Tuesday, 17 September 2013

Day 168: Déja vu all over again

For information on accessing documents, see note at the end of this post.

One of the grand narrative arcs in the history of tobacco is the attempts by tobacco companies to refute the mainstream opinion of science.

Or, as a committee of the U.K. House of Commons put it in a report filed in the Montreal Tobacco Trials last week: "It seems to us that the companies have sought to undermine the scientific consensus until such time as that position appears ridiculous." (Exhibit 1572)

Those present in the courtroom during today's session had an opportunity to witness this type of history in the re-making as BAT consultant and expert witness Michael Dixon tried to convince Justice Riordan that health authorities are wrong in thinking that low-tar cigarettes are without health benefit.

He was working hard to make that position not seem too ridiculous.

Michael Dixon, redux.

Michael Dixon is a pony of choice in BAT's stable of witnesses, and listening to him today, it is easy to see why. He not only talks a good line, he does so in a colourful Midlands lilt and with a disarming conversational delivery. To the extent that an Englishman can be folksy, Mr. Dixon is. (He has, however, a disconcerting gaze - Justice Riordan who was facing him all day may have had a somewhat different impression.)

Certainly, this is a witness who is practiced in appearing before juries and judges. He reported today that he had already testified as an expert witness for tobacco companies on ten previous occasions.

"Congratulations, sir on number 11" said Justice Riordan when he over-ruled the objections of the plaintiffs to Mr. Dixon being qualified as an expert witness  in "smoking behaviour, cigarette design and the relationship between cigarette behaviour and smoking design." Pierre Boivin based his opposition on Mr. Dixon's long career within the industry, suggesting that his bias would diminish his contribution as an expert advisor to the court.

An insider turned expert-witness

Mr. Dixon completed a PhD in physiology, but gained his knowledge of smoking behaviour over a 25-year career shared between BAT, Rothmans and research consultants to the tobacco industry. (Exhibit 20256.2) As with many of the other defence witnesses in this trial, he maintains a contractual relationship with his former employer.

In theory, Mr. Dixon had been brought in to respond to the report of the plaintiff's expert witness, André Castonguay. (Mr. Castonguay's report is Exhibit 1385, Mr. Dixon's 45-page report is Exhibit 20256.1).

In practice, he seems to have been given the task of casting doubt on the allegations that light cigarettes are not a defective design and that smokers do not "smoke for nicotine." 

Much of his testimony centered on his view that:
* smokers compensate, but not enough to compromise the aims of tar reduction policies.
* compensatory smoking is driven not by the psycho-pharmacological need for nicotine, but by the more physical "sensory impact" of smoke in the mouth. Smokers "chose one brand over another not because they give better mood control," but because of the sensory impact.

This perspective is significantly at odds with the current scientific consensus, although you would not have known that from listening to Mr. Dixon's testimony.

There were many moments today that felt a time warp back to the Isabelle Committee or other occasions when industry representatives have denied the prevailing public health conclusions, whether with respect to causation or the harms of second hand smoke or addiction.

Changing sides, changing rules

Mr. Dixon's task today was made easier by the use - for the first time in this trial - of an easel on which some of his organizing ideas were presented.

Because the use of prepared visual aids had been denied to the plaintiffs, plaintiff lawyer Mr. Pierre Boivin weakly protested that he felt "obliged to object" to the change in practice. If Justice Riordan was not consistent in his application of the "no powerpoint" rule, he was at least consistent in his practice of giving Imperial Tobacco's counsel a wide latitude in how they present their proof! The easel stayed.

Visual aids helped Michael Dixon
present his views
Defending the way things were

Mr. Dixon is a firm believer that standardised machine smoke testing is relevant to both smokers and regulators.

From their early use, he said, the limitations of smoking machines were well understood. The somewhat arbitrary parameters by which smoke yields were measured cigarette meant there was never any intention to represent what a real smoker would inhale.

"The critics of the machine smoking procedure have frequently failed to understand that values presented in tables published by DHSS have never been intended to be actual yields obtained by any one smoker. Rather they enable brands to be ranked."

Although the tobacco companies developed their own ways to better mimic actual smoking behaviour, Mr. Dixon said these measures in no way rendered the initial systems "obsolete" - and that industry science was were never secret:
* the "smoke duplicator" and other methods developed to analyze human smoking behaviour were a less reliable indicator of a cigarette's potential yield, as the variance between one person and another was so vast.
* BAT made public its insights on smoking behaviour in a 1978 volume "Smoking Behaviour and Psychological Influences" (Exhibit 20009). More recent findings are openly shared at the annual Tobacco Science Research Conferences, to which anyone is welcome to attend.

Defending the way things were thought to be

Mr. Dixon holds fast to the view that the machine yields of cigarettes are relevant to the exposure of smokers to harmful compounds. In addition to his own research dissecting butts to measure the residue (Exhibit 20261, 20262, 20263, 20264), he cited the work of other industry researchers who have found a relationship between machine-yields and smoker-exposure.

He said that the reduction in tar yields has likely resulted in the reduction of deaths from smoking. He cited as support for this view publications by researchers like Ernst Wyndar (Exhibit 20053.1), the Froggatt committee (Exhibit 20035), and Peter Lee (Exhibit 20267).

So where does that leave those scientists who have, in recent years, renounced the low-tar strategy?

Attacking the way things changed

More than a decade has passed the U.S. National Cancer Institute published "Monograph 13" and its finding that there was no conclusive evidence of any benefit to low tar cigarettes. (Exhibit 40346.221).

Mr. Dixon has testified against this report in other trials, and time does not seem to have softened his opinion. A long stretch of time today was given over to his detailed critique of the report and its authors.

The editors of Monograph 13 - David Burns and Neal Benowitz - were presented today as the ones whose ideas were not supported by mainstream scientists, or in the parlance established earlier in the trial, as the scientific "outliers". Mr. Dixon expressed confidence in the conclusions of other researchers, such as Geoffrey Kabat and Peter Lee (Exhibit 20269, 20269), who "concluded that David Burns' analysis wasn't correct."

Mr. Benowitz, came in for a more personal repudiation. Mr. Dixon displayed a graph from Mr. Benowitz's chapter in the Monograph, and then slowly dissected its conclusion. He said a more reliable understanding of the limited level of compensation was provided by Gerard Scherer (Exhibit 20010).

Even his former BAT colleagues who had reported on compensation came in for a scientific tongue wagging. The methodology of one such report, which had been cited by André Castonguay (Exhibit 346 H) was described today as "fairly crude." Its conclusion that smokers "as a whole took larger puffs from the lower delivery products" was not one that was either supported by its own data and certainly not a view that would have been shared amongst other BAT scientists, said Mr. Dixon. Perhaps insiders can also be outliers!

By the end of the day, Ms. Glendinning was well past the half way mark of the 80 or so documents she had selected for Mr. Dixon's comments.

Mr. Dixon's testimony continues tomorrow.

To access trial documents linked to this site:

The documents are on the web-site maintained by the Plaintiff's lawyers. To access them, it is necessary to gain entry to the web-site. Fortunately, this is easy to do.

Step 1: Click on: https://tobacco.asp.visard.ca

Step 2: Click on the blue bar on the splash-page "Acces direct a l'information/direct access to information" You will then be taken to the document data base.

Step 3: Return to this blog - and click on any links