Exhibitions as Public Health Interventions: The University of Alabama Center for the Study of Tobacco and Society

Introduction

The collection and preservation of archival materials and their communication through physical and digital exhibitions can serve to address public health issues. Archived historical documents and other artifacts are hidden from public consumption until museums and allied institutions deploy exhibitionary practices to make them visible, as built physical spaces or online exhibitions. In the case of the tobacco industry, exhibitions featuring colorful advertisements and promotional artifacts, incriminating internal publications, yellowed scientific journal reports, and countless disturbing and ironic items survive to bear witness to one of history’s most ghastly corporate misdeeds: Cigarette smoking now takes the lives of 480,000 people annually in the United States (Centers for Disease Control and Prevention, 2020). Such ephemeral items were usually discarded in their day, making their survival and exhibition even more noteworthy.

Institutions that document, investigate, and present public health artifacts complement disease prevention efforts by providing historical evidence and creating spaces for education and discussion. One public health research institute exposing the tobacco industry’s history of callous disregard for human life in the pursuit of profits is the University of Alabama Center for the Study of Tobacco and Society (CSTS). While tobacco is the focus of its curatorial activities, CSTS collects broadly in multiple areas of public health, such that the study of the tobacco industry provides a metaphor for addressing emerging health issues such as tanning bed use, digital media addiction, and childhood obesity (CSTS, 2018). A hybrid institution, CSTS operates as a public health research center, archive, and museum, with documentation, preservation, and public engagement fundamental to all its activities. As an archive, tobacco-related materials are collected, preserved, and cataloged. As a museum, the Center exhibits collections physically and virtually. As a research center, CSTS produces original manuscripts for medical journals, historical videos, presentations and research posters for scientific conferences, and opinion columns for newspapers, the tobacco industry trade press, and advertising publications. These activities emanate almost entirely from the Center’s collections (CSTS, 2019).

In a growing body of scholarship about health and museums (cf. Hsu & Lincoln, 2007; Johnson, 2008; Lee, 2017, 2019a, 2019b; Mold, 2017), the focus is on exhibitions rather than collections. Museum collections are usually distinct from public-facing exhibitions, but such a distinction is not so easily drawn at CSTS. The splash page of the website has four links for the visitor to choose her or his own adventure: Exhibitions, Collections, Multimedia, and Our Team. A first-time visitor might expect the “Exhibitions” link to lead to collections of public facing images, and the “Collections” link to lead to a staid, itemized list of archival materials. On the CSTS website, both links display eye-popping visual materials. The Exhibitions link takes the site visitor to 20 multimedia exhibitions dated by year, going back to 1988 when the collection, amassed by Alan Blum, MD, was housed at Baylor College of Medicine. The first exhibition, When “More Doctors Smoked Camels”: A Century of Health Claims in Cigarette Advertising, 1888-1988, was displayed at the Texas Medical Center Library in conjunction with the First National Conference on Tobacco Use in America at Houston’s MD Anderson Cancer Center. The Texas Medical Center Library hosted two other exhibitions from the collection in the 1990s (not featured on the website). One, a 30-year commemoration of the Surgeon General’s Report on Smoking and Health and the other an exposé of the American Medical Association’s (AMA’s) decades-long collaboration with the tobacco industry. In 1998, after the University of Alabama named Dr. Blum as the first holder of the Gerald Leon Wallace, MD, Endowed Chair in Family Medicine, it approved his proposal to establish the Center for the Study of Tobacco and Society. The university also provided space to house part of his 2,000-archive box collection. Blum and his longtime co-author Eric Solberg received a museum planning grant from the National Endowment for the Humanities in 2000, following which CSTS began producing a steady stream of exhibitions, beginning with Merry X-Ray and a Happy New Lung: When Santa Sold Cigarettes.

The Collections link opens on an array of 21 sequential squares, emblematized with a visual artifact from each collection. For example, “Christmas and Tobacco” has a cartoon penguin dressed like Santa, a carton of KOOLs under his arm. The “Greeting Cards” image is a garish illustration of a flip top box, flung open, packed with filterless cigarettes. The package is emblazoned with the text “Here’s a pack of get-well wishes” with a cute, anthropomorphic mouse smoking in the foreground. Clicking on a collection opens a webpage that looks much like one of the CSTS exhibitions, and not a mere catalog entry. For example, clicking on “Hospitals and Tobacco” reveals a tasteful, annotated webpage with black and white photographs of doctors smoking; a vending cart packed with cartons of cigarettes being wheeled between hospital beds; ashtrays branded with the names and insignia of venerable hospitals; and a sign, presumably for a nightstand, reminding patients not to smoke in bed.

The CSTS website stands out visually when compared with other tobacco research centers. Based on a perusal of their websites, neither the Institute for Global Tobacco Control at John Hopkins (IGTC) nor the Tobacco Research Center at University of California, San Francisco (UCSF) produces exhibitions. The UCSF site boasts 45 topic areas among its collection of millions of digitized photocopies of tobacco industry documents, plus TV commercials and corporate films searchable by keyword. A “Popular Tobacco Documents” link returns 23,303 results (UCSF Library, 2019), but these appear as a list of titles and keywords, rather than a high-resolution scan or photo. Little is provided in the way of interpretation, juxtaposition of materials, or visually engaging layouts. UCSF archives appear to be geared toward researchers with the requisite background knowledge to know what they are looking for. This contrasts with CSTS, where materials are curated, contextualized, organized by subject matter and accessible to the neophyte as well as the seasoned expert. ¹

The design sensibility and commentary from CSTS archivists help viewers understand the significance of the artifacts. Like evidence mounting against the tobacco industry, CSTS artifacts seem to burgeon outward, revealing themselves to the public in visual, textual, and televisual modalities. Some of the imagery displayed is iconic (such as innumerable versions of Joe Camel or the Marlboro man on horseback) and some of the taglines (“More Doctors Smoke Camels” or “Come to Flavor Country”) seem to have become lodged into American collective consciousness. Other items displayed are more esoteric, such as Charles Saatchi’s surrealistic Silk Cut campaign, flagrantly poached from the slashed canvases of artist Lucio Fontana, or print ads showing baseball greats Jackie Robinson endorsing Chesterfields and Hank Aaron hawking Camels to African American readers.

CSTS is located in the University of Alabama’s medical school, the College of Community Health Sciences. It partners with the College of Communication and Information Sciences’ School of Library & Information Studies, as well as with external libraries and museums. Archives, the “critical infrastructure” (Summers & Punzalan, 2017, p. 824) of CSTS, are managed in consideration of the narratives they contain, and how these narratives can be effectively communicated to the public through online display. Since 2015, a collections manager and digital archivist (both roles currently being filled by one individual) have digitized content and curated online exhibitions, as if anticipating the closure of brick and mortar institutions due to COVID-19. With School of Library & Information Studies as a partner, an experiential learning program is supported, with graduate student interns assisting in digitalization and curation, gaining experience processing, arranging, and describing collections. Along with undergraduate premedical and prenursing students in the Catherine J. Randall Research Scholar program, these students learn to use archives and exhibitions as tools for public health advocacy.

Documentary filmmakers call for “documentary advocacy” (Miller, 2009, p. 61) to bear witness and spread awareness of corporate crime. The CSTS is a similar endeavor, except documentary methods include still photos, scans, and other media besides film. For example, the online exhibition Kids, Candy & Cigarettes (2020) contains a poster of Henry Ford denouncing youth smoking; a signed 1910 “Anti-Tobacco Pledge” (suggesting that smoking was regarded as unhealthful long before the 1964 Surgeon General’s Report); unnerving illustrations of children smoking in magazines and on postcards; professional photos of store displays for candy cigarettes, toy lighters, and piggy banks (in the shape of cigarette vending machines). Such artifacts broaden tobacco collecting to the realm of public cultural history, that is, above and beyond the often acontextual internal corporate documents that plaintiff attorneys and historians hired as expert witnesses love to pounce on. Communication takes place over a variety of channels in Kids, Candy & Cigarettes: pictorial, phraseological, and even edible, in the case of candy cigarettes.

CSTS holdings are parsed into over a hundred unique collections and divided into more than fifty themes. Examples of specific items exhibited include the following:

CSTS has taken its show on the road with twelve traveling exhibitions. Cartoonists Take Up Smoking (2004-2008), which took a decade to research, was at the National Museum of Health and Medicine in Washington, D.C., for a twice-extended showing lasting a year, before traveling to eight other cities. Up in Smoke: The Airline Flight Attendants’ Battle for Clean Air Aloft (2003-2005) debuted at the Louis A. Turpen Aviation Museum in San Francisco and was also on view at the Buffalo-Erie International Airport and the Southern Museum of Flight in Birmingham. The Surgeon General vs. The Marlboro Man: Who Really Won? (2013-2014, the only traveling exhibition to commemorate the 50th anniversary of the Surgeon General’s Report), was shown at UA’s Amelia Gayle Gorgas Library; the Lyndon B. Johnson Presidential Library; the Texas Medical Center Library; and the LSU Health Sciences Library (CSTS, 2019, Exhibitions). However, with the operational complexities of traveling exhibitions involving original, often one-of-a-kind artifacts, web-based exhibitions became the preferred format. The aim was also to reach wider audiences, including students from middle school to medical school. Switching to digital exhibitions was well timed for an age of physical distancing. Specific examples of topics covered by CSTS online exhibitions include the following:

Of the six online exhibitions released in 2018-2020, two took 3 years to produce: Big Tobacco in the Big Apple: How New York City Became the Heart of the Tobacco Industry . . . and Anti-Smoking Activism, and Of Mice and Menthol: The Targeting of African Americans by the Tobacco Industry. Other 2018 exhibitions include The Makin’s of a Nation: Tobacco and World War I and Smoking in the Balcony Only: When Movie Stars Sold Cigarettes (CSTS, 2019).

“Art-Washing” Cigarettes and the Museum Malignancy Exhibition

Museum Malignancy: Tobacco Industry Sponsorship of the Arts is an online exhibition relevant to this special issue because it profiles tobacco company support for art exhibitions over more than half a century. In the next five paragraphs Museum Malignancy (MM) is described as a brief case example, to give a sense of CSTS in more detail. Clicking on the MM link, visitors are greeted with videos of an art gallery, with an introductory stanza of text stating that cigarette maker Philip Morris (PM) was a pioneer in corporate sponsorship of art exhibitions and other art forms like dance and opera. PM sponsorship is bluntly described as “a means of diverting attention from the growing body of medical evidence of cigarette smoking’s devastating death toll from cancer, heart disease, and emphysema.” The text goes on to say that corporate sponsorship of the arts was far less than the cost of advertising, and was “so successful in buying complacency about smoking among opinion-leaders in the arts, commerce, the mass media, and politics that PM adopted the slogan, ‘It takes art to make a company great.’”

On clicking “Enter Exhibition” visitors can listen to a four-minute audio recording from CSTS Director Blum, who begins by noting protests at museums by activists in 2019, against wealthy donors such as the Koch brothers (for climate change denialism) and the Sackler family (for profiting from its aggressive marketing of prescription opioids). Blum observes that no comparable protests have taken place against Altria, parent company of PM, a leading benefactor since the 1970s of high-profile institutions such as the Metropolitan Museum of Art, the Whitney Museum of American Art, and the Smithsonian Institution. Blum mentions a 2019 New York Times editorial titled “Museums Must Reject Tainted Money,” which asks, “When it comes to blood money for the arts, how bloody is too bloody?” (Giridharadas, 2019). Blum notes that PM corporate sponsorship masquerades as beneficence. In 2002, Altria donated a substantial 12 million dollars (tax deductible) to arts organizations, but in a year when corporate profits were 12 billion dollars. This “one one-thousandth of one percent” donation is characterized by Blum as “a cheap price to pay for goodwill, complacency and silence.”

After the video ends, there is a click-on “Enter Exhibition” for six virtual exhibits. These feature an endless scroll design, spanning multiple pages for each section. Items are displayed with a title card complete with metadata including the type of item, author, sponsoring company, hosting museum, and date. Special items are placed in black boxes that include the metadata tag and either a quotation or extended description, as well as a “translation” (a statement of context) written by Blum of the tobacco company’s true intentions. Links to related online CSTS exhibitions provide more context and content.

“Philip Morris and the Arts” details the cigarette giant’s efforts to use fine arts to enhance its public profile. Nowhere was tobacco largess more critical for the high art scene than New York City, which is the subject of the “New York City—The Heart of Art in America” exhibit within MM. “The Smoking Smithsonian” exhibit lists past and ongoing exhibition sponsorships by PM at the Smithsonian Institution, as well as large donations to the National Museum of African American History and Culture and other Smithsonian museums. The second half of the exhibit, entitled “Carbon Copy” invites viewers to consider the extent to which a 2019 Smithsonian exhibit, “More Doctors Smoke Camels” plagiarizes Dr. Blum’s similarly named 1988 exhibition (mentioned above).

“Tobacco and the Arts Nationwide” is about tobacco industry influence on art exhibitions from coast to coast. PM-sponsored exhibitions took place in Boston, Houston, Richmond, and even in CSTS’s backyard, Birmingham. The company’s longstanding support of Exhibits USA put its name on travelling exhibitions to smaller cities throughout the country. “Tobacco Industry Sponsorship of African American Art” shows that tobacco companies are eager to ingratiate themselves to minority communities and sponsor art galleries and performances celebrating diversity to distract from the disproportionate death toll tobacco related illnesses have on these communities. This section features a link to CSTS’s Of Mice and Menthol exhibition. “Tobacco Industry Sponsorship of Hispanic Art” features veteran Houston journalist Juan Palomo in a clip from a 1994 video by Eric Solberg and Blum, entitled Medicine vs. Madison Avenue: Fighting Smoke with Fire, saying, “They need to advertise their products and that’s all they care about. They do not care about our culture. They never have, and they never will.”

“Taking a Stand,” the concluding section of MM, provides a history of the meager resistance to the tobacco industry’s corrupting influence. It features street theater “house calls” by DOC, who worked with artist Doug Minkler to create parodies such as the poster “Artists as Ashtrays” (see Figure 1). A 1989 letter from Hans Haacke to Blum includes clippings from The New York Times’ reviews of the artist’s “Helmsboro Country” installation.

OPEN IN VIEWER

Figure 1.

Doug Minkler’s “Artists as Ashtrays.”