to grow the Reynolds advertising depart- and proclaims, "I'm going to tial regulation and litigation."^^ a hundred years oM!" ment soon realized that they grow a hundred years old" to the Source. Good Housekeeping. might have overstepped their evi- Even so, the "More Doctors" kindly man in white (Figtire 4). July 1946. dence. With the Federal Trade campaign resonated effectively Commission already challenging with American cultural values suspected health claims in ciga- about contemporary medidne. rette advertisements, RJ Reynolds Throughout 1946. the slogan toned down their copy, quickly flooded print, radio, and television shifting their claim to "113,597 media. Doctors were often ideal- physicians" surveyed rather than ized, as in the 1946 advertise- fl//physidans.'" ment "I'll be right over!" Here, a At least some individual physi- middle-aged physidan, in bed in cians questioned the original his pajamas, telephone in hand, is claim. In a letter to Howard T about to grab the black bag lying Behrman, a physidan who had re- ready on his bedside table and quested "more specific Intbrma- make a middle-of-the-night visit to tion concerning the survey of a patient in need: physidans' smoking preference," RJ Reynolds advertising executive 24 hours a day your doctor is W T. Smither assured liim that "on duty."... [l]n his daily rou- tine he lives more drama, and the surveying had heen thorough display.s more devotion to the and sdentific. Explaining that the oath he has taken, than the question about brand preference most imagijiative mind could ever invent. And hf asks no had been embedded in a survey speciai credit. When there's a More Doctors smoke (>amcls that included less relevant topics- job to do, he dops it. A few such as medical journals, medical winks of sleep. , a few puffs of a eigaretle. . . and he's back at N conventions, and ntimerous con- the job again.^'' sumer products—Smither empha- sized how 3 independent surveys This neighbortiood family had garnered "similar findings, physidan is saintly and deserving and in doing so, sei"ved to conlirm of trust, r'eprescntiiig (as another the acctiracy of each ^^ 1946 advertisement explained) CAMI:I.S

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Referring to the "amazing strides and 1948 continued to remind answering this quesdon, the ad- in medical science [that] have readers about the survey as the verdscment juxtaposed a "doc- added years to life expectancy," focus of the adverdsements tors report"—illustrated with a the advertisement goes on to shifted. Tbe main slogan of one physician, cigaiette in hand and "thank medical science for that. sucb campaign was "Experience head mirror sd'apped ai'ound his Thank your doctor and tliou- is tlie best teacher." In this series brow—with a "smokers report"— sands like him.. . toiling cease- of adverdsements, Rj Reynolds illustrated with a smiling "Sylvia lessly. .. that you and yours may explained that the cigarette short- MacNeill, secretary." Physidans, enjoy a longer, better life."''* age created by the war had the adverdsement explained, had With medical advances having forced many to smoke whatever concluded after scientific invesd- brands were available, and this gadon that there was "not one experience, they claimed, had single case of throat initadon" made the superiority of Camels' from smoking Camel dgarettes. quality dearly evident. The In fact, "noted throat specialists" smoker was able to tell the difler- had conducted "weekly examina- ence between brands, and such dons" of padents in making this "experience" translated to other determinadon. Reynolds used areas where someone might have this depicdon of careful, clinical know how. When the slogan ap- observation to substandate their peared in magazines like Life and health claim (Figure 5).^^ Saturday Evening Post, the "expe- The adverdsement went be- rience" dted might be that of a yond medical authority, however, talented celebrity athlete able to asserdng that smokers didn't even discern quality in his or her have to take their pbysidans' sport. In medical journals, the word for it Instead, they could references were to famous scien- take their "own personal 30-day tific researchers. These advertise- test," as Sylvia MacNeill had done. ments championed physicians She concluded that she "knew" and medicine and reminded their that "Camels are the mildest best- audience again that "More doc- tasdng dgarette I ever smoked." tors smoked Camels" as they also Advertisements in popular maga- continued to praise science,"" zines took smokers' ability to But the idea of "experience" judge for themselves even further, also figured into another preva- with Elana O'Brian, real estate lent theme communicated in RJ broker, declaring in a typical ex- Reynolds's adverdsing—that of in- ample, "I don't need my doctor's dividual authority, both the report to know Camels are mild" physician's and the individual 'Yhe adverdsement underlined consumer's. The quesdon of her asserdon with photos of 6 throat irritation so central to other smokers from various walks of life under the heading "Thou- Figure 5—Advertisement: "How mild captured popular imaginadon, many 1920s and 1930s ad cam- can a cigarette be?" paigns again emerged here as RJ sands more agreel"^' Source. OMo State Journal of connecdons drawn between sd- Medicine, iuly 1949:45:670. endfic discovery and Camel- Reynolds introduced a "mildness" In another example, Anne Jef- smoking doctors added to the ap- theme. With the central claim freys, a stage and screen star, in- peal of their cigarette of choice.""' that Camels did not irritate the sisted, "The test was fijn and it throat, Reynolds featured both was sensible'." Parallel to earlier MEDICAL AUTHORITY the physician-researcher and the solidtadon of physidans' opin- AND TOBACCO everyday smoker to convince ions, in this series of adverdse- readers of Camels' mildness. ments RJ Reynolds requested After the inidal onslaught of In July 1949 issues of both that smokers determine the heroic physidans and medical local and nadonal medical jour- safety of Camels on their own miracles in 1946. the "More nals, Rj Reynolds asked, "How and praised their acumen. With Doctors" advertisements in 1947 mild can a dgarette be?" In some advertisements calling on

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smokers to "Prove it yourself!' and findings connecting lung cancer "PIay-Safe-with-Luckies" idea— even guaranteeing a money-back to cigarette smoking in national or with Caniels or with ajiy- thing else.)^" guarantee for dissatisfied cus- magazines like Time and tomers, Reynolds insisted on the Reader's Digest—and the corre- superiority of their product. '•* sponding declines in sales and Hill & Knowlton's advice was These advertisements worked to stock prices—forced tobacco ex- that the industry as a whole must subvert the emerging population- ecutives to assess strategies for desist from health claims that based epidemiological findings responding to growing medical had been a centerpiece of the ad- by emphasizing the primacy of and public concerns about their vertising that featured physicians. "individual" judgment. product.*"^ Such claims, the agency now contended, would now draw at- By 1952, advertising copy By 1953. when Wynder, Gra- tention to the "health scare." as went beyond the typical individ- ham, and their colleague Adele they professed to call it.^' ual smoker to emphasize the Croninger published laboratory sheer volume of people who fmdings confirming that ciga- chose Camels as their cigarette. rettes were carcinogenic, scien- Highlighting that Camel was tific fijidings constituted a critical Tobacco executives were well aware both "America's most popular cigarette threat to the industry."''* Tobacco of these findings and of the public attention by billions." the ad copy men- executives were well aware both tioned that "long before Camel of these findings and of the pub- they were receiving, and their statements reached those heights, repeated lic attention they were receiving, and actions reflected an understanding surveys showed that more doctors and their statements and actions that this new scientific evidence constituted smoke Camels than any olher reflected an understanding that cigarette.""* The cigarette's popu- this new scientific evidence con- a full-scale crisis for their corporations. larity in itself became a selling stituted a full-scale crisis for their point; how could so many people corporations. In popular magazines, the last be wrong? And physicians' ciga- Most notably, company execu- notable reference to doctors in an rette choice served to contirm tives realized that they would advertisement came in 1954, this popularity. As the heading of have to work together in the face After the other tobacco compa- a similar advertisement ex- of the scientific evidence. Al- nies had left such marketing tech- plained, "The doctors' choice is though each company still sought niques behind, Liggett and Myers America's choice.'"*^ an advantage over its competitors, {which had declined participation the new healtli evidence threat- in the joint industry program THE DISAPPEARING ened the hilvre of the entire in- directed by Hill & Knowlton) DOCTOR dustiy. In December 1953, the to- made the claim that their L&M bacco executives met to devise a filter cigarette was "Just what the Ultimately, however, the use joint strategy. They hired promi- doctor ordered!" In a typical ad- of physicians in Camel advertise- nent public relations firm Hill & vertisement that appeared in a ments could not be sustained as Knowlton to aid in this effort. As February issue of Life magazine, the health evidence against ciga- a planning memo makes deay, Hollywood star Fredric March rettes accumulated. When dis- health claims were considered to made this assertion after having turbing scientific results connect- be no longer viable. According to i-L'ad the letter written hy a ing lung cajicer and cigarettes Edward Dakin, a Hill & Knowlton "Dr Darkis" that was inset into began to emerge, Camel adver- executive, it would be critical to the advertisement Darkis ex- tisements shifted away from plained in this letter that L&M physicians' judgment and author- Develop some understanding filters used a "highly purified ity. In 1950, the publication of with companies that, on this eilpha cellulose" that was "entirety the now-famous work of Evarts problem, none is going to seek harmless" and "effectively filtered a competitive advantage by in- Graham and Kmst Wynder in ferring to its public that its the smoke" (Figure 6), the United States—as well as that product is less risky than oth- Dr Darkis was in fact not a of A. Bradford Hill and Richard ere. (No claims that special fil- lers or toasting, or expert selec- medical doctor at all but a re- Doll in the United Kingdom- tion of tobacco, 01' extra leii(rth .search chemist, yet another ex- showed that there was cause for in the butt, or anything else, ample of misrepresentation in a alarm.'*'' The reporting of their makes a given brand less likely (o cause you-know-what. No tobacco ad.^^ More significantly,

February 2006, Vol 96, No. 2 I American Journal of Public Health Gardner | Peer Reviewed 1 Public Health Then and Now I 229 PUBLIC HEALTH THEN AND NOW

this use of implicit doctor en- and "Why is it, doctor, that one "hucksterism," it became even dorsement of cigarettes would filter cigarette gives so much more clear to tobacco companies not occur again in American ad- more protection than any other?" that the purported allegiance vertising after this campaign. One advertisement mentioned with physidans was no longer Much in the way that the indus- how "thousands" of physicians at feasible or effective. try had used doctors to reassure a recent AMA convention wit- One additional indicator of smokers in the 1940s, filter ciga- nessed "a convincing demonstra- the growing medical disdain for rettes were heconiing the indus- tion. . . [of] the effectiveness of cigarettes was the very fact that try's new strategy for appealing the MICRONITE FILTER" and many physidans who followed to consumers, whose concerns included photos of the experi- tbe emerging health evidence about the health risks of smoking ment demonstrated there. In began the [irocess of giving up would be repeatedly confirmed their marketing of Kent, Loriltard smoking. According to one study by new research studies. In had created a campaign reminis- of physicians' smoking practices 1950, filter dgarettes were 2'Vii cent of those designed by Philip in Massachusetts, nearly 52% of the US dgarette market; by Morris and RJ Reynolds in the had reported being regular 1960, they were 50"/[j.^-' 1930s and early 1940s.^*' Just as smokers in 1954 (over 30% re- in those earlier advertisements, In medical journals, the last- ported smoking at least a pack Lorillard called on physicians to gasp attempt by a tobacco com- per day); just 5 years later, only interpret scientific results using pany to ally itself with physicians 39% were regular smokers. Ad- their individual, clinical judg- came in 1953, when the Loril- ditionally, only 18% now re- ment But tbe swift and vehe- lard Company appealed to physi- ported consumption of a pack or ment reaction to these advertise- cians as they promoted their new more per day.^" FIGURE G—Actor Fredric March in ments clearly illustrated bow the filter dgarette, Kent. These ad- Although the industry would an advertisement for L&M RHers: social and scientific climate had "This ts K." vertisements queried, "Have you continue to solicit physicians shifted, A 1954 JAMA editorial Source. Life Magazine. February 22, tried this experiment, doctor?" witb materials disputing the rela- 1954. labeled the reference to physi- tionship between smoking and cians and the MIA convention disease and would also seek out an "unauthorized and medically physicians who doubted the unethical use of the prestige and harmfulness of cigarettes in reputation of the American Med- order to imdermine emerging ical Assodation. "^^ No longer scientific findings, such efforts could tobacco companies count would be gi^eeted with rising on physicians to serve as public skepticism.'''^ The era of explicit advocates of their product. use of pbysicitins and health In fact, in \953JAMA had de- claims to promote smoking had cided to stop accepting cigarette ended even though the AMA advertisements in its publications would not publicly acknowledge and banned cigarette companies the harms of cigarette smoking from exhibiting their products at until 1978."" The smoking AMA conventions.^'* After con- physician had become a visual ducting its own survey of physi- oxymoron. The industry would cians, the AMA explained in a turn to new images and more so- letter to tobacco companies that phisticated strategies to hawk "a large percentage of physicians their dangerous product. • interviewed expressed their dis- approval" of dgarette advertise- ments m medical journals. Other About the Airtlior JAMA advertisers had come to Martha N. Gardner is with the Depurt- dislike having their products ment of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, appear next to cigarette adver- Boston. Mass. Allan M. Brandt is with the tisements as well.'^ With tbe Department of Social Mediane. Hurvard AMA publidy condemning the Medical School and the History of Science Kent ad campaign In 1954 as Department. Harvard University. Cam- bridge, Mass.

230 I Public Health Then and Now I Peer Reviewed I Gardner American Journal of Public Health | February 2006, Vol 96. No. 2 PUBLIC HEALTH THEN AND NOW

Requests for reprints should be sent to 1987), See Ochsner and DeBakey, 14. Philip Morris advertisement, at http://iegacy, library, ucsf.edu/tid/ Martha N. Gardner. PhD. Department of "Symposium on Cancer," for a din;(-t from Saturday Evening Post. Septem- cst78dOO. Arts and Sciences. Ma'isachuseits College reference to "chronic irritation" and can- ber 25, 1943, available at http:// 28. RJ Reynolds, "Camels Costlier To- of Pharmacy and Heatth Sciences, 179 cer (p. 446), tobaccodocuments,org/pollay_ads/ baccos," advertisement, available at I.ongWDod Ave, Boston. MA 02115 PbilO3.O4.html, 6. See "Good laste in Advertising." (e-muil: [email protected]). bttp://tobaccodocuments .org/po II ay _ads Fortune 1 (1930): 60-61, aaid The 15. "Pliilip Morris & Co.," 116. /Camel4.17.html. This ad appeared in 77iis (irtide uxis acceptedfune 20, 2005. American Tobacco Co.," Fortune 14 Saturday Evening Post. Life, and Colliers 16. C. A. Wemer, "The Triumph of the (1936): 96-102, 154-160, in May 1944, and similar ones ap- Cigarette." American Mercury 6 (1925): Contribiftors peared in the New England Journal of 7. R. Marchand, Advertising the Amer- 419-420; W, M. Johnson, "The EU'ecLs Both authors lieveioped, researched, aiid Medicine and the Journal of the American ican Dream: Making Way for Modernity of Ibbacco Smoking," American Mercury wrote the artide. M. N. Gardner is prttid- Medical Association. pa] aulhnr and A, M. Brandt is coauthor. (Berkeley: University of California Press. 25 (1932): 451-454; A. G. Ingalls. "If' 1985). 21-22; R. Sobel, They Satisfy: You Smoke," Scientific American 154 29. J.C. Bumham, "American Medi- Acknowledgments The Cigarette in American Life (Garden (1936): 310-313,354-355. cine's Golden Age: What Happened to City. [S[Y: Anchor Books; 1978), 101; It?" Science 215 (1982): 1474-1479, A. M. Bi-ajidt is the recipient of the G. H. Allen. "Alhert Davis Lasker," Ad- 17. J. C. Bumham, "American Physi- William Calian Distinguished Professor 30. R] Reynolds, '"Every Doctor in Pri- vertising and Selling 19 (1932): 21-22, cians and Tohacco Use: Two Surgeons Award, granted by the Flight Attendants vate IVactice Was Asked. According to 16-37. General. 1929 and 1964," Bulletin of Medica] Research Institute. This award the History of Medicine 63 (Spring a Recent Nationwide Survey: More Doc- provides finandal support for research. 8. In a report to the Federal Trade 1989): 1-31. tors Smoke Camels 'ITian Any Other A.M. Brandt served as a consultant Commission, Amencan Ibbacco Com- Cigarette!" March 1946, available at and expert witness on behalf of the pany detailed this survey. See American 18. See R. A, Aronowitz, Making Sense http: //www. trinketsandtraih. org/re- Department of Justice in USA v Philip Tobacco Company, "United States of ofniness: Science, Society and Disease sults.asp. The Trinkets and 'Trash Web Morris el al. M. N. Gardner also served America, Federal 'Trade Commission: (New York: Cambridge UnivereiQ' Press, site notes that the ad appeared in the as a consultant in the case. Memorandum Submitted by the Ameri- 1998), 111-144. March 1946 Ladies Home Journal can Ibbacco Company." pp. 18-22, 19. H. Wolinsky and T. Brune. The 80-89, 1976, Bates No. 980306396/ 31. See letters from Helen Tiemann. Endnotes Serpent on the Staff: The Unhealthy Poli- secretary to William Hsty, to the RJR 6603. available at http;//legacy,libraiy, tics of the American Medial Association !, See P. Crist, W.K.Marple.S.J, Advertising Department dated Januaiy ucsfedu/tid/rum85!00. (New Yoi-k: Jeremy P. TaiT:hor/Putnam, Kaczynski, and T. [„ Abrams, "re. 9, 1946 (Bates No. 502597537, avail- 1994), 145-147; ''When 'More Doctors Jones/Day Liability Summary ('Corpo- 9. Lucky Strike advertisement frotn able at http://legacy,library.ucsfedu/ Smoked Camels,'" 1347. rate Activity Project")," pp. 379-381, Golden Book 12 (70) (1930), available at tid/ijs78d00) and December 26, t986. Bates No. 681879254/9715, http: // tobaccodocuments.org/pollay _ads/ 20. Philip Morris, "If You ,Advise Pa- 1945 (Bates No. 502597519, avail- available at tobaccodocu ments.el's/ Luckn.07,html. tients on Smoking," August 1939, adver- able at http [//legacy.library,ucsf.edu/ tid/qis78dOO). ness/37 37 5.html (acces.sed November 10. Philip Morris, "Report on the tisement. Bates No. 2061011925, avail- 12. 2005, as were all Internet dtations); Findings of a Group of Doctors Call for ahle at http://tobaccodocuments.org/ 32. Letter from W.T.Smither.RJ "[Memo to John \V, Hill] Re. RJR Claim Philip Morris," October 16, 1937. ads4)m/2O6IO11925.html. Reynolds Tobacco Company, to Dr of Doctor's Use of Camels." J. J. D. to Bates N(j. 2061014890, available at 21. RJ Reynolds, "The Medical Relatioas Howard T. Behrman, February 22, John W. Hill, December 14, 1953. Wis- htl4]://tobaccodocuments. org/ads_pm / Division of Came! Cigarettes Believes 1946, Bates No. 2022238658/8660. consin Historical Society, John W. Hill 20610I4890,litml. That," September 1942. advertisement available at http://legacy.library.ucsf.edu/ Papers, Box 110. Folder 10. 11. A. Blum. "When 'More Doctors available at http://tobaccodocuments.org/ tid/rtx74e00. 2, D. E. Nelson, G. A, Giovino, S. L. Smoked Camels': Cigarette Advertising po llay_ads/CameO 2.16 .html. 33. RJ Reynolds, "liveiy Doctor in Pri- Emont, et al,. "Trends in Cigarette in the Journal," New York State foumal 22. Crist et al. "re. Jones/Day Liability vate Practice Was Asked." Smoking Among US Physicians and of Mediane 83 (1983): 1347-1352. Uurses," Journal of the American Medical Summary." 379-381. 34. W. T. Smither, "Memorandum of 12. M. G. Mulinos and R. L. Osbf>me. Association271 (19941: 1273-1275. 23. RJ Reynolds, "When You Record Visit to William F:sty," June 10, 1946, "Irritating Properties of Cigarette Smoke tbe Effectiveness of Nicotine Control- Bates No. 501689543, available at 3- [„ S. Snegireff and O. M. Lomhaitl, as Influenced by 1 lygroscopic Agents," Less Nicotine in the Smoke. Camel- http://legacy.lihraiy.iicsf,edu/tid/ "Survey of Smoking Habits of Massachu- ;Veui York State fourruil of Medicine 35 The Cigarette Of Costlier Tobaccos," guv29dOO. setts Physidans." New England fimmal of (1935): 1-3. and "Pharmacology of In- July 1942, advertisement, available Medidneim (24) (1954); 1042-1045; flammation, III: Influence of Hygroscopic 35. See also James T. Weldi to A. G. al http://legacy.library.ucsf.edu/tid/ "The Physidan and Tobacco." Southwest- Agenis on Irritation I'rom Cigarette Clarke, February 4, 1952. Bates No, sgt78dOO. em Medicine 36 (1955): 589-390. Smoke," Proceedings of the Sodety for 502400834. available at http://legacy. library.ucsf.edu/tid/blc 19d00. 4, H. L, Lombard and C. R. Doering. Experimental Biology and Medidne 32 24. C. W. Crampton, "The Cigarette, "Cancer Studies in Massachusetts. 11: (1934): 241-245. For disjiute on their the Soldier, and the Physidan." Tlie Mil- 36. RJ Reynolds. "More Doctors Smoke Habits. Characteristics and Fnvironinent findings, see internal memas from ll.H. itary Surgeon 89 (1941): 1-13. Camels." advertisement available at of Individuals With and Without Can- Hanmer, research director at American bttp: //tobaccod ocuments.org/ 25. B. DeVoto. "Doctors Along the cer." New England foumal of Medicine Tobacco, to C. F, Nailey (August 29. pollay^ads/Camel8.]7,htnil. Internal RJ Boardwalk." m Harper's magazine 196 (10) (1928): 481-487; FL.HofT- 1935, Bates No. 90516197711978, Reynolds records note that this adver- (1947), repnnted in DeVoto. The Easy man. "Cancer and Smoking Habits," An- available at http://legacy.lihrary.ucsf.edu/ tisement appeared in Life. Limk, Ladies C/iuiV (Boston: Houghton Mifilin Com- nals ofSurjieri/ 93 (1931); 50-67; A, tid/Tioj54n30) and to E. Bogen (l^ecem- Home Journal. Colliers, and Country Gen- pany, 1955), 91. Ochsner and M. DeBakey, "Symposium ber 27, 1935, Bates No. 950143321/ tleman tinder the heading "I'll Be Right on Cancer: Primary Pulmonary Malig- 3,328. available at http://!egacy.library. 26. Philip Morris, "At the AMA. Con- Over!" RJ Reynolds, "According to a Re- nancy. Treatment by Total Pneumonec- ucsfedu/tid/pko54fOO). Howaid C. Bal- vention," June 6, 1942, Bates No. cent Nationwide Survey: More Doctors tomy. Analysis of 79 Collected Cases lenger had findings tbat contrailirted 1003071327, available at http://legary. Smoke Camels 'Than Any Other Ciga- and Presentation of 7 Personal Cases." Mulinos in "Irritation of the Throat ["rom libraiy. ucsf.edu/tid/ fvmO 2 aOO. rette!" May and June 1946, advertise- Surgery, Gt/necology and Ohstetrits 68 Cigaret Smoke: A Study of Hygroscopic ment Bates No. 502470699. available 27 RJ Reynolds, "Camel Invites You to (1939): 435-451. Agents," .Archives of Otolaryngohgy 29 at http://legacy.lihrary.ucsf.edii/tid/ Enjoy the Interesting Features of the (1939): 115-123. jyi88d00. 5, J. Patterson, The Dread Disease- Camel Cigarette Exhibit at the .\MA. Cancer and American Culture (Cam- 13. "Philip Morris & Co.," Fortune. Manh Convention—June 8 to 12," June 1942, 37 RJ Reynolds, "l"he Doctor Makes bridge. Mass: Harvard Universi^ Press, 1936. ip. 106-112.114.116, 119. Bates No. 502596871/6871. available His Rounds: According to a Recent

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Nationwide Survey More Doctors the I.ung; Preliminary Report," British Only Cigarette With the Micronite Filter Smoke Camels Than Ajiy Other Ciga- Medical Journal 2 (1950): 739-748. for the Greatest Protection in Cigarette rette!" August and September 1946. For a discussion of the significance of History," 1953, Bates No. 92373147, Bates No. 50247074:*, available at these ajticles. see Ernst L. Wynder, "Ib- available at http://legacy.library.ucsf, http://le8acy .library.ucsf edu/Eid/ bacco as a Cause of Lung Cancer: Some cdu/tid/mej54a00; Lorillard, "Have Reflections," American Journal o/F.pide- You Tried Tbis Fxperiment. Dactnr?" miologif 14(i (9) (1997): 687-694, and 1953. Bates No. 92373153, available 38. Compulsonf Health Insurance: The Allan M. Brandt, "line Cigarette, Risk, at bttp://Iegacj.libriiry.ucsf edu/tid/ Continuing American Debate, ed. R. L. and American Culture," Daedalus 119 gej54a00; Lorillard, "Some Questions Numbers (Westport, Conn: Greenwood 14) (19901: 155-176. About Filter Cigarettes That May Have Press. 1982). Occurred to You, Doctor and llieir An- 48. For examples of coverage in the 39. RJ Reynolds internal doaiment. swers by tbe Makers of Kent," August pojjutar press, see R. Norr, "Cancer by Bates No. 502470717, available at 22. 1953, Bates No. 89749655, avail- tlie Carton," Reader's Digest. December bttp;//legacy.librdry.ucsf.edii/tid/ able at http://legacy.librarj.ucsf 1952, pp. 7—8: "Smoking & Cancer." bwj88dOO. edu/tid/dnml3cOO. rime, July 5, 1952, ji. 34; "Beyond Any 40. See [' Ue Kniif, Micrvbe Hunters Doubt," Time. November 30, 1953, pp. 55. "Cigarette Hucksterism and tbe (New York: Blue Ribbon BtHjks, 1926), 60-Hl: L. M. Miller and J. Monaban, AMA." Journal oj the American Medical and B. SokolofT, The Miracle Drugs "Tbe Facts Behind the Cigarette Contro- Association. April 3,1954, p. 1180. (Clucago: Ziif-Davls Pub Co. 1949). versy," Reader's Digest, July 1954, pp, 56. Serpent on the Staff. 152-154. 41. RJ Reynolds, "E-^xperience Is the 1-6; "Smoke Gets in tbe News," Life. Best Teacher Sir Cbarles Bell." Maj-cb December 21, 1953. pp, 20-21. See 57 " 'AMA Journal' Stops Taking Ciga- 1947, Bates No, 502470841. available also Hans 11. Tocb, Terrence M. Allen, ret Ads," Adifertising Age 1 (1953): 93. and William Lazer, "Efiec-ts of the Can- al btlp[//legacy.library iicsf.edu/tJd/ 58. L.S. Snegireif and O.M. Lombard, cer ScaiTs: Tbe Residue of News Im- moj88d00, and RJ Reynolds, "Experi- "Smokuig HabiLs of Massachusetts pact," you r««/is"i Quarterly 33 (1961): ence Is tbe Best Tcacber. Mildi-ed Physicians: Five-Year Fotlow-Up Study 25-34. ODonnell," May and June 1947, {\954-1959): New England Journal of Bates No. 502470864, available at 49. Enist L. Wynder, FIvarts A. Gra- Medicine2bl (1959): 603-604. ht^: //I egacy. library ,u csf.edu/tid/ ham, and Adele B. Croninger, "Experi- 59. For a discussion of a newsletter jp]88d00. mental Pnxluction of Cai-cinoma With distributed across the counti^' in doc- Cigarette Tar," Cancer Research 13 42. RJ Reynold.s. "How Mild Can a tors' and dentLsLs' offices, see Hill & (1953): 855-864. Cigarette Be''" July 1949. Bates No. Knowiton, "i. Tobacco ajid Health— 502471375, available a! bttp:// 50. Edwin Dakin and Hill & Kiiowlton, 1962," (November 15, 1961, Bates legacy.libiary.ucsf.edu/tid/nii8BdOO; "Forwarding Memorajidum: To Members No. 966046705/6719, available at RJ Reynolds. "Mow Miid Can a Ciga- of tbe Planning Committee," December bttp://legacy.library.ucsfedu/tid/ rette Be?" July 1949, Bates No. 15, 1953, Trial Exbibit 18,904. avail- zgo21aOO. 502598073. available at bttp:// able at bttp://tobaccodocumenLs.f)rg/ 60. Serpent on the Stajf. 155. legacy.library.ucsf.edu/tid/ztr78dOO. ness/3793.html; also available at Wis- RJ Reynold.s bad also bad a related consin Historical Society, Jobn W. Hil! long term campaign in tbeir ads, ask- F^pet^, Box 110, Folder 2, pp. 8-9. ing consumers to take a "30-day test" of their "T-iione" so tbat tbey cnuld 51. See K.M. Cummings, C. P. Morley, decide for themselves abnut tbe effect ajid A. Hyiand, "Failed Promises of the of Camels on tbeir tbroat. Cigarette IndiLstry and Its EHett on Consumer Misperceptions About the 43. HJ Reynolds, "Not One Single Case llealtb Risks of Smoking," Tobacco Con- of Tbroat Irritation Because of Smoking trot 11 (SuppI 1) (2002): 1110-1117, Camels! Noted Tbiijat Spedalists Report and R. W. Pollay, "Propagajida, Piiftirig on 30-Day Test of Camel Smokers," Jan- and the Public Interest: Cigarette Public- uary 1949. Bates No. 502598158, avail- ity lactics. Strategies and Effects," Public able at http^/legaty.library.ucsf edu/tid/ Relations Review 16 (1990): 27-42. flr78dOO. 52. Liggett and Myers,"[ redric March 44. RJ Reynolds, "SO-Day Smoking Says-Tbis Is It: 'L&M Filtere Are Just Test Proves Camels Mildness!" Novem- Wbat ibe Doctor Ordered,"" February ber 20. December 4, 6, 7. 1948, Janu- 22, 1954, Bates No. 2021368933, avail- ary 1949, Bates No. 502597957, avail- able at http://tobaccodoaiments.org/pm/ able at bttp [//legacy .library.ucsf edu/ 2O21368933.btml. tid/obs78dOO. 53. See R.W. Pollay, 'Tbe Dark Side 45. Display ad. New York Times. of Marketing Seemingly 'Light' Ciga- August 25, 1952, p. 6. rettes: Successful Images anti Failed 46. Display ad. New York Times, June Fact," Tobacco Control 11 (Supjil 1) 16, 1952, p. 10. (2002): 118-130. 47. K, L. Wynder and 1:;. A. Grabam, 54. l.orillard, "Have You Heand the "Tobacco Smoking as a Possible Etio- Stoiy of New Kent Cigarettes, Doctor?" logic I'actor in Bronchiogenic Carci- 1953, Bates No, 92373155, available noma: A Study of 684 Proved Case.s," at bttp://Iegacy.library.ucsf edu/tid/ Journal of the American Medical .-Issoaii- eej54aOO: l.oi-illard, "Wby Is It, Doctor, tion 143 (1950): 320-336: R. Doll and "ITiat One I iltcr Gives So Mucb More A. B. Hill, "Smoking and Carcinoma of Protection TTian Any Otber? Kent. Tbe

232 I Public Health Then and Now I Peer Reviewed I Gardner American Journal of Public Health | February 2006, Vol 96, No. 2