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c t a Tobacco and Health &,I/,.-,~f /4- /~ . Publiahed by the Tobacco lnformation Committte, representing tobacco manufacturers, growers and .rare.bouaemen. Volume I Number 2 150 Eut 42nd Street, New York 17, N. Y. January-February 1958 TIRC Re orts Pro ess In New Statistics p ~ Contradict Anti- Smoking-Health Research Cigarette Theory Continuing scientific rtsearch knde support to the position thnt too many unknowns eziet today concerning lung cancer to warrant conclusions pladng a major uuaative role on dgarette smoking, aocording to the 1957 Report of the Scientific Director of the Tobacco Industry Research Com- mittee. In the report, just published, Dr. Clarence Cook Little discusses some of the unknowns, quebtions, and problems under study through granta to independent scientists. Dr. Little is also chairman of the Scientific Advisory Board, which recommends all grants to be made by the Tobacco Industry Research Committee. "Broad and specific accusations and claima of harmful effects from tobacco have been made," be aaid, "and the incorrectness or correct- nees of such statements must be prbved, no matter how long or hovw dif5cult the effort ma)• be." Seek New Facts "The program of the Scientific Advisory Board is one of basic and unbiaaed research," he said. "It is not planned with a preconceived purpose of proving tobacco innocent or guilty in its effects on human health. Its purpose is solely to ob- tain new information and to ad- vance human knowledge in every possible phase of the tobacco and bealth relationship." Dr. Little said the nine scientists on the Board "t.ake the general posi- tion that definitive conclusions on predictions of individual risks are unwarranted by the present stBte of knowledge in the complex 5eld of lung cancer causation. (Continued on pa6e 2) REPORT AVAILkBLE Copies of the 1957 Report of the Scientific Director of the Tobacco lndu.trs- Research Committee are available upon requeat to: Executive Secretary, Tobacco Induetm Reacarch Committee, Room 305, 150 Faet 42nd Strect, Ne•+• York 17, N. 1'. "Tar' Misnomer For Condensed Smoke The term "tobacco tar," often seen in articles about smoking, actu- ally is a misnomer. Recognition of this fact is neees- sarti• to an understanding of some of the difficulties involved in an- al}zing and assaying tobacco smoke. A discussion of this problem is contained in the 1957 Annual Re- port of the Scientific Director of the Tobacco Industry Research Committee. Many factors affect the composi- tion of the smoke itself. In labora- ton• work, tobacco smoke when trapped and condensed becomes a dark-colored, viscous liquid. This ap- parently has led to the use of the ternn "tobacco tar." However, this liquid is not a substance which is the same from one experiment to the next. Smoke Variee As a result, different investiga- tors may be using different conden- sateF whose contents are far from standardized or known. Such es- periments ma-v be .cith material that is not comparable to the smoke that people get when they smoke. Tobacco smoke produced during the normal burning of a eigarette has two phases. One, virtually in- visible, is a complex mixture of gases and vapors. The other is a (Continued on paEe 4) Cigarette smoking ia compatible with normal bealth, a.nd even bnavier- than-average eigartitte smoking is compatible witb better-than-average mortality rates, according to a sci- entific report presented before the Southern Medical Association. This finding iu based on a study of cigarette factory employees covering 116,000 person-years of mortality riak over a 10~14-year span. The workera : (1) Smoke far more cigarettes than the ge.neral U.S. population - almost double the average rate ; (2) Definitely live longer than average; (8) Show average, or lower-than- average, death rates for cancer or lung cancer, and for cardiovascular and coronary disease. The report was pre.aented by Dr. H. B. Haag, professor of pharmacol- ogy, Medical College of Virginia. and H. R. Hanmer, research directot of The American Tobacco Compan~, whose employePs were studied. "The ezistence of such a popula- tion makes it evident that cigarette smoking per se is not necessarily or invariably aaaociated with a higher risk of lung cancer or cardiovascular disease or a-ith diminished longev- ity," Haag and Hanmer concluded. One proponent of the anti-cigar- ette theory, E. Cuyler Hammond, director of the American Cancer Society's atatietical section, criti- eiied the Haag-Hanmer results on two counta : first, that the employees involved enjoy good medical care; and second, that employee popula- tions generally show better-than- average mortality rates. However, Dr. R. H. Rigdon, pro- feasor of pathology at the University of Texas Medical Branch, in a die- cuasion of the paper, concluded that "Scientists who support the statis- tical association between cigarette smoking and (1) higher death rates (Contitwed on poge 2) CTR 401.9 C I R, 1-11-4 0 () ~tG} 2_ 1

r ZTRC Reports Progress In Smoking-Health Research (Continued Jrom pette 1) "In regard to heart disease, they tAhe a similarly open-minded atti- tude toward causation, consistent vi-itb the expressed positions of such organiution.s as the American Heirt Association and the National Heirt Institute," he said. Reaulu of Reaearch In discussing research progress, the report included these points: 1. No specific substance has been found in tobacco smoke that can account even for limited reports of biologic activity on skins of some laboratnry mice. 2. Ezpoeure of laborator.• ani- ma.ls to Inhalation of massive doses of cigarette smoke has not devel- oped ans bronchogenic carcinoma. 3. Tobacco smoke condensates painted on susceptible animals in the Quamtity and exposure rates simulating conditions of human s.moY.ing have not induced akin can- ctr on these animals. 4. ExpeJimente with nicotine show that constriction of peripheral blood tesaels, often attributed to smoking, occurs only in certain peo- ple under certain conditions. This effect nay be masked by other in- flue.nces snr.h as room temperature. Some esperiments indicate that nicotine 1.ay actually result in a slight dilation, rather than constric- tion, of Iarger blood vessels, such as coronary arteries. 6. Studies showed that cigarette smoking by patients with duodenal ulcern did not produce significant changea in certain gastric secre- tions often associated with ulcers. 6. One study reported thnt smok- ing b.ad no significant effect on the mechanice of the breathing func- tion of normal subjects. This is the first annual report to include abstracts of papers pub- liabed by some scientists working with rranta-in-aid from the Com mi t toe- The report also discusses scien- tific problems involved in searching for pceaible causative factors in such a complex disease as human lung cancer. "All evidence from both labora- tories and clinics indicates that the problem of causation of any type of eancer is complex and difficult to analyze " Dr. Little ssid. "A philos- ophy of over-simplification and an attempt to contiince the public of a final solution or of a lethal risk not TIRC Funds For Smoking Research Now Over $2,000,000 The Scientlfic Advisory Board to the Tobacco Industry Research Committee approved 62 grant;-in- aid, including renewals, totaling i560,000 during the 12 months e-nded June 80, 1957. Since the start of the Commit- tee's scientific program in the 1964- 65 fiscal year, the Board through last June 30 has allocated $1,715200 for 67 separate research projects in 62 of the nation's medical schools, hospitals and research in- stitutions. All grants are listed in the 1957 Report of the Scientific Director. Many of these have been renewed after the first year. During this same period, the TIP.C has appropriated funds amounting to E2,200,000 for re- aearch grants, including a special 1200,000 appropriation requested by the Scientific Advisory Board in the 1956-57 fiscal year to finance antici- pated new granta. Each year the TIRC has allocated $35,000 for fellowships for medical achool students for basic research in any field of their choosing. One scholarship is offered to each of the nation's accredited medical schools to encourage basic medical research. The Scientific Advisory Board has responsibility for research policy and programming. All grants are made solely upon recommendation of the SAB. Its nine members are doctors, cancer research scientists and educators who retain their re- spective institutional affiliations. den-,onstrated by experiment$1 evi- dence are neither kind nor accurate nor wise." Eftorts are being made to extend studies of individual human dif- ferences between ao-c.nlled heavy smokers and light smokers or non- amokere - differences already indi- cated by existing work, the report aays. "Excesses in various types of be- havior are one of the refiections of the presence of neuro-hormonal un- balance," Dr. Little writes. "They are not the primary causes of such unbalance and they do not furnish the cure. They are an outward and visible sign of an inner and invisi- ble crisis of some sort. Excessive use of tobacco, alcohol, coffee, or other agents, may therefore be pri- marily a s>•mptom, not a cause." Page 2 New Statistics Refute Anti-Cigarette Tbeory (Continued Jrom page 1) from all cauees, (2) a higher lung eancer death rate, and (3) a higher death rate from cardiovascular dis- eases will, in my opinion, find the study made by the University of North Carolina, the one by Dorn and Baum, and this one by Haag and Hanmer very difficult to refute." In the Nnc York Herald Tribune of Dece.mber 22, Dr. Joaeph Berkaon, chief medical statistician of the Mayo Clinic, was reported aa saying the existence of such a group of em- ployeea who amoke heavily and yet do not succumb in large numbers to lung cancer shows that if there is a toxin in eigarettca, it is not very potent. The basic findings on employee mortality for 1946-52 were made by Dra. Harold F. Dorn and William S. Baum of the U.S. Public Health Service. Smoking habits of the to- bacco company population were measured by the Institute of Statis- tics of the University of North Caro- lina. Both smoking habits and deaths were tabulated on almost a complete "head count" basis. No estimates or sampling errors were therefore in- volved in their study, the Haag- Hanmer report says. The full Haeg-Hanmer study, with Dr. Rigdon's discussion of the paper, was published in the December 1957 issue of Industriel Afedieine cr.d Surgery under the title "Smoking Habits and Mortality Among Work- ers in Cigarette Factories." Tobacco and IHe.alth A publication issued by the Tobacco Information Commit- tee, representing the tobacco manufacturers, growers nnd vc-arehousemen who support the Tobacco Industry Re- search Committee. "Tobacco and Health" pre- sents a selection of material from a variety of sources, in- cluding lay and scientific pub- lications. The opinions quoted herein are those of the identi- fied sources and do not neces- sarily represent the officisl policy or position of members of the Scientific Advisor~• Roard to the Tobacco Industr~ Research Committee or recip- ients of TIRC reeearch grants. C T R 401210 ~ R t`=11-4 t~D 2. CT

, Press Questions Study Suggests Bronchitis May Anti-Smokinb Plan Be Prime Factor in Lung Cancer A suggestion that chargea against smoking In connection with lung cancer warrant a state-supported campaign against eigarettes, fi- tzanced by tues on cigarettes, brought editorial comment from several leading newspapers. The proposal was reported in the Neu York Neraid Tribune aa eom- ing from an official of New 2'ork State's Department of Health. Commenting on the proposal, T1 e R•oI! Street Journal aaid in part : "kiiuionary Campaign" "well, we don't know whether smoking eigarettes contributes t.o lung cancer deaths or not. The last time we discussed this Mith our doc- tor he advised us to cut down on cigarette8, sweets, gin rummy, mar- tinis, long auto trips and editorials that question the advisability of some aspects of the foreign aid pro- gran-a. Your doctor rw• have vastl>• different ideas about all these things. "The faQ is that nobody has yet proved anT ease against cigarettes to our aatisfaction. 'We'd suppose that cigarattes are bad for some people and not for others, but rnuch the same statement maY be made about eroaring the street. "tti'e do think, though, that until there ia aonclusive proof one wa* N• or another the state health depart- ments would be wise to restrict their endtavors to research and stav out of the missionary campaign business." Othera Object The New York Dnilt, News said In an editorial: "Dr. Levin talks as if it were noK, established - which it emphatically is not - that ciga- rettes cause cancer. ... The scheme, obviou.ly crazy as a cockroach, re- minds you of the oldtime prohibi- tionista and their belief that you could compel teetot.alism by lak• and dr.• propaganda." Newidoy, published for Long Island, I:. Y., called it a suggestion that "a political campaign agains: smoking be financed by a tax on cigarettes. This is ridiculous. "When we let politics into the pic- ture. we are getting too close to legislation for our - or any amo- ker'b - comfort." The possibility of bronchitis as a likely candidate for the rol,e of pri- mary cause of lung cancer was sug- gested by Dr. R. D. Passey of the Chester Beatty Reaearch Institute, London,in a paper before a special University of Wisconsin ASedical School convocation. He reported that a preliminary study now going on at the Beatty Institute thun far favors this poasi- bility. The study is based on death certificate records in England. Challen6e. 80 pc FiFnre Dr. Paasey challenged the reli- ability of a recently published fig- ure claiming that 80 percent of lung cancer deaths are directly caused by smoking. "Just because a man dies of lung cancer and also smoked during his lifetime, it is not justifiable to call smoking the primary cause," he aaid. His talk was reported in Medica! Doctors' Comments On Smoking-Health "Far Too DoFrnotic" Dr. John W. Cline, chairman of the California 1•ledical Association's cancer commission, believes the in- creasing number of new chemicals, including some which find their way into the atmosphere, are partly re- aponsible for the rise in many kinds of cancer. "People have been far too dog- matic about blaming smoking for lung cancer. There are too many other factors to call it the sole or chief cause," he aaid during the annual meeting of the Los Angeles County Branch of the American Cancer Society. (From o atory in the Los AnDelea Times) "A'o Contlutive Evidence" Dr. Edgar V. Alien, professor of medicine at the University of Diin- nesota's rfayo Clinic and (then) president of the American Heart Association, said there ia "no con- clusive evidence" that cigarette smoking causes lung cancer or heart disease. Despite the report by a commit- tee of the American Cancer Society that there is a definite relationship (Continued on page 4) Science, Scope Weekly and the Mad- iton (wiu.) Capital Times. No Relationabip to Deatb Age Dr. Paaaey reported on his study of 600 reoorded deaths of lung can- cer now under way. There appeared to be ao relationship between the number of cigarettes smoked per day and the age at death, he said. Thoae who smoked least had the earliest average death age, 61.7 years, be said. Those who smoked most, 40 to 60 a day, had the next earliest death age, 652 years. The second heaviest smokers, 81-39 a day, lived the longeat, 69.2 years. Dr. Passey posed a number of un- answered questions that challenge the theory that cigarette smoking is the primary cause of lung cancer. ENGLISH WORK WITH hiICE Work in vvhicL Dr. Passey is par- ticipating in England was recently described in the .lournal of the American Medica! Aaaoeintion. The JARIA referred to the 1956 report of the Britiah Empire Cancer Cam- paign in part as follows: "Professor R. D. Paasey and co- workers have failed, in spite of per- sisting efforts, to demonstrate any carcinogenic properties in the tar from cigarettes when applied to the skin of mice. . - . Groups of ham- stera were eiposed to the smoke of cigarettes for long periods daily .,. without any evidence of lung or other cancer. "In other experiments, three groups of rats have been exposed, over a period of 10 months, to at- mospheres containing cigarette and coal smoke and to a combination of the two. In none of these animals has any sign of neoplastic change occurred.... "Professor Passey says: 'During the last three years all those in Great Britain working on the eBects of exposure to cigarette smoke or its tars have been consistent in re- porting complete failure to demon- strate any carcinogenic action in a variety of laboraton• animals, in spite of the proved presence of traces of the carcinogenic hydro- carbons in cigarette tars. This is in marked contrast to the reports from 11'ynder and his co-a•orkers in America (1953, 1955). The differ- ence in these results must be in the tars.' " Page 3 c`~_R t-~tt~t c~~.a~~ ~~. ~

. , k i,orrtments by Dociors on Smoking and IIealth (t;onri>vserl J.ntn pa6e 3) bet.veen cigarette smoking and lung uncer, Dr. Allen said :"I don't think this has been proven by a long way." Interviewed whik attending the annual meeting of the Georgia Heirt Aaaociation, be said: "I don't think any relationahip bedR•een amoking aAd heart disease has been proved. But I have an open mind on the subject and feil that studies ahould be made to find the truth." (From a story in tAt Atlanta Jour- Sal) ILebunks ArLruments Dr. Charles J. AfcCammon, Uni- veralty of Southern California in- atruct.or, tended to debunk argu- ments that cigarette smoking is a cause of lung cancer. At a meeting of the Orange County Branch of the American Cancer Society he showed graphs depicting figures or. cigarette smoking in England and the United States from 1930 to 1950. Although use of eigarettes by the Brit.ons doubled in the 20-year period, incidence of cancer over the "me period rnultiplied more than five-fold. During the same period, he said, American use of cigarettes more than tripled, but the increase in cancer incidence was not as sharp a5 the increase in England. Iie in- dicated smoF was a possible major contributing cause of cancer. (Fror; a ato•y in the Santa Anc (CaliJ.) t:epister) Fumes of Civilisation Dr. Seymour M. Farber, San Francisco tuberculosis and ches: specialis:, said "fumes of modern civilization, includinf smog but not necessarily the eigarette," are niak- igg more and more Californians breathless. He told the California Academy of General Practice meeting that smog and other types of foul air, coupled with chronic colds, are the major culprits causing emphyaema. lie said he could not list tobacco as a defv:ite troublemaker in this in- stance. (From a atory in the 1,os Anptlea Times) Accidental Relationship? Dr. Herman J. Tfoersch of the Tfayo Foundation at Rochester, hiinn., said there is no question of a relationship between heavy amok- ing and lung cancer, but a•hether , i Nation-Wide Lung Tissue Study Now Being Evaluated Lung tissues from more than 1,600 peraons are being evaluated in a nation-wide study originated in 1954 by the Tobacco Induatry Re- search Comtnlttee. The &c.ienti6c Advisory Board to the TIRC sponsored in late 1954 a conference of 12 pathologiati from various part.e of the country to dia- eusa means of coordinating a study of the pathologic anatomy o! the trachea, bronchial tree and lungs obtained from autopaied apecimens and surgical excisions. (The pro)- ect, called the Pathologic-Anatomic Study, is reported in the 1957 Re- port of the Scientific Director) The pathologists studied ehangeb. in lungs from individuals of both seiea, all ages and living in urban and suburban and rural areas. Lung CbanEes Wide Spread Results of the study are now being evaluated. Among the pre- liminary observations was the rela- tively wide prevalence of lung tissue changes among alI groups and all ages studied. It also was noted that the condition termed "carcinoma in aitv" was rarely di:gnosed by any of the pathologists and then usually only when invasive carcinoma was present. Agreenient was reached on tech- niques for preparation of tissues and the sections to be taken from strategic spots in each lung. While a somewhat standardized procedure was adopted, esch pathologist was free to use in addition his own tech- niques. Much of the work commenced un- der the Pathologic-Anatomic Study is being continued, and arrange- ments have been made for keeping the group of 12 pathologists intact and for holding future meetings. it's accidental, or bow much of a role smoking or many other factors play are questions for research to discover later. Dr. Tfoersch was in Portland to address the annual meeting of the Oregon State Medical Society. (From a story in the Portland (Ore.) Oreponian) Jtlouse Skin Tests Dr. ]an Macdonald of the Univer- sity of Southern California believes oiled or tarred roads may be in- Page 4 `Tobecco Tar' 1liianomer For Condewed Smoke (Contin ued f rdtn paae 1) particulate phase consisting of mi- troacoplc liquid droplets suspended in the atmosphere. The visible part of the bluish smoke is composed ehietly of these suspended particles. fiach droplet is an e=oeedintly com- pkz mizture of ehemicai substances. 8o-cilled "t.obactw ta r" na u al ly is a aondenute eonaisting chiefly of the particulate phase of the smoke and trapped by some method such aa ehllling to a low tempera- tnre- The trapping method dettr- ailnea wbether some part of the gas phase ls alao caught along with the particvlate portion of the smoke. Factory A-Hectin6 Smoke Composition of the smoke emerg- ing from the mouth-end of a ciga- rette varies with such factors as: tbe compoaition and condition of the burning mi.zture, the temperature of the combustion Lone, the time of expoeure of gaaea and particulate matter to the higher temperature area, the relative proportion of oz:i•- gen available from the air at each point, the leng-th of the column of unburned tobacco and other ma- terials through which the smoke pasaes, the elapse of time after it emerges from the cigarette, and probably a,any others. In a practical sense the factors influencing smoke composition are related to the blend of tobacco ty-F.es used, their history, treatment and condition, additives present as f1z- vorants or humectants, size and shape of the tobacco shreds, den- sity of packing, porosity of paper, volume, frequency and duration of puffs taken, length of the original cigarette and of the butt discarded. and other factors. volved in the increase in lung can- cer. He told an American Cancer So- ciety chapter meeting in Omaha, Neb., that many proponents of the cancer from smoking theory based their conclusions. on the develoj,- ment of skin cancer on mice painted with cigarette tars. "But common, everyday Los An- geled smog, painted on the backs of mice, produced greater skin car.- cerE. Which just goes to show that if mice are going to use tobacco. they ought to smoke it and not paint it on their backs." (From ar Asaociated Pre,sa atory in the T3'osl,- inpton Star) CTfl Pn.rt/ ie C-S..t 4022 Ct RI t I N C)05-J 2e1