The Fear of Losing Out
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HEIKKI HIILAMO The Fear of Losing out Tobacco Industry Strategies in Finland 1975–2001 ACADEMIC DISSERTATION To be presented, with the permission of the Faculty of Medicine of the University of Tampere, for public discussion in the auditorium of Tampere School of Public Health, Medisiinarinkatu 3, Tampere, on August 24th, 2007, at 12 o’clock. UNIVERSITY OF TAMPERE ACADEMIC DISSERTATION University of Tampere, School of Public Health Finland Supervised by Reviewed by Professor Arja Rimpelä Dr. Jeff Collin University of Tampere University of Edinburgh Docent Matti Rimpelä Docent Sakari Karvonen University of Tampere University of Helsinki Distribution Tel. +358 3 3551 6055 Bookshop TAJU Fax +358 3 3551 7685 P.O. Box 617 [email protected] 33014 University of Tampere www.uta.fi/taju Finland http://granum.uta.fi Cover design by Juha Siro Printed dissertation Electronic dissertation Acta Universitatis Tamperensis 1229 Acta Electronica Universitatis Tamperensis 617 ISBN 978-951-44-6937-4 (print) ISBN 978-951-44-6938-1 (pdf) ISSN 1455-1616 ISSN 1456-954X http://acta.uta.fi Tampereen Yliopistopaino Oy – Juvenes Print Tampere 2007 "Those who cannot remember the past are condemned to repeat it." – George Santayana (1863–1952) 4 List of contents Abstract ......................................................................................................................................................7 Tiivistelmä..................................................................................................................................................9 Abbreviations...........................................................................................................................................11 Original communications ........................................................................................................................12 1. Introduction.........................................................................................................................................13 2 Review of the literature .......................................................................................................................19 2.1 Tobacco industry and tobacco control in Finland........................................................................19 2.2 Tobacco industry document research ..........................................................................................23 2.3 Smoking and health......................................................................................................................26 2.4 Environmental Tobacco Smoke...................................................................................................28 2.5 “Light”, “mild” and “thin” cigarettes ..........................................................................................29 2.6 The properties and effects of nicotine and research on addiction .............................................31 2.7 Research on additives in tobacco products..................................................................................32 2.8 Marketing of tobacco products ....................................................................................................32 2.9 Economics and taxation ..............................................................................................................34 2.10 Industry tactics for resisting public policy on health................................................................35 2.11 Litigation ....................................................................................................................................38 2.12 Strategies outside the USA ........................................................................................................39 2.13 Summary.....................................................................................................................................42 3 Aims of the present study....................................................................................................................43 4 Methods and data.................................................................................................................................45 4.1 Tobacco industry documents .......................................................................................................45 4.2 Search strategies...........................................................................................................................47 4.3 Analysis strategies........................................................................................................................51 5 Results..................................................................................................................................................53 5.1 Tobacco control implication of the first European product liability suit (Paper 1)...................53 5.2 The impact of strategic funding by the tobacco industry of medical expert witnesses appearing for the Defence in the Aho Finnish product liability case (Paper 2)........................56 5.3 Tobacco industry strategy to undermine Tobacco Control Act in Finland (Paper 3)................59 5.4 Tobacco industry documents from outside sources: new perspectives on industry strategies on local levels (Paper 4)..............................................................................................................62 5 6 Discussion ............................................................................................................................................66 7 Conclusions..........................................................................................................................................72 8 Summary ..............................................................................................................................................75 9 Acknowledgements..............................................................................................................................78 10 References..........................................................................................................................................79 Original publications................................................................................................................................92 6 Abstract This study analysed tobacco industry lobbying strategies in Finland from 1975 to 2001. Tobacco industry documents were used as a primary source of data. The study was focused on tobacco control measures in Finland, including product liability litigation against the tobacco companies between 1988 and 2001. The tobacco control implications of tobacco litigation were analysed e.g. by examining the different roles of international tobacco companies and the level of control they employed in the Finnish litigation. The Finnish case was further highlighted through analysis of the possible linkages between tobacco industry’s scientific strategies and its legal defence. With regard to tobacco control measures, the aim was to examine how global tobacco companies have tried to influence tobacco regulation in Finland. The main question was: did the tobacco companies succeed in finding a successful strategy for undermining the development of tobacco control in Finland? Finally, this study explored the validity of the tobacco industry documents by examining whether the material from the private archive of a tobacco lobbyist might augment or revise the earlier reports on tobacco industry manipulation in Finland. This study clearly demonstrated that international tobacco companies considered the legal proceedings in Finland as a global threat. However, tobacco industry tried to play down the importance of the product liability process by portraying it as a local dispute with no international connections. The preparatory work was conducted in committees or groups, which assembled the companies’ internal and external resources and were of crucial significance for the implementation of the defence. The Finnish defence was to be constructed on the same principles as in the USA. Besides using the same argumentation, meaning same terms and descriptions, for example, for general and specific causality, the witnesses were also partly the same. The proceedings revealed that the industry had concealed the health hazards of its products and, despite indisputable evidence, continued to deny them. The positions taken by the industry rocked its reliability as a social actor and thus weakened its chances of influencing tobacco policy. The findings demonstrate that research funding was closely connected to witness development in the product liability case. By granting research funding, the industry had created a pool of experts who were willing either to testify or to recommend other potential medical expert witnesses for the industry. As many as 33 of 45 tobacco industry’s medical 7 expert witnesses received research funding from the industry before or after the testimony. 19 of them worked in different positions as consultants for the industry. The older witnesses testified to the existence of a controversy, which they, in fact, had helped to create. Those appearing in Helsinki District court apparently downplayed the importance of their involvement with the industry. The tobacco industry funded the majority of expert witnesses appearing for it, beyond simple recompense for the time involved. This may have unconsciously influenced the testimony the witnesses gave. The tobacco industry documents