Cigarette makers and the drug firms that market nicotine gum and patches
would seem to be natural enemies, at war in a multibillion-dollar market of
people hooked on nicotine.
The 7%-8% success rate with nicotine gum or patches rises when the product is
combined with counseling. Yet a peaceful coexistence has reigned between them since nicotine
replacement products were introduced in the 1980s to help smokers kick the
habit.
The quit-smoking aids are widely advertised, and in recent years have
joined such remedies as Advil, Tums and Robitussin on a list of the country's
top-selling over-the-counter medicines. Yet they are promoted in a manner
certain to minimize conflict with cigarette manufacturers. Veterans of the smoking wars
think they know why.
For at least a decade, Philip Morris sought to intimidate drug firms
marketing the stop-smoking products, using the threat of economic reprisals to
make them tone down their ads and refrain from supporting the anti-smoking
cause, according to once-secret documents from the world's biggest cigarette
maker. Philip Morris officials declined interview requests.
R.J. Reynolds, the second biggest U.S. tobacco company, also was engaged
in some of the efforts, documents and interviews show.
Pressure tactics were exerted against at least two major drug firms
between 1982 and 1992, although they may have continued beyond that date. A
nonconfrontational marketing approach for the nicotine products remains in use
today.
Moreover, within the last three years, a major worldwide supplier of
cigarette filters to the tobacco industry has become a power in the gum and
patch business cards, thus playing in both arenas of the nicotine market.
Drug firms say their ads are not intended to appease the tobacco
industry, but rather aim for the best approach to boosting sales. Even so,
their marketing message is the same one that cigarette makers sought to
dictate in the past by threatening to cancel supply contracts with the drug
firms' corporate parents, internal memos show.
- A SmithKline Beecham television commercial for Nicorette gum
- Rather than attack cigarettes directly or implore all smokers to quit,
their ads target the narrow band of smokers who are currently trying to
quit--offering a product that can help ease their nicotine cravings.
As ads for top-selling Nicorette gum put it, "You can do it. Nicorette
can help." It's a catchy slogan, but also consistent with guidelines tobacco
executives sought to impose when the gum was introduced. For example, a 1985
Philip Morris memo cited the tobacco firm's "understanding" with the marketer
of Nicorette that it would avoid "emotional . . . pleas to stop smoking" and
advertise "strictly on the basis of 'if you want or need to quit, we have the
product.' "
- Companies Muffle Anti-Smoking Message
- The involvement of drug firms in anti-smoking politics has been limited
as well. Since gaining federal approval in 1996 for over-the-counter sales,
patch and gum marketers have financially supported the American Cancer Society
and American Lung Assn. in exchange for using their logos in ads. But to the
disappointment of tobacco foes, they have chosen not to involve themselves
directly in political fights--such as by lobbying for higher tobacco taxes
that would help their business by making quitting more attractive.
Considering the history of tobacco industry pressure, "I think there's no
question that there's still a residual influence," said Gregory N. Connolly,
director of tobacco control for Massachusetts.
Drug firms seem determined "not to get into a public war" with cigarette
makers, when "what the public needs is a war between the tobacco industry and
the drug industry," Connolly said.
"There are a lot of people who hoped that when they [drug companies] got
into the 'quit' market, they would be more aggressively involved in a lot of
activities to reduce tobacco use," said Matt Myers, general counsel for the
National Center for Tobacco-Free Kids.
Some observers have even suggested there is a symbiotic relationship
between drug and tobacco firms as millions of would-be quitters cycle between
buying cigarettes and gum or patches in a long-term struggle against nicotine
addiction.
For their part, drug companies say their targeting of committed
quitters--rather than the universe of smokers--reflects the reality that
quitting is extremely difficult. Targeting those who are ambivalent about
quitting--and thus almost certain to fail--can only breed a sense of defeat
and a poor image for the products.
"There's nothing more important in making a quit attempt than being
committed to it," said George Quesnelle, vice president and director of
medical marketing and sales for SmithKline Beecham Consumer Health Care, the
top marketer of patches and gum. "If people quit smoking using our products,
that creates great word of mouth . . . but there's nothing that can kill a
product faster than bad word of mouth."
Tobacco companies have not influenced the marketing "in any way, shape or
form," Quesnelle said.
Boasting that over the years more than 1 million smokers have quit with
their help, drug firms say they must be doing something right.
- Hand-in-Glove Tobacco, Drug Firms
- Patches and gum, meant to ease cravings while users try to wean
themselves from smoking, are not cheap. Buying and using the products for 10
to 12 weeks, as recommended, costs up to $300--about the same as smoking a
pack and a half per day for the same amount of time. But smokers who succeed
in quitting can save thousands of dollars over time.
Since the Food and Drug Administration approved nonprescription sales,
the over-the-counter sales have increased sharply to about $700 million per
year. Another $100 million to $200 million is spent on prescription-only
nicotine products--patches, inhalers and nasal sprays. Non-nicotine products
also are prescribed for smoking cessation, including Glaxo Wellcome's Zyban
anti-depression drug.
With its 90% share of over-the-counter sales, SmithKline has a huge lead
on its only rival in that market, Johnson & Johnson's McNeil Consumer
Healthcare.
Both SmithKline's Nicorette gum and Nicoderm patches rank among the
country's top 10 over-the-counter medicines, with an estimated advertising
budget of $120 million in 1997, according to Competitive Media Reporting, a
New York ad tracking service. In annual sales, the firm's nicotine business
appears to have surpassed that of Liggett Group, Inc., the country's fifth
largest cigarette maker.
SmithKline has its own generally unknown link to the tobacco industry.
While the patch and gum business bears the SmithKline name, it is actually a
joint venture between the pharmaceutical firm and Hoechst Marion Roussel, a
subsidiary of German giant Hoechst A.G.
Another Hoechst subsidiary, Celanese, is the world's largest producer of
the cellulose acetate used to make cigarette filters--a business worth
hundreds of millions of dollars in annual sales. Officials of SmithKline and
Hoechst Marion Roussel say the tobacco connection has not compromised their
marketing of nicotine patches and gum.
If so, the lack of interference would be a notable exception. Documents
disclosed in anti-tobacco lawsuits show that cigarette makers exerted
significant pressure on gum and patch marketers from at least the early 1980s
to the early 1990s.
When Nicorette was made available by prescription in the early 1980s in
Europe, Canada and later the U.S., Philip Morris sought to keep the original
marketer of the nicotine gum, Merrell Dow Pharmaceuticals, on a tight leash.
(SmithKline got involved in the business later in a joint venture with the Dow
subsidiary. Eventually, Dow sold the unit to Hoechst.)
The pressure point: a long-standing, multimillion-dollar customer
relationship between cigarette makers, including Philip Morris, and Merrell
Dow's corporate parent, Dow Chemical, which sold tobacco companies the
chemical humectants they use to keep tobacco moist.
A July 21, 1982, memo revealed Philip Morris' ire when Merrell Dow began
publishing a smoking cessation newsletter as part of its Nicorette launch.
According to the memo, tobacco executives told Dow the problem was not
Nicorette per se, but publication of "anti-smoking propaganda, particularly
literature which has little or no scientific basis." Subsequent memos show the
newsletter was killed after that first issue.
- Cigarette Maker Flexes Muscles
- When Merrell Dow's 1984 U.S. launch of Nicorette again offended Philip
Morris, the tobacco maker retaliated by canceling chemical purchases from Dow.
The move was retribution for the "offensive" Nicorette campaign, Philip Morris
executives told Dow, according to a May 7, 1984, memo.
Among their grievances: Merrell Dow had prepared literature for doctors'
offices urging smokers to quit; supported a study concluding that smokers
incur higher medical costs than nonsmokers; and encouraged workers to quit
smoking at the very Dow plant that made chemicals for Philip Morris.
"We had been assured that Nicorette would have a low-key introduction and
would be aimed only at those smokers who had to stop for medical reasons," the
memo said. "Dow continually insisted that they were not taking an anti-
cigarette industry position."
But "the recent spate of activity can only be interpreted as a conscious
corporate decision that Nicorette is more important than the Philip Morris
[and other tobacco] business," the memo said. Dow "cannot realistically expect
a customer to spend millions of dollars for materials when the profits from
those sales . . . are used to attack that customer's product."
Dow sought to make amends, and was rewarded a few months later when
Philip Morris resumed a portion of the chemical purchases, said an October 25,
1984, memo.
Dow assured Philip Morris it was "committed to avoid contribution to the
anti-cigarette effort," the memo said. And in an extraordinary gesture of
appeasement, Merrell Dow president David Sharrock informed tobacco executives
that he personally had begun "screening advertising and promotional materials
to eliminate any inflammatory anti-industry statements."
At a briefing for senior tobacco executives--including William J.
Campbell, then executive vice president and later president of Philip Morris
USA--Sharrock gave examples of "anti-smoking themes" proposed by an ad agency
but vetoed by the Dow president.
Philip Morris was angered again a couple of months later following what a
company memo described as "an extremely alarming development." Merrell Dow had
donated $25,000 to the National Interagency Council on Smoking and Health--a
group the memo said was intent on "the demise of our industry."
In response, Dow officials pledged that Merrell Dow's support for the
council would cease. And Dow performed an internal review "to assure that the
company had no anti-cigarette industry programs or policies at a corporate
level," a memo said.
According to the memo, Dow also agreed that Nicorette ads would stick to
the theme: "If you want to quit smoking, we have a product."
Several months later, a September 1985 memo took stock of Philip Morris'
"ongoing efforts to 'tone down' " ads for Nicorette. It said "some progress"
had been made and that continuing as a Dow customer should have "an
ameliorating influence on Nicorette promotions."
Philip Morris used a similar strategy several years later when Swiss
chemical giant Ciba-Geigy began marketing Nicorette under license in Europe,
according to internal Philip Morris memos.
A memo in January 1988 urged retaliation against Ciba. A boycott or "even
a Philip Morris-funded negative publicity campaign . . . would send a strong
message to a few other multinational corporations who could be investigating
possible opportunities in the growing 'anti-tobacco' industry," the memo said.
It's uncertain if the recommendation was followed. But four years later
Philip Morris and R.J. Reynolds did put pressure on Ciba when it launched its
Habitrol nicotine patch in the U.S.
Ciba was a big supplier of agricultural chemicals, including products
used by tobacco farmers. Accordingly, the two cigarette makers and a North
Carolina growers group implored Ciba's agricultural chemicals division to
intercede with its pharmaceutical branch. The goal: to assure "more
appropriate advertising for this product in the future," the memo said.
The mission was accomplished. Skip Raglund, formerly of Ciba and now vice
president for communications with Novartis Corp., said Ciba's pharmaceutical
executives agreed to restrict their advertising appeals to "people who were
committed to quitting. . . . It would not be a, quote, anti-smoking campaign,"
Raglund said.
- Competing Forms of Nicotine
- For all the fears of tobacco companies, research suggests that a
relatively small proportion of smokers who use gums and patches actually quit
on any one attempt. The products double the odds of quitting, but even then
the quit rate remains low.
According to some studies, on any single attempt people who try quitting
cold turkey succeed about 3% of the time, whereas success with gum or patches
rises to 7% or 8%--even higher when the products are combined with counseling.
As marketers acknowledge, successful quitters usually need to make several
attempts.
The result is thousands of smokers cycling between competing forms of
nicotine, "turning to a patch, gum or pill for a month" as a result of a New
Year's resolution, "then relapsing to a cigarette product," said Connolly of
the Massachusetts tobacco control program.
"You get this sort of strange, symbiotic relationship between the tobacco
industry and the drug companies where everybody makes money."
Source(s): THE L.A. TIMES, Sunday, February 14, 1999, By MYRON LEVIN, Times Staff Writer.
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