Petticrew, MP; Lee, K (2011) The ”Father of Stress” Meets ”Big
Tobacco”: Hans Selye and the Tobacco Industry. American journal of public health, 101 (3). pp. 411-8. ISSN 0090-0036 DOI:
10.2105/AJPH.2009.177634
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HEALTH POLICY AND ETHICS
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Accessed December 7, 2006.
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55. Roark D. Impact on afloat sailors by
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Accessed November 9, 2009.
54. Morris P. Navy cracks down on
smoking with uniform new regulations.
November 17, 1993. Philip Morris collection. Bates no. 2048159074/9146.
Available at: http://legacy.library.ucsf.
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57. Scott GR. DoD—cigarettes. May 5,
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The ‘‘Father of Stress’’ Meets ‘‘Big Tobacco’’: Hans Selye
and the Tobacco Industry
Mark P. Petticrew, PhD, and Kelley Lee, DPhil, DLitt, MPA
The concept of stress remains prominent in public
health and owes much to the
work of Hans Selye (1907–
1982), the ‘‘father of stress.’’
One of his main allies in this
work has never been discussed
as such: the tobacco industry.
After an analysis of tobacco
industry documents, we found
that Selye received extensive
tobacco industry funding and
that his research on stress and
health was used in litigation to
defend the industry’s interests
and argue against a causal role
for smoking in coronary heart
disease and cancer.
These findings have implications for assessing the scientific integrity of certain
areas of stress research and
for understanding corporate
influences on public health research, including research on
the social determinants of
health. (Am J Public Health.
2011;101:411–418. doi:10.2105/
AJPH.2009.177634)
AN ANALYSIS OF INTERNAL
tobacco industry documents since
the 1990s has revealed extensive
efforts by the industry over decades to undermine the scientific
evidence on smoking and health.
These efforts include commissioning research from pro-industry
scientists to challenge scientific
findings and offer alternative explanations. To this end, the industry created the Council for Tobacco
Research (CTR) in 1953, initially
known as the Tobacco Industry
Research Council, to fund research
with significant ‘‘adversary value.’’1
Award letters for CTR ‘‘special projects’’ instructed recipients not to
March 2011, Vol 101, No. 3 | American Journal of Public Health
disclose that such research was undertaken predominantly for litigation purposes1 or that industry legal
reviews, rather than the normal scientific peer review process, served
as the basis for publication.2–4
Previous analyses have shown
how scientists were used to defend
and promote smoking, thus giving
the impression of ‘‘a chorus of
seemingly authoritative voices
from respected institutions around
the world spreading damaging arguments designed to benefit the
tobacco companies and damage
health.’’5 Smoking bans to protect
against secondhand smoke (SHS)
were undermined by paying scientists to disseminate industry messages in the United States.6 In
Europe, the industry attempted to
infiltrate the World Health Organization’s cancer research arm and
the International Agency for Research on Cancer; under what was
known as ‘‘Project Whitecoat,’’ it
aimed to recruit ‘‘groups of
scientists [that] should be able to
produce research or stimulate controversy in such a way that public
affairs people in the relevant countries would be able to make use
of or market the information.’’7,8
In China, British American Tobacco
funded liver disease research to
divert attention from SHS.2 It has
also been shown that social scientists were used to promote smoking
in many countries, including the
United Kingdom, the United States,
Australia, New Zealand, South
Africa, and Germany.5
We analyzed another important strand of tobacco industry–
funded research not hitherto described: the relationship between
Petticrew and Lee | Peer Reviewed | Health Policy and Ethics | 411
HEALTH POLICY AND ETHICS
stress and illness. Stress is regularly cited as an important social
determinant of health.9–15 Contemporary research on stress, however, must take into account the
decades-long support by the tobacco industry for stress-related
research beginning with the role of
physiologist Hans Selye (1907–
1982). Selye developed the concept
through animal studies from 1933
to 194516,17 and popularized it in
many best-selling books.18 In
1977 he retired and set up the
International Institute of Stress in
Montreal and the Hans Selye
Foundation to fund stress research.19 Selye drew parallels between his own career and that of
the chemist and microbiologist
Louis Pasteur.17 He died in 1982,
having been hailed the ‘‘father of
stress.’’ During his career, he wrote
1700 articles and 39 books, was
nominated for the Nobel Prize 10
times, and received the Order of
Canada, one of the country’s highest honors.20–22
Selye’s links to the tobacco industry have not been hitherto examined, to our knowledge. We
analyzed internal industry documents and describe how the industry funded his work, used him
as an expert witness in legal proceedings, and made extensive
use of his research for litigation and
public relations. Our findings raise
important questions about assessing the scientific integrity of stress
research and about the scope of the
industry’s influence on public
health research and policy.
METHODS
We reviewed internal tobacco
industry documents by searching
the Legacy Tobacco Documents
Library (http://legacy.library.
ucsf.edu) using as keywords relevant terms (i.e., ‘‘stress,’’ ‘‘cancer,’’
‘‘heart disease,’’ ‘‘personality,’’
‘‘emotional,’’ and ‘‘psychological’’)
and individuals (Selye and his industry contacts). This initial search
identified 6225 documents, most
of which we assessed as not relevant to this specific analysis (e.g.,
bibliographies citing papers on
stress). We downloaded 594
documents and coded them according to whether they related
to Selye, his research, his funding,
or the industry’s use of stress
research. From this we identified
a subset of documents directly
relevant to Selye’s work with the
industry (cited herein). We used
triangulation with secondary
sources about Selye, his published work, and tobacco litigation to validate findings from industry documents.3,23
RESULTS
Contact between Selye and the
tobacco industry appears to have
been initiated in 1958 when he
wrote to the American Tobacco
Company seeking funding. Although his request was declined,24
the following year Edwin Jacob (of
New York law firm Davis, Polk,
Wardwell, Sunderland, and Kiendl)
wrote to him when preparing a defense against liability actions
brought against tobacco companies.
Jacob explained that the firm
wished to argue that a statistical
association between smoking and
cancer is not proof of causality:
We should very much appreciate
it if you would . . . give us the
benefit of your views as to the
412 | Health Policy and Ethics | Peer Reviewed | Petticrew and Lee
medical material we might use.
For example, we should be very
interested in demonstrating that
medicine has previously seen
striking correlations suggested as
representing cause and effect,
only later to find that the significance, if any, of the correlations
was otherwise.25
The firm offered to pay Selye
US $1000 to produce a memorandum to that effect. Selye agreed
but would not testify and preferred not to be quoted.26 He
eventually wrote 2 memos (unavailable in existing collections).27
In 1966 industry lawyers including Alexander Holtzman,
counsel for Philip Morris, and
William Shinn, counsel for Lorillard, Philip Morris, and Brown &
Williamson, again contacted
Selye.28 Writing to industry lawyer
David Hardy (Shook, Hardy, and
Bacon), Shinn noted that Selye’s
earlier memoranda were problematic: ‘‘I think we were all aware that
the problem with the memoranda
which had been prepared earlier
was [that] the approach appeared to
be one that conceded some carcinogenic factor in tobacco.’’29
Shinn also reported that Selye
was willing to write a paper on
smoking and stress but wanted
guidance on what to write. He
noted that ‘‘Dr. Selye should comment on the unlikelihood of there
being a mechanism by which
smoking could cause cardiovascular disease.’’ Selye could also emphasize the ‘‘stressful’’ effect on
the US population of antismoking
messages. Selye met again with
industry lawyers in January 1967
to advise how the industry should
adopt a defense emphasizing
the ‘‘prophylactic and curative’’
aspects of smoking.28,30,31 Shinn
reported that at this meeting Selye
recalled and retrieved the 2 memos
he had written previously. In May
1967, Shinn set out his ‘‘ideas on
Selye’’ in a letter to Holtzman and
outlined the procedure for using his
work on stress: ‘‘The desirability of
adjusting to a stressful life by seeking diversions . . . would be established as a general proposition. . . .
The theory should be promulgated
through articles, books, TV appearances etc. . . .’’ with the ‘‘creation
of [the] image of smoking as a right
for many people—as a natural act
for man.’’32
This reference to ‘‘diversions’’
reflected Selye’s view that disease
was a result of unsuccessful adaption to environmental stimuli.17
This stress could be counteracted
by other stimuli, a process he called
‘‘deviation,’’ of which smoking was
a form.
Publicly, Selye did not declare
his consultancy work for the tobacco industry. In a 1967 letter to
Medical Opinion and Review, he
argued against government overregulation of science and public
health, implying that his views on
smoking were objective: ‘‘I purposely avoided any mention of
government-supported research
because, being too largely dependent upon it, I may not be able to
view the subject objectively.
However, I do not use . . . cigarettes so let these examples suffice.’’33 Though not a cigarette
smoker, he did smoke a pipe.29
In June 1969, Selye (then director of the Institute of Experimental Pathology, University of
Montreal) testified before the Canadian House of Commons Health
Committee against antismoking
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HEALTH POLICY AND ETHICS
legislation, opposing advertising
restrictions, health warnings, and
restrictions on tar and nicotine.
When approached by Philip
Morris in March 1969, he initially
declined; according to Holtzman,
He told me during an interview
last Friday that he has no information to give the Parliamentary
Committee since we had declined
to support his proposal more than
a year ago. He felt that if the work
had gone forward, he might, by
now, have had some results.34
A week later the proposal was
recirculated within Philip Morris,
and on March 28 William Hoyt
(CTR executive director) informed
Selye that he had been awarded
US $50 000 per year for a 3-year
‘‘special project,’’ with another
US $50 000 a year pledged by the
Canadian tobacco industry.35,36
Subsequently, Selye testified on
June 12, 1969,37,38 arguing the
benefits of smoking and arguing
against antismoking messages:
the question is not ‘‘to smoke or
not to smoke,’’ but to smoke or
drink, eat, drive a car—or simply
fret. Since we cannot discard our
surplus energy, we must occupy it
somehow . . . that often more
damage is done by creating,
through well-meant crusades
of enlightenment, innumerable
hypochondriacs whose main
sickness is really the fear of sickness.39,40
A few days later he appeared on
a Canadian Broadcasting Corporation radio program citing the
benefits of smoking for people
under stress, such as expectant
fathers and condemned criminals.41 In July that year Helmut
Wakeham (Philip Morris director of
research and development)
recorded that Selye would be
available as a consultant.42
However, although keen to
benefit from his supportive statements, privately some in the industry saw Selye’s work as ‘‘not
really pertinent to the task of
proving the benefits of smoking
in overcoming stress.’’43 Nonetheless CTR continued to fund Selye,
and the tobacco industry continued
to cite the concept of stress in
litigation and public inquiries. Selye
wrote to CTR again in 1971 seeking
further funding,44 and in 1972
‘‘special project’’ funding for Selye’s
work was awarded, amounting to
a further US $50 000 per year for
3 years.45 Industry lawyers appear
to have influenced the content of
some of Selye’s writings:
He is willing to write for us and
wants us also to provide a suggested guideline. . . . Dr. Selye
should comment on the unlikelihood of there being a mechanism
by which smoking could cause
cardiovascular disease. . . . Dr.
Selye can point out that even if
cigarette smoking had some carcinogenic effect . . . it might account for only a markedly small
number of deaths, the balance
being the result of other influences. . . .28,30,31,46
Philip Morris subsequently used
Selye’s statements on the benefits
of smoking to argue against the
use of health warnings on tobacco
products in Sweden47 as well as
in other rebuttal materials.48 Similarly, in 1977 the Australian Cigarette Manufacturers quoted Selye
extensively in their submission to
the Australian Senate Standing
Committee on Social Welfare.49 In
1990, the Tobacco Institute of New
Zealand deployed the stress argument to criticize a Ministry of
Women’s Affairs policy document
on female smoking:
March 2011, Vol 101, No. 3 | American Journal of Public Health
Clearly it is not the ‘‘glossy images
of advertising’’ which draw these
women to smoke. The problems
as depicted reflect a high level of
stress. . . . Perhaps the Ministry
could address the stress problems
. . . rather than the alleviators of
the stress.50
The San Martin Conference
Selye was a key contributor to
a major Philip Morris initiated
conference in January 1972.51,52
The event, the Conference on the
Motivational Mechanisms of Cigarette Smoking held on San Martin
in the French Antilles, involved
prominent behavioral and social
scientists, and all 6 major tobacco
industry companies attended. Internal documents noted that ‘‘the
conference will provide authoritative statements in support of smoking. These statements can become
the basis for a pro-cigarette public
relations campaign.’’53
William Dunn (Philip Morris
assistant principal scientist) observed that, although 16 of 23
attendees had received support
from the tobacco industry, some
had also been funded by other
organizations, including the American Cancer Society and the National Institutes of Health.54 Along
with the speakers’ stature, he believed this ensured that ‘‘no question could possibly be raised by the
scientific community about the
objectivity of the conference . . . the
published proceedings will be
credible to the scientific community.’’54
Dunn also described an informal
discussion with Selye to Helmut
Wakeham (Philip Morris vice
president of research and development) after the conference, suggesting that Selye was interested
in the scientific directorship of
CTR:
Professor Selye’s world eminence
makes his name a most valuable
commodity. The association of
his name and presence with a research institute or foundation
would be a most beneficial arrangement for all concerned.55
This did not happen, however,
possibly because of doubts about
the relevance of Selye’s work.The
perceived importance of the 1972
San Martin conference to the industry is clear from a scribbled
note on an internal memo: ‘‘This is
probably the most important conference ever for the tobacco industry. Every word should be
taped and transcribed.’’56 Publication of the conference proceedings
as a book (titled Smoking Behavior:
Motives and Incentives) followed,
subsidized by the CTR.57 Cigarette
manufacturers’ evidence to the
Australian Senate Standing Committee on Social Welfare in 1977
quoted the proceedings, and Selye,
at length. Selye’s contribution had
been edited and partly rewritten by
Robert Hockett, the acting scientific
director of CTR, with other modifications suggested by Dunn.58–
60
The International Committee on
Smoking Issues Working Party, set
up by tobacco companies to agree
with industry positions on issues
that ‘‘affect the long-term interests
of the tobacco industry primarily in
the area of smoking and health,’’61
also noted the importance of the
San Martin conference as a ‘‘starting
point for its work.’’62 The 1983
British American Tobacco Board
Guidelines on Public Relations—which set out general strategies for
dealing with government, medical
authorities, and the media—cite
Petticrew and Lee | Peer Reviewed | Health Policy and Ethics | 413
HEALTH POLICY AND ETHICS
Selye’s foreword.63,64 Philip Morris
also cited the book in 1995 as an
example of the industry’s openness
when rebutting accusations of secrecy by US congressman Henry
Waxman:
Why does Mr. Waxman characterize Philip Morris’s research
interest in why people smoke,
including the possible role of
nicotine, as ‘‘secret’’ when a scientific conference on this subject
was organized by a Philip Morris
researcher in 1972, and papers
from the conference were published in a 1973 book? The book
. . . is available in public libraries
and has been cited more than
500 times in the scientific literature.65,66
Selye also appeared in a Tobacco Institute public relations
film, The Answers We Seek, described by the industry as ‘‘an
honest, no-punches pulled look at
the facts about tobacco and
health’’ and produced in 1976 for
free circulation to community and
civic organizations.67,68 A 1977
memo from Ray Fagan (Philip
Morris scientist) to Robert Seligman
(Philip Morris vice president of research and development) noted that
another film had been made that
included Selye and British psychologist Hans Eysenck, also a tobacco
industry consultant and, like
Selye, a recipient of CTR special
project funding.69 Fagan noted that
‘‘the film’s message is quite clear
without being obvious about it—a
controversy exists concerning the
etiologic role of cigarette smoking in
cancer.’’70
In July 1977 Selye sent details
to RJ Reynolds of other scientists
working on stress who, he believed, could be approached as
potential consultants.71 By this
time, however, Selye’s value to the
industry may have been dwindling.
That same year he sought
US$50000 from RJ Reynolds to
support the development of a US $1
million project on coping with
stress.72,73 This request was not
well received. One memo described
Selye as showing signs of senility
and having ‘‘contributed little to the
field in the last 10 to 15 years.’’74
Despite this cooling of relations,
the industry continued to use
Selye’s prosmoking statements.
This is highlighted by the Tobacco
Institute’s 1978 publication ‘‘The
Smoking Controversy: A Perspective,’’75 a document Landman
described as ‘‘one of the most
strongly-worded and comprehensively-misleading missives issued by
the industry . . . written before the
industry chose its words more
carefully.’’76 It quotes Selye at
length, stating, for example, ‘‘It is
frightening that no-one mentions
the benefits of tobacco . . . I am sure
that often more damage is done by
creating, through well-meaning
crusades of enlightenment, innumerable hypochondriacs. . . .’’75,77
Stress as One Risk Factor
Among Many
Even after Selye’s research had
fallen out of favor with the industry, stress research continued
to be used to stoke controversy. In
particular, it was often argued that
the causes of cancer and heart
disease were multifactorial (with
stress being 1 factor), with any
observed relationships with
smoking probably attributable to
confounding, or that smoking was
a helpful diversion. These arguments were promoted in academic
papers written by industry consultants.78–80
414 | Health Policy and Ethics | Peer Reviewed | Petticrew and Lee
Stress research was used in this
way. A 1981 British American
Tobacco document cited Selye’s
claims that the association of
smoking with cardiovascular diseases is relatively weak compared
with other factors, including
stress.81 This was also used as an
argument against the carcinogenic
effects of SHS.82 Stress is similarly
put forward as an alternative to
what was termed ‘‘the smoking
hypothesis’’ in a 1989 British
American Tobacco document
written for circulation to UK government ministers, regulatory authorities, and scientific and medical
professionals.83,84 Similar arguments were rehearsed in other
documents,85–87 including briefing
materials.88–90 For example, the
suggested response to the question
‘‘Does smoking cause disease?’’ is
the following:
While some scientists have associated cigarette smoking with
heart disease, it is reasonably
[here, the word ‘‘reasonably’’ has
been deleted, and the word ‘‘certainly’’ inserted] clear that a number of other factors including
life-style, blood pressure, biochemistry, genetics and in particular, stress, may also be involved.91,92
British American Tobacco also
used the multifactorial argument
in 1994 to argue against restrictions on smoking in Uzbekistan as
part of the ‘‘Tashkent Decree,’’93
and stress was cited by Irish company PJ Carroll Limited (then part
of Rothmans International) in
a statement to the Irish Joint Committee on Health and Children in
1998: ‘‘These diseases are also
statistically associated with many
other variables, such as diet, lifestyle, heredity and stress. . . . But the
existence of a statistical association
does not mean that smoking causes
these diseases.’’94
Similar arguments were made in
the Irish and Brazilian courts.95–98
In 1995 industry lawyers Shook,
Hardy, and Bacon supplied Philip
Morris with a detailed summary of
the epidemiological evidence linking workplace stress and heart disease99 to be used as an argument
against the US Occupational Safety
and Health Administration plan to
regulate workplace SHS. Stress was
also used as an argument against
giving up smoking in a 1979 BMJ
paper by tobacco industry consultant Peter Lee.100
DISCUSSION
The extent to which the tobacco
industry sought to undermine the
scientific process relating to tobacco and health is well documented. Our study shows that the
concept of stress is a further area
of public health research that has
been subject to extensive tobacco
industry influence. Using the categories of industry influence
identified by Gruning et al.,101
Selye’s expert evidence diluted
existing evidence of the adverse
effects of smoking and distracted
attention from its harms. In failing
to declare his receipt of tobacco
funding when expressing his views
against tobacco control, documents
suggest he concealed a lack of
scientific independence; and by involving tobacco industry lawyers,
Selye allowed the industry to manipulate the scientific process.
Assessing the public health effect of the industry’s influence on
stress research is difficult. Although Selye spoke out against
American Journal of Public Health | March 2011, Vol 101, No. 3
HEALTH POLICY AND ETHICS
smoking restrictions, there is no
clear trail between his research
and policy decisions. Rather, his
research added to a multipronged
effort by the industry to cloud
public debate about tobacco and
health, and his role as expert
witness, consultant, and ‘‘talking
head’’ in industry publications and
films lent scientific credibility to
industry efforts to undermine tobacco control. Since 1999, as part
of an antiracketeering case
brought by the US Department of
Justice against 7 tobacco companies (British American Tobacco,
Brown & Williamson, Philip
Morris, Liggett, American Tobacco
Company, RJ Reynolds, and Lorillard), the CTR, and the Tobacco
Institute, the implications of the
industry’s influence on stress
research has begun to be
revealed.102 Among the 116 racketeering acts listed in the legal
action successfully concluded in
2006 and upheld in May 2009,103
Act 15 states,
CTR proposed to support and
publicise research advancing the
theory of smoking as beneficial to
health as a stress reducer, even
for coronary prone persons;
[and] representing that stress
(rather than nicotine addiction)
explains why smoking clinics fail
. . . and proposing to publicize the
image of smoking . . . as a scientifically approved ‘‘diversion’’ to
avoid disease-causing stress.102
Racketeering Act 25 related to the
1973 San Martin conference,
whose organization and communications were deemed to be in
violation of anti-racketeering laws.
Racketeering Acts 44 and 45 related to a 1979 proposal to fund
research on stress and cardiac
disorder by British psychologist
and tobacco industry consultant
Hans Eysenck.102,104 Selye’s letter to Robert C. Hockett (CTR)
regarding this project’s ‘‘elimination of arguments presently used
against smoking’’ violated US Code
Title 18 x1341 (‘‘Frauds and
Swindles’’).105,106 CTR support of
Selye was also cited in The State of
Florida v. The America Tobacco
Company et al. as part of the plaintiff’s case, citing the tobacco industry’s ‘‘perversion of the lawyerclient relationship as well as the
language, mechanisms, and institutions of scientific research.’’107Selye
remains a significant figure in this
field, and at the time of his induction into the Canadian Medical Hall
of Fame in 2006,108 it was suggested that the time was ripe for
a comprehensive evaluation of his
life and work.16 Such an evaluation
should include the extent to which
his research on stress was entwined
with tobacco industry interests.
Our findings also point to the
tobacco industry’s broader interests
in research in to the social determinants of health. For example,
there are many industry documents
relating to unhealthy lifestyles, and
in the 1990s British American Tobacco–funded research on fetal
programming.109–112 This suggests
the need for further analysis of the
extent to which the tobacco industry has played a role in funding
contemporary public health research.113 These findings relating to
Hans Selye also have wider implications, given similarities between
tobacco industry strategies and
those used by the food industry,
including disputing the science, focusing on issues of personal responsibility, and using paid scientists to attempt to influence key
March 2011, Vol 101, No. 3 | American Journal of Public Health
decision-making bodies.114 The case
of Selye, therefore, has implications,
not just for how the tobacco industry sought to influence research
on stress but also for understanding
corporate influences in general on
public health research and policy,
and it strengthens the case for
improved disclosure of all industry
influence on research.
About the Authors
Mark P. Petticrew and Kelley Lee are with
the Public and Environmental Health Research Unit (PEHRU), Department of
Public Health and Policy, London School of
Hygiene and Tropical Medicine, London,
United Kingdom.
Correspondence should be sent to Mark
Petticrew, PEHRU, PHP, London School of
Hygiene and Tropical Medicine, Keppel St.,
London UK, WC1E 7HT (e-mail: mark.
[email protected]; http://www.lshtm.
ac.uk/people/petticrew.mark). Reprints can
be ordered at http://www.ajph.org by clicking the ‘‘Reprints/Eprints’’ link.
This article was accepted October 12,
2009.
Contributors
M. P. Petticrew developed the idea for the
study and conducted the searches. Both
authors contributed to the interpretation
of the data and to the preparation and
writing of the article.
Acknowledgments
When the project was initiated, M. P.
Petticrew was funded by the Scottish
Executive Department of Health’s Chief
Scientist Office and the UK’s Medical Research Council. M. P. Petticrew also receives funding from the Wellcome Trust,
the UK Department of Health Policy Research Programme, and the Medical Research Council (UK). K. Lee is supported
in part by funding from the National
Cancer Institute and the National Institutes of Health and has received funding
from the Wellcome Trust, Health Canada,
and Cancer Research UK.
We thank Martin McKee (London
School of Hygiene and Tropical Medicine)
for advice on the design of the study; Lisa
Dove, who assisted with indexing the
documents while paid by the Medical
Research Council and Public Health
Sciences Unit as a temporary assistant;
and Nathaniel Wander for additional information on links between stress research and the tobacco industry.
Human Participant Protection
No institutional review board approval
was required.
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American Journal of Public Health | March 2011, Vol 101, No. 3