Health Affairs, 24, no. 4 (2005): 994-1004 doi: 10.1377/hlthaff.24.4.994 © 2005 by Project HOPE	New Online   May/June Issue: Health Reform   Election Year Health Politics   Health Reform in Indiana   Promoting off-label drug use information

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Tobacco Control

The Power Of Paperwork: How Philip Morris Neutralized The Medical Code For Secondhand Smoke

A new medical diagnostic code for secondhand smoke exposure became available in 1994, but as of 2004 it remained an invalid entry on a common medical form. Soon after the code appeared, Philip Morris hired a Washington consultant to influence the governmental process for creating and using medical codes. Tobacco industry documents reveal that Philip Morris budgeted more than $2 million for this "ICD-9 Project." Tactics to prevent adoption of the new code included third-party lobbying, Paperwork Reduction Act challenges, and backing an alternative coding arrangement. Philip Morris’s reaction reveals the importance of policy decisions related to data collection and paperwork.

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