In the last two years, the Ladies' Home Journal, The New Republic and The Atlantic have all considered publishing articles wholly or partly devoted to the dangers of smoking or the influence of cigarette advertising in suppressing news of smoking hazards.
The Ladies' Home Journal cut out all references to smoking in an article it had commissioned on women's health. The New Republic decided not to print the article it had commissioned on the impact of cigarette advertising on print media. Editor William Whitworth of The Atlantic decided not to pursue a proposal for a similar piece by one of his principal writers.
The editors involved in all three pieces denied that advertising considerations were involved. Ladies' Home Journal editor Myrna Blyth said the section on the dangers of smoking was removed from the Journal story because another article in the same issue discussed smoking. The New Republic publisher Martin Peretz said he killed the article on tobacco advertising because he found it "hysterical." Whitworth said The Atlantic decided not to pursue its article because the proposal offered little news.
These incidents and others have led to a widespread perception among many writers, editors and antismoking organizations that cigarette advertising is influencing the news Americans read about smoking. And major medical organizations -- joined yesterday by the American Medical Association -- have begun to campaign for legislation to ban all cigarette advertising in magazines and newspapers, as it has been banned in broadcasting.
The AMA House of Delegates voted to oppose all media advertising of tobacco products. AMA officials said efforts to get newspapers and magazines voluntarily to refuse tobacco advertising had been largely unsuccessful.
Surveys by The Washington Post and others suggest that major newspapers and news magazines regularly publish stories about the dangers of smoking. But at many other magazines that cover health, surveys and interviews suggest that dependence on cigarette advertising may indeed inhibit coverage of the risks of tobacco.
According to the Readers' Guide to Periodical Literature, three major magazines that refuse cigarette ads -- Readers' Digest, Good Housekeeping and the Saturday Evening Post -- published 18, 15 and 13 stories on smoking, respectively, during the last 10 years.
Of 10 other major magazines surveyed that do accept cigarette advertising, none published more than four stories on smoking, and five published no articles on the subject during the same 10 years.
The same pattern appears in surveys by the American Council on Science and Health and by two Seattle physicians, Dr. Robert Jaffe and Dr. Michael Lippman, who presented their findings at the recent American Public Health Association convention.
Some smoking researchers claim that the degree to which the consequences of smoking are publicized affects smokers' behavior. Research has shown that cigarette consumption drops each time extensive media coverage highlights smoking's risks, according to Kenneth E. Warner, a professor at the University of Michigan School of Public Health.
"If it were just lousy journalism, that would be one thing," he said. "But this is lousy journalism that's going to kill people."
Newsweek and Time have regularly covered the dangers of smoking in news stories. But doctors' groups have charged recently that antismoking messages were removed from health-related advertising. In the last three years, both magazines commissioned health messages from doctors' organizations for use in special advertising supplements, and then -- according to the organizations -- removed almost all antismoking references from the supplements before publication. Spokesmen at the magazines said the supplements were cut because they were too long, and that edited versions were submitted to the doctors' groups for approval.
Brian Brown, Time's public relations director, said that advertising considerations and editorial decisions are kept completely separate. "We and, I suspect, Newsweek and any other publication worth its salt have a separation of church and state."
Helen Gurley Brown of Cosmopolitan, asked whether cigarette advertising influenced her editorial decisions, said she preferred to leave detailed coverage of smoking to others.
"We all know a great deal about it these days," she said. "Much of our information comes from television," which, she noted, has no tobacco ads. "They have nothing to lose . . . . They can be totally truthful as often as they please, as often as they can get anybody to listen . . . . Having come from the advertising world myself, I think, 'Who needs somebody you're paying millions of dollars a year to come back and bite you on the ankle ?' "
Many magazines and newspapers seek to attract cigarette advertisers by quoting statistics on readers' smoking habits. As Dr. Alan Blum pointed out in the New York State Journal of Medicine, publications woo the tobacco industry in trade journals, promising manufacturers an "editorial environment" that will deliver thousands of tobacco-puffing readers ready to try new brands.
"Where there's smoke . . . there's a hot market for cigarette advertisers in Time," promised one ad published this year in the U.S. Tobacco and Candy Journal. It continued, "The good news is certain demographic groups are hotter than ever: women, singles, 25- to 49-year-olds and high school grads."
Newsweek's pitch in the Journal was briefer: a drawing of a cigarette smoldering in an ashtray with the slogan, "Light up your sales."
People magazine ran a 1981 ad in the Journal showing a pack of cigarettes wrapped in one of the magazine's covers. "Over 8 million smokers enjoy the flavor of People," proclaimed the headline.
The New York Times courted tobacco companies in an ad in the Journal last year that said, "It makes sense to stake out your prime locations in The New York Times. However you position your brand, there's an editorial environment right for it."
Officials at these publications said that it is standard practice to quote marketing figures on readers' habits in soliciting advertising for products and that the ads had nothing to do with editorial coverage of smoking.
Leonard Harris, director of corporate relations at The New York Times, said the phrase "editorial environment" in The Times' ad referred to the option of placing an ad in different sections of the paper to reach different readers, not to The Times' editorial attitude toward cigarettes.
Cigarettes are the most heavily advertised product in the United States, with total expenditures for 1983 totaling more than $2.6 billion, according to the Federal Trade Commission. In 1984, tobacco products constituted 9 percent of all advertising revenue for magazines and 1 percent for newspapers, according to publishing sources.
Tobacco accounts for a larger share of ad revenue -- in the range of 10 to 30 percent -- at most of the 20 magazines with the largest circulation, according to estimates published this year by Dr. Paul Fischer of the Medical College of Georgia.
Recent incidents at several magazines illustrate the possible effect of advertising considerations on what magazines print about smoking and health.
When Georgetown University medical school Professor Estelle Ramey agreed to contribute a story on women's health for Ladies' Home Journal's centennial issue last year, she decided to make smoking the centerpiece.
"I wrote what I considered to be a really bang-up article . . . and gave about two typewritten pages to the smoking issue," Ramey recalled. She sent in her manuscript, aware that it was longer than requested. Then she flew to a conference in Europe.
"It never occurred to me, since I gave such a central place to smoking, that they would take out everything I said," she continued. "There wasn't a word on smoking when they printed it."
"We cut it . . . but not because of smoking, just because we edited the piece," said Myrna Blyth, editor-in-chief of Ladies' Home Journal. She added that smoking and rising rates of lung cancer were discussed in the same issue by Health and Human Services Secretary Margaret M. Heckler. She said the smoking section was removed from Ramey's story "just so that we would not repeat what we said the page before." Heckler's article devoted one paragraph to smoking's role in lung cancer, and included it in lists of risk factors for heart disease and osteoporosis.
The health effects of smoking are played down in many women's magazines that accept cigarette advertising, according to surveys of health coverage by the American Council on Science and Health and interviews with writers and editors. When smoking is mentioned, it is often only as a brief reference in a list of risk factors for cancer or heart disease.
Ms. magazine promised in its first issue in 1971 to refuse ads for products "that might be harmful." Yet a recent issue of Ms. contained four full pages of cigarette ads, including the back cover. Writer Marie Shear reported last March in the Women's Review of Books that Ms. had published nothing on smoking from its founding in 1971 through December 1984 except one children's story and one letter.
Ellen Sweet, health editor at Ms., said that to her knowledge the magazine had never published a separate article on smoking, but had mentioned its risks in other health stories. Ms. Editor Gloria Steinem decided in 1971 to accept cigarette ads as long as a health warning appeared on each ad. Asked if Ms. had considered dropping cigarette ads, Sweet said, "Sure, we've considered it, but it's not something we can consider and stay in publication."
About four years ago, Australian physician Paul Magnus approached James Fallows, Washington editor of The Atlantic, about collaborating on an article on cigarette advertising and press coverage of smoking. "Bill Whitworth the magazine's editor said he was willing to look at it," Fallows recalled, adding that Whitworth told him such stories were "difficult for magazines because it's a big source of revenue."
Fallows said Magnus eventually handed in "a bunch of notes, and the idea was that I would write them all over into a story." He said Whitworth looked at the notes and decided they contained too little new information to justify taking Fallows off other projects.
"The prominence of cigarette advertising entered into the decision," Fallows said. "Whether it would have been different if there had not been cigarette advertising, I can't say."
Whitworth denied that advertising was a factor in dropping the project. "If somebody had a terrific piece" with new revelations, such as that smoking "caused leprosy or something besides . . . heart disease and lung cancer . . . there is no question we would do it," he said.
Free-lance writer David Owen said The New Republic commissioned an article from him last year on the cigarette industry. New Republic Editor Michael Kinsley was enthusiastic about the finished story, but Owen said the publisher, Peretz, ordered it killed, telling Owen "that this was an expensive crusade that he was willing to forgo." Owen's article, including charges that The New Republic had spiked the story, appeared last March in The Washington Monthly, which does not carry cigarette ads.
Peretz denied that advertising concerns made him cancel the story. "I thought it was a hysterical piece," he said. "I myself can't judge what is medically sound, but . . . I thought it was journalistically inflammatory and therefore not illuminating in any serious way."
Last Sept. 9, Newsweek published a 24-page advertising supplement on personal health. Known as an "advertorial" in the magazine trade, the supplement contained advice provided by the American Medical Association on "building and keeping a healthy body," mingled with paid advertisements for products such as Pepto Bismol and Listerine. Despite its health-promotion theme, the text mentioned smoking only four times.
There was no mention of smoking as a risk factor in sections on heart disease and stroke, no mention of smoking in a section on pregnancy, and only a passing reference to the role of smoking in making lung cancer the most common fatal cancer in women. In contrast, the supplement devoted six paragraphs to explaining how women can examine their breasts for cancer, and advocated other preventive measures such as eating a low-fat diet, exercising and wearing seatbelts.
Dr. M. Roy Schwarz, an assistant executive vice president of the AMA, said the original text contained more about smoking, but that Newsweek removed many of the antismoking references. "We had more copy in it than we had space," he said. He said that the AMA has asked for a promise from Newsweek that next year's supplement would be allowed to run with a stronger stand against tobacco.
Newsweek editor Richard Smith said editing of advertorials was done by the advertising department and was unrelated to the magazine's editorial coverage of smoking. The Readers' Guide to Periodical Literature shows that, from March 1975 through March 1985, Newsweek published 22 stories on smoking. It ran a major article on smoking and women's health last Nov. 25.
Gary Gerard, Newsweek's director of communications, denied that tobacco references had been deliberately cut from the advertising supplement. "I know that we don't go around editing references to smoking or booze or whatever," he said. "As we cut for length . . . smoking may have gone out . . . all the way through. It was in no way something we looked at and started cutting as a specific."
Last year, Time also performed surgery on its health advertorial, according to the American Academy of Family Physicians, which provided the text. Time's health advertising supplement contained no warnings about cigarettes and mentioned smoking only briefly in a health quiz.
After the supplement was published, Dr. Robert D. McGinnis, chairman of the academy's board of directors, wrote in a letter to the magazine that "Time's editors blunted, short-circuited and impaired the credibility of our message by cutting out all narrative references to smoking."
Time's public relations director, Brian J. Brown, said, "Our response at that time . . . was that there had been changes but that they had been approved by the American Academy of Family Physicians. They had a veto and it was shown to them."
Dr. Harmon Holverson, president of the academy at the time, said that during the editing process Time gradually removed smoking references, until shortly before publication the academy was shown the final version, which contained nothing about smoking, and was told to take it or leave it.
Brown said the advertising supplement was unrelated to Time's reporting on smoking or other issues, and was considered "strictly a sales vehicle."
The Readers' Guide to Periodical Literature lists 14 stories on smoking or cigarettes in Time between March 1975 and March 1985.
Newspapers receive a much smaller proportion of their advertising revenue from cigarette ads than most national magazines, but some opponents of smoking say they should refuse to accept any cigarette advertising.
The Washington Post Publisher Donald E. Graham said cigarette advertising brought in $2,100,000 last year, about two-thirds of 1 percent of total advertising revenue.
"Our policy is, we allow advertising of lawful products within certain well-defined limits, and we don't allow that to inhibit our news coverage or our editorial coverage," he said. "As a newspaper, our job is to see that readers know what reputable people think are the harmful effects of various products."
The New York Times' position is similar. "We accept cigarette advertising and we take a very strong editorial position against cigarette smoking," said Leonard Harris, The Times' director of corporate relations. "We report all the news . . . about the effects of cigarette smoking, and any other developments which may be important on the whole question."