Tobacco Documents Online

More than a quarter of a century has passed since the has been extenszve, znt~nszve -- and often frultful. T~ tobacco industry alone has contributed more than $80 million to smoking and health research; other research support organizations have given many additlonal millions. Despite this scientific inves- tigation, gaps in knowledge remain, anomalies persist and the controversy continues unresolved. ~e ~ of the smoking and health controver~ below. Subsequent articles, panels, brochures and other pre- sentations~ and materials will be coming your way over t~=e next year or two, all designed to better acquaint you with the history, current status and probable future developments relati g to ~oklng and health, i~ Medical and Scientific Ouestions " " The scientific arena is the one in which-the controversy developed and, when all is said and done, is where the controversy

must finally be. resolved. By far the-most attention has been glven, to claims that smoking_ causes lung cancer, but.a.~itional...~ claims link smoking to heart disease, chronic lung dls/~ses (such as bronchitis and emphysema) and many other ills afflicting people, especially those that come as people grow older. Initlally, studies were publlshed reporting that lung cancer occurred more frequently among smokers than non-smokers. These werefollow~d by a report of an experiment An which condensate of tobacco smoke caused tumors on the skins of mice. Then, a series of large statistical studies were published, from which, together with other data, it a~peared that smokers differed from non-smokers with regard to practlcally everything and, in particular, that smoking was associated with various diseases. Efforts were made to identify substances in tobacco smoke that might be responsible, and studies were done which suggested that smokers had more abnormal changes in the tissues of their lungs than did non-smokers. And many concluded that smoking caused lungcancer and other diseases. " ' BUt these concluslons did not go unchallenged. Many eminent doctors and other scientists questloned whether smoking was indeed

causally related to huma~n disease. Perhaps pre-eminent among these was Sir Ronald Fisher, often called "the father of mod n statlstics"~ who pointed out that statistical studies could not dem~strate '* causal relationships. For a variety of reasons, ranging from the large number of different diseases and other characteristics associated with smoking to the curious fact that one of the more important studies seemed to show,that non-lnhalers had a higher risk of lung cancer than inhalers, Sir Ronald suggested that smoking might well be a reflection of the kind of person who would be afflicted by various diseases rather than a cause of them. Others pointed to a11 sorts of discrepancies in the studies, and the controversy was underway. Over the years, there hasbeen very. little change in the kind of evidence linking smoking and disease. But repetition of many of the studies, coupled with a~deslre on the part of public health officials (who reasoned that llttle was lostlifo they were wrong and smoking did not cause disease, but much might be lost if they did nothing and ultimately smoking was shown to be _ . at fault} to protect the public against possible risks, led to o 0

ever-wider attacks on smoking and corresponding acceptance of the wlth the whole story ~b~lleve that smoking is a major.~Ipr~t. Unfortunately, the other side of the story is rarely publi- cized. There is nothing newsworthy about a study which fails to show smoking causes something, or about a doctor who says he doesn't know the answer to questions about smoking and health. But there~are many such studies and many such doctors. As you will see from future presentations, there is definitely another side to the story~ many scientists believe that smoking has not been sclentifically established as a cause of human disease, and so the smoking and health controversystill goes on. Among the many reasons why causation theories are ~uestio~e~ are these~ (i) As Sir Ronald Fisher pointed out, the reports of statistical associations between smoking and various diseases do not establish cause and may be better.explalned by constitutional theories (~moklng-ls not related to disease, but the smoker's constitutional makeup is} than by causatlon~ o O O O

(ii) No ingredient or ingredients as found in cigarette smoke have been shown~to.cause, human dlsease~ ~~ . (iii) Many envlronmental and other factors a well as smoking are statistically associated with various of these diseases, but we still do not know which, if any of these factors are causal. (iv) Nor dowe know the way in which these diseases develop. (v) With regard to lung cancer in partlcular, which is still foremost in the public mind, reports have appeared re- cently of increases of the disease in non-smokers, of increases of lung cancer of kinds unrelated to smoking and of lung cancer in women of a type other than that usually claimed to be related to smoking. The type of lung cancer most often clalmed to be related to smoking has not been increasing. Inhalation experiments aimed at producing this type of lung cancer, in which anlmals inhale clg~arette smoke over virtually their entire li~e span, have had consistently negative results. And the age of diagnosis of lung cancer is unaffected by when a person begins to smoke, the amount smoked or even whether or not the patient has been a smoker.

Research to answer the many questions still remaining.ln the scientific arena continues. Some of the world's m~st eminent doctors and scientists will tell you of the past research and of that planned for the future, as well as telling you what is and not known about smoking and lung cancer, heart disease and all other ailments involved in the smoking and health controversy. ~iti@ation Not long after the first scientific claims about smoking and health appeared in the. early 1950s, the first lawsuits came on the scene. These were cases in which, typically, a widow would claim that her husband smoked cigarettes for many years, and died of lung cancer. Therefore, she said, the tobacco manufacturer should pay her hundreds of thousands or millions of dollars. You will hear much of the smoking and -health litigation; it, too, continues and its importance to the industry is obvious. For now, you should know that from the beginning to this day, no plalntiff has ever won and not one penny has been paid to any plaintiff by way of judgment, settle- ment or otherwise.

Politics Political involvement in the smoking and health ~controversy has been extensive. Indeed, considering the wide-spre impact of the smoking and health controversy on society, it is not surprising that interested government bodies have included not only health and~regulatory agencies, but lawmakers as well. Government (and non-governmental) health agencies throughout the world have passed many resolutions on the subject of smoking and health, at is rather odd, because never before have such bodies found it necessary to determine causation by resolution. In other areas, the scientifle evidence ha~ been able to speak for itself. / Lawmakers and regulatory agencies in many countries have sought, in various ways, to restrict the tobacco industry's adver- rising and other aspects of the marketing -- and even the PrOduc- tion • -- of its products. The many interrelationships of s~.moklng and health considerations to these efforts will be a continuing o 0 source of interest and concern for the industry. Underlying most governmental action has been .the assumption -- tacit or explicit -- that smoking causes disease. Yet, when the

Congress of the United States heard both sides of that issue in ~ considering whether to.strengthen the.warning label, Itidi~ not . wish to choose between the eminent sclentists on the op~slng sides of the issue. The United States warning label says only that the Surgeon General has determined that smoking is dangerous to health -- and not that Congress agrees with him. _P_ublic" Smokin@ In recent 5,ears, anti-smoking forces have seized upon the public smoking issue in an effort to make smoking socially unaccep- table. These forces, in their effort to restrict smoking increasingly until it is a custom practiced only by.consenting adults in private, have seized upon fea~s that tobacco smoke in the atmosphere can cause disease in non-smokers. Much of the current smoking and health battle evolves around this public smoking and health issue. But when scientific scrutiny islapplied to the claims made, they just don't stand up. That was the con- cluslon reached by a number of eminent experts in their testimony 0 o tO a U' S. Congressional committee two years ago. And, despite o

some Scattered press and other report~, research since that time has not provided reason to change that conclusion. ~ The above outline is not designed to acquaint you with all the details of the smoking and health controversy. It does try to give you some idea of where that controversy stands, as seen by many outstanding medical and scientific experts. Why they believe the way they do is the principal question that will be addressed in the presentations and other materials you will receive. ~en that material is in hand, you will then receive pe):io~]ic npdates, so that you may be fully familiar with the smoking and health' controversy, how it stands and how it relates to your company.