1. Schwarz, Thom RN, AJN editorial director

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The East Hanover, New Jersey, offices of Kraft Foods reminded me more of a well-groomed military base than the headquarters of the makers of Oreos. I'd come as a proxy shareholder with 11 other nurses from seven states to the April 29 annual shareholders' meeting of the Altria Group, Inc., the parent company of Kraft Foods and the Philip Morris tobacco companies, intending to bear witness to the suffering and death caused by tobacco products. The five security checkpoints, with their X-ray scanners and crews of muscular guards, sent a message to all who entered: this was serious business. And I felt like David confronting Goliath: representing the 440,000 Americans who die of tobacco-related disease annually, I stood before a corporate giant whose 2003 net revenues exceeded $81 billion.


Ruth Malone, PhD, RN, organized the demonstration by forming Nightingales ( Malone was inspired by the 1998 Master Settlement Agreement-a document signed by the attorneys general of 46 states prohibiting tobacco advertising that targets anyone younger than 18 years of age. She spent thousands of hours studying tobacco company documents, which included hundreds of anguished and outraged letters written by those affected by tobacco-related diseases. Malone said one of the most compelling documents she read was an internal memo warning that nurses could become "formidable opponents" if they organized themselves against the tobacco industry. From this unlikely source, Nightingales was born.


Dressed in white lab coats with black armbands in memory of their patients, the Nightingales spoke with eloquence, anger, and occasional disbelief when they stepped to the microphone to address Louis C. Camilleri, Altria chairman and chief executive officer. All nurses had purchased one share of Altria stock, which permitted them to attend the meeting. "Buying that one share weighed on me," said Sharon Brown, NP, from Tucson, Arizona. "I came because today would have been my dad's 78th birthday, except he died of lung cancer from this company's products."


Malone was the first to address the Altria board. "Do we have a board ethics committee that actually reads [letters to the company from aggrieved patients and families] and discusses social responsibility regarding promotion of products that cause harm with ordinary use?" she asked. Camilleri replied, "Our belief is that making cigarettes and being socially responsible are compatible. Thank you for your question."



FIGURE. Sharon Brown... - Click to enlarge in new windowFIGURE. Sharon Brown, NP, holds a photograph of her father, John Pratt, who died of a tobacco-related illness. She stands with 10 Nightingales, including group organizer Ruth Malone (to the left of Brown), at the annual shareholders' meeting of the Altria Group, Inc., April 29, in East Hanover, New Jersey. Brown used her opportunity at the podium to ask for 30 seconds of silence in memory of her father.

When Brown asked what Altria is doing to warn the public of the addictive nature of tobacco, Camilleri responded, "We agree that cigarette smoking is addictive, but that doesn't mean that people can't quit." Malone later said to the other nurses: "That blame-the-victim rhetoric is typical. . . . [P]eople choose to smoke when they are young and the choice appears glamorous."


Nightingales supported four of the five proposals voted on by the 300 stockholders present: better verbal warnings for pregnant women, a request for an independent scientific investigation of health risks associated with filters, stopping the promotion of "light" and "ultralight" products, and voluntary placement of Canadian-type warnings (large pictures and text on all labels) on all Philip Morris tobacco products worldwide. All four proposals were defeated.


Malone wasn't discouraged by the defeats or by Camilleri's response. "We're going to return every year until there are 1,000 nurses telling the board to stop marketing." I told her that a clutch of elderly women who sat behind me had asked, "Why are all these nurses here?" Malone smiled softly and said, "We're here to start making smoking socially unacceptable. We'll be back."