Blowing the whistle on Big Tobacco

“See it. Say it. Sorted.” 

If you’ve been on public transport in the UK in the past three years, you may well have heard this slogan over the tannoy or seen it on a poster. According to the comms agency behind the campaign, it was created because passengers thought it was difficult to report something suspicious and weren’t confident that anyone would take action if they did.

Despite confusing a lot of us who couldn’t hear if it was “sorted” or “sort it”, it’s been a success. Apparently texts and calls to British Transport police have increased by 365% since the campaign began.

But there’s another barrier to raising concerns – retaliation. While we’re unlikely to face reprisals for texting the police about a suspicious bag or a group of people acting in an antisocial way, speaking out in other circumstances can come at a high cost. Just ask any whistleblower.

Whistleblowing is when you report suspected wrongdoing at work (and not just someone putting the wrong kind of milk in your tea). This week my newsroom published a major investigation about a new whistleblower who worked for one of the ‘Big’ tobacco companies, Philip Morris – if you didn’t already read it, check it out here.

You can count the number of ex-employees that have spoken out against Big Tobacco on one hand. One of the first was Jeffrey Wigand, a biochemist who blew the whistle on Brown & Williamson in 1995.

Wigand spent much of his career working in healthcare, including for several major pharmaceutical companies. He wanted to retrain as a doctor but his wife, Lucretia, said he was too old. This fantastic Vanity Fair article details what happened next – it’s an oldie but a goodie.

His brother also couldn’t believe it. But Wigand was optimistic: “I thought I would have an opportunity to make a difference and work on a safer cigarette,” he told Vanity Fair. The company, he believed, wanted him to help make a lower-tar cigarette to compete with a rival.

But the reality was a little different. The low-tar cigarette he was hoping to compete with was withdrawn from the market just three months after he joined Brown & Williamson. And he was surprised by what he found in the company, describing “Stone Age” data and a lab like something you’d see in a high-school. He was surprised there was no physicist or toxicologist, roles he felt vital for a company serious about tobacco and fire safety – once he was on board, he recruited them.

As time went on, he learned more about what he didn’t know of the company’s work, despite being head of R&D there. He told Vanity Fair: “There were essentially two research-and-development departments. They did the work on nicotine overseas.” He felt that his “safer cigarette” project was being cancelled.

Eventually, he says he was fired after demanding the company remove what he called a cancer-causing additive from pipe tobacco.

He later exposed “the industry’s disregard for the public’s health and safety” during an interview with 60 Minutes and court testimony. The wrangling over that 60 Minutes and the lawsuits that followed were adapted into the 1999 film The Insider, where he was portrayed by Russell Crowe. (Who would play me in the movie version of The Spark, I wonder?)

Going public wasn’t easy. As well as losing his job, he was accused of fabricating claims that he was being stalked and harassed. In the 60 Minutes interview he describes receiving death threats against his children and said he was so scared that he started carrying a gun.

But he spoke out. He kept going.

Wigand still works to curb the harm done by the tobacco industry. He had some words for TBIJ on Shiro Konuma, the man speaking out about Philip Morris’s web of payments to fund research into its flagship product.

“They’re going to try and crucify him,” he said, “and make him a devil.”

So why do it?

Because it changes the world. According to the National Whistleblower Center, Wigand is credited with being the key witness in successful tobacco reform law suits in the US. One suit filed by 46 US states led to a $368 billion settlement by the tobacco companies. It laid the groundwork for cigarette packaging warnings, free stop-smoking campaigns, and massive repayments for the medical expenses of treating smoking-related illnesses.

Blowing the whistle can bring terrible risks, but what about when the worst has already happened?

I’ve talked to Merope Mills about what it’s like to speak up when – or, in fact, because – tragedy happens.

Her daughter Martha was just 13 when she died from complications of a cycling accident. Her death from sepsis was preventable. Sadly, she’s not alone. An estimated 11,000 people die due to failings in patient safety in England every year. Globally, more than 3 million people globally lose their lives after receiving unsafe healthcare, and 10% of patients are harmed.

Read on to hear from Merope herself.

“After her accident, Martha was in a “good” hospital. She had an injury that we were told she was going to recover from. So there was no sense that she was in any danger. 

But she got an infection and we started to worry. She bled through her tubes onto her sheets and had so many other serious symptoms that we started openly to express anxiety about sepsis [a life-threatening reaction to an infection caused by an overreaction of the immune system], which she had though the doctors kept this from us. And we started to dread the Bank Holiday weekend that was coming, when no consultants are around on the ward. It’s plain that Martha should have been moved to intensive care, but the consultants on the ward wanted to keep control. They kept reassuring us that all was normal. They ignored my anxieties and kept us in the dark. 

Martha went into septic shock on the weekend, exactly as I predicted. The doctors had failed to do what every investigator since has said they should have done – move her to ICU – and so took great risks with her care. And she died.

I knew instantly that I would want to tell people, and as somebody who worked at The Guardian, I knew that I was able to do that.  I felt really angry and I thought Martha was the victim of a real injustice. I found it incredibly shocking. And I still do. I’m still as shocked by it today as I was when it happened. And I soon found out that this kind of story isn’t told enough; people simply don’t know.

Martha’s story highlighted the lack of power that you feel as a patient or relative in hospital. If you are worried and you think that they’ve got something wrong, there’s nothing you can do, there’s no lever you can pull. 

Telling Martha’s story was the one bit of power that I had when I’d been completely powerless before. So I wrote about it. Lots of people contacted me and said, ‘You know, I’ve had something similar’. Crucially, some medics from Australia got in touch. There they have Ryan’s rule, named after Ryan Saunders, a boy who was failed terribly when he was in hospital in 2007. This gives a way to escalate queries and get a medical review if a patient or family member is worried. 

And so we started looking into that with the thinktank Demos. We arranged a roundtable with senior people from the NHS and that’s how the idea of Martha’s rule came about. 

After writing the piece I was also contacted by the Today programme, where I gave a long interview. And then it just took on momentum. Immediately, various newspapers started supporting it. And crucially, it was a non-partisan issue so it was covered by publications across the political spectrum. This had a big impact on Westminster. And I think that’s one of the reasons why it became a reality.

While most doctors and healthcare workers are well intentioned, there are things that go wrong. Also, intention isn’t everything: doctors can be careless or arrogant. We don’t talk about the mistakes enough, because it feels like an attack on the NHS itself. But the only way to fix them is to talk about them, and understand that there are patterns of behaviour that lead to the large number of preventable deaths. 

Obviously, we hope that Martha’s rule will save lives. But it’s about more than that: it’s about changing the culture within the NHS, eroding deference, encouraging an openness to being challenged among doctors, giving patients more power and creating a more listening environment.“

The first phase of Martha’s law was implemented in April this year. I’m humbled by the courage and determination of Merope and her husband Paul Laity in channelling their grief and loss into action – action that could save hundreds and thousands of lives.

And without the courage of whistleblowers, the tactics of big corporations who put profit over people and money over morals would remain hidden from our sight. It’s not easy to speak up. I’m full of admiration for those who put exposing the truth above their own needs, comfort and even safety.

So now it’s your turn – drop me an email to let me know what you think about this newsletter and to share any ideas or questions you have about the impact journalism can have in the world.

According to the Old Farmer’s Almanac, today is the first day of the Dog Days of summer for those of us in the Northern hemisphere. Looks like someone forgot to tell the London skies that... But wherever you are, I hope I’ve brought a little ray of sunshine into your day with these stories of courageous people and how they have turned adversity into action, making the world a better place.

See you next time!