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Philip Morris knew nicotine is just one part of smoking addiction

Company’s secret research showed that cigarette use is driven by multiple social and biological factors

Louise Prime

Wednesday, 02 May 2018

The tobacco company Philip Morris secretly knew for at least two decades that smoking addiction was about much more than simply nicotine dependence, even as it continued to promote both smoking behaviour and nicotine reduction products, according to a new analysis* of the company’s papers published today in PLOS Medicine.

The researchers explained that the tobacco industry knew from the 1960s that nicotine is addictive, but for decades publicly denied the role of nicotine dependence in smoking addiction – then, in 2000, Philip Morris (PM) “became the first tobacco company to publicly state that nicotine is addictive”. They have now analysed previously secret PM documents that were released following litigation against the tobacco industry, to see what the company really believed about nicotine and smoking addiction, and when.

These documents reveal that from the mid-1990s to at least 2006, at the same time as PM was making public statements reinforcing the idea that smoking addiction is driven principally by nicotine’s pharmacology, the company’s scientists had found that addiction was the result of interconnected determinants, with nicotine as but one component. PM’s internal models of addiction positioned biological, psychological, social, and environmental factors as equally important to nicotine in driving cigarette use; and in 2000 an internal document noted that, consequently, quitting smoking was “not simply a matter of replacing the nicotine”. PM continued to research the causes of addiction through the 2000s in order to create successful new nicotine products.

The researchers said the papers showed that PM has internally understood since at least 2006 that its actions (for example advertising, lobbying, and litigation) influence addiction by shaping users’ psychology, social milieu, and environment; and that PM’s “public embrace of nicotine’s addictiveness currently works to redirect policy away from proven social and environmental interventions and toward the promotion of the industry’s potentially reduced harm products”.

In other words, they said, PM’s ‘opportunistic’ shift from denying to affirming nicotine’s addictiveness was driven not by a substantive change in scientific understanding but by public, regulatory, and legal pressures.

The analysis authors said: “As PM’s internal research indicates, positive health outcomes are more likely to be achieved by complementing [nicotine replacement therapy] and behavioural counselling with ever-stronger society-level interventions addressing the psychological, social, and environmental components of addiction.”

They concluded: “To help tobacco users quit, policy makers should increase attention on the social and environmental dimensions of addiction alongside traditional cessation efforts.”

*Elias J, Hendlin YH, Ling PM. Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents. PLoS Med 2018; 15(5): e1002562. The National Cancer Institute in the US funded (but had no other involvement in) the analysis.

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