The board of trustees of the American Medical Association has called product-safety litigation against tobacco makers "an ineffective and unwieldy tool" for shaping public policy on smoking and health.
The board's evaluation is contained in an eight-page report obtained and released yesterday by the nonprofit Public Citizen Health Research Group, which was founded by Ralph Nader. The HRG said the report would encourage physicians to avoid involvement in smokers' lawsuits that attribute disease, injury or death to cigarettes.
The HRG said that to counsel physicians to refrain from litigation would be "medically indefensible," and "nothing less than public health malpractice."
William S. Hotchkiss, a Virginia Beach, Va., specialist in chest diseases who is chairman of the board of trustees, will present the report Monday at an open session of an AMA legislative committee at the Shoreham Hotel. He could not be reached last night.
The committee may recommend approval of the report Tuesday by the House of Delegates, the AMA's governing body, which had requested the study of the role of the medical community on the issue of cigarette smoking.
The report comes at the start of a "second wave" of smokers' lawsuits against tobacco companies in which plaintiffs' medical experts are disputing defense medical experts on fundamental issues, particularly the reliability of evidence pointing to cigarettes as the leading cause of premature death and preventable diseases. The first such trial began Nov. 18 in Santa Barbara, Calif., and a second is set to start Monday in Knoxville, Tenn.
The AMA report said that changing legal doctrines, medical studies of tobacco-related disease, and the development of a theory of tobacco addiction have led plaintiffs' attorneys "to think that they have a greater likelihood of defeating the cigarette companies' claims that the tobacco-user plaintiffs were contributorily negligent, assumed the risk of sickness or death, were adequately warned, or misused the product. . . .
"Mass products-liability litigation, however, appears to be an ineffective and unwieldly tool for shaping public policy with regard to the health issues of tobacco use," the report continued. It said numerous lawsuits could lead to "inconsistent and at times conflicting results, attained only at a prohibitively high cost to society in terms of legal, financial and judicial resources.
"Furthermore," the report said, "it is not clear that the purported economic impact of successful litigation against tobacco companies will be sufficiently onerous to significantly alter the patterns of production or consumption of tobacco products."
The board report contended that "educational activities and strong initiatives," including physicians serving as "nonsmoking exemplars to their patients," is a better way of dealing with the public health issues posed by tobacco use.
HRG Director Sidney M. Wolfe, a physician, and staff attorney Allen Greenberg called the report an effort "to effectively sabotage" a litigation strategy, and said "there may be no more effective tool for shaping future public policy on this issue than litigation."
Without physician participation, smokers' cases "will be much more difficult, if not impossible, to win," Wolfe and Greenberg said in a letter to AMA President Harrison L. Rogers of Atlanta.
They said they found "startling" the assertion that litigation is prohibitively costly, citing a recent estimate by the congressional Office of Technology Assessment that smoking-caused illness, disability and death cost $65 billion a year in health care and lost productivity.
Wolfe and Greenberg also said that successful smokers' suits will impose "quite substantial" economic costs on the industry while conferring "significant" benefit on the public.
Noting that 50 million Americans are smoking 21 years after the first surgeon general's report on the risks of smoking, and that smoking is blamed for the premature deaths of about 350,000 Americans annually, they said traditional strategies have been "insufficient."
The HRG released a separate protest by Boston Drs. Samuel Solish and Michael L. Charney labeling the report "incomplete," in need of "factual corrections," and an invitation to "embarrassment" of the physicians' organization. Charney is cochairman of the Tobacco Products Liability Group, which encourages smokers' litigation.