Big Tobacco Keeps Thumb on Makers of Stop-Smoking Aids

Cigarette makers and the drug firms that market nicotine gum and patches would seem to be natural enemies, at war in a multibillion-dollar market of people hooked on nicotine.

Yet a peaceful coexistence has reigned between them since nicotine replacement products were introduced in the 1980s to help smokers kick the habit.

The quit-smoking aids are widely advertised, and in recent years have joined such remedies as Advil, Tums and Robitussin on a list of the country’s top-selling over-the-counter medicines. Yet they are promoted in a manner certain to minimize conflict with cigarette manufacturers.

Veterans of the smoking wars think they know why.

For at least a decade, Philip Morris sought to intimidate drug firms marketing the stop-smoking products, using the threat of economic reprisals to make them tone down their ads and refrain from supporting the anti-smoking cause, according to once-secret documents from the world’s biggest cigarette maker. Philip Morris officials declined interview requests.

R.J. Reynolds, the second biggest U.S. tobacco company, also was engaged in some of the efforts, documents and interviews show.

Pressure tactics were exerted against at least two major drug firms between 1982 and 1992, although they may have continued beyond that date. A nonconfrontational marketing approach for the nicotine products remains in use today.

Moreover, within the last three years, a major worldwide supplier of cigarette filters to the tobacco industry has become a power in the gum and patch business, thus playing in both arenas of the nicotine market.

Drug firms say their ads are not intended to appease the tobacco industry, but rather aim for the best approach to boosting sales. Even so, their marketing message is the same one that cigarette makers sought to dictate in the past by threatening to cancel supply contracts with the drug firms’ corporate parents, internal memos show.

Rather than attack cigarettes directly or implore all smokers to quit, their ads target the narrow band of smokers who are currently trying to quit--offering a product that can help ease their nicotine cravings.

As ads for top-selling Nicorette gum put it, “You can do it. Nicorette can help.” It’s a catchy slogan, but also consistent with guidelines tobacco executives sought to impose when the gum was introduced. For example, a 1985 Philip Morris memo cited the tobacco firm’s “understanding” with the marketer of Nicorette that it would avoid “emotional . . . pleas to stop smoking” and advertise “strictly on the basis of ‘if you want or need to quit, we have the product.’ ”

Companies Muffle Anti-Smoking Message

The involvement of drug firms in anti-smoking politics has been limited as well. Since gaining federal approval in 1996 for over-the-counter sales, patch and gum marketers have financially supported the American Cancer Society and American Lung Assn. in exchange for using their logos in ads. But to the disappointment of tobacco foes, they have chosen not to involve themselves directly in political fights--such as by lobbying for higher tobacco taxes that would help their business by making quitting more attractive.

Considering the history of tobacco industry pressure, “I think there’s no question that there’s still a residual influence,” said Gregory N. Connolly, director of tobacco control for Massachusetts.

Drug firms seem determined “not to get into a public war” with cigarette makers, when “what the public needs is a war between the tobacco industry and the drug industry,” Connolly said.

“There are a lot of people who hoped that when they [drug companies] got into the ‘quit’ market, they would be more aggressively involved in a lot of activities to reduce tobacco use,” said Matt Myers, general counsel for the National Center for Tobacco-Free Kids.

Some observers have even suggested there is a symbiotic relationship between drug and tobacco firms as millions of would-be quitters cycle between buying cigarettes and gum or patches in a long-term struggle against nicotine addiction.

For their part, drug companies say their targeting of committed quitters--rather than the universe of smokers--reflects the reality that quitting is extremely difficult. Targeting those who are ambivalent about quitting--and thus almost certain to fail--can only breed a sense of defeat and a poor image for the products.

“There’s nothing more important in making a quit attempt than being committed to it,” said George Quesnelle, vice president and director of medical marketing and sales for SmithKline Beecham Consumer Health Care, the top marketer of patches and gum. “If people quit smoking using our products, that creates great word of mouth . . . but there’s nothing that can kill a product faster than bad word of mouth.”

Tobacco companies have not influenced the marketing “in any way, shape or form,” Quesnelle said.

Boasting that over the years more than 1 million smokers have quit with their help, drug firms say they must be doing something right.

Hand-in-Glove Tobacco, Drug Firms

Patches and gum, meant to ease cravings while users try to wean themselves from smoking, are not cheap. Buying and using the products for 10 to 12 weeks, as recommended, costs up to $300--about the same as smoking a pack and a half per day for the same amount of time. But smokers who succeed in quitting can save thousands of dollars over time.

Since the Food and Drug Administration approved nonprescription sales, the over-the-counter sales have increased sharply to about $700 million per year. Another $100 million to $200 million is spent on prescription-only nicotine products--patches, inhalers and nasal sprays. Non-nicotine products also are prescribed for smoking cessation, including Glaxo Wellcome’s Zyban anti-depression drug.

With its 90% share of over-the-counter sales, SmithKline has a huge lead on its only rival in that market, Johnson & Johnson’s McNeil Consumer Healthcare.

Both SmithKline’s Nicorette gum and Nicoderm patches rank among the country’s top 10 over-the-counter medicines, with an estimated advertising budget of $120 million in 1997, according to Competitive Media Reporting, a New York ad tracking service. In annual sales, the firm’s nicotine business appears to have surpassed that of Liggett Group, Inc., the country’s fifth largest cigarette maker.

SmithKline has its own generally unknown link to the tobacco industry. While the patch and gum business bears the SmithKline name, it is actually a joint venture between the pharmaceutical firm and Hoechst Marion Roussel, a subsidiary of German giant Hoechst A.G.

Manufacturer of Filter Material

Another Hoechst subsidiary, Celanese, is the world’s largest producer of the cellulose acetate used to make cigarette filters--a business worth hundreds of millions of dollars in annual sales. Officials of SmithKline and Hoechst Marion Roussel say the tobacco connection has not compromised their marketing of nicotine patches and gum.

If so, the lack of interference would be a notable exception. Documents disclosed in anti-tobacco lawsuits show that cigarette makers exerted significant pressure on gum and patch marketers from at least the early 1980s to the early 1990s.

When Nicorette was made available by prescription in the early 1980s in Europe, Canada and later the U.S., Philip Morris sought to keep the original marketer of the nicotine gum, Merrell Dow Pharmaceuticals, on a tight leash. (SmithKline got involved in the business later in a joint venture with the Dow subsidiary. Eventually, Dow sold the unit to Hoechst.)

The pressure point: a long-standing, multimillion-dollar customer relationship between cigarette makers, including Philip Morris, and Merrell Dow’s corporate parent, Dow Chemical, which sold tobacco companies the chemical humectants they use to keep tobacco moist.

A July 21, 1982, memo revealed Philip Morris’ ire when Merrell Dow began publishing a smoking cessation newsletter as part of its Nicorette launch. According to the memo, tobacco executives told Dow the problem was not Nicorette per se, but publication of “anti-smoking propaganda, particularly literature which has little or no scientific basis.” Subsequent memos show the newsletter was killed after that first issue.

When Merrell Dow’s 1984 U.S. launch of Nicorette again offended Philip Morris, the tobacco maker retaliated by canceling chemical purchases from Dow. The move was retribution for the “offensive” Nicorette campaign, Philip Morris executives told Dow, according to a May 7, 1984, memo.

Literature for Doctors’ Offices

Among their grievances: Merrell Dow had prepared literature for doctors’ offices urging smokers to quit; supported a study concluding that smokers incur higher medical costs than nonsmokers; and encouraged workers to quit smoking at the very Dow plant that made chemicals for Philip Morris.

“We had been assured that Nicorette would have a low-key introduction and would be aimed only at those smokers who had to stop for medical reasons,” the memo said. “Dow continually insisted that they were not taking an anti-cigarette industry position.”

But “the recent spate of activity can only be interpreted as a conscious corporate decision that Nicorette is more important than the Philip Morris [and other tobacco] business,” the memo said. Dow “cannot realistically expect a customer to spend millions of dollars for materials when the profits from those sales . . . are used to attack that customer’s product.”

Dow sought to make amends, and was rewarded a few months later when Philip Morris resumed a portion of the chemical purchases, said an Oct. 25, 1984, memo.

Dow assured Philip Morris it was “committed to avoid contribution to the anti-cigarette effort,” the memo said. And in an extraordinary gesture of appeasement, Merrell Dow president David Sharrock informed tobacco executives that he personally had begun “screening advertising and promotional materials to eliminate any inflammatory anti-industry statements.”

At a briefing for senior tobacco executives--including William J. Campbell, then executive vice president and later president of Philip Morris USA--Sharrock gave examples of “anti-smoking themes” proposed by an ad agency but vetoed by the Merrell Dow president.

Philip Morris was angered again a couple of months later following what a company memo described as “an extremely alarming development.” Merrell Dow had donated $25,000 to the National Interagency Council on Smoking and Health--a group the memo said was intent on “the demise of our industry.”

In response, Dow officials pledged that Merrell Dow’s support for the council would cease. And Dow performed an internal review “to assure that the company had no anti-cigarette industry programs or policies at a corporate level,” a memo said.

According to the memo, Dow also agreed that Nicorette ads would stick to the theme: “If you want to quit smoking, we have a product.”

Memo Took Stock of Company Efforts

Several months later, a September 1985 memo took stock of Philip Morris’ “ongoing efforts to ‘tone down’ ” ads for Nicorette. It said “some progress” had been made and that continuing as a Dow customer should have “an ameliorating influence on Nicorette promotions.”

Philip Morris used a similar strategy several years later when Swiss chemical giant Ciba-Geigy began marketing Nicorette under license in Europe, according to internal Philip Morris memos.

A memo in January 1988 urged retaliation against Ciba. A boycott or “even a Philip Morris-funded negative publicity campaign . . . would send a strong message to a few other multinational corporations who could be investigating possible opportunities in the growing ‘anti-tobacco’ industry,” the memo said.

It’s uncertain if the recommendation was followed. But four years later Philip Morris and R.J. Reynolds did put pressure on Ciba when it launched its Habitrol nicotine patch in the U.S.

Ciba was a big supplier of agricultural chemicals, including products used by tobacco farmers. Accordingly, the two cigarette makers and a North Carolina growers group implored Ciba’s agricultural chemicals division to intercede with its pharmaceutical branch. The goal: to assure “more appropriate advertising for this product in the future,” the memo said.

The mission was accomplished. Skip Raglund, formerly of Ciba and now vice president for communications with Novartis Corp., said Ciba’s pharmaceutical executives agreed to restrict their advertising appeals to “people who were committed to quitting. . . . It would not be a, quote, anti-smoking campaign,” Raglund said.

For all the fears of tobacco companies, research suggests that a relatively small proportion of smokers who use gum and patches actually quit on any one attempt. The products double the odds of quitting, but even then the quit rate remains low.

According to some studies, on any single attempt people who try quitting cold turkey succeed about 3% of the time, whereas success with gum or patches rises to 7% or 8%--even higher when the products are combined with counseling. As marketers acknowledge, successful quitters usually need to make several attempts.

The result is thousands of smokers cycling between competing forms of nicotine, “turning to a patch, gum or pill for a month” as a result of a New Year’s resolution, “then relapsing to a cigarette product,” said Connolly of the Massachusetts tobacco control program.

“You get this sort of strange, symbiotic relationship between the tobacco industry and the drug companies where everybody makes money.”