4,500 Physicians Agree
There is a five-step process that has been used, with minor variations, to sell every major product and policy of the last century. It works for breakfast. It works for engagement rings. It works for regime change wars.
- Simplify. Reduce a complicated reality to one sentence. No qualifiers.
- Find the emotional lever - and make it visual. The best simple stories aren’t sentences. They’re images. A cocktail on the beach. A vial held up to the light. A mushroom cloud over a city. The image arrives before the critical mind can engage.
- Route through authority. Doctors, institutions, heads of state. The claim doesn’t need to be true. It needs to come from someone trusted.
- Make questioning it feel wrong. Frame the story so that scepticism looks like moral failure.
- Act before verification. By the time anyone checks the facts, the action is irreversible.
This process was first documented in 1928 by a man named Edward Bernays, in a book titled Propaganda.1 He later rebranded the concept as “public relations,” which was itself a masterclass in the discipline he was naming.
Understanding these five steps has changed how I think about my work, my decisions, and the news I consume. It is the most useful framework I’ve encountered for navigating a world that runs on simple stories.
It is also, when you trace its applications, one of the most disturbing.
Bacon and cigarettes
In the 1920s, the standard American breakfast was coffee and a roll. The Beech-Nut Packing Company, which sold bacon, found this unacceptable. So they hired Bernays.
Bernays didn’t just advertise bacon. Rather, he asked his agency’s in-house physician a carefully constructed question: “Is a heavier breakfast better for people’s health?” The doctor said yes. Bernays then asked the doctor to write to 5,000 physicians and pose the same question. About 4,500 confirmed that a more substantial breakfast was advisable.2
Headlines: “4,500 Physicians Urge Heavier Breakfasts.” No mention of bacon. No mention of Beech-Nut. The American public, told by medical authorities that they were eating too little in the morning, went looking for something substantial. Bacon and eggs. Obviously.
Steps 1-3, clean execution. Today, 70% of bacon consumed in the United States is eaten at breakfast. The “traditional American breakfast” was invented by one man in a PR office.
For his next act, Bernays doubled the cigarette market. The American Tobacco Company wanted women to smoke in public, which was socially taboo. Bernays hired women to march in the 1929 New York City Easter Parade, each lighting a Lucky Strike on cue. He tipped off the press that suffragettes would be lighting “Torches of Freedom.”
The papers reported it as news. Women started smoking. A man paid women to consume a corporate product and called it feminism, and it worked.3
Incredible, isn’t it? He didn’t have to change the product. He didn’t change the women. Rather, he changed the story, and the story changed everything else.
Diamonds
All married men know the De Beers story - “A Diamond Is Forever,” the manufactured tradition, the two-month salary rule pulled from nowhere. Before 1938, fewer than 10% of brides received diamond engagement rings. By 1990, 80% did. An advertising agency created a social norm from scratch in one generation.4
What you may not know is the Japan operation.
For context, there was no tradition of diamond engagement rings in Japan. Absolutely none. For 1,500 years, marriages were arranged through intermediaries and sealed by drinking rice wine from a shared bowl. Romance was not part of the process. A diamond ring was as relevant to a Japanese wedding as a surfboard.
In 1967, when De Beers entered the market, fewer than 5% of brides received diamonds. Diamond imports weren’t even legal until 1959. De Beers convinced the government to change the law, then launched a campaign telling young Japanese women that a Western-style wedding was modern, aspirational, and incomplete without a diamond.
By 1981 - within fourteen years - 60% of Japanese brides wore diamond rings.
Fifteen centuries of unbroken cultural tradition. Overwritten by an advertising agency in fourteen years.5
De Beers looked at a civilisation and said, “We can rewrite that.” And they did. If you can do this with rocks, you can do it with anything.
Liberation Operations
The transition from selling products to selling wars is smaller than it should be. The playbook is identical. Only the product changes.
On October 10, 1990, a 15-year-old Kuwaiti girl identified only as “Nayirah” testified before the U.S. Congressional Human Rights Caucus. She described volunteering at a hospital in Kuwait City and witnessing Iraqi soldiers pull babies from incubators and leave them to die on the cold floor.
If I were teaching a masterclass, I would open with this testimony. It deploys every step simultaneously. Authority: Congress. Social proof: Amnesty International corroborated it. Emotional bypass: dead babies - try thinking critically about dead babies; you can’t. Simplicity: soldiers killing infants. No geopolitical context required.
President Bush cited the testimony at least ten times. Seven senators quoted it in speeches supporting the use of force. The Senate voted for war by five votes.
As it turned out, Nayirah was the daughter of Kuwait’s ambassador to the United States. Her testimony was organised by PR firm Hill & Knowlton, hired for $10 million by the Kuwaiti government-in-exile. The firm’s vice president coached her delivery. Before settling on the incubator narrative, the firm focus-tested multiple atrocity stories with American audiences and selected the one that scored highest for emotional impact.6
After the war, Human Rights Watch, Physicians for Human Rights, and ABC News all investigated. None found evidence supporting the story. Amnesty International retracted their report. There were not 312 incubators in all of Kuwait’s hospitals combined.
Thirteen years later, Condoleezza Rice gave the game away. Selling the case for invading Iraq on CNN, she said: “We don’t want the smoking gun to be a mushroom cloud.” What a vivid picture! And once the picture is in your head, it doesn’t matter whether her rationale made sense or not.
Then came another visual to match: Colin Powell. United Nations Security Council. He holds up a vial of simulated anthrax for the cameras.
“My colleagues, every statement I make today is backed up by sources, solid sources. These are not assertions. What we’re giving you are facts and conclusions based on solid intelligence.”
As it turned out (again!), the intelligence came from a single Iraqi defector codenamed “Curveball,” who later admitted he fabricated everything. Germany’s intelligence service had warned the Americans he was unreliable. None of the grave threats that were sold to the public actually existed.7
One of the reasons this worked so well is that Powell was the most trusted man in American public life.
Powell later called his UN presentation a “blot” on his record. I’d say it’s a big “blot”, but I digress. 8
February 28, 2026
When Russia invaded Ukraine in 2022, Putin called it a “special military operation.” The stated justification: denazification of a country. Interesting. No doubt, he used a slightly different school of persuasion but the structural logic is identical.9
I mention this because naming matters. Euphemism is a critical element of the discipline. You cannot sell violence in plain language. “Special military operation.” “Enhanced interrogation.” “Collateral damage.” “Pre-emptive strike.” Each phrase exists to make something unacceptable sound like procedure.
And then there is perhaps the most elegant deployment of Step 4 in modern warfare: a military that branded itself “the most moral army in the world.” Not a moral army. The most moral. Repeat it enough - through prime ministers, defence ministers, retired colonels on speaking tours - and every report of civilian casualties becomes an attack on morality itself rather than evidence against it. The phrase doesn’t need to be true. It just needs to make the questioning feel wrong.10
I am writing this on February 28, 2026 - the day the United States and Israel launched strikes against Iran (again). The Pentagon calls it “Operation Epic Fury.” Israel calls it “Operation Roaring Lion.”11
Morals aside, the entire conflict with Iran has been another textbook case of public relations work over the last three decades. The stated justification for attacking Iran is simple: Iran is pursuing nuclear weapons. And once they get a nuke, they want to use it to remove Israel (and the USA) from the map.
Now, Iran has apparently been trying to build a nuke for decades now. And they’ve always been “months away”. It makes you wonder about the gap between the simple message and the messy reality, no?12
If this feels familiar, it should. The playbook is the same one that coached a teenager to cry before Congress, that held up a vial at the United Nations. The same pattern of escalation that has played out across this region for decades - each time with new names, new operations, and the same five steps.
I’ll let you run the playbook yourself. You have the steps.
It has not changed in a hundred years. It is publicly documented. Edward Bernays wrote it down in a book called Propaganda and published it for anyone to read. Robert Cialdini explained the psychology in Influence. Daniel Kahneman explained why it bypasses rational thought in Thinking, Fast and Slow.13
It works every time.
I find this simultaneously the most useful and the most disturbing thing I’ve ever learned about human beings. Useful because - if you can see the playbook - you can choose not to be played. Disturbing because the playbook has been visible for a century, and we keep falling for it anyway.
Footnotes
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Bernays was Sigmund Freud’s nephew. He synthesised Freud’s psychoanalysis with Gustave Le Bon’s crowd psychology and Wilfred Trotter’s herd instinct research. The result was a discipline that treats humans not as rational agents but as emotional animals that can be steered. ↩
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The precision of the question is what is genius. He didn’t ask “Is bacon healthy?” - which would have produced a complicated answer - he asked “Is a heavier breakfast better for health?” The doctors answered the question they were asked. 4,500 physicians didn’t endorse bacon. They endorsed bigger breakfasts. Bernays supplied the association. This is not deception in the legal sense, but rather the truth, carefully cut and arranged until it tells a different story. ↩
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Cigarettes killed roughly 100 million people in the 20th century. The “Torches of Freedom” campaign specifically targeted women. Lung cancer rates among American women increased approximately tenfold between 1930 and 1990. Bernays went on to apply the same techniques to the United Fruit Company, whose PR problem was that Guatemala’s democratically elected president was implementing land reform. Bernays branded him a communist. The CIA overthrew him in 1954. Guatemala spent the next 36 years in civil war. Approximately 200,000 people died. Bernays charged about $100,000 a year. Case studies about his career tend to focus on the bacon thing instead of the deaths. ↩
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“A Diamond Is Forever” also means “please do not discover what this is worth on the open market.” Try reselling a diamond - you’ll get 25-50% of what you paid, if you can find a buyer. Diamonds are not rare. The resale market barely exists because De Beers spent seventy years convincing people that selling a diamond is emotionally equivalent to selling your marriage vows. ↩
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In 1967, diamond imports into Japan weren’t even legal. De Beers created the demand, the supply chain, the cultural norm, and the legal framework. From scratch. ↩
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This is incredibly dark on so many levels. A public relations firm conducted focus groups to determine which fabricated atrocity story would be most effective in persuading the American public to support a war. They tested multiple stories. They measured emotional responses. They selected the winner. Then they coached a 15-year-old girl - the daughter of an ambassador - to deliver it before Congress. The Senate vote for war passed by five. Lovely, eh? ↩
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Curveball’s real name was Rafid Ahmed Alwan al-Janabi. In a 2011 Guardian interview, he admitted fabricating his claims. “Maybe I was right, maybe I was not right,” he said. “They gave me this chance. I had the chance to fabricate something to topple the regime.” He was running the same playbook - uphill, from a position of no power, with nothing but a simple story and an audience that wanted to believe it. ↩
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Powell’s chief of staff, Lawrence Wilkerson, called the UN presentation “the lowest point in my life.” As it should be. Estimates of Iraqi civilian deaths range from 150,000 to over 600,000, depending on methodology. The lowest estimate is 150,000 people who died because of a prop, a fabricated source, and a trusted man at a podium. ↩
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As of 2025, over 19,000 Russians have been detained for anti-war protests or speech. When Bernays sold breakfast, he had to be clever about it. When you control the media and the prisons, you don’t have to be as clever. ↩
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The phrase “most moral army in the world” has been repeated by successive Israeli prime ministers and defence ministers since at least 2005. Meanwhile, a 2024 investigation by +972 Magazine - based on interviews with six intelligence officers who served in the military - revealed AI targeting systems called “Lavender” and “Where’s Daddy?” Lavender flagged 37,000 Palestinians as suspected militants with a known 10% error rate. “Where’s Daddy?” tracked them to their family homes at night. Human review of each target averaged twenty seconds - enough time to check whether the name was male. Junior operatives were struck with unguided “dumb” bombs to conserve precision munitions for senior targets. Pre-authorised civilian casualty “limits” permitted 15-20 deaths per junior militant. You can place this on your own spectrum of morality. ↩
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“Operation Epic Fury.” “Operation Roaring Lion.” These are the names that adults in positions of power chose for a military operation that will kill human beings. I want to note that if I named a marketing campaign “Operation Roaring Lion” or “Operation Epic Fury” my colleagues would epically roar me out of the building and never let me back in. ↩
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It is worth saying that it’s the best-known secret that Israel has an estimated 80 to 400 nuclear warheads of its own. It has never signed the Nuclear Non-Proliferation Treaty. The IAEA has never been permitted to inspect its weapons facility at Dimona - not once, in over sixty years of operation. In contrast, the IAEA has been active in Iran. Iran officially insists its programme is entirely peaceful, though analysts widely interpret it as maintaining a latent nuclear capability - the knowledge and infrastructure to build a weapon if sufficiently threatened, without actually building one. The country demanding military action over a latent capability in its neighbour possesses an actual undeclared nuclear arsenal that no international body has ever verified. The hypocrisy is interesting, but not the point I am making. Rather, this is a footnote about what you can get away with when you control the story. ↩
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I realise that my tongue-in-cheek style might be hiding my utter disgust with war. So let me make it clear in a footnote most people will not read. I abhor it. Using propaganda or PR techniques to mask the atrocities of killing humans is unforgiveable. No matter who does it. The reality is, however, that the playbook that works for marketing bacon also works very well for selling war. ↩