If you’ve ever taken Tylenol for a headache or powdered a baby’s bottom with Johnson’s Baby Powder, journalist Gardiner Harris has some bad news for you. In his book No More Tears (2025), he exposes how pharmaceutical giant Johnson & Johnson (J&J) knowingly deceived its customers over decades, causing them to rely on unsafe or actively harmful products.
Harris uses internal J&J company records, legal documents, and scientific research to show how an industry that’s supposed to care for consumers’ health and well-being is driven by profit to do the opposite. Simultaneously, he reveals how the industry’s watchdogs cover for its crimes. Read more in our overview of No More Tears below.
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Overview of No More Tears by Gardiner Harris
Journalist Gardiner Harris’s book No More Tears (2025) exposes how pharmaceutical giant Johnson & Johnson (J&J) knowingly deceived its customers over decades, causing them to rely on unsafe or actively harmful products. In his exposé, Harris uses J&J’s internal company records, legal documents, and scientific research to show how an industry that’s supposed to care for consumers’ health and well-being is driven by profit to do the opposite. Simultaneously, he reveals how the industry’s watchdogs cover for these crimes.
Harris began his investigations into the company when an anonymous J&J sales representative told him that her nephew developed lifelong health consequences as a result of a drug she sold to his doctor. Her pain and regret moved Harris, motivating him to uncover J&J’s decades-long deception about its products.
(Shortform note: Johnson & Johnson responded to the April 2025 publication of No More Tears with a statement conveying their trust in their products’ safety and emphasizing their commitment to providing patients with innovative medical solutions.)
Johnson & Johnson’s Origins and Reputation
Harris argues that J&J has avoided accountability partly because it successfully branded itself as a company that puts its consumers first. In this section, we’ll explore how J&J built a pristine, seemingly shatter-proof reputation. We’ll also discuss the strategies the corporation used to market harmful yet profitable products.
J&J’s Reputation
Harris notes that by 2023, Fortune ranked J&J among the world’s most admired corporations for the 21st consecutive year. (Shortform note: In 2023, J&J ranked 22nd on Fortune’s list of 324 companies. The company’s ranking fell slightly—to number 27—in 2024. In Fortune’s 2025 rankings, J&J dropped to number 31.)
Harris points to two key factors that supported the company’s positive reputation:
1) Its evocative consumer products. Household staples like their baby powder and Band-Aid built emotional trust. Harris argues they’re symbolic of the loving care you receive from family when you’re young or sick.
2) J&J’s credo. Written in 1943 and etched in stone at headquarters, J&J’s credo promises to put people before profits. It’s a point of pride for employees, who invoke the statement at every major company meeting. Harris suggests that the trust employees place in the credo and in leaders’ willingness to abide by it blinds them to their company’s harmful actions.
J&J’s Strategies
The enduring power of J&J’s pristine reputation has allowed it to retain a privileged position in consumers’ minds. However, Harris suggests the corporation’s strategies reveal a disconnect between its image and its actions. Below, we highlight five strategies that Harris says J&J used.
1) Marketing to medical providers: J&J invested heavily in marketing its products directly to doctors, hospitals, and nursing homes, often disguising its marketing efforts as educational or research initiatives. For example, they sponsored professional development courses that hospitals offered to their doctors. However, Harris says that instead of educating doctors on new treatments or medical insights, the courses were equivalent to infomercials for J&J products.
2) Corruption: The company found legal loopholes to incentivize medical providers to prescribe its products. For example, Harris discovered that J&J paid doctors to give speeches at conferences, but the payment was more than what was expected for that kind of work. This suggests that J&J was rewarding the doctors for the number of J&J products they prescribed.
3) Interfering in scientific research: J&J limited information about the safety and efficacy of its products. For example, Harris found that the company pressured researchers not to publish unfavourable results, and it tampered with studies to direct them to a specific result.
4) Manipulating the media: J&J routinely threatened to pull advertising from media outlets planning critical coverage, which helped them silence investigations by the press.
5) Legal maneuvering: A large portion of J&J’s budget went to legal expenses, which they saw as part of the cost of doing business. Also, when facing mounting lawsuits, J&J transferred liabilities from products like Johnson’s Baby Powder to a subsidiary with limited funds, then declared bankruptcy. Harris says this strategy limited how much J&J had to pay out in settlements.
The Food and Drug Administration: J&J’s Watchdog or Friend?
If J&J is the antihero of this story, who’s the hero? According to Harris, it’s not the FDA (the US Food and Drug Administration)—they’re often more of a sidekick to J&J. From its creation in 1906 to crack down on medicines with misleading ingredient lists, the FDA’s mandate has grown. It now includes approving new medicines and requiring proof that drugs are both effective and safe. However, Harris argues that the FDA is far less powerful than people imagine. In this section, we’ll explore how the pharmaceutical industry co-opted the institution and Harris’s argument that the FDA serves the industry, not the public.
How the Pharmaceutical Industry Co-opted the FDA
While consumers widely see the FDA as a protector of their health, Harris explains that the FDA lacks the resources to fulfill its mission. It doesn’t have enough employees or financial resources to effectively monitor the industries under its purview and investigate suspected wrongdoing. For example, it can’t analyze all the drugs on the market, so it relies on pharmaceutical companies to report on the safety and efficacy of their own products.
Harris argues that the FDA’s chronic lack of funding made it an easy target for the pharmaceutical industry. To keep functioning, the FDA asked the very industries it’s meant to oversee for help. Over time, the agency’s budget became largely supported by industry, making it financially dependent on the companies it supposedly regulates. This gave industry players who help finance the FDA, such as J&J, enormous leverage over regulatory decisions affecting their products.
How the FDA Serves the Pharmaceutical Industry
As a result of its financial dependence on pharmaceutical corporations, Harris argues that the FDA serves the interests of industry, not the public. Next, we’ll discuss three of the ways the FDA protects the industry over consumers.
1) A revolving door: Many FDA officials leave the agency to work for the pharmaceutical industry, either as executives or consultants. According to Harris, this creates a conflict of interest for officials who hope to secure industry jobs after their tenure at the agency, leading them to make decisions in their FDA roles that favor corporations. For example, FDA commissioner Arthur Hayes Jr. (1981-1983) took money from drugmakers while in office, then he left the administration to work for a J&J-affiliated PR firm.
2) A direct line of communication: When the FDA’s investigations reveal a potential problem with a drug, it often shares these results privately with companies instead of alerting the public. Harris explains that this allows manufacturers to downplay risks, dispute scientific findings, and, in some cases, manipulate or redact portions of lab reports.
3) A useful enemy: The pharmaceutical industry coordinates press campaigns to create a public perception of an overly strict FDA that limits innovation. Harries argues that this public image helps companies convince their employees to carry out illegal schemes, since there’s an assumption that FDA oversight prevents truly dangerous behavior. In reality, says Harris, the FDA rarely pushes back on a pharmaceutical company’s actions, even when it’s needed. The FDA’s reputation for being anti-innovation also helps companies garner public support when controversies arise over their products.
J&J’s Harmful Products
As we’ve seen, millions of consumers around the world opened the doors of their homes and medicine cabinets to products from a company that didn’t serve their best interests. But how did this all play out? In this section, we’ll explore how J&J knowingly put its customers’ health at risk through three key products: baby powder, Tylenol, and Duragesic. For each product, we’ll explain what the product is, discuss why it was dangerous, and explore how it illustrates the pattern of deception Harris uncovered.
Harmful Product #1: Johnson’s Baby Powder
In 1894, J&J developed a powder to soothe skin irritation from adhesive bandages. The powder later became Johnson’s Baby Powder—a talc-based product used to prevent diaper rash. According to Harris, the product was successful partly thanks to its powerful branding and emotional resonance. J&J meticulously crafted the powder’s fragrance to create emotional associations with motherhood, trust, and safety. In recent decades, Baby Powder represented less than 1% of the company’s revenues. Still, it remained key to J&J’s brand because it established a foundation of consumer trust that benefited other company products.
The Lie: Asbestos-Free Talc
While Johnson’s Baby Powder projected an image of purity and care, J&J covered up mounting evidence of harm resulting from its use. Harris argues J&J knew from internal testing dating back to 1958 that its talc contained asbestos, which are harmful fibrous minerals.
By the 1960s, scientific literature was establishing clear links between asbestos and cancer, yet J&J continued to claim the product was safe. During the 1970s, scientists found that talc—even when it wasn’t contaminated with asbestos—could also cause cancer.
Harris explains that instead of changing the powder’s components, J&J added minimal warnings on the packaging that failed to convey the true risk. The company only stopped selling talc-based Johnson’s Baby Powder in the US and Canada in 2020. J&J announced it would cease global sales in 2023, more than 60 years after it first learned its product was dangerous to consumers.
Harris outlines several strategies J&J used to keep their baby powder on the market, including:
- Manipulating research. J&J created a talc testing method purposely designed to miss asbestos contamination and forced employees to remove mentions of asbestos from laboratory notebooks.
- Manipulating the FDA. J&J refused to share talc test results with the FDA and lobbied against the stringent testing standards the agency tried to enforce. Still, the FDA helped J&J by claiming, with no evidence, that it was possible to source asbestos-free talc.
The Impact: Cancer
J&J’s lies about Johnson’s Baby Powder affected millions of users. Babies and their mothers inhaled thousands of cancer-causing particles every day for years, sometimes leading to mesothelioma (a rare type of cancer linked to asbestos). In addition, Johnson’s Baby Powder was a popular personal care product for women, who used it in their genital area. Harris explains that, by some estimates, Johnson’s Baby Powder contributed to around 2,500 women being diagnosed with ovarian cancer annually in the US.
Harmful Product #2: Tylenol
Tylenol is an over-the-counter pain reliever used to treat headaches, colds, fever, and other minor aches and pains. Its main component is acetaminophen. Tylenol appeared to have no adverse effects on the stomach or heart, unlike other pain medications. This became Tylenol’s primary selling point during the 1970s, when ulcers and gastritis were widespread health issues. By the early 1980s, Tylenol had become the most widely used pain reliever in the US.
The Lie: Safe Pain Relief
Despite its promising start, danger was lurking in Tylenol. The company used slogans such as “the pain reliever hospitals use most” to suggest medical endorsement and reassure consumers that Tylenol was safe. However, the drug had an extremely narrow safety margin.
By the mid-1970s, several medical studies had demonstrated that Tylenol caused serious liver toxicity issues. Minor dosage errors could lead to fatal liver damage, including taking slightly more than recommended, combining it with other products containing acetaminophen, or drinking alcohol while Tylenol is still in your system.
In addition, Harris says that Tylenol’s confusing product lineup and labeling led to fatal dosing errors. For example, J&J sold pediatric acetaminophen in different concentrations: a concentrated one for babies and another for older children. The formula for babies was more concentrated—parents could give them fewer drops—to make the process of giving a baby medicine a bit easier. However, the different formulations were both labeled for pediatric use, which confused parents, and even nurses and pediatricians. For example, if an older child was prescribed 10 drops of children’s Tylenol, and a parent or doctor gave them 10 drops of infant Tylenol, this could cause a fatal overdose.
Despite mounting evidence of Tylenol’s risks, J&J continued to market the drug as safe. The FDA and several medical associations requested J&J add warnings to its labels, so consumers would know to take precautions. However, J&J believed that the warnings would cause people to take less Tylenol, so they fought off the requests for decades.
While continuing to market Tylenol as safe, J&J ran a secret research program to develop a safer version. Harris explains that they later abandoned the program because executives worried that launching an improved product would acknowledge the existing one wasn’t as safe as they had claimed.
The Impact: Liver Failure and Accidental Overdoses
Harris explains that by 2013, acetaminophen had become the leading cause of acute liver failure in the US, killing at least 150 people annually and hospitalizing 30,000.
Harris adds that children were also vulnerable to acetaminophen-related deaths. Between 2000 and 2009, the FDA received reports of 20 children dying from acetaminophen overdoses.
Harmful Product #3: Duragesic
Duragesic is an opioid patch designed to provide steady pain relief over 72 hours. The patch contains fentanyl, an addictive, synthetic opioid 75 times more powerful than morphine. The patch uses a timed-release technology, where a reservoir of fentanyl is gradually absorbed through the skin, theoretically offering stable and prolonged pain control. The product was originally intended for cancer patients who had difficulty swallowing oral pain relief medications, but J&J started marketing it for chronic pain conditions, like arthritis. According to Harris, this pivot was profitable because chronic pain patients could become repeat customers, unlike those with terminal cancer.
The Lie: A Safer Opioid
Harris states that J&J falsely promoted Duragesic as a safe alternative to other opioids. The positioning of the fentanyl patch as safe was based on two lies:
Lie #1: Duragesic’s timed-release technology was overdose-proof. In reality, the controlled-release system was unreliable. It often delivered 150% of the intended dose in 24 hours, causing overdoses even with proper use. What’s more, people with an opioid addiction could easily bypass the system by chewing the patch to release the full dose instantly, which was often fatal.
Lie #2: Duragesic was less addictive than other opioids. Abuse rates seemed lower than they were because hospital urine tests couldn’t detect fentanyl. J&J sales representatives used this flawed data, telling doctors that their patch caused less than 1% of ER visits, while knowing it was impossible to know how many people overdosed on Duragesic.
Despite these lies, J&J successfully established Duragesic in the opioid market. Harris outlines several strategies J&J used to increase sales of their patch, including:
- Manufacturing consensus: J&J funded patient groups and medical societies, with whom they coauthored statements endorsing opioids for long-term pain management. J&J then distributed these materials to encourage doctors to prescribe opioids.
- Exploiting patients’ pain: J&J’s sales teams targeted doctors treating high-risk patients and encouraged longer treatments to boost sales. J&J rewarded top prescribers, even if the number of prescriptions the doctors made suggested they were catering to addicts.
In a landmark case against J&J, the state of Oklahoma successfully argued that the company targeted vulnerable patients such as veterans and children to boost sales. During that trial, it also emerged that J&J salespeople encouraged doctors to ignore their suspicions that patients were addicted if they asked for a higher dose, and trust that they were truly in more pain than they could manage. This likely contributed to patients—including addicts—getting higher and longer prescriptions than they otherwise would have.
The Impact: Normalizing Addiction
Harris argues that J&J stoked the opioid epidemic in several ways—we’ll focus on describing two of these. First, Duragesic’s marketing normalized long-term opioid use and overprescription. J&J’s misleading safety claims led doctors to prescribe the patch to more patients, worsening opioid misuse and overdose deaths.
Second, J&J’s involvement spanned the entire supply chain. In addition to producing their own products, they grew opium poppies in Tasmania through their subsidiary and sold the raw material for opioids to other pharmaceutical companies, such as Purdue Pharma.
Harris’s Proposals for Reforming the Industry
Given the gravity of Harris’s findings, you may be wondering what can be done. Harris argues that J&J’s behavior is symptomatic of a broader problem in the health care industry. He calls for a comprehensive overhaul of the ecosystem around the pharmaceutical industry, including corporations, health care providers, and the government. He argues that fixing this ecosystem requires questioning the for-profit health care model that enabled these abuses.
Below, we’ll describe four of Harris’s suggestions for overhauling the ecosystem around the pharmaceutical industry.
Proposal 1: Hold Wrongdoers Accountable
According to Harris, a lack of meaningful consequences gives J&J—and other corporations—the green light to continue deceiving the public for a profit. While it’s forced to pay to settle lawsuits from consumers, the payments make a small dent in its profit margins. In addition, individual executives don’t face accountability for their actions. Instead, Harris favors holding pharmaceutical companies and executives accountable in a way that makes it unprofitable for them to continue using harmful strategies.
Proposal 2: Outlaw Medical Marketing
Harris argues that the government must ban doctors from accepting money or gifts from drug companies and eliminate industry-funded classes that market products at the expense of medical training.
Proposal 3: Protect Independent Scientific Research
Harris writes that research that can lead to the discovery of new drugs, or that tests the safety and efficacy of existing ones, must be independent. To achieve this, Harris suggests increased data transparency so the information from clinical trials (studies that assess the effect of drugs and treatments) and adverse event reporting (reports on side effects or harm caused by drugs) is freely accessible. He also argues for increased financial transparency to ensure pharmaceutical companies aren’t making direct payments to doctors and scientists participating in research.
Proposal 4: Strengthen Regulation
Finally, Harris writes that there must be independent government agencies capable of regulating and sanctioning the pharmaceutical industry. He believes this would require funding the FDA through taxpayers, not industry contributions. In addition, he thinks it’s necessary to create an agency separate from the FDA to investigate products’ safety once they’re on the market, similar to how aviation regulators have two separate agencies for approving new aircraft and for investigating crashes.
