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“the doctors’ choice is america’s choice”

IN 1946, THE RJ REYNOLDS Tobacco Company initiated a major new advertising campaign for Camels, one of the most popular brands in the United States. Working to establish dominance in a highly competitive market, Reynolds centered their new campaign on the memorable slogan, &#x0201c More doctors smoke Camels than any other cigarette.&#x0201d This phrase would be the mainstay of their advertising for the next 6 years. Touting surveys conducted by &#x0201c three leading independent research organizations,&#x0201d one typical advertisement proclaimed that according to &#x0201c nationwide&#x0201d surveys of 113597 doctors &#x0201c from every branch of medicine,&#x0201d Camel was the brand smoked by most respondents. It also asserted that this statistic was an &#x0201c actual fact,&#x0201d not a &#x0201c casual claim.&#x0201d

In reality, this &#x0201c independent&#x0201d surveying was conducted by RJ Reynolds&#x02019 s advertising agency, the William Esty Company, whose employees questioned physicians about their smoking habits at medical conferences and in their offices. It appears that most doctors were surveyed about their cigarette brand of choice just after being provided complimentary cartons of Camels.1

Even without the suspect nature of the data used in the &#x0201c More Doctors&#x0201d campaign, the frequent appearance of physicians in advertisements for cigarettes in this and many other ad campaigns is both striking and ironic from the vantage point of the early 21st century. Any association between physicians and cigarettes&#x02014 the leading cause of death in the United States&#x02014 is jarring given our current scientific knowledge about the relationship of smoking to disease and the fact that fewer than 4% of physicians in the United States now smoke.2

In 1930s and 1940s, however, smoking had become the norm for both men and women in the United States&#x02014 and a majority of physicians smoked.3 At the same time, however, rising public and scientific anxiety existed about cigarettes&#x02019 risks to health, creating concern among the tobacco companies. The physician constituted an evocative, reassuring figure to include in their advertisements. In retrospect, these advertisements are a powerful reminder of the cultural authority physicians and medicine held in American society during the mid 20th century, and the manner in which tobacco executives aligned their product with that authority.

Even before modern epidemiological research would demonstrate the health risks of smoking at mid century, there had already arisen considerable concern about the health impact of cigarette use.4 Questions of the moral and health consequences of cigarette smoking that had been prevalent at the beginning of the 20th century still lingered. Although many physicians were unconvinced by this older research, some had begun to recognize a disturbing increase in lung cancer, and some had also started to consider the respiratory and cardiovascular effects of smoking. A common theory held that cancer resulted from chronic irritation to the affected tissue, and many wondered whether cigarette smoke &#x0201c irritated&#x0201d lung tissue in this manner.5

Well aware of these concerns&#x02014 and their impact on cigarette sales&#x02014 the tobacco companies devised advertising and marketing strategies to (1) reassure the public of the competitive health advantages of their brands, (2) recruit physicians as crucial allies in the ongoing process of marketing tobacco, and (3) maintain the salience of individual clinical judgments about the health effects of smoking in the face of categorical scientific findings.

These elements would be of growing importance as the health effects of smoking came to be more fully elucidated. One aspect of these promotional strategies was to refer directly to physicians in both images and words. We explored how physicians were depicted in these advertisements and how the ad campaigns developed as health evidence implicating cigarette smoking accumulated by the early 1950s.