Misusing Youths to Serve their Purposes: The Campaign for Tobacco-Free Kids and Ignite

Last week, I exposed that a new anti-smoking group (Ignite) being run by youths and young adults was conducting its own deceptive (and therefore inappropriate and unethical) campaign to promote the FDA tobacco legislation. This group, I reported, has issued public statements suggesting that Big Tobacco (including Philip Morris) is opposed to that legislation, when in fact, Philip Morris supports the bills and considers them to be its chief legislative priority for the 2005 Congressional session.

I suspected that deception of this magnitude, which seemed to be following propaganda and rhetoric that was all too familiar, had to stem in some way from the Campaign for Tobacco-Free Kids, which I believe is running a major campaign of deception to promote the FDA bills. I found it hard to believe that a group of youths and young adults, completely on their own, could have come up with a campaign like this.

Just think about it for one minute. A group of youths and young adults decides to mobilize to fight Big Tobacco. They are so aggressive in their efforts that they go publicly on record as calling the tobacco companies terrorists and suggesting that our government is harboring terrorists by allowing the tobacco companies to undertake a legal business in our country. They are so aggressive that they attack every politician in the nation who takes tobacco money as being corrupt and call for the ouster of each and every one of them (which would leave very few in office).

And then, they .....

... decide to help Philip Morris lobby for the bill that it most wants Congress to enact??????????

Something just didn't make sense to me.

There seemed no way that a group of young people who were so strongly against the tobacco companies would, of their own accord and of their own initiative, decide to stand shoulder-to-shoulder with the biggest "terrorist organization" of them all - Philip Morris - and help the company promote its legislative agenda. The group would, after all, be helping to "harbor terrorists," would it not, if it helped them achieve their desired legislation? And I can't imagine the young people would want to do that.

Therefore, I couldn't help but suspect that the Campaign for Tobacco-Free Kids was somehow largely behind this effort, either directly or indirectly.

Today, I report that my suspicions were "on the money" and that the influence was apparently quite direct indeed. There are strong connections between the Campaign for Tobacco-Free Kids and Ignite, and in my opinion, the Campaign has inappropriately used these kids and their organization to help promote its own legislative agenda (not an agenda that seems near and dear to the hearts of these kids and what they really are all about, since I don't think they're all about helping Philip Morris do its legislative bidding). Today, I reveal ...

The Rest of the Story

Here are some of the connections between the Campaign for Tobacco-Free Kids and Ignite:

• Most importantly, the Campaign for Tobacco-Free Kids has provided substantial funding to Ignite, although its affiliation with Ignite does not seem to be revealed on its web site: "Ignite has been graciously supported by the Campaign for Tobacco-Free Kids, based in Washington, D.C." The Campaign provided at least $10,000 to Ignite to get it off the ground.
• A member (past or current) of the Board of Directors of the Campaign for Tobacco-Free Kids serves as the President of Ignite, and appears to have been (if not continuing to) serving both of those roles at the same time.
• A member of the Campaign for Tobacco-Free Kids was described as being the "founder" of Ignite.
• The Campaign for Tobacco-Free Kids has provided training, including direct experience promoting the FDA tobacco legislation, to a number of the leaders of Ignite. This has been accomplished mainly through giving individuals a youth advocate award and then providing them with an "opportunity" to promote the FDA legislation. The awards involve giving these youths money and training them for one year: having them work directly with the Campaign on issues such as the FDA legislation. In fact, the award recipients work as "ambassadors" for the Campaign.
• The Campaign for Tobacco-Free Kids gave a youth advocacy award and the associated training and lobbying experience that comes with it to the individual who is now president of Ignite, who worked with the Campaign to promote the FDA legislation. The Campaign has also given these youth advocacy awards to the individual who was the co-founder of Ignite, the individual who is vice-president of Ignite Iowa, a past vice president of Ignite, a current vice president of Ignite, and an individual who helped found the Connecticut chapter of Ignite.

Essentially, what I think is going on here is that the Campaign for Tobacco-Free Kids has used these youths and young adults to try to achieve its own agenda - enacting FDA tobacco legislation.

I think it is sad enough that the Campaign has been conducting its own campaign of deception to promote the FDA legislation in what I view as an unethical manner. But to start involving kids, youths, and young adults in that effort is a real shame.

It's sad to think that the way that these motivated, conscientious, and otherwise laudable young people are getting their public health careers off the ground is by being used by the Campaign for Tobacco-Free Kids to achieve its own narrow-minded political objectives. And that the way the whole thing has apparently been done is so under-the-cuff.

The young people don't seem to have any kind of understanding of the politics or strategic issues behind the FDA legislation and the policy issues involved in its consideration. They don't seem to understand that the bill was essentially negotiated between the Campaign for Tobacco-Free Kids and Philip Morris. They don't seem to understand that Philip Morris wants this legislation badly because it will help freeze the existing market, stifle competition from other companies, and allow the nation's leading cigarette manufacturer to advance its reduced exposure products with immunity, allowing it to even further its market domination.

And why don't they? Is it because they are not intelligent enough or sophisticated enough to obtain such an understanding? Not for a minute. It's simply because, I think, their training has come from the Campaign itself, which undoubtedly did not disclose to these youths the whole truth and the full details behind the origins of the FDA legislation and the reasons for Philip Morris' vehement support of these bills.

And now - as a result - you have these young people running a deceptive campaign of their own. I want to make it clear: I'm not blaming them. I think they have been used. I blame the Campaign for Tobacco-Free Kids for the inappropriate training of our new generation of tobacco control leaders. They are getting off to an unfortunate start, I think, largely because their training and initiation into the field of tobacco control has been so poorly managed by the Campaign.

They have certainly not learned from the Campaign the importance of being accurate in their public communications and the ethical value of telling the truth. You only need to look as far as their public declaration that: "Currently tobacco products are the only consumer product not regulated by the FDA." That's interesting - I wasn't aware that FDA regulates all other consumer products.

I find it quite unfortunate that our new generation of leaders in tobacco control is being trained to be as inaccurate, as misleading, as deceptive, and as inappropriate as our current leadership. Again - not through any fault of their own. They are very well-intentioned and are to be applauded for their efforts. But they are apparently being wildly misled by the Campaign's rhetoric about the FDA legislation - rhetoric so wild that these youths can't help but spew more of that rhetoric out and exaggerate the claims even more, to the point where they become fallacious. That doesn't say a lot for where the anti-smoking movement is headed. But sadly, it says even more about the sad state of affairs with the current anti-smoking movement.

After all, if we can't train our future leaders to have the highest standards of integrity and ethics and the utmost concern for telling the truth to the public and trying to be accurate in their public statements, then we are in deep trouble. (Once more, I don't think the young people are doing anything wrong. I just think they have been misguided).

Ultimately, I guess we can't train the next generation to have high ethical standards unless we ourselves have those standards. They will only follow the example that is being set for them. And I'm afraid that example is, right now, a very bad one.

Campaign for Tobacco-Free Kids Misusing Kids to Promote Philip Morris' Legislative Agenda

Tomorrow is Kick Butts Day - a day of youth advocacy for tobacco control sponsored by the Campaign for Tobacco-Free Kids. According to its web site: "Every year on Kick Butts Day, America's youth STAND OUT...SPEAK UP...and SEIZE CONTROL in the fight against tobacco use."

The Campaign for Tobacco-Free Kids is encouraging youth groups all over the country to organize advocacy events for tomorrow. To guide the youths in their endeavors, the Campaign has provided a booklet that describes the potential activities and provides background on various tobacco issues.

It appears that events are planned for all 50 states.

The Rest of the Story

Sounds like a rather innocuous event, does it not? Youths organizing to help reduce tobacco use and to promote policies to protect the public's health.

There's just one problem. One of the issues that the Kick Butts Day organizing guide apparently is promoting is the enactment of legislation, supported by the Campaign for Tobacco-Free Kids and by Philip Morris - the nation's largest cigarette maker - to give FDA regulatory jurisdiction over tobacco products.

On page 17 of the organizing guide is a picture of a Kick Butts Day 2006 youth holding a sign saying "Why Isn't Tobacco Regulated by the FDA?" Later, on page 32, kids are urged to write to Congress to support legislation that would require tobacco companies to disclose their ingredients (in other words, to support the FDA tobacco legislation supported by Philip Morris).

Then, on page 52, youths are recruited directly to support the FDA legislation favored by Philip Morris: "Include a letter writing campaign to your Members of Congress as part of your event. Let them know you want stronger warning labels on tobacco products, and that they should give the U.S. Food and Drug Administration the authority to regulate tobacco products and require stronger warning labels. Visit tobaccofreekids.org for more information about FDA regulation of tobacco, and check page 32 for contact info for your Members of Congress."

On page 56, there is another attempt to recruit kids to support the FDA legislation being promoted by the Campaign for Tobacco-Free Kids and Philip Morris: "Include a letter writing campaign to your Members of Congress as part of your event. Let them know you want them to do something to stop Big Tobacco from targeting kids with magazine ads. Ask them to give the U.S. Food and Drug Administration the authority to regulate tobacco products and stop the tobacco industry from marketing to kids in magazines with high youth readership."

In other words, Kick Butts Day is largely an event that is being planned by the Campaign for Tobacco-Free Kids in such a way as to engage youth in the Campaign's efforts to lobby for passage of its pet legislation - the FDA tobacco bills that are currently pending before Congress.

These bills are vigorously supported by the nation's leading tobacco company.

With all of the literature in the Kick Butts Day organizing guide which condemns Big Tobacco, criticizes the tobacco companies for everything under the sun, and attempts to rally the nation's youth to fight Big Tobacco in every way possible, it is simply a travesty that the Campaign is trying to trick kids into supporting legislation that is actually being promoted by the nation's leading tobacco company.

And that's exactly what this is. It's trickery and deception.

Kids are not being provided with the relevant facts. Nowhere in the organizing guide does it even give kids the option of making an informed decision about what position to take on this complex policy issue. Kids are not even informed about the fact that Philip Morris supports, and deeply desires, the FDA legislation and that a number of anti-smoking advocates stand in strong opposition to the proposed legislation.

Nowhere does the Kick Butts Day organizing guide outline the many giant loopholes that have been placed in the legislation to protect the interests of Philip Morris and Big Tobacco at the expense of the public's health.

Nowhere in the Kick Butts Day guide does it explain that the FDA legislation was negotiated with Philip Morris and that it included specific provisions that the company felt were essential to achieve its goals of solidifying and expanding its market share and protecting its profits, and that important public health goals and principles were compromised in order to allow this negotiation to be successful.

I believe that it is unethical for the Campaign for Tobacco-Free Kids to misuse youths in this manner. It is unethical to engage youths in a lobbying effort without fully informing them of the issues involved so that they can make their own autonomous decision about what action is in the interests of the values for which they stand. Essentially, the Campaign is violating the public health equivalent of the principle of informed consent.

What's worse is that not only is the Campaign omitted key information, but it is essentially tricking kids into taking an action that is supporting the cause of Philip Morris. Certainly, any reasonable kid reading this propaganda is going to take away the impression that the activities outlined are supporting policies that would be opposed by Big Tobacco and that the cigarette companies do not consider to be in their best interests.

But that is not the case.

The rest of the story is that Kick Butts Day 2006 is being exploited by the Campaign for Tobacco-Free Kids. They are misusing youths in order to promote their pet legislation. They are tricking and deceiving kids in order to get them to take an action which is quite possibly not in line with the values that the kids themselves would support. They are using kids to promote their own pet policies without providing adequate information and without informed consent being achieved.

In summary, this is one of the most unethical actions I have ever observed by an anti-smoking group.

Kick Butts Day 2006 is a true disgrace.

Not for the innocent kids who will be participating in it, unaware of what they are doing. But it is a disgrace for the anti-smoking movement, which has to face up to the fact that its leading organization is misusing kids, violating basic ethical standards of public health practice, and embarrassing the whole movement through its unethical behavior.

Campaign for Tobacco-Free Kids Manipulating Kids to Promote FDA Legislation

Today is Kick Butts Day, a national day of youth advocacy on the tobacco issue run by the Campaign for Tobacco-Free Kids. The Campaign is asking youths throughout the country to "Stand Out, Speak Up, and Seize Control in the fight against Big Tobacco."

The Rest of the Story

While the Campaign's goal of encouraging youths to advocate for tobacco control policies seems laudable, surprises await for those who take the time to read what the Campaign is actually telling kids, and not telling them.

The online Kick Butts Day guidebook links youths to a Campaign for Tobacco-Free Kids web site that provides education and guidance about tobacco control activities in which youths are encouraged to take part. And one of those activities is advocacy in support of the Tobacco-Free Kids and Philip Morris-supported legislation to grant FDA authority to regulate tobacco products.

The web site tells kids that: "Tobacco products are deadly and addictive, yet they're almost completely unregulated by the government to protect our health and safety. That's because Congress has not granted the FDA, which regulates food and other consumer products, the authority to regulate tobacco. There are many actions that the FDA could take to better protect people from tobacco products and the tobacco industry's deceptive marketing. The Campaign for Tobacco-Free Kids has a special report on FDA regulation and a series of factsheets that summarize what effective FDA regulation of tobacco products means."

"How does effective FDA regulation help people? If effective FDA regulation becomes a law, the FDA could regulate how tobacco products are made, marketed and sold. Here are some examples of how:
• The FDA could require tobacco companies to take out some of the dangerous chemicals in tobacco products so they won't be as harmful or addictive.
• The FDA could stop marketing that targets youth.
• The FDA can crack down on stores that sell cigarettes to youth.

The Campaign for Tobacco-Free Kids goes on to tell youths to "Write, call or e-mail your U.S. Representatives and Senators and tell them you support FDA regulation of tobacco products. Send them information about effective regulation of tobacco. Tell them not to support any bill that protects the tobacco industry instead of our health," and to "Organize your community around the importance of FDA regulation."

Importantly, a March 17, 2005 report that the Campaign refers kids to states that: "The FDA’s authority to regulate tobacco products would be comparable to its existing authority for drugs, devices, and foods."

And most importantly, nowhere on any of the Campaign's youth web sites and in none of the reports or fact sheets to which the Campaign refers youth does the Campaign inform the kids they are trying to recruit to promote the FDA legislation of a critical piece of information: that Philip Morris, the nation's largest tobacco company, supports the very same FDA legislation, is actively lobbying for its passage, and has told its shareholders that the defeat of last year's FDA legislation was "a significant disappointment" and that passage of this year's legislation is "a key priority."

I believe that the Campaign for Tobacco-Free Kids' actions are unethical and inappropriate because it appears that the Campaign is manipulating kids to further its own legislative goal of enacting S. 666 and H.R. 1376. It certainly appears that the Campaign is being intentionally deceptive in its presentation of the critical issues regarding this legislation to the youths it is trying to recruit to promote these bills. There a number of elements of this deception:

First, the Campaign states that: "The FDA’s authority to regulate tobacco products would be comparable to its existing authority for drugs, devices, and foods." Presumably, this statement, released on March 17, 2005 (the date S. 666 and H.R. 1376 were introduced) refers to the FDA legislation that was introduced. Such a statement is grossly misleading, if not inaccurate and false.

The very first provision of the FDA legislation is that: "Tobacco products shall be regulated by the Secretary under this chapter and shall not be subject to the provisions of chapter V." So the very premise of the entire legislation is that tobacco products are not to be regulated under the same rules by which FDA regulates drugs and devices (and foods). In fact, FDA's authority to regulate tobacco products under the legislation is not at all comparable to its existing authority for drugs, devices, and foods. Far from it - the FDA's authority to regulate tobacco products is completely different from its authority to regulate drugs, devices, and foods.

Second, the Campaign is asking youths throughout the country to "Stand Out, Speak Up, and Seize Control in the fight against Big Tobacco." Is it not then only fair to inform these youths that Big Tobacco (at least in the form of its largest and most important and influential component - Philip Morris) - supports FDA regulation of tobacco products, supports the specific legislation that youths are being recruited to promote, viewed last year's defeat of the essentially identical FDA legislation as a signficant disappointment, and views the passage of the legislation this year as a key priority.

It seems to me that if you are going to try to recruit kids to support FDA legislation, then they at very least have the right to know that Philip Morris is vigorously supporting and lobbying for that legislation. To omit this critical piece of information is deceptive, and it is hard to imagine that it is anything other than intentional deception, since it's difficult to believe that it represents a simple oversight on the Campaign's part. The Campaign obviously made a deliberate decision not to include this information in its recruitment package provided to the kids.

Third, the Campaign instructs youths to tell their Congresspersons not to support any bill that protects the tobacco industry instead of health. But the Campaign fails to inform youths that there are a number of provisions in the legislation that are there specifically to protect the tobacco industry and that have no health protection purpose. The Campaign itself has admitted that these are compromises; there is no disagreement that these provisions are specifically there to protect the tobacco industry.

Fourth, the Campaign leads kids to believe that by taking out "some of the dangerous chemicals in tobacco products," these products will not be "as harmful." Is the Campaign not aware that such an assertion is misleading, since the Campaign itself, on the very same Kick Butts web site, empasizes to kids that "There are over 4000 chemicals in a single puff of cigarette smoke, and 69 of them are known carcinogens." Is the Campaign ready to make a public statement that removing just some of these 4000 chemicals and 69 carcinogens will produce a safer cigarette? Is it not hypocritical to suggest such a fact to kids on the one hand, and then on the other hand, to complain about how terrible it is that cigarette companies may make even mild claims (such as that a product reduces exposure to a given substance) without having solid documentation of the reduced risk?

As the Campaign itself has stated: "These bills would prohibit tobacco companies from making any explicit or implicit health claims, such as reduced risk of disease or reduced exposure to specific toxins, without first proving to the FDA that the scientific evidence is adequate to conclude BOTH 1) that the product as actually used by consumers will significantly reduce the risk of disease to individual consumers AND 2) that the product as marketed will benefit the health of the population as a whole." Is it unacceptable for tobacco companies to make health claims without incontrovertible evidence but somehow acceptable for the Campaign for Tobacco-Free Kids to make just about the very same contention to kids, but without any solid documentation?

Finally, is it not deceptive to tell kids that the FDA legislation will allow the Agency to "stop marketing that targets youth" when the Campaign knows full well that the Supreme Court of the United States has overturned even far less restrictive advertising laws on the grounds that they are too sweeping to satisfy the requirements of the First Amendment of the Constitution?

Manipulation is defined as "influencing or managing shrewdly or deviously," and devious as "not straightforward...misleading...deceptive." It certainly seems to me that the Campaign for Tobacco-Free Kids is influencing kids to promote FDA legislation, and that the Campaign is doing so in a devious way - a way that is not straightforward, but rather is quite misleading and quite deceptive.

I find the Campaign's manipulation of kids to be not only highly inappropriate, but also unethical, because it violates accepted standards of professional public health conduct that require public health organizations to provide the public with full and accurate information that is necessary to make decisions on policies. This is what the APHA Public Health Code of Ethics calls the "community-level" equivalent of the individual-level ethical principle of informed consent:

"Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community’s consent for their implementation. ... there is a moral obligation in some instances to share what is known. For example, active and informed participation in policy-making processes requires access to relevant information. ...Such processes depend upon an informed community. The information obtained by public health institutions is to be considered public property and made available to the public."

I think that the obligation to share the information relevant to the decision whether to support a public health policy is particularly important when it is children that are being recruited to promote such a policy. This is because kids are far less able to find out the necessary, relevant information on their own, and they are more susceptible to the possibility of manipulation of their attitudes.

The rest of the story reveals that the Campaign for Tobacco-Free Kids is manipulating kids to promote FDA tobacco legislation by presenting them with incomplete and misleading information about that legislation. These actions, I think, violate established standards of ethical public health practice. This story should once again underscore to tobacco control and public health practitioners the obligation for us to use appropriate and ethical means to pursue our intended ends, regardless of how noble and important we think those ends might be.

Campaign for Tobacco-Free Kids is Hiding the Truth from Youths, Misusing Them to Promote Its Pet Legislation

According to the Campaign for Tobacco-Free Kids, "The Youth Advocates of the Year Awards, sponsored by the Campaign for Tobacco-Free Kids, honor the outstanding work of young advocates who have taken the lead in holding the tobacco companies accountable for their efforts to market products to youth. These young activists are fighting to protect their peers, their communities and the nation from the dangers of tobacco use through public education efforts, student-to-student training and outreach to policymakers. Many have worked to change policies at the national, state and local events to limit youth access to tobacco, protect people from secondhand smoke, and ensure that tobacco prevention programs continue to receive funding. Their work inspires and motivates other young people to join in their advocacy efforts."

The Rest of the Story

At first glance, this may look like an innocent, well-intentioned, appropriate program to honor youths who are health activists in their communities.

But upon closer inspection, it turns out to be an unethical, deceptive, propaganda program which misuses youths in an attempt to promote passage of legislation which, unbeknownst to the youths, is supported by Philip Morris - the nation's largest tobacco company.

The telling fine print is on the application form itself, where tucked in among the required questions about what activities a youth has undertaken is a mandatory question in which youths are required to state their position about the proposed FDA tobacco legislation, after reviewing a Campaign for Tobacco-Free Kids propaganda page about the bill.

There's one major problem: nowhere on the propaganda page does it disclose the truth - that the legislation is supported by the the nation's leading tobacco company. Such information would be crucial to obtain informed consent from youths regarding their willingness to work for such legislation, something they will be asked to do if they win this youth advocate "award."

The very fact that youths are required to state their position on the FDA legislation is despicable. This is supposed to be an award for community service, not a test of whether a youth supports the Campaign's political positions.

These youths are going to be used to promote the Campaign's pet legislation (the FDA bill), which might be fine if they were informed of the truth about the bill. If you are going to use youths for your own advocacy purposes, you must - at a minimum - inform them of the relevant details about the legislation. In this case, the most important detail is omitted: the fact that the legislation is actually favored by the nation's largest tobacco company. Thus, the Campaign is violating the principle of informed consent, making their misuse of these youths unethical.

That the Campaign for Tobacco-Free Kids is deceiving its adult constituents and the rest of the public is bad enough. But to do this to youths is just where I have to draw the line and say: enough of this nonsense. This is really despicable.

It is, by the way, this same organization which has been called out for violating the Obama transition team's policy of not allowing lobbyists to serve in the field in which they lobbied. According to an Associated Press review, the Campaign's executive director - Bill Corr - has lobbied the Congress in support of the FDA legislation and is now on the team reviewing the Health and Human Services Department, which oversees the FDA. According to the review, "the group has spent $675,000 this year trying to influence policymakers." This is a clear violation of the transition team's ethics policies.

The Campaign for Tobacco-Free Kids appears to have the ethical integrity of ... well ... a tobacco company, to be frank. Which is ironic, because the hallmark of the Tobacco-Free Kids campaign for the FDA legislation is that we need to end the deception and unethical practices of the tobacco companies.

The Campaign for Tobacco-Free Kids' lack of ethics, however, are far better than the tobacco companies' lack of ethics, because they are working for a noble cause, or at least the Campaign would like people to think. But the truth is that the cause they are working for is not so noble (protecting the profits of the tobacco companies at the expense of the public's health) and ethics are ethics, no matter who you are. Being an organization with supposedly noble interests does not absolve you of the responsibility to conduct your business in an ethical manner.

And misusing youths to promote a highly controversial and political federal policy is about as low as one can go. To my knowledge, even the tobacco companies have not attempted that one. At least they used adults to do their political bidding. Not so with the Campaign for Tobacco-Free Kids. If you can walk and you can talk, then you're eligible to be used to do the Campaign's political bidding (OK, so you have to be at least in middle school).

Yet Another Article Documents that Campaign for Tobacco-Free Kids Has Deceived the Public About Philip Morris' Role in Crafting FDA Legislation

Despite the Campaign for Tobacco-Free Kids' public denials of - or complete refusal to acknowledge - the role that Philip Morris played in co-crafting the FDA tobacco legislation, yet another article confirms that the legislation which stands to pass the Senate today or tomorrow is indeed the result of a deal worked out between the Campaign and the nation's leading tobacco company.

An article in the Winston-Salem Journal highlights a new book by Patrick Basham, entitled "Butt Out! How Philip Morris Burned Ted Kennedy, the FDA & the Anti-Tobacco Movement." In this book, Basham provides a detailed, extensive, and well-documented treatment of the origins of the FDA tobacco legislation. He describes, in no uncertain terms, how that legislation was the result of an unholy alliance between the Campaign for Tobacco-Free Kids and Philip Morris.

According to the article: "Patrick Basham argues that Philip Morris is teaming with anti-tobacco groups to write legislation beneficial to its business. Patrick Basham has taken on one of the most intriguing deals in Washington -- how Philip Morris USA came to support Food and Drug Administration oversight -- in a new book titled Butt Out! How Philip Morris Burned Ted Kennedy, the FDA & the Anti-Tobacco Movement. ... Basham's book focuses on how Philip Morris has worked with anti-tobacco groups to create potential FDA regulations that would cement it as the dominant U.S. manufacturer and stifle smokeless innovation being developed by R.J. Reynolds Tobacco Co. Both Philip Morris and the anti-tobacco groups, mostly prominently the Campaign for Tobacco-Free Kids, have denied those allegations for years."

In the article, Basham states: "Though the alliance between anti-tobacco activists and the nation's largest tobacco company has been probed by some journalists, the public denials have tended to convince those who have not dug deeply enough. As I provide chapter and verse on how this unholy alliance has developed and worked, perhaps this will galvanize opposition to this travesty of public-health legislation."

In response to a question about the biggest revelation in his book, Basham responds: "That Philip Morris is really smart at pursuing its corporate interest and that Sen. Ted Kennedy, Rep. Henry Waxman, and their anti-tobacco partners are really dumb at pursuing the public's interest. As I show in my "scorecard of who won and lost," Philip Morris got virtually everything it wanted, while the anti-tobacco leadership in Washington struck out."

The Rest of the Story

As recently as last week, the Campaign for Tobacco-Free Kids publicly denied that there is any truth to the allegation that it teamed up with Philip Morris in negotiating and crafting this legislation. But we now have evidence from numerous sources that the Campaign is being dishonest: there seems to be no question that the bill is the result of a negotiation between the Campaign for Tobacco-Free Kids and Philip Morris. There seems to be no question that the bill was crafted, in part, by the nation's leading tobacco company.

While I will have plenty to say in the next two days about the public health merits (i.e., lack of merits) of this legislation, I think we need to take at least a moment to consider the implications and consequences of this unethical behavior by the Campaign for Tobacco-Free Kids.

Dishonesty and deception is unethical, and in my view, it violates the basic code of ethical conduct that we adhere to in public health. It is especially egregious because the entire premise of the Campaign for Tobacco-Free Kids' support for the FDA legislation is that the tobacco companies are lying to and deceiving the American public and that their misrepresentation of the truth needs to be reigned in.

I find it difficult to find any credibility in the Campaign's position to issue these complaints when they are themselves engaging in massive deception of the public.

If we want to be the organizations that uphold ethical integrity in terms of honesty in communications to the public, then should we not first and foremost be beyond reproach in our own communications to the public. And at very least, should we not be expected to be honest, truthful, and forthright in our communications? Should we not be expected to be honest in our communications to our own constituents? Should we not expect anti-smoking groups to tell the truth to each other?

That the overwhelming majority of health and anti-smoking groups have jumped onto the Philip Morris-crafted deal to institutionalize tobacco use, give it the government's approval, and provide unprecedented special protection to Big Tobacco (and especially Philip Morris) is a testament to the degree to which these organizations were deceived by the Campaign for Tobacco-Free Kids.

And not only has the wool been pulled over the eyes of anti-smoking groups, it has been pulled over the eyes of the leading policy makers who previously had a history of actually supporting the protection of the public's health from tobacco.

Clearly, a huge act of deception was necessary, because to tell the truth and reveal that Philip Morris helped craft the bill would have been devastating to its support. The bill would never have made it this far without that massive act of deception.

The Campaign for Tobacco-Free Kids pulled off this massive act of deception, but I will note that it comes at a huge price. That price is the destruction of the ethical integrity of the tobacco control movement.

Campaign for Tobacco-Free Kids Appears to be Deceiving Youth into Supporting Proposed FDA Tobacco Legislation; Unethical Tactics are Accelerating

In what appears to be a desperate effort to save the proposed FDA legislation that has stalled in the Senate because its own sponsors were not informed by bill supporters of its potential public health shortcomings, the Campaign for Tobacco-Free Kids is now conducting a campaign to entice youths to support the proposed legislation, but without telling them exactly what they are supporting.

The campaign is spearheaded by a website - WhatAreYouSmoking.org - which entices the public (the target audience appears to be youths) into signing a petition to support the idea of granting the FDA the authority to regulate tobacco products by noting that cigarettes contain over 4,000 toxic chemicals and why shouldn't they be regulated?

"Cigarettes contain 4000+ chemicals. They should be regulated to protect kids and save lives."

The website mentions nothing about the drawbacks of the legislation, hiding the most critical fact of all: that the legislation is being supported by none other than Philip Morris itself, the nation's largest cigarette company.

If you then provide your name and email address, you pledge your support for the proposed FDA legislation (without knowing that you are pledging your support for a bill that Philip Morris desperately wants Congress to enact), and you automatically become a Tobacco-Free Kids e-champion (so that you can receive email updates).

If you then click on the link to sign the petition, you will see the following message:

"Fill out the form below to sign the petition and be a part of the growing effort to make sure Congress gives the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products."

The petition itself states:

"WHEREAS, Tobacco use is the number one cause of preventable death in the United States and is responsible for over 400,000 deaths per year;

WHEREAS, Every day another 1200 Americans die because of tobacco and more than 1,000 kids become new regular smokers. Nearly 90 percent of all smokers begin smoking in their teens or earlier;

WHEREAS, Tobacco use costs the United States more than $96 billion a year in health care bills;

WHEREAS, Tobacco industry marketing expenditures increased by 123 percent since 1998 to a record $15.4 billion in 2003, according to the Federal Trade Commission; and

BE IT RESOLVED the undersigned has endorsed this petition and urges Congress to give the U.S. Food and Drug Administration the authority to regulate tobacco products."

After you sign the petition, you will receive the following email from the Campaign for Tobacco-Free Kids:

"Thank you for visiting WhatAreYouSmoking.com and taking action to help protect America's kids by supporting legislation before Congress to grant the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products.

Tobacco use is the number one preventable cause of death in America. Every year, smoking and other tobacco use kill more than 400,000 Americans and cost the nation more than $96 billion in health care bills. Every day, another 1,200 lives are lost and more than 1,000 kids become new regular smokers.

Please be sure to visit WhatAreYouSmoking.com again and check for updates and new ways you can help. With your support we will beat Big Tobacco and save lives."

The Rest of the Story

It appears to me that the Campaign for Tobacco-Free Kids is enticing kids to support the proposed FDA tobacco legislation without informing them of what the bill actually is, what its drawbacks are, and the critical fact that it is in fact supported by the largest company within Big Tobacco.

In fact, the Campaign is actively deceiving kids into thinking that Big Tobacco is uniformly opposed to the legislation. In its message back to the kids who sign the petition, they tell the kids that their support for the legislation is going to help to "beat Big Tobacco." This clearly gives the impression that Big Tobacco is fighting the proposed legislation. Of course, this is untrue - as we know, Philip Morris is actually supporting the legislation.

This campaign is deceptive even for a reader who is an expert in the regulatory issues involved. I myself was deceived and I signed the petition. I in fact agree with everything in the petition. I would urge Congress to give the FDA the authority to regulate tobacco products. In fact, I supported legislation introduced in previous years (prior to the deal that was struck with Philip Morris in 2004) that would have done just that. And so I joined the effort to "make sure Congress gives the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products."

Then, to my surprise, I found out that what I had actually signed was not a petition to urge Congress to give the FDA authority to regulate tobacco products, but a petition to support specific legislation that had been introduced which would severely limit the ability of the FDA to regulate tobacco products.

What a surprise when the email returned from the Campaign thanking me for "supporting legislation before Congress to grant the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products."

I intended to do nothing of the sort. I was told that I was simply signing a petition to express support for the idea of giving the FDA the authority to regulate tobacco products. Nowhere did it indicate that the petition was actually to support a specific piece of legislation. On the petition web page, there is no mention of any specific legislation. And there is no mention of any details of the specific legislation that would allow me or anyone else to make an informed decision about whether I want my name associated with supporting that legislation.

While I agreed to express my support for the notion of granting the FDA authority to regulate tobacco products, I sure as hell did not give the Campaign permission to use my name in support of specific legislation - about which I was not informed on the web page - that would severely limit the FDA's ability to regulate tobacco products, that is supported by Philip Morris, that would ensure that nicotine could not be removed from cigarettes, and that would eliminate the possibility of finding and making available truly lower risk tobacco products.

I think there would be hundreds - perhaps thousands - of kids around the country who would be appalled to find out that they had inadvertently and unknowingly supported legislation that is being championed by Philip Morris.

Imagine if we could get the names of all the kids who signed on to petition and then we wrote them to inform them that they had just expressed their support for legislation that was being championed by Philip Morris to protect the financial interests of the nation's largest cigarette company. I imagine they would be appalled. And more importantly, that they would be shocked. Certainly, this is a fact they should have known about before they were enticed into signing the petition, not afterwards.

Furthermore, what would those kids say if we wrote them to inform them that rather than give the FDA the authority to regulate tobacco products, the legislation would actually severely limit the FDA's authority to do so?

What if we wrote those kids to tell them that although they weren't informed about it, the legislation for which they had just pledged their support actually limits the ability of FDA to regulate tobacco products, granting the tobacco companies unprecedented special protections enjoyed by no other companies whose products are regulated by the FDA?

What if we told the kids, for example, that the legislation would prohibit the FDA from outlawing the sale of tobacco products at youth community centers, youth arcades, youth amusement centers, amusement parks, bowling alleys, or candy stores?

What if we emailed the kids who had just signed the petition and informed them that they had just unknowingly pledged their support for legislation that precludes the FDA from eliminating the addictive nicotine in cigarettes, ensuring that the tobacco companies will always be able to addict new generations of their peers?

And that the legislation gives Congress specific veto power over any major FDA rules so that Big Tobacco can block any regulations that it doesn't like simply by exercising its political power?

And that the legislation blocks the FDA from raising the legal age of purchase of cigarettes?

And that the legislation ensures that new products which would actually reduce the harms of smoking will never be researched, developed, and marketed?

And that the legislation contains special provisions, inserted solely to appease Philip Morris, that would protect Big Tobacco profits at the expense of the protection of the public's health?

I don't think those kids would be too happy about it. In fact, I'm quite sure that many, if not most or all of those kids would feel tricked, duped, deceived, misled, and manipulated. And they would be angry.

The bad news is that this campaign is only a small part of a much larger effort in which kids are being taken advantage of and misused to support the Campaign for Tobacco-Free Kids' legislative agenda, without their fully informed consent. The Campaign is organizing Kick Butts Day this Wednesday, an event which appears to me to be designed to exploit kids' naivete in order to advance the Campaign's own political aims.

As its March 22 press release makes clear, more than 2,000 youth events are planned across the nation for Kick Butts Day. This year, "Kick Butts Day is raising awareness about the thousands of chemicals in each puff of cigarette smoke and the need for elected officials at all levels to step up the fight to reduce smoking and other tobaccco use."

That may sound fine, but if you read the press release further, you see that the actual purpose of Kick Butts Day appears to be to use kids as pawns in a political maneuver without their consent. The actual purpose -- unbeknownst to the kids -- is to specifically promote legislation that is the chief legislative priority for Philip Morris. How many kids who are participating in Kick Butts Day on Wednesday do you think realize this?

According to the press release: "This year, health advocates are urging Congress to pass legislation granting the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products. Among other things, the FDA could require that tobacco companies disclose the contents of tobacco products and remove harmful ingredients; crack down on tobacco marketing and sales to kids; and stop tobacco companies from misleading the public about the health risks of their products. ... 'It is inexcusable that tobacco products, the number one preventable cause of death in America, are one of the least regulated products sold in America,' said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. 'By granting the FDA authority to regulate tobacco products, Congress can stop the tobacco industry from targeting our children and misleading the public. We hope Kick Butts Day will inspire elected leaders across the nation to support effective measures to protect children and save lives.'"

In other words, the Campaign has orchestrated this entire day of youth advocacy primarily as a lobbying event for the FDA legislation. But kids do not necessarily know that this is the case. Kids are certainly not being told what the legislation is all about. And they are not given information with which they could make their own informed judgment about whether to participate in an event in support of this legislation.

Most of the kids likely think that they are making a general statement about how evil the tobacco companies are, how toxic cigarettes are, and how it makes sense to regulate tobacco products to save lives. Little do they know that they are being exploited to make a very specific statement about a very specific piece of legislation that stringently restricts the authority of the FDA to regulate tobacco products in ways that might actually save lives.

The Campaign for Tobacco-Free Kids certainly has the right to support any legislation it wants to, whether the bill is a result of discussions within the public health community or negotiations with Philip Morris. But to misuse kids and get them to do the dirty work of promoting the legislation without informing them of what the debate is all about - or even that there is a debate - is unacceptable.

The rest of the story is that in my opinion, this latest campaign by the Campaign for Tobacco-Free Kids is one of the ugliest, most unethical, most deceptive, irresponsible, inappropriate, and sleaziest tactics I've ever seen in my 21 years in tobacco control.

The Campaign for Tobacco-Free Kids is supposed to be supporting the interests of our nation's young people, not manipulating, exploiting, deceiving, and misusing them.

I hope others will join me in calling for an immediate end to this deceptive, inappropriate, and unethical campaign.

Kick Butts Day 2009: Campaign for Tobacco-Free Kids Misusing and Tricking Kids into Doing Its Special Interest Lobbying for It

This Wednesday was Kick Butts Day 2009, a day on which the Campaign for Tobacco-Free Kids tries to trick kids into supporting the Philip Morris-negotiated FDA tobacco legislation without telling those kids that the bill before Congress prohibits the FDA from taking meaningful action to protect the public from tobacco products and that the legislation is supported by, and was crafted in part by the nation's leading tobacco company.

In my opinion, the Campaign for Tobacco-Free Kids is unethically tricking kids into supporting this legislation because it is not giving them the truth about the legislation. Under the guise of a day to fight Big Tobacco, the Campaign is trying to get kids to support legislation which would actually provide unprecedented special protection to Big Tobacco. Nowhere does the Campaign reveal to the nation's youths that the legislation ties FDA's hands and limits its regulatory authority in a number of important ways -- regulatory limits which are not present for any of the other drugs or products regulated by the Agency. And nowhere does the Campaign inform youths it is recruiting to lobby for this legislation that this is a Philip Morris supported bill, one which contains numerous loopholes inserted specifically to appease the financial interests of the nation's largest cigarette maker.

Consider the following two "tricks" that the Campaign is playing on our kids:

1. Getting the kids to support the FDA legislation without explicitly telling the kids that they will be supporting a specific bill.

One activity set out by the Campaign for Kick Butts Day is entitled "Contact Members of Congress." For this activity, youths are instructed: "Let your members of Congress know that you think the tobacco companies should tell the public what exactly is in their deadly products. You can take action!"

This is ostensibly a trick. By writing Congress and telling lawmakers that you think the tobacco companies should tell the public what exactly is in their deadly products, you are unknowingly expressing support for HR1256, the proposed FDA tobacco legislation. Why? Because that is the legislation currently before Congress which requires tobacco companies to disclose the ingredients in their products. Any policymaker reading a letter from a youth which demands that Congress require the companies to disclose their ingredients is certainly going to read that as supporting the legislation before Congress which would do exactly that.

However, the activity sheet does not inform youths that there is a bill pending in Congress that would require disclosure of ingredients and that their support for disclosure is going to be read as an endorsement of the entire piece of legislation. And furthermore, youths are not informed about what else is in that legislation, including the numerous limits of the FDA's ability to effectively intervene to protect the public's health.

Youths are also told to write letters to Congress urging lawmakers to do something about tobacco companies targeting youths. Again, this is ostensibly a trick to get youths to unknowingly support the FDA legislation, which is clearly what "do something about it" means in this case. With a House vote on the FDA legislation due up next week, what else could "doing something" about it possibly mean?

This is despicable and unethical behavior, because the Campaign is not informing these youths that there is a bill up before Congress and that their letters will be construed as expressing support for that specific piece of legislation. There is an ethical duty here to inform the youths about this piece of legislation and what it would (and would not) do.

In all seriousness, this is the sleaziest maneuver from a tobacco control organization that I have ever witnessed during my 23 years in the tobacco control movement.

To take advantage of kids like this is truly unfortunate.

2. Getting the kids to demand FDA regulation of tobacco products on the basis that they contain arsenic and other toxic chemicals, but without informing them what the legislation would actually do or not do to eliminate these toxins.

In the "They Put What in a Cigarette?" activity, kids are urged to create a display that tells people about the ingredients in tobacco and their common uses as poisons or toxins. For example, kids are to highlight the fact that cigarette smoke contains arsenic, which is used in rat poison and pesticides.

The Campaign for Tobacco-Free Kids makes a specific suggestion for a poster that kids can use. A large poster is displayed on the activity page which states "The FDA keeps arsenic out of lollipops, but not cigarettes." Clearly, the message that the Campaign is trying to get kids to send to Congress is that the FDA should be given regulatory authority over cigarettes because the Agency could then get rid of all the toxic constituents in tobacco smoke.

This is a sham. The FDA legislation would not allow the Agency to require the elimination of all the toxic constituents in cigarette smoke, and in fact, it is not clear whether the Agency could even require the elimination of one such constituent. We don't know whether it is technologically possible for cigarette companies to selectively remove a specific chemical from the smoke, and if it is not possible, then the FDA cannot require it to be done, no matter how many lives it would save, according to a loophole in the legislation.

Passage of the FDA legislation is not going to eliminate arsenic (nor most of the thousands of toxic chemicals) from cigarette smoke, and the Campaign knows it. It is not that simple and the Campaign is misleading youths (apparently intentionally) into believing that this legislation is going to get rid of the toxins from cigarettes.

This is another unethical, and sleazy maneuver.

I think that we as public health practitioners have an ethical obligation not to misuse kids by misleading them and deceiving them in order to trick them into doing our lobbying for us. If we want kids to be involved in tobacco policy advocacy, that's great, but our obligation is to provide them with adequate information so that they can make their own informed decisions about what they choose to support or not to support.

I know for a fact that massive numbers of these kids would be appalled to find out that they were supporting a bill that is supported by Philip Morris. Nowhere in the Kick Butts Day manual does it mention that Philip Morris supports the bill. Not even in a rebuttal to the argument that because Philip Morris supports the bill, we should oppose it. It simply hides the truth from these kids.

If the Campaign for Tobacco-Free Kids wants to lobby for special interest legislation that will protect Philip Morris at the expense of the public's health, it certainly has the right to do so. But it doesn't have the right to trick children and teenagers into supporting this legislation without knowing that they are expressing support for a specific piece of legislation, and without knowing the details of what that legislation encompasses, or the history behind it.

That the Campaign for Tobacco-Free Kids has run a campaign of deception among its constituents (whom it has repeatedly failed to inform of the truth) is unfortunate. But that the Campaign is waging a campaign of deception among the nation's youths is disgraceful and appalling.


Note: One of the activities outlined by the Campaign encourages kids to set up a boxing match where people simulate physical violence against tobacco company executives by punching a mock tobacco industry representative. I could understand punching a cigarette or even a cigarette company logo, but to punch a real person and simulate committing violence against an individual is completely uncalled for and I condemn it.

Campaign for Tobacco-Free Kids Decries Use of Menthol to Recruit Youths, But Protects Menthol from Cigarette Flavoring Ban

In its Kick Butts Day activities guide (the same one in which it recommends that youths simulate physical violence against tobacco industry representatives), the Campaign for Tobacco-Free Kids decries the use of menthol to recruit youth smokers. In particular, the Campaign blasted R.J. Reynolds for using a crushable menthol tablet in its new Camel Crush brand.

The Campaign states: "In May 2008, R.J. Reynolds launched a new cigarette, the Camel Crush. Inside each cigarette is a blue pellet that the user can crush to turn the regular cigarette into a menthol one. The cigarette is packaged in a sleek black and blue box and this new innovation can be seen as marketing to youth."

The Rest of the Story

The rest of the story is that at the same time it is blasting R.J. Reynolds for using a crushable menthol pellet to recruit youth smokers, the Campaign for Tobacco-Free Kids is lobbying Congress to exempt menthol from a ban on cigarette flavorings which the Campaign itself has argued is necessary to prevent tobacco companies from marketing to youth.

The Campaign has now itself acknowledged that the menthol pellets are an example of marketing to youth which it says must be outlawed, but rather than call for a ban on the use of these pellets, the Campaign is actually working to protect these pellets from regulation.

If these were strawberry pellets, cherry pellets, or chocolate pellets, you can be sure the Campaign for Tobacco-Free Kids would be calling for a ban on their use. In fact, the FDA tobacco legislation would ban each of these flavorings (plus every other flavoring in existence). Except for menthol, and that is at the Campaign's insistence.

Am I arguing here that menthol should be banned in cigarettes? No. What I am arguing is that the Campaign for Tobacco-Free Kids is full of hypocrisy and insincerity. It is clear to me that they don't really mean what they are saying. They say that tobacco companies must not be allowed to market to kids and they acknowledge that menthol flavoring in Camel Crush is marketing to kids, yet they then lobby to prevent Congress from banning the use of this flavoring.

What has become clear to me now - as suggested by a number of commenters - is that the Campaign for Tobacco-Free Kids is nothing more than a political, propaganda organization. It is not a legitimate public health organization. It has no sincerity, no regard for honesty and integrity, and it is playing a game of politics and deception with our nation's youth, and with its own constituents.

A large part of the reason for this blog in the first place is that my conscience could not live with the unethical, inappropriate, insincere, dishonest, and deceptive propaganda-based methods of the Campaign for Tobacco-Free Kids. Their tactics have bothered me - and my conscience - for a long time. What I realize now is that the only way for me to rid myself of this blight on my conscience is to dismiss the Campaign as a public health organization. What troubles me is that a public health organization is using such techniques. But if I view the Campaign as a political propaganda organization that is not a legitimate part of public health, then it becomes possible to dismiss its behavior without bothering my conscience as much.

The good news - for the Campaign - is that it is now very much in the running for the 2008 Anti-Smoking Hypocrisy Award, which will be announced at the end of the year.

Campaign for Tobacco-Free Kids Again Deceives Constituents About Philip Morris' Support for FDA Tobacco Legislation; Is TFK Even Capable of Honesty?

In a communication sent to its constituents on Friday, the Campaign for Tobacco-Free Kids again deceived citizens around the nation in order to entice them to support the proposed FDA tobacco legislation. The communication implored citizens to contribute money to help youth advocates promote the FDA tobacco legislation and indicated that this money was necessary because those advocates would need to fight Big Tobacco in the halls of Congress. The constituents were informed that Big Tobacco is a staunch opponent of the legislation.

According to the email: "This summer Youth Advocates from across the country will stand up for kids and take a stand against Big Tobacco's outrageous marketing. Will you help support these Youth Advocates as they take the battle against Big Tobacco right to Capitol Hill? ... These youth will insist Congress pass legislation allowing the FDA to regulate tobacco products and sinister tobacco marketing campaigns like Camel No.9. Your contribution to the Action Fund will aid our efforts to provide vital training and resources so these Youth Advocates succeed. The Youth Advocates are taking on a wealthy and powerful opponent. It's up to you and me to make sure they're armed with the tools they need to fight Big Tobacco in the halls of Congress - and win. Please support the Youth Advocates with a gift to the Tobacco-Free Kids Action Fund. ... Help us empower the leaders of tomorrow today by supporting the Youth Advocates' efforts to fight Big Tobacco and pass life-saving FDA legislation. Thank you!"

The Rest of the Story

The truth is that the wealthiest and most powerful of the tobacco companies - Philip Morris - is not an opponent of the legislation at all. Philip Morris will not in fact be taking on the Youth Advocates, but will instead be helping them to try to win passage of the bill. The Youth Advocates will not be fighting Big Tobacco, at least not the largest of the tobacco companies. The largest and most dominant of the companies will be joining the Youth Advocates in trying to secure passage of this legislation.

By informing its constituents that the Youth Advocates wil be fighting Big Tobacco in order to promote the FDA legislation and that these advocates are taking on a wealthy and powerful opponent, the Campaign for Tobacco-Free Kids is misleading citizens throughout the nation into believing that Big Tobacco is uniformly opposed to the proposed legislation. This, in my view, is outright deception. It is untruthful and dishonest. It is unethical.

The Campaign for Tobacco-Free Kids appears to have turned into a pure propaganda machine. The organization, in my view, has lost its legitimacy as a public health advocacy organization because it does not respect the basic public health ethical principle of informed consent.

This ethical principle, which the Campaign for Tobacco-Free Kids is consistently violating, is the community-level equivalent of the principle of informed consent, which is spelled out in the American Public Health Association Code of ethics. Just as public health organizations must provide individuals with full and accurate information before enrolling these individuals in research studies, public health organizations must also provide the public with full and accurate information that is necessary to make decisions on policies that affect them:

"Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community's consent for their implementation. ... there is a moral obligation in some instances to share what is known. For example, active and informed participation in policy-making processes requires access to relevant information. ...Such processes depend upon an informed community. The information obtained by public health institutions is to be considered public property and made available to the public."

I don't think that the Campaign for Tobacco-Free Kids (nor other groups supporting this legislation) have made available to their constituents the relevant information needed for them to be able to make an informed decision about the proposed policy, and about whether or not to donate money to this cause.

If I, as a citizen, am approached by a public health group asking for my financial support to send some youth advocates to Washington to fight Big Tobacco, I am very likely to open up my pocket book and write out a check. It sounds like a great cause. How could it not be?

However, if instead, I am told the truth and am informed that I am being asked for my financial support to send some youth advocates to Washington to help Philip Morris encourage policy makers to enact legislation, it doesn't sound like such a great cause anymore. It certainly adds a critical "nuance" to my understanding of the plea for financial help if I am told that while the smaller tobacco companies oppose the bill, the largest company supports it. This still might not deter me from contributing money, but at least I am given the opportunity to make my own informed decision. Such an opportunity is not being afforded to citizens whose money is being elicited from the Campaign for Tobacco-Free Kids' communication. Their constituents are not being provided with the opportunity for informed consent.

While informed consent would be important even if the sole purpose of the communication was to enlist citizens' support for the legislation, informing them of the truth about the tobacco companies' position on the legislation seems even more critical when the purpose of the communication is to ask for our money.

How would financial contributors feel if they found out they were solicited on false grounds: that in fact the largest company of Big Tobacco and its huge financial resources are backing the bill in the halls of Congress? I'm sure that many contributors would be quite angry, and this could quickly become a scandal.

I condemn these unethical tactics and I think it is time that some semblance of integrity be restored to the tobacco control movement.

IN MY VIEW: Why the Campaign for Tobacco-Free Kids' Campaign of Deception on the FDA Bill is So Unethical

Given the controversy of the past two days over what I feel is the misuse of the Ignite youth anti-smoking group by the Campaign for Tobacco-Free Kids (TFK) and over what I feel is an unethical campaign of deception being run by TFK (and Ignite - although I have been hesitant to blame the young people for this), I think it may be useful and important at this point to try to summarize the reasons why I think TFK's campaign of deception for the FDA legislation is indeed a campaign of deception and why I think the campaign is so unethical.

First, we need to establish three core ethical principles of public health and tobacco control. Two of these have been spelled out in a recent Tobacco Control article (see Fox BJ. Framing tobacco control efforts within an ethical context. Tobacco Control 2005;14[Suppl II[:ii38-ii44). One is spelled out in the APHA Code of Ethics.

1. Truthfulness

While it may seem obvious, I think it is worth being explicit about the fact that truthfulness is an important aspect of ethical behavior, not only by individual practitioners but by public health organizations. As Brion Fox points out in his outstanding review of ethical principles in tobacco control practice, if organizations fail to be truthful, they will actually be doing a disservice to the public: "Hence the tobacco control community must hold this principle sacrosanct and strive for disclosing the whole truth, otherwise it may lose its credibility."

2. Transparency

This is similar to truthfulness, but it entails something more. Not only must public health organizations be truthful about the facts that are relevant to judging a public health intervention or policy, but they must also be forthright about the relationships and process by which these interventions or policies came about. As Fox argues: "The tobacco control community should strive for transparency in its dealings. If the tobacco control community fails to explain its dealings within an appropriate framework, it may be perceived as biased or hiding relationships, and it could lose its reputation for independence."

3. The Community-Level Equivalent of the Principle of Informed Consent

Just as public health organizations must provide individuals with full and accurate information before enrolling these individuals in research studies, public health organizations must also provide the public with full and accurate information that is necessary to make decisions on policies that affect them. This is what the APHA Public Health Code of Ethics calls the "community-level" equivalent of the individual-level ethical principle of informed consent:

"Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community'’s consent for their implementation. ... there is a moral obligation in some instances to share what is known. For example, active and informed participation in policy-making processes requires access to relevant information. ...Such processes depend upon an informed community. The information obtained by public health institutions is to be considered public property and made available to the public."

The Rest of the Story

There are a number of elements to what I view to be a campaign of deception being conducted by the Campaign for Tobacco-Free Kids to promote the FDA legislation, but here are some specific examples of what I consider to be deceptive, misleading, or non-transparent aspects of the campaign:

1. Lack of Truthfulness and/or Forthrightness about Philip Morris' Support for the Legislation

A. Direct Claim that Big Tobacco was Trying to Kill the FDA Legislation

The Campaign for Tobacco-Free Kids sent out a 2004 communication to its constituents stating that Big Tobacco was opposing the FDA legislation and was mounting a huge campaign to defeat it. This was, in my opinion, quite clearly an intentional failure to disclose that the largest member of Big Tobacco by far - Philip Morris - was in fact supporting the legislation and using its massive lobbying and public relations resources to promote the bill's passage.

By neglecting to mention this critical fact, and by not being forthright about Philip Morris' support for the bill, I believe that TFK misled its constituents into believing that this was simply an issue of public health vs. Big Tobacco: that everyone in public health supported the bill and that everyone in Big Tobacco opposed it. But this was not the truth. In fact, the Campaign was well aware that Philip Morris supported the bill and that many tobacco control advocates believed that it represented a huge bailout for Big Tobacco that would harm the public's health. This "nuance" was not revealed to TFK's constituents in the above communication.

There is no question that Philip Morris - by far the dominant company of Big Tobacco - with approximately half of domestic cigarette market share, was and remains a vehement supporter of the legislation.

In contrast to the impression that TFK gave its constituents, Philip Morris expressed significant disappointment that the 2004 FDA tobacco legislation failed, and has made the re-introduced bills its key legislative priority for the 2005 Congressional session: "Although PM USA has been increasingly successful in pursuing its societal alignment initiatives, regrettably, Congressional legislation providing for regulation of the tobacco industry by the U.S. Food and Drug Administration (FDA) was not passed in 2004. Although this was a significant disappointment, obtaining FDA regulation of the tobacco industry remains a key priority."

So the Campaign for Tobacco-Free Kids' communication to hundreds of tobacco control advocates stating that Big Tobacco was fighting vigorously to kill the FDA legislation in 2004 was, in my view, quite clearly a distortion of the truth, a hiding of the truth, and it resulted, I supect, in hundreds of advocates being misled about the truth of "Big Tobacco's" position on the legislation.

B. Continued Implication that Big Tobacco is Fighting the FDA Legislation

The TFK web site still implies that Big Tobacco is fighting the FDA's efforts to regulate tobacco, even though the largest company of Big Tobacco is actually pushing vigorously for such legislation. A special report, entitled "Tobacco vs. the FDA" is described as outlining "the Food and Drug Administration'’s tireless efforts to regulate tobacco as a drug and the industry'’s escalating legal challenges, which continue to block the federal government from protecting American children."

I think it is misleading to state that the tobacco industry is continuing to block the federal government from regulating tobacco, since Philip Morris is pushing the federal government to do so. By calling the report "Tobacco vs. the FDA," I think TFK is implying to the public that Big Tobacco is against FDA regulation. This is misleading and can probably be considered to be inaccurate as well.

Not only is the largest component of Big Tobacco pushing vigorously for FDA legislation, but by no means is the industry escalating its attempts to derail FDA legislation. Certainly, the truth is that Big Tobacco, overall, is decreasing its attempts to derail the legislation, as Philip Morris, the company with the greatest lobbying power, is now using that power to support the legislation.

C. Implication that Tobacco Interests are Trying to Buy Congress' Opposition to the FDA Legislation

As I discussed in a previous post, TFK has publicly attacked Philip Morris, among other companies, for contributing money to Congressmembers to try to get them to vote against legislation that TFK thinks will support the public health and which TFK claims are not in the interests of the tobacco companies. A recent press release claims that: "With over $600,000 already donated to candidates this year, the tobacco interests are hoping to continue to see federal policies that favor their bottom line over the public's health."

Unless TFK is also misrepresenting its position on the FDA legislation (which is that this legislation will favor the public's health over the interests of the tobacco companies), then it cannot be accurate for TFK to claim that the money that Philip Morris is donating to Congressional candidates is being contributed in order to promote federal policies that "favor their bottom line over the public's health." Clearly, TFK believes that the FDA legislation will favor the public's health over Philip Morris' bottom line. Thus, by logical inference, TFK must believe that Philip Morris' donations to influence Congress are actually being given in the hopes of enacting a federal policy that will favor the public's health (after all, the FDA legislation is the primary, if not only, major federal tobacco policy issue that will be considered by the current Congress).

D. Public Statement that Defeat of FDA Legislation was a Win for the Tobacco Industry

This statement, made in a press release, communicates to the public and the media, I believe, that the tobacco industry was against the FDA legislation. In the release, TFK stated: "Tobacco Industry Wins, Kids Lose As Conference Committee Votes Down FDA Authority Over Tobacco." If the tobacco industry won by the defeat of this legislation, then I think the public and media would naturally assume that the tobacco industry must have been against the legislation.

But in no way was the defeat of the FDA legislation a win for Philip Morris. In fact, as revealed above, the company expressed its extreme disappointment over the bill's defeat. While this particular example might be explained by suggesting that TFK was interpreting a loss for the tobacco industry in its own opinion as opposed to that of the industry itself, I still find this to be a misleading statement that implies to probably the bulk of readers that the tobacco industry was opposed to the legislation.

E. Failure to Disclose Philip Morris' Support for FDA Legislation on the TFK Web Site

Despite a voluminous amount of public information and public statements about the FDA legislation on its web site, a thorough search of the site failed to reveal any mention of the critical and relevant fact that Philip Morris supports this legislation. The Campaign had any number of opportunities to disclose this information (it's not like they just have one web page devoted to this bill), yet decided not to disclose it each and every time (unless I'm missing something, but I don't think I am because I did a quite thorough search).

Among the web pages that provide public information and public statements about the legislation but fail to disclose the fact that Philip Morris supports the legislation are the following:

Report on the FDA Legislation

Press Release in Support of the FDA Legislation

Statement on FDA Legislation

Fact Sheet on FDA Legislation

Information Sheet on FDA Legislation

Support for FDA Legislation

What FDA Legislation Really Means

Another Press Release on FDA Legislation

Yet Another Press Release on FDA Legislation

And Yet Another Press Release on FDA Legislation

One More Press Release on FDA Legislation

Another Press Release

And Another

One More Press Release on FDA Legislation

Press Release on FDA Legislation

Another

Additional Press Release on FDA Legislation

Another One

Second to Last Press Release Example

Final Press Release Example

2. Lack of Truthfulness and Forthrightness About What the FDA Legislation Does and Does Not Do

In a letter to members of Congress which purports to inform policy makers about the FDA tobacco legislation, the Campaign for Tobacco-Free Kids (and other health groups) compared the authority that FDA would be given to regulate tobacco products with existing authority that the Agency has to ensure the safety of other products. The Campaign stated that the legislation provides "FDA with authority over tobacco products similar to the authority it has over other products. FDA would have the authority to stop tobacco marketing and sales to our children and to subject tobacco products to the same consumer protections, such as ingredient disclosure, product regulation and truthful packaging and advertising, applied to other products. Just as we entrust FDA with the authority to approve every ingredient in food to ensure safety, we should give FDA the same authority to regulate tobacco products."

The problem is that in no way is the authority provided to FDA in this legislation similar to that provided to the Agency for the regulation of other products, such as food and drugs. In fact, it is fundamentally different, as I have discussed in detail.

I believe that this letter is misleading and deceptive and likely had the effect of providing members of Congress with an inaccurate understanding of the nature of the proposed legislation. I think the letter misrepresents the nature of the legislation in a profound way.

3. Lack of Transparency and Forthrightness About the Process that Led to the Legislation

This legislation was the result of a negotiation process - a back-and-forth process - mediated by certain members of Congress. The major (and I think only) public health group at the table was the Campaign for Tobacco-Free Kids and the major (perhaps only) tobacco company at the table was Philip Morris, since it was the only company that desired FDA regulation.

Clearly, this legislation resulted not from a simple request by the Campaign for Tobacco-Free Kids to adopt it, but instead, from a process of compromise (what I would call negotiation) between the two major parties with a stake in the legislation - the Campaign for Tobacco-Free Kids (representing the public health community) and Philip Morris.

While I am not claiming that any direct negotiation took place between TFK and Philip Morris, I think that the accurate way to depict the nature of the process by which this bill arose is to explain that it resulted from a negotiation process that involved TFK and Philip Morris. And because the only significant party opposed to the legislation was Philip Morris, I think it is safe to describe the process as a negotiation between TFK and Philip Morris.

Again, I am not suggesting that the two parties ever communicated directly, but since presumably they had to let the Congressional mediators know whether they were willing to accept certain provisions in the bill, the process does essentially represent a negotiation between the two parties (TFK and Philip Morris).

If TFK had simply provided the text that they favored and left it at that, then I would not characterize the process as a negotiation. But because it is quite clear that TFK had to let the Congressional mediators know what they considered to be acceptable and unacceptable compromises to what they really would have desired (a bill with no loopholes), what took place was indeed a negotiation. The Campaign has itself admitted that compromises were made in the process of developing this bill. But who were the compromises made to appease if not for Philip Morris, the major tobacco interest being represented in the negotiations?

I think this is absolutely critical information that must be disclosed publicly in order to provide "the information ... needed for decisions on policies or programs." I simply do not think that any member of the public or any public health practitioner or any young person thinking about joining an organization to fight Big Tobacco can possibly be considered to be adequately informed about this proposed public health intervention without understanding that it was the result of a negotiation between TFK and Philip Morris.

So far as I know, such a disclosure has never been made by the Campaign. In fact, the Campaign has publicly denied that any negotiation with Philip Morris took place. While the Campaign can certainly argue that it is technically correct (since it could claim that it is interpreting the word "negotiate" in a very narrow way), the denial is, I think, misleading to the American public and to public health practitioners who I think deserve to have this critical information before making a decision on what position to take on this proposed public health policy. At very least, a full and honest disclosure about the nature of the process that led to the formation of this public policy proposal is warranted.

Conclusion

For all of these reasons, I believe that the Campaign for Tobacco-Free Kids' campaign to promote the FDA tobacco legislation is, and has been, a campaign of deception.

And because TFK's actions violate the core ethical principles of truthfulness, transparency, and the community-level equivalent of the principle of informed consent, I believe its campaign to be unethical.

In his Tobacco Control article, Brion Fox makes the point that "There are many reasons to better integrate ethics into tobacco control, not least of which is that it is morally appropriate to act ethically as professionals. This is true even if acting ethically may have short term costs." He also argues that "by consistently framing ourselves and actions in accord with sound ethical principles, we can seize the high ground from the tobacco industry and provide a common language to communicate with the public and among ourselves."

The Campaign for Tobacco-Free Kids has, I think, failed to do this. Instead of seizing the high ground from the tobacco industry, it has seized the low ground right next to the industry. And that is not going to bode well for the reputation, credibility, and perceived character of the tobacco control movement.

Fox argues that acting ethically is not only important in its own right, but because it is necessary to preserve the perceived character and credibility of the tobacco control movement. Once the public's trust is lost, he argues, the movement is pretty much shot: "if the public health community cannot shape the moral argument and resonate with the public, there is a very real risk that consumers and policymakers, whether they are smokers, potential smokers, or ardent nonsmokers, will be less receptive to tobacco control efforts. Moreover, by the time we observe that the tobacco control community has lost the public'’s trust, perceptions will be so entrenched they will be difficult to change, so it is best that we proactively consider our ethical goals and how to best portray ourselves before observing dramatic problems."

The rest of the story reveals, I think, that it is too late. We are already observing dramatic problems, and none is so dramatic as the Campaign for Tobacco-Free Kids' campaign of deception.

IN MY VIEW: Campaign for Tobacco-Free Kids' Lying Has Got to Stop

In an action alert emailed today to its constituents, the Campaign for Tobacco-Free Kids insinuated that the tobacco companies are producing gummy worm electronic cigarettes. The title of the email is "Gummy worms," and the headline of the action alert states that "tobacco companies" are "luring kids with candy-flavored e-cigarettes and cigars."

As I've noted previously, this is simply not true. None of the tobacco companies is producing gummy worm-flavored electronic cigarettes.

While the Campaign for Tobacco-Free Kids has every right to fight for a ban on e-cigarette flavorings (a policy with which I vigorously disagree), it has no business lying to and deceiving its constituents in order to promote such a ban.

Telling the truth to its constituents would apparently not be glitzy enough for the Campaign. So instead, it has to lie by making the public think that Big Tobacco has sunk to the level of trying to get kids to use gummy worm-flavored nicotine products. This may be a catchy and eye-grabbing claim that succeeds in getting people riled up, opening up their pocket books, and eliciting donations, but it does so by misleading and deceiving them. That's fundamentally dishonest and unethical, and I don't believe a campaign like this has any place in public health.

Why is the truth not enough?

The Rest of the Story

Perhaps the reason that the truth is not enough is that the truth destroys the made-up story that the Campaign for Tobacco-Free Kids is trying to tell. Their story is that Big Tobacco is up to its old tricks, trying to seduce and addict kids to electronic cigarettes through outrageously blatant appeals to obvious youth-appealing flavors like gummy bear, gummy worm, and cotton candy. But unfortunately for the Campaign, that's not the truth. The truth is that the largest cigarette company in the United States - Altria - produces its MarkTen XL Bold e-cigarettes in only two flavors: tobacco and menthol. And their original MarkTen e-cigarettes come in only four flavors: tobacco, menthol, fusion, and winter mint.

If Altria were truly interested in getting kids addicted to e-cigarettes, I hardly think that it would restrict itself to tobacco, menthol, fusion, and winter mint, when there are thousands of sweet-tasting, candy, fruit, and dessert flavors available that they could be marketing.

The truth just destroys the Campaign's story. But apparently, the Campaign's motto is "never let the truth get in the way of a great story."

The real story is not a pretty one. The rest of the story is that the Campaign for Tobacco-Free Kids continues to incessantly deceive the public by falsely accusing tobacco companies of marketing gummy worm, gummy bear, and cotton candy electronic cigarettes to children.

Look - I have issued my fair share of accusations against the tobacco companies. I testified in about 10 cases against Big Tobacco, one of which resulted in a $145 billion verdict against the companies. But my testimony was always based on the facts. There were different ways to interpret those facts, but I would never lie or deceive the jury in order to try to make a point or embellish the case.

If we issue false accusations like this against the tobacco companies, then what reason is there for anyone to believe us when we complain about actions that they really have taken?

Perhaps this is why the actions of the Campaign for Tobacco-Free Kids are so disturbing to me. They tarnish the reputation of the entire tobacco control movement, including myself.