The price paid: Manipulation of otolaryngologists by the tobacco industry to obfuscate the emerging truth that smoking causes cancer§


  • Robert K. Jackler MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
    • Stanford Otolaryngology–HNS, 801 Welch Road, Stanford, CA 94305
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  • Hussein A. Samji MD, MPH

    1. Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

  • All figures used in this article were drawn from the collection, “Not a Cough in a Carload,” which contains images from the campaign by the tobacco industry to hide the hazards of smoking, and can be found at the National Museum of American History of the Smithsonian Institution. The collection is a gift of the Jackler family in memory of Marilyn Jackler. A portion of the collection can be viewed at:

  • §

    Editor's Note: This Manuscript was accepted for publication August 11, 2011.



Our objectives were to explore the multifaceted campaign by the tobacco industry to enlist otolaryngologists in support of their efforts to reassure consumers that cigarettes were safe, and to elucidate the incentives that led so many leading otolaryngologists to give testimony denying a causal linkage between tobacco use and head and neck cancer.

Study Design:

Historical analyses.


Recent litigation has exposed for public viewing a huge trove of internal tobacco industry documents. These documents include correspondence files, internal memoranda, research solicitations, grant agreements, records of payments, marketing plans, and testimony by otolaryngologists on behalf of tobacco interests in court proceedings, before congressional committees, and at U.S. Federal Trade Commission hearings.


Evidence shows that marketing divisions of major tobacco companies systematically sought to use the authority and prestige of otolaryngologists to support their promotional efforts. Industry documents reveal widespread collaboration by leaders in the field through conducting research and giving well-compensated testimony favorable to tobacco interests. Invariably, industry-funded research showed tobacco in a favorable light. The industry also sought to influence otolaryngologists with free cigarettes, elegant dinners, and hospitality booths at conventions.


In revealing this unfortunate period in our history, we by no means intend to diminish the memory of distinguished leaders whose tobacco involvements were certainly more acceptable by the standards of their own time. Rather, by exposing the pervasive tobacco industry manipulation of scientific research for commercial purposes we seek to encourage vigilance by contemporary researchers who might consider seeking funding from an industry that places the pursuit of profits above the well-being of its customers.Laryngoscope, 122:75–87, 2012