Tilting at Tobacco

Saul Bromberger/Sandra Hoover

The jury filed into Courtroom No. 2 in the Duval County Courthouse last August 9 and calmly tossed a live grenade at the tobacco industry. The six Jacksonville, Fla., jurors ordered the nation's third-largest cigarette maker, Brown & Williamson, to pay $750,000 to a lung cancer victim and his wife. For the first time, a living ex-smoker had convinced a jury that a tobacco company should be held liable for selling a product it secretly knew caused disease. The door was suddenly wide open for Joe Smoker to sue the smile off Joe Camel's face.

On the other side of the continent, medical professor Stanton Glantz was sitting in his tiny 11th-floor office on the UC-San Francisco campus. It was a quiet day, good for watching the fog glide through the Golden Gate, ideal for plowing through the foot-high stack of unanswered mail piled on one corner of his desk. The phone interrupted him. It was a reporter calling to get his reaction to the landmark verdict in Florida.

"I was stunned, sure," says Glantz, PhD '73, a hint of pride creeping into his gravelly Midwestern voice. But even though the devoted anti-tobacco crusader had helped set the stage for the verdict, he doesn't remember pumping his fist in the air or allowing himself a satisfied grin. He just uttered the obligatory quotes, said goodbye to the reporter--he doesn't even recall who it was--and went back to work. "It was strange," he says. "It was almost routine."

Routine, indeed. For the man who's been called the Ralph Nader of the anti-tobacco movement, these are the best of times. Consider the news of the last few months alone: The Clinton Administration has imposed unprecedented new regulations on the industry, 15 states are now suing cigarette makers seeking money for smokers' medical bills, and ailing ex-smokers are lining up for a litigation lynching. The tobacco issue even found its way into the early stages of the presidential race, tripping up GOP nominee Bob Dole.

And where there's smoke, there's Glantz. For nearly two decades, the intense, combative researcher has assaulted the $45 billion industry using the preferred weapon of a savvy academic: intellectual bombs thrown from the ivory tower. He's a restless scholar who is the author or co-author of eight books and 96 scholarly articles and a source for journalists from People to 60 Minutes . His in-your-face tactics helped change the terms of the tobacco debate by recasting smoking as a social and political issue, not just a medical problem.

Glantz has done as much as anyone to put smoking on the public agenda. His landmark work on the dangers of secondhand smoke launched smoking bans in public places from restaurants to airplanes. Dubbed a "pain in the butt," he was one of Newsweek's 100 newsmakers of 1995. In a recent book, Smokescreen , New York Times tobacco writer Philip Hilts calls him one of the Seven Samurai of the anti-tobacco movement. Glantz showed up on an ABC News special in July to analyze the industry's political clout and called tobacco executives "cockroaches." His office phone rarely stops ringing. Last summer, he went all the way to Australia for vacation just to get away from the hubbub.

"He has moved the marble for tobacco control," says John Seffrin, CEO of the American Cancer Society. "You can argue it would have happened eventually, but when you talk about a thousand deaths a day caused by tobacco, time is of the essence."

***

Proud of his iconoclasm and fabled abrasiveness, Glantz, 50, cultivates a certain eccentricity. The stocky, rumpled academic likes to wear a T-shirt that says, "Here Comes Trouble." He lives modestly in San Francisco's Sunset district and drives a '69 Dodge Dart, the only new car he's ever bought. He still turns up in the trademark orange vest his mother knitted for him. ("Although people now expect it, so I don't wear it as much.") And he takes almost as much pride in offending his friends--the California branch of the American Cancer Society, the California Medical Association--as his avowed enemies in the tobacco industry.

Is he a loose cannon? "Yeah," he says, taking a sip of warm tea as Mozart burbles on his office radio. "I like it that way."

Not surprisingly, the blunt professor has made his share of enemies. He is, of course, a favorite bobo doll for tobacco companies. They love to punch him; he loves to come bouncing back up. "He's apparently addicted to puff pieces, because there's been one in about every publication you can find," says Tom Lauria, a spokesman for the Tobacco Institute. He says Glantz's research has no validity because the professor has it out for the tobacco companies.

Thomas DiLorenzo, a conservative professor of economics at Loyola College in Baltimore, has slammed Glantz and others for taking government money for anti-tobacco research. "I'm a nonsmoker. I agree 100 percent that cigarettes are unhealthy," DiLorenzo says. "I just think it's illegal and unethical to use taxpayer money to organize a lobbying effort to prohibit cigarettes."

Glantz counters that his government-funded research is designed to improve public health--and that often means criticizing tobacco companies and the politicians they support.

"He just calmly tries to tell the documented truth," says Martin Perl, a Stanford physicist, Nobel laureate and Glantz fan. "He's not a zealot."

***

For those who knew Stan Glantz as a Stanford graduate student in the early 1970s, his career as a rabble-rousing academic makes perfect sense. By the time he finished his PhD in applied mechanics in 1973, the 27-year-old had learned how to stand in the hurricane of public debate that often follows politically charged social research.

Like many engineering and science students in 1971, Glantz worried about Pentagon-sponsored research on campus. "We had the anti-war radicals on the one hand saying that the faculty was out murdering babies in Vietnam," he recalls. "And, on the other hand, we had the faculty saying this is all basic research with no connection to anything, and the Defense Department just gives us all this money because of our incredible good looks and they love science because we won World War II for them."

Glantz led a group of students in an investigation of the two perceptions of Pentagon funding. Their project was sponsored by the newly formed Stanford Workshops on Political and Social Issues (SWOPSI), a series of free-form courses created by young faculty and graduate students.

The student investigators followed a simple plan. They compared the faculty's explanations of its Pentagon-sponsored research with official Defense Department rationales for funding the work. The inconsistencies suggested that the professors were more deeply involved in direct military research than many knew. "We just laid them side by side and said, 'Draw your own conclusions,' " Glantz recalls. "The faculty went completely berserk. The radicals went berserk, too, because we weren't saying that the faculty was all killing babies in Vietnam, it's more complicated than that."

Glantz reveled in the ruckus he'd created. "He struck me as an amazingly strong, unflappable character," says Norm Albers, who as a graduate student in physics became Glantz's partner in the project. "The way he could stand in the flak and argue in the face of people's anger--it was something that was hard for me to learn."

The report's disclosures made it onto the front page of the Washington Post. Pentagon officials loved the report because it showed their university-backed research had some military merit. Back at Stanford, the debate helped push the University toward limiting defense contracts.

"Most faculty researchers were genuinely surprised," about the disclosures, says Philip Zimbardo, then one of the young faculty heavily involved in anti-war protests. "You can either say we were naive or narrowly focused." Zimbardo, now a full professor of psychology at Stanford, decided not to renew his grant from the Office of Naval Research because of the report.

For Albers, as for Glantz, the SWOPSI course was a turning point. Albers remembers being called into the office of his Physics Department adviser, whose own work had come under scrutiny in the report. "He said, 'Albers, if I can get you thrown in jail, I will.' " Albers recalls. The professor didn't manage to bring charges against the young physicist, but Albers was shaken. "I realized at that moment that we were playing with the big boys, and this is how the big boys played: hardball." The experience helped convince Albers to quit physics. He moved to southern Oregon and started a new career as a piano builder and tuner.

For Glantz, on the other hand, this was just practice for taking on the really big boys.

"That SWOPSI course was one of the most valuable things I did at Stanford in terms of learning how to do research on complicated, highly charged issues," Glantz says. The course also gave him a litmus test for future research: Will it make a difference in society? "If I can't answer that in a reasonable way, then I don't do it."

***

In 1976, three years after getting his PhD, Glantz found himself plugging away a bit too quietly as one of the few non-M.D. medical research fellows at UCSF. He worked at figuring out the complicated biomechanics of the human heart--but wanted something that would speed up his own pulse. He decided to apply for a year's fellowship in Washington, D.C. The program, sponsored by the American Academy for the Advancement of Science, brought scientists to work on congressional staffs and committees.

Glantz made the final cut. Now he had to choose a topic and bang out a briefing paper in 24 hours. There was only one health-related subject on the list: a proposal by Sen. Ted Kennedy to tax cigarettes based on their nicotine content.

Donning his orange vest, Glantz flew to Washington with his briefing paper and passionately argued that the senator had a dumb idea. What you should really do, Glantz said, is attack the social acceptability of smoking, undermine the subtle web of support for smokers.

He didn't get the fellowship. "I was just crushed because, like a lot of people who go to Stanford and are overachievers, this was the first time I'd ever really tried for something and not made it." But Glantz had accomplished more than he realized: His briefing paper, expanded and refined over the next few years, became a blueprint for the modern anti-tobacco movement. This new paradigm saw smoking not as a medical problem but as a social scourge and fountain of political corruption. Tobacco companies weren't normal businesses, they were duplicitous peddlers of death. Secondhand smoke wasn't just smelly and annoying, it was an environmental toxin that killed more than 50,000 people a year.

Losing out on that Washington year was probably for the best, Glantz says now. "Being a highly opinionated, loud-mouthed person is not the psychological profile of the successful career staffer."

But those same qualities may have helped him attract his wife. The couple, who now have two children, met in the '70s at a conference. Marsha noticed Glantz because he was yelling at somebody for bad-mouthing Ralph Nader. She joined the argument--on Glantz's side.

***

By 1981, Glantz had become an expert on the effects of smoking on the unsuccessful California initiative campaigns aimed at limiting smoking in public. He'd helped found Californians for Nonsmokers' Rights, which a few years later became Americans for Nonsmokers' Rights.

And he was getting good at pitching the tobacco story to a media that had yet to see its significance. "There were many years that Stan was frustrated because he had very good material and he couldn't get anybody's attention," says Douglas Foster, the former editor of Mother Jones who headed Stanford's news service from 1994 until last September. "In the early '80s, this was not considered a story. Tobacco was a legal product, just part of the landscape. In a case like that, it takes somebody who is a big pain in the ass. That was Stan."

Glantz knocked on Foster's door with a story in 1982. Californians for Nonsmokers' Rights had received a plain brown envelope with no return address. Inside was a pirated videotape of "Death in the West," a 1976 British documentary that juxtaposed images of the Marlboro man with stories of real cowboys with lung cancer. The film, aired only once in England, had been effectively banned after legal pressure from Philip Morris, Marlboro's manufacturer.

Foster, then a staffer at the Center for Investigative Reporting in San Francisco, helped Glantz get the documentary aired on KRON, the NBC affiliate in San Francisco. Eventually it received worldwide exposure. It also spawned a smoking-prevention program aimed at kids. Since 1983, more than 750,000 children have completed the "Death in the West" curriculum.

In some ways, Glantz began operating like an investigative reporter himself: He looked for dramatic story lines, gathered documents obsessively and followed the money. In recent research, that m.o. led him to track the tobacco companies' political contributions and the connection between the number of smokers and the amount of money spent on cigarette advertising.

Given his emerging profile, it wasn't all that unusual that, on the morning of May 12, 1994, another mysterious package loaded with explosive tobacco material arrived at Glantz's office. The return address on the big FedEx box said simply, "Mr. Butts," an apparent reference to the Doonesbury comic-strip character who pushes cigarettes on kids. Glantz was on his way out the door to teach a biostatistics class, but his curiosity got the better of him, and he decided to have a look inside.

What he found was a treasure trove of sensitive documents from Brown & Williamson. There were memos showing that the maker of Kool, Pall Mall and Lucky Strike knew about the cancer-causing and addictive properties of cigarettes as far back as the early 1960s. There was evidence of a sophisticated disinformation campaign sponsored by the industry. There was even a 1983 letter from Sylvester Stallone in which the actor agreed to use B&W products in five action movies--in exchange for $500,000.

"It was stuff that everybody always sort of expected," Glantz says. "But to actually see it was just mind-boggling." Even to his jaded eyes, the documents still had the power to make blood boil. "It's like thinking your wife is messing around and then knowing your wife is messing around--but then coming home and catching her messing around."

Glantz went to class and then returned to his office with a couple of students to photocopy the whole 4,000 pages. He took one set home to index at the dining room table, put one set "in a safe place"--he still won't say where--and sent another off to Hilts, the Times reporter, who used them as the basis for a three-part series in June 1994.

Back in Glantz's office, the original papers were cluttering up the place; visitors were using the box as a footrest. He decided to place them in the newly formed tobacco archive at UCSF's library. Before long, dozens of journalists, plaintiffs' attorneys, government officials and researchers were signing up at the special collections desk to have a look at the rare papers.

Brown & Williamson, meanwhile, went on the offensive. The company sent a letter demanding return of its "stolen property" and insisting that public access to the documents be cut off immediately. Then the company's private investigators started hanging out in the library, taking note of anybody who used the collection. "They had leather jackets and cell phones and cameras," says Karen Butter, deputy director of the campus library. "They were kind of obvious."

When Brown & Williamson filed suit to force the return of the documents in February 1995, the stage was set for a First Amendment fight. Suddenly, the very freedom of a researcher and a university to disseminate information was on the line. "Basically, they were trying to keep books out of the library, and universities are here to spread information, not suppress it," Glantz says. He was summoned to a meeting at the university counsel's office, across Parnassus Avenue, which runs through the UCSF campus. "I was riding the elevator down and I was thinking, 'Time to walk the plank. They're going to toss me overboard.' "

It was a reasonable concern. This was just six months before ABC would make a humiliating on-air apology to settle a $10 million suit filed by Philip Morris over a Day One story claiming that the company spiked its cigarettes with extra nicotine. Three months after that, producers at 60 Minutes , fearing a lawsuit by Brown & Williamson, held off on airing a controversial interview with Jeffrey Wigand, the turncoat tobacco executive.

But saying they'd rather fight than quit, the UC administrators backed Glantz. The university lawyers argued that the documents were a legitimate subject of study and that they were already public records because they had been written about so extensively in the New York Times and elsewhere. In June 1995, the California Supreme Court ruled in the university's favor. To spare strain on the library, the university published them on the Internet and sold copies on CD-ROM.

In Jacksonville, Fla., the lawyers for Grady Carter, a 44-year smoker who was suing B&W, knew what to do with such hot stuff. They introduced some of the most compelling documents as evidence, arguing that the papers proved the company knew its cigarettes were addictive and deadly years before the surgeon general warned the public in 1964. Carter won his case, clearing the way for an avalanche of similar lawsuits. "It wasn't until we got Stan Glantz's book and his CD-ROM that we were able to put together the evidence we needed," says Greg Maxwell, one of Carter's attorneys.

Meanwhile, Glantz and four colleagues were themselves poring over the documents. They cross-matched them with other records subpoenaed by various congressional committees and put the whole lot in the context of a 30-year effort by cigarette makers to stay ahead of regulators, health advocates and anti-tobacco groups. The resulting book, former Surgeon General C. Everett Koop wrote in a foreword, "is a vital weapon in the battle against tobacco. I don't think that anyone who reads it can remain passive in the struggle."

After shopping the manuscript to 30 litigation-wary commercial publishers, the authors finally found a home with the University of California Press. The Cigarette Papers came out last May.

Glantz wasn't surprised that publishers shied away from the manuscript. But his literary agent, Jane Dystel, "was completely shocked at how badly it went," Glantz says. "I thought she would have a hard time. But the level of cowardice out there was just truly amazing."

***

Glantz's work has made waves in political as well as legal circles. In July 1995, he and his colleagues scored an unprecedented triumph when their analysis of the Brown & Williamson papers filled almost an entire edition of the prestigious Journal of the American Medical Association . After President Clinton read the issue, he decided to push new restrictions on teen smoking. ("It's hard to argue with this," he told senior aides.)

The research presented in the jumbo JAMA issue, which was partially funded by a $600,000 National Cancer Institute grant, also caught the eye of Rep. John Porter (R-Ill.), a tobacco industry defender. At his behest, Glantz's NCI funding became the first National Institutes of Health grant ever targeted for cutoff by a congressional committee. Most of the funding was restored after vociferous lobbying by the American Cancer Society.

Closer to home, Glantz made an antagonist of Willie Brown, the former all-powerful speaker of the California Assembly and now mayor of San Francisco. In a May 1995 study of the political influence of tobacco money, Glantz and a colleague showed that since 1980, Brown had received in excess of $659,000--more than any other single legislator in the nation.

But even before that, Brown (who has since become a born-again tobacco foe) was no fan of the professor. In the fall of 1993, Brown was meeting with three UC administrators to discuss state funding for the system. The assembly speaker took the opportunity to pitilessly dress down the administrators on the subject of Glantz's research on the tobacco industry. "You're going to have trouble with me on every single appropriation!" Brown thundered, according to an account that appeared in the February 1994 issue of the Atlantic . "If that guy gets one more cent of state money, you'll have trouble with me."

Glantz is prone to such scrapes. "The people who pay attention to the facts about tobacco end up being partisan--because the facts are so clearly one-sided," Hilts says. "That's a difficult position for a professional like him to get into, to be constantly attacked by the tobacco companies. He's one of the few who has a hide thick enough that he can handle it."

***

Glantz has few illusions about the future of the tobacco wars he is helping lead. No single blow--lawsuit, regulation or embarrassing disclosure--can knock the cigarette makers out. It is a war of attrition, and Glantz, safely ensconced in his tenured professorship, isn't going anywhere. "They know they're losing," he says, leaning back in his office chair until his feet dangle. For Glantz, their defeat can't come soon enough.