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"The Doctors' Choice Is America's Choice”: the Physician in US

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"The Doctors’ Choice Is America’s Choice”: The Physician in US Cigarette Advertisements, 1930-1953 The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters 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 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA PUBLIC HEALTH THEN AND NOW 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 rising public anx- major new advertising campaign cartons of Camels.' of the cultural authority physi- iety about the health risks of 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 from the 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. 222 Public Health Then and Now I Peer Reviewed Gardner American Journal of Public Health February 2006, Vol 96, No, 2 PUBLIC HEALTH THEN AND NOW 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 January 2006, Vol 96, No. 1 ! American Journal of Public Health Gardner |Peer Reviewed | Public Health Then and Now 223 PUBLIC HEALTH THEN AND NOW 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).
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