Stan Glantz, tobacco warrior.

Stan Glantz’s voice carries the conviction and decibel level one would associate with a man who, with a handful of other courageous souls, has stood up to the mighty tobacco industry. A man who has played a key role in revealing to the world how over the past four decades tobacco executives have concealed the findings of their own scientists that tobacco kills and that nicotine is addictive. Yet, he is almost matter-of-fact about that fateful morning when the ‘‘Butts box’’ arrived at his office. ‘‘My first reaction was, this isn’t really my thing. I’ll send it to a tobacco litigator.’’ Glantz’s thing up to then had been studying the effects of secondhand smoke and doing basic research on cardiovascular function in laboratory animals. ‘‘I didn’t evenwant to knowwho Mr Butts was. Then I started reading these documents. It was fascinating. I got sucked in, like with a cheap novel.’’ At about the same time, several journalists, politicians and lawyers had received similar, but much smaller, packages.Thedocuments are nowknown to have been leaked by an out-of-work drama professor, Merrell Williams, who had been hired by the US tobacco giant Brown &Williamson Tobacco (B&W) to ‘‘screen’’ their internal documents for ‘‘sensitive’’ material and who became disgusted at what he found. Mr Butts was the pseudonym for a lawyer who had received the documents fromWilliams. Altogether about 4000 pages of documents were floating around. Why was Glantz, who had never shown an interest in nicotine addiction or tobacco litigation, singled out to receive the bulk of the booty? The voice, again, is matter-of-fact, almost dead-pan: ‘‘I’m smart. I’m aggressive. I’ve got balls. And I’m the first person who’d be crazy enough to do something with it.’’ Glantz recognized right away that ‘‘there were some real bombshells in the parcel, like Addison Yeaman, B&W President and General Counsel, saying in 1963 ‘we are in the business of selling nicotine, an addictive drug.’ ’’ Within days, Glantz assembled a team of colleagues and began analysing the contents of the parcel, mostly memos and reports from B&W and its multinational parent, British American Tobacco. The team decided to get the documents as quickly as possible into the public domain — in five articles in The Journal of the American Medical Association (July, 1995), on the Internet (at http://www.library.ucsf.edu/ tobacco), and in a 500-page book, The Cigarette Papers (University of California Press, 1996). Along the way, B&W lawyers tried, unsuccessfully, to recover or cast a legal net over the documents. In fact, courage was not Mr Butts’ only reason for choosing Glantz. For over a decade, the Ohioan scientist, now 54, had been a thorn in the side of the tobacco industry. Starting in the 1980s, Glantz and his colleagues have been running a research programme that, among other things, involves keeping a tally on tobacco industry contributions to politicians. ‘‘We would publish our findings every year or two and this put enormous pressure on the industry, who tried to shut downour research programme.’’ They failed, despite massive legal and political pressure on UCSF, the California Legislature, and even on the US Congress. Glantz also recalls ‘‘the personal pressure that was put on me, including hate mail and periodic attacks in print and on the internet.’’ Clean air and its corollary, passive smoking, rather than nicotine addiction, is where Glantz’s crusader’s heart lies— and, he says, very much where the tobacco industry’s greatest fears lie. ‘‘We now know that the most effective thing you can do to reduce smoking is to create a smoke-free environment that helps people quit the habit and discourages people from starting. It also changes the social environment surrounding tobacco, and if you read the industry documents, that’s what the tobacco people are most worried about.’’ The discovery and publication of those documents in 1994 was, in Glantz’s view ‘‘crucial to the huge progress that has been made in the war against a smart, aggressive, devious industry. It really set the ball rolling.’’ In 1996, the ball gathered speed when Jeffrey Wigand, former B&W Chief of Research, admitted publicly that he and his colleagues had consistently lied about tobacco’s effects on health. Finally, in 1998, the ball hit pay dirt: in November of that year the United States tobacco companies agreed to pay nearly US$ 250 billion compensation to 46 states for the costs of treating tobacco-related disease and to put another 40 million pages of internal documents on the Internet. ‘‘Ten years ago, such an agreement would have been unthinkable,’’ says Glantz. ‘‘There’s no question that we’ve got the cigarette companies on the run. But cigarettes are immensely profitable and the industry people are very powerful, aggressive and smart, and that’s a tough combination.’’ Glantz too embodies a tough combination. And he’s not letting the industry go. In April, 2000, The Lancet in the United Kingdom published a paper by him and a colleague detailing how the tobacco industry attempted to subvert the findings of a 1998 study by the WHO-owned International Agency for Research onCancer showing that second-hand smoke increases by 16% the risk of lung cancer in nonsmokers. Then, in May, Glantz and colleague Edith Balbach brought out a new book, Tobacco War: Inside the California Battles (University of California Press, 2000). And in July, the California Court of Appeals threw out a case brought by a tobacco industry front group against the University of California because of Glantz’s research showing that clean indoor air laws do not damage the restaurant business. Today, as Big Tobacco turns its marketing sights increasingly on the developing world, Glantz is also going global, helping governments and international bodies, like the WHO, to achieve what he hopes will one day be a smoke-free world. n