Only a Smokescreen? Big Tobacco Stands Down as Colorado and Oregon Hike Cigarette Taxes


This story also ran on Fortune. It can be republished for free.

Big Tobacco did something unusual in Marlboro Country last fall: It stood aside while Colorado voters approved the state’s first tobacco tax hike in 16 years.

The industry, led by Altria Group, one of the world’s largest tobacco companies, has spent exorbitantly in the past to kill similar state ballot initiatives. In 2018, Altria’s lobbying arm spent more than $17 million to help defeat Montana’s tobacco tax ballot initiative. That same year, it spent around $6 million to help defeat South Dakota’s similar measure.

And four years ago, Altria was the leading funder in a successful $16 million campaign to quash Colorado’s previous proposed tobacco tax increase.

In November, by contrast, Altria didn’t spend a penny in opposition and Colorado voters overwhelmingly approved the tax with two-thirds support. Likewise, in Oregon, Big Tobacco stayed on the sidelines while a tax hike passed there.

The tax measures are major wins for anti-smoking advocates after a string of defeats but, in an example of how politics makes strange bedfellows, Colorado’s tax might not have been possible without Altria’s help. And, advocates said, the way those measures passed could provide a blueprint for states to follow in future elections.

In Colorado, Altria, the parent company of Marlboro cigarette maker Philip Morris, insisted that a minimum price be included in the proposal, according to The Colorado Sun, citing emails between political consultants and Gov. Jared Polis’ office. So while supporters see an increased tobacco tax as more revenue for the state, a disincentive for kids to smoke and a win for public health, the measure could also allow America’s premium tobacco companies to gain market share.

The Colorado measure will increase the total state-levied tax from 84 cents to eventually $2.64 per pack by 2027. The tax rate on vaping products, not currently taxed, will be 30% of the manufacturer’s list price in 2021, gradually increasing to 62% by 2027. The proposition also set the minimum price per pack of cigarettes at $7 as of Jan. 1 and that floor rises to $7.50 in 2024. The change could effectively help premium cigarette companies corner the market, since discount cigarettes would rise to at least $7.

Discount cigarette companies Liggett Group, Vector Tobacco and Xcaliber International — which funded opposition to the tax initiative, Proposition EE — tried to sue the state over the minimum tax provision, alleging “Philip Morris will reap huge benefits from the new legislation” and the changes will “destroy their ability to compete in Colorado.” In December, a federal judge rejected the company’s request for a preliminary injunction. A spokesperson for Liggett said the company plans to appeal.

“When it came to entities like Altria and other stakeholders that we engaged in the legislative process, I think that they saw the writing on the wall,” said Jake Williams, executive director of Healthier Colorado and one of the key organizers behind Proposition EE. “And it helped us get through the legislative process, not just with Democratic votes, but Republican votes to refer the measure to the ballot.”

Altria officials said in a statement that their tobacco companies oppose excise tax increases, but they did not say whether they had worked with Colorado lawmakers.

“Altria did not advocate for or against Proposition EE, and after evaluating the content and intent of this measure, Colorado voters decided to vote in favor of it, some aspects of which were focused on tobacco harm reduction and may help transition adult smokers to a non-combustible future,” the statement said.

Polis’ office did not respond to a request for comment. The Colorado Attorney General’s Office said it would not comment on matters under active litigation. State Democratic Sen. Dominick Moreno and Rep. Julie McCluskie, both state sponsors for the legislation, declined to comment for the same reason. Fellow Democrats Rep. Yadira Caraveo and Sen. Rhonda Fields, also state sponsors for the legislation, did not respond to requests for comment.

Colorado campaign finance records show Altria and Altria’s lobbying arm in 2020 contributed to funds that support both Democratic and Republican candidates in the state — a pattern playing out nationally.

Williams said Altria’s absence of public opposition wasn’t the only factor in the initiative’s success. The tax revenue will initially fund revenue lost during the covid-19 pandemic, then fund tobacco use prevention and eventually preschool education.

The American Lung Association, which supported the Colorado measure, said it believes tobacco taxes are among the most effective ways to reduce tobacco use, especially among youths, who are more sensitive to changes in price. The organization cites studies that found every 10% increase in the price of cigarettes reduces consumption by about 4% for adults and 7% for teens.

“Without tobacco industry opposition, it’s very popular among the public,” Thomas Carr, the association’s director of national policy, said of the tax increase. “We’ve long seen it in polling on the subject.”

There was no major industry opposition to the Oregon increase, either. Its tobacco tax increase — Measure 108 — also got a resounding two-thirds of support. But Oregon didn’t negotiate with Altria lobbyists or set a minimum price provision, according to Elisabeth Shepard, campaign manager for Yes for a Healthy Future.

“I don’t know what the [Colorado] deal was,” Shepard said. “All I know is that before it even made it to the ballot, Altria indicated that they were not going to oppose the measure and stuck with their word.”

While Shepard worried until Election Day whether Big Tobacco would swoop in with opposition in Oregon, it didn’t. She believes her campaign worked because the effort had early resources and money, the tax was targeted to fund the Oregon Health Plan (the state’s Medicaid), and her campaign’s coalition had 300 endorsers, including those in health and business communities.

“We had the left, we had the right, we had the far-right, we had the far-left,” Shepard said.

Her campaign paid its advisory committee members, including representatives from affected communities such as Indigenous Oregonian tribes. At least 30% of American Indian and Alaska Native adults in the state smoke cigarettes. Oregon’s measure increases tobacco taxes $2 per pack, from $1.33 to $3.33, as well as creates a new tax for e-cigarettes. The revenues will help fund an estimated $300 million for the state’s health plan.

Altria did not respond to a request for comment about Oregon tobacco taxes, but the company has previously said it opposed Oregon’s measure.

Shepard believes her campaign model could work in other states. Other anti-smoking advocates took note of the 2020 election.

“We certainly support establishing minimum prices for all tobacco products in conjunction with tobacco tax increases, as we know increasing the price of tobacco products is one of the most effective ways to reduce tobacco use,” said Cathy Callaway, director of state and local campaigns for the American Cancer Society Cancer Action Network.

It could just come down to a state’s voters and its politics, according to Mark Mickelson, a former Republican in South Dakota’s legislature. Mickelson was behind creating his state’s failed 2018 tobacco tax ballot initiative.

“We just got beat,” Mickelson said. The opposition “got ahead of us on the message. They had a lot more money and had just played on doubts that the [tax revenue] money would go to tech ed.”

The average state cigarette tax is $1.88 per pack, but it varies across the country — as high as $4.35 in New York but only 44 cents in North Dakota, where a 2016 ballot initiative to increase that to $2.20 was defeated.

Tax increases can translate into hundreds of millions of dollars in new revenue for states, said Richard Auxier, senior policy associate at the nonpartisan Urban-Brookings Tax Policy Center.

“It’s a little easier to pass a tax on someone else, which is often how this is seen — passing this tax on smokers, rather than passing it on all working people, [compared to] if you were to increase income tax or … a sales tax.”

But not all voters get a say.

In Kentucky, which isn’t a referendum state, Republican state Rep. Jerry Miller said there’s not a lot of sympathy for tobacco companies anymore.

“The agriculture community, which used to be on the same page with cigarette companies, are now always in opposition because the cigarette companies are always trying to tweak their formula to use cheaper tobacco,” he said.

Miller’s recent vaping tax bill failed in the state legislature, but he’s working on a new one.

“We don’t have that tradition or the mechanism that somebody collects 10,000 signatures and they get a referendum on a ballot,” he said. “That’s why things like this have to go through the legislature — and so it really just depends on the state [government].”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Cancer Risk from Arsenic in Rice and Seaweed

A daily half-cup of cooked rice may carry a hundred times the acceptable cancer risk of arsenic. What about seaweed from the coast of Maine?

“At one point during the reign of King Cotton, farmers in the south central United States controlled boll weevils with arsenic-based pesticides, and residual arsenic still contaminates the soil.” Different plants have different reactions to arsenic exposure. Tomatoes, for example, don’t seem to accumulate much arsenic, but rice plants are really good at sucking it out of the ground—so much so that rice can be used for “arsenic phytoremediation,” meaning you can plant rice on contaminated land as a way to clear arsenic from the soil. Of course, you’re then supposed to throw the rice—and the arsenic—away. But in the South, where 80 percent of U.S. rice is grown, we instead feed it to people.

As you can see at 0:52 in my video Cancer Risk from Arsenic in Rice and Seaweed, national surveys have shown that most arsenic exposure has been measured coming from the meat in our diet, rather than from grains, with most from fish and other seafood. Well, given that seafood is contributing 90 percent of our arsenic exposure from food, why are we even talking about the 4 percent from rice?

The arsenic compounds in seafood are mainly organic—used here as a chemistry term having nothing to do with pesticides. Because of the way our body can deal with organic arsenic compounds, “they have historically been viewed as harmless.” Recently, there have been some questions about that assumption, but there’s no question about the toxicity of inorganic arsenic, which you get more of from rice.

As you can see at 1:43 in my video, rice contains more of the toxic inorganic arsenic than does seafood, with one exception: Hijiki, an edible seaweed, is a hundred times more contaminated than rice, leading some researchers to refer to it as the “so-called edible hijiki seaweed.” Governments have started to agree. In 2001, the Canadian government advised the public not to eat hijiki, followed by the United Kingdom, the European Commission, Australia, and New Zealand. The Hong Kong Centre for Food Safety advised the public not to eat hijiki and banned imports and sales of it. Japan, where there is actually a hijiki industry, just advised moderation.

What about seaweed from the coast of Maine—domestic, commercially harvested seaweed from New England? Thankfully, only one type, a type of kelp, had significant levels of arsenic. But, it would take more than a teaspoon to exceed the provisional daily limit for arsenic, and, at that point, you’d be exceeding the upper daily limit for iodine by about 3,000 percent, which is ten times more than reported in a life-threatening case report attributed to a kelp supplement.

I recommend avoiding hijiki due to its excess arsenic content and avoiding kelp due to its excess iodine content, but all other seaweeds should be fine, as long as you don’t eat them with too much rice.

In the report mentioned earlier where we learned that rice has more of the toxic inorganic arsenic than fish, we can see that there are 88.7 micrograms of inorganic arsenic per kilogram of raw white rice. What does that mean? That’s only 88.7 parts per billion, which is like 88.7 drops of arsenic in an Olympic-size swimming pool of rice. How much cancer risk are we talking about? To put it into context, the “usual level of acceptable risk for carcinogens” is one extra cancer case per million. That’s how we typically regulate cancer-causing substances. If a chemical company wants to release a new chemical, we want them to show that it doesn’t cause more than one in a million excess cancer cases.

The problem with arsenic in rice is that the excess cancer risk associated with eating just about a half cup of cooked rice a day could be closer to one in ten thousand, not one in a million, as you can see at 4:07 in my video. That’s a hundred times the acceptable cancer risk. The FDA has calculated that one serving a day of the most common rice, long grain white, would cause not 1 in a million extra cancer cases, but 136 in a million.

And that’s just the cancer effects of arsenic. What about all the non-cancer effects? The FDA acknowledges that, in addition to cancer, the toxic arsenic found in rice “has been associated with many non-cancer effects, including ischemic heart disease, diabetes, skin lesions, renal [kidney] disease, hypertension, and stroke.” Why, then, did the FDA only calculate the cancer risks of arsenic? “Assessing all the risks associated with inorganic arsenic would take considerable time and resources and would delay taking any needed action to protect public health” from the risks of rice.

“Although physicians can help patients reduce their dietary arsenic exposure, regulatory agencies, food producers, and legislative bodies have the most important roles” in terms of public health-scale changes. “Arsenic content in U.S.-grown rice has been relatively constant throughout the last 30 years,” which is a bad thing.

“Where grain arsenic concentration is elevated due to ongoing contamination, the ideal scenario is to stop the contamination at the source.” Some toxic arsenic in foods is from natural contamination of the land, but soil contamination has also come from the dumping of arsenic-containing pesticides, as well as the use of arsenic-based drugs in poultry production and then the spreading of arsenic-laced chicken manure on the land. Regardless of why south central U.S. rice paddies are so contaminated, we shouldn’t be growing rice in arsenic-contaminated soil.

What does the rice industry have to say for itself? Well, it started a website called ArsenicFacts. Its main argument appears to be that arsenic is everywhere, we’re all exposed to it every day, and it’s in most foods. But shouldn’t we try to cut down on the most concentrated sources? Isn’t that like saying look, diesel exhaust is everywhere, so why not suck on a tailpipe? The industry website quotes a nutrition professor saying, “All foods contain arsenic. So, if you eliminate arsenic from your diet, you will decrease your risk…and you’ll die of starvation.” That’s like Philip Morris saying that the only way to completely avoid secondhand smoke is to never breathe—but then you’ll asphyxiate, so you might as well just start smoking yourself. If you can’t avoid it, you might as well consume the most toxic source you can find?!

That’s the same tack the poultry industry took. Arsenic and chicken? “No need to worry” because there’s a little arsenic everywhere. That’s why it’s okay the industry fed chickens arsenic-based drugs for 70 years. If you can’t beat ’em, join ’em.

How can the rice industry get away with selling a product containing a hundred times the acceptable cancer risk? I cover that and so much more in my other videos on arsenic and rice, which also include concrete recommendations on how to mediate your risk.


Check out:

Pesticides were not the only source of arsenic. Poultry poop, too, if you can believe it! I cover that story in Where Does the Arsenic in Chicken Come From? and Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?.

Chronic low-dose arsenic exposure is associated with more than just cancer. See The Effects of Too Much Arsenic in the Diet.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

No Purveyor of Unhealthy Products Wants the Public to Know the Truth

In 2011, Denmark introduced the world’s first tax on saturated fat. “After only 15 months, however, the fat tax was abolished,” due to massive pressure from farming and food company interests. “Public health advocates are weak in tackling the issues of corporate power…A well-used approach for alcohol, tobacco, and, more recently, food-related corporate interests is to shift the focus away from health. This involves reframing a fat or soft drinks tax as an issue of consumer rights and a debate over the role of the state in ‘nannying’ or restricting people’s choices.” I discuss this in my video The Food Industry Wants the Public Confused About Nutrition.

“The ‘Nanny State’ is a term that is usually used in a pejorative way to discourage governments from introducing legislation or regulation that might undermine the power or actions of industry or individuals…Public health advocacy work is regularly undermined by the ‘Nanny State’ phrase.” But those complaining about the governmental manipulation of people’s choices hypocritically tend to be fine with corporations doing the same thing. One could argue that “public health is being undermined by the ‘Nanny Industry’…[that] uses fear of government regulation to maintain its own dominance, to maintain its profits and to do so at a significant financial and social cost to the community and to public health.”

The tobacco industry offers the classic example, touting “personal responsibility,” which has a certain philosophical appeal. As long as people understand the risks, they should be free to do whatever they want with their bodies. Now, some argue that risk-taking affects others, but if you have the right to put your own life at risk, shouldn’t you have the right to aggrieve your parents, widow your spouse, and orphan your children? Then, there’s the social cost argument. People’s bad decisions can cost the society as a whole, whose tax dollars may have to care for them. “The independent, individualist motorcyclist, helmetless and free on the open road, becomes the most dependent of individuals in the spinal injury ward.”

But, for the sake of argument, let’s forget these spillover effects, the so-called externalities. If someone understands the hazards, shouldn’t they be able to do whatever they want? Well, “first, it assumes individuals can access accurate and balanced information relevant to their decisions…but deliberate industry interference has often created situations where consumers have access only to incomplete and inaccurate information…For decades, tobacco companies successfully suppressed or undermined scientific evidence of smoking’s dangers and down played the public health concerns to which this information gave rise.” Don’t worry your little head, said the nanny companies. “Analyses of documents…have revealed decades of deception and manipulation by the tobacco industry, and confirmed deliberate targeting of…children.” Indeed, it has “marketed and sold [its] lethal products with zeal…and without regard for the human tragedy….”

“The tobacco industry’s deliberate strategy of challenging scientific evidence undermines smokers’ ability to understand the harms smoking poses” and, as such, undermines the whole concept that smoking is a fully informed choice. “Tobacco companies have denied smokers truthful information…yet held smokers [accountable] for incurring diseases that will cause half of them to die prematurely. In contexts such as these, government intervention is vital to protect consumers from predatory industries….”

Is the food industry any different? “The public is bombarded with information and it is hard to tell which is true, which is false and which is merely exaggerated. Foods are sold without clarity about the nutritional content or harmful effects.” Remember how the food industry spent a billion dollars making sure the easy-to-understand traffic-light labeling system on food, which you can see at 4:26 in my video, never saw the light of day and was replaced by indecipherable labeling? That’s ten times more money than the drug industry spends on lobbying in the United States. It’s in the food industry’s interest to have the public confused about nutrition.

How confused are we about nutrition? “Head Start teachers are responsible for providing nutrition education to over 1 million low-income children annually…” When 181 Head Start teachers were put to the test, only about 4 out of the 181 answered at least four of the five nutrition knowledge questions correctly. Most, for example, could not correctly answer the question, “What has the most calories: protein, carbohydrate, or fat?” Not a single teacher could answer all five nutrition questions correctly. While they valued nutrition education, 54 percent “agreed that it was hard to know which nutrition information to believe,” and the food industry wants to keep it that way. A quarter of the teachers did not consume any fruits or vegetables the previous day, though half did have french fries and soda, and a quarter consumed fried meat the day before. Not surprisingly, 55 percent of the teachers were not just overweight but obese.

When even the teachers are confused, something must be done. No purveyor of unhealthy products wants the public to know the truth. “An interesting example comes from the US ‘Fairness Doctrine’ and the tobacco advertising experience of the 1960s. Before tobacco advertising was banned from television in the US, a court ruling in 1967 required that tobacco companies funded one health ad about smoking for every four tobacco TV advertisements they placed. Rather than face this corrective advertising, the tobacco industry took their own advertising off television.” They knew they couldn’t compete with the truth. Just “the threat of corrective advertising even on a one-to-four basis was sufficient to make the tobacco companies withdraw their own advertising.” They needed to keep the public in the dark.

The trans fat story is an excellent example of this. For more on that, see my videos Controversy Over the Trans Fat Ban and Banning Trans Fat in Processed Foods but Not Animal Fat.

Isn’t the Fairness Doctrine example amazing? Just goes to show how powerful the truth can be. If you want to support my efforts to spread evidence-based nutrition, you can donate to our 501c3 nonprofit here. You may also want to support Balanced, an ally organization NutritionFacts.org helped launch to put this evidence into practice.


More tobacco industry parallels can be found in Big Food Using the Tobacco Industry Playbook, American Medical Association Complicity with Big Tobacco, and How Smoking in 1959 Is Like Eating in 2016.

Want to know more about that saturated fat tax idea? See Would Taxing Unhealthy Foods Improve Public Health?.

Also check:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Food Industry’s “model of systemic dishonesty”

In 1993, the Harvard Nurses’ Health Study found that a high intake of trans fat may increase the risk of heart disease by 50 percent. That’s where the trans fat story started in Denmark, ending a decade later with a ban on added trans fats in 2003. It took another ten years before the United States even started considering a ban. All the while, trans fats were killing tens of thousands of Americans every year. With so many people dying, why did it take so long for the United States to even suggest taking action? I explore this in my video Controversy Over the Trans Fat Ban.

One can look at the fight over New York City’s trans fat ban for a microcosm of the national debate. Not surprisingly, opposition came from the food industry, complaining about “government intrusion” and “liken[ing] the city to a ‘nanny state.’” “Are trans fat bans…the road to food fascism?”

A ban on added trans fats might save 50,000 American lives every year, which could save the country tens of billions of dollars in healthcare costs, but not so fast! If people eating trans fat die early, think about how much we could save on Medicare and Social Security. Indeed, “smokers actually cost society less than nonsmokers, because smokers die earlier.” So, “we should be careful about making claims about the potential cost-savings of trans fat bans….more research is needed on the effects of these policies, including effects on the food industry.” Yes, we might save 50,000 lives a year, but we can’t forget to think about the “effects on the food industry”!

How about “education and product labeling” rather than “the extreme measure of banning trans fats”? As leading Danish cardiologist “puts it bluntly, ‘Instead of warning consumers about trans fats and telling them what they are, we’ve [the Danes] simply removed them.’” But we’re Americans! “As they say in North America: ‘You can put poison in food if you label it properly.’”

People who are informed and know the risks should be able to eat whatever they want, but that assumes they’re given all the facts, which doesn’t always happen “due to deception and manipulation by food producers and retailers.” And, not surprisingly, it’s the unhealthiest of foods that are most commonly promoted using deceptive marketing. It’s not that junk food companies are evil or want to make us sick. “The reason is one of simple economics”—processed foods simply “offer higher profit margins and are shelf-stable, unlike fresh foods such as fruit and vegetables.” The food industry’s “model of systemic dishonesty,” some argue, “justifies some minimal level of governmental intervention.”

But is there a slippery slope? “Today, trans fats; tomorrow, hot dogs.” Or, what about the reverse? What if the government makes us eat broccoli? This argument actually came up in the Supreme Court case over Obamacare. As Chief Justice Roberts said, Congress could start ordering everyone to buy vegetables, a concern Justice Ginsburg labeled “the broccoli horrible.” Hypothetically, Congress could compel the American public to go plant-based, however, no one can offer the “hypothetical and unreal possibility…of a vegetarian state” as a credible argument. “Judges and lawyers live on the slippery slope of analogies; they are not supposed to ski it to the bottom,” said one legal scholar.

If anything, what about the slippery slope of inaction? “Government initially defaulted to business interests in the case of tobacco and pursued weak and ineffective attempts at education” to try to counter all the tobacco industry lies. Remember what happened? “The unnecessary deaths could be counted in the millions. The U.S. can ill afford to repeat this mistake with diet.”

Once added trans fats are banned, the only major source in the American diet will be the natural trans fats found in animal fat. For more on this, see Banning Trans Fat in Processed Foods but Not Animal Fat and Trans Fat in Meat and Dairy.

Ideally how much trans fat should we eat a day? Zero, and the same goes for saturated fat and cholesterol. See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero, Good, Great, Bad, and Killer Fats, and Lipotoxicity: How Saturated Fat Raises Blood Sugar.


More on industry hysterics and manipulation in:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How the Lead Paint and Gas Industries Got Away with It

We have known for thousands of years that lead can be toxic and for more than a century that children could be poisoned by lead paint. Since those first cases, the “lead industry has mobilized against the advances of science,” as I discuss in my video How the Lead Paint Industry Got Away with It.

By 1926, lead poisoning was already “of relatively frequent occurrence in children,” yet “the United States continued to allow the use of lead-based paint until 1978.” In contrast, in Europe, many countries said, Hmm, poisoning children? No, thanks. and “banned the use of lead-based paint as early as 1909.” 

“The delay in banning lead-based paint in the United States was due largely to the marketing and lobbying efforts of the lead industry,” profiting from the poison. It knew it couldn’t hold off forever, but the industry boasted that its “victories have been in the deferral of implementation of…regulations.”

And now, “peeling paint turns into poisonous dust,” and guess where it ends up? As a Mount Sinai dean and a Harvard neurology professor put it: “Lead is a devastating poison. It damages children’s brains, erodes intelligence, diminishes creativity…” and judgment and language. Yet, despite the accumulating evidence, the lead industry didn’t just fail to warn people—“it engaged in an energetic promotion of lead paint.” After all, a can of pure white lead paint had huge amounts of lead, which meant huge profits for the industry.

But, as you can see in an old advertisement featured at 1:55 in my video, “[t]here is no cause for worry” if your toddler rubs up against lead paint, because those “fingerprint smudges or dirt spots” can be removed “easily without harming the paint.” Wouldn’t want to harm the paint. After all, “painted walls are sanitary…”

The director of the Lead Industry Association blamed the victims: “Childhood lead poisoning is essentially a problem of slum dwellings and relatively ignorant parents.”

“It seems that no amount of evidence, no health statistics, no public outrage could get industry to care that their lead paint was killing and poisoning children,” but how much public outrage was there really?

“It goes without saying that lead is a devastating, debilitating poison” and that “literally millions of children have been diagnosed with varying degrees of elevated blood lead levels…” Compare that to polio, for example. “In the 1950s, for example, fewer than sixty thousand new cases of polio per year created a near-panic among American parents and a national mobilization that led to vaccination campaigns that virtually wiped out the disease within a decade.” In contrast, despite “many millions of children [who have] had their lives altered for the worse by exposure to lead…[a]t no point in the past hundred years has there been a similar national mobilization over lead.” Today, after literally a century, the Centers for Disease Control and Prevention estimates over five hundred thousand children still suffer from “elevated blood-lead levels.”

The good news is that blood lead levels are in decline, which is celebrated as one of our great public health achievements. But, given what we knew, and for how long we knew, “it is presumptuous to declare the decline in childhood lead poisoning a public health victory.” Indeed, “even if we were victorious…it would be a victory diminished by our failure to learn from the epidemic and take steps to dramatically reduce exposures to other confirmed and suspected environmental toxicants as well as chemicals of uncertain toxicity.”

That’s one of the reasons I wanted to do this series on lead. We need to learn from our history so the next time some industry wants to sell something to our kids, we’ll stick to the science. And, of course, lead levels aren’t declining for everyone.

As the whistle-blowing pediatrician who helped expose the Flint drinking water crisis explained, “The people in Flint have a 20-year lower life expectancy than people in a neighboring suburb. We were already struggling with every barrier to our children’s success. Then we gave them lead.”

Her research showed that the switch in water supplies from the Great Lakes to the polluted Flint River “created a perfect storm” for lead contamination, doubling the percentage of kids with elevated lead levels in their blood, as you can see at 0:42 in my video How the Leaded Gas Industry Got Away with It, whereas out in the suburbs, where the water supply remained unchanged, children’s lead levels stayed about the same. That’s how she knew it was the switch in water supplies. That’s what broke the story of the Flint crisis: a doubling of elevated lead levels.

But wait a moment: Even before the switch from Lake Huron to the polluted Flint River, when everyone was getting the same water, lead levels in children in Flint were twice that of the suburbs. There was already a doubling in elevated lead levels in Flint and other poor communities around the country, but where have all the crisis headlines been? Indeed, even with all the bottled water in the world, the children in Flint will continue to live in a lead-polluted environment.

Many have pointed out the irony that the new water from the Flint River was “so corrosive” that the nearby General Motors plant switched back to a clean water source when it started noticing rust spots on its new parts, all while water quality complaints from Flint residents were being ignored. But, there is an additional irony: General Motors is a major reason why the world is so contaminated with lead in the first place, as GM invented leaded gasoline. “Shortly after manufacture began, workers…began to become floridly psychotic and die.”

“In the wake of blaring headlines” about the lead-poisoned workers, public health leaders “warned of the potential for damage to broad swaths of the population” posed by putting this “well established toxin” into gasoline, “into the daily lives of millions of people. Yet, despite these warnings, millions…were harmed…and this entirely preventable poisoning still occurs today.”

“Virtually all the lead in the environment is there as a result of human activity.” Because we put it there. It used to be locked away, deep underground or under the ocean, but that was before we drove it around the Earth. “In the early 1970s, 200,000 tons of lead was emitted from automobiles in the United States each year, mostly in urban areas.” Had lead not been added to gasoline, the industry would have had to use higher-octane gas, which is less profitable. So, the “oil and lead industries…successfully thwarted government efforts to limit lead in gasoline for 50 years.” But, how were they able to do that? “Early public health warnings were not heeded because the industry assured the scientific community and the public that there was no danger.” I could see how a gullible public might be swayed by slick PR, but how do you manipulate the scientific community? By manipulating the science.

“The lead industry was able to achieve its influence in large part by being the primary supporter of research on health effects of lead,” and it got the best science money could buy. “Long before Big Tobacco, the lead industry understood the inestimable value of purchasing ‘good science.’”

“Consequently, the vast majority of relevant studies of lead in gasoline published [for decades]…were favorable to the lead industries.” What’s more, they “even sent a delegation to try to convince the U.S. EPA administrator that the lead regulation was not necessary because they alleged lead was an essential mineral required for optimum growth and development.”

Of course, the exact opposite is true. Lead is toxic to development. There are, however, nutritional interventions that can help alleviate lead toxicity. For example, there are food components that can help decrease the absorption of lead and help flush it out of your body. I’ve produced a series of three videos on specific dietary interventions, such as particular foods to eat, but—spoiler alert—in general, “food patterns that reduce susceptibility to lead toxicity are consistent with the recommendations for a healthy diet.”

As soon as I learned about the unfolding crisis in Flint, Michigan, I knew I had to take a deep dive into the medical literature to see if there is anything these kids might be able to do diet-wise to reduce their body burden.

Most of the time when I cover a subject on NutritionFacts.org, I’ve addressed it previously, so I just have to research the new studies published in the interim. But I had never really looked deeply into lead poisoning before, so I was faced with more than a century of science to dig through. Yes, I did discover there were foods that could help, but I also learned about cautionary tales like this one about our shameful history with leaded paint. By learning this lesson, hopefully, we can put more critical thought into preventing future disasters that can arise when our society allows profits to be placed over people.


This is part of a series on lead. You can view the rest of the series here:

 You may also be interested in How to Lower Heavy Metal Levels with Diet.

If you enjoyed this article, you may also like:

What relevance does this have for us today? See, for example, my video How Smoking in 1959 Is Like Eating in 2019.

In health,

Michael Greger, M.D.

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Medical Meat Bias

When famed surgeon Michael DeBakey was asked why his studies published back in the 1930s linking smoking and lung cancer were ignored, he had to remind people about what it was like back then. We were a smoking society. Smoking was in the movies, on airplanes. Medical meetings were held in “a heavy haze of smoke.” Smoking was, in a word, normal. Even the congressional debates over cigarettes and lung cancer took place in literal smoke-filled rooms. (This makes me wonder what’s being served at the breakfast buffets of the Dietary Guidelines Committee meetings these days.)

I’ve previously talked about a famous statistician by the name of Ronald Fisher, who railed against what he called “propaganda…to convince the public that cigarette smoking is dangerous.” “Although Fisher made invaluable contributions to the field of statistics, his analysis of the causal association between lung cancer and smoking was flawed by an unwillingness to examine the entire body of data available…” His smokescreen may have been because he was a paid consultant to the tobacco industry, but also because he was himself a smoker. “Part of his resistance to seeing the association may have been rooted in his own fondness for smoking,” which makes me wonder about some of the foods nutrition researchers may be fond of to this day.

As I discuss in my video Don’t Wait Until Your Doctor Kicks the Habit, it always strikes me as ironic when vegetarian researchers are forthright and list their diet as a potential conflict of interest, whereas not once in the 70,000 articles on meat in the medical literature have I ever seen a researcher disclose her or his nonvegetarian habits––because it’s normal. Just like smoking was normal.

How could something that’s so normal be bad for you? And, it’s not as if we fall over dead after smoking one cigarette. Cancer takes decades to develop. “Since at that time most physicians smoked and could not observe any immediate deleterious effects, they were skeptical of the hypothesis and reluctant to accept even the possibility of such a relation”—despite the mountain of evidence.

It may have taken 25 years for the Surgeon General’s report to come out and longer still for mainstream medicine to get on board, but now, at least, there are no longer ads encouraging people to “Inhale to your heart’s content!” Instead, today, there are ads from the Centers for Disease Control and Prevention fighting back.

For food ads, we don’t have to go all the way back to old ads touting “Meat…for Health Defense” or “Nourishing Bacon,” or featuring doctors prescribing meat or soda, or moms relieved that “Trix are habit-forming, thank heavens!” You know things are bad when the sanest dietary advice comes from cigarette ads, as in Lucky Strike’s advertisements proclaiming “More Vegetables––Less Meat” and “Substitute Oatmeal for White Flour.” (You can see these vintage ads from 2:34 in my video).

In modern times, you can see hot dogs and sirloin tips certified by the American Heart Association, right on their packaging. And, of all foods, which was the first to get the Academy of Nutrition and Dietetics’ “Kids Eat Right” logo on its label? Was it an apple? Broccoli, perhaps? Nope, it was a Kraft prepared cheese product.

Now, just as there were those in the 1930s, 40s, and 50s at the vanguard trying to save lives, today, there are those transforming ads about what you can do with pork butt into ads about what the pork can do to your butt: “Hot Dogs Cause Butt Cancer—Processed meats increase colorectal cancer risk” reads an for the Physicians Committee for Responsible Medicine’s “Meat Is the New Tobacco” campaign, which you can see at 3:56 in my video. As Dr. Barnard, PCRM president, tried to convey in an editorial published in the American Medical Association’s Journal of Ethics, “Plant-based diets are the nutritional equivalent of quitting smoking.”

How many more people have to die before the Centers for Disease Control encourages people not to wait for open-heart surgery to start eating healthfully?

Just as we don’t have to wait until our doctor stops smoking to give up cigarettes ourselves, we don’t have to wait until our doctor takes a nutrition class or cleans up his or her diet before choosing to eat healthier. No longer do doctors hold a professional monopoly on health information. There’s been a democratization of knowledge. So, until the system changes, we have to take personal responsibility for our health and for our family’s health. We can’t wait until society catches up with the science again, because it’s a matter of life and death.

Dr. Kim Allan Williams, Sr., became president of the American College of Cardiology a few years back. He was asked why he follows his own advice to eat a plant-based diet. “I don’t mind dying,” Dr. Williams replied. “I just don’t want it to be my fault.”


I find this to be such a powerful concept that I have come at it from different angles. For other takes, check out Taking Personal Responsibility for Your Health and How Smoking in 1959 Is Like Eating in 2019. Are the health effects of smoking really comparable to diet, though? Check out Animal Protein Compared to Cigarette Smoking.

The food industry certainly uses the same kind of misinformation tactics to try to confuse consumers. See, for example:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: