Despite scientific evidence to the contrary, a small group of otolaryngologists have repeatedly testified, on behalf of the tobacco industry, that heavy smoking did not cause the cancer in cases of dying patients suing for damages, according to a study by a Stanford University School of Medicine researcher.

“I was shocked by the degree to which these physicians were willing to testify, in my opinion in an unscientific way, to deny a dying plaintiff — suffering the aftermath of a lifetime of smoking — a fair trial,” said Robert Jackler, MD, professor and chair of otolaryngology-head and neck surgery, referring to the physicians cited in the study as a “pool of experts willing to say over and over again that smoking didn’t cause cancer.”

The study was created by a Stanford University School of Medicine researcher and published online July 17 in Laryngoscope.

Jackler, who holds the Edward C. and Amy H. Sewall Professorship in Otorhinolaryngology, conducted a year and a half of research, which included reading through thousands of pages of publicly available, expert-witness depositions and trial testimony. He then reviewed the scientific literature to see if testimony by expert witnesses for the tobacco industry was supported by evidence. Jackler said that a physician serving as an expert witness has an ethical obligation to interpret the scientific data in a fair and balanced manner. The literature, he found, repeatedly repudiated the testimony. “My study found they used scientifically invalid methods to support their testimony,” he said.

Salted fish, mouthwash — but not tobacco?

The study reports that six board-certified otolaryngologists were paid by one or more of the tobacco companies R.J. Reynolds, Phillip Morris and Lorillard to serve as expert witnesses. These physicians gave testimony that indicated a multiplicity of environmental factors, ranging from exposure to cleaning solvents to the consumption of salted fish to the use of mouthwash, were more likely to have caused the plaintiffs’ head and neck cancers than years of heavy smoking. The cases occurred between 2009 and 2014. One physician said he was paid $100,000 to testify in a single case. Another admitted that her opinion was written by tobacco company lawyers and then approved by her. Still another rejected reports from the Surgeon General as authoritative sources.

Together, the six otolaryngologists in this study helped to defend the tobacco industry in more than 50 cases.