[Intl-tobacco] Israel: Lawsuit on additives

[Robert Weissman]

Smokescreen
Haaretz
 October 29, 2003

 By Sara Leibovich-Dar

 A huge lawsuit against the Dubek tobacco company focuses on additives,
some of them toxic, which are put in cigarettes without the smoker's
knowledge. These may include ammonia, cadmium and DDT - or even
chocolate, vanilla and cinnamon.

 The paltry sum of NIS 7.6 billion is what Dubek,the Israeli cigarette
company, is being asked to pay members of Clalit health maintenance
organization for damage they allegedly suffered by smoking the company's
products. This is the largest civil suit ever filed in Israel, and at
its center is one key contention: The Israeli cigarette manufacturer
adds to the tobacco materials that are even more detrimental to the
smokers' health, without informing them that they are doing so.

 Last week, a hearing was held in Jerusalem District Court on the Clalit
HMO lawsuit. Its representatives, attorneys Amos Hausner and Lipa Meir,
maintain that Dubek adds to its cigarettes materials that are damaging
to human health such as ammonia, cadmium, radon and other materials
"whose main goal is to hide the bad taste of the nicotine. These
products significantly heighten the toxicity and the damage caused by
the cigarettes." In its defense, Dubek says the materials it uses "meet
the demands of the law as they were at every relevant date." The
company, however, does not specify which materials it uses.

 Sometimes it seems that the list of additives to tobacco is the
best-kept secret in the cigarette industry. Dubek has never published a
list of them and the Health Ministry does not exercise supervision of
any kind over the content of cigarettes.

 "I am not knowledgeable about this subject," admits Health Minister Dan
Naveh. The former health minister, Ephraim Sneh,
 explains: "I thought that anyone who wants to know what cigarettes
contain would check on the Internet."

 Dubek CEO Aryeh Zeif says reassuringly that "there is nothing I have to
be afraid of. We are not doing anything untoward. Dubek does not add
anything that constitutes a deviation from the strictest rules anywhere
in the world." Surely you know there are no such rules anywhere? Zeif:
"There are unwritten rules that the tobacco industry follows. There is
no difference between our cigarettes and the cigarettes in Europe and
the United States."

 Clalit HMO is not the first organization to sue
 Dubek. In 1998, the Maccabi HMO filed a suit
 against Dubek for NIS 1 billion in Tel Aviv
 District Court. That suit was rejected in 1999
 on the grounds that the HMO's members were the
 ones who should sue, rather than the
 organization. The suit did not reach the stage
 of evidence. Maccabi's appeal to the Supreme
 Court is still pending.

 In 1997, 78 cancer patients filed a class action
 suit against Dubek in Tel Aviv District Court.
 In 2001, four weeks before the stage of
 evidence, Dubek proposed to the litigants that
 they enter into negotiations with the aim of
 reaching a compromise. Eventually a settlement
 was reached, according to which the price of
 cigarettes would be raised by NIS 2 a pack,
 with the extra revenues to be transferred to a
 fund that would compensate smoking victims. The
 fund has yet to be established. In that trial,
 too, the list of additives was not revealed -
 indeed, the subject was mentioned only briefly
 by the lawyers for the cancer victims.

 Sophisticated taste

 In April 1994, for the first time, the six
 largest tobacco companies in the United States
 published a list of 599 additives, which
 constitute about 10 percent of the content of
 cigarettes. The information stunned consumers.
 The cigarette manufacturers had never before
 admitted to using ammonia in order to intensify
 the absorption of nicotine by the brain. Other
 materials, some of them bizarre, are intended
 to reduce the bitter taste of tobacco: sugar,
 chocolate, almond oil, date juice essence,
 lemon oil, rum, sage, vinegar, laurel leaves,
 cinnamon, cocoa, coffee, prune juice and
 coconut oil. The manufacturers explained that
 each of these additives could also be found in
 fruits and cookies, but the experts thought
 otherwise. There's nothing wrong with these
 items when they are eaten, they argued, but the
 burning process makes some of them very
 hazardous to health.

 The differences between cigarettes without
 additives and cigarettes with additives can be
 likened to the differences between an apple
 that naturally contains arsenic and an apple
 that has been sprayed with DDT, Prof. Stanton
 Glantz, from the School of Medicine at the
 University of California in San Francisco,
 noted in his book "The Cigarette Papers."

 In February 2000, a similar list was published
 in England at the initiative of the Department
 of Health. In addition to numerous sweeteners,
 the list also showed that a number of chemicals
 are added during the manufacturing process,
 such as methanol, which helps dissolve the
 tobacco. Also on the list were toxic materials,
 such as cyanide, which enter the manufacturing
 process when tobacco leaves are sprayed. A
 "lethal cocktail," The Daily Mirror observed in
 reaction, and added its own exhortation to
 light up, take a puff and enjoy the
 sophisticated taste of arsenic, cocoa,
 radioactive polonium, lead and, yes, tobacco.

 In March 2000 the list reached New Zealand. Two
 researchers, Jefferson Pauls, a toxicologist,
 and Michael Bates, an epidemiologist, carried
 out a comprehensive study based on the reports
 of the New Zealand cigarette companies. They
 found that cigarettes contain pesticides such
 as DDT along with various sweeteners such as
 honey, molasses, caramel, malt, maple syrup,
 pine needle oil, licorice, vanilla and rose
 oil. The sweeteners, they observed, can
 encourage young people to smoke.

 Dubek, though, has never published a similar
 list. Last week, after intensive discussions by
 the company's executive and consultations with
 media advisers, Dubek gave Haaretz a list of
 440 additives of which it uses a few. "All the
 cigarette companies, including Dubek, add
 essences of flavor and aroma from the attached
 list of essences," the company said. "The
 flavor and aroma essences that Dubek uses have
 received the strictest and most rigorous
 approvals for use by the food industry in the
 world."

 The list that Dubek provided is identical to the
 one that the American tobacco companies
 submitted in 2001 to the U.S. Department of
 Health. It is general in character and notes
 only the name of the additive and the use made
 of it in the food industry. It's also a "clean"
 list: It makes no mention of ammonia, methanol,
 cyanide or arsenic. It's not clear whether
 these toxic materials were removed from the
 cigarettes or only from the list. Dubek also
 refuses to specify the chemicals it uses in the
 manufacturing process or the additives it uses
 and their dosage per cigarette.

 Nevertheless, the list is interesting. It
 includes acetone, butter, beet juice essence,
 brown sugar, caramel, carrot juice, celery seed
 essence, coffee, cocoa and chocolate. Why
 chocolate? Maor Davidor, Dubek's chief chemist,
 says there is no chocolate in the company's
 cigarettes.

 "It's impossible to add chocolate to
 cigarettes," he observes. "What's added is a
 mixture that is approved by the American
 pharmaceuticals directorate, which creates a
 taste of chocolate when it burns."

 Are the other materials, all of which are used
 by the food industry, as innocent as they
 appear to be? Not necessarily. Take cocoa, for
 example. Prof. Glantz noted in his book that in
 the 1970s, the British National Cancer
 Institute found that adding cocoa to the
 tobacco mixture heightens the toxicity of the
 smoke and increases the risk of getting cancer.
 In the wake of the study, the British
 government removed cocoa from the list of
 additives. In the 1980s, a further study was
 carried out, whose results partially mitigated
 the conclusions of the previous study. In its
 wake, Britain allowed cocoa to be added to the
 tobacco in cigarettes, provided it did not
 exceed 5 percent of the cigarette's weight. In
 his book, Glantz reveals a document of the
 tobacco company Brown & Williamson, in which it
 admits that removing the cocoa from cigarettes
 is a lengthy and expensive project that will
 affect the company's status vis-a-vis its
 competitors. The company's experts therefore
 recommend not looking for cocoa substitutes,
 but rather focusing on defending the use of
 cocoa.

 According to the New Zealand study, menthol,
 another additive on the Dubek list, is intended
 to soothe the discomfort caused by inhaling
 cigarette smoke. It helps new smokers get
 through their first cigarettes. New Zealand and
 Britain have limited the menthol content of
 cigarettes. No similar restriction exists in
 Israel. The addition of coffee, the same study
 found, stimulates the central nervous system
 and is harmful to the heart. Glycerol, another
 additive on the Dubek list, becomes
 carcinogenic when burned.

 Ammonia, yes or no

 Dubek cites commercial secrecy as its reason
 for refusing to publish the amount of each
 additive it uses. "To tell our competitors what
 we are putting into the cigarettes is a
 wonderful idea," says Zorah Gehl, a shareholder
 in Dubek and its former CEO, in a phone
 conversation from his home in London. "The
 Americans published a list of 600 additives
 even though they don't use all the 600 and so
 made a big impression."

 Why won't Dubek make an impression by publishing
 the percentage of cocoa it uses in each
 cigarette, for example?

 Gehl: "We will present that in court. Cigarettes
 have to be treated as a food product. Food
 packaging also lists flavor and aroma additives
 without elaborating."

 Many food products now do elaborate. Why won't
 you specify, say, how much ammonia there is in
 a Time cigarette?

 "Let's get one thing straight about ammonia for
 once. My father, Martin Gehl, who was in Dubek
 before me, already claimed that ammonia has a
 bad effect on the product, and we took ammonia
 out. We have no reason to use it."

 However, Arie Ovadia, the previous CEO of Dubek,
 told a different story. He told Channel 1 in an
 interview broadcast on December 1, 1998: "Our
 use of ammonia is simply [intended] to prevent
 the leaves from becoming moldy."

 Dubek denies this: "He was talking nonsense,"
 says Maor Davidor, the chemist. "He didn't know
 what he was talking about, that's all."

 Why did he mention ammonia, of all things?

 Davidor: "If you work fixing tires you smell
 glue. Don't you have acids at home? There is
 acid in wine vinegar, but does that mean that
 you are adding acid to your food and poisoning
 anyone who eats at your house? No cigarette
 company ever added ammonia. How does that grab
 you? And I'm ready to sign to that. Ammonia is
 a gas. You can't add it - it escapes."

 Prof. Ben Ami Sela, director of the Institute of
 Chemical Pathology at Sheba Medical Center, Tel
 Hashomer, notes that in his lab, he has vials
 of ammonia: "There is ammonia in the form of
 gas and there is ammonia in liquid form. The
 cigarette companies claimed that they were
 adding ammonia in order to improve the aroma of
 cigarettes. Afterward it turned out that the
 ammonia releases the nicotine from the salts
 and the reaction time for the smoke to pass to
 the brain is shortened, and that's critical,
 because the smoker wants a short reaction
 time."

 Numerous studies from around the world prove
 that ammonia is systematically used in the
 cigarette industry. Jeffrey Wigand, a
 biochemist at Brown & Williamson, who was the
 first to reveal the use of toxic additives by
 cigarette manufacturers - Russell Crowe played
 him in the film "The Insider" - gave detailed
 testimony to a Mississippi court in 1995 about
 the "ammonia technology." The New Zealand study
 also mentions ammonia as an additive. In May
 1997 the largest study on the subject was
 published by the American Chemical Society. The
 five directors of the research project, from
 the University of Oregon, state that ammonia
 constituents are routinely added to cigarettes.


 None of this can make Gehl change his opinion.
 Arie Ovadia didn't understand the subject, he
 says about the former Dubek CEO's televised
 remarks. Did Ovadia really not know what he was
 talking about, or did he blurt out a well-kept
 secret? "After I said what I said, we did a
 check and it turned out that there is no
 ammonia in our cigarettes," says Ovadia, who is
 now chairman of the Phoenix Insurance Company.


 Then what did you base yourself on when you said
 that Dubek uses ammonia?

 Ovadia: "I had heard that somewhere. Afterward
 they explained to me that there is no
 ammonia."

 Glantz's book reveals the use of a series of
 additional toxic substances in cigarettes,
 including pesticides such as DDT. The New
 Zealand study found metals in the tobacco,
 which result from the process by which tobacco
 is grown. Among them metals - lead, cadmium
 (the toxic metal that is found in batteries) -
 and polonium, a radioactive substance.

 Dubek refuses to reveal the list of pesticides
 that enter its cigarettes from the tobacco it
 uses. "We buy the best tobacco," says CEO Zeif.
 "There are pesticides in tomatoes, too.
 Cigarettes contain the fewest materials."

 Isn't it the case, according to various studies,
 that tobacco contains large quantities of
 pesticides?

 Zeif: "Pesticides don't constitute anything
 here. They are not the issue. We are considered
 small-time. Dubek buys in a year what Phillip
 Morris buys in a day."

 What does that have to do with anything? There
 can be pesticides even in a small quantity of
 tobacco, can't there?

 "We are stricter than the strictest."

 What use is publicity?

 Dubek was founded in 1935. Martin Gehl, Zorah's
 father, joined the company a few years later.
 In 1989 Dubek was declared a monopoly in the
 cigarette market in local manufacture. It
 controls 36 percent of the market with its
 Time, Golf, Noblesse and Europa brands. More
 than a quarter-of-a-million Israelis smoke
 Dubek cigarettes. In 2002 the company had a net
 profit of NIS 16.2 million.

 "This is an industry that holds great attraction
 for the state treasury," said attorney Yehiel
 Guttman to the Knesset's committee on drugs.
 "By definition, the state loves anyone who
 brings in NIS 2 billion a year [in taxes]. So
 they love to hate it, that's true, but they
 also love it."

 So great is this love that the Health Ministry
 has never asked Dubek to make public the types
 of additives it uses in its cigarettes and
 their dosages. "There were arguments in the
 ministry between those who advocate exposure
 and those who are against it," says a senior
 official in the ministry. "Some think exposure
 is called for, others say the ministry has to
 concentrate on the war against smoking and not
 on exposing data of this kind. Because of the
 dispute among the experts, there are no
 regulations that address the subject."

 In fact, the Health Ministry has not even asked
 Dubek to provide the list to the health
 authorities, as was done in the U.S. "What will
 we gain if some senior official sees the list
 but it's not accessible to the public?" says
 another senior official in the Health Ministry.
 "Maybe we'll get to that, but at the moment
 it's not one of our priorities."

 Prof. Yona Amitai, a toxicologist in the Health
 Ministry, agrees that publication of the list
 is not especially important: "The public knows
 that cigarettes are carcinogenic. It won't be
 more effective if the public also knows the
 names of the additives. There is definitely a
 reason to provide more information - over the
 years, the public has become accustomed to
 getting information, and the process is
 important - I just don't know how effective it
 will be."

 The country's health ministers have shown little
 interest in the subject. "In principle, I
 decided that we have to adopt the standards of
 the European Union," says the current minister,
 Dan Naveh. "But I am not familiar with this
 specific subject."

 Nissim Dahan, the previous health minister: "The
 publication of the additives is something that
 should be done."

 Then why didn't you do it?

 Dahan: "The answer is very simple. We
 established the Gillon Commission [headed by
 Judge Alon Gillon] to examine the damage done
 by smoking, and it had not yet completed its
 work when my term of office concluded."

 Ephraim Sneh, health minister from 1994 to 1996:
 "I treated a cigarette as a cigarette. What
 difference does it make what materials it has?
 Anyone who wants to know what materials go into
 cigarettes can look on the Internet. It's not
 my job. My job is to state that smoking is bad
 for your health. Period."

 That's also the opinion of Miri Ziv, director of
 the Israel Cancer Association. In the U.S.,
 similar organizations were pressuring the
 health authorities more than 20 years ago to
 reveal the list of additives and chemicals in
 cigarettes. Ziv has not initiated similar
 activity: "So what if they tell me what the
 materials are? I am not familiar with all of
 them and the public won't know whether it's
 good or bad. It's the whole thing that's bad,
 not this or that element."

 Prof. Glantz is amazed at the Israeli approach.
 "It's ridiculous," he says by phone from his
 home in San Francisco. "It's true that the
 effect of the additives is more indirect, but
 people have the right to know what they are
 introducing into their body. Anyone who says
 it's not important is wrong. The tobacco
 companies are trying to hide this information,
 and that's the proof of how important the
 information is. If there's ammonia in
 cigarettes, people have to know about it, and
 there are cigarettes that contain ammonia.
 People will be shocked when they understand
 that there are sweeteners in cigarettes. Sugar
 and chocolate are usually used for sweets and
 not for cigarettes."

 First-hand testimony

 Glantz devotes a special subchapter of his book
 to cumarin, a vanilla-flavor additive that is
 also used as rat poison and was in use in the
 cigarette industry for years. The use of this
 substance in cigarettes was revealed in 1995 by
 Jeffrey Wigand, the Brown & Williamson
 biochemist who ran the company's research
 division. Wigand worked for the company for
 five years until being fired in 1993 for his
 revelations.

 In September 2000, Wigand testified before the
 Gillon Commission and reconstructed the course
 of events: "The company had a policy of not
 using any additive that was not approved.
 Cumarin had been removed back in 1984 from the
 list of approved plants, but the company
 continued to put in these additives. I met with
 the company CEO, Thomas Sandefur, and told him
 that I had new information according to which
 that chemical compound posits an increased
 hazard and has to be removed. He ordered me to
 go back to the laboratory and find a
 substitute. He told me he was unwilling to
 remove the compound because it increases sales
 and profits. In the light of that development,
 I felt I couldn't take any more."

 Wigand paid a high price for his activity
 against the cigarette manufacturers. In
 interviews to the monthly Vanity Fair and on
 the CBS television program "60 Minutes," he
 said that Brown & Williamson was trying to ruin
 his life. He and his family were subjected to
 threats and he had to hire a bodyguard. In
 recent years he has been lecturing all over the
 world about the way the cigarette companies are
 run.

 In his testimony to the Gillon Commission, he
 spoke at length about the need to supervise the
 content of cigarettes. "I know of these matters
 first-hand, having worked in the industry and
 as an expert witness. My recommendation to all
 governments is to impose supervision on
 cigarettes ... The information the public gets
 is misleading and the industry has not
 cooperated in any way with the government
 authorities ... Many of the additives that are
 in use have never been subjected to toxicity
 tests separately or together with the other
 additives. You should not trust this industry,
 because when it supervises itself, it doesn't
 do the job properly. It doesn't have standards
 of execution. The consumer has to be given
 information about what the industry has tried
 so diligently to hide."

 A few countries have summoned up the courage to
 take on their cigarette manufacturers. In 1997,
 the British health authorities obliged the
 cigarette companies to publish precise data
 about every new additive - though not about the
 600 additives that were already in use. The
 British and New Zealand cigarette companies now
 have to state the maximum proportion of each
 additive per cigarette. The state of Minnesota
 supervises the amount of ammonia, arsenic,
 cadmium and lead in cigarettes. Thailand passed
 a law in 1998 that obliges the cigarette
 manufacturers to report on the additives they
 use.

 In Israel there is no supervision over the
 content of cigarettes. The Standards Institute
 says the Health Ministry is responsible for
 setting standards for cigarettes. The Industry
 and Trade Ministry stated in response to a
 question: "We have no standard for the content
 of cigarettes. There is no such thing." The
 Israel Consumer Council has never taken up the
 subject. Its director, Galit Avishai, says the
 council is fighting other battles. The chairman
 of the Israel Society of Toxicology, Dr.
 Yedidia Bentur, says the body he heads can't
 handle the subject: "We deal with acute
 poisoning and not with long-term implications.
 What we can do is turn to the Health
 Ministry."

 Yair Amikam, Health Ministry deputy
 director-general for information: "We examine
 food and water, but not cigarettes. We don't
 have the money to maintain laboratories like
 that. There is a hazard to public health in
 food, and in the case of cigarettes it's clear
 that there is a health hazard, so why do I have
 to check cigarettes? Not even the law obliges
 the cigarette companies to make public the
 content of cigarettes."