HealthCommentary

Exploring Human Potential

Who’s This? The Fathers of “Stress” and “Type A.”

Excerpted from CODE BLUE: Inside the Medical-Industrial Complex. Purchase online HERE.

In 1953, JAMA stopped accepting cigarette ads for its journals, and the AMA prohibited cigarette companies from exhibiting at its conventions. A JAMA editorial one year later went so far as to condemn the “unauthorized and medically unethical use of the prestige and reputation of the American Medical Association.”35

But Big Tobacco was not easily bowed, and along the way, Big Pharma would watch and learn from the cigarette makers’ gutsy and totally unscrupulous techniques. Deprived of the protective cover that had been provided by the AMA, the tobacco companies enlisted Hill & Knowlton, which proposed mirroring the professional education approach by the Pharmaceutical Manufacturers Association (PMA) in forming what it called the Tobacco Industry Research Council (TIRC).

The manipulation then became more subtle and more sinister, spreading into the surprisingly corruptible branch of the Medical Industrial Complex known as academic medicine. To continue selling cigarettes in the face of devastating scientific evidence of tobacco’s link to both lung cancer and cardiovascular disease, the companies had to come up with an alternate explanation for the rise in cardiac deaths that clearly tracked alongside the rise of cigarette smoking. Their savior was a Hungarian-born endocrinologist named Hans Selye, a man nominated multiple times for the Nobel Prize.39

Selye was famous for his formulation of the concept of stress as the source of microscopic injuries to the cell.40 But he was also known for his ability to attract research funding, which was enhanced by his willingness to tailor the evidence to suit the highest bidder.

Years later, as part of document disclosure during litigation by state attorneys general against the tobacco industry, communications between Selye and industry representatives proved that he had conspired to hold back supportive testimony and publications suggesting a link between tobacco use and stress reduction until he received his cash.41

In the mid-1950s, two New York cardiologists, Meyer Friedman and Ray Rosenman, had observed 3,000 men and speculated that those who developed heart disease were more likely to be what they labeled “type A.” They postulated that certain people were genetically hard-wired to experience and magnify stress, and that these hard-charging type A personalities were sitting ducks for heart disease, cancer, and early death, as they explained in their 1974 book, Type A Behavior and Your Heart.42,43

For the leadership at the Tobacco Industry Research Council, here were findings that offered beautifully plausible deniability. When a 45-year-old man dropped dead during a Saturday-afternoon softball game, it wasn’t cigarettes; it was stress. In fact, if anything, he should have smoked more—it might have relieved some of his tension. 

Tobacco litigation documents released in 1998 as part of the Master Settlement Agreement between 46 state attorneys general and the five largest cigarette manufacturers in America demonstrated that both Selye’s research and that of the type A creators was subsidized by large grants from the Tobacco Industry Research Council.44 

When Hans Selye died in 1982, he was regarded as a venerable scientist, but the tobacco industry’s funding of his work, and Selye’s willingness to recruit additional scientists to present tobacco’s messages in meetings and publications, was later cited by the US Department of Justice as a clear example of racketeering

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