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A hundred years of smokes

Cover of "Cigarette Century."

KAI RYSSDAL: Changing gears for just a second, you know one of the perks of running a big cigarrette company? You get complimentary tobacco products. Reynolds American disclosed late last week CEO Susan Ivey's pay package last year came to $6.5 million dollars. Including those free smokes.

You might have noticed there are more anti-smoking campaigns now than ever. But the World Health Organization says a billion people are still going to die from a tobacco-related disease over the next hundred years. Allan Brandt is a professor of the history of medicine at Harvard University His latest book is called "The Cigarette Century." Professor Brandt, welcome to the program.

REPORTER'S NAME: Thanks very much, thanks for having me on.

RYSSDAL: Lot of things happened in this country in the 20th century. Ford made cars, lot of people made a bunch of different things. Why are you calling the 20th century "The Cigarette Century?"

BRANDT: Well I think one of the most dramatic stories in the history of business but also in the history of medicine and the history of health was the dramatic rise of the cigarette. Smoking in the United States has fallen pretty dramatically, but almost 450,000 Americans are dying every year of a tobacco-related disease. In one way, we think no one smokes anymore. On the other hand, there are just about as many smokers as there have ever been in human history today across the globe.

RYSSDAL: Why is it that you can still buy a cigarette in this country? Obviously they're legal. Is it a success of marketing? Is it a failure of regulation? Is it an abdication of public health responsibility? What is it?

BRANDT: There's a lot of evidence to suggest that advertising has been a crucial component to promoting tobacco. One thing they started to do in the 1950s is mass-produce filter cigarettes and what they would later call light cigarettes. They convinced many consumers that they were smoking safer products. They also were very successful, especially in Congress, at heading off any kind of very serious regulation. The first regulations were passed by Congress in 1965 and 1966 for labels on cigarettes. But what we now know is that the industry actually understood that the label would protect them from litigation. So they actively sought a label, all the while denying that cigarettes were a serious risk to health.

RYSSDAL: What do you make of moves afoot now in the Senate, for example Senator Kennedy, and then at the FDA as well trying to perhaps regulate nicotine as a drug?

BRANDT: I think this is a moment where we might begin to see more serious federal attention to regulating cigarettes. And there's reason to believe that we could have effective regulation of tobacco. At the same time, one is somewhat concerned when Philip Morris is perhaps one of the strongest advocates now for FDA regulation that they're trying to lock in their very strong position in the American market. But I think we'll really see in the debate that goes forward just how serious Congress is now about limiting tobacco use and moving the public health agenda forward.

RYSSDAL: Is any of this a message that the American consumer wants to hear? "I don't smoke and my kids don't smoke, so everything's fine."

BRANDT: But the reality is that this is a big risk, and it's harming people's health. It tends to harm people's health who are less well-educated and less well-off. There is also an issue of morality and ethics in saying to the American industry, "We're going to help you sell cigarettes abroad," which our U.S. trade representatives have often done. So I think it's a big issue that defines, in a way, how we think about health and risk, regulation and responsibility. Not now in the 20th century, but for the 21st century. And how we take this on and manage it will be a very powerful indicator of how we think about the relationship of industry, public health and business in the future.

RYSSDAL: The book is called "The Cigarette Century." Author Allan Brandt is a professor of the history of medicine at Harvard University. Professor Brandt, thanks a lot for your time.

BRANDT: Thanks very much for having me on.

About the author

Kai Ryssdal is the host and senior editor of Marketplace, public radio’s program on business and the economy.
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