Yesterday's Battle Against Big Tobacco, Today's Battle Against Big Pharma

Tobacco and J&J building

A cursory glance at recent headlines will reveal story after story of huge, multi-billion dollar pharma companies being sued for the part they played in the creation of the opiate epidemic. Now the cat is out of the bag, one could say, and the American public knows the truth. Big Pharma is not the only engineer of the opiate crisis, but it certainly played its role.

Purdue Pharma is facing bankruptcy, and Johnson & Johnson lost a major case in Oklahoma. In light of those lawsuits, and many others, I can’t help but be reminded of similar legal battles that were going on from the 1970s to the 1990s. Except during that time, Big Tobacco was Public Enemy Number One, not Big Pharma.

What similarities can we draw from America’s fight against tobacco corporations? And more importantly, what lessons can we learn from that era? How can we learn from those struggles, in the hopes that today’s conflicts might be ameliorated?

The Tobacco Battles

The American Museum of Tort Law offers an excellent and in-depth analysis of several major lawsuits against tobacco companies. Cigarette use surged from the 1920s to the 1960s, but it didn't take long for the medical community to see the harmful effects of smoking. An immense amount of pressure was brought by Big Tobacco (and their army of lobbyists) to keep tobacco going strong. But the medical community, the U.S. government, and the American population slowly turned away from their support of tobacco use.

By the 1980s, laws had been passed, regulations were instituted, and lawsuits were in full swing. Quoting an analysis by the American Museum of Tort Law, “These cases have reduced cigarette consumption, shed light on the dangers of smoking and on the tobacco manufacturers’ conspiracy to deceive the public, reimbursed states for the cost of treating injured and dying smokers, and funded antismoking programs, among other accomplishments.”

Today, people are less likely to use tobacco than they were in the 1960s. And that’s saying a lot, as tobacco use had been on an unshakable upward curve since the 1800s.

“When tobacco use peaked in the mid-1960s, more than 40 percent of the U.S. adult population smoked cigarettes.”
An old cigarette store

Quoting a study in the National Academies Press, “When tobacco use peaked in the mid-1960s, more than 40 percent of the U.S. adult population smoked cigarettes.” That study goes on to talk about how tobacco use immediately dipped following the 1964 Surgeon General’s report on the harmful effects of cigarette smoking. And tobacco use has continuously declined since then.

Again quoting the study, “The percentage of adults who are current smokers declined steeply between 1965 and 1991, with an estimated 39 percent drop in the prevalence of cigarette smoking. By 2005, the prevalence of adult cigarette smoking had declined to half the 1965 rate. An estimated 20.9 percent of American adults, or 45.1 million people, were current smokers in 2005.”

Shortly after the Surgeon General's famous 1964 report, Americans immediately began smoking less. But there were still the damages caused by smoking that had to be considered. As it turned out, the Big Tobacco litigations wouldn't be nearly sufficient in correcting almost half a century of harm caused by said tobacco companies.

Sadly, we are now seeing much of the same in lawsuits being taken against pharmaceutical companies.

One Expert Draws the Connection Between Big Tobacco and Big Pharma

A recent opinion piece in the Washington Post, caught my attention, as it sought to discover the similarities and the contrasts between the Big Tobacco cases of the past and the Big Pharma cases of the present. The opinion piece was written by Dr. Leana S. Wen, an emergency physician and a professor at George Washington University Milken Institute School of Public Health.

Dr. Wen served as the Baltimore health commissioner from 2015 to 2018. In doing so, she saw first-hand just how dangerous and deadly opiates were, as Baltimore was and is one of the cities hit hardest by the opiate epidemic. In 2017, nearly 700 people died in Baltimore from opiate overdoses.

Opioid lawsuit

Dr. Wen wrote about the groundbreaking cases against big pharma, citing the cases against Purdue and Johnson & Johnson that I referenced earlier. But the big concern on Dr. Wen’s mind is if these settlements will result in actually reversing the addiction crisis. The entire goal behind suing Big Pharma for hundreds of millions of dollars is to hold those companies accountable for the damage that they caused. But will the funding be used for its intended purpose?

The historical record says it might not be. And here, Dr. Wen dives into a historical analogy to the Big Tobacco Battles. These legal battles started as early as the 1980s, but many did not come to fruition till much later. Quoting Dr. Wen, “The 1998 Tobacco Master Settlement Agreement shows what can happen when funding decisions on public health matters do not employ a public health approach. That settlement required major cigarette companies to pay an estimated $246 billion over 25 years. The payouts were supposed to be used to fight tobacco-related disease, but only 2.4 percent of revenue collected ended up being spent on prevention and cessation.”

The doctor goes on to talk about how state-level government officials need to keep in mind three key points:

  • First off, policymakers of states who receive settlements for lawsuits must commit to a robust public health approach. Politicians need to commit to using the funding to treat addicts within their states with residential treatment approaches. Money earmarked for fixing a state’s drug problem should not be spent on something else.
  • Secondly, policymakers should allocate funding to the areas hardest hit. Regions with the most drug use, the highest overdose statistics, and the most drug crime should receive priority.
  • Third, policymakers must apply principles of equality in all their decisions. Funds should go to treating prescription drug users. But funds should also go to treating those who are hooked on street drugs and other substances.

Dr. Wen concluded her opinion piece with a compelling statement. “The decisions soon to be made in our courts, legislatures and statehouses will answer critical questions. Even now, do our policymakers fully grasp the scale and breadth of their constituents’ suffering? Will they do what’s needed to end this epidemic once and for all?”

If Your Loved One is Hooked on Prescription Drugs…

There are so many lessons we can learn from history. In this case, we should remember to hold pharma companies accountable for the creation of the opiate epidemic. We should not let them off easy. And once lawsuits are won, we should not make the mistakes that policymakers did following Big Tobacco litigation. We must use funds appropriated from Big Pharma litigation to reverse the opiate crisis.

Reversing the opiate crisis is something we can all work on. We don’t have to wait on cash settlements from pharma companies. In fact, we shouldn’t wait on them at all. If we know someone who is struggling with an addiction, our mission immediately becomes one of helping that person to overcome their habit. The safest way to do that is by enlisting the help of a residential treatment center. If you know someone who is struggling with a drug problem, make sure they get help as soon as possible.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.