Doubt is Their Product - Introduction

Dout is Their Product


"Sound Science" or "Sounds Like Science"?

Reproduced with permission of Oxford University Press.

Since 1986 every bottle of aspirin sold in the United States has included a label advising parents that consumption by children with viral illnesses greatly increases their risk of developing Reye’s syndrome, a serious illness that often involves sudden damage to the brain or liver. Before that mandatory warning was required by the Food and Drug Administration (FDA), the toll from this disease was substantial: In one year—1980—555 cases were reported, and many others quite likely occurred but went unreported because the syndrome is easily misdiagnosed. One in three diagnosed children died. [1]

Today, less than a handful of Reye’s syndrome cases are reported each year—a public health triumph, surely, but a bittersweet one because an untold number of children died or were disabled while the aspirin manufacturers delayed the FDA’s regulation by arguing that the science establishing the aspirin link was incomplete, uncertain, and unclear. The industry raised seventeen specific ‘‘flaws’’ in the studies and insisted that more reliable ones were needed.[2] The medical community knew of the danger, thanks to an alert issued by the Centers for Disease Control (CDC), but parents were kept in the dark. Despite a federal advisory committee’s concurrence with the CDC’s conclusions about the link with aspirin, the industry even issued a public service announcement claiming ‘‘We do know that no medication has been proven to cause Reyes’’ (emphasis in the original).[3] This campaign and the dilatory procedures of the White House’s Office of Management and Budget delayed a public education program for two years and mandatory labels for two more.[4] Only litigation by Public Citizen’s Health Research Group forced the recalcitrant Reagan Administration to act. Thousands of lives have now been saved—but only after hundreds had been lost.

Of course, the aspirin manufacturers did not invent the strategy of preventing or postponing the regulation of hazardous products by questioning the science that reveals the hazards in the first place. I call this strategy ‘‘manufacturing uncertainty’’; individual companies—and entire industries—have been practicing it for decades. Without a doubt, Big Tobacco has manufactured more uncertainty over a longer period and more effectively than any other industry. The title of this book comes from a phrase unwisely committed to paper by a cigarette executive: ‘‘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’’ (emphasis added).[5]

There you have it: the proverbial smoking gun. Big Tobacco, left now without a stitch of credibility or public esteem, has finally abandoned its strategy, but it showed the way. The practices it perfected are alive and well and ubiquitous today. We see this growing trend that disingenuously demands proof over precaution in the realm of public health. In field after field, year after year, conclusions that might support regulation are always disputed. Animal data are deemed not relevant, human data not representative, and exposure data not reliable. Whatever the story—global warming, sugar and obesity, secondhand smoke—scientists in what I call the ‘‘product defense industry’’ prepare for the release of unfavorable studies even before the studies are published. Public relations experts feed these for-hire scientists contrarian sound bites that play well with reporters, who are mired in the trap of believing there must be two sides to every story. Maybe there are two sides—and maybe one has been bought and paid for.

* * *

As it happens, I have had the opportunity to witness what is going on at close range. In the Clinton administration, I served as Assistant Secretary for Environment, Safety, and Health in the Department of Energy (DOE), the chief safety officer for the nation’s nuclear weapons facilities. I ran the process through which we issued a strong new rule to prevent chronic beryllium disease, a debilitating and sometimes fatal lung disease prevalent among nuclear weapons workers. The industry’s hired guns acknowledged that the current exposure standard for beryllium is not protective for employees. Nevertheless, they claimed, it should not be lowered by any amount until we know with certainty what the exact final number should be.

As a worker, how would you like to be on the receiving end of this logic?

Christie Todd Whitman, the first head of the Environmental Protection Agency under the second President Bush, once said, ‘‘The absence of certainty is not an excuse to do nothing.’’[6] But it is. Quite simply, the regulatory agencies in Washington, D.C., are intimidated and outgunned—and quiescent. While it is true that industry’s uncertainty campaigns exert their influence regardless of the party in power in the nation’s capital, I believe it is fair to say that, in the administration of President George W. Bush, corporate interests successfully infiltrated the federal government from top to bottom and shaped government science policies to their desires as never before. In October 2002 I was the lead author of an editorial in Science that alerted the scientific community to the replacement of national experts in pediatric lead poisoning with lead industry consultants on the pertinent advisory committee.[7] Other such attempts to stack advisory panels with individuals chosen for their commitment to a cause—rather than for their expertise—abound.

Industry has learned that debating the science is much easier and more effective than debating the policy. Take global warming, for example. The vast majority of climate scientists believe there is adequate evidence of global warming to justify immediate intervention to reduce the human contribution. They understand that waiting for absolute certainty is far riskier—and potentially far more expensive—than acting responsibly now to control the causes of climate change. Opponents of action, led by the fossil fuels industry, delayed this policy debate by challenging the science with a classic uncertainty campaign. I need cite only a cynical memo that Republican political consultant Frank Luntz delivered to his clients in early 2003. In ‘‘Winning the Global Warming Debate,’’ Luntz wrote the following: ‘‘Voters believe that there is no consensus about global warming within the scientific community. Should the public come to believe that the scientific issues are settled, their views about global warming will change accordingly. Therefore, you need to continue to make the lack of scientific certainty a primary issue in the debate. . . . The scientific debate is closing [against us] but not yet closed. There is still a window of opportunity to challenge the science’’ (emphasis in original).[8]

Sound familiar? In reality, there is a great deal of consensus among climate scientists about climate change, but Luntz understood that his clients can oppose (and delay) regulation without being branded as antienvironmental by simply manufacturing uncertainty.

* * *

Polluters and manufacturers of dangerous products tout ‘‘sound science,’’ but what they are promoting just sounds like science but isn’t. Only the truly naïve (if there are any of these folks left) will be surprised to learn that the sound science movement was the brainchild of Big Tobacco, as we shall see. While these corporations and trade associations are always on the side of sound science, everyone else in the public health field, according to this construct, favors ‘‘ junk science.’’ Posthumously, George Orwell has given us a word for such rhetoric. The vilification of any research that might threaten corporate interests as ‘‘ junk science’’ and the sanctification of its own bought-and-paid-for research as ‘‘sound science’’ is indeed Orwellian—and nothing less than standard operating procedure today. But to give credit where credit is due, the sound science/junk science dichotomy has worked wonders as a public relations gimmick and has gained widespread acceptance in the current debate over the use of scientific evidence in public policy.[9]

We are at a crossroads, I believe. The scientific enterprise is at a crossroads. We need to understand what is going on in the name of ‘‘sound science’’ and what the consequences may be—and have already been—for public health. At its heart, this book documents the way in which product defense consultants have shaped and skewed the scientific literature, manufactured and magnified scientific uncertainty, and influenced policy decisions to the advantage of polluters and the manufacturers of dangerous products.

During my service at the Department of Energy, I was the chief architect of the historic initiative to compensate nuclear weapons workers who developed cancer and other diseases as a result of their work protecting America’s security. In addition, my research has contributed to the scientific literature on the health effects of exposure to asbestos and lead. I have been in the middle of the national debates over the regulation of beryllium, chromium, and diacetyl (the chemical in artificial butter flavor that is destroying workers’ lungs) and a leader in the science community’s response to the Bush administration’s attempts to stack scientific advisory committees and weaken federal regulatory agencies. All are the subject of this book. I have reluctantly omitted many other sagas equally damning but in which I have had no involvement.

Throughout, I have included what may be an overabundance of references, but I make some strong claims and raise questions about the motives of some scientists and corporations along the way. I have been very careful to document these claims. I have posted many important unpublished documents, including the ‘‘smoking guns’’ that support these assertions, at, the Web site of the George Washington University School of Public Health and Health Services’ Project on Scientific Knowledge and Public Policy. These documents provide much additional and damning detail. I wish I could promise that the documents will be available on this website in perpetuity, but that is not the way the web or the world works. Regardless, you can rest assured that every story and every outrage presented in this book is absolutely true.


1. Belay ED, Bresee JS, Holman RC et al. Reye’s syndrome in the United States from 1981 through 1997. NEJM. 1999;340(18):1377–82.

2. U.S. Food and Drug Administration. Advanced notice of proposed rulemaking: Labeling for salicylate-containing products. Fed. Reg. 1982;47: 57886.

3. Lurie P, Wolfe S. Aspirin and Reye’s syndrome. In Paradigms for Change: A public health textbook for medical, dental, pharmacy, and nursing students. Washington, DC: Public Citizen Health Research Group, unpublished.

4. Hilts P. Protecting America’s Health: The FDA, Business, and One Hundred Years of Regulation. New York: Knopf, 2003.

5. Brown and Williamson. Smoking and health proposal. Brown and Williamson document no. 680561778–1786, 1969. Available at: Accessed in June 2007.

6. Whitman CT. Effective policy making: The role of good science. Remarks at the National Academy of Science’s Symposium on Nutrient Over-enrichment of Coastal Waters. October 13, 2000. Available at: Accessed in June 2007.

7. Michaels D, Bingham E, Boden L. et al. Advice without dissent. Science. 2002;298(5594):703.

8. Luntz F. Memo: The environment: A cleaner, safer, healthier America; ca. 2003. Available at: Accessed in October 2006.

9. Herrick C, Jamieson D. Junk science and environmental policy: Obscuring public debate with misleading discourse. Philos Public Policy Q. 2001;21:11–16.