Challenging Tobacco Industry in Latin America

In 1994, when 4,000 pages of secret internal tobacco industry documents turned up mysteriously at the office of Stanton Glantz, PhD, a UCSF professor of medicine, a new era of tobacco litigation began. The tobacco industry, which had been universally successful in quashing all lawsuits against it, suddenly found itself in trouble. No longer able to deny knowledge of the addictive nature and harmful effects of cigarette smoking, the industry began losing billions of dollars in settlements and lost court cases. Greater restrictions on advertising and marketing strategies followed, and public sentiment slowly turned against the tobacco industry. This is how the story unfolded in the United States. But what's happening in the rest of the world? Is anti-tobacco litigation proving effective elsewhere? While there has been increasing success in some parts of the world, Latin America lags behind. Eliseo Pérez-Stable, MD, a professor of medicine and director of the Medical Effectiveness Research Center for Diverse Populations at UCSF, decided to find out why. In a study published in a recent issue of the journal Tobacco Control, he and his colleagues looked at the state of tobacco litigation in Argentina, a country with one of the highest smoking rates in Latin America. Through a systematic search of library and online documents, the team discovered 15 litigation cases in Argentina between 1978 and 2002, in which individuals attempted to sue multinational tobacco companies. All of them failed. Pérez-Stable hopes to help local health advocates and lawyers understand why litigation is not working in Argentina, so they may improve their strategies for the future. The legal system in Argentina poses the first major barrier to anti-tobacco litigation. "The Argentinean courts are more like European courts," says Pérez-Stable. "The legal precedents in liability are different." Plaintiffs seeking damages for tobacco-related diseases were "not even getting in the door," he says. "The judges were saying, 'Well, if you have a certain level of education, you must know that tobacco is harmful to you. You must have been doing it willingly.'" Most cases were immediately dismissed on these grounds. Presenting Evidence The few cases that managed to get past this hurdle, most notably those involving secondhand smoke exposure, were lost on the basis of weak evidence. "The people bringing lawsuits against industry were very poorly prepared," says Pérez-Stable. "They would bring evidence of tobacco-causing disease that was based on popular literature, newspaper clippings and magazines. They wouldn't go to the abundant scientific evidence." And most surprisingly, the plaintiffs' attorneys attempted to prove the industry's knowledge of the negative effects of smoking without presenting any evidence at all. The internal documents that surfaced in the United States show without a doubt that the multinational tobacco companies were aware of these effects. But lawyers in Argentina chose not to use the documents. A third reason litigation has failed in Argentina stems from the tobacco industry's extensive anti-litigation strategies. By hiring prominent law firms and international consultants, it has won every case against it. And by saturating the media with cigarette advertisements and logos, and encouraging the opinion that tobacco revenues are important to the Argentinean economy, the tobacco industry has successfully created a favorable opinion of smoking in Argentinean society, says Pérez-Stable. "Industry in the US has been hammered, so they've backed off on a lot of these strategies," he says. "But they're not being restricted in many international markets. The social acceptability of smoking is still there in Argentina." Changing Public Opinion Pérez-Stable argues that tobacco control is sorely needed in Argentina, where 40 percent of adults smoke, compared to 22 percent in the United States. He says changing public opinion is the first step. "One of the goals of this study is to raise public awareness," he says. "This will help put pressure on politicians and public health officials." The federal government controls the price of cigarettes in Argentina. Pérez-Stable says pressure will need to be strong before the government will impose higher taxes on cigarettes, as many state governments have done in the United States. Pérez-Stable hopes this study also will encourage Argentinean lawyers to bring more cases against the tobacco industry, and use better evidence. Only through the use of hard evidence, such as the internal industry documents and scientific papers, will plaintiffs have a chance of succeeding. The most promising cases will be those involving secondhand smoke exposure in a smoke-free workplace, he says. Judges will be unable to dismiss these cases based on the victims' knowledge of the harmful effects of smoking. He also thinks pursuing class action lawsuits is a viable strategy. A good example of this was the Master Settlement Agreement concluded in the United States in 1998. The tobacco industry was required to give 46 states billions of dollars every year in health care reimbursement costs. While Pérez-Stable doubts anything like that agreement will occur in Argentina, he thinks there is hope for increasing tobacco control policies and reducing smoking rates. To that end, Pérez-Stable is overseeing a long-term study of smoking habits in children age 13 to 15 in Argentina. He intends to learn how local attitudes and feelings of cultural identity effect smoking behavior in adolescents. He says education campaigns aimed at young adults - such as the advertisements by thetruth.com in the United States - have promise in Argentina. But success lies in tailoring them to the local culture. In addition to Pérez-Stable, the Tobacco Control paper was authored by Laura Flores, JD, Joaquin Barnoya, MD, Raul Mejia, MD, and Ethel Alderete, DrPH. Source: Aria Pearson