Tobacco Documents Online

THE WEBB-WARING INSTITUTE FOR MEDICAL RESEARCH (Dedicated to the Study of Diseases of the Lungs) ~ I,Ir. J, y. Cullr~,~.n III, President ' P.cilin '_orr i_s _JInc . 100 Park AvenAe '°, New York 17, New fork i`, . Dear i•ir. Cu lman: Gerald B. Webb Memorial Building 4200 East Ninth Avenue Denver 20, Colorado P:arcii 20, 1963 In spite of your official capacity, you surely must have some inner concern over the possibility that regular cigarette smoking for many years is seriously harmful to the health of many humans. r•Then the observations relating the inveterate inhaling of tobacco smoke to various chronic lung diseases first began to appear some 10 or 12 years ago, cigarette manufacturers had an obvious right, and even a duty, to question it. i?ow, however, if you have read a11l of the available evidence, both pro and con, you must at least have serious doubts. It is because I feel you must have such doubts that I am taking the liberty of writing you this letter. P=an,y people will doubtless continue to do certain things they know can harm them; some will even continue to do things they know will surely harm them. In a democracy this is acceptable, I think, pro vided the indivi dual knows what he is doing, t::at is, knows the risks involved. P-ianufacturers of foods and drugs are required by law, among other t hings, to label their products carPfully in order to protect the public health. In addition, certain industries which manufacture a potentially harmful product at times voluntarily recom:-rend moderate usage of their product, and yet do not seem to have suffered economically from such public service. In other words, I believe that most young people today are aware that alcohol can be harmful. At least, they are not deliberately persuaded by television, radio and magazine advertising paid for by the liquor industry that they should drink in order to grow up, to be sophisticated and be desirable. Smoking is a source of pleasure for a great many people. It is particularly gratifying to the habitual smoker. In moderation it can even be useful as a sort of relatively harmless minor indiscretion availa'~le to satisfy our natural yearnings to break the rules. In strict moderation, cigarette smoking is probably not harmful at all, except to rare individuals with some kind of hypersusceptibilit.y to tobacco tar or nicotine. It is my conviction that information on the potential dangers of prolonged heavy cigarette smoking and the ways one can smoke with little or no hazard should be made avai lable to all ,roung people at the time they are under great social pressures to start (i.e., age 10-16). °ublic health and school health officials, interested physicians and parents, voluntary health agencies and even organized medicine can never do this job thoroughly without help. In particular, thsy T•rill be unable to com-)at the manifold skills and the dollars of the advertising and tobacco industries working in a contrary direction. Formerly The Colorado Foundation For Research In Tuberculosis .

I,:r. J. F. tla.llman III -2- :_arch 20, 1963 If these two economic giants were to assist in a campairn of public enlirht?nment about the hazards of smoking, I seriously doubt that the per capita consumption of tobacco products would be reduced ver;; much. Instead, I believe that the majority of peonle would continue to take their chances in return for the obvious satisfactions of smoking. But our neople could no longer be justified in feeling that they had not been adequately warned. The tobacco industry could also point with nride to a ver-r real public service. You may well thus be abie to forestall some sort of legal restraint regarding smoking which would be most undesirable. And furthermore, unless jou take some public cognizance of the ootential hazards of smoking fairly soon, you may well ultimately be held financiall,y accountable for lunG cancer deaths in our courts. I personally t'rLink that this would '?e unjust up to this time, but that such a finding will become just in time to come. A review of all the available evidence toda-, has convinced me that lung cancer and the chronic bronchitis-emphysema complex of diseases each have- several causes, all or most of which must be interacting to nroJuce these ais:;ases: chronic irritation (from air pollutants, particularly tobacco smoke), chronic infection, chronic injury (i.e., chronic, severe coughing), and an individual predilection. The possibility that animal experimnts can be designed and carried out which will adequately- test such an hypothesis i s remote; for instance, the e-sneriment would have too many variables; e,cperimental animals lon't live long enough; they do not smoke the =aa7 humans 3.0; the study would be too ti,qe consuming. In short, I seriously doubt that at least for years to come, ?nedi cal science will be able to obtain the clear-cut kind of proof of the causes of lung cancer and chronic bronchitis-emphysema that Robert Koch was able to obtain for tuberculosis about 80 years ago. The lack of such final rp oof does not alter the facts already known today. If I were in your position, therefore, I would be seriously considering the following sort of actions: 1. Avoid em^hasis on persuading young people to smoke in ;rour a3vertising. 2. Emphasize instead the proper and safe ways to smoke, somewaat as follows: inhale as little as possible; smoke only a third to a half of a cigarette; smoke cigarettes with low tar and nicotine content; try a switch to ci gars and/or pipes; don't start smoking until you are 20 or more; be sure to cut down or stop if you have chronic cough or repeated deep chest infections. 3. Research directed toward removing or effectively reducing the harmful substances in tobacco smoke. it is quite likely that you are already doing the research, and you may well have contemplated the proposed change in advertising emphasis. However, you may have rejected the change in advertising for fear of economic loss to your corporation. If so, this is not a justifiable reason for avoiding your responsibility to the American people, in my opinion.

< _s. J. . Cullman III -3-' -,~iarch 20, 1963 IIn closin¢, I;r s:. to emphasize that this letter is entirely my own idea anl contains my own personal views based upon special interest and study in the field of chronic lung diseases ~I am Director of the T ebb-:°Taring Institute for 3:ed,ical Zesearc::, which has a special interest in diseases of the lungs; I arn also in c1harge of the Pulmonary )isease 3ervice, :Tniversity of Colorado I edical Center, and a past-President of the American Thoracic Society).. Others to whom I have suggested that such a letter be written have tended to deny that it miFb.t accomplish any good. However, T do not believe that a tobacco company executive is by definition selectively lacking in both intelligence and conscience on the subject of this letter. Zespectfully yours, ~ e ~~o fr . I. i'tbh i ,1-~.