How Tobacco Companies Created the Disinformation Playbook

This article is republished from SciLight, an independent science policy publication on Substack.

In this current age, a meme on Facebook, a video on TikTok, or a comment thread on Reddit can have substantial influence over people’s views and perspectives. For instance, half of adults in the United States obtain their news at least sometimes from social media.

While social media can be a great source of information, misinformation – the accidental spread of incorrect information – also runs rampant through our online spaces. Disinformation – misinformation’s more nefarious cousin – is when bad actors are intentional in their attempts to disinform the public.

Science unfortunately is an appealing target for people looking to disinform the public. For instance, oil and gas companies have long denied or undermined climate change science. And anti-vaxxers are eager to persuade you that vaccines (one of history’s greatest public health achievements) is somehow suspect.

My colleagues and I have previously published research on the “disinformation playbook,” a series of tactics used by these groups to ensure that you are disinformed about the best available science. Such tactics include harassing scientists and inappropriately influencing policymakers away from science-based decisionmaking.

In this article, I’m going to breakdown how disinformation affects the public’s knowledge and perception of science. To get a handle on the disinformation playbook, we’ll look at the original “granddaddy” who developed these tactics in the early- and mid-20^th century – tobacco companies. Specifically, we’ll look at how tobacco companies fought to sideline the science that linked the smoking of cigarettes with an increased risk of lung cancer.

Science from the early 20^th century was clear: smoking was linked to lung cancer

Before the widespread availability of cigarettes, lung cancer was once a very rare condition. In the early 20^th century, when medical professionals encountered cases of lung cancer, they used to tell their students to pay attention because they may never see another case during their professional career.

One study from 1912 looked at autopsy reports from hospitals in the United States and Western Europe. The researchers only found a few hundred cases of lung cancer, a rate that at the time represented 0.5% of cancer cases. In comparison, in the United States in 2023, lung and bronchus cancer cases represented 12-13% of all new cancer cases and 21% of all cancer deaths.

In the 1920s, scientists and medical professionals became increasingly puzzled by the sharp rise of lung cancer cases. While they had several theories, the scientific evidence linking lung cancer with tobacco products started to especially build from the 1930s to 1950s.

I highly recommend reading Proctor (2012) for further information, but in general the scientific evidence from the 1930s to the 1950s was accumulating in four areas of research:

• Population studies – people who smoked had higher rates of lung cancer
• Animal studies – tobacco caused tumors in model organisms
• Cellular pathology – cigarette smoke was shown to deaden the hairlike cilia in the lung’s upper airway
• Cancer-causing chemicals in cigarettes – cigarette smoke contained polycyclic aromatic hydrocarbons (PAHs), which had been previously shown to cause cancer in people exposed to coal tar   

Multiple lines of evidence converging like this, linking a health effect with a specific factor, is one of the important ways that epidemiologists assess whether an exposure – like smoking a cigarette – can cause a detrimental health outcome.

For the science geeks in the room, I’m referring to the “consistency” item from the famous Bradford Hill criteria. And as an aside, Bradford Hill was also one of the pivotal scientists that helped build evidence of a link between smoking and lung cancer. See in particular Doll and Hill’s famous 1954 paper on the British Doctors’ Study, a long-term prospective cohort study that lasted from 1951 to 2001.

But the tobacco companies worked to sideline this science

The 1920s corresponded to when cigarettes began to be widely sold in the United States. Shockingly, images of doctors and medical professionals were used in advertisements to sell cigarettes from the 1920s to the 1950s, similar to the advertisements you may hear today where “4 out of 5 dentists recommend this toothpaste brand.”

The tobacco companies were well aware of the science that showed the linkage between lung cancer and smoking. In 1998, the US government won a famous lawsuit against the tobacco companies. This lawsuit resulted in the public disclosure of 30 million pages of industry internal documents on how, for decades, these companies hid scientific evidence showing that their products can result in conditions like cancer, heart disease, and addiction. These documents suggest that by the 1950s, tobacco executives knew without a shadow of a doubt that their products increased the risk of lung cancer.

The tobacco companies decided to target this science. On December 14, 1953, the President of the American Tobacco Company, Paul Hahn, invited the heads of the leading tobacco manufacturers to a meeting at the Plaza Hotel in New York City. At this meeting, it was decided that a public relations firm, Hill & Knowlton, would be employed and jointly paid by the tobacco companies to develop a response to the smoking and health allegations.

This meeting in turn led to a 1954 advertisement campaign called “A Frank Statement,” an ad that ran in over 400 newspapers and was believed to have reached around 43 million readers. This ad can be viewed as one of the tobacco company’s first attempts to develop their disinformation playbook and to use it to mislead the public.

Here’s a quote from the ad: “For more than 300 years tobacco has given solace, relaxation, and enjoyment to mankind. At one time or another during these years critics have held it responsible for practically every disease of the human body. One by one these charges have been abandoned for lack of evidence.”

The “Frank Statement” ad laid out the tactics that companies and other bad actors use to this day to disinform the public about scientific research. For instance, the ad falsely claimed that the science that found harms associated with smoking is questionable, that “many aspects of modern life” are just as bad as smoking, and that scientists paid by industry will do a better job investigating the problem.

But these tactics are not simply issues of the past, tobacco companies continue to peddle their mistruths to this day. The Truth Initiative has a great report showing how tobacco companies currently undermine scientific research, such as by sponsoring entire issues of prestigious research journals and participating in tobacco control research conferences.

In recent years, the tobacco company Juul targeted teenagers and young people through their flavored e-cigarette products and worked to stop the FDA from enacting science-based safeguards. Specifically, Juul watered down and delayed FDA regulations on their products, disregarded research showing that their product’s formulation was especially addictive and was linked to an epidemic of teenage nicotine use and paid massive amounts of money to think tanks to produce more favorable research and to influence congressional leaders. In 2022, the FDA finally banned Juul products and required the company to remove its products from the marketplace.

How to spot and stop the spread of disinformation

While science is vulnerable to attacks by people trying to spread disinformation, all hope is not lost. Government agencies, scientific journals, the media, and members of the public have a vital role to play in safeguarding scientific integrity and stopping the spread of disinformation.

There are evidenced-based methods that you, dear reader, can use to combat disinformation. Perhaps the most important one is to not share the disinformation with others (even as a joke), as you further the goals of these bad actors when you share them.

Another good technique is to learn how to spot disinformation pieces. In general, online posts or articles that are designed to appeal to your emotions, that fail to cite reputable sources, and that are linked to shady funding sources are more likely trying to spread disinformation.

So, the next you are scrolling through your social media accounts, take a moment to reflect on what types of information you are consuming. Just by asking some thoughtful questions about the intentions of the people posting and what evidence they have to back up their claims, you can go a long way in helping stop the spread of disinformation.

Originally published in Union of Concerned Scientists.