Tobacco Documents Online

q ~tr. Crone, based Upon your that has c~e to you fr~n ~hatever ~ources it-may be, M~, lla~aer or anyone else, do you feel that there As a relationship between the s~okAng of your cigarettes, let us say, Lucky Strikes, and the develop:eat of cancer or helot disease? A Do you thank there is an~ aggravating that is, precipitating or accelerating [SoCe: ~arlan was asked vlth re- spect to smok.l.~ ~ cancer whether he there ~as an~ relationshAp and an~vered, no. Borden was asked whether ~n hls opinion there is a rela¢ion~hip between cs=dlovascular dAseaee. He answered " ~ 4on' t know of say connection be- tween ~aokAz~ and cancer and cardio- vascular disease or an~ other disease." (pp. ~- ~'6) ] Co that? And vhat has been your polAcy vith respect

Q Let me ask y~u thAst Would you se~7 that you don' t beZteve that there Is a relatAonshAp, or ~ould you sa~ that you ~ust don' t kno~ ye~? k b~at do you mean by a relaZAoas~Ap? A relatAoas~1~ as t~ v~at? Q Be~eea sao~A~g sad cancer. A ~ you sesa a s~sttst£csl rels~:lonshlp or a causal re~atloashlp? Q Causal, eAtJ~e: A~ part or ~a ~d~ole. A l should s~y thaC we don' t knov, because after a good ma~y y~s ~ pretty ~Ce~lve sty, ~ ~e~ ~ca~ ~s dev~oped ~er~ent~ly of s~ ~ ~olvmeat.

yet or doee that mean -- yots b~t £t ~ sO~ ~t ~ £t ~S Vo~ hoav~F ~volv~ ~ O~t ~ ~ve ~ on s~, more def- ~te ~~tton of 1~ ~ ve (a) tud Orou "5~e s~ tota~ of sctenttf$¢ evidence establishes beFo~ a reaso~ble ~ubt ~ ct~ette ~~ As a causative fac- ~r ~ ~e ~cAdence o~ h~ eptde~old Was ~hat over ~a~ed to you= attention? [Note: Crove answered the me question, saying, "Thls is the first ever." (pp. ~-lO) Hetaana ansvere4 It ~s been bro~ to Kaa8 sad Hoeke~;~ both J~lca~ed that they were. faal~£az wlth the ~tUd~ Qr~up report. ~HaaS, p. 2~1 Rockett, pp. ~-~) [The ~tud~ Oroup report was published ~9~7. ] -3-

Q Are you familiar with the facet, sir, that Dr. Leroy Burney, the Surgeon General of the United States~ has stated that, "The weight of the evidence is increasingly pointed in one directlonl that exeesslve smoking is one of the factors in the causation of lung cancer"? A I am familiar with that statement. I have seen his statement. (Hoekett) p. 156) [Rote, ~ei~ann stated that Burney bad made a (p. ) number of statements 73 and that the above quoted~as "a vet7 carefully worded statement, and I eanrt remember whether the Surgeon Oeneral stated it in exactly th~se words." (p. C rowe answered that the ~rney statement had not been brought to his attention (~. 11) although he had earlier indic•ted that he had read the reports of Surgeon General ~Arney in the ~a~er (p. 8) ~o~den was asked whether he was familiar with the pronouncements of Burney and replied, "I know ~u'ney has made some remarks, yes." (p. ~%) Haag ~as asked whether the Publi~ Health Service had taken a stand and answered "It is my impression that Dr. B~rney issued a statement to the ~ress. Now the e~act wording of that, I don~t know. That I suppose represents the feeling of the Public Health Service." (p. Hamner ~as shown • copy of state- ment whieh.Hastlngs desoribed as prepared by the National Cancer stltute of the Publle Health Service and issued through Dr. Holler and also through B~rney. ~a~er

~led~e of ,Posl.~tons Taken Various Bodies" (~ontl~ued) asked If he had ever seen the state- s~tnethin~ $£m~.ar ~o ~J~.s, ~ don' ~ red.abet l~ ~ de~." (pc 8~)] [Note8 The above Burney quotation Is from a ~ubltc Health ~orvlce p:ess tton q~ted ~s preceded .~ ~e p~ase "~e ~e~ ~e ~~y d~ferences of op~o~ ~ ~te~ret~g ~e. ~ on Pu~Ic ~e~ ~e~lce reels ~e ve~t ~he s~atenaa~ concludes with this paragraph, "The Service notes ~t the study group fo~ thai more study is .R~eded to ~ s~ti~tic~ a~oc~tton ~ween ~~ ~ heart ~e st~ group repoP~ed is ~ co~c~ bio~ogic~ or ~ca~ ~t ~~ per se is on~ o[ ~ causat~v~ Eacto~s s~ce p~vtded ad~tlo~ ~ta on ~is subject, ~ ~erv1c~ ~eels ~st more s~tts ttc~ ~d ~ostc~ ~ Is needed li~ a def~ position on ~s ~¢er." (~Y ~, 19~ Press geon Gen. Leroy E. _~ney, re- printed at pa~es ~-~ of Durney is the author of a special enti~led "S~o~in~ and L~ ~C~cer~ A m~t Of ~e PU~iC He~ ~e~lce:" ~ ap- p~ ~ ~e ~ber 28, 19~9 ~o~ of The ~ertc~ ~iedi~ Assoclation~ He co~ ~eds "Th~ Public Heal~h ~ervlce be- lieves that the followln~ s~a~e- mon~s are ~ust~fied by s~ud~es to date. i. The weight of evidence at present implicates smoking as

Positions Taken a~ (Continued) the principal etiological fac- tor An the increased incidence of lung canners 20 Cigarette smoking particularly ls associa- ted with an increased chance of developing lung cancer. 3. Stop- £1o~ng ciga,.tt, smoking ..n after exposure ls beneficial, ~0 No method of treating tobacco or filtering the s~oko has been dem- onstrated to be effective In ma- terially reducing or olAminatlng the hazard of lung cancer. • 7- The nonsmoker ha= a lower Incidence of lung canner than the smoker in all controlled studios, vhothor analyzed in terms of rural trots, urban regions,., industrial occupa- tions, or sex. 6. Persona vho have never smoked tt all (cig- arettes, cigars, or pipe) have the beat chance of oseaplng lung canner. 70 Unless the use of tobacco can be made safe, the Individual person risk of lung canner can beat be re- duced _by .the elimination of rooking." This article vat the sub,oct of an edi- torial in a subsequent issue of the ~.A.M.A. Dr. ~ohn H. Talbot, Editor of the vrote In part as follovs t "A ~ber of t~tho~,ttlos vho ha~e examined the sane ev- Idenee elted b~r Dr. Btu.ne~' do not agree vlth his eoneluslons." Further, "Selthe: the p~eponents nor the opponents of the theoz7 have sufflelent evldenee to var~nt the asawnptlon of an a11-o~-none authoritative ~osltlon." (~.A.M.A., Dee- mb~ 12, 1979)] A Z have read about tone of his. Z don't .~eeall speelfloall¥ vhat he said, but Z do know that he nat e~ented on the subject. (~k~en, p. [Note t Haag had heard of Dr. Helle: (p. 26). Ha~er vat shown a stateuent and stated that he had seen s~ething stnilar to it, but didn't remember it in detail. (p. 88)]

referred ~o Was ~ before ~e Sub--tree your attention; ~ star, eat by the ne~ off2cer of hea~th of the Central Counm~ fo~ ~ealth, ~ducat£on of ~h~ Tavtstoa~ House ~a Tavl~t~ak ~quare, in London, "l~ is my du~y to warn a~l cig- arette smokers ~t there is now con- s greater ri~ of ~ntract~g c~er Glv~ ~ ~~ reduces ~e rl~." ~nder~eath ~hat ~sJ "The Centra~ Council for ~e~th ~ducat£on, Tav£stoak house, Tav~stock ~quare, LOJ:U~or~ 0'* A NO, (C~ow~, po 20) [~ot~: The above quo~t£on Is the legend on a pos~er He,mann was stoked whether it had ever been brou@ht to his attaat£on tha~ the B~£tiah ~over~en¢ had d~strXbuted posters t~ast t~.~ relationah£~, between ctg- and ~ung cancer was one of dlrect cause and effect." fie replied "I have • ead reports o~ various kinds of actlon ~t ~9 spe~ of ~ s~e 8~por~ (~. 76) ~ Q Are you also fmm~.~ar with ~h~ fact tha~ Brltlsh Gover~ent has a~ao s~a~ed -- I~, Iff~flt ~mae objection. (Cont~) -- that" "~he r~at£onship between ~tgaret~es and -7-

~l~e conclusion was based ~ large part Co~c~ ~d ~te ~t "five subs~ce8 have ~e8~ been ~o~d (~ ~cco ~e) c~s~ces, of caus~ ~cer ~ ~- m~s~ ~e ~rkers h~e succeed~ ~ concentrated extracts o~ ~cco ~ar -8-

-9-

The papel's thomselves~- (Cz~ee, p. 19) [iloto~ D~. Chazles ~;. posSt~on ~ 1~6 ("I~ (g~e A.C.S.) ~~ to t~ ~e p~l*e ~t to rake. It does ~t~ to eq~p P. ~he A.C.5. adopted the Study

you ~ boy ~ ~otzospeetl~e studLes A ~Jo. I don0t Jtm~ boy ma~y thee hate boon. I donOt ~l~l~lt tt0s too tmpol~c~nt ho~ ma~v thas'o have boon. A The question bsvo boon ]wopewly £ntea~F~tad o~ w~ot~ the~, have boon ovo~£ntmted. (~ekett, p. ~ Do you kna~ how many px~speotlve st~tts- A I donor knov ho~ m~n~, but I know th~o halo boon tlwoo ox. (1LDokett: p. 1~) A +1oi I eanOt. (Llttlo, p. Ii

• tn~e~ e~e~ b~en b~ousht to ~ou~ attmst~on~ [Iotos Hu~ yes ~uJ~L~ vlth the I/anmund-l/o~n study and stated time he vent ~h~ouSh 1~ ~.er7 ea~oLhzLl~ at one vho had 4ohm 8tat2st~eal vos~ /n Hoen 1~po1~ p_ubliahsd ~ one fo1~ or anothee. (p..~) ] ~ Zn~tdonta~¥, a~o you asm~o o£ 1~. DO~l~n0s latos~ 8tatLstLoa~ et~¥ vith ~ospoet to motc~nj llo/mann, rhea asked ~ he ~as mm~o a oompL~at~on b~ ~e~ sons ~d of 8u~ ope~at~n Vh4Oh Yes v~y d~fe~ent

(a) you tanili~ with the studies done who ha~Q• A~e the~e any othe~ people you ean think done epldemlolo~t~al work? has e~aluated ~he Ineldence, and atteapted to a~:Ive at a ~easonable ease of the g~eate~ ineidenee in one locality t~an another, for ~ ¥tth ~espeet to the ~e-ealle4 s~attstical relationship, wo:Id it be fal~ to say that tJae people that we have :ontlono4~ that iS the Doll ~ Hill ~udios, the ~k:aend s~udles, D~. _~_~n': s~udies, ~ated that the~e va: a ~elatlonshlp -

MR. ~s I ob~oet ~o that qmst~on, boeause It a~ ett~ts to oltelt the t~h the test~ of. t~s witness. t~at as a standing~.bJoetton to each one. All ~tght. A. ~ ~ as I k.now all studios of that so~t whteh have taken a saaplo of the ~p~t~on ~o ~ I ~ean those people vo were speaJ~i~ abou~ said t~ has a causal rolattonahlp, dld they ~t~ ~ t~ ~n~lusion he said t~ It ~u~ ~O ~ld ass~p~tons~ bu~ vlth the~ ~ ass~~ns he ~e ~o the ~ncinslon t~t th~e wee a ~~tty of ~ause and effect. ~ And did ~nd ~,-o to a s~~ ~n- eluslon~ A ~a~mond ~o ~ a s~lla~ eonelnslon. But I ~vo ~tst~ to ~~, I ~Vo ~d ~~, ~t with ~e ~thesls." I ~h~ he t~t "It offoe~ Felat~n." ~ ~ ~8 boon v~y ~~us In ~;he ltn~ut~o he has uotd. ~ has neve~s 8o fa~ as I know, sald that these optdemtoloKleLl studios pl~vo that With l-espo~ to ~. Do~n5 Is his opln- M~ D~rdh Samm ob~ootton. A It is a little difftenlt fo~ ae to say what D~. Do~nOs eonelasions, a~es beeaase D~. visited us~and in £aet it was boeanse of the of the National Canee~ Institute to ~ake t~As And the last t~e I sav hi~ he did not thLnk the~e was an~ causal ~elation. I don~t k~w vhothe~

~ta~t~tiea~ S~dies (Contia~ed) (Continued) A As ~a~ as I ,i~ov they have, vAth the one exeeption of the suzvey whlch we n~de, whleh was not a sample suzwey but ~cluded the entire population. Q Yours was done on Amerioan Tobacco Com- pany el~ployeus over a p~lod of a~ fo~ y~s, a~ I th~ it was done by ~u ~d ~. t~g, is ~ "I do not recall how they worded that. They discussed the :attez o~ oausal relationship. Whethe~ they stated it as a definite eoneluslon, or vhethe~ they stated it as a tents- t lye conclusion, or whether they stated it as soaethtn~ that their york wou~d lndl~ate ~ght be a con- (po

~t~tixtleal ~tt,d~e~ (Continued) Ha~lan stated that the stray ~ed an assoalation and we| asked "They d~d not say i~: was an aetual relattonship~ to the best of ~ou~ knoeledse?." to . whieh he replied "~, SLOe" ~po 127)o ~akett 8rated that "The:e a~e se~ea-al sta~Istleal s~.dles tha~ report an asso¢iatlon between mokJ~g and the ineldenee of l~ng cance~, but, of course, these stetisties a~e disputed feel that this. ~ay be a ~atheemtieal fietion. ~hoy donOt believe that it rill ovontua£1¥ stand up," (p. 133)0 Little aoknowledged that the sa~oeity of the studies showed an assoelation edd/~g "~hethe~ they al_l do or ~ot l don,t ~ow.. (p. 203)] [ Note, In thei~ study ]~as~ond a~nd thee is ~ do~t ~ o~ m~s as tO the ~tdt~y o~ the assertion £o~ b~e~ etg~ette ~k~ ~ ~~ Causation vas not even discussed in thei~ second or final, report, although it had been ~entioned ~n theL~ p~el~y repo~ where they said "FoF rea~ns dAs- eus~ed, we aze of the opinion that the associations fOl ~ betveen regula~ ~lgmtte o£ the cozonazy a~ta~lea and betvoen :e~ula~ eiga~ette mkAn~ and death ~tee f~ l~ng eanee~ reflect ~ause and effeet ,Some months a.~e~ thOi~ final "* * *. The fact t~at • disease is associated with so~e faeto~ in the environment does not ~eos~ily ~ the faet~ ~ues ~e dtmse • • ..- U~mmond. "Smoking and Death 3ares - ~ Riddle in Cause a~d Effeet," ~:e~lean Selentist ~(~), 331-3~, Dee. 195~, at ~p. 3~:~-3~3). 3.6

ltahed, a d~wing of conclusions of thls kind f~om my etudy yes not done. ~ ~ou ~aeau ~ou d£~net do At £a you~ stud~ , £ No, my ~tnd¥ is not fini~ed, When the ~tud¥ is finished, X e~pee, t to ~ato v~a& ~.y~. eonelusioas are e~nee~nAng ~e ~eeults of aF st~¥ ~d¥ is not e~lerce4. tabha M~ s't|a~N¥ is mt ~ot, ed s~nnl,. ~ ~ do Feel X am in a poaitlon at thAe time to (~. the • ~de~ad it, and of eo~e l £nt .end n~ reflection at all on yo~, lnte~it¥ o~ oth~ b~~t~s ~ m~i~ doer.s ~ ~£os~8 o£ p~blAe heath in eonee~ express ~h£s opinion etth

A I a~ n~t ~a~e~ to ~ake that s~ate-. ment at the ~A~sent t~8. with It, ~ ~ ~ ~ neith~ a~eo ~r di~ee. q and y~u don,t '~ t~ ~ess an opi~on ~tlt ~u ~ve ~=plet.M ~ o~n ststlstl~l lnves~i ~ i~ha~ is eo~Teet. you rant to e~tdenee to this effeet. Zt is d:J~fl-

(b)

tho B~ttlsh onv~onmont, and ha found~ tho anm~o~ o Dooto~, is m~ question o~eo~? If notj lo~ ml Ko back and have It Feed aKa~n. Po~hape l did not mako It o~e~. MR. HA£TII~S, (Roeord reed.) WLII .l,,o= road the q~e- ~ DYERm I wLII oh jolt to tho form of tho quostlon unless the question also ineoz~po~ate8 the v~toue faotoFe t~t ~e ~olv~ In tho ~tl~ tt~l st~tos~ ~ ~t ~ust ~ttsti~l ~tom t~ ~e ass~ the fa~t t~t bo~u~ a ~n is a be~oon t~t p~n ~ 1~ ~~ w~t~ the oth~ ~eeossa~y factors bo~nK tnvol~od ~n tho study. No~, ~o ahead and ans~o~ tho best jmu Did you hea~ tho quoet~on, Dooto~? I hoard the qtsos~i.Ono I don0t thl~ T could alto any study that poaltt~oly d~Jpa~o~os a possSblo statt~teal ~olatfonshlp botwoen the tnotdonoo of' oen.ez, and mokln~. (Hookott, pp, 3~36-~38 2O

~ Do6tor, do you know of any one spoolflo A ThatV8 a ha~d quostLon to anseo~, in Lot no ask you fu~th~ -- 1 ~ an honostly t~tnk~n~ --- ~ I soo. I an sorry. ~o ahead. tlon~ plea#, read.) A I vould say -- Q Dootor, you nay an~e~ the quostlono n~. of' them do not die of lung eaneee. . I tmuld say that o~e~y statistlo~l pspe~ 8ho~ed tho abNnee o£ rolatlonsh£p in tho ntJorit¥ o£ pooplo tnoluded in the study. 21

Sta~latlea! ,Studig| (Contln~d) t~on shown? Would you say that there is an assoela- A The n~gatlve ueoelatlon is mush stronger ~han the positive one. (Llttle, pp. 191-1.93)