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When cigarette makers agreed to pay almost $250 billion
in a landmark settlement with the states 18 months ago,
anti-tobacco advocates hoped the national anti-smoking
foundation that the deal created would become a
formidable counterbalance to the tobacco industry's
powerful marketing efforts.
Instead, the American Legacy Foundation has been
vociferously criticized by the very advocates who lobbied
to create it. The foundation's decision last week to pull two
controversial television ads under pressure from the
tobacco industry has caused public health and anti-smoking
advocates to charge that the group's independence
and integrity have been seriously compromised.
Foundation officials said last week they pulled the ads to
avoid a draining fight with the industry and its supporters
as the first major anti-smoking campaign was being rolled
out. They said they might try to use the ads in the future.
But reflecting the growing concern of anti-smoking
advocates, Sen. Frank R. Lautenberg (D-N.J.) said Friday
he would lead other senators in calling for hearings if "the
censorship" continues. Pulling the ads, he wrote in a letter
to the foundation, "creates the unfortunate appearance that
the foundation will back down when tobacco interests
object, and undermines public confidence in the foundation's
independence and ability to run an effective campaign."
The controversy -- over two ads shot in and around Philip
Morris headquarters in New York -- has also exposed a
largely unknown compromise written into the 1998 master
settlement agreement between the tobacco industry and
46 state attorneys general. That agreement was signed
after the Senate had killed a comprehensive tobacco bill,
reducing the leverage of the attorneys general.
In exchange for $1.5 billion from the tobacco industry to
fund the foundation's five-year national teen anti-smoking
campaign, the attorneys general agreed in the settlement
that the effort would not "vilify" the industry or its officers.
The two ads were pulled last week after Philip Morris and
several attorneys general complained that they were
"inconsistent with the objectives of the settlement
agreement" and that they vilified the industry.
But public health and anti-tobacco advocates say that
attacking the industry for what they see as its duplicity -- by
producing a deadly product that it advertises as appealing
and sophisticated -- is essential for any successful anti-tobacco campaign.
"How can you run an anti-smoking campaign and not vilify
the industry?" said former FDA commissioner David
Kessler, an active anti-tobacco advocate. "It would be
better to not take the money if the industry is able to pull the
strings and take control."
"I'm very uncomfortable with the tobacco companies being
the censors of what kind of anti-tobacco message can be
used to reduce teenage smoking," said Mississippi
Attorney General Mike Moore, who led the states' legal fight
against the tobacco industry. His state was one of four that
settled early with the industry, and he said there is no "anti-vilification"
clause in his agreement.
"I think the Legacy Foundation has basically destroyed
itself," said Stanton Glantz, a longtime anti-tobacco
advocate at the University of California at San Francisco.
"The tobacco companies always threaten aggressive ads,
and you have to stand up to them. You just cannot turn over
control of your ads to Philip Morris."
But officials of the foundation defend their decision as
necessary to keep their anti-smoking campaign from being
derailed by tobacco politics. State legislatures stand to
receive more than $250 billion from the national tobacco
settlement, and that money has created a powerful lobby
eager to keep the agreement from being jeopardized in
"There are very strong incentives for the political forces
dependent on the larger streams of money to weigh in,"
said Cheryl Healton, president of the foundation. She said
that while the board still believed it was on sound legal
grounds when it approved the ads, there is "another
political interpretation that might be different."
That reality was reflected in a letter sent by North Carolina
Attorney General Michael F. Easley to foundation board
chairman Christine Gregoire, the attorney general of
Washington and an architect of the national tobacco
Three days before the board decided to pull the ads,
Easley wrote that the attorneys general had agreed that the
foundation would use its funds "for anti-smoking and health
related ads, and not for ads designed to vilify the
companies." Doing anything other than pulling the ads,
Easley continued, "will jeopardize continued funding of the
very important anti-youth smoking goals" of the foundation.
The advertising controversy comes as public health
advocates also express mounting concern over the way
states are using the billions of dollars due them under the
tobacco settlement. While the Centers for Disease Control
and Prevention has concluded that the states need to spend
about 25 percent of their money on tobacco control if they
want to create effective programs, the CDC estimates that
the states have so far allocated an average of 7 percent on
smoking prevention programs.
"There are some success stories and some notable
failures," said Michael Eriksen, director of the CDC's Office
on Smoking and Health. "Overall, the states are not doing
as well as we would like to see."
Under the national tobacco settlement, the foundation will
receive about $200 million this year to organize a national
anti-smoking program and media campaign. While that
amount is unprecedented, it is considerably less than the
tobacco industry's estimated yearly advertising budget of
about $5 billion.
States including California, Massachusetts and Oregon
have initiated their own tobacco reduction programs in
recent years -- often with very aggressive anti-smoking ads
and with impressive results -- and the national settlement
envisioned all the states doing the same. While tobacco
companies have complained about some of those ads -- some of
which do vilify the industry -- none have been
precipitously pulled as a result.
The two ads that were "rotated out" by the foundation are
part of a consciously "edgy" campaign called "thetruth,"
inspired and often managed by teens. One of the ads, shot
in grainy black-and-white, shows hundreds of body bags
laid around the Philip Morris headquarters as a way to
dramatize the death toll from cigarette smoking.
The second ad features an actress entering the Philip
Morris building with a suitcase labeled "lie detector." She
asks to speak with a marketing director about whether
nicotine is addictive, and is escorted out by security. Both
ads scramble the faces of Philip Morris employees and
neither identifies the company. Nonetheless, Philip Morris
threatened legal and other action after viewing the ads.
Jared Perez of Tallahassee, one of the young activists of
"thetruth" campaign, said he's "disappointed" that the ads
"I definitely wish those ads were on the air," Perez said.
"But I don't want to jeopardize the funding of the entire truth
campaign. Would that have really happened? That's a
matter of speculation for us all."
That the foundation is looking over its shoulder so early in
its life is what has anti-tobacco advocates so worried and
mad. The agreement that created the organization
describes it as independent of the tobacco companies that
fund it, and its board includes governors, attorneys general,
doctors and prominent public health leaders.
Foundation officials say inclusion of the anti-vilification
clause was an important goal for the tobacco industry.
One likely reason for their insistence on the clause,
officials said, is that in recent months the companies
have mounted major advertising campaigns to present
themselves as "responsible corporate citizens."
Complicating the foundation's efforts to air the two
controversial ads was the reluctance of major networks
to show them. While the networks accepted two ads in
"thetruth" campaign, they resisted or rejected the ones
shot at Philip Morris headquarters.
As seen by one top federal public health official, the
foundation was in an enviable position several weeks
ago--with the tobacco companies attacking it and the
networks undermining its efforts.
"That opposition could have been used to their benefit if
they had chosen to fight," the official said. "Instead, they
gave in and put themselves in a stupid, ridiculous position
. . . . If it had been me, I would have tested the waters and
let them sue."
Despite the setbacks, foundation president Healton is
optimistic that "thetruth" campaign will ultimately help
inspire a decline in teen smoking. Three dozen more ads
are scheduled to be released this year, in what is believed
to be the largest public health campaign in the nation's
And by the end of last week, Healton said, the networks
had agreed to run some of them.
Amount of spending per capita on tobacco use prevention
as a percentage of the amount recommended by the
Centers for Disease Control and Prevention, as of Dec. 31.