Tobacco Documents Online

STATISTICS AUTOPSY LUNG CANCER AUTOPSY LUNG CANCER HEA RT AIR' POLLUTION -8- July-August ]i971, Clinical Pharmacology & Therapeutics 12/4 Feinstein,, Alvan R., "Clinical Biostatistics - X. Sources of 'Transition bias' in Cohort S£atis£ic~ ..... "For example, none of the cohorts investigated in research on cigarette smoking or the 'pill'~ was obta{ned by random sampling from a base populati;on of smokers and nonsmokers, or pil, l users andl non-pill users." (Page 7~7) September ~5, 1971, New York State Journal of Medicine, Vo1.71,#~18 ~osenblatt, Milton B.; Teng, Peter K.; Kerpe, Stase; Beck, Irene "Causes of Death in 1,000 Consecutive Autopsies" "Carcinoma of the lung was the only neoplasm which was greatly overdiagnosed clinica~ky and in which~ no unsuspected~ cases were found at autopsy." (Page 2~92) October 1971, Medical Counterpoint • Rosenblatt, Milton B.; Teng, peter; Kerpe, Stase; Beck, Irene "Prevalence of Lung; Cancer: Disparity between clinical and Autopsy certification" "There was a markedl contrast in accuracy in the diagnosis of lung cancer as compared with other internal neoplasms. A'utopsy confirmation in carcinomas~ of the colon, pancreas, stomach andl ovary was very high whereas in, carcinoma of the lung the diagnosis was verified in only 4~5 per cent of the cases." (Page 58) November 1971, Journal of Chronic Diseases, Vol.24/10,p.601-~l Jenkins, D.C.; Zyzanski, S.J.; Rosenman, R.H;.; Cleveland, G.L. "Association of Coronary-Prone Behavior Scores with Recurrence of Coronary Hea~rt Disease" : "Evidence has been accumulating in recent years that social and psychological factors are involved in an important way with the etiology of coronary heart disease...This overt behavior pattern (Type A.)I has been shown, to be associated with increased prevalence of coronary heart d~sease (CHD), by three different research groups..." (Page 601), ~971, Environment-Resources, Pollution & Society, Sinauer Assoc. Hickey, Richard J,., Chapter 9, "Air Pollution" "The evidence impl£cating smoking, particularly cigarette smoking, as a cause of ~ungl cancer is based primarily on statistZcal evidence...Since statistics are heavily involved, one might inquire whether the statistics have been interpreted with the rigorous objectivity demanded by scfence. Too often, unfortunately, when statistics are used in a problem which, has some 'moral' overtones (:some religions proscribe tobacco use; puritanism is skeptical of pleasure)i, biased, subjecZive interpretat£ons may not be far behind." (Page 206)

LUNG CANCER STRESS PREGNANCY LUNG CANCER! CRIITIQUE DOLL & HILL LUNG CANCER~ AIR POLLUTION -9" 1971, Textbook of Medicine, W.B. Saunders Co., p.923-24 Feinstein, Alvan R., "Neoplasms of the Lung:" "No singl~e cause for lung tumors has been id~ntified...The many conflicting claims and counterclaims about the cause of lung cancer will, probably not be resolvedl until prolonged, well,-desilgned! clinical epidemiologic studies can be conducted." (Page January 197.2, Fortune 924) "What Stress Can Do. to You" A general, discussion on, the subject of stress including references to~ Dr. Hans Selye and Dr. Meyer Friedman and Dr. Ray Rosenman. January 15, 1972, American Journal of Obstetrics & Gynecolloqy. 277-284 yerushallmy, J., "Infants with Low Birth, Weight Born Before Their Mothers S£arted to Smoke Cigarettes" "Smoking mothers have a higher incildence of low-birth-weight infant but in~ants of smoking, mothers do not suffer higher perilnatal mortality rates than those of nonsmokers. The low-birth-w.eight infants of smoking mothers have considerably lower perinatal mortality rates than low-birth-weight infants of nonsmoking~ mothers." (page 282-283). January 28, 1972, Nature 235(5335)1220-2 Rao., L.G.S., "Lung Cancer as an Endocrine Disease" "...the association with cigarette smokilng and lung cancer is far less significant than that with steroid abnormali£ies."(Page 221) January 29, 1972, The Lancet, pp.243-248 Seltzer, Carl C., "Critical Appraisal of the Roya~l College of Physicians" Report on Smoking and Health" "This reapprailsal of the full data provides strong support ~or Bradford Hiill's injunction about the hazards of analysing secu,~ar changes iln death rates. The reappraisa{l also raises ma~or d~ubts about the Royal College o~ Physicilans' conclusion that i~ has presen,ted 'the strongest evidence there is of the value o~ giving up cigarettes'." (Page 8). February 1972, America~ Jour~all of Public Healthp~52-58: S~erling, T.D.; Polllack, S.V. "The Incidence ef Lung Cancer in the ~.S. Since 1955 in Relation ~o~ the Etiology of the Dilsease" "The fact that the incidence of lung cancer is leveling~ off at a time when it ought to have increased (if smoking is the major cause of lung cancer) ought to. give us some pause. Together wilth other anomalies, these d~ta suggest the possibiili~y that par~icula~te pollution ra~her than smoking may be the primary sour~ o~ the incidence of lung cancer in the Unilted States." (page 158),

LUNG CANCER AIR POLLUTION }{EART HEART -I0- VOW. 63, NO. 3 March, 197.2!, The Journal of Thoracic and Cardiovascular Surgery Langston,, Hiram, T., "Lung Cancer-future project£on" "Based on age incidence studies of lung cancer for the 301 year period ~rom 1939 to. i968~ at the Veterans Administration Hospital, Hines, Illinois, the following comments are justified: i. The currently recognized wave of increased incidence in lung cancer is principally composed of persons born between, ~ 1890 and 1900. 21. When this generation passes on there should be a marked redUction in the overall problem of lung cancer in this institutilon. This is to be expected by. about 1980." (Page 415): March 19~2, Indus£rilal Medicine, Vol. 41, No. 3 Penha~, P. Daniel;~ Amaral, Leonard:;~ Werthamer, Seymour "Ozone Air Pollutants and Lung Damage" "We have attempted to demonstrate that ozone, as the representative of oxidant air pollutants, ~s an ~njurious agent tomammalian lung:, including that of man. That it results in emphysema, and pulmonary ~ibrosis in animals, andposs£bly chronic obstructive pulmonary disease in man, fs accepted by many .... It should be eonsideredl, perhaps, as much a factor iln the etiology of pulmonary cancer as cigarette smoking."' (Page 20) April 19721, Circulation, Volume XLV Keys, Ancel et al. "Probabilihy of Middle-Agedl Men Developing Coronary Heart Disease in Five Years" "Coronary heart disease (CMD)I is now commonly held to. have a multivariable causality; in other words, several!, perhaps many, variables promote the disease....It will be noted also that for the three most universal~y established risk factors, age, blood pressure, and cholesterol, the difference between the cases and noncases is larger for hard CHD: than for any CHD~ This indicates that the more secure the CHD d~agnosis, the more clearly is the disease related to age, blood pressure, and serum cholesterol." (page 815 &~819): May 1972, Geriatrics 27/5:74-9 Friedman, Meye~ & Kosenman, R.H. "The prudent Management of the, Coronary-prone Individual" "We and others also believe that any subject exhibiting a part£cular behavior pattern (Type A) also may be relatively coronary-prone .... Nor should it be forgotten that excessive cigarette smoking may only be the indicator of the presence of some other pathogen at play. For example, Type A subjects habitually smoke more cigarettes than. Type B subjects."

AIR~ POLLUTION ANIMAL STUDIES AI~R POLLUTIION LUNG CANCER! STA'TISTICS AIR POLLUTION -ii- June 1972, Ecoiibrium, Vol. i, No~ l, House publication of Shell 0il Co. Hickey, Richard "Environmental Chemical Mutagens: Are They Health Hazards?" (Excerpt printed in Ecolibrium) "It is a much, too co~on, part of sc£entific methodology these days, in dose-response experiments ~n biology, to employ unrealisti.cally high doses...of some chemical at varying levels in studies on small numbers of inbredl experimental animals. It is also commonplace to [extrapolate] high level findings into quite low dosage regions in which it is quite difficuLt to detect effects, and to assert on the basis of subjective judgement or opinion something about the effects in this low dosage region, and what it means to human health. How much~ regulation or law has been made by such speculation I will leave £o you, to estimate. Based on my understanding of science and scientific methods, extrapolation into unknown regions is scientificaLly invalids, and shou,ld be called by its proper name: speculation."' (Page 12) June 13, 1972!, Paper presented at the 6th Annual Conference on, Trace Substances in, Environmental Health, Columbia, Mo. Mancuso, Thomas, F~; Coulter, E.J.; Macdonald, E.J. "Milgrat~on and Cmncer Mortality Experience--A Study of Native 8nd Southern Born Nonwhite Ohio, Residents" ~ "The present study indicates that there are some factors mssociated with place of birth in the U.S., and in particular, birth in the South, whilch influence the subsequent death r~te of some cancer sites." (Page 23) 1972, Pa,thology Annual 7:45-79: Herroldl, Katherine McD., "Survery of H~stologic Types of Primary Lung Cancer in, U.S. Veterans" "There was no correla~tion found between the histologic type of primary lung. cancer and the amount of tobacco smoked among 'current smokers of cigarettes only'." (:Page 77)i "Extremely important from a biologic standpoint is that only ~ small percentage of hea~y cigarette smokers develop lung cancer." (page 7.4) JuLy, 1972, American Journal of Public Health, Vol. 62!, No. 7, 909-9~6 Lave, Lester B;. Seskin, Eugene p., "AZr PoLlution, Climate:, and Home Heating:~ Their Effects on U.S. Mortality Rates" "These studies make it apparent that there is ~ close association between mortabity rates and a~ir pollution. This investigation strengthens the conclusions cited in a previous work that mortality rates could be lowered substantially by abating air pollution." (Page 915)

EMPHYSEMA TWIN STUDIES STATIISTICS -12- Jully, 1972, Bulletin of N.Y. Academy of Med~icine, Vol. 4~8, No. 6, 823-84,1 Rosenbla£t, Milton B., "Emphysema: Historical persective" (s~cl "It is difficult to reconcile the prevalence of emphysema in the 19th century with official statistics showing virtual nonexistence of the disease in the early decades of the 20th century~. The present view is not concerned~ with the reasons for this disparity except to poin~ that the sudden apparent increase of emphysema in the United States may well be an artifact produced by revision~ of the International List of the Causes of Death in~ 1949 permitting emphysema,, for the 9irs£ time, to be accepted as a primary cause o~ death." (:page 838~, August 1972,The Lancet Wakeham, Helmut R.R., "Smoking andl Health" "It is disturbing that twin data in relation, to smoking and mortality have been virtually ~gnored in major smoking and health reports such as those of the Royal College of Physicilans and the U.S. Publiic Health:Service. A~though the present d~ta base is small and resu,lts to d~te must be considered tentative, the twin data~ seem to weaken the in~erence of a causal connection between smoking and~ e~rly death which has been~ drawn from, the conventiona~ epidemio~ogica{ studies." (Page 275) September, 197.2, Archives of Environmental Health, Vol. 25, ~87-191 Seltzer, Carl C., "DZffe~ences Between Cigar and Pipe Smokers in. Heal%by White Veterans" "In studies involving smokilng and hea~th, the practice of combining pure cigar smokers and pure pilpe smokers into a single category wi~l also. have a blurring effect in those instances where the health or illness criteria are different for cigar and pipe smokers, as for example when considering morbidity or mortality, or both. That such a situation is possible is evidenced by the manifold differences in, disease mortality rates between pure cigar and pilpe smokers in two population studies." (Page 191)

ERRORS IN' DIAGNOS I S ASBESTOS AS,BESTOS TWIN STUDIES SMOKING & PREGNANCY -12a- September 1972, Journal of the A.merican Medical Association, Vol. 221 No. 13, Fredrick W. Bauer and Stanley L. Robbins, "An Au,topsy Study of Cancer Patients: I. Accuracy of the clinical Diagnoses (1955 to 1965), Boston City Hospital" Despite the select group which, our aut6psy patients represent the autopsy remains the indisputable arbiter of the accuracy of any clinical diagnoses for which these are morphologic criteria. Our study indicates that accurate clinical diagnoses of cancer in, municipal " hospitals are as much a problem today as they were a half-century ago." (Page 1474) -:- October 1972, The Kansas City Times (Oct. 5, 1972) Anonymous, "More Cancers Linked to Asbestos" "Asbestos, already linked with lung cancer in insulation workers, who smoke, was further linked yesterday with cancers of the esophagus, stomach,, colon and rectum. A substantial number of deaths over what would be expected from these cancers were found: in a study of insulation workers in the united States and Canada covering the period from 1943 through 1971." (page 18A) February 1973, The Kansas city Times (February 24, 1973) Anonymous, "'Deadly' Asbestos Danger" - "Calling asbestos a 'hidden time bomb' a noted: researcher told a Senate subcommittee yesterday the fibrous mineral will claim one million Amercian lives by the year 2000.. . . Millions of other persons are exposed to asbestos fibers to an unknown degree every dBy of their lives, without their knowledge, he said. 'We are all now. contaminated with asbestos,' he ~Selikoff] said. (Page 9A) February 19.7.3, The Lancet Hickey, Richard J., Clellandl, Richard C., Harner, Evelyn B., "Smoking, Bith-Weight, Development, and Pollution." "The greater concordance in smoking behaviour among monozygotic than among comparable dizygotic twin,s is compat- ible with the constitutional hypothesis, but discouraging to the smoking-causality hypothesis. The constitutional hypothesis asserts, in th,is case, that smoking: behaviour of women and the. birth-weights o.f their children are influenced by a common cause--the individu~l genotype. The validity of the smoking-mortality statistics is in question." (Page 270') 10051Z4965