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.