Country Level Units As Of Country Page Afghanistan 0.45 USD 2010 Albania 1.43 USD 2010 Algeria 1.14 USD 2010 Angola 0.67 USD 2008 Antigua and Barbuda 2.41 USD 2010 Argentina 1.37 USD 2010 Armenia 1.49 USD 2010 Australia 10.77 USD 2010 Austria 5.21 USD 2010 Azerbaijan 0.87 USD 2010 Bahrain 1.86 USD 2010 Bangladesh 0.48 USD 2010 Barbados 5.50 USD 2010 Belarus 0.84 USD 2010 Belgium 6.31 USD 2010 Belize 2.50 USD 2010 Benin 0.99 USD 2010 Bolivia 0.85 USD 2010 Bosnia and Herzegovina 1.53 USD 2010 Botswana 2.63 USD 2010 Brazil 1.84 USD 2010 Brunei 1.39 USD 2010 Bulgaria 2.74 USD 2010 Burkina Faso 1.39 USD 2010 Burundi 0.65 USD 2010 Cambodia 0.33 USD 2010 Cameroon 0.99 USD 2010 Canada 7.84 USD 2010 Cape Verde 2.36 USD 2010 Central African Republic 0.62 USD 2010 Chad 0.99 USD 2010 Chile 3.06 USD 2010 China 0.74 USD 2010 Colombia 1.02 USD 2010 Comoros 1.32 USD 2010 Congo 1.11 USD 2010 Congo Brazzaville 0.99 USD 2010 Costa Rica 1.55 USD 2010 Croatia 3.23 USD 2010 Cuba 0.30 USD 2008 Cyprus 3.67 USD 2010 Czech Republic 3.31 USD 2010 Denmark 6.47 USD 2010 Djibouti 1.13 USD 2010 Dominica 1.30 USD 2010 Dominican Republic 3.24 USD 2010 Ecuador 1.70 USD 2010 Egypt 0.70 USD 2010 El Salvador 1.75 USD 2010 Equatorial Guinea 2.12 USD 2008 Eritrea 3.90 USD 2010 Estonia 2.66 USD 2010 Ethiopia 0.55 USD 2010 Fiji 1.30 USD 2008 Finland 5.73 USD 2010 France 7.30 USD 2010 Gabon 1.99 USD 2010 Gambia 0.35 USD 2010 Georgia 0.71 USD 2010 Germany 6.45 USD 2010 Ghana 1.39 USD 2010 Greece 4.17 USD 2010 Grenada 2.83 USD 2010 Guatemala 1.70 USD 2010 Guinea 0.39 USD 2010 Guinea Bissau 0.60 USD 2010 Guyana 1.47 USD 2010 Honduras 1.43 USD 2010 Hungary 2.80 USD 2010 Iceland 7.47 USD 2010 India 1.51 USD 2010 Indonesia 1.47 USD 2010 Iran 0.46 USD 2010 Iraq 0.64 USD 2010 Ireland 11.14 USD 2010 Israel 5.56 USD 2010 Italy 4.82 USD 2010 Ivory Coast 1.39 USD 2010 Jamaica 6.75 USD 2010 Japan 3.47 USD 2010 Jordan 2.39 USD 2010 Kazakhstan 0.68 USD 2010 Kenya 1.25 USD 2010 Kiribati 7.19 USD 2010 Kuwait 0.14 USD 2010 Kyrgyzstan 0.51 USD 2010 Laos 0.61 USD 2010 Latvia 2.81 USD 2010 Lebanon 1.49 USD 2010 Lesotho 3.82 USD 2010 Liberia 0.69 USD 2010 Libya 1.31 USD 2010 Lithuania 2.87 USD 2010 Luxembourg 4.79 USD 2010 Macedonia 1.06 USD 2010 Madagascar 0.92 USD 2010 Malawi 1.03 USD 2008 Malaysia 3.14 USD 2010 Maldives 1.48 USD 2010 Mali 1.39 USD 2010 Malta 5.21 USD 2010 Mauritania 1.51 USD 2010 Mauritius 2.48 USD 2010 Mexico 2.37 USD 2010 Moldova 0.73 USD 2010 Mongolia 1.11 USD 2010 Montenegro 0.85 USD 2010 Morocco 2.06 USD 2010 Mozambique 0.41 USD 2010 Namibia 3.67 USD 2010 Nepal 1.14 USD 2010 Netherlands 6.58 USD 2010 New Zealand 8.19 USD 2010 Nicaragua 1.30 USD 2010 Niger 0.99 USD 2010 Nigeria 1.69 USD 2010 North Korea 0.14 USD 2008 Norway 13.30 USD 2010 Oman 1.69 USD 2010 Pakistan 0.33 USD 2010 Panama 3.25 USD 2010 Papua New Guinea 4.21 USD 2008 Paraguay 0.27 USD 2010 Peru 1.59 USD 2010 Philippines 0.48 USD 2010 Poland 2.59 USD 2010 Portugal 4.56 USD 2010 Qatar 1.65 USD 2010 Romania 3.03 USD 2010 Russia 1.03 USD 2010 Rwanda 0.85 USD 2010 Saint Kitts and Nevis 2.41 USD 2010 Saint Lucia 2.41 USD 2010 Saint Vincent and the Grenadines 2.00 USD 2010 Samoa 3.22 USD 2010 San Marino 5.21 USD 2010 Sao Tome and Principe 1.06 USD 2010 Saudi Arabia 1.87 USD 2010 Senegal 1.29 USD 2010 Serbia 1.05 USD 2010 Seychelles 5.95 USD 2010 Sierra Leone 0.41 USD 2010 Singapore 8.52 USD 2010 Slovak Republic 3.15 USD 2010 Slovenia 3.26 USD 2010 Somalia 0.30 USD 2010 South Africa 3.00 USD 2010 South Korea 2.11 USD 2010 Spain 4.43 USD 2010 Sri Lanka 3.38 USD 2010 Sudan 1.26 USD 2010 Suriname 2.19 USD 2010 Swaziland 3.75 USD 2010 Sweden 6.91 USD 2010 Switzerland 6.93 USD 2010 Syria 0.64 USD 2010 Tajikistan 0.68 USD 2010 Tanzania 1.81 USD 2010 Thailand 1.80 USD 2010 The Bahamas 2.69 USD 2010 Timor Leste 1.25 USD 2010 Togo 1.09 USD 2010 Tonga 3.79 USD 2010 Trinidad and Tobago 2.51 USD 2010 Tunisia 1.30 USD 2010 Turkey 2.98 USD 2010 Turkmenistan 1.19 USD 2010 Tuvalu 5.39 USD 2010 UAE 1.91 USD 2010 Uganda 0.66 USD 2010 UK 9.80 USD 2010 Ukraine 0.70 USD 2010 Uruguay 3.32 USD 2010 USA 5.72 USD 2010 Uzbekistan 0.69 USD 2010 Vanuatu 6.56 USD 2010 Venezuela 6.17 USD 2010 Vietnam 0.75 USD 2010 Yemen 0.75 USD 2010 Zambia 1.64 USD 2010 Zimbabwe 0.50 USD 2010

Tobacco manufacturers’ defence against plaintiffs’ claims of cancer causation: throwing mud at the wall and hoping some of it will stick

Duty-free cigarette depot

An extensive body of research has existed for many years, showing that cigarette smoking causes lung cancer, other cancers, heart disease, stroke, chronic obstructive pulmonary disease, and many other illnesses.1,2,3 Despite this large volume of evidence, it has only been in recent years that tobacco manufacturers have admitted, to varying degrees, that smoking causes lung cancer and other diseases.

In this paper, we examine tobacco company arguments about whether their products caused cancer in plaintiffs who filed lawsuits against the companies. In order to understand the context in which these arguments have been presented to judges and juries, it is important to review the public admissions that these companies have made in regards to the adverse health effects of tobacco use.

The Liggett Group, Inc was the first cigarette company to admit unconditionally that smoking is harmful to health.4 Liggett (now part of the Vector Group Ltd) currently sells Eve, Pyramid, and Liggett Select cigarettes, and several generic or private&#x02010 label brands in 1999 the company sold its well&#x02010 known Chesterfield, L&#x00026 M, and Lark brands to Philip Morris. In a March 1997 settlement of lawsuits filed against the company by 22 state attorneys general, Bennett LeBow, the chief executive officer of Liggett, agreed to the following statement 5

&#x0201c We at Liggett know and acknowledge that, as the Surgeon General and respected medical researchers have found, cigarette smoking causes health problems, including lung cancer, heart and vascular disease and emphysema. We at Liggett also know and acknowledge that, as the Surgeon General, the Food and Drug Administration and respected medical researchers have found, nicotine is addictive.&#x0201d

In October 1999, Philip Morris USA&#x02014 the leading US cigarette manufacturer and the maker of Marlboro, Virginia Slims, Benson &#x00026 Hedges, Merit, and many other cigarette brands&#x02014 made the following announcement on its website

&#x0201c There is an overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema and other serious diseases in smokers. Smokers are far more likely to develop serious diseases, like lung cancer, than non&#x02010 smokers. There is no &#x02018 safe’ cigarette. These are and have been the messages of public health authorities worldwide. Smokers and potential smokers should rely on these messages in making all smoking&#x02010 related decisions.&#x0201d 6

That statement did not indicate clearly whether the company agreed with the medical and scientific consensus on causation. Indeed, in a response to a shareholder’s resolution on this subject, a letter sent to the Securities and Exchange Commission on behalf of Philip Morris (dated 10 February 2000) stated &#x0201c Mr. Neuhauser’s letter mischaracterizes the Company’s web site as constituting a public admission that cigarettes cause illness. It does not.&#x0201d 7

Eliminating the ambiguity in its earlier admission, Philip Morris placed informational inserts in 28 major newspapers in the United States (including the New York Times and USA Today) on 13&#x02013 17 November 2002, stating &#x0201c We agree with the overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema, and other serious diseases in smokers.&#x0201d 8 A similar statement has appeared on the company’s website since then.9,10

As early as August 2002, RJ Reynolds (RJR)&#x02014 maker of Winston, Salem, Camel, and many other cigarette brands&#x02014 stated on its website &#x0201c We produce a product that has significant and inherent health risks for a number of serious diseases, and may contribute to causing these diseases in some individuals.&#x0201d 11 The words &#x0201c may&#x0201d and &#x0201c in some individuals&#x0201d weakened the RJR admission in comparison to Philip Morris’s most recent admission. Now RJR’s website states &#x0201c R.J. Reynolds Tobacco Company (R.J. Reynolds) believes that smoking, in combination with other factors, causes disease in some individuals.&#x0201d 12 In this latest version of the company’s admission, &#x0201c may contribute to causing&#x0201d was changed to &#x0201c causes,&#x0201d but &#x0201c in combination with other factors&#x0201d was added.

The Brown &#x00026 Williamson Tobacco Corporation (B&#x00026 W), a long&#x02010 time subsidiary of British American Tobacco (BAT), has manufactured several well&#x02010 known cigarette brands, including Kool, Lucky Strike, Pall Mall, Tareyton, and Viceroy. The US operations of B&#x00026 W merged with RJR in July 2004, under a new parent company, Reynolds American Inc. Pre&#x02010 merger URLs for the B&#x00026 W website ( and ) are now directed to the RJR website.

B&#x00026 W’s pre&#x02010 merger website, as far back as April 2001,13 included a lengthy and rather tortured statement explaining the &#x0201c Evolution of Brown &#x00026 Williamson’s Position on Smoking &#x00026 Disease&#x0201d . According to this history (1) the company had accepted for many years that &#x0201c smoking is a major risk factor for many diseases&#x0201d (2) B&#x00026 W revised its position in 1997, stating that, &#x0201c far from denying that smoking causes disease, there are serious risks associated with smoking and that smoking may cause certain diseases&#x0201d (3) the company revised its website during 1999 and 2000 because B&#x00026 W &#x0201c still had not achieved its goal of clear communication&#x0201d and &#x0201c its position was still misunderstood&#x0201d and (4) &#x0201c As reflected in Brown &#x00026 Williamson’s web site today, its scientists have concluded that, assessing all of the scientific evidence together, the best judgment is that smoking is a cause of disease.&#x0201d Elsewhere on its website, under the heading &#x0201c Smoking and Disease,&#x0201d 13 B&#x00026 W stated &#x0201c in the most simple and commonly understood sense, smoking is a cause of certain diseases.&#x0201d In other words, during this evolutionary process, the company moved from &#x0201c risk factor&#x0201d to &#x0201c may cause certain diseases&#x0201d to &#x0201c is a cause of certain diseases&#x0201d .

Lorillard Tobacco Company manufactures Newport, Kent, True, Old Gold, and other cigarette brands. As early as August 2003, Lorillard’s chairman and chief executive officer Martin Orlowsky offered the following on its website

&#x0201c Several years ago, Lorillard publicly promised the Congress of the United States that it would not engage in any public debate over statements of the United States Surgeon General or any other public health authorities regarding smoking and health.&#x000a0 Consistent with that promise, Lorillard has not publicly stated its position on smoking and health except when called upon to do so in litigation&#x02026 . I n the course of such litigation in the past few years, I have been asked what advice I would give to a smoker or potential smoker who might ask me about the health consequences they faced if they chose to smoke. Were that to happen, this is what I would say

&#x02018 All cigarettes are dangerous and smoking can cause serious diseases, including lung cancer. Cigarette smoking can also be addictive. Lorillard supports the continuing efforts of public health authorities to inform the public about the dangers of smoking. Lorillard believes that the public should pay attention to and rely upon the Surgeon General’s warning printed on every cigarette package and in every cigarette advertisement, as well as the wealth of other information provided by public health authorities in making informed decisions about smoking.’&#x0201d 14,15

The conditional language in some of the admissions by these cigarette companies mirrors their answers to questions posed in the pre&#x02010 trial process in the US Department of Justice’s civil la
wsuit against the companies. A report prepared for Congressman Henry Waxman found that four of the five major cigarette companies &#x0201c failed to admit without qualification that smoking causes disease&#x0201d .16

US Smokeless Tobacco Company (USSTC) is the world’s leading producer and marketer of moist snuff products, including Skoal and Copenhagen. The company does not include on its website ( /) an admission about the adverse health effects of smokeless tobacco use, like the admissions described above on cigarette company websites. Instead, it includes several statements made to legislative and regulatory bodies asserting that smokeless tobacco use should be embraced as a &#x0201c harm reduction&#x0201d strategy for reducing cigarette smoking. Their website includes a USSTC petition to the Federal Trade Commission that states &#x0201c it is USSTC’s position that smokeless tobacco has not been shown to be a cause of any human disease.&#x0201d 17

This review of tobacco company admissions indicates that the major US&#x02010 based cigarette manufacturers now admit, to varying degrees along the continuum from risk factor to cause, that cigarette smoking is related to lung cancer and other diseases. These admissions raise the question as to whether the companies have conceded that their products have caused (or have contributed to the causation of) cancer or other diseases in specific individuals. This paper examines the following research question how have tobacco manufacturers defended themselves in personal injury lawsuits against charges that their products caused cancer in individual plaintiffs&#x0003f