Tobacco industry and death certificates

The tobacco industry worked to prevent changes in regulations that would allow a doctors to indicate on death certificates whether tobacco contributed to the death of the deceased. The Tobacco Institute argued that people who fill out death certificates are not qualified to answer such "contribution" questions, and that death certificates are an unreliable source of information. The Institute argued that

"If death certificates are used to target controversial or unpopular lifestyle choices, questions about alcohol, drugs, AIDS and diet are likely to follow. Inclusion of questions about lifestyle choices will turn the death certificate into a propaganda tool."

They feared that such a check box would facilitate the accumulation of statistics regarding the death toll from tobacco, and lead to more smoking bans, limits on tobacco advertising and higher cigarette taxes. A lengthy R.J. Reynolds (RJR) internal briefing manual discusses tobacco industry stands on issues such as secondhand smoke, advertising, fire-safe cigarettes, sponsorship, corporate contributions, initiative and referenda. Page 70 (Bates page 507591859) addresses the subject of death certificates. RJR argues in the manual that including information about tobacco use on death certificates "...is contrary to sound public health policy" and advances the argument that such questions are "likely to undermine efforts to achieve national uniformity in death certificate information by scrambling rather than clarifying the national data."

The manual states,

"Support the [Tobacco Institute] in monitoring and defeating all regulatory and legislative attempts to place specific tobacco use or 'contribution' questions on death certificates."