The Nightingales

The tobacco industry has to create 440,000 new smokers each year, in the United States alone, to replace those that die each year from tobacco-related illness. In an effort to prevent this, Ruth Malone, RN, PhD, a professor at the University of California, San Francisco, has come out fighting.

Malone is a faculty member at the Center for Tobacco Control Research and Education. When seven million documents were released by the tobacco industry as a condition of the 1998 Master Settlement Agreement signed by attorneys general in 46 states, she began to examine what these contained. She found "boxes and boxes and boxes" of papers without any organization. Malone examined 50 years' worth of diaries, policies, marketing strategies, and internal memos, but it was only when she found a folder filled with letters written to tobacco executives from the family members of the dead and dying – people who had witnessed firsthand the suffering caused by cigarette smoke – that she knew that these letters couldn't be packed away again.

That was the beginning of the Nightingales – Malone's group of nurses who volunteer to represent these absent victims.

In the Lions' Den

With her Nightingales, Malone has twice attended the annual shareholder meeting of Altria, the parent company of two of the world's biggest tobacco companies (Philip Morris USA and Philip Morris International). "These meetings are carefully controlled by the corporation to put their best face forward," she says. "They are attended by the major shareholders, the Board of Directors, and the business press – all the really important people."

Malone and her nurses attended their first board meeting in 2004. Before the meeting, Malone advised the group to wear lab coats and, despite the outrage they felt, to behave professionally. Each nurse used his or her allotted two minutes to read aloud selections from the letters from the family members of tobacco's victims. She felt that the presentation was a success and vowed to return.

In 2005, Malone appeared at the board meeting with another group of 12 nurses, but this time they used their two minutes to ask pointed questions of Louis C. Camilleri, Chairman of the Board of Altria. "Are you aware of the suffering you've caused, and if so, how do you justify the work you do?" was one of the opening questions fired off in the time allowed. Activists from around the world joined the Nightingales, all questioning why Phillip Morris has entered third world markets, potentially addicting millions more.

The nurses found their appearance at the meeting to be "powerful and exhilarating," especially since they believed that the tobacco representatives tried hard to be intimidating. As one student nurse said, "If I can talk to them, I can talk to anyone."

Expanding the Nightingale Network

Malone now has Nightingales in 27 states. They receive frequent emails urging them to continue their fight and offering suggestions about how to do so. In her search through the tobacco companies' internal documents, she came across a sentence that showed that industry executives were worried that nurses could be "formidable opponents" if they ever organized. Her goal is to become that force.

And why not? Nurses are considered the most trusted of healthcare professionals. And nurses in every kind of clinical and education practice, from schools to adult health to behavioral health, see the results of cigarette smoking on just about every body system. Who better than nurses to lead this battle for the public?

For information on how to contact Ruth Malone, to read some of the powerful letters for yourself, or to learn more about how you can fight tobacco-related illness in your community see the NightingalesNurses.org.

Also see the article about the anti-tobacco activism of respiratory therapist, Anne Landman, at: Taking on a Giant.

In the Lions' Den

Expanding the Nightingale Network

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About the Author

Christine Contillo, RN-C

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