American Scandal

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Every scandal begins with a lie. But the truth will come out. And then comes the fallout and the outrage.

Scandals have shaped America since its founding. From business and politics to sports and society, we look on aghast as corruption, deceit and ambition bring down heroes and celebrities, politicians and moguls. And when the dust finally settles, we’re left to wonder: how did this happen? Where did they trip up, and who is to blame? From the creators of American History Tellers, Business Wars and Tides of History comes American Scandal, where we take you deep into the heart of America’s dark side to look at what drives someone to break the rules and what happens when they’re caught. Hosted by Lindsay Graham.


Big Tobacco | The New Frontier | 5

Big Tobacco | The New Frontier | 5

Tue, 04 Aug 2020 09:00

It's been over 20 years since a major settlement forced the tobacco industry to reform—and pay billions of dollars for its mistakes. Still, despite a sea change in the public’s attitude toward smoking, the tobacco industry remains strong. And it continues to win over new customers. Annice Kim, a public health expert, joins Lindsay to discuss the explosion in e-cigarettes’ popularity, and the ways in which companies now use social media to sell these products.

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From Wondry, I'm Lundy Graham and this is American Scan. Today we wrap up our series on Big Tobacco and the whistleblowers and lawyers who fought to hold the industry accountable. For decades the tobacco industry lied to the public about the harms of smoking. Millions of Americans became addicted to cigarettes and millions died as a result of this dangerous habit. Even today, despite a sea change in the country's attitude towards cigarettes, hundreds of thousands of Americans die every year from smoking. And over 16 million Americans have a disease that's caused by smoking. How has the tobacco industry managed to get so many people hooked on such a dangerous product? And how have they gotten away with it for so long? Today I'm joined by Anise Kim, a public health expert who's currently studying the ways in which tobacco and eSigarette companies use social media to sell their products. Kim is a senior scientist at RTI International Center for Health Policy Science and Tobacco Research. In her work she's found that the industry is drawing from an old playbook in order to get a new generation hooked on nicotine. Here's our conversation. American scandals sponsored by Sachi Art. I'm lucky. Not only is my wife beautiful, funny and smart, she also has great taste that matches mine, which has made decorating our home together a delight. But how do we go about finding the art for our home? Well we agree on that too. Sachi Art. They have artworks from thousands of emerging artists around the globe in all styles. So you're guaranteed to find art that fits your style, space and budget. Their view your room feature lets you visualize the art on your walls. And my advisor, Siting, was instrumental in finding our newest piece. Get 15% off your first order with promo code podcast. Just go to sachiart.com and enter code podcast at checkout. Find art you love today. Okay, the kids are already asking what's for dinner, but breaking news, empty fridge. That's okay, I'll instant cart. Let's add some organic asparagus and some farm fresh chicken. Easy. Wait, is the oldest vegetarian this week or was it gluten free? Gluten free pasta. Covered either way. Cart it. And finally some vegetarian gluten free olives from my well earned cocktail. Your family shopping list has more footnotes than groceries. The world is your cart. Visit instacart.com or download the app and get free delivery on your first order. Offer valid for a limited time minimum order $10 delivery subject to availability additional terms apply. And he's Kim welcome to American scandal. Thanks Lindsey, happy to be here. So tobacco has been with Americans since well before the nation's founding. The growing processing, selling of tobacco became a huge industry with deep pockets and a ferocious reputation for never losing a fight in court. Our series took a look at some of the first victories against them in the 1990s, but I was wondering if you could set the table for us with a quick history of the industry up until that time. Sure, I think up until that time there was a heavy focus on marketing cigarette products largely to the public and we know now in retrospect from some of the lawsuits and a very detailed analysis of the tobacco industries internal documents. That the big tobacco companies were marketing their products specifically to certain populations, even despite the fact that there was some internal knowledge that tobacco products were harmful. And so a lot of the marketing that ensued in the early years really kind of set the stage for developing the general consumers perceptions about cigarettes and getting generations really hooked on a very addictive product. This marketing was obviously effective millions of Americans took up smoking and continued smoking even when public perception of its health risks continued. But the tobacco industry was effective in staving off most legal consequences with a resilient defense of personal responsibility. The choice to smoke they said was up to the people who bought the cigarettes and certainly not the majors of the product on its face that that seems reasonable. So why did many feel that that argument was deceptive? Yeah, I mean, I think with any products that get marketed into our world and our society, there's a sense that ultimately it's about individual choice. And so what the tobacco companies did was they essentially created a desire for a product and they did that effectively through marketing. They in the very early years employed physicians and doctors who gave credibility to the product and they were very explicitly positioned in the advertising. And then they also started to use models that really kind of glamorized smoking, they targeted women, they targeted racial ethnic groups and really kind of like set the stage of creating the desire around that product. Now, marketing alone wasn't what they did that's definitely what gets the most attention when we talk about I think big tobacco. But you have to also understand that there was an environment completely created to then feed that desire. So the tobacco industry engineered their products to make them more addictive, right? So we know that tobacco crops were genetically engineered to have two times more nicotine, they adjusted their cigarette design so that there was more nicotine that was delivered. And then there were all these chemical compounds like menthol and flavors like menthol that kind of doled the harshness of a cigarette. So it made it easier for people to inhale that nicotine could travel faster to the brain. So they really kind of creatively engineered a product that was going to make people more addicted because it's nicotine in cigarette products that really kind of a dicks users. And then on top of all that what they did was they also made these products really available in your local communities. So it isn't enough just to put advertisements in magazines and TV and other kinds of media, but to make it readily available. So we know that the tobacco industry spends majority nearly 90% of their advertising dollars every year on marketing tactics that really make cigarettes cheaper and prominently displayed at the point of sale. And so it's really this kind of confluence of all of these various activities that really would suggest that it's not an individual choice so much, but a carefully designed system to kind of hook users. Efforts made to make cigarettes more addictive are obviously purposeful. You don't accidentally breed a tobacco plant with twice the nicotine. You don't accidentally add ammonia to increase nicotine uptake. And so this purposeful attention on nicotine indicates that the industry clearly knew nicotine was addictive. And yet throughout the history of the industry tobacco companies have denied it creating what could be called an alternative narrative of tobacco's benefits. How did this narrative shape the public's attitudes towards smoking? Yeah, I mean, I think early on they knew that there were probably going to be some doubts, right? I think there. People were aware of things like the smokers cough and had some potential concerns about the potential health risk. And so that's why I think when they started to kind of gain wind of that in the 1950s, if you look at some of the specific ads, they really kind of featured medical specialist and physicians and really tried to put credibility and some sort of science around this idea that tobacco products were not as harmful. So the Stanford tobacco website they have such a wonderful repository of advertisements of tobacco advertisements. And it's interesting if you looked for some of the ones from like the 1950s that feature physicians, there's ads that had these kind of taglines and information. And I saw one where it said that medical specialist gave smokers exams every two months and they saw that there was no adverse effects to their nose or throat. And they really kind of featured doctors in a series of ads and even had taglines like more doctors smoke camels and any other cigarette. Doctors kind of in their everyday life seeing patients at hospitals answering calls in the middle of the night from their home and just really trying to drive home and shape this public opinion that cigarettes were not as harmful. And I think that probably that had a pretty big impact in terms of really shifting public perceptions. So that gave a cigarette to baseline reputation as a safe product, a reputable product, but then marketing shifted and started targeting as you mentioned different genders and ethnic groups. What was the impetus behind these marketing campaigns? Yeah, I think with any kind of product that you start to market, right, you try to market to the general population and then you try to think about, okay, what are some niche target markets that we need to reach and how do we reach those groups? I think the tobacco industry realized that they wanted to start targeting women and they really started to use themes that would resonate with women and like a stronger sense of independence may be kind of some of their concerns around body image. And so if you look at some of the again old ads that really kind of targeted women, they use themes like you've come a long way, baby, the slim is slim, you know, what else can I do but smile and they really kind of like pictured women who were glamorous, sometimes there were models or celebrities and then there were run in magazines that women read. Similarly, the tobacco industry took a similar approach to targeting racial ethnic minority groups. So we know again from the industry document analysis that researchers have done that they targeted the black community again using black models. There was also a heavy focus on cultural events, cultural identity, a big focus on music, kind of really linking and sponsoring jazz festivals, the cool brand also had promotions where they sponsored rap competitions and a lot of this got a lot of attention from the public health community. And so they were able to try to kind of fire back and and make that kind of more broadly aware to the public. But what you'll see is that the tobacco companies ran these ads more heavily in certain communities. So what you see is that there were more ads more tobacco ads and stores in racial ethnic minority communities compared to white communities. And that overall there were just more also tobacco retailers and racial ethnic minority communities. So what does that really mean? That means every time you go into a store you're going to see more ads and then there's more stores in your community that sell tobacco products. And so it's not a surprise then that we see disparities in kind of the health outcomes related to tobacco use among racial ethnic minority groups. And one of the most pernicious tobacco marketing campaigns was its attention to youth smokers. What did they do there? Well, with youth smokers, I think there's a couple themes in this kind of arc of the history of where the tobacco industry started. If you look back into the ads of the early 50s, they used a lot of images of young people whether it kind of has themes of like high schools or university students where the models are shown like smoking or holding cigarettes. But they're in cap and gown or they're at a football game and some of the ads even targeted specific universities naming them and the ads and saying that you know Princeton voted our cigarettes the best compared to other companies. And so even kind of early on there was this kind of attention to that like young group. And then I think what we saw kind of a little bit later on was them shifting to other themes so they may not have tried to use young models, but some of those ads still kind of displayed activities that I think really resonated with younger audiences. So you would see models hanging out of the beach or playing together on a swing or playing football and they use themes like break free or be a rebel. So as you can imagine themes that really kind of resonate with younger audiences. And then probably one of the most egregious kind of campaigns that has been pretty well documented in the research literature is Joe Camel. So I'm sure you're familiar with Joe Camel. He was the cartoon character that Camel ran from like 1988 to 1997. And you know, there were some really prominent research published in the Journal of American Medical Association that confirmed that kids, six year old kids, 91% of six year old kids were able to correctly identify the Joe Camel character with the picture of cigarette. And that level of being able to identify a cartoon character with the product was comparable to them being able to identify, for example, Mickey Mouse with Disney. So those are just some examples of, you know, how the tobacco industry really use marketing that appealed and targeted younger audiences. Let's talk about what we call the hidden jewel of streaming. 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Join one Dree Plus on Apple Podcasts or on the one Dree app. So that's a survey of where the tobacco industry was and then in the 90s they had a reckoning. Of course they didn't go away the tobacco industries with us today but it has changed a bit and it has a new product, eSigrets. It also has a new venue for advertising social media. So first what are eSigrets and vaping and how are they different from regular combustible cigarettes? Sure. ESigrets is such a fascinating new landscape because it's a product that's constantly changing. So it comes in many shapes and sizes. People may have no about it with different terms like eSigs, eHookas, vape pens, mods, tanks. So in short what makes eSigs unique is that they mostly, most of them have a battery component. They have a heating element and a place to hold the liquid. The eSig works by heating a liquid which usually contains like nicotine or other flavors and it produces a vapor or aerosol which the person then inhales. So that is very different than a traditional cigarette which you have to fire up and by the act of making it combustible there's a lot more chemicals that gets produced when you're inhaling that combustible tobacco product. That's been the focus of why cigarettes are so much more dangerous. So the eSigret marketplace has really hit and taken off. And what we're seeing now as a result of it is that now among middle and high school students they are more likely to use eSigs than traditional cigarette products. What we see in terms of the stats is that like now about 27% of high school students and about 10% of middle school students report using eSigs in the past 30 days. So we really see the shift. We've made tons of progress in reducing youth use of cigarette products with all these aggressive marketing campaigns and educational policies. But now kids are really have shifted to eSigs. So we might have made progress in reducing nicotine use in traditional cigarettes but it's been supplanted by eSigrets. Correct. What do we know about their health risk? Yeah, so I think the science about the health risk is evolving. So when eSigs first came to the market they were marketed really kind of as an alternative to traditional cigarettes to help current smokers quit. And so I think the science around that would definitely suggest that it is healthier or better for a current smoker to shift to eSigrets completely and get off regular cigarettes. What has this concern now in the public health community is that people who have never used traditional cigarettes before are now picking up eSigrets. And so there the concerns are similar in the sense that at the core the main component of eSigs is nicotine. And nicotine we know from decades and decades of research that it's an addictive chemical. It can be toxic at high concentrations and we know that it's really harmful to brain development. So that's why there's such a heavy focus on adolescents and young adults because the brain continues to develop into our mid 20s. And so if youth or young adults are using nicotine at an early age that really can detrimentally affect their brain development. And similarly we know that if nicotine is consumed in eSigret format or regular combustible cigarettes it is also harmful to pregnant moms in terms of their health as well as their baby's health. But the long term health consequences is still evolving and there's still a lot of research that is being done now and that will continue to pursue collectively because as I said it's just an evolving product. And there's still a lot of unanswered questions about the long term consequences of eSiguse. So just as the product is evolving I imagine the legislative landscape is evolving. How are they regulated versus regular tobacco? Yeah so it's very interesting. So in 2009 Congress passed what's called the Tobacco Control Act. And what that did was that gave FDA regulatory authority to regulate cigarettes, smokeless and roll your own tobacco. At the time it wasn't inclusive of all tobacco products because again the product marketplace was changing. So I think one thing for you know people to really be aware of is that eSig is a relatively recent phenomenon in terms of kind of tobacco product category. And it wasn't really until 2016 when FDA's regulatory authority was then extended to also include authority over eSig or as pipes and as well who goes. So there's you know the FDA you know what they can and can't do you know it continues to evolve. So they regulate certain things like products cannot be sold to persons under you know the legal age to purchase. They try to restrict marketing to kids. They of course oversee things like placing health warnings on product packages and ads. Make sure that brands are not making claims about modified risk of their products. And then I think the big challenge they have is really trying to regulate the marketplace through what's called the pre market tobacco product application. So companies if they're selling tobacco products on the market they need to register with the FDA and provide kind of the product listing what kind of ingredients. You know and any other kind of data and information they have there about their products. So this is again a pretty recent phenomenon and it's something that's going to continually evolve. And I think you'll be seeing a lot of kind of just coverage around what happens with FDA now kind of at the center of having this regulatory authority. When we think about the marketplace the other big challenge Lindsey here is that it's no longer the major tobacco companies. You know 20, 30 years ago we just had a handful of major tobacco companies who were players in the market. E cigarettes really has just exploded. There was a study done by some researchers back in 2014 or 2015. And at the time they noted that there was about 460 different E sig brands and counting. So you can imagine just the challenge of trying to figure out what's in the marketplace, what those products contained, who's being exposed, where they're being sold, who's using it, and what impact it's having on the public's health. It is an incredible challenge. And so I think that's been one of the biggest kind of forms in this process of understanding the E cigarette marketplace is that there's so many different players now. In addition to the new players there's also a new landscape for marketing. How are E cigarette and vaping companies using social media to sell their products? And how are these campaigns any different from the way cigarettes were marketed before 30 years ago? Yeah, that's a great question. So that's primarily why I do most of my research looking at social media because I'm just fascinated by this landscape and the technology and the evolution of that. But then also just concerned about what does that mean as we move forward for public health. So traditional cigarette companies that don't really have social media presence. Most of their activities online have been on a brand website which you have to sign up and prove your age before you get access. It's really been the E cigarette companies and cigar companies to some extent that have really used social media to kind of promote their products. And I think the other thing that we need to talk about is what is advertising in the age of social media. And so if you use Facebook, Twitter, Instagram, whatever social media platform of your choice, you know that as you scroll through your feed, if you see an ad and it will tell you it's a promoted ad. So you know a promoted ad means that company paid to make sure their ad was placed in front of your eyeballs to get your attention. So the social media companies have been pretty responsive. So like for example, Facebook has banned any advertisements, any paid advertisements on their platforms. And several other companies have done the same. So tobacco companies and ESA companies can't pay for ads. So that's a good thing. However, they can still have public brand pages. And so what you're seeing now is essentially branded profile pages. That's public where it's not regulated because it's where they can place posts related to new products. They can have information about where to buy. And then social media working the way it does, you get a lot of engagement from your users and you get comments and you get testimonials. And so on some level social media is this kind of like free marketing platform because it allows brands to talk about their products and engage a much broader audience without really ever having to pay a dollar for paid advertisements. So I think this is the challenge in the digital age. What counts as advertising and what can we actually regulate? If you're into true crime, the Generation Y podcast is essential listening. We started this podcast over 10 years ago to dissect some of the craziest and most notable murders, crimes and conspiracy theories together. And we'd love for you to join us. Generation Y is one of the longest running true crime podcasts out there. And we are still at it, unraveling a new case every week. We break down infamous cases like the evil genius bank robbery and lesser known cases like the case of Kimberly Rico. Did she actually kill her husband after they took part in a murder mystery game? 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And so if you think about this going forward, if you want to be able to sell electronic cigarette device, you're going to have to submit this pre market tobacco application to FDA. It's called PMTA. And so by virtue of having that requirement in place, I think most folks who work in this space would argue that the marketplace and the players are going to winnow down. And then the other thing you need to think about is that the major tobacco companies, RJ Reynolds, Altria that makes Marborough, they have also gotten into the eSugurite game. So RGR owns the brand views, the brand blue. And if you saw any of the news over the past couple years, Altria acquired a 35% stake in Jewel, which is by far one of the most popular brands that exploded into the scene. And so I think this story is going to evolve and it's going to be this kind of interplay between who the brands are and who the players are at the table and the regulatory authority of FDA, as well as what states are doing. You know, even in the Jewel space, there are several lawsuits that states have filed against Jewel. It will be interesting to kind of see what comes out of those litigation efforts going forward. In general, what are those litigation efforts against? What are they claiming? Largely, it has to do with targeting younger audiences with the marketing. And so that's at the core of some of those litigations. And as you know, Jewel really kind of exploded, you know, as of 2019, it accounted for like 75% of the entire end's marketplace in terms of sales volume in the U.S. And I think some of the research that has come out has shown that Jewel use tactics, such as, you know, using younger models, promoting events, and really kind of using advertising tactics that research has shown definitely appeals to younger audiences. You said earlier your focus on fascination was the use of social media by tobacco companies. If you think back to your own research, what have you discovered that perhaps the public needs no most? I think one of the thing to really note here is about the importance of data. You know, as you know, from your story that you've done around the tobacco industry, evidence and the importance of data played such a critical and crucial role in any of the litigation process, the master settlement agreement, which was, you know, a landmark settlement. And so building the science and the data around what's happening in the social media landscape to me is the biggest challenge. And it's, it's definitely appropriate here in the context of tobacco marketing, but it's for any other product. So, you know, we're talking about tobacco and ends products today, but, you know, similar kinds of challenges can be said about understanding what's happening in the cannabis or CBD landscape. And the main issues there are a lot of the advertising and what's happening, we can't really see. So back in the days, if companies advertise in magazines or newspapers, things happened in the public view. And there was some sort of documentation of it. With social media, you can hyper target to a very small niche audience because social media companies have built out very sophisticated targeting platforms for, you know, brands to target their ads to their audiences. And that's the kind of content we don't see. And then, you know, companies can have social media accounts and then they can delete them. And this is definitely what happened with Joule. They deleted their Instagram account. And so what does that mean in terms of the evidence base and the data to really be able to dig into what happened. And so I think as we move forward, not just for this particular topic, but as a society, as a whole, we need to be really thoughtful and mindful about how we think about social media, the data behind that. And, you know, how we can move forward together more collectively to really help researchers and government agencies use that data in a way to protect the public's health. And East Kim, thank you for talking to me today. Thank you so much, Lindsay. It was a pleasure to be here. That was a East Kim senior scientist at RTI International Center for Health Policy Science and Tobacco Research. Next on American scandal, Standard Oil was a monopoly unlike any in US history. With its iron grip on the country's oil supply, it made John D. Rockefeller the richest American of all time. But Standard Oil also had a dark secret. One that a tenacious journalist would expose as she worked to take down the Titan of Industry. From wondering, this is Episode 5 of Big Tobacco for American Scandal. American Scandal is hosted, edited, and executed produced by me, Lindsay Graham for Airship, audio editing by Molly Bach. This episode is produced by Audrey Know and Gabe Riven. Executive producers are Stephanie Jens, Jenny Lauer Beckman, and her nonlopes for wondering.