The Disconnect Between Science and Policy

Image Credit: Max Pixel. This image has been modified.

Back in 1912, when hardly anyone smoked cigarettes, lung cancer was like a museum curiosity: extremely rare. In the next few decades, however, it rose dramatically around the world, roughly fifteen-fold. But researchers had already nailed it way back then. By mid-century, the evidence linking lung cancer and tobacco was considered overwhelming. Says who? Says the tobacco industry’s own research scientists in an internal memo. We now know that “senior scientists and executives within the cigarette industry knew about the cancer risks of smoking at least as early as the 1940s.”

Publically, though, they said things like, “Sure there are statistics associating lung cancer and cigarettes. There are statistics associating lung cancer with divorce, and even with lack of sleep. But no scientist has produced clinical or biological proof that cigarettes cause the diseases they are accused of causing.”

What was the government saying? My video American Medical Association Complicity with Big Tobacco includes several real cigarette advertisements, including one in which a leading U.S. Senator advises readers to smoke Lucky Strikes. Who wouldn’t want to “give [their] throat a vacation,” as another ad proclaimed? Others assured “not one single case of throat irritation,” and how could your throat and nose be adversely affected when cigarettes “are just as pure as the water you drink”? What if you do feel irritation from smoking? No problem—your doctor can write you a prescription for cigarettes, according to an ad from the Journal of the American Medical Association. After all, “don’t smoke” is advice hard for patients to swallow, as we’re told in another ad.

This reminds me of the recent survey of doctors that found the number-one reason doctors don’t prescribe heart-healthy diets was their perception that patients fear being deprived of all the junk they’re eating. After all, Philip Morris reminded doctors in an ad that we want to keep our patients happy and to “make a radical change in habit…may do harm.”

The tobacco industry gave medical journals big bucks to run ads like the ones I’m sharing with you. Should we be concerned about a conflict of interest? Not if we listen to Philip Morris, who assured us their “claims come from completely reliable sources” based on studies conducted by “recognized authorities…whose findings have been published in leading medical journals.” They even kindly offered to send free packs of cigarettes to doctors so they can test them out themselves and invited physicians to “make the doctors’ [smoking] lounge your club” at the American Medical Association convention.

What did the AMA have to say for itself? Like most other medical journals, they accepted tobacco ads but asserted that “[p]ostmortem examinations do not reveal lesions in any number of cases that could be definitely traced to the smoking of cigarettes.” So, as far as the AMA was concerned, case closed.

In fact, even after the Surgeon General’s Report on Smoking and Health came out, the American Medical Association, American Cancer Society, and Congress continued to drag their feet. The government was still subsidizing tobacco, just as our tax dollars subsidize the sugar and meat industries today. The AMA actually went on record refusing to endorse the Surgeon General’s report. Could that have been because they had just been handed ten million dollars from the tobacco industry?

Today the money is coming from big food. The American Academy of Family Physicians has accepted large sums of money from Coca-Cola “to fund patient education on obesity prevention.” I wonder what that pamphlet will say.

Who was featured as a top partner on Coca Cola’s website? The American College of Cardiology.

Just as it would have been hazardous to your health to take the medical profession’s advice on your smoking habits in the 1950s, it may be hazardous to your health today to take the medical profession’s advice on your eating habits.


If the balance of scientific evidence favors plant-based eating, why isn’t the medical profession at the forefront of encouraging people to eat healthier? That’s the question this video tries to answer. Looking back to smoking in the 1950s, we can see how all of society, the government, and even the medical profession itself could be in favor of habits that decades of science had already overwhelmingly condemned as harmful.

For more on the influence industry can have on food policy, see:

In health,
Michael Greger, M.D.

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