In my new book Reality Check, I described research by a number of authors who investigated and exposed the 50-year-long effort by the tobacco companies to deny that they made a product that was dangerous. They did all they could to obfuscate and delay public health action by the well-known tactic of “smokescreens” to hide their real action. As the famous quote by the PR firm Hill & Knowlton (hired in the 1950s to advise Big Tobacco) said, ”Doubt is our product since it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public. It is also the means of establishing a controversy.” For the next fifty years, the tobacco companies pursued this strategy. They paid for research by their own scientists, and suppressed or censored the results if they showed that tobacco was dangerous, but vigorously promoted any results that seemed favorable to them. They waged an all-out campaign to harass and impugn the research by outside scientists who discovered that tobacco was dangerous. They played the classic game of “doubt” mongers everywhere: insist on absolute scientific “certainty”, so that if the results are overwhelming (say, 80-90% certain), they would argue that it’s not good enough. (This, of course, plays on the public misconception about science, which is always about statistical likelihood, and rarely deals in true “certainty”). They hired prominent scientists in totally unrelated fields like nuclear physics to be their spokesmen, and to fight their battles in the public arena, especially in the halls of Congress. These people often played the “other causes” fallacy: if a disease like lung cancer can occur because of multiple causes, the tobacco companies would focus on these minor “other causes,” and insist that nothing should be done about regulating their own industry—even though all the independent research clearly showed that smoking was by far the most important cause of lung, throat, mouth, and other cancers. They fought their opponents vigorously with lawsuits and armies of lawyers, and battled tooth and nail to never lose a lawsuit against them—because one admission that they were responsible for someone’s death due to smoking would unleash an avalanche of lawsuits against them. Above all, they waged a relentless PR campaign to make tobacco seem safe and glamorous, or minimize its dangers, even as the weight of scientific evidence and public opinion was becoming overwhelmingly against them.
This campaign kept the restrictions on tobacco at bay for over 50 years, until societal norms began to change, and smoking became less “cool”. Now in most parts of the United States, smoking is banned in almost all public places and even in some outdoor places, so that in many states (like here in California) it’s very rare to smell cigarette smoke except in the streets. Today, many places have limited “smoking areas” where the addicts huddle together in the freezing air, trying to assuage their “nic fits.” But the final blow came in the late 1990s, when Congress had to use the RICO (Racketeering and Corrupt Organizations) Act, originally written to break up organized crime, to call the tobacco company executives on the carpet before Congressional subcommittee investigations. There, one after another, the execs perjured themselves by claiming they knew nothing of the efforts of their companies to hinder unfavorable research and trumpet favorable research, and otherwise hide the truth in order to protect their bottom lines.
Having researched the history of this topic, it gives me a strange sense of deja vu to read of another huge American corporation pursuing the same strategy: the National Football League. As detailed in the book League of Denial: The NFL, Concussions, and the Battle for Truth by Mark Fainaru-Wada and Steve Fainaru (as well as a series of other books and TV documentaries), the NFL has used the same type of “smokescreen tactics” for decades. Twenty years ago their internal documents show that they were aware of the link between brain damage and frequent football-related concussions. They tried to cover up or suppress the many studies that were establish this linkage, attacked those who published research unfavorable to them, and did all they could to deny that NFL football caused brain damage. Meanwhile, they had “hired gun” scientists who produced results favorable to them, and touted those extensively to contradict the evidence coming from independent research. As the Fainaru brothers demonstrated:
• Two original members of a concussion committee established by Tagliabue disavowed the committee’s major findings, including the NFL’s assertion that concussions were minor injuries that never led to long-term brain injury.
• As far back as 1999, the NFL’s retirement board paid more than $2 million in disability payments to former players after concluding football gave them brain damage. But it would be nearly a decade before league executives would publicly acknowledge a link.
• Beginning in 2000, some of the country’s top neuroscientists warned the NFL that football led to higher rates of depression, memory loss, dementia and brain damage.
• The league in 2005 tried unsuccessfully to have medical journals retract the published work of several independent concussion researchers.
• Independent researchers directly warned Goodell about the connection between football and brain damage in 2007, but the commissioner waited nearly three years to acknowledge the link and to dismantle the league’s discredited concussion committee. In 2009, two other independent researchers delivered still more evidence that football caused brain damage during a private meeting at the NFL’s Park Avenue headquarters. Yet the league committee’s co-chairman, Dr. Ira Casson, mocked and challenged the researchers so aggressively that he offended others who were present, including a Columbia University suicide expert and a U.S. Army colonel who directed the Defense and Veterans Brain Injury Center.
• As the crisis escalated, the NFL tried desperately to regain control of the issue and contain damage to its brand. Before an October 2009 hearing on football and brain injuries conducted by the House Judiciary Committee, the NFL lobbied successfully to prevent Goodell from testifying on the same panel as the father of a high school quarterback who had died after sustaining a concussion.
• Dr. Ann McKee, the leading expert on football and brain damage, told the authors that she believes the incidences of neurodegenerative disease among NFL players will prove to be “shockingly high” and that “most NFL players are going to get this. It’s just a question of degree.” Since 2005, when the disease was first diagnosed in deceased NFL players, McKee has studied 54 brains harvested from deceased NFL players. All but two had chronic traumatic encephalopathy (CTE). “I’m really wondering where this stops,” she told the Fainarus. “I’m really wondering if every single football player doesn’t have this.”
As Josh Holland writes:
For years, the chairman of the NFL’s Mild Traumatic Brain Injury Committee, Dr. Elliott Pellman, portrayed concussions as nothing more than minor injuries. In fact, Pellman, a rheumatologist with no prior expertise in brain research, was the lead author of nine of the 16 studies published in 2003 that minimized the significance of concussions in the NFL. Pellman, who served as chairman from 1994 to 2007, also “discredited various independent studies concerning the severity of concussions,” writesSean Newell of Deadspin.
Now the lid has been blown off the cover-up, and sports journalists across the country have joined in the outrage over the NFL’s actions. Perhaps it is the recent rash of young NFL players demonstrating brain damage, including the tragic suicide of San Diego Charger linebacker Junior Seau and several others, which has riveted the attention of the public. It’s hard to tell how far this scandal will go: better headgear, stricter rules about hitting and especially hits to the head, or possibly more severe restrictions. Either way, it’s striking how the NFL has followed the tobacco companies’ playbook to the letter. In fact, most of these strategies are universal to those who would deny what science tells us, whether they be creationists, climate change deniers, anti-vaxxers, AIDS deniers, and many others discussed in my new book.
I used to be a big fan of NFL football, following the “heartbreak kids”, the Minnesota Vikings, since 1968. But as the years go by, I no longer watch much football , and once the Vikings are out of contention (as they are already this season), I stop paying attention to the league at all. Now, with the realization that these huge men smashing each other with enormous force each Sunday means many will die of brain damage, I can’t watch it at all. I just wonder how much this will change the interest of the average fan in the future.
People say that the NFL is the most profitable and popular sport in the U.S. right now, and can’t imagine it falling from its place of dominance. But I remember when heavyweight boxing was a popular sport, and even the casual citizen who was not a boxing fan knew the names of Joe Louis, Muhammad Ali, Joe Frazier, George Foremen, and many others. The last fighter that almost everyone knew about was Mike Tyson. These days, hardly anyone but a hard-core boxing fan can tell you who is the current heavyweight boxing champion (partly because they split up the championships, so no one can keep track of which crown is which). Some of it is clearly due to mismanagement of professional boxing by overzealous promoters, the promotion of too many mediocre fighters, and possibly the declining quality of boxers. But a lot of it is probably due to the fact that most people see Muhammad Ali or other legendary boxers today, standing mute in a haze with almost no idea what’s going on around them, and are stunned to see their legends fall. It is then that you realize that boxing isn’t just a sport; it’s a brutal battle to hurt your opponent, and try to knock them out with a mild concussion. Any fighter who stays at it very long ends up becoming a vegetable. For many people, watching the combat of the arena is overshadowed by the realization that these men will pay a heavy price down the road.
Now many people see the NFL the same way.