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No ifs, ands, or butts, Canada showed how to beat the tobacco lobby. American antismoking groups, take note.

NO IFS, ANDS, OR BUTTS

On the morning of January 25, 1988, an extraordinary advertisement filled page three of Canada's most influential newspaper, The Globe and Mail. The ad featured two friends who weren't anxious to have their friendship advertised: Brian Mulroney, the prime minister, and William H. Neville, the newly appointed president of the Canadian Tobacco Manufacturers' Council.

The headline was big and black: HOW MANY THOUSANDS OF CANADIANS WILL DIE FROM TOBACCO INDUSTRY PRODUCTS MAY BE IN THE HANDS OF THESE TWO MEN. Below the headline were photos of Mulroney and Neville, the best-connected lobbyist in Ottawa. Neville had been in charge of setting up Mulroney's office when he became prime minister. He'd also been a major strategist for Mulroney's Conservative party and chief of staff for a former Conservative prime minister.

The ad ran only hours before a House of Commons committee dominated by Mulroney's Conservatives, would begin to mark up a bill that would revolutionize Canada's system for warning about tobacco hazards, while setting stunning global precedents (see "It's the Law," p. 35, for the key provisions). For example, the Tobacco Products Control Act would outlaw cigarette advertising and promotion in new newspapers and magazines, starting on January 1, 1989.

The industry had reason to be concernred. If parliament--first Commons, then the Senate--were to enact the Tobacco Products Control Act and the complementary Non-smokers' Rights Act, which would impose severe new restrictions on smoking. Canada would become the world's pacesetter for antitobacco laws.

Enactment would "propel companion U.S. legislation forward," former U.S. Federal Trade Commission Chairman Michael Pertschuk testified in Canada's Parliament. Tobacco lobbyist Neville agreed. "There is no question that the health lobby is international, well coordinated and networked, and therefore, if [the legislation] passes, it is going to be encouragement for similar forces in other jurisdictions," he said. In short, if Canada can virtually ban cigarette and advertising, so can we. But the Canadian experience shows that to do so, American anti-smoking groups must shift their interests and sharpen their tactics.

The Mulroney ad had been created in 36 hours by C. Garfield Mahood, executive director of the Non-smokers' Rights Association (NSRA), and was known as his "master stroke." The NSRA and the Canadian Cancer Society (CCS), which had become the NSRA's closest ally, published it two days after Mahood finished it. It was the perfect moment. The ad devastated Neville's influence by personalizing the tobacco lobby and making whatever success it might have politically damaging to Mulroney. It "made that lobbyist so famous [that] the government could not be seen giving in to him," says Ottawa lawyer David H. Hill, past national vice-president of the CCS. In all but destroying Neville's credibility, the ad also all but destroyed the industry's hopes. The committee approved the draft of the Tobacco Products Control Act the same day. Six months later Parliament passed both bills.

You probably haven't heard the Canadian story, because the U.S. press missed it. The Mulroney-Neville ad was just one of dozens of aggressive, creative strikes in Canada against the immensely rich and powerful tobacco industry. For all their impact in Canada, their most important consequence is the strong message they send to Americans, particularly at a time when the industry is increasingly on the defensive here: voluntary health associations can become the David that fells the tobacco Goliath.

Thy RODDS and thy staff

The key to the success of the Canadian antismoking campaign was the recognition of the hopelessness of the traditional strategies, such as trying to fight the plague of tobacco-induced diseases with sweet reason, gentle persuasion, and endless fund-arusing for biological research.

Instead, the Canadian antitobacco forces played adroit, tenacious hardball: using advertising and public relations to win the support of the man in the street and lobbying to make allies of the movers and shakers--government officials, legislators, publishers, and popular artists. "Generally, every single strategic move that was made by the tobacco industry was countered in similar terms by the health lobby," says Globe and Mail Parliament reporter Graham Fraser. "There were times it was almost unnerving, the sheer intensity of the lobbying."

Exquisite timing was decesive in another NSRA ambush. It began when Mahood asked McCarthy & McCarthy, probably Canada's most prestigious law firm, to answer two questions, assuming that cigarettes are lethal and addictive: Does Canadian tort or common law impose on tobacco companies and executives the duty to warn of hazards that are or should be known to them? And if such a duty is imposed, could they be held criminally negligent for failing to honor it?

The firm's David Doherty, former Crown counsel for the Province of Ontario, delivered the opinion in April 1987, and it was a time bomb: charges of criminal negligence could indeed be filed against the tobacco executives. Again Mahood waited for the perfect moment to detonate it in The globe and Mail, this time in the news columns. The moment came nine months later--the day in January 1988 when tobacco executives were making their case against the Tobacco Products Control Act before the House of Commons committee.

Meanwhile, when the industry fathered "smokers" rights" groups, antitobacco forces fathered RODDS (Relatives of Dead and Dying Smokers). The goal was, in Mahood's words, "to attach an air of criminality to tobacco industry executives and their dishonest, callous marketing practices." News stories blossomed with headlines such as JAIL TOBACCO BOSSES, GROUP SAYS.

"Both sides were waging a war for public opinion, and the NSRA, which pioneered in this area, taught the rest of the health lobby an important lesson about using the media," CCS CEO Douglas Barr said in narrating "Lobbying for Lives," a compelling TV documentary. The lesson: "Politicians are sure to hear you when you take your case to the public."

Such vigorous lobbying helped Canada pass the largest sales tax increase in its history. The new levy took effect April 1, 1989. It raised the federal tax on a pack of cigarettes by 40 cents to $1.10--seven times the U.S. levy--which put the price of a pack at more than $4. A Gallup poll done for the CCS indicated that 77.5 percent of Canadians supported the increase as part of a comprehensive approach to tobacco control.

The double whammy of tough new laws and high tobacco taxes led to a startling decline in Canadian smoking rates, which already had been falling faster than in the United States or any other industrialized country. In 1989 alone, says David T. Sweanor, the NSRA's staff legal counsel, the decline in Canada among those age 15 and older was 7.9 percent, compared with about 3 percent in the United States. Sweanor put the total decline from 1983 to 1989 at 29.3 percent--a world record and enough to have saved the lives to more than 100,000 Canadians. A later study showed that in the first quarter of this year cigarette consumption fell another 10.2 percent below the same period last year.

Even larger declines in Canadian cigarette use seem predestined as additional deterrents to smoking are phased in under the Tobacco Products Control Act. For example, a new warning on the pack will say, "Smoking Is Addictive." That bold statement of fact will be a world first; the industry has defeated efforts to require addiction warnings in every other country where they've been sought, including the United States.

Breathing lessons

"The bottom line is that we outmuscled them," the CCS's David Hill said. "Do it right and everyone becomes our ally." A good example is the way Jake Epp, then Mulroney's minister of national health and welfare, became an indispensable ally of the antitobacco forces. In 1985 Mahood and Epp sat across the table from each other in Epp's office. Mahood told him that of the 25 million Canadians then alive, about 7 million were smokers; of the smokers, about 2 million would die prematurely--2 million families torn apart because of tobacco products.

Mahood went on to tell Epp, the son of a minister, that he knew him to be a decent man, and, "with death rates of this magnitude, we believe that you have an ethical responsibility to do whatever is necessary to bring an end to this carnage. If taking a stand risks losing your psotiion in the cabinet or your seat in Parliament, we appeal to you to do so. No cabinet position or alleginace to any political party is important enough to deter you from confronting this industry."

Mahood said that Epp looked him in the eye and said only, "My record will be my response." The record he proceeded to make established him, in David Hill's words, as "our best lobbyist." It was thanks to Epp that the government of Brian Mulroney, friend of William Neville, became the sponsor of the Tobacco Products Control Act.

Blame the victimizer

Rosalee Berlin, a nursing instructor who had banned smoking in her home in 1971, formed the NSRA in Toronto in 1974. today it has about 6,000 members. Mahood, 49, who in the 1960s redirected his career from encyclopedia sales to public issues, became her consultant and, in 1975, executive director. He and lawyer David Seanor lead a staff of six. They operate on a financial shoestring: 1989 revenues were about $500,000.

Unlike the private health organizations which in Mahood's words "seemed more interested in fund-raising and protecting monies raised for biological research," the NSRA focused from the very start on the tobacco industry as "the source of the epidemic and on its deception and diminishing credibility." "The voluntary health associations were nowhere to be seen for years, except for their blame-the-victim smoking-cessation campaigns," says Mahood. "The tobacco industry loves that because they can bring people into the market faster than the health agencies can get them to quit."

Canada has its "Weedless Wednesdays" and "Cold Turkey Days." The United States has "The Great American Smokeout." Publicizing this annual event in the winter 1989 issue of its magazine, World Smoking & Health, the American Cancer Society carried two full-page ads with these headlines: IF YOU SMOKE 4,000 HOURS A YEAR, STOPPING FOR 24 WON'T KILL YOU and IF YOU SMOKE 10,000 CIGARETTES A YEAR, GIVING UP 20 WON'T KILL YOU. Of course, the people who quit for one day out of 365 will not do much good for themselves or much harm to the industry.

As Mahood puts it, the NSRA began to set itself apart from the health community by deciding "to go after a ban on all advertising of tobacco before a lot of health agencies would even accept that bans lead to a drop in consumption. The first major breakthrough was in 1979, when we got the Toronto Transit Commission to reject tobacco advertising," Mahood told me. "We did it almost alone. It was a classic campaign."

National breakthroughs began in the 1980s. "We were working with a group of physicians who traveled with and looked after Canadian Ski Association teams when we learned that Export 'A', a Canadian cigarette brand, ws going to sponsor the CSA's team in the national championships," Mahood recalls. RJR-Macdonald, makers of Export 'A' cigarettes, had offered the CSA a $1.7 million deal.

Unable to persuade the CSA to reject the deal, the doctors took the issue public, knowing they could become pariahs, at least in the eyes of CSA leaders. But, Mahood reccals, "they said that our priority in ethics is to the public. That's when we came in with full-page advocacy ads and press conferences to have Export 'A' dumped as a sponsor." The compelling, powerful headline on a November 1983 ad was a forerunner of many others to come: SHOULD THE CANADIAN SKI ASSOCIATION GET IN BED WITH THE TOBACCO INDUSTRY? 28,700 DEATHS ANNUALLY IS NOT A SPORTS STORY!

The campaign lasted a year and a hall and enlisted health agencies, including the Canadian Medical Association. Despite this, the CSA in the end narrowly voted to retain the cigarette sponsorship. "However," Mahood says, "the dispute forced the issue onto the federal agenda, resulting in adoption of a policy by the health minister and the minister of Fitness and Amateur Sport: for every dollar national sports bodies get from the tobacco industry, the government decided, it will deduct an equal amount from their federal funding. This started to accelerate debate on the role of tobacco sponsorship of sports."

While the NSRA had been Mr. Hardball from the start, the CCS originally had been Mr. Goodworks. Beginning in 1985, however, former vice president David Hill, the CCS's senior volunteer, began pressing the society to become the first voluntary public health agency in Canada to hire a political lobbyist. The society did so in 1986, when Hill began a three-year term as chairman of the public issues committee.

Canadian health professionals, Hill says, "are too much trained to look at biological causes of illness, too comfortable receiving praise for medical and research achievement rather than being attacked by angry opponentson on controversial issues. "This was the existing medical model, and Hill says it was one that "the CCS felt it could not rely on." Nor, he said, could the CCS depend only "on its existing volunteer base of people steeped in fund-raising, service to patients, or traditional public service. We needed a new type of . . . volunteer advocates who has expertise or who could be trained to be soldiers in our lobbying war. . . . Once you have the resources, the allies, and the soldiers, then you can get down to waging war seriously, using imagination and courage."

In 1988, the CCS and the NSRA jointly set up a "war room" to work for passage of the Tobacco Products Act and the Non-smokers' Rights Act. Only three blocks from Parliament in Ottawa, the war room did much to galvanize a coalition of dozens of health agencies. For more than a year, the coalition, led by the NSRA and CCS, waged the most intense, controversial public health battle in Canadian history, tracking the position of all MPs, blitzing them with phone calls while they were home on recess, and enlisting physicians to collect petitions.

In Washington, the Coalition on Smoking OR Health is perhaps the equivalent of that war room. But just barely: its resources are meager. To operate on the same scale as the war room does in Canada, the coalition would need a staff of 100. Instead, it has a part-time executive director and only one full-time lobbyist. Its annual budget of about $150,000--less than one-third of the NSRA's alone--is financed in equal shares by the organizations that formed it in 1982: the American Health Association, the American Lung Association, and the American Cancer Society (ACS). By contrast, the ACS spends about $90 million a year on cancer research.

"Why spend millions on microbiologists, and not on lawyers, if the lawyers will be more effective in fighting the tobacco epidemic?" asks CCS lobbyist Kenneth Kyle. When the CCS allotted $200,000 to hire lawyers to intervene on the side of the Canadian government in defending against still-pending industry court challenges to the constitutionality of the Tobacco Products Act, the CCS knew the eventual cost could be as much as $1 million. Yet, Kyle says, CCS members strongly supported the intervention. In a poll, 60 percent said they would contribute money for it, and 28 percent said they would contribute more than usual to help pay the legal costs. David Hill says Canadians now view the CCS "as a leading public advocate." That's why the 1989 CCS fund-raising drive brought in more money than ever before.

Paper tigers

"When leading newspapers started to reject cigarette ads voluntarily," Mahood says, "the issue had been decided ethically in the community." But it took years of effort by the NSRA to achieve this critical breakthrough. "We knew we weren't going to get editorial support for a legislated advertising ban as long as the conflict of interest existed for newspapers taking tobacco industry revenues."

The NSRA gathered executive evidence that tobacco ads breached the Canadian Code of Advertising Standards prohibition of ads that "depict situations which might encourage . . . unsafe, or dangerous practices." Then, as in their other campaigns, the NSRA, the CCS, and their allies held a news conference and published attention-getting full-page advocacy ads. The headline on one was: NEWSPAPERS AND THE ADVERTISING CODE: CASH OR CONSCIENCE. The text began, "Here is one story that some Canadian publishers would rather not discuss. . . ."

The campaign was difficult, prolonged, sensitive, and, like the others, complicated by the need to do almost everything in both English and French. Moreover, some publishers said they resisted not simply because they feared the loss of tobacco ads--a tiny proportion of newspapers' total ad revenues--but because thee balked at denying access to a legal product, even though tobacco is the only legal product that kills when it is used exactly as intended. U.S. publishers solemnly make the same argument, although many routinely decline ads for a wide array of legal items, including X-rated movies, "Happy Hours," and Planned Parenthood services.

During an extensive dialogue with the huge Southam publishing chain, the NSRA put together for the coalition a detailed brief addressing issues of concern to chain executives, such as the tension between addiction and "freedom of choice," whether smoking was causing an "epidemic" of deaths, whether the vast majority of smokers were truly aware of the health risks, and whether the industry was a net drain on the economy.

By the winter of 1987-88, five major Ontarion dailies--accounting for 45 percent of weekday circulation in the province, and for 20 percent of such circulation throughout Canada--had voluntarily decided to forgo tobacco ads. Eventually joining these papers were The London Free Press, widely read in tobacco-growing country, and Montreal's Gazatte, Eastern Canada's largest daily. In stark contrast, cigarette ads are rejected by only 11 American papers, mostly small U.S. dailies, representing a trifling 0.6 percent of weekday circulation.

Later, trying to defeat the Tobacco Products Control bill, the tobacco companies launched multimillion-dollar, multipronged, and ethically questionable campaigns. In one, they portrayed themselves as defenders of freedom of speech and asserted that the bill would deny that freedom. The companies also alleged that ad bans in Norway and other countries had failed. But the chairman of the Norwegian Council on Smoking and Health, whom the CCS brought to Ottawa, produced the evidence that the ban had indeed worked.

In addition, the companies generated a massive campaign to enlist small shopkeepers and others who sell tobacco products to write protests to every member of Parliament. As a result, MPs were deluged, confused, and misled by ostensibly spontaneous letters costing about $25 each. The letters--some with deliberate typographical errors to create an aura of authenticity, "were written and printed by a PR firm hired by the industry," Barr says. "Not only did they make sure they got to the shopkeepers by expensive courier, but they followed up with several phone calls just to make sure that those letters got to their MPs."

On December 1, 1987, after the industry had sent out 200,000 letters, a full-page ad blossomed in 22 newspapers across Canada. The headline: WILL TOBACCO INDUSTRY DECEPTION OUTMUSCLE PARLIAMENT? A box revealed the campaign's dark secrets, saying, for example: "Each letter is made to look different. Form, text, colour of paper, are all varied by using automated equipment." Once again, the timing was just right." We waited until the industry was well hooked and then turned on the lights," Mahood says. "We believe we . .. prevented the manufacturers from using 800,000 names remaining on their list, and almost destroyed industry credibility--that is, whatever was left."

David Hill recalls another memorable tactic. The CCS printetd hundreds of thousands of black-bordered postcards "in memory of the 35,000 Canadians who die annually from smoking-related illness." At the start of many meetings, the CCS and like-minded organizations set aside 10 minutues for each volunteer in attendance to send one of the cards or a letter urging MP and their party leaders to defy the tobacco lobby and pass the Tobacco Products Control Act. "There was a deluge of mail on Parliament," Hill said. "The professional letter-writing campaign of the tobacco industry was no match--we buried them."

Butt heads

Until two decades ago, Canadian cigarette makers advertised and promoted as they pleased. The abuses were so many that an all-party committee in the House of Commons recommended enactment of an outright ban on tobacco advertising. But in 1971 the Canadian Tobacco Manufacturers' Council, in an informal deal with the Liberal government, adopted a toothless code of self-regulation. In exchange, the government shelved the recommendation.

By January 1986, the NSRA had documented violations of more than half of the code's no-no's. For example, although the code prohibited ads within 200 meters of schools, NSRA researchers said a "small, random" sampling had found hundreds of cigarette billboards inside the prohibited zone. In further violation of the code's guidelines, tobacco promotions used models under 25, and the ban on tobacco advertising on television was circumvented by sponsorship of sports events.

The NSRA released a report on code violations at a news conference and summed it up in a two-page ad in Maclean's. The ad said that more than 300,000 Canadians had died from tobacco-related disease in the 15 years since the code was adopted, and that by the end of 1986, while "the federal government sits in legislative silence," 30,000 more would die.

However, Health Minister Epp continued to oppose an ad ban, assuming that a new voluntary code would suffice. To change his and the government's mind, the NSRA launched what Mahood called "the hardest-hitting nongovernmental attack on the tobacco industry ever."

The campaign demanded "equal treatment" of the tobacco industry with other industries. Thus one of the ads inquired why, if tobacco is addictive, it is exempted from the food and drugs law, and why, if it's hazardous, it is exempted from the hazardous products law. The headline on the other ad was: GANGRENE AND TOBACCO. Under it was a photo of a man on crutches; one leg had been amputated. The caption read: "Gangrene is just one of the results of the government's failure to regulate the tobacco industry."

"This forced tobacco onto the legislative agenda in Canada," Mahood says. Ultimately, Epp would tell the NSRA he was grateful for the almost relentless pressure. In an unusual letter to Mahood, he praised the organization for its "leadership role . . . in mobilizing public support so that the government could more seriously address the tobacco-related chronic disease epidemic."

Six months later, in April 1987, the government gave the industry something to worry about when, supported by a big majority in the House of Commons, including members of the opposition Liberal and New Democrat parties, it introduced the Tobacco Products Control Act. The industry then mounted an advertising, PR, and lobbying counteroffensive. As Douglas Barr said, it seemed to be "steamrollering over the health minister and the health community." Burson-Marsteller, a huge international public relations firm retained by the industry, recruited members of the arts community for a protest group called Coalition 51. (Yet it took three months to sign up 56 people, and by no means were all of them artists.)

Then the press was invited to an event in a Toronto hotel at which the recruits--some flown in for the occasion--denounced the Tobacco Products Control Act as potentially dangerous because, by ending the promotion of tobacco products, it would starve culture and sports. But Coalition 51 didn't reveal that it was supported entirely by Rothmans tobacco company. The sponsors had billed the event as a news conference but abandoned the format, almost at the last moment, on learning that Mahood, Sweanor, and Barr were poised to hold a counter news conference in the same hotel.

The NSRA--in one-third of the time it took the tobacco companies--enlisted more than four times as many artists, 250 in all, many of them quite prestigious, to come out against tobacco sponsorship of their activities. In October 1987, these artists endorsed a statement of conscience to Parliament that the NSRA published, along with their names, in a full-page ad in five newspapers. "[T]he arts community cannot allow itself to be used to block or subvert a bill designed to safeguard the health and lives of future generations," the statement said. "That is too high a price to pay."

In waging such counterattacks, the coalition learned a crucial lesson: Sometimes it is necessary to go head-to-head with your opponent. "Traditionally, health groups have been reluctant to mix it up in the political arena," Barr says, "but we quickly learned that in this fight, the Marquis of Queensbury rules didn't apply and that if we didn't get in close and play hardball the same way the industry was playing, in the end we would have nothing to show for it but our dignity, and there would be no legislation."

The counterpunching succeeded: the bill was given a second reading. The next hurdle was a Commons hearing in late 1987, where a group of pro-industry MPs, led by Ron Stewart, a Conservative, intended to gut the bill, which he derided as "this craziness." "I was not about to sit in my place and see an industry destroyed by a lot of do-gooders," he said.

The last gasp

Although many Canadians didn't know it, Stewart was not merely an MP, but also a tobacco wholesaler, and what David Hill called "an advocate ally for our enemy, the tobacco industry." In November 1987, in an action unprecedented for a federal campaign in Canada, Mahood wrote a flyer accusing Stewart of a conflict between his pocketbook and the lives of his constituents, and particularly of their children. Signing on with him were Hill, Victor Lachance, executive director of the Canadian Council on Smoking and Health, and Dr. Andrew Pipe, chairman of Physicians for a Smoke-Free Canada.

Then the NSRA and the CCS sent the flyer to all of Stewart's more than 30,000 constituent households. In addition, the NSRA and the CCS held a press conference in the heart of his district accusing him of acting against the health of his constituents for personal gain. "We threatened to do the same thing against any legislator opposing our legislation," says Hill. Stewart withdrew from the committee, and the bill came out of it as tough as when it went in.

The Tobacco Products Control Act passed easily in Commons. But the government still hoped to see the Non-smokers' Rights Bill defeated because it was sponsored by an opposition MP. To become law, both pieces of legislation still had to be passed by the Senate. There, the industry, in fighting the Tobacco Products Control Act, made a major issue of freedom of speech, much as it does in the United States, where Philip Morris presents itself as the Great Protector of the First Amendment.

The Canadian companies argued that a ban on cigarette ads would deny freedom of speech, even if the ads were to be directed at children under 13. This "may seem innocuous, but it is an inroad on the right to send, and the public's right to receive, any message, commercial or otherwise," an industry lawyer told a Senate committee hearing. "Otherwise, it would give carte blanche to the legislature. Children under 13 today, so why not 14, 15, or 16 tomorrow?"

But the health agencies, says Douglas Barr, "again applied a lesson that had been reinforced throughout the campaign--health groups succeeded by framing the issue in health terms." That's what David Hill did when he told the Senate committee: "There is little freedom in addition . . . in a cancer ward, or in the chronic care facilities of our hospitals. What we need . . . for us and our children is more freedom from advertising pressure and sales promotion [about] these deadly products."

On June 28, 1988, the Senate passed both bills by substantial majorities. Afterward, in assessing his defeat, Bill Neville grudgingly revealed what the Canadian antismoking lobby had done. "Clearly one of the . . . successes of the antitobacco lobby was to make this appear to be a health issue, and when that happens that is a diffucult area for the industry." In Barr's words, "Our organizations can . . . in the long run do more for the health of Canadians than all the hospitals put together." There's no reason why American antismoking forces can't do the same.

Morton Mintz is a retired Washington Post reporter. He began covering tobacco issues in 1965.
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Author:Mintz, Morton
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Date:Jul 1, 1990
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