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Operating the smokescreen

Chris Proctor tells Kamran Abbasi why he works for the tobacco industry

"Haven't you sold your soul to the devil?" I ask Dr Chris Proctor, the head of science and regulation at British American Tobacco (BAT), one of the major tobacco companies. He smiles back at me. "I don't think I have, and my kids don't think I have," he reassures himself.

"I know there is a notion of how can you possibly work for a tobacco company, and my view is that as long as I do things that I believe in, as long as I do things to the highest ethical standards, I'm quite happy to work for this company. And I believe I do that."

But how do you sleep at night, Dr Proctor, knowing that your job is defending one of the biggest killers on the planet? "Everyone knows about the risk related to smoking, but smoking does give people a pleasure; there is something enjoyable about smoking, otherwise I wouldn't do it myself. And, as long as adults--and it has to be adults--are fully informed, then it is another one of those things in life that people do that are risky."

Dr Proctor is not a medical man. He is a chemist with a PhD in mass spectrometry and postdoctoral degrees from Cornell University in the United States and the University of Kent in Britain. His research interest in environmental tobacco smoke eased him into a job with BAT, where he believes his role is to ensure that the company's pronouncements are backed by science. Picking holes in research about the adverse effects of smoking would be how most people view it.

He has a well rehearsed defence, accepting that: "Statistics point to it [smoking] being a real strong risk factor for lung cancer, emphysema, and most of the respiratory diseases. Obviously less of a risk factor in terms of heart disease, where the causes are multifactorial, but just the same, the statistics suggest caution. Whether you can go and identify a specific cause is less clear, but in terms of the broad picture, the statistics clearly point to causation."

But that's as far as it goes. What about accusations of misdeeds by the tobacco industry in suppressing damning research about the adverse effects of smoking? Denied: "You haven't seen big PR campaigns by the tobacco companies suggestin that what the BMA's saying is absolutely wrong."

Because it isn't, I suggest? "Well, you could say that some of the statements are overstatements on some issues. And certainly on things like environmental tobacco smoke and addiction."

An agenda to recruit scientists likely to be friendly to the tobacco industry? Refuted. In fact the point was to recruit scientists who weren't tainted by contact with either side of the argument, he claims.

The risks of passive smoking? Downplayed. Many of the studies that suggest a link between passive smoking and lung cancer do not reach statistical significance, he argues, and are weakened by misclassification and confounding.

Leaking favourable research findings to the press? Sidestepped. He is obviously skilled at wriggling away from the question and putting his point across.

Dr Proctor is firm in the defence of his company, however, and denies that he has a conflict of interest: "I have strong enough ethics that I wouldn't say anything that I didn't believe in. We've never spoken to a scientist or provided funds for research that have had any strings attached to them. You have to trust scientists or medical researchers, and you have to trust the peer review process. And it doesn't matter where the funding comes from, whether it's from a pharmaceutical company, whether it's from the government, or whether it's from the tobacco industry. You should clearly have disclosure where the research money comes from."

Honourable words perhaps, but one of the oldest criticisms of the tobacco industry is that a reasonable public face hides an industry hellbent on promoting its product at all cost. Critics argue that the tobacco industry was slow to accept evidence about the dangers of smoking, even suppressing its own research findings, and is now defending its corner over passive smoking until the evidence becomes undeniable. Dr Proctor disagrees. In his world, the tobacco industry has played a cooperative and constructive role in "smoking health"--as he curiously calls it--and will continue to collaborate with governments and public health authorities to produce a safer product.

Children smoking

While adults should be free to make an informed choice, to my surprise, he volunteers that the legal age of smoking in the United Kingdom should be raised from 16 to 18 years. Perhaps this is a response to allegations that the tobacco industry targets children in its advertisements. Perhaps he is concerned for his own children, whom he says he would advise against smoking.

His conviction and concern that children shouldn't smoke (especially as he says: "If you look at the data, the earlier you start the higher the risk there is, in relation to lung cancer anyway") sit uneasily with claims that BAT selectively leaked part of a WHO report to the press. That report was being considered for publication by an American journal and didn't show any link between passive smoking in childhood and lung cancer--the part disclosed by the press--but suggested an increased risk in spousal and occupational passive smoking.

He maintains that it was the journalist's initiative that brought about a discussion of the WHO report, rather than BAT's desire to counter growing criticism of the tobacco industry over passive smoking. His aim, he argues, is purely to place facts honestly in the public domain. Many would disagree, dismissing him as a tobacco industry spin doctor.

None the less, Dr Proctor is more accustomed than most to defending his paymaster. "I don't like conflict," he pleads, but clearly, in his line of work, it is survival of the slipperiest. (See p 333.)