INSIDE STORY FROM STAN GLANTZ [05/12]

To provide an additional perspectives on the settlements talks now going on, and the cooperation or lack or cooperation between different individuals or organizations, ASH presents below the views and notes of Stanton Glantz, a well-known antismoking activist.

These notes are presented here with his kind permission.

As was reported in the press, Julia Carol, Henry Waxman, and I
"crashed" the meeting in Chicago two weeks ago to discuss the global
settlement. What follows are some notes I dictated to myself after the
meeting.  I am posting this note because it outlines the DIFFERENCES
in opinion among people in the tobacco control community regarding the
current global settlement deal.  People calling for unity should take
note of the fact that, at least now, it is simply impossible.  There
are two strongly held views.  One camp, led by the Center for Tobacco
Free Kids, is strongly committed to the negotiations and is doing
everything it can to rally the public health community behind its
participation.  The other camp, led by the American Lung Association
(and supported by much of the media) holds that supporting a "global
settlement" though these negotiations is a mistake.
 
I agree with ALA.
 
In any event, here are my notes:
 
Last Wednesday I got a call telling me about a secret meeting to be
held on Friday, May 2  which would be attended by the CEO's of Heart,
Lung and Cancer as well as members of their key volunteer leadership
together with a group of "Public Health Experts" to discuss the
situation surrounding the settlement and negotiations.  At that point
I learned that the "experts" were Dave Burns, Ron Davis, Dick Daynard,
Greg Connolly and Ken Warner.  (Later I learned that John Slade would
also be there.)  With the exception of Slade, all of these people have
recently expressed views consistent with the idea that some sort of a
global settlement mediated through Congress would be an acceptable, if
not good, idea.
 
I called Dick Daynard to find out what was going on and he told me
that he had been sworn to secrecy and couldn't talk about it.  I
expressed great unhappiness with his view and pointed out to him that
we had been working together for many years and that I knew about the
meeting, I knew the agenda and I knew who was going and so he
shouldn't play games with me.  In the middle of this conversation one
of us was interrupted to take another call.  When we connected later,
I told him that I thought this looked like a setup designed to
legitimize the positions being taken by those in favor of a settlement
and that it was outrageous that people who had a different view,
including myself, had been purposefully excluded.  In the meantime I
had learned that the American Lung Association had invited Congressman
Henry Waxman and that the Cancer Society had de-invited him.  This
only further heightened my concern that this was not going to be a
fair discussion of the outstanding issues.  I told Daynard that he
should simply refuse to go to the meeting on the grounds that it was a
setup.  I was pretty disgusted, particularly when Dick started talking
to me about how he was now thinking that public opinion had changed to
the point that Congress would not dare change any legislation that the
tobacco companies and public health interests agreed on.  When he told
me that he thought we could specifically control the mark-up process,
I told him that he was nuts.  (I think that the mark-up was the most
dangerous step of a dangerous path through Congress.)  I ended the
call very discouraged, since Daynard now seemed to be willing to
accept the very same Kluger-type solution that had so upset him a few
months earlier. 
 
I subsequently learned that the meeting had been called by ACS at the
request of Mississippi Attorney General Mike Moore; I do not know if
the list of invitees was cleared with Moore, but would not be
surprised if he vetoed me to avoid dissent.
 
On Thursday around noon I got a call from Julia Carol, Robin Hobart
and Paul Loveday to discuss the situation.  They had also heard that
Congressman Waxman had been de-invited from the meeting but was
thinking about crashing it.  (He had been invited by ALA and
de-invited by ACS.  It is not clear if ALA re-invited him.)   They
then patched in Phil Schlero from Waxman's office to urge him to urge
Congress and Waxman to attend the meeting uninvited.  Schlero told us
that Waxman had made the decision to do so.
 
After Schlero got off the line, Robin, Julia and Paul told me that I
had to go to the meeting too.  I told them that I was completely
disgusted with the behavior of all those concerned, that no one that
would be there was listening to me, and it was just a complete waste
of time.  I had never crashed a meeting before and didn't feel
comfortable doing it.  Robin and Julia had told me that Julia had
decided that while she didn't want to go either, there was a moral
imperative for her to attend, to simply bear witness to the mistakes
that were being made.  Robin Hobart said that she did not want Julia
going to the meeting alone and that I had to go. 
 
During the flight out we had a long discussion about what to do if we
were denied admission or thrown out of the meeting.  We finally
decided to show up at the Boston Room a little after 9 o'clock when
the meeting was scheduled to start.  It was Julia's belief that they
would simply not have the nerve to throw us out of the meeting.  The
fact that Henry Waxman was also showing up uninvited seemed to reduce
the likelihood that we would be thrown out.  Had we been thrown out,
the plan was to immediately begin calling reporters.



When we arrived, people were eating the obligatory Continental
Breakfast.  The first person I bumped into was Dick Daynard who walked
up to me and said that he was really pleased that I had been allowed
to attend.  I pointed out to him that I was crashing the meeting and
he walked away.  Lonnie Bristow from AMA (who did not seem aware of
the fact that we had not been invited) came up and greeted me warmly. 
Several other people, included Matt Myers, came up to say hello.  We
were given name cards and packets and allowed to participate in the
meeting.
 
When people went around the table to introduce themselves, John
Garrison, the CEO of the American Lung Association, introduced himself
as John "No immunity" Garrison.  I introduced myself as the co-author
of the Cigarette Papers and a person who was crashing the meeting.
 
John Seffrin chaired the meeting.  The agenda was the creation of a
public health technical advisory mechanism in support of the global
settlement negotiations. 
 
Matt Myers gave an extensive and passionate defense of his actions to
date.  He stated that many of the items reported in the newspapers had
been wrong, although, based on his presentation of the status of the
settlement discussions and the kinds of things being negotiated it
seemed to me that the immediate reports were generally accurate.  He
asked that his comments on the details of the negotiations be kept
confidential.  This was not a problem for me because he did not
present anything that I did not already know about from one source or
another.
 
The next speaker was Congressman Waxman. While he was not on the
agenda, it seemed that there was no choice but to let him talk. 
Waxman gave a strong and what I thought was a very wise assessment of
the situation.  He began by saying that he felt he was among many
people who he considered friends that he had worked with for years. 
He recounted many fights in Congress in which he and Matt and others
had worked together to do battle with the cigarette companies.  Then,
looking straight at Matt, he said that on this one Matt was wrong.  He
said that Matt was not advocating for the public health, but rather
advocating for this process in this settlement and that was a mistake.

He said that the job of the health groups was to advocate for the
health, not to engage in these kinds of negotiations and back room
deal making that was attempted to usurp Congress's authority.  He
pointed out that he had been a member of Congress for 24 years and
that he knew how the place worked.  When a piece of legislation got
moving in Congress many factors, often factors having nothing to do
with the legislation directly, come into play.  He noted that even if
the tobacco companies actually allowed the bill to move forward in
Congress unchanged and did not lobby for amendments, there were many
other ways that amendments and changed could be introduced into the
process and that individual tobacco state senators representing
tobacco unions or advertisers and that it was simply unrealistic to
expect this process to move forward without any changes being made in
Congress.  He stressed the fact that since the Republicans took over,
there have been many procedural changes which would have been unheard
of in earlier years. 
 
In a very pointed set of comments he returned to his view that it was
the job of the public health groups to advocate for public health and
begged them not to create a situation in which people like himself,
Dick Durbin, C. Everett Koop, and David Kessler would have to be on
the opposite side of a piece of legislation from groups like the
American Cancer Society.
 
I felt that Waxman's comments were very strong and very well taken but
landed on deaf ears for most of the people in the room.  
 
It had been my intention to simply sit quietly throughout the entire
meeting.  It was my view, given my normal level of exuberance, that
silence makes the strongest statement.  I managed to sit quietly
through all of the material discussed up to this point (about an hour
and a half).  During this time John Seffrin had walked around behind
me and made a friendly comment which somewhat disarmed me and had the
affect of cracking my resolve.  (Sitting quietly is not my normal
state of being.)  After Waxman's speech, Seffrin said that there would
be a break and that we would then have some presentations by Greg
Connolly, John Slade and others on the public health dimensions of the
settlement.  At that point I raised my hand and said that I thought
that, having come to the meeting uninvited, I would suggest they throw
out their agenda because it was really addressing the wrong issues.  I
said that while I thought that Greg, John and others were all very
bright people, I expected that they would give the same presentations
that we had all heard several times and that the real issues that
needed to be discussed were not on the agenda: (1) whether or not we
wanted to encourage a process that would ultimately lead to Congress,
and (2) what we were willing to give up as part of a settlement.  
 
I pointed out that in the history of the tobacco issue we have never
done well in Congress and that centralized solutions had always worked
toward the tobacco industry.  I suggested that the health groups could
control the venue but only if they acted in a clear, consistent and
strong way and that discussions of  the details of what to negotiate
was of secondary importance compared to the question of whether one
wanted this problem ultimately to end up in Congress.  I also pointed
that the most important thing in any negotiation is not what you get,
but what you are willing to give up.  All I had heard from Matt was a
laundry list of all the goodies that the health groups were hoping to
get.  I suggested that the people running the meeting change the
agenda after the break to focus on these two issues.
 
After we reconvened, John Seffrin announced that they were going to
pass on the formal presentations and go into a discussion, including
the two issues I raised.  I found the discussion to be quite
disconnected from reality.  Few people seemed to be picking up on the
points that were made by Henry Waxman,   Allen Morrison from Public
Citizen made the point that the parties to this process had differing
interests.  He identified the parties as the Attorney Generals,
individual harmed smokers, individual harmed non-smokers, class
actions of these two groups of people, and the private plaintiff's
bar, as well as the health groups and the tobacco interests.  He made
the point that at some point the interests of the different groups
that are "on our side" can diverge in a significant way.  I thought
this was a very good point but, like most of the other things that
were said at the meeting that I agreed with, there did not seem to be
much follow through.  The people from the "health" groups seemed
mostly preoccupied with all of the wonderful possibilities that face
them without a real serious discussion of the downside risks.  I kept
trying to inject those downside risks without much success; no doubt I
talked too much.  If I had it to do over again, I think I would have
done best to have limited my comments to the comment about the agenda
and then shut up through the rest of the meeting.



Julia made the point that all the secrecy was breeding distrust and
that public health always did better in the open, as opposed to the
tobacco industry, which thrived behind closed doors.
 
Given that I had been lead to believe that this was to be a meeting of
health people (with Henry Waxman excluded on the basis that he was a
"politician"), I was surprised to see Mike Moore and Dick Scruggs walk
in around lunchtime.  (By that point Waxman had left to go back to
Washington, but he did leave several staffers).  Moore was welcomed
very warmly by Seffrin.  ( I later learned that ACS had arranged the
meeting at Moore's request.)  Moore was to give us a briefing on the
talks.
 
I was expecting some sort of technical briefing from Moore, but
instead he gave essentially the same "campaign" speech that he did
when I first met him at a public meeting in Michigan.  He talked about
concerned he was about his elderly father who continued to smoke and
how he was afraid that someday he would get a phone call saying his
father had just had a heart attack or had been diagnosed with lung
cancer.  He talked about his ten year old son Kyle and how he was
concerned that Kyle not smoke.  He talked about how this was a fight
about kids and not about money.  He also vigorously defended Matt's
performance at the talks and said that Matt had vigorously presented
the health viewpoint.  Moore did not provide any specifics about the
negotiations.  He received a very warm reception from most of the
audience.  
 
When he finished speaking, there was a question period.  I said I was
very skeptical about all of  this (which everyone, including Moore,
knew), but said that, for the sake of argument, suppose that  they
could work out a deal that was so good that even I would like it.  I
asked what assurances Moore could give that the result would get
through Congress unscathed.  He waved off the question saying that he
was simply confident that it could be done.  In a private conversation
with Dick Scruggs, Scruggs said that he had been given personal
assurances by both the President and his brother-in-law, Trent Lott,
that this would happen.  I remained skeptical.
 
At one point I suggested that Moore and Scruggs not stay and listen to
the discussion.  This was a mistake on my part because it was rude,
although later Allen Morrison made the same point, and a bit later
Moore and Scruggs did leave the room.  
 
There was some discussion of Matt Myers' "Core Principles" which I
missed because I was in the back talking to Moore and Scruggs.  There
was a straw vote held on them and they were unanimously accepted. 
After the meeting Julia Carol said to me the reason she had changed
her mind and supported them because they no longer only pertained to a
Congressional deal and were tougher than earlier drafts that Matt had
circulated (although not to Julia or me) and she felt that they could
be used as a weapon against the AMA when they sold everyone else out.
 
As the meeting was winding down there was the issue of further
representation at the "table" came up and Myers thought it would be
helpful to have some other people there.  While I missed some of the
discussion because of my conversation with Scruggs and Moore, the
drift of it seemed to be that people were willing to accept having one
or more additional individuals participating and providing technical
input, but no one seemed very comfortable with having them serve as
institutional representatives.
 
This discussion was also combined with a somewhat confusing discussion
of what "no immunity" meant.  Phil Barnett (formerly of Waxman's
staff, then the FDA, now back on Waxman's staff) suggested that if "no
immunity" was the group's goal, then they should pull Matt out of the
talks and tell the negotiators that he would return when they came up
with an acceptable agreement on immunity.  I thought that this was a
very shrewd negotiating tactic, but it landed with a thud.  Matt
simply seemed too committed to the process and others seemed
enthusiastic about "going to the table."
 
Throughout the entire discussion, and particularly near the end,
Lonnie Bristow, the Immediate Past President of the AMA, seemed quite
adamant that the settlement was a good idea and that he thought that
there was a lot of "filibustering" going on against this idea and that
we should just "get the show on the road.".  When I raised the issue
of how we could keep control of the bill in Congress, he stood up and
said very clearly that the AMA had a large staff of people for
tracking and monitoring bills and the AMA would "take care of it."
 
After the meeting broke up I stood and listened to john Seffrin make a
very carefully worded statement to CNN.  CNN then grabbed me and I
gave them an interview and continued to express skepticism and talked
about being puzzled as to why the public health groups wanted to go
into the dragon's lair of Congress.  
 
After the meeting I got in a discussion in the hall with Moore and
Scruggs.  I told them that I had no problem with negotiating with the
tobacco companies about a settlement.  Indeed, it was my understanding
that they had to have such talks as part of the normal judicial
process.  I also told them that I had no problem with some people from
the public health community participating in the discussions.  The
problem I had was with the scope of the discussions; I felt that they
should be working on resolving their cases, not trying to write a law
that dragged in lots of other issues.  Moore responded that he could
accomplish something for the people of Mississippi, but that would not
do any good for the people of Alabama.  I said that Alabama was not
his problem and that if he got a good deal for Mississippi, the people
of Alabama would force their politicians to get them a similar deal
soon enough.  He also noted that there was a large spectrum of issues
covered in the different attorney general suits; I told him that I
viewed this as a strength rather than a weakness.
 
Overall I was quite disgusted and depressed by the meeting since none
of the public health people who were there seemed to take the risks of
the path they were on very seriously. 
 
As we were flying back to San Francisco I admitted to Julia that I was
glad that she and the others had forced me to go to the meeting
because it was, in fact, the right thing to do.  I think that had
things moved forward as they did without me at least showing up to
exhibit my disagreement with the drift of things, I would have
regretted it for a long time, regardless of the outcome.  At least, if
things move forward in a way that I fear they will, no one can say
that it was not because I didn't try to stop it.
 
After our meeting broke up there was another meeting of the "Executive
Committee" which I believe were the CEOs of the Voluntary Health
Agencies, the AMA and maybe a few other people.   While I do not know
what happened at that meeting, press calls over the weekend indicated
that Lonnie Bristow had been added to the negotiating team.  Moore and
the other pro- settlement attorneys general were spinning the meeting
as a decision by the public health community to "get on board".  My
sense of the meeting was much more ambiguous than that near the end. 
There is no doubt that the goal of getting these groups "on board" was
what Moore had in mind in requesting the meeting.  I believe that the
presence of Henry Waxman, myself and a few others presented a clear
decision by the group to do that. 
 
I later heard that John Garrison had continued to take a strong
position against joining the negotiations and Bristow wanted to join. 
Seffrin and Myles Cunningham (president of ACS) also seemed to want to
join the negotiations, but a few days later ACS issued a statement
saying that they would remain outside the negotiations in order to
"maintain objectivity."  This result made me feel a bit better.
 
P.S.  After the meeting I learned that the meeting had been called at
the request of Mike Moore.  I found this particularly troubling since
it signals a position by the American Cancer Society to move into a
more partisan role among the attorney generals about the proper way to
proceed.  A couple of ACS people said that all the attorney generals
were supposed to have been invited, (it is not clear by whom).  I
called Eric Johnson in Hubert Humphrey III's office and asked them if
they were invited and he assured me that they had not been, and in
fact, considered crashing the meeting themselves.  I wish they had
because I think it would have lead to a more balanced discussion.

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