Biomedical subjects
S Chapman
Publications and source records attributed to S Chapman.
Tobacco in the news: an analysis of newspaper coverage of tobacco issues in Australia, 2001.
OBJECTIVE: To assess the extent and nature of newspaper coverage of tobacco related issues in Australia in 2001. DESIGN: Content analysis of newspaper articles. SUBJECTS: All articles (n=1188) at least seven lines long and containing at least one paragraph focused on tobacco in all major Australian national and State capital city newspapers (n=12) in 2001. MAIN OUTCOME MEASURES: Number of articles, month of publication, State in which newspaper published, prominence of article, type of article, article theme, and slant of article relative to tobacco control objectives. RESULTS: The number of tobacco articles varied considerably in different months over the course of the year, from a low of 51 in December to a peak of 180 in May. The most frequent theme was secondhand smoke issues (30% of articles), with the second most dominant theme related to education, prevention, and cessation programmes and services (20%). Events that were covered were predominantly positive for tobacco control: 62% of articles were related to events that were positive, compared with 21% that were negative for tobacco control objectives. Excluding news articles, the opinions expressed by the authors of articles were also mainly positive (61%) rather than negative (22%) for tobacco control objectives. The amount of coverage of and population exposure to tobacco focused articles showed considerable variation across different Australian States, with Victoria having the highest frequency and rate of articles and the most media impressions per capita throughout 2001. CONCLUSIONS: : Coverage of events and opinions related to tobacco in Australian newspapers in 2001 was generally positive for tobacco control objectives. Given that over 2 million individuals (out of a population of 19 million) were potentially exposed to tobacco related newspaper articles per day in Australia, this represents good news for tobacco control advocates. The variation in news coverage in different States and at different times in the year, however, illustrates how a combination of local events and advocacy efforts may at times combine to make tobacco more newsworthy. Understanding which tobacco issues are most likely to be covered and the nature of the coverage about them provides valuable feedback for tobacco control advocates and is a useful gauge of actual events as well as the tobacco related agendas promoted by the press.
"Australia is one of the darkest markets in the world": the global importance of Australian tobacco control.
"Australia is one of the darkest markets in the world... it probably is the darkest, I mean ourselves and Canada fight every month for who's got the darkest conditions to do tobacco manufacturing and marketing. And one of the things we can offer the world is what we do best, which is how to work, maximize, proactively drive our market position in a market that's completely dark. Now that takes a different skillset... a different type of learning. We need to export that... we know we have a lot of expatriates who come down to Australia for learning. they can come here and learn these techniques and take them back to Europe or Latin America or to the United States or to Africa... But the other thing that is really good for us is that we are also a huge net exporter of Australian talent. about 30 or 40 people currently off-shore... We do things really differently here than most other BAT organizations." David Crowe, Marketing Director, British American Tobacco (BAT) Australia(1).
"Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking.
BACKGROUND: Major reviews of the health effects of passive smoking have been subjected to tobacco industry campaigns to refute the scientific evidence. Following the 1992 US Environmental Protection Agency review, the Australian National Health and Medical Research Council (NHMRC) initiated a review of the health effects of passive smoking. At the time of this review, evidence that environmental tobacco smoke causes disease was being increasingly accepted in courts of law and voluntary adoption of smoking restrictions was rapidly growing. OBJECTIVE: To demonstrate how the tobacco industry attempted to delay and discredit the publication of a report on passive smoking that the tobacco industry anticipated to contain recommendations that would be unfavourable to their business. METHODS: A search of tobacco industry documents on the Master Settlement Agreement websites was conducted using the terms and acronyms representative of the NHMRC review. RESULTS: The tobacco industry sought to impede the progress of the NHMRC Working Party by launching an intensive campaign to delay and discredit the report. The main strategies used were attempts to criticise the science, extensive use of Freedom of Information provisions to monitor all activity of the group, legal challenges, ad hominem attacks on the credibility of the Working Party members, rallying support from industry allies, and influencing public opinion through the media. CONCLUSIONS: The Australian tobacco industry deliberately impeded the NHMRC Working Party's progress and successfully prevented the publication of the report's recommendations. The tobacco industry's motivation and capacity to disrupt the advancement of scientific knowledge and policy in tobacco control should be recognised and anticipated.
"Can't stop the boy": Philip Morris' use of Healthy Buildings International to prevent workplace smoking bans in Australia.
OBJECTIVE: To document the relationship of the indoor air consultancy company Healthy Buildings International (HBI) with the Australian tobacco industry. DESIGN: Systematic keyword and opportunistic website searches of tobacco industry internal documents made available through the Master Settlement Agreement. RESULTS: Since 1987 HBI has played a high profile role in advancing the Australian tobacco industry's concerns to prevent building owners introducing smoke-free workplaces by advocating for ventilation solutions. HBI invoiced Philip Morris' US lawyers Covington and Burling for work undertaken in Australia and sought to publicly deny its association with the industry. HBI breached Standards Australia protocols in providing PM with confidential public submissions made to a review of the Australian standard on ventilation and acted as an undeclared cipher into the review for Philip Morris's concerns, leading to the eventual dismissal of the HBI representative from the standards subcommittee. CONCLUSIONS: HBI in Australia exemplifies the tobacco industry's use of third party strategy in publicly advancing a case against smoke-free indoor air.
"Avoid health warnings on all tobacco products for just as long as we can": a history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes.
OBJECTIVE: To review critically the history of Australian tobacco industry efforts to avoid, delay, and dilute pack warnings on cigarettes. DESIGN: Systematic keyword and opportunistic website searches of tobacco industry internal documents made available through the Master Settlement Agreement. RESULTS: Four industry strategies and six recurrent arguments used by the industry are described, which were used to thwart the passage of three generations of health warnings (implemented in 1973, 1987, and 1995). These strategies are shown to have been associated with major delays in the implementation of the warnings and in keeping them inconspicuous, unattributed to the industry and non-specific, and particularly in delaying the use of warnings about addiction. The industry today continues to oppose warnings, which might "repel" smokers from tobacco use. CONCLUSIONS: Efforts by governments to introduce potent health warnings will be resisted by the tobacco industry. Tobacco control advocates should anticipate and counter the strategies and arguments used by the industry, which are described in this paper if they wish to maximise the use of the pack as a vehicle for raising awareness about the harms of smoking.
Smoking, disease, and obdurate denial: the Australian tobacco industry in the 1980s.
OBJECTIVE: To contrast the Australian tobacco industry's awareness of the diseases caused by smoking with their aggressive public denial on the relation between smoking and disease in the 1980s. DESIGN: Analysis of 325 industry documents from the world wide web. RESULTS: In the 1980s Australian cigarette manufacturers were informed constantly by the international industry of the medical consensus that smoking caused disease. In addition Philip Morris (Australia) Limited received reports of Philip Morris' international biological research programme and visited its Richmond research facility; and WD&HO Wills part funded, co-managed, and contributed research to the British American Tobacco groups' biological research programme. Despite this knowledge, the Australian manufacturers had a policy of arguing to their employees, decision makers, and the general public that questions of smoking and disease were unresolved. The industry catalogued the literature, developed arguments against the main claims made by health groups, and attacked public health advocates who made statements linking smoking to death and disease. Industry studies suggested that a 20-30% minority of the Australian public agreed with the industry on smoking and disease, diminishing across the decade. CONCLUSION: Australian manufacturers were clearly negligent in the 1980s, deliberately working to undermine Australians' understandings of the diseases caused by smoking despite their own private knowledge. Continuing scepticism about smoking and disease, corresponding with the industry's deceptions, exists in Australian smokers today, suggesting that their actions may have slowed the rate of decline in smoking prevalence. These revelations provide important evidence for Australian litigation and advocacy.
"We are anxious to remain anonymous": the use of third party scientific and medical consultants by the Australian tobacco industry, 1969 to 1979.
OBJECTIVE: To document the history of visits to Australia by tobacco industry sponsored scientists and news media reports about smoking and health matters generated by their visits. DESIGN: Systematic keyword and opportunistic website searches of tobacco industry internal documents made available through the Master Settlement Agreement. RESULTS: At least nine sponsored scientists visited Australia from 1969 until 1979. The industry sought to promote the scientists as independent from the industry and on occasion, scientists publicly lied about their industry connections. The industry was sometimes delighted with the extensive and favourable media coverage given to the visits. CONCLUSIONS: These media reports are likely to have influenced many who were exposed to them to believe that the evidence against smoking remained equivocal.
"A deep fragrance of academia": the Australian Tobacco Research Foundation.
OBJECTIVES: (1) To review the history of the tobacco industry supported Australian Tobacco Research Foundation (ATRF)(1970-1994) for evidence of the industry's use of the Foundation to further its objectives that "more research was needed" on smoking and health and to promulgate the view that nicotine was not addictive. (2) To review efforts by public health advocates to discredit the ATRF as a public relations tool used by the Australian industry. METHODS: Systematic search of previously internal industry documents released through the US Master Settlement Agreement. RESULTS: The ATRF was headed by prestigious Australian medical scientists, with at least one considered by the industry to be "industry positive". An international ATRF symposium on nicotine was vetted by the industry and heavily attended by industry approved scientists. Following sustained criticism from the health and medical community about the industry's creation of the ATRF to further its objectives, the ATRF's scientific committee was provoked to publicly declare in 1988 that smoking was a causative agent in disease. This criticism led to growing ATRF boycotts by scientists and substandard applications, causing the industry to see the ATRF as being poor value-for-money and eventually abandoning it. CONCLUSIONS: The raison d'etre for the ATRF's establishment was to allow the Australian industry to point to its continuing commitment to independent medical research, with the implied corollary that tobacco control measures were premature in the face of insufficient evidence about tobacco's harms. Sustained criticism of tobacco industry funded research schemes can undermine their credibility among the scientific community.
"It is possible he is a kind of nut": how the tobacco industry quietly promoted Dr William Whitby.
Dr William Whitby was a general practitioner in Sydney who, from 1978 until about 1987, self published two books extolling the virtues of smoking and ridiculing anti-smoking claims. Privately the tobacco industry regarded him as "nutty", while nonetheless believing that his views should be promoted. They quietly supported him by distributing his book, offering legal advice, and persuading him to take media training. Many Australians would have been exposed to his views.
"Keep a low profile": pesticide residue, additives, and freon use in Australian tobacco manufacturing.
OBJECTIVES: To review the Australian tobacco industry's knowledge of pesticide residue on Australian tobacco and its policies and practices on resisting calls by tobacco control advocates that consumers should be informed about pesticide residue as well as additives. METHODS: Review of previously internal industry documents relevant to pesticides and additives in Australian tobacco located from the Master Settlement Agreement websites. RESULTS: Between 1972 and 1994 Philip Morris Australia was aware that its leaf samples were often contaminated with pesticide residue, sometimes including organochlorine levels described by PM's European laboratories as being "extremely high". Consumers were not advised of the contamination nor products withdrawn. From 1981, the industry also resisted calls to declare fully the extent of use and long term safety data on all additives used in their products. They developed standard public responses that were evasive and misleading and, in 2000, implemented voluntary additive disclosure which allowed the companies to continue to avoid disclosure of any ingredient they deemed to be a trade secret. There was extensive use of ozone depleting freon in Australian tobacco manufacturing. Again, the industry kept this information away from consumers. CONCLUSIONS: Australian smokers are unable to make informed decisions about smoking because pesticide and additive disclosure remains voluntary. The Australian government should regulate tobacco to require full disclosure including information on the likely health consequences of inhaling pesticide and additive pyrolysis products.
The Australian tar derby: the origins and fate of a low tar harm reduction programme.
OBJECTIVE: To document the development of the low tar harm reduction programme in Australia, including tobacco industry responses. DATA SOURCES: Tobacco industry documents, retail tobacco journals, newspapers, medical journals, and Anti-Cancer Council of Victoria (ACCV) newsletters and archival records. STUDY SELECTION: Documents on the strategies and knowledge bases of the ACCV, other Australian health authorities, and the tobacco industry. RESULTS: The ACCV built a durable system for measuring and publicising the tar and nicotine yields of Australian cigarettes and influencing their development. The tobacco industry initially sought to block the development of this system but later appeared to cooperate with it, as is evidenced by the current market dominance of low tar brands. However, behind the scenes, the industry used its substantial knowledge advantage regarding compensatory smoking and its ability to re-engineer cigarettes to gain effective control of the system and subvert the ACCV's objectives. CONCLUSIONS: Replacement of the low tar programme with new means of minimising the harms from cigarette smoking should be a policy priority for the Australian government. This will require regulation, rather than further voluntary agreements, and stringent monitoring of successor programmes will be necessary.
"Some convincing arguments to pass back to nervous customers": the role of the tobacco retailer in the Australian tobacco industry's smoker reassurance campaign 1950-1978.
BACKGROUND: Epidemiological studies and reports on smoking and health published in the 1950s and 1960s threatened the tobacco industry worldwide, which acted to reassure smokers and counteract mounting evidence that smoking posed a serious risk to smokers' health. OBJECTIVE: To document the use of tobacco retailers (1) as a conduit to pass messages of reassurance onto smokers, and (2) to recruit youth and women into smoking. METHODS: Review of an extensive collection of Australian tobacco retail trade journals (1950-1978) for articles consistent with the industry's efforts to counter messages about smoking and health, and how to attract non-smokers, particularly youth and women. RESULTS: The main arguments advanced in the journals included the notion that air pollution and other substances cause cancer, that "statistics" did not constitute proof in the tobacco health scare, and that the industry was committed to research into the causes of cancer and into developing a "safer" cigarette. CONCLUSIONS: Numerous articles designed to be reiterated to customers were published, arguing against the link between tobacco and ill health. Tobacco retailers, salesmen and retail trade organisations played a significant role in dissembling the tobacco health nexus. Tobacco retail journals may be an important component in tobacco industry misinformation strategies.
Lack of apolipoprotein-E exacerbates experimental allergic encephalomyelitis.
Experimental autoimmune encephalomyelitis (EAE) was found to have a chronic and significantly worse course in apolipoprotein-E (apoE) deficient female mice when compared with matched controls. Disease measures compared included incidence of EAE (64% versus 31%, P < 0.05, chi2 test), maximal clinical score (average +/- SD 2.81 +/- 2.5 versus 0.75 +/- 1.1, P < 0.01, Mann-Whitney test) and mortality (27.3% versus 0%, P = 0.02, Mann-Whitney test and chi2 test). ApoE deficient mice had significantly increased lymphocyte proliferation responses to both myelin antigens and mitogens and significantly more infiltrating lesions in the central nervous system (CNS) in histopathology. Defective neuronal repair mechanisms and enhanced immune reactivity in apoE deficient mice may explain our findings. Clinical implications for MS are discussed.
Hungry for Hungary: examples of tobacco industry's expansionism.
OBJECTIVE: To give an overview of available internal tobacco industry documents on the transnational tobacco companies' (TTCs) efforts to enter the new market of the emerging democracy of Hungary and how it developed allies in its efforts at resisting tobacco control regulations. METHOD: Internal tobacco industry documents relevant to Hungary, available on the World Wide Web, were searched between 26 July and 30 November 2001. Documents on the identification of Central and Eastern Europe (CEE) as a great market potential have been reviewed; another set of reviewed documents are of particular relevance to Hungary, as they indicate who the main partners of the industry are. CONCLUSIONS: TTCs not only invaded the markets of the fragile new CEE democracies by making their product widely available, but also introduced sophisticated lobbying and marketing tactics. TTCs will try to shape the country's regulatory framework in a manner to help increase their profits. The fiercer the reaction of TTCs against a planned regulatory measure is, the more impact on the health of the population could be expected from the introduction and enforcement of that measure.
Tobacco industry efforts to keep cigarettes affordable: a case study from Hungary.
OBJECTIVE: To review strategies of multinational tobacco companies aimed at keeping tobacco products affordable to smokers in Hungary and to provide background information on the Hungarian request for the delayed introduction of minimum European Union tobacco excise duty levels. METHOD: Review of internal tobacco industry documents available on the World Wide Web, downloaded between 26 July 2001 and 31 October 2002. CONCLUSIONS: Appropriate pricing strategies and lobbying for low tobacco tax policies were used by the tobacco industry in Hungary to keep cigarettes affordable to the public. During the 1990s and in the early 2000s transnational tobacco companies (TTCs) were still able to prevent substantial cigarette price rises, which would have been desirable for more effective control of Hungarian tobacco use. Strategies used by TTCs included the creation of new partnerships, use of supportive MPs, communication around tobacco tax issues and also the successful management of the differences in approaches used by individual companies regarding taxation of tobacco products. These resulted in the adoption of governmental policy aimed at delaying the introduction of the EU directive on the minimum tax levels of retail prices of cigarettes.
Fetal magnetic resonance imaging in prenatal diagnosis of central nervous system abnormalities: 3-year experience.
OBJECTIVE: To evaluate the comparative merits of ultrasound and fetal magnetic resonance imaging (MRI) in the correct antenatal diagnosis of suspected central nervous system abnormalities. METHODS: A retrospective review of 27 consecutive pregnancies referred for fetal MRI for suspected central nervous system abnormalities between July 1998 and July 2001. Women were referred for the MRI examination when further anatomical and/or pathological clarification of the ultrasound scan findings was needed. Antenatal ultrasound scan and MRI were reviewed in relation to the findings on postpartum investigations. RESULTS: Data were complete for 26 pregnancies. The median gestational age at the time of the ultrasound examination was 26 weeks (95% CI 24 weeks 2 days to 28 weeks 1 day). The median gestational age at the time of magnetic resonance imaging was 27 weeks' gestation (95% Cl 26 weeks 1 day to 29 weeks 2 days). Eight fetuses had associated skeletal, renal and/or cardiac abnormalities previously noted on ultrasound examination. MRI confirmed the ultrasound diagnosis in 15/26 cases (58%). It changed the diagnosis to the correct one in 7/26 (27%) and misdiagnosed four cases (15%). Three of the four cases that were misdiagnosed on MRI occurred in the first 18 months of our 36-month experience. CONCLUSION: Ultrasound remains the primary imaging modality for prenatal diagnosis. Fetal MRI appears to be a useful adjunct to ultrasound to confirm or exclude certain abnormalities; this will consequently help in the counselling of parents and assist in planning further management. However, like any imaging technique, the sensitivity and specificity of the test are likely to improve with experience.
Antivaccination activists on the world wide web.
AIMS: To determine the likelihood of finding an antivaccination site on the world wide web and to characterise their explicit claims and rhetorical appeals. METHODS: Using "vaccination" and "immunisation", examining the first 10 sites displayed on seven leading search engines. Detailed examination of content of 100 antivaccination sites found on Google. RESULTS: 43% of websites were antivaccination (all of the first 10 on Google). Main rhetorical appeals involve themes of the scientific veracity of antivaccination argument; rapport with parents seeking to protect their children from harm; and alleged collusion between doctors, the pharmaceutical industry, and government to deny vaccine harm. CONCLUSIONS: There is a high probability that parents will encounter elaborate antivaccination material on the world wide web. Factual refutational strategies alone are unlikely to counter the highly rhetorical appeals that shape these sites.