After decades of legal victories by smokers over tobacco companies, some recent lawsuits are being undermined by a new round of medical experts — some with university ties — who have taken hundreds of thousands of dollars to dispute plaintiffs’ claims, according to a study published on Friday.
The tobacco industry, after long denying connections between smoking and disease, has been ordered to pay hundreds of billions of dollars in various settlements since 1998. But Florida courts in 2006 rejected a major class-action settlement, leaving smokers and companies to fight out thousands of individual cases.
A Stanford University professor of otolaryngology, Robert K. Jackler, combed through court records of those cases. His goal: to find who was giving the tobacco companies the expert credibility they needed to continue the fight.
His conclusions, published on Friday in the journal The Laryngoscope, identified six fellow otolaryngologists — specialists in diseases of the head and neck — who have repeatedly given sworn testimony in Florida courts that offered reasons other than smoking for the cancers suffered by plaintiffs or their deceased relatives.
Possible alternative causes of cancers suggested by the experts, Dr. Jackler found, included alcohol, asbestos, cleaning solvents, gasoline fumes, genetic predisposition, the human papilloma virus, mouthwash, and salted meats.
Such testimony defies established medical evidence, Dr. Jackler wrote.
Under the rules established by Florida courts, a plaintiff needs to show only a greater-than-50-percent probability that his or her cancer was caused by smoking. Smoking, however, is the only factor that meets that threshold, Dr. Jackler said. The other factors cited in the Florida testimony aren’t even close. Even a smoker who quit 15 years ago has a risk of cancer three to four times as high as that faced by a nonsmoker, he said.
Paid for Testimony
Of the six experts identified by Dr. Jackler, at least three had current or former university affiliations, including a Stanford colleague, Willard E. Fee Jr. Dr. Fee, a professor emeritus of otolaryngology, served 20 years as his department’s chairman and also served a term as president of the American Head and Neck Society, his field’s leading professional association.
In one case in 2014 — a failed lawsuit by a husband whose late wife, Carol E. Hetzner, developed oral cancer after 30 years of smoking — Dr. Fee collected $100,000 for his testimony. In that case, he suggested Listerine mouthwash as an alternative cause of Ms. Hetzner’s cancer. He said he had given depositions in more than 100 such cases since 1976. Dr. Fee, who retired to emeritus status in 2013, declined a request from The Chronicle to comment on his work.
Others identified in Dr. Jackler’s report include Merrill A. Biel, an adjunct assistant professor of otolaryngology at the University of Minnesota-Twin Cities, and Kim R. Jones, a former associate professor at the University of North Carolina at Chapel Hill. Both have private practices, and neither responded to requests for comment.
A spokesman for one of the tobacco companies involved in the lawsuits, Philip Morris USA, provided a two-sentence response to a request for comment. The spokesman said that Dr. Jackler’s critique has “no place in our judicial system” and suggested that Dr. Jackler has undisclosed ties to plaintiffs’ lawyers.
In response, Dr. Jackler said that he had never worked with any such lawyers and that the company’s statement had made “no effort to defend the indefensible opinions of their highly compensated, ethically challenged physician defenders.”
Shock and Astonishment
The current president of the American Head and Neck Society, Dennis H. Kraus, said he had trouble understanding how professional otolaryngologists could offer such testimony against tobacco plaintiffs.
“I wish I were shocked,” said Dr. Kraus, director of the Center for Head and Neck Oncology at the New York Head and Neck Institute. “Unfortunately I’m not.”
Another of Dr. Jackler’s colleagues at Stanford, Laura Roberts, a professor of psychiatry and behavioral sciences, is now conducting a similar investigation into experts who have given testimony in the Florida lawsuits on the issue of addiction. Under the state’s guidelines, the tobacco companies can prevail if they show the smoker was not actually addicted. Dr. Roberts said she had been “astonished by the number of psychologists who provide testimony in these cases suggesting that tobacco is not addictive.”
In his deposition in the Hetzner case, Dr. Fee said he too had been a longtime smoker who had struggled over the years to quit. Under questioning, he declined to describe himself as addicted. But he added: “I tried every method known and written about. You name it, I’ve done it.”
Paul Basken covers university research and its intersection with government policy. He can be found on Twitter @pbasken, or reached by email at paul.basken@chronicle.com.
