Neal L Benowitz

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This article is part of the Tobacco portal on Sourcewatch funded from 2006 - 2009 by the American Legacy Foundation.

Neal L Benowitz (aka Neal Leon Benowitz) was a physician at the San Francisco General Hospital and a Professor of Medicine at the University of California San Francisco. He was board-certified in internal medicine, medical toxicology, and clinical pharmacology, and he is considered to be an expert in nicotine and addiction. [1]

Dr. Benowitz has testified on behalf of plaintiffs in cases against the cigarette companies, but the tobacco document in the archives raise questions about his role as a helper to the tobacco industry. He is recorded in attendance at meetings of the industry where the records show fairly clearly that they were conducting research in a manner which is totally unscientific in nature, and directed towards obtaining a favourable outcome.

While there is no suggestion of corruption, he appears to be entirely tolerant of company and industry efforts to corrupt both the science and other scientists and doctors who were more compliant. He appears to have taken the view that everyone must be free to use a 'dangerous' substance like tobacco, and therefore there should be no government-inspired attempts to limit its sales. [2] [3]

The tobacco industry classed him as an "avowed enemy of our industry".[4] But since he dealt only with nicotine and had a reputation as being against tobacco, he was a convenient scientific member to have on boards and panels conducting industry pseudo research, since he provided a gloss of authenticity to the whole project. He was marginally valuable to the industry also:

  • because he didn't believe cigarettes were a risk factor for chronic hypertension.
  • he didn't support the anti-smoker's claim that the industry deliberately used ammonia to boost the addictive nature of nicotine.[5]

See his Biographical Sketch for a court case. [6]

Documents & Timeline

1985 Published a study with Gio Batta Gori. "Mouth versus deep airways absorption of nicotine in cigarette smokers". This appears to be the only one in a long list of publications where he was associated with corrupt (or even dubious) tobacco industry researchers. [7]

1988 He testified for Don Barrett, the attorney for the plaintiff in the wrongful death case of Nathan Henry Horton, who died of cancer after smoking Pall Mall cigarettes for 35 years. Horton's case ended in a hung jury. Benowitz was a paid consultant to nicotine patch manufacturers and a scientific editor of the 1988 Surgeon General's report on smoking.[Reference needed] [8]

1988 Sept 15 Center for Indoor Air Research (CIAR) Board of Directors meeting. The cabal of corporate conspirators in attendance were: Max Eisenberg (PM), Robert Pages]] (PM) Charles Green (RJR), John Lyon (TI), Alex Spears (Lorillard), Gary Burger (RJR), John Rupp (C&B), Davis (?), Don Hoel (SH&B) Tom Osdene (PM) and David Remes (C&B).

They had three well-known guests who were there to make presentations about their projects: John Viren (RJR) and Max Laird (ex Biometric Branch of NCI ), and also Delbert Eatough (a science consultant from Brigham Young Uni)

[There are two different records of this meeting, one in the PM files and the other from the Tobacco Institute (this is a composite)]

The two presented proposals were:

  • "Personal Exposure to ETS in an commercial airline."A 12 month Canadian airline smoking study of 24 flight attendants to be controlled by Delbert Eatough of Brigham Young University. Individuals will wear personal passive dosimeters to provide comparative exposure data. United Airlines are willing to work with the CIAR, but they didn't want them to take any ozone measurements.

    Comments 1: "Charlie Green believes that results on Airline Study will be believable. The levels may be low ... but it will help establish CIAR, and add to the Reynolds data"
    Clement Associates. will make the risk assessment (and present it as a Department of Transport in response to their normal request for comments procedures. Neil Benowitz will conduct nictotine/cotinine analysis.
    Comments 2: the blood sample provisions are very fragile. The NCI-EPA [study is] half way completed: Canadian flights; couple of dozen flight attendants.
    Study Justification: data inconsistent; the industry's data is much lower in the concentration of ETS than NAS; [so this gives us] new comparative data; [which also has value in creating] CIAR and EPA cooperation.

[NAS=National Airspace System of the FAA.
[The CIAR pretended to be independent of industry influences, and it assumed that the EPA could be persuaded to cooperate with them. Delbert Eatough and Max Eisenberg were to visit the EPA and test the waters of cooperation.]
[Eatough was using Brigham Young Uni students and post-doctorate faculty to collect air measurements during flights. They were smokers. RJR was to do the chemical analysis and could add test for aldehydes for no-extra costs. University of San Francisco work on biomarkers could cost $12,500 more.]
Results: Eatough will be funded by CIAR, He must explore the survey with United Airlines and try to get them to agree to ozone measurements also. MUCH MORE NOT RELEVANT TO THIS ENTRY HERE ALSO (worth reading). [9]

1990 Benowitz testified for the Plaintiffs in the Kotler (NY) lawsuit in 1990, according to the Boston Globe, 2/21/90. He said that "A smoker's addiction to nicotine resembles some characteristics found in cocaine and heroin users." He further told the court that virtually all people who smoke a pack-a-day over a period of a year or two, develop a dependency to nicotine. When smokers try to quit, according to Benowtiz, they experience "acute withdrawal symptoms."

Benowitz acknowledged that millions of people have quit smoking and the vast majority have stopped on their own. He explained that nicotine doesn't impair smokers' cognitive abilities or impair their ability to make decisions. While people insist they smoke because they enjoy it, they wouldn't like it if they weren't dependent on it.

Dr. Benowitz says, "You need nicotine to feel normal . . . This is drug-driven behavior." He says, that like heroin and cocaine use, nicotine use prompts psychoactive changes in the brain. It is difficult to stop using nicotine and provokes a high relapse rate among those who try to quit. Benowitz has also said that in its pure form, nicotine is poisonous and has been used as an insecticide. For smokers, nicotine can act either as a stimulant, to help concentration, or as a tranquilizer, to help relieve stress, per Benowitz (Boston Globe 2/21/90).

1991 Oct 15 {HANDNOTES} Ernest Pepples (mis-written as Pebbles - A JOKE) of Brown & Williamson, disgraced scientist Gio Batta Gori, and Chris Proctor (then with Covington & Burling - ex-BAT) had a meeting with Tom Borelli and Robert Pages of Philip Morris. They were proposing a six-month confounder study [to find promotable 'doubt' about epidemiological research] which would cost between $0.7 and $1.3 million.

Gori has worked with Equifax before and recommends them.They query whether then need to have Peter N Lee do the analysis/statistics (he was being overused) and ask, "What about outside collaborators?" [10] [11] [12]  

1991 Dec 3 A memo from Robert Pages to Steve Parrish and Tom Borelli (Philip Morris) "Gori Confounders Proposal" Clausen Ely, a lawyer with Covington & Burling has copied them with the latest version of the Gori proposal for a $1.3 million study into possible 'confounders' in epidemiological studies.

In comparison with what was discussed with Borelli and me at our meeting with Gori/Proctor on Oct 15th, the only new things here are: l) the cost estimate ranges,- and 2) the acknowledgement of the active participation by Peter N Lee. Neither of these is surprising, although $1.3M makes you pay attention.

The bottom line still is: the study, if done right, is worth doing.

The " if done right" according to this proposal depends upon our confidence in the team of Gori/Lee/Proctor and Gori's connection with 'EQUIFAX' -- the company that would actually conduct the survey, I have no reason to doubt their ability to oversee the work. I'm not totally comfortable with signing up for a study which could cost "as little" as S700K or as much as $I.3m -- to be determined along the way -- but 1 can't think of a good alternative.

One thing that might make me a little happier is if they already had their questionnaire in hand, but ... .

The point Borelli raised on Oct I5th also remains to be addressed; Is there a way that this study could be done to yield a more 'credible* publication?   Presumably, we're looking at Gori and Lee (?}.   Farming out the cotinine analyses to Neal Benowitz is a nice touch, but it won't make him a coauthor.

[This is a perfect illustration as to how Benowitz was used by the tobacco industry to gain credibility for their research. They would have dearly liked to credit him as a co-author.]

O.K.   Where does all this leave us?   WE SHOULD GET ON WITH IT!   It'll probably take months to get all the interested companies 'on board' anyway. Let's do it while we still have the money and before we think of more stupid things to spend it on. [13]

1994 June He was at the San Francisco General Hospital, in the Department of Medicine, Pharmacy and Psychiatry.(DJ 6/23/94). Dr. Benowitz is an expert on nicotine.(Science 5/6/94)

1994 Dr. Benowitz had done a study in the early 1980s (published in the New England Journal of Medicine) that showed that "some smokers who were using 'light cigarettes' [low tar and low nicotine] wind up with more nicotine (and nicotine metabolites) in their blood plasma," per David Kessler.(Barron's 5/16/94) Benowitz says reducing the level of nicotine in cigarettes to 0.6 mg apiece, and curtailing total nicotine consumption to four to six milligrams per person per day, would help smokers cut back and stop teenagers from becoming addicted.(DJ 8/2/94)

Dr. Benowitz says "nicotine is what makes people smoke" and its delivery through cigarettes should be regulated by the federal government.(DJ 8/2/94) Dr. Benowitz proposes that the amount of nicotine in cigarettes be decreased gradually over the next 10 to 20 years to reduce the number of Americans who smoke. He admitted that his theory that lower nicotine levels would make cigarettes less addictive hasn't been tested and was based on his research on smoking, nicotine and addiction.(DJ 8/2/94) Benowitz testified before U.S. Food and Drug Administration Drug Abuse Advisory Committee.(DJ 8/2/94).

1998 Nov 11 Benowitz was a facts witnesses in Texas Case [14]

2002 June He is involved in a study "Maternal Smoking During Pregnancy and Severe Antisocial Behavior in Offspring." The reports says that recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorders and delinquency. Newer evidence suggest that it may have consequences that extend far beyond the perinatal period. [15]

2003 Jul 25 Benowitz as a Professor of Medicine co-wrote a letter with anti-smoking activist, Stanton Glantz to Vice Provost for University of California, Research to argue against acceptance of tobacco funding. He cited Enstrom and Katab article in BMJ May 2003 [16]


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  1. (State of Florida's Proposed Plaintiff's Disclosure of Expert Witnesses, 2/5/97)