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Bates  numberisthestampedaccessionnumber,onepereverypageofdocumentintheentiredepository.((3 $ %!UKUS.,..,,        TRWl6&A43' 6&A43'T"UK        0  (#$  0   "$UKUS.,..,,        "UK      11    ݀RJR500288899901 "$UKUS.,..,,        "UK      5    RJR500949355 "$UKUS.,..,,        "UK      8    PM2022850392402 "$UKUS.,..,,        "UK      3    PM250107600623 "$UKUS.,..,,        "UK      6    ݀Bates30115017984 "$UKUS.,..,,        "UK      12    PM250126522728 "$UKUS.,..,,        "UK      9    ݀PM250147425359 "$UKUS.,..,,        "UK      10    ݀PM2501011504.A "$UKUS.,..,,        "UK      18    RJR503684304and503684313 "$UKUS.,..,,        "UK      17    PM202281612526H "$UKUS.,..,,        "UK      16    PM250104780305  $UKUS.,..,,        "UK      19    WHO, TobaccoorHealth:Aglobalstatusreport.Geneva,1997pp.223,353 $UKUS.,..,,        "UK      22    PM2024702082  $UKUS.,..,,        "UK      20    InternationalAgencyforResearchonCancer, IARCMonographsonEvaluationofthe  CarcinogenicRiskofChemicalstoHumans.TobaccoSmoking,Volume38,February1985,p.69. $UKUS.,..,,        "UK      21    WHO, TobaccoorHealthpp.30304 d  $UKUS.,..,,        "UK      23    Fordirectquotes,see,clickonTobaccoAlert:A  QuarterlyBulletin,clickagainonAdvisoryKit,1998,thenon IntheTobaccoIndustrysOwnWords. $UKUS.,..,,        "UK      24    PM250107577378 "$UKUS.,..,,        "UK      2    PM204404647576 $UKUS.,..,,        "UK      3    PM250107600623,15October1996. %!UKUS.,..,,        TRWl6&A43' 6&A43'T"UK    7XXdd7       TRY 3' LetterWl6&A43' Letter 6&A4T    TRWl6&A4Wl6&A4 6&A4 6&A4T ̛̜@qq a TOBACCOINDUSTRYSTRATEGIESANDTACTICSINTHENETHERLANDS.  p М@aa)a @) ) aEvidence  fromTobaccoIndustryDocuments  p @aByNorbertHirschhorn,MD@  aConsultanttotheWorldHealthOrganization,TobaccoFreeInitiativèDecember9,1998  H!>  TableofContents P 1.Introductionpage3  8   2.TobaccoIndustryCorporateStrategyfortheNetherlandspage3     3.Recruitmentofscientiststosupporttheindustrypositionspage5   4.Recruitmentofjournalistsandotherstosupportthetobaccoindustrypositionpage85.Distortionofscientificdatatomakethemmorefavorabletotheindustrypage86.Marketingtoyouthpage11̀7.Asummarypage12  h  1.Introduction h   Thispaperispreparedfromtwoindustrysources:fromdocumentslocatedintheMinnesotaDepositoryasaresultofthe1998trialsettlementbetweenthestateandtheAmericancigarettemanufacturersandmadeavailabletothepubliconindustrywebpages,andfromsocalledattorneyclient privilegeddocumentsdiscoveredinthesametrialanddumpedontoaU.S.Congresswebsite,butsincescannedintoaprivatewebsite.Onlyaboutathirdofthelatterarenowaccessible,butalldocumentswillbescannedbynextspringandavailabletoresearchersandtobaccocontroladvocates.  TheevidenceofactivitiesintheNetherlandsisremarkablysimilartothatinothercountriesbutthispaperwaspreparedbyspecificsearchfortheindexterm Netherlandsintitles(publicdocuments)andtext(privilegeddocuments),withsupportingevidencefromBritishAmericanTobaccodocumentslocatedintheMinnesotaDepository.2.TobaccoIndustryCorporatestrategyfortheNetherlands H   PhilipMorrishasasubstantialbusinessintheNetherlands,aselsewhere.Itscorporatestrategy,similartotheothertransnationalfirms,istomonopolisticallydominatethemajorityofthecigarettemarketthroughouttheworld:0  TosatisfygrowingworldwidedemandforAmericanblendcigarettes,wehavebegunaseriesofexpansionsandupgradesofourtobaccofacilities,fromVirginiatoNorthCarolinatoGermanyandtheNetherlands.AsourU.S.exportscontinuetoclimb,wearestrengtheningourpositionsinlargeandgrowingmarketsabroadbyinvestingintobaccobusinessesinEasternEuropeandTurkey. #  1      כ#*"" PhilipMorrisispleasedthatmostofitsAmericantobacconowisbeingsoldtoPhilipMorrissubsidiariesoverseas.J.G.RamseywrotetoThomasOsdene(DirectorofPhilipMorrisresearch)on16September1994:(` #  2      כ ((!0 0  Youmightbeinterestedtoknow,forexample,thatthebiggestexportdestinationofU.S.tobaccoleafincludingtheincomparablefluecuredleafgrownhereinVirginiais *$4 notforeigncustomersinJapan,ItalyorHolland.ItisPhilipMorrisoverseassubsidiariesandlicensees!ThepurchasesofU.S.leafexportsbyPhilipMorrisanditsvariousoverseasoperationsexceedsthetotalU.S.leafexportstothebiggestleafexportmarketJapan.Someexportdestinationsseemforeign,buttheyrenotreally.ThethirdbiggestexportmarketforU.S.leafisHolland,butitsnottosometulipfarmerinwoodenshoes.Itsforaguyinacowboyhatandboots.PhilipMorrisHollandmanufacturesoverhalftheentireNetherlandsnationalcigaretteproduction,andmostofitisMarlboro. ""   Thereis,however,astrongmovementagainstthetobaccoindustryintheNetherlands,principallyonhealthgroundsgiventheoverwhelmingevidenceofthediseasecausedbysmokingandthedifficultysmokershaveinquittingbecauseofaddictiontonicotine(whosecontentisnowknowntobemanipulatedbytheindustry).ThestrategytocombattheseantitobaccoeffortsintheNetherlandsarespelledoutinaPhilipMorrisdocument CorporateAffairs1996/1997TheNetherlands, dated15  October   October    1996.    ) #  3      כ H   ThedocumentnotesthattheNetherlandshasa purplecabinet,whichis strongandpopular[but]antismoking,withjuvenilesmokinga keyissue.Thegeneralpublic,however, resentgovernmentinterference[and]thepublicdebateismoreandmorebalanced.Thedocumentdescribesgeneralstrategiestoincludeintensifyingdirectandindirectlobbying,positioningPMasa biginvestorandjobprovider,intensifyingandincreasingpresscontacts,usingthe momentumofDutchpresidencyEU,anddealingwiththe juvenileissue.Withrespecttothedebateonanincreaseinexcisetax,thedocumentproposesto Boostlobbyingefforts(direct/indirect)tosecureamajoritytovoteagainstanexciseincrease.IfworsecomestoworsepresentalternativescenariosofindustrypriceincreasetofriendlyMPs.ThedocumentsaysPhilipMorriswouldopposeastricterEUadvertisingcodealiveandto keepHollandinblockingminority. LobbytoensureDutchpresidencycallsforreferraloftheCommissionadbanproposalfromtheHealthCounciltotheinternalmarketauthorities.  ThedocumentrevealshowtheindustrysupportsandcoordinateswithasupposedϜ voluntary citizens organization group ,the 50,000member SmokersRightsGroup(SRG): DevelopmissionwithSRGBoard,developactionplan/prioritiesthataddvalue.Theindustryalsocreatesstrategic -`'8 alliancestopreventlegalsmokingbansinprivatesector: IntensifystrategicalliancewithRoyalHorecaNederland[thelocalrestaurantassociationchapterofInternationalHoreca,basedinZurich]andmobilizethemwhenappropriate.Finally,directinducementstolegislatorsaresuggestedbyadvising TraineeprogramsforMPs.  Theindustryreactsvigorouslyandcontentiouslyagainstanyattempttolimititsadvertisingandpromotionalactivities.IntheNetherlandsandotherdemocraticnations,theindustryseekstotakecoverunder freedomofspeechandhumanrights!Shook,HardyandBacon,alawfirmwithlongstandingtiestothetobaccoindustry,preparedCharlesGielen,anAmsterdamattorneyrepresentingPhilipMorrisforwhattosaytotheDutchpressintheeventAustralialimitedproindustrystatementsabouttheharmlessnessofenvironmentaltobaccosmoke.  #  4       x 0  Mr.Gielen,areyouaware[bythisdecision]thattheTobaccoInstituteofAustraliawouldbeenjoinedfromexpressingitsviewsonthepossibleeffectsofenvironmentaltobaccosmokeonnonsmokersasaviolationoftheAustralianTradePracticesActwhichprohibitsfalseandmisleadingstatementsinadvertising?WouldyouexpectasimilarresultinTheNetherlands?[scriptedreply:] IwouldnotexpectasimilarresultinTheNetherlands.InTheNetherlands,thelawprovidesagreatdealofprotectiontofreespeech.Itistheveryfoundationofafreeanddemocraticsocietythatallpointsofviewmust,inprinciple,bepermittedtobeexpressedandtobeheard.AspecialinterestgrouplikeAFCO[inAustralia]wouldnotbepermittedtosilencethosewithwhomitdisagrees....Iwouldexpectstatementsofthetypeinvolved[inAustralia]tobeprotectedundertheEuropeanConventiononHumanRights. "" 3.Recruitmentofscientiststosupporttheindustrypositions &X .   Innearlyeverymajormarket,thetobaccoindustryseekstorecruitresearchinstitutes,eminentscientists,andrespectedphysicianstotaketheindustryside.Anelaboratemethod,pioneeredbyPhilipMorrisbutadoptedbytheothertransnationals,istohaveanintermediaryorganizationalawfirm,apublicrelationsfirmassemblelonglistsofexpertsinhealth,smoking,environmentalpollution,etc.,andtoscreenoutthosewhosewritingsorstatementsare -`'8 obviouslyantitobacco.Therestareapproachedbytheintermediarytoenlistthemasconsultants,researchers,spokespersons.Thosewhoarewillingformthecorpsofexpertsineachcountry.Thedetailsofthisapproacharespelledoutina1974documentpreparedbyFrankG.Colby,DirectorofScientificIssuesforR.J.Reynolds #  5      ,andin1988bySharonBoyseofBritish  8 AmericanTobaccoCo. #  6      כIntheNetherlandsthisapproachhasbeentakenmostseriouslyand   faithfully,ascanbeseeninthreeimportantdocuments.ThefirstisasummaryofminutesofaPhilipMorrisResearchMeetingbyCharlesWalltoW.Murray,20May1992. 8 #  7      ׀Themeeting p  discussedwhatresearchtofundin1993,andthecriteriatobeusedincludestudiesoftheroleofcigarettesmoking, ifany,indisease,otherfactorsthatmaycausesuchdisease,andtheimportance tosupportresearchincertaincountries,becauseweneedtohavearesearchpresenceincertainmarkets.FundedresearchersandinstitutesfromtheNetherlandsareidentified:AnthonievonLeeuwenhoekhuisforbasiccancerresearchattheDutchCancerInstitute;CIVO/TNOInstitute(Delft)forinfluenceofsmokeonbronchialtubesandroleofvitaminA;Dr.SnowattheAmsterdamFreeUniversityENTClinicongenotoxicfactors(thatis,geneticpredisposition,afavoriteindustryexplanationforcancersassociatedwithtobacco)inheadandneckcancers;VanBekkumattheRadiobiologicInstitute.148,500dollarstotal.  Inaseconddocument,CharlesWallnotedtoM.BringinJuly1992thattheresearchfundingintheNetherlands providesuswitharesearchpresenceintheNetherlands,whichisconsideredofsomevalue. #  8       P$   TheapplicationoftheindustrysrecruitmentapproachintheNetherlandsisquitewelldetailedinalongmemowrittenbyD.RemestoB.Robinson, ThePMEEC/EEMAETSProject.drafted20February1988. #  9      ׀ThememooutlineshowEuropeaninstitutionsandscientists #*  aretoberecruitedtosupporttheindustrypositiononETS: X%, 0  Scientistsmustbeavailablewhocanattackthestudiesreliedonbytheantismoking forcestojustifysmokingrestrictionsonhealthgrounds....TheindustrywillhavetoestablishaffirmativelythatETSpresentsnosignificanthealthrisktononsmokers...[Mobilize]ineachmarketacorpsofscientificconsultantswhocanmakethecaseagainstsmokingrestrictionsthrougharticlesinthescientificjournalsandpresentationsatscientificconferencesandsymposia,througharticlesandinterviewsinthemassmedia,andthroughmeetingswithandappearancesbeforeregulatoryauthorities. "" ЀTNOofDelftisoneoftheidentifiedresearchinstitutionsengagedbytheindustry.TheentireeffortistobecoordinatedbythelawfirmofCovingtonandBurling,includingcoordinationwithPhilipMorriscorporateaffairs.  Sometimessuchrecruitmenteffortsbackfired,andtheindustrybecameevenmorecarefultoscreenforsuitablescientists.RobertPagetwrotetoThomasBorellion8May1992aboutaproposalbyaDr.DeWalleoftheNetherlandstostudypassivesmokinginHolland: #  10      . Thisis H anotherSpitzerstudywaitingtohappen....Itlooks,smells,andsoundslikeadisaster....(W.O.SpitzerofMcGillUniversityinTorontowaspaidbytheindustrytoreviewtheliteratureonthehealthimpactofenvironmentaltobaccosmoke,andcameupwithapublishedarticleinClinicalInvestigativeMedicinein1990,substantiallyconfirmingtheill  effects.)BorellipassedthenoteontoCorporateVPStephenParrishsaying, IbelieveweshouldtellDeWallewedonthavethemoneyforsuchadetailedstudybutwemaybeopentoareviewofthelimitationsofepi[demiology]asitappliestoweakassociations.Inotherwords,ifDr.DeWallewereamenabletocriticizingthefindingsonETSheorshemightgetfundedafterall.  TheDutchCigaretteManufacturersAssociationonceseemedwillingtoconsiderthepossibilityofalinkagebetweentobaccoanddisease,inthehopeofdeveloping safercigarettes.FrankColbyofRJRtookthemtotask,inamemotoSamuelB.Witton26November1980 #  11      ; &X . ColbycomplainedthattheDCMAwasessentiallyendorsingthelinkagebysendingscientificarticlestothemedicalprofessionintheNetherlandsonthelinkage.ColbynotedthattheDCMAusedanindependentScientificAdvisoryCouncil(DeWetenschappelijkeAdviesraadRokenenGezoundheidWARG)whichmaderesearchgrantsavailabletogranteeswho,saidColby, all `,%6 moreorlessagreewiththeMedicalEstablishmentpointofviewonsmokingandhealth,butnograntstothe fewscientistsinHollandwhohaveamoreobjectivepointofviewonthesmokingandhealthcontroversy.(Objectiveisthecodewordfortakingtheindustryside.)̀4.Recruitmentofjournalistsandotherstosupportthetobaccoindustryposition     Friendlyjournalistsarecrucialtotheindustry.J.M.Hartog,writingtoS.E.OdmanofPhilipMorrison10April1978 #  12      ׀proposedtoarrangelunches withselectedjournalists....The p  purposeoftheselunchesistoenlightenthejournalistsoftheexistenceoftheSmokingandHealthcontroversy,therebyhopefullyachieving:a)amorebalancedreportinginSmokingandHealthmatters,b)amoreobjectivetreatmentofSmokingandHealth,c)achannelthroughwhichtheindustrysidecanbefedtothepress.  Allianceswithotherorganizationsareimportanttogivetheappearanceofwidespreadpublicpressureagainstrestrictionsontobacco,particularlysmokinginpublic.G.WirzoutlinedastrategyforseveralEuropeancountriestoA.Reimanon11November1992,sayingthatintheNetherlandstheobjectiveis tooverturntheDutchshorthaultrainsmokingbanbeforeitsplannedimplementationonJanuary1,1994,byworkingthroughtheNMA,mobilizingtheSmokersRightsGroup,lobbyinglegislatorsdirectlyandindirectlythroughallies,using PMstatusasimportantclientwithDutchrailways,[using]marketablesurveystodemonstratepublicattitudes.Mobilizesuppliersagainstban.(A marketablesurveyisonethatisfavorabletoindustry.)5.Distortionofscientificdatatomakethemmorefavorabletotheindustry #*   ReadingthesedocumentsleavesonedismayedwiththeOrwellianandGoebbelsian X%, languagetheindustryusestoexplainawayeveryscientificfinding,whetherwithrespecttotobaccoandhealthortotheroleofadvertising,ormarketingtoadolescents.Theindustryhaslongusedtheword controversyasintheSmokingandHealthcontroversy,ortheETS controversytosowconfusionanddoubtinthepublicsmindabouttobacco.Whatismeantby *$4  controversy?SamuelB.WittofRJRwroteaspeechonsmokingandhealth,dated9February1981: #  13       h  0  Whenwesaythatacontroversyexists,itmeanstwothings:Ontheonehand,itmeansthatnoneofthemanyallegationswhichhavebeenmadeagainsttobacco,andspecificallyagainstcigarettesmokingasbeingascientificcauseofcertaindiseases,havebeenproven.Ontheotherhand,italsomeansthattheoppositeistruethatwecannotprovethatcigarettesmokingcanbeexoneratedofsuspicionasapossiblehealthhazard.Similarly,noingredientorgroupofingredients,asfoundinsmoke,haseverbeenproventobethecauseofanydiseaseinman.Again,ontheotherside,atthistimeitisimpossibletoexonerateunequivocallyanyofthesmokecomponentsofanyinvolvementintheailmentsallegedlylinkedtosmoking.[handwritten:]Inshort,wecannotscientificallyprovethenegative....TheTobaccoIndustryhasalwaysmaintainedthatthebestwaytoaddressthesmokingcontroversyisthroughscientificresearchandareasonedapproachtothefacts,notpropagandaandemotionalism. ""   HowacarefulanalysisoftheeffectsofETSintheNetherlandswasprofoundlydistortedisshowninthefollowingdocumentbyG.WirztoPhilipMorrisstaff,reportingontheETSissueinEuropeon15November1991  #  14      ׀soonaftertheissuanceofareportbytheNetherlandsHealth P" CounciltotheStateSecretaryforWelfare,HealthandCulturalAffairs,TheNetherlands,December10,1990. 8 #  15      ׀ThememoincludestheHealthCouncilsExecutiveSummarybutdistorts  !& itremarkably.WheretheCouncilacknowledgedthatwhileeachepidemiologicalstudyissubjecttodistortions,thepreponderanceofevidenceandbiologicalplausibilitymakeanincreaseinlungcancerinnonsmokers likely.WirzwroteinsteadthattheCouncilfoundthat TheevidenceonETSismainlystatisticalandisbesetbymethodologicalproblems.(Mainlystatisticalisafavoriteputdownoftheindustryonanyassociationbetweensmokingandhealth.)WheretheCommitteenotedthat atpresent,occasionalexposuretotobaccosmokeisaninevitableconcomitantofpeoplessociallives,theindustrydocumentomits atpresent.Wherethe *$4 CommitteeconcludedunequivocallythattheirritationandnuisanceofETS mustberegardedasharmfultohealth[and]thecontinuousdiscomfortandthenecessitytoavoidpublicplacesconstituteafundamentalassaultuponapersonswellbeing,theindustrydocumentmisrepresentedtheCommitteeassaying: TheCommitteesconclusionthatETSisharmfultohealthisprimarilybasedasaresultoftobaccosmokessmellandirritatingeffects.Moreover,theindustrydocumentsaidnothingabouttheCommitteesaffirmativeconclusionontheilleffectsofETSonchildren.  Theindustryregularlytrotsoutconsultantswitholdandfalsedataontheroleofadvertising.J.J.Boddewynisaprofessorofmarketingandalongtimepaidconsultantandproadvertisingwitnessforthetobaccoindustry(RJR,PhilipMorris,TobaccoInstitute).Histhesis,longdiscreditedbypeerreviewersandbylegislativecommitteesinCanadaandAustralia,isthatadvertisingneithergetsyoungpeopletosmokenorhasanycorrelationwiththeamountofadultsmoking.Oneofhislastwritingsfortheindustry,18December1989(itseemsheisnolongercredible)wasapieceforthepressunderthesponsorshipofthepublicrelationsfirmofBursonMarstell e a  %   r.Initheclaimsthat thegreatestreductionsintobaccousehaveoccurredincountrieswhichpermitadvertisinginmanymedia,suchastheNetherlandsandtheUnitedKingdom. #  16      ׀  TheauthoritativeWHOpublication Tobaccoorhealth:Aglobalstatusreport,however,documentsfortheNetherlandsanunremarkabletenpercentdecreaseinaverageadultconsumptionofcigarettes,includingrollyourown,between1970and1992(p.352).  Evenmorerecently,a27January1994memofromPhilipMorris, CigaretteAdvertisingAndTargeting #  17      ׀deniesthewelldocumentedobservationthatcigaretteadvertisingtargets " ( minoritypopulationsorwomen.Innonadvertisingbancountries,suchastheNetherlands,therebuttalsays, smokingincidenceamongwomenofmostagegroupshasdeclinedoverthepastseveraldecades.TheWHO TobaccoorHealth:AglobalstatusreportshowsvirtuallynochangeinprevalenceofsmokingamongwomenintheNetherlands:29%in1950,31%in1990,29%in1994(p.353).  Distortionsoflungcancerdataarealsomadetothegeneralpublic.Hereisadraftfilmscript, Untitled.(FilmonSmokingandLungCancer)preparedunderRJRs Special `,%6 Projects, #  18      ׀24May1982.MapsofEuropeandNorthAmericaareshownandtheannouncers h voiceoversays:0  TheU.S.andCanadahavethehighestpercapitacigaretteconsumptionintheworld,buttheyrankeighthand15threspectivelyinlungcancerdeathsofmales.Conversely,theUnitedKingdom,FinlandandtheNetherlandshavelowerpercapitaconsumptionthan "" 0  theU.S.andCanada,buttheyhavefarhigherlungcancerdeathrates. "" Thedatatelladifferentstory:Lungcancerratesinthemid1980sintheNetherlandsandtheUSratesarebothquitehigh(120and86per100,000population)quadruplingpreWWIIlevelsin @  eachcountry. %  19      ׀Theseepidemicsaredirectlyrelatedintimewithmarkedincreasesinsmoking. @  IntheNetherlandsthenumberofcigarettesusedperadultperyearrosefrom670in1933,1370in1953,and2370in1973.ComparativefiguresfortheUSAwere1230,3380,and3850. 8 %  20      ׀ x Finlandslungcancerrates,ontheotherhand,havedroppedprecipitouslyfromabout100per100,00in1970toabout60inthemid90sper100,000,alongwithsubstantialreductioninsmokingprevalence,! %  21      ׀theresultofpersonsquitting(whoseriskoflungcancerfallstothatof H nonsmokerswithin1020years)andothersnotbeginning.  Eveninthefaceoftheoverwhelmingevidenceofthelinkagebetweenlungcancerandsmoking,theindustrycontinuestotryfindothercausesfortheepidemic.IntheNetherlands,oneindustrylawyersuggested,birdkeepingmaybeassociatedwithanincreasedriskoflungcancer.(Shook,HardyandBacontoE.Merloe,telex,5April1994.  %  22      ) % $   P$ 6.Marketingtoyouth " (   Industrydocumentspriortothemid1980softentalkedaboutmarketingtoadolescents1418yearsold,thosepotentialreplacementcustomerswhoseinitiationintosmokingandbrand X%, loyaltywasimportanttoachieve.% %  23      ׀Documentssincethenhavebeenmorecircumspect.Philip h MorrisexecutivesdiscussMarlborosdecliningholdonyoungpeopleintermsof startersandunder20yearolds;butasitisknownthat8090%ofadultsmokershavestartedbeforeage18,theexecutivesmeaningcannotbemissed% ' .InamarketinganalysisofMarlborosalesinTheNetherlands,29April1992,&` %  24      ׀onewritercommentsthat, Marlboroisageing;majorproblem   isunder20'sand20to24yearsold,and, CamelwinswhereMarlboroloses,while YoungandtrendybrandslikeLuckyStrike,GauloisesBlondesandWestare aggressiveinpromotionsandadvertising.Theauthorsconclusion: Marlboroneedsrevitalizationofimage,gettingthebrandsclosertostartersand20to24yearsold.7.Asummary x   Thetransnationalindustriesshownearlyidenticalpatternsofaggressivetactics,obfuscation,andoutrightdeceptionwherevertheirbusinessgoes.Eachnationmustdealwiththeindustryinitsownway,butbeingalertedtoandinformedaboutpracticesspecifictothatnationaspartofaninternationalsetofbehaviorsisessentialtocombattingtoepidemicthatistobacco. %   ̀