Tobacco Documents Online

l Z 5 4 $ 6 ? 8 9 10 11 1Z 14 15 16 ,17 18 19 Zo 2] ZZ 23 Z~ II (Ouest~c~ from the a~ianct. I DR. RIC~O~: Well, if you look a~ SecretL~ Harris' letter of t~ns~ttai, sh~ ln~oa~es ~hat i.= we ~annct, on a ~i~n~-~ bas£s, le~n more abou~ what is ~ei~ added to ci~re~tes, th~ we would seJk such le~s~on -- that is, we would red--end ~ee~g such legislation. (0uestion from ~he audience.) DR. RICB~O~D: Yes, because we n~ do not ha~e any direct authority. (Question from the a~lence. ) DR. R~CBYDNDz Well, I thi~k a reasonable time woUld be ~%easured in several weeks, Z would think, since i~'~ been a few weeks si~ce we ~e5 with theJ~. (~estion from the audlence. ] DR. RZC~0ND: I thirLk In a @-ireu"~ way, yes. That we specifically Eequeste<~ ~hat infoln~a~lo~ from but' Z can't speak for all of my p.~edec~ssors. no~ been done early in my tense. (QUeStion from ~he audience. ) ~R. R~C~MOND: Well, ~res~a~ly t~ make the cigarette ~re acceptable, and additives w~id ass%~e ABL ~SCCIATE~. ~. (0ues~i~n from the audience.] DR. RIC~OND: NOt to the 5est of my kn~ledge, Z~ had

i 2 3 5 6 ? 8 9 10 11 17 13 14 IS 16 17 1B zo 2-" 12 a more pro~inamt place as th~. t~s ~d ~i¢otiDe levels drop. Many Of ~hese cigarettes now contain c~nsiderably less tobaoco than they once c3ntained, and obviously the manufactu/ers are intsres~.ed In maintaining th~L hiphes~ iQvel of acceptability for their cigarette-';, ar~ we think that additives axe probably being u~e~ more extensively than mlgh~ have been the case in earlier years when T.he tohacco c~nte~t ~f ¢/gare%~es may have been conslderahly higher. {QL~estion from the aud/ence.) DR. R~CL"4OND: Well, certainly greater ed%!cational effort, greater research effor%s and ce~tinly more clinical observation of the effects Of the ~ga~et~;e as it is now baing produced in the smmker. ' (Question from the at~lience.) DR. R~C~OND: Irm sorry, this pmrson has not had a ch~ce. (Question from the audience. ) DR. RICI~OND: Wells t~hat's a i/ttl-~ difficul% to say since the n~ admiais~-~a~ion will have to s:leak for itself. But we will leave ~hem with all the documenta- tion that we have acc~ulated. The timing ~f this repot, I would call your attention, is the customary timing of the annual report which Congress .has direc~.ed ~ to SU~T~ ~ •

13 3 4 S 6 7 S 9 10 11 12 13 14 1$ 16 17 15 19 2O 21 2~ 23 24 2~ We have ~radlticnally submluued the repo;~ on the a~-~versa.-y of the Sirs% SUrgeon General's report in 1964, so this is the 17th anniversary OS the first surgeon Seno--al's report. That Sate is ordinarily January 11. Since %,%at was a Sunday, we put the date of presenting the repo--t ~:o you over to today. SO we will, of course, co~uricate all of t~his Information to the incoming Secretary, ar~ I can't predict precisely what his actlons will he. {Question fro= the a~ience. } DR. RXC~OND: I was not asked by the transition tea~ for any infoz~ation on this specific issue. N~ ~2~ey we-~e up an~ dow~ the depa--tme.nt speaking with people in ~rlous agenc/es SO ~ could not vouch for the fact that they may not have spoken to some of oux scientists, hut X can vouch fo~ my exchanges with them. And it didn't i~clude any co~unic~ltion o~ this subject. (Question from uhe audience. ) DR. RIC~OND: Well, we thi.nk there is a process in motion. (Question from the audlenca.) DR* .~IC~MOND: Well, ~here is ~ process in motion. We thi.nk t.hat there may be some real possibility of acquit-rig this in2orm~tio.~ if it isn't available,

I l 4 5 6 ? 8 g I0 II 12 13 14 IS 16 17 18 19 20 21 23 )4 2S 14 since this info~-matlon ks generally ragardad to fall within the pu~ew cf trade seoretg. W~ woul~ then need legislation in order to ~ke t~ha~ kln~ of infom~ation accessible ~Q ttsl Yes? (Question fru~ the audiemce. ) DR. RIC~OND: My r~co!!ecticn is that it will be at about 52 billions totally. That's not all for education. Milllo~s -- millions. That's not all fop educ~t/on. A good deal of tha~, about 36 milli0ns, will go for research. The remainder is for demonstration progr~s and educational effort~+ X think, john~ what were we at~ 49? ~p from 49. Yes~ (Oueshion f=o~ the ~udience. ) DR. RIC~OND: Well, ~ think the p-~ogress ~n this field iB one thatls chaEactehized by 51~t steady acc~mulatlon of data, and I think that one of the ~roblems we have in thi~ .~ieldl it's on~ which was ralated to ~e fact that it took us ~o long tQ recognize ~he carci.no- go.nit effects of tobacco smoklng~ is the probl~ of t~e lon~ itemcy perlo~ between the £hitiation of th~ i.~estion of a subs~anc~ a~ the appeara~ of the pathology Or th~ ~se~se. ~o ~ha~ ~ thi~k i~ ~e~e.-a!~ one ne~ds long- ABL ASS0CIA~.S, In~.

• • k• j- l 2 3 4 S 6 7 8 9 I0 II 12 14 15 16 17 18 19 20 21 Z2 Z3 2~ 25 15 term ae=~ulation of data, and ~ think your charscterization is probably a ~ood one -- that ~here is no one stricklngly new f£n~ing. Yes? (Quest/on f-~om the audience. ) DR. R~C~OND: Yes, an~ this lllust=ates the dlf-~icul~y ~n a~c~ulat/ng ~at~. This study was published in '76, but ~h~ cu~-of~ point in ~e~s of the collect!on of data was 1972. ~ at tha~ time, c/garet~es tha~ were on the market had higher tar a.n~ hico~ine l~vels than som~ o.* tha so-calle~ very low yleld uig~:ettes at the curreat t/me. This is one Of the problems. We're dmaling with a changing pradu~. And it takes a long ~i~e to accu~ulatB da%ao Yes~ (Question f=om the audience. ] DR.R~OND: The question ks whether we consi~e~ In~us~ry's position con~ernlng ~ra~e soc.-ets as ~ .~easonahle one, an~ if ~he i~omln~ a~ministrationqs post~e ks one of as bein~ more r~sponsive to -- you used the wor~ "big busi~ss~" What k/nd of a probl~ ks ~haping ~? Is "that a fair chara~er~z~tlon -- I do~.'t want ~o put wo.-ds An your .~¢~h tz~ng to ~ha-~a~terize ~he que-.~iOno We thi.~k we Could ac~--ulre, i~ we were in a position to acquire the inforr~tlcn concer.~ng so-~-:a!led trade secr-°~-s. We ~.hink ~hat we cc~id, with t~t ~.nd ABL ASSCCIAT~, I~.

1 Z 3 S 6 7 8 9 10 11 IZ 13 14 15 16 17 18 ig ZO 2| ZZ Z3 16 of information, conduct approp=ia~e evaluaUions ~nd ~tudies ~o make be~a.- ~u~gment5 about the publ/c heal~h hazards that the additives represent. We think tha~ the trade Secrets issue can be ~ealt with effectively. We can, I think, respect tha~. without £mpairi~g our c~nce-~n for protectin~ the public heal~h. I think we ce--tainly would k~uw bet~e-~ ~f we had more sp~Ific ~ata, what kinds of next steps would he appropriate in order to learn mora about¸ the effects of thosa compounds which are ~wn as ad~itivas. (Quest.on fz~m the a~l.e~ce. ) DR. ~C~O~D: The gt~y has cost ~ appro~tely -- well,• I shoul~n't say approximately -- by ouz cal~ul~/o~s, $227,000 and a few -- (Q~.~s~on f=om the audience. } D~. RIC~OND: This is ove~ a ~e~lod of -- we we~ ma~a~ to do ~he stay by Con~.-ess £~ 19T~ ~e it's in a ~erio~ of about 2-i/2 years. (Q~s~o~ ~=um the a~ie=ce. ] DR. R~CHMO~D: Wel~, no, we h~ve ca~-efully reviewed the data which a.-e available. Yea~. [Question from the a~die~ce.) • DR. RiC~OND: Well, ~di~ives, fi.-st of ~:ii, are not the o~ly issue. The ~ajor issues tha~ we've A~ ASS0C~7~, Inc.

1 2 5 5 6 B g i0 Ii 12 15 15 !6 17 18 ig ~0 21 Z2 Z5 ~S 17 bee~ concer.ned wi=h over the gears have been the ~f.=ec~s of sm~klng generally o.n he~-luh. T-t took us many, many years to a=c~!ate thcse data, I'l~ are con~,inui~g ~O acc~--~!ate data, ~nd it is ~ot t--we ~hat there are .no new studies. We don't, ourselves, do all Of t-~se s~dies end, indeed, the TDbacco Ins~tu~e, to its g~eat credit, has invested a ~:~-~t deal of money -- some $15 millions -- that it gave at one point to the ~.mexicen Medical Association' educational a.-~ resea2ch committee. N~w, out of all of those studies, we see some ve--y distinct public heal~h trerls. Now~ the Tobacco ,'z.dustry. expends s~me $900 millions in promotinq, adve~.isinq ciga~e='.e s~oki~q, a.~ we t~nk this is a ve~ ~odes~ inves~ent in ~he p,ubli= heal~-h in order ~o keep the ~erizan people as well informed on the hazards o~= cigar~tt& s~oki~g ~s we C&~. A~other re.--Z important reason, of co~se, is that ws are ma.-~a~ed by Conqress to make a~nual reports, b~t also i would say it's a very ~odest i~ves~me~.~, indeed, when ~ne conslders ~--~s the major public health issue that is really s~b~ect to preventlo~. ~.%at is, scma~nq that somebody can do ~ometi"--~'nq a~ut. The distiz-~shad epide~ole~_st at the .".arvard Schoc! o~ _~u~ii~ Hea!~h, Dr. Z.~-an McMann, h=-s .-e~etitive!y said, "}~o one t~i.~.g would babe=it the he=-!zh 3i th_= A~e.~ica~

7 $ g i0 II 12 13 15 16 17 18 19 20 Zl Z2 23 Z~ 2S 18 people more than the cessation of smoking." That's becauss of the very large burden of il~eDs ~d m~rt~ality that 19 the consequence of so~s~hing that is entirely preventable. (Ques6~ion f-~o~ the audience. ) D~. EIC~MO~D: NO, we also -- I sho ~u!d 9o back to the fact that we ~hav~ assembled Borne 62 experts to present thelr e~_ertise and thelr reviews, a~d to dev~lop for the nation a conc~nsus of the expe~m. (0uestion f=om the au~ie.~¢e. ) DR. RICHMOND= Yes, aed a r~po~t tO the ~=~e-~ican people, which is very important, an~ which thin American people pr~s~ably wan~. B~ ~'s something w.hlch ~e A~erican peopl~ wanto We don't have any options. ~e w~e di=e~ed by Confess, bu~ I think -- I jus~ happen to think tha~ Congress was very wise in dlre~in~ ~ to do this. If this was the maJo= public h~alth probl~L~ that the nation faces, why ~ot? "~es? (Question f.-om ~h audience.) DR. RIChmOnD: Well, I'll try ~o ~o that ~nd be b.~ief because you've asked me • .~athe~ f~-~midabl.e question. ~ think in te~s of what we have ~o¢omplished I ~hink I wo~id gay first Of alll o~e of our v~.~" ~gh prlori~ies h~s be~n ~o t.~y ~o provide services ~0 ~he A~L ~S~IAT~S, Zn~

1 2 3 4 5 6 7 8 9 i0 ii 13 la IS 16 17 18 19 20 23 :5 19 underse=ved populations of this nation who, .~cr either economic reasons or geography, do not have ready a=:=ess to ser%~, cos. We have ~ore th~n do~bl-~d the ntmbe.-s of people served through o~ co.unity health Ge~te.~S a~ O~ miurant health ce~ers. 0u= National Health Service Corps, which is de~'~ned ~o meet the needs of people in ~erse~ve~ areas has been ~pand~ ~ns£dexably, a~"~ we have p!am.ne~ addle-lena! expanslo~, In addition, we tDink that Medicaid and H(dloare have b~e~ ver~ user111 in maklnq services more avail~Lble. SO I have felt that that has been a very important .~Irecti~n. wogld Couple that wi~h the fact that X thi:Lk there still remain less than l0 percent of our population-- psxhaps somewhere he.~ween 18 ~-~ 23 mil~ons Of people -- who ~ay not be the reciplents Of the kinds of health Services tha~ we would ~ke to see th~ have access to so that ~.hat job is incomplete, ~l~hou~h we h~w! doubled the nudgers who are served by OU: direct prDgrams, should also mention that when we lock a~ the data in te-~ o.~ se.~¢ices f~r l~er i.~:ome people, ~.ha~ by and large, -.he visits that !cw-income _~eople axe making to p-~o%~deL's Of various kinds is n~ jusu abou= az the s~e level of the more affluen~ popul~uion. Eo~ever, ~ha~ still ~$ nor as fay=table a

i . 1 Z 3 4 S 6 7 8 9 lO 11 12 !3 14 15 16 17 18 19 ZO 21 Z3 ~S 20 st=-~istic as it so'~nds be=a~se ~zny of ~he !c~-inco~.e pec~le a.-e using Se.-~ces more frequan~lF because ~hey hav~ mo.~ illness, The Seco~ ..~a~o~ dirac~ion £n w~-~ ch I thi~ik we have made sigr~fi.-a.~ accomo!ishm~nts is in ~h=. wh~1~ area of prevent~or.. Part of wha~ we are ~a!kin~ about here ~hls mornln~. It seems to me that we have, firs~ Of allJ ~s~abllshed preventlon ~s a vQry high o~iori~y on the na~on's health agenda. ~n Connection with ~h~ im~'u-nization c~.p~%~ fo-~ ~.pl~t th~ we %z~dertook whe~. w~ c~me i~o office a]=~ost four ~ears ~o, that i~m'%mlzation c~mpaign f¢~ children has b~.ouqht us a .-emarkable yi~l~° Firs~ of all, du~-n~ th~ cour~ of these fc~ years, we've h~ ~.he World ~ealth Or~a~za~io~ On a mor~ global basis, ~eclare th~ worl~ enti~-=ly f.'ee o~ a great sco'~o of ~nkindt s~,~llpo~. ~n ~hls coun~-y we not only some years a@~ e_~radic~d s.%allp~ bu~ ~e thl.~k as a co~sequenc~ of o%1r i.~u~.-~ion c"-m~ign, w~'r~ on the v=..'~ o~ ~i~inat£~q ~eas!e~ ~s an i~di~eno%is disease in t.~s ~.3~.~ a~d as a pe.-son who s.o~-.~.~ a c3cd oar~. o-= his ~_a.~ly car~e.~ takln~ ca.-e o.= c~id--~ wi~h meas!es &n~ ~he ~ev~s~a~inc co~.~czui~ns of ~ha~ disease, ~. ~eel ve.~i~ k~=-~l? ~-h-=~ ~.h~ ~.as been a si~r..~fican'- ad~an~e, A3L AS~CL%T=-S, I~.