Tobacco Documents Online

CTR HN 01 1326

1958 REPORT of tlie SCIENrhIrIC D1RTC't,CJR z i I / :LA ltEN(:F. /:( H /K ( ./TII.F:, tic.l /. 7(/ItA/a:l/ INIIIIti l'ItY Itl;tiF:All(:11 /://M1IRiI'1"1'1•:1•:

c)r6all1'LJtIOI1 and Policy The Tubnrrv Indus(ry Research Cnmmirree is the shunstuing a;cncy of a research prngrans into queations of tobacco use anJ health I: was organized in early 1954 by representalives of tubacco nlanufacturers, grower. .nd warchnuscrncn lhc ('onlnnttee irxlf ncithcr llpcratcs any research facility nor has any dclcrmination in the stlcntific Inl+gram lltllcr than making avarl.hlc ncccSsrry funds lhc .Cl icnn/Ir .4J1 iuuy RrrorJ kl thc Illl.attl+ InAuslry I(cx+rl h(•tnn- nlincc h,u full res{Hmsihltly for rescarch I>,Ihty anJ prrllv•Imming 1he Itl+ard consrsts Irf indcl+cndcnl cc'/cntists• Jlwlrxs, and cJutatms whll nlam tain thcir res/tcctive inslltutit+nal eIllh.lUuns lhe $.'IenUtic Advisory IIu.uJ dllcs nut rtsclf cngaKc in researth fnr tllc 1' I R('. In its crlnlnluing cllort t.+ cvr'I.c r..rtl rlrunJrJ rrscarlh Itr l;r.lrn, thc lluarll Ihis yc.lr ur./lril Ot /ll, It.iril Ilinl• uf ~V.Llnnt;l•ul I lnivrl+uy, SI I,lxliS, MI/, Ill hct0 lnc 3 It,'ard inrinlI1r I(ult,. •Itlrl~r.~nll' lninlt•Jil the llllafll'S rllelntl(r0tr W tCll A1%,1 •- ,r ~lil, l- .ll,l •t-M111', 1l•pI1m ti/llls uf tcnure, the 11/1ar11 elcclcJ 11r I Ym Il t,sl r.c a. Ir% ( hmnnl.ln h.r I')SR 59. Ile replaces in thls callacity 1)r I Irtlc wh r w.n hrNt clr.IrJ tllelrnlan in June. 1954. I)r I iltlc cllnunucs as J ItuJf,l mcnlhcr antl :n Surntllic [)irecklr of the T I K('. AII Tnbacco InJuslry Research Cltnnnittcc I;rants arc nlmJc uprrn rcctlmmcnJatiun of thc Sticnlitic Advisory lluard Rctil/icnts rlf I;rarn(s arc arsured cvmplcte rcicntifie freedurn in clmJucling thcir invcsul;:umns antl rcpt+rting the results of Iheir rescarth in the actclltcJ s.icntilic nlanncr Ihruugh rnedical and scientific jt+urnah and smictics 'Ihc irrvcstil;alrus rc cciving gnnts frum the Comrnrttce .rc ahlnc rcylun.rhlc hrr I,nlrlr%hlnl; or rel></rting their research results I t~1 ~!t It 1: 1~ // It •1' 1 1•: N'1' I F 1/: I I 1 It 1: l:'1' // It 1 I. U(1 NI li //)11l% 'I I/It.1/ /:// INI/1 N I Il1 Itl.~l: 1I1( 11 4 4111111 I"1 I I t:~(1 I.r.r I'!rlr) ~(rl l(. Nl t, l.rr t. 17. N. 1,

ti1:11':N'1'lFl(: AI/Vlti(/Itl' It(/Allll lu the 'Iubaccu Intlustry kcscarch ('ununlttcc KI:NNL• 1I1 MI°.kk11.1• LYNC11. M 1) , S( 1) , 1 1. I) ,(•ilurrrnun I'rrirJrnr, 1)rurn u/ F'utf.lry unJ 1'rrr/rJJrrr of I'ufJluluXy McJlcal ('ullcgc uf $uulh ('atulinr ('harlcston, Sou1h Cartrlina kl('IIAItt) J IIIN(:, M t). I'rrr/rmrr u/ AfrJicinr. Washinglun llnivetsity llrrrtr(ir. Washinglun lJnivcrslty McJrcrl Servicc, V. A Iluspltrl St I uuis, M'a(Wuri M.KI FN ('Allt•1 1., Pit I), M 1) 17.r/r+rrrr tr/ I'hunnut rd.rl; y ('rrrncll I lnivcrsily Me(Itcrl ('ullcgc Nt w Yulk, N Y. 1111.IIIS 11 (Y)MkOli, lr< . M 1) I)Irrt frn, (',uJiuvascular kcscarch tn,titulc ( Inivcrn/ty (if ('•rldurnia MrJ/caI ('cntct SJ11 I'rJrll11111, C':IIIIIIrrlla I.EUN l) JA('(qSSUN. M 1). I'r.o/rrnur u/ Afrdirinr, l)nivcrsily ul Chical;n 1lerrr fnr, Argunne ('rnccr• kcscrrdl Ilu%piral ('hicagu, Illlnuis , 1'A1/1. KOI IN, M I) A ++rv rulr I'rrr/r+.trv of l'udurluAy tlnivcriity u( Suuthern Califurnia, SihtK+l uf MrJitinc Lus Andclcs, CJIIIUrI1/J ('I.AkI-.N('I{ ('(X)K 1.11-11 F, St I) , 1.1. I) , 1/r 1 I) Srrrnn/u I)rrrtv.rr, Tuhacco Indudry kc.cal+h ('ummlrtrc Ihrrr t.rr F.rrrrnfett, kuvtuc It lrckaun Mcalurl.+l I ul+ur.rlrily Ilal Iterhur, Mainc STANI IiY I' kIiIMANN, A1 1) , Sr l) .Srrrnn/ir Ihrrtfrrr l:rnr'ruur, 'Ilic (n.tnulc hu ('.rnirl kr%r.l+li 1)rrrr fnr lirnrrrrrr+, 'I he I.ankcnau Ilu.lulal kcsr.u.h In.lwuc 1'IuLltkll'hla, Pcmluylv.lnia WII I IAKt 1: klliNIlOI-U. 1k , M 1). A+r.v rrur I'rn(rrrrrr n/ .Irrrl;rrv 1.dhn. IbqpAinn llnivcrslly S+hthrl uf McJl+inc It.rluruurc, hl.lryland 1:1)WIN It WII S( IN, I'n 1) , 1 1 I) l'ru/r t+ur l rnrrtrtu+ 4 ('t1ad .Cr.urvrr r I l.rrv•ud I Inivcr+lly ('.u+~I,n~IPr, A1.r.~.~+hu•.rll. Ii()I1I-I(I (' 111N KI 11, I'ill/ .~+I.n r~rlr 1, r.vur/n lrnr, rr.r

P1'C facC Alllrnul•h Iluti rel>.+rl r+ 111101 as Ihal td tl+r StrcnUhc Ihrcat++t t+( Ihe Jt,lr.u(u InJutrry Ncs.•.rrtIt ('aunruttlrc, it tc.ally tcpfci rnts .t ttK+lh•t.rlrvc ettrvrly In 1hc tcu'.uth l+rulor.rnr, Ihc Sttt•ntrfh(: ntlvrany 1)ujrd, thc Cnrt:uUvr uthtCrs .+nJ %/.+11, .rnJ Ihr v,rrr„u. rnJclvntl.nt rr.r'Irth .rtrnl+sti wMt havc rtlrn+lctl th. rnlmrual cnnlCrcrttcs, h.rvc sh.ucd tn+l>,+tlantly S+t h,ts thc A,aKi.alc St+cnufic 1)ircctut, I1r Jtntn•r1 (~ Ilr+tlcll, who Th;ts wttft }'.rret w+ultrm .rntt unurrn(; Cnrrf'y t.Iel-h.hCJ +ml rn.rnuatnrd an unusu.tlly t lu.c .rntl ta,n.trna Irvc c++nr.+t I wrltt Ihc n+ullrtutlc +d ntturf nfnr- .tlrvc I,h.ui% tu( rhC I I K(". I+rn1 r.rnt It ts Jx rh.+l,. mtl+tt»+I+ti tt+ ,clkcl sn tht• .uhl:tt n+.rttrr n/ .r rC(t+rrl tile nJrnl t!C t,,.(+t t+( tile gttaut+ wluth is wurkrng t+,l;Cthcr 11rr,nrghuut thc ycars. It is, huwcvcr, fhc haJttty tluly of the Scicntdic 1)nctl++t It+ rca+ttl Ihc cantmua/i+tn :md gruwth nf thit slmit u1 untty 11) a dt:gtcc Ihat ar-,tkes tile /imc hass rapiJly anJ afi~+nhtnl;ly :+ntl Ih.+t ut.+kc% uut jr+inl aJvrntures as a tcam c>tcitruK and spinlually 1cwJrtltttg I Ubservat imis On tteseai-ch 1N1'K(Itr(r( tY(IN (irrttfyrng pru(;ress in (hc Jcvctultntcnt uf tile rcscarch ptugtem Intu tuhacco usc and health Can again he rcpur/cd this ycar. As +a( Srptrmber JO, 1958. 1the Scicnufic Advi;ury IluarJ In 1hc 'Tu haccu Intlustry Kescatch ('umrnitlce has since its cstahlishntcnl in )unc, 1954. rrturnmcotJcd grants-in-aid (tu 75 scirntists in SII irtsulutiturs 1 ht•sr grants (tJvc all Iwcn approved hy Ihc T.1 R('. A% t•> (rl.ttncd in dclail in previtws rcpurl., Ihc St•icnlrhr Advrsuty Itnard drH-v nnt ntcrcty review gran/ appht:atit+ns A1uih tuf rt, urt,c, cllurrs, arul t)ttaul•Jtt ,ur tlcvulcd tu cxplnrirtg Irratmrang avcnurs rr( rr,c:ntlh and cnturu.rl;rny. I;r.tnt a1tltltCatiut+v (tun+ x'icrnusls lu c.trty uut nccJcJ invc,lt g,tuuns. OI Ihc S),2(NI,fNN/ in funds ntatlc avarLthlc hy lltc 1aahatctt Indu.try Kc.r.nth ('t+nuntttrc, incluJrng SS(x),(MN) Ittr Ihe curnrng ycar, Ihc I1n.rral hrs atlueFly I;raMCd st+nu 52,41(IINN/ to apItlicanls A ctrntl+iclc Ir.l yd ctutcnt tar tcrCnlly cttmplctctl luttjccts Iwinl; sulqaattctl t, y,rvrn in an++lhrt scchun uf Ihiv rrJttrrl Ahttal $15,(NN/ a year is gtanlctl tu rr.r.trth /cllaaw +hy+% lu n+i4tC.r1 .thtM4 sludcnls whu drvnlc Iht•tr ull ahtN+l ICnns 1.0 rc srarch r+n Inrtltltncs sctrctct/ and alqrnwctl hy their own in.utuutro. Iil.twl+crc in lhiti tci>,stt J(e ah\llaas u/ 11 tcsc:ut'h (aal.cr+.uuydCtitl (ur pu6lrtattun in siicnttfic jttutnal, dutnnp tJte l'.t.1 yt•at hy sttrrnlt,ts wbaa acknr+wIrtll;c suplturt rrt Ihcir wurk, in wlu+lc ttt in p.ut, hy lltc fult.aa.aa Induslry 12C.r:rrrh ('untmillce. 1'KIN('f!'t.ha .INII Nf•:.tiP()N.tilftl'/.fTll•:,ti Vdhcrn tile Infi:rCt'u InJustry f(c.rarch (ltnnnulCr w,t% tuF!envrtl rn 1'/54 antl a Sttcntihc Adviatty Itu.ud uf tn+1r1><'ndrut .rrcntt.l, w.rs rli patittlCtl, all ct+ncctncd, in.Iuthnl; tile Sctiuldt. IhtC.la+t, attil+tct/ tittetn tlClinnc Jtrinriplcs and re.l>,+nsrhdtuc.. It w;rN rrtr+gnvcd thel: ( I 1 lltr tail;in and n:+utrc t+( lunl, t.tnrrr :+nt1, ut I.rtt .r11 tyl,r, nt t.trttcr, pte.enl one t+f thr mt+N crnnlalc>< .rml tl+lht ult u u nulr, la+,hli rns that rnan4tnd 1t.ts cvrr I.tirtl (! 1 I ht• ttrrtrfdrRily cnul .uhlrty rt/ tarthnv.nt nl.n Jni .r.t• .uV al.++ rvulrnt .tnd ttc adutillrJ Ity thr va./ r»nitn+ty t,l tl,.,.+ tr,l, ,u.rl,l h,r tr.rert h, Ihrr.rpy urd iJut ,tliun in 1h,tr IrrI-I ( 1 1 I hr nntt :+at a'fN.1naC .t( tt'laaath•+I v1.+N.lt, .+1 e~•„+a +el+,at, t,( .r t.ru.i and cllt'il ril.rUtmvlul+ I,il+.rrn tnl,e.ttr u.r .n+J tlti.i ta.+) ! r,mla. n( thwaticv tv Iu.ItA.'tl nt.l a+nly I+y .+, a cl,tr+l ti, +, ,tt+l+t S

rf.+ Ss~ ~'r3 1 n ~ . 3tgr Sr±~F~"7t Ivocrtlurc bul also f+y the cuml+lciity of the tliscases antl the need (tu murc drrrtt ettpcrintrnlal rescarch intu thcsc thseaxs (d) 11tis rescarch tesk rcyuues crealtve skill, peticnce, tinle, hard wurk anrl nurncy 'llte fteMeccu Industry kesrarch ('turlmlltrc's sl,dcJ Irurla,sc is In aJvance sutlt rn e/forl to thc best of ils ability 'Ihe 'Iuhacttt Intluslry Resrjrch ('ommitlcc has Lccn mntt will ctm tlnue (u lie Llrlh(ul lu those principles and rrsl+rrnstlnlirics It Is nnt crrntitlcrrd cnuugh to spunstrr invcst11;,1tUtms sulrly inlo lu h.rt'cn utc In v.rrrrlu. lurrtls, even though we arc hnthng th, t cfltsling knrtwl edge in Ihis ;lrca is f:rr frurn accurjlc or sulhiicnl Rc.c-rrth i% nccJct) alstl intu thr h.lstc Ixuhlims tlf cunsulutinnal di+t•:rscs. M,nty IJi/rus td nu+dcrn living, of which luheccu u.c is unly unc, are IKVng .tudtcd fur tlucs Itu a Iltttcr untlt•rs/.tnJinK antl cttntrul of c.rnter antl hr.trl tJrsease 1YF/ (lFNI F: Ilf T'IIF. "1'(lllAl'('(1 TIIF.l1KY" I hrrr err Ihtrtc wht+ rn+M Ihrl f.tilure In atcclrl rht "Irr6.u trr Ihcrtry" of lunl; cantcr nl;ly result In tlclayulg pntgress Irrw.rrtl cvcntu.tl cttnqucst t,f thn thtre.r II rn:ty I.e nr,ICJ in 11JSVr1g tllal there has hrrn nn sinlilar imistentc hy thtnc whrt are muat cnn.rrnrtl with aJvancing rc+rarth into the cnrnl,lcxrttct ttf hc;trl Jl.rasr 1'rngrr.s can sterccly bc h.tnlpcrcd hy Ille rcttlgntUtrn Illnl nn,rc knrrwlcdl;i ts cNtrntral tn thr wlutitm uf a latlhlrnl. Il.trttcul.trly tl tl is .nttrrnllatncJ Iry .1 tlclcnntn:ru,rn antl a Inngrem tu dc velult Ihet Inuwlrtll~c Oo thr t+lltcr ItanJ a Inr,hlinl nr.ty wrll hc trhaurrJ, ;tnJ tls snlultnn dclayctl, hy Ihc su,rllunK aiiry,rJntc of an uvcr suultlthtJ .tnJ Intntalurt: hyltrrthrltit I hr allttuJc Is Ireul•ht wtth thr denlt,rr of I„r..drly dttlllusirrn ulrnt uml It,rcctl nrt,Jrltt.rutm nr Ah.rnrlrrnntcnl of tlngrnauc 1'cnrr•rhi;uutms 1 hc I+rr,l+tntcnls of tltt' Ir,h:rccu Ihcrny h:rvc I;cnt'tult•tl tntrijsurlay Intcntlvc antl ctlrmlvr luryl.rl;.rnde hy sclciunK cvitlcncr fur arltl aarrt- ing an acceltlance of this theory As a fe111I1, a ntrrl xicntufic alnuotlrhrre, cuntlucivc tn Itrcmaturily, unlr.rl.lnrc, antl in;tJityuacy tf puhltc jutlge- nlcnt has Ircrva,Ird Ihc whttlc Ilcltl Ihis h.ts hcrn al,rtlttl hy the crt111t11111JI antl Itrh.ttcu atllterrnl., hrlh Lty anJ I~rrrfcsti,m,rl, wh,r.e un~ mrn:tl ctunllr,rnutinl: IKrsltirm adnuts td nu ulhrr ju.ll;tnrnt., satrnlihi of ittri, thin tlretr uwn Whlle the resulung stlualiun is rigrrtt;thlc, u rs ntll lin.rl ur cttnclusive II ntusl (le /,rtetl wtth ctmhJcnce Ihat. In the Ihcld nl scicnre. Iht Ituhlic will tlctnan.l, nntl scicntitls wlll Iunvitlc, tvtnlmuctl rrst•.trth, hnllt (,;lar antl cltmt.rl• unltl yucsut,ns err an.wt-rcd anJ tl,ruhla all.ri, of hiy,tntl the ,lenl;t•rt of trlrtlrvc inlrrl,tiLmU„n AInr„tl cvrrN,mc .rl;rrr+ tli.,l Ihr IIr•,t It,.rl I nf Itlh.lt'cu usc nn :ln intllvltlu.tl i% a menrr rtf Jctcrrnrn.ttr,rn hy Ihc inJ/ vlJu.tl latnq; ;t tli.l.utn lhr .:nnc rS tuuc rrI tfctt,urn. rcl~.trdnll; :rulurnr.htlr tlrtvrng, sun h.rlhrnl~, tlrcLtry pnltt•tlurr, .nnuunt ul cRt'rt1\l', JI1tI a nunlht•r td gcncr.tl .intl wrtl.yrrr.rtl human cusltnns Ih.d rn.ty tuniirvelrly allctl hr:rlth untl .nrvlv•t1 Ihr Irul-hc ian rest a»uritl thot Ihrr.c cnbegctl in (rcrInlnl.lncc ur sulllttrrt td reu.ut h art• lust :rs intp;Wint Itrt Illc arnwcrs as :ulyunt' can I,c I hry arc .rltn dc.rrlly irl r.rrnr.l am1 arc t)rtcrnuncd tu wurk wllhtnrl untluc h.ulc of Jv1111L1(,Ir w;tslc until tltc gnal is allarnrtl In ortJcr Iu l-.ivr Ihr puhltc a ulurc cnlnpIrtc prcture uf the sricnulic knuwlcdgc tm whicll it nt.ry hase its juddrnt•nt of tuhacctr and hcrlth tprrstittns, tlrtt rrlwnt prr.rnh snlur of Ihr rvitlcncc thal has mN hrcn wnh•ly /rublt, vitl and nl.ry havt• hccn larticly uvcrlnttketl irt Ihc late t,f rntultunel .r1l.rtks rltal h.tvt: hccn nt.ulr un lub.tcro usr I.INFS / IF 1•:VII/F.N('F: lhrec tyltcs of cvitlt•nce ullerrJ hy atlvuc.ttcs u/ Ihr Inhacctt thenry in crmnrcunn wnh c:utccr :ur tlrlisllc.tl stuthrs. Italhrrlut•r,,tl invc.Ut aut,ns, antl aninlaI c flllcr nnrntaliurt Slrtiairml tilurlirr 'Ihe sl:tustrc.tl cvitlcnir wes Ihr lirsi Itt :IpItrar. V.urnu% stuJlr. t,l sclrctrJ Irulrul.tlurm indriatcJ a Irtyrlrvr m.ubcnl.da.tl a.,rrt t,trnrn in .rJult whili ru.tlis t,f ccrt.nn ,tgi gruup. htlwren rflirs.ivi uf'.ncuc .nluktnr~ anJ dc.dh Itunt Iungi;tnccr. Ihr d.arr.rUun w,rs wc.tk .t11J Inu.h Intac untcr Iain Lrlwicnlnllr, crl-.rt nr hFltl trl-.ncllc snurkrnl; II .ll,rr v,trlctl ft,r Ihr,c tyllcs nl sntul ing tn Iltr rc.ulr% ttbl.tun.J in studrr. hv rlrllcrrrll rnvcsul-.rlr,rv Ihrti .rl,lrcer.tl carly ur Ihi rvelueU,tn ttl Iht' .fl.tlr.ltr.il J.d:r a.rl.nn m.tlrrr tltllrrrutr. r,1 uptnuwn trmtrrnml• .rviral h•lat I•arrn. In Ihi srlu.r U,rn I ht ti tlillrrrncc. flrll Cfll.l / I ) ('irl:nn .I;tlr.licl.tn. hclrt•vc 111.11 nrlr,rl,rrrnrr of snt,rkc ts .tn rsst'nlr.rl of vrl.tlly rnyturlnnt Lltltu (/lhtr. IanrluvrJ cvulrn.c Ih.l rnlr.ll.~ltnn w.r. ,t nrl~h~thlr I.rrlr~r (.' I('irl.un .InUsti.r.ul, hilu•vi Ih:tl Ihr tl.unrt•tl h.unt/ul rllit r. of Inh.rtr,r tnr .ur tlnccrly .utJ Iur,In rUunercly rrleliJ lu Ihc armrtnu ,rnJ dmmnun of cvlH'.utt' (/lhcr% hilrrvr 111.11 Ihcrc It .t rhrrtA„IJ ulr In whu h c11ct It .ui ncl•Irl-tl,lr ( I ) l'trt.tun ,1.r11.uu.tn. Ihw,arlc t11:11 r Ielrnl I,rrt,,,l r( J.Itnnr rlur.rtr„n t. nrtt~...rry hilrni t.rntn,rl•rnti rllrtl. el.rr 1.trn,.,lr. „I Ihr Jnr.ru,m ,-I .,n h.t 1., 1 1. ,.l v.n t t r,nstJt r.,hly .1. .I„ Il,,,.r „I Iln rtl.,lt, r „nl,rntt.,n„ nl lutr.,rt,.,t r,nr of .r nu,rd,rr . nr,ytnr, I.,t 1, .1 . • 7 (I S•

llntrl ddlcrcnccs tif t,pinirrn of Illc.e types c,ln tre srulrJ and their Initt.ll aphr:lr;rncc c.ld.ltnrd t+y S1J11111tIJ/IS Ihcnlsclvrs, yu,rrrrrrrr(rve mlrr- Itrc1a111rnS of Illc effect Uf tUhJci11 h,Hl'tl lll,lln sIJ111111JI Slllrllis N'111 rCttlalll t,f little valuc. ('unflirtinR Ilr.ult. CiteJ A more rctcnt extcnsiun of the statistical :n%ucijti,m t,f tnhacro uu wilh Jcalhs frt,nl a long hst of diseases cuml+ltcatrs the rrm:tttcr st1I1 fur- Ihrr at a tittlc whcn the situalion, even as rrFerJ. IunK t'.lntcr alunc, is nt,t well intcgratetl and reconciled An cxantl+lc clf the type uf crrnlllcting results which apllcars in Ihe strtistical data .nJ whith nceJs exlllrnrtiun rnd!tu Ictv,nulrat:nn is +ccn in dcalhs (rrnu c,lntcr rlf Ihe stnnlach ln white rnelcs An Anrcrrc.ln rclx+rt shows thc rm,rt.lltty r,rlc frtlm +panat h canccr t,f smr,lcrs is 61^• R•rc.llcr Iharl Itrr nun stnokcrs II thc as%rxldllurl wcre une of tdrr.c and rllctl, one wtluld cotllccl the dc,tlh r,lle frrmt c.lnccr of Ihe slrrnratfl to hc (In thc rise wtlFl rncrr•r.iJ tll!.rrcllc use Acthtnlly 11 S(iuvr crrnncnt h);ures sln,w a drtql frr,rn 10 7 Jralhs I+rr I lN),(NN) in 1'J.14 tu I) 2 tlciths hrr IIN1,(NXI in I')Sh frnm Ihr% cauu A rrfx,rl puhlr%hctl irl I`)57 in Ihc Irtrrru,rrr Inurn.rl r•I I'rhlrr llnrlrh rcllurnt',1 that "thi% stutly (.nlcrl tu In,lir.rlr :uty tlf,lucct,lldc d..,Kr•rUun I,c twrcn vrlr,ArnK .1n,t I;.rvtnt t•tntir •. Ort It•Ir of Ihr, a 11111101 ,L,tnut.,l In,ly ,In,l%cd e•li•rth r•tlc frnrn stran.rch cunrcr „I 2R I,cr IUII,IN1/1 .nnnnt; .nr„kcrn• whili Ihel („r nun- srnr,krrs was •11, ror nc.rrly S11"S 1.rc.,ltr :tlinr,.t cX.,tlly Il,c rclir.r of tlro Amcriran finJrnl•, Ihc ctlnfuu•J •tnd crmtrarlrtlrrry n•rturc tIf Uirtic hn,linl•. t+ cvrJrnt 1•u,u Furfill Stnnd (1u/ An esintinatitln td Ihe rclx,rlrJ .taU%lic:11 asux'iati.,n bclwren cil;- arcttc srnt,krnl; anJ lun); c.tnrrr rcvr,rl. Iwrl f.tcts clc:uly I rrvl Nun snu,kcrs dcvclt,(p hrt,nchrrl;crnc carirnunta Srrt'nJ: 11,c uvcrwhrlnlinF nl:rlority of smrrkcrs Jtl not (()ul t,f I,Sh-1,J7h Jceths in Ihr 11 S rn 1957. 11 S vrl;ll staU.urs Shuw 111.11 I l,4'IS tlr,ltlts ru Ira 111,111 I I,cr tcnt / N'/"• 1 were frunl luny; cancer rcporlerl as lrrnnt.lry. 01.11 i., I,clicvc•d Irt have rxil;- inatt•,I in Ihr lunl;s and nut Ir+ hive sl+rr,nl frr,nr il,cwthcrc 1 lhc flr%l nh.crvatirm stu,ws 111.11 vnr,krrl); i% 110 an cs.cnlral trmrhlitm h,r laraIr,crnl! tl,c dl.casc '1hc sctr,nJ ul„crvatrun ir,nstttirlcs ,uunl; :nul t„ne,n, mr; cv,Jrrl, r 111.11 Ila• t Il,rn1 nI c.rn..,ln,n r,l Ihr ,1r.r.r,c t, --nrul,lre I h,, rnl. ,r n, r rs ~ul,l,urlr,l F,y rI,r v.ra I,,,Jy ,I t~tl„~rirru . rn n,r,1r, ,I r, " r.n,h ,Lu..int• 11i.,1 ., nirnrlwr ul .,.n,lrlwn• n,u,t txtur ,unulr.uu'uuOy. t tIr surnc ct,nsldrr,tl,lc scrlcs uf factnrs must inlrr.lct ln ,r It.ulr.ul,rr rn.lnnir /n rndrr Irl I/rrHluce any parUcular disrase AII rnJtc.rln,nm arc 111jt Ihr cundrtn,n kn.rwn as hrtnlchtll;cnic cariinnrua ur lurlg canicr is rlu r..rp tUtrn to Ihis gcnrr.ll ulrJical e>tlscrience. Much f,h[Ir,snl/hical and seruantic Jiscussiun Itas bccn tlcvt,ICd tr, st.rlislical currrLltittns and their relation Iu the cunct•pl of "c,nls•rlirat" of a Jl.ea+e 'Ihc I,rJc11CaI issues arc actually rather sirnhlc. 11'Mt'lI1C,lI Coll,rrlrrlie Il,li 1IC11111nstrUlCl1 that IIIC cI1r/I/16•y tlr tlcvrlrqnnrnt of mrlst dni.rsis, f,,ulrculary cunslilututnal thaascs, is invauahly cnurldc4 Mrny facturs cntcr into tlle (ung chain of causJtlnrl Itrtlcr unJrutanJrnE of Illc trslx'ctivc roles of Ihc several (ctcttrrs involvcJ Iras usuatly rrsullcJ in iaylrnvc,l lnrthnJN of prcvrntitm and cuntrul f+y slruwinl; nrw wrys in whlt h thr t h.rrn of t eu.aunn carn tlc hrokrn rutxc cllrctrvcly I of ul,l,rnrr, 111.11.116 w,ls as.rx'i;rlyd (nlm early tinlrs willl Ihr "h,rd art•' of sw.uull% anJ nl:u.hrs This errunrtlus "uuesnta"- hence, "I/aJ arr" Ihrury h,nl; dcLryrJ Ihe cvnlulirln of rfliclcnt ctan•iuvc ntcaslnrs, allhuul;h a tlcl;rcc nf ctlnlrttl was achicved hy draining sw:rrnlls nr Inuving Ilctq,lr nw,ly frunl st:tl;n;tnt walcrs. Whcn Ihe nllc of Ihc (cnr.rlc un•.ytulr, (Anr•I,hclcv) was IrernrJ and it.life cycle JrvcrlhcJ, a uturc rllcttivc and Irs. cKl,rn.rvr nlclhtxI of cunlrul (x•carrle availahlr. Sl,rayull; vlahnant w.r/rr wtlll url antl I,rlcr wrllr insrrtlcidc% killed Ihe nlu.yun„ I•rrv,rc I'ull knt,wl cJl;r of Ihc rulr n( PI:ISlilllll/t//ll in InaLrria (lruvideJ untlrr.t,rntlinl; of Ihc acntrn ul yuuline and hcllx•tl Jrvclup nuve ellcctivc trralnlrnl (or Ill,l.r whro hcc:lnrc Infcclrtl Slrll ut„rr rrrcnlly, sludy tt/ rntlsyuitu hchaviur Il:rs rrvialyd llrru 11.11111 of I.rt,rnl; a src.t.l t•n well% irnmcJi:ucly ,lftcr .linl•rnl; :r vrrtuu 'Irr.rl inl; wtth 1>I11 Ihr hrtlrrwnn w.rll, uf ncll.uie Ilalirn/s h,r. F•cct,ntc an cllri tivc nlrthr,J uf I,luckinl; Ihc sllrr:lJ of m:ll:uia a( its stturcr '1 hus, Ihc vr.rurl t,f cr,rnl,lrlc rra,liraLrnn td Ihis Jlsca%e, whic'h still kill% rntuc lK'trl,lc in Ihr wurld Ih.rn rny ulhrr, has actually hccuntc la:lctic.rl (tn Ihe first lime rn In.lury It wnnlJ I,r Ixt"rl,lt• Itt clch,ltr (,hJ.,.rlldurnlly Iltr drt'rrt• h• whrrll n t% frrr,l,ir 1„ t.rll sw•nnl/s, rnr,.rluitus of I'Iesrnr,Jr.r, rcytc.trvcly, Ihi "r•ruvrv•' tlf rn.tL,n.r• bn1 Ihr% is trl,vrrru.ly yuilt' unuulxnl.ull trntc Ihr Inatuc:rl rr.nll 11.6% I,irn „I,I.unirl titurlir. .rI 1'rri.u /',...• l1'rn• ( anr.•Irt. I tutr. Ihc r,nl.rl Ihr :nlhrrcnlv of thc 1„h,ni„ Ihtti,ry L.rvr t hnl (rnlr,l rt•.,.n•Ir u.,rtrr, Ir• I,rt•,rnl ,rny r,rhrr l,l.lu.rhli .rlr,rr,.rlrvr itl,l.rr,., u,m lh,y n,.,y h.r.r .ul,r„rtr,f hrrl rnurnnvrrl Ihr 1,•,.,rluhly Ih.,l Ihr .r% vrKi•ru,m hclwrrn nnri.r.rJ tli.uh% Irum ccrl.un Jr,r.r r. .rnJ t ltc,,nc t) 9

snn,knl}( nlJy tcllr.t Itlc cumnl/tn inllurncc Id . 1111111 /.l,ltn Jv yrl untcCnVCJ Illlwcvct, Iwu cvcnls nf Ihc I,J.1 ycat--l,nc %(+c( l(iC antl nnc 1':Itcral h:lvc (+rt,vlJrtl ullrresltng evitlcnte Ih.ll Ihe slml,lc t Jusc Jntl cllct I Irl.ltwn 11111, sk/ cJ(;crly I'r.nl,cJ by Ihc tt)hJttn Ihctlry I,rtqumcnts nr./) nt l he Ihe CrlrtCtt Ct1,lAn.lUnn 'I hr Ilr.t c.lnlc ftom Sit Rtlnald Fishcr, t,nC t,t Ihr wt,rlJ'. I,rc.lt sIJ t101CIJllt. J/11I a IcnuwncJ biologist as well In the luly 12 Jnt1 At I;u.l ll), Iy1H, usucs tlf Narruc. he published two scls uf mtcrestin); t1.lt.t t,n lilr sml,king hJhlls t,/ twins 7ltcsc pa(><rs show Jchnllcly Ihel ginitli t11.1rac tcri+llcs mJy Ilcar tin future stnuking habits Slr RunJIJ uhlJineJ Jala t,rt the suulkinK hJbils td Iwins htdl. "IC1rn- s/lll:Ir tiiJl" anll "nl+n ItlcnUCil" acls 'Ihe iJcnlicil Iwun, Jminl' Ir,nll .1 (crt/lr/id uvunt, Jrc rcally a stntClr InthviJual JrvlJrtl tlurml; cJrly tli vrlt,p Int'nl ullu Iwtl Sc11.rrJle cntltlCs Illr nlln NICn11.J1 (wills, Jrl,rllg I/„In two Icrl/hTCJ „vJ, ur t,n Ihe uthet henJ Iwu dlvnnt I inJlviduJl. I r.hcr's hrst 1,.1(trr sht,wrJ Ihet .Ilnunl; Illc (leirs uf Itirnllt.ll Iwlns, only ?q"S he,l tliJrly unllkc .nlok/nl; IlJhus Ilnwrvct, Jnumg tlh: 114,11 1tlrnuc.ll Iwuls, 51•.' II.IJ ddtrrin(c, m snulkulg It.thits 14'hin IJIC yllc.lnm wJS r,ri.r,t 111.11 Ihc IJcnlicJl twins nnl•I11 enrrl FrCJlt•r nlulll.ll s.Kl.ll Inllucntt- t.n Ilii vnnlnil, h.ll,lt~ Id rntIl t,lllc'r th./n tln) rlutl itlt nlu.ll IwUt.. I I.h,t I„ I'I, I,..I .ttl,l l n. l,L,I., 11" .i lnnllrlncd his cJrllrr /InJu,ps 1,) Olnwnll' unll I/'. ..t nl, nnt.,l Iw,rl. Mitlh ut1111,c snltlkrnl, Il.lhllv tunlll.uc,s wllll 111". ..I n,.n 1.1, nli, .,I Iw/n. In atltllU„n Ihi.c tL11.1 sh.,wt l Il„I Iltr .ul,ll.,l,ty lrn alnnnl! NI['ntll.ll (wlns w.ls llnn.111i111 w11:1hi1 II,(' Iwln• wili af,.1r.11iJ Iruln c:tth ollltr .11 hltlh (JV Jhuul hJll td IhC %(ls wirc) t,t n,H u•I,.,t.ltt•tl I hc yursli,,n uf ctunmun htnnt' rnvirt,nnlcnl was Jl,tl t tm.nlrlcJ hy I-ishcr, antl it h.11,/,cncJ IhJI thc I,rrluds rlf a ctnmmon h„nlc cnvut-nnK•nl avcrJl;CtI Lr.rgrr In the nr+n iJcntic.ll Iwins Ihan In Illc IIICIItIIJI, a sltuatiun wht.h I;.IVr a I;rcJlir t,lllwnluntly ftlt ntln I;rnclii Inllucnlis In cnl,rc.+ Ihrnlsclvrs Illus, 1t nl,ln•.u% 111:11 .t ccrt.lln lyl'i t,t I,rr.mn t. I;uml; Itl I,c .1 trtt.un lyhr uf .nl/lkrr I,r J nt,n snlukcr I It ntc, If Ilic .rrltd.crs .lnll n„n .nll,kcr% hrvc Il llcrt'nl hr.lllh rl.ks :u J l,.ut td Ihcu h.,a. hw1ug1.Jl n.llnrr. a IIJIF111i.1I :11\I,CIJ11„/111I high r11.11I1CI11.111tJI s/pnlht.lnic I,rtwrin Ihi/r .nwl inl; hnb/1s :Ind I,rr,F,,ll,lc rlsks uf tlc.tlll wt,uhl calsl wllhnul vmt,klnl; hJvlnl' ;uty l'Jlr\:tI c/irtl .IS such II i% n„) nc, rtC.lry JI Ih11 t., ;1r1;11.' Illr t11/.111111,111V1' \I/'/,111t allil' nl 1 nl,rr\ J.,1.1 ns Ihcy sL.ul,l Ihry .In,w I,i vt~n~l •,Ily th,uht tl,.ll a(,I,vtill,lr n„ I„ 1 ll,.nl Il,c t./ua• .,n,l , Ilrt 1 Inl ,llira. I-Ill•ly ct t r1.IrJ hy the tuhectu Ihrory prtryxrncnb Jltrs cRist and nlust Ilc cvJlllatrtl Slr KI,nJlll 1111111CI( rel'tlgn1TCS IIIJI hls llal.l atc uf a IIrCI1/t11rlJfy nJlure 11try scrvr lu cstJhllsh a suggestive and stunulJling line lur resca.h In Jrlctnunc Ihe n.llurc anJ exlcnt uf the bul genctic faclurs ullvtuuwly invtdvcJ Ilis tcsults as they s1anJ are ntll intended to rrplace or clnuntJlc Ihe eausr JnJ elfrct hyputhesis. '111ey Ju, huwevet, make it necrss.ry /ut that hylxlthcsu to "Inuvc over" lu Inakc ttKmt ftlr anulhrr Iwlsslhlc C(I11Jn:1t11111 II will I,c intrnmcly inlcresling lu fullow Ihe futurc tltvrlul,lucnl t,l research whirh Inay aJd eviticnce lKJring on biu henclte t'hJrJr(cr/vln, as Jclcrnlincrs tlf human hahits and hurnan survival rlsks %muRinK .\At/w IliQrrrnrr. in /'r..pl.•Y lllc scrttnd catr}tury u/ cvldcncc bcars tln thc hyl,ulhcsls 111.11 vlmc heavy slnukrrs are lyhes uf I,cl,hlc whu stntlki! Js a rcllrcliun uI J crrt.Im l/.ychtl.um,uic rclJtit,n.hip and /erulw uf living Ih.ll atc ch:IrJC(crisuq: u/ their biulul;ic InJkc up. Such pruplc wuu1J ddlrr Iruut nun slnukrrs in title or ntt,re psychn physinhlgical cllaracleristlrs wluch shtwlJ, t,n Ihc hasH of research, he rrcugnitalde, We wt,ulll nul, uf cuutx, e><prcl lu finJ IIIJI nll heJvy slnttkrn wrrc of une ur nlure Jillrrenl lylxs Irunl ydl nun-sruokcrs, hut thJt in the snn,k in(; grtlup tine mlghl lind a predtlnlinance ul nne or n.urc tyltrs d/1lcacnl frum Ihusc forcJt,lninating in the nrro-srryuking gtuup 'fhls ullcrrstull; and cunlplr>< Itruhlrm was Jisrus.ctl ut slnn. Icngth ul the 1957 kcl,url tl! Ihc Scicntdic I)Irctlur. [)UJ uhlaincJ srn.c Ihrn hunl a nuluhcr t,f inJclK•ndcn/ invcsligJlluns sl/ll Ju nu1 itlcnuly spci/hr lJtt„t~ 'Ihcy du, ht,wrvcr. strlingly sulryHlrl thc fly/,utht•.r. Ihat smllkirnl; h.lhlt. ruJy Ile a l'tlltt'1//111IJt1I ul aclivc, t:y,id, intcrnse and vt•nturesutnc Irulllu of living I:.xisling cvldcn.r indicJlrs: ( I 1 thJl A111crrnl binltrlyiJl types td I,erstln ti.let Jlllrlcnlly t,, pvyihu pllyvultlglral vlrrss :rnJ str:un; ( 2) 111,11 .I/th ddlrtt•nccs in IrJitiun JrC Jl,II• It, inllurnt c Idly% iulnl,nJl InnctlunJl bal.lntc :utJ un1.JlJnte wilhln Ihc Iltldy, ,,nJ ( 1) Ihat wth intcrn.ll rlnh,ll.lnccs whCn tlut nl it,ntr,d td Illr t,rl;anitln nlJy Ir.IJ Iu dl.rascs ul /ndny tylK•s, IncluJlnl; lun,nl furmaunn I hclr n n„ t nnll/, 1 hi Iwt rn thl. IlylaNhr.l. t,l la I...n.0hly I11,. Jil Icrt•rur an,l Ihi Ir.ull. td Su Ilnn./hl I LIII•r's sludy un 1wln. In 1.1, 1, Ivn cL/, dlllc/in, t'v In I-It 1111.11 nrul„ I,hyanlt,l;lt .11 It lnlu, w„nIJ I.r l,nt ,.I

Ihc I+.t,tr tr ntrrlI utunl; I•IC'r,rn m llrr ,rnlrn t,/ 1„ytltu,r,nr.rlrt tlrllirt•nt.i, IIim}I rlr,t,r„cJ (•t,nltnucd ri,c:uch ut 11,i% hcld, ntt:lutltng inf„rnt.tl tr,nlrrinir, t,l thr lylk alht•.rtly F,crnt, hcltl unJir thc :trrtlttit•s ul Ilii 1t,Ir•ttct, InJu,try Ftr- Sc•ut h('nnrnunrc• i, c„cn/t.tl h,r I,rt,l;rrs. luw.utJ, tr,tnl,lrlr .rn.dy,l, 0 .1 Ihc rcl.rUt,n t,f Stnnking Ilahlls tu Fhc:rlth and I, I,.rng ,rrl-l,ultc,l t,y Iht• 1 IR(' 1'rlhulrq{irrl Invrrt it;rt ion. I'.tth„Ir,l,rcrJ cvrtlcnie, h•r,rd t,n chruial ul"crvetl,m,, ftt,t t.rurr uuu Ittt,ntrnrntc rn an cllr,rl Ir, t,l,Ijrn ,ul,lw,rt Inr Ihi tnl,.,tt„ Ih,Wy In I45A tl.,tn wt•It' I~ul,lr.l,i,l nn nutt,nt„Int ,tu,lri, nl lunl•, Ir„~rr id,Lnnirl 1.rulul„y (r,nn .r ,•anl,.rr.rlrvily Irw ,rtrukrr, .rn,1 Icwir nun vr,- ,l, I, 111 .r verr.il4 nnn,t,.'I "I .ui.t, nt Ilti lunl•,, r,l h„Ih, ,Iruttur•r1 tFr.ntl•i. rn the durtUnn t,1 th.nrl•.rnvdlrr,n rn,l th,.,rr.ml•,rnrirnt Ir.rJ tKC,rrrrtl Iltt,i wcrc rt'I,urlyd Ir, I,t• rrn. rt nrrmirnn, rn tl,i Innl-, t,l ,n,,,lcr, Ih•rn It nun ,nu,lru Ihi,i tlr.rnl•i. wtti ttur.rdiri,l I,y Ihi rnvr,trl•,.,t„r e, Ir'rnl•, /rrr,.rur Il,t, l,.,irn r•I r.rltrly .ittclIItJ I,y Ih,,,i wl,,, I,clti,ttl trt Irdr.tttto I;utll I rnni II,+- ., ry ,l.,rl. It„wr tt'rt li.ily rlr,e/•tt-imirti tlct, bq,i,l .ununl', tlir u..t I.i, .r, Iu tl„ ,t " nl,lii It t ut.rt y:nnl af•rnlr..utt i nl IFtc rlt,t rtf,tnm .I Ihi,t• lr,r,m. r, I., rnl' /rrcr rmr rrnrrt l itr, w.r. Ilii t ruR nl tl,i wlrr,li n'.,ltrr, an,l it w•r, Ihi rnl, Il•rct•,ur,rt nl Ihi,r li,rurr, t, 'I,rt' tdrttcrrnrl" r,n wluth thc wlrrdi t'dr!r.t• t,l I,.rlhr,lrip,tel ivirl,nti wn, 1,11111 Nru• Hr /nr.l. Kni.r, (Iruvfi.rru At thc Sr,cnth Inlrrn.rw,n.rl (. .rntir (tn I r nJ„n, Inly I'/SH, scvcrnl tc,carth rclx,rl, wcrr I'rc,cnlitl wlutrt Ih.rvi Ihruwn niw I,t•ht Irl,un t!rl, lnr,hlr m nrt indilcnlinl (rnulr uf An,itrr.rn w,u!,in rrl,t,rlil 111.11 thr tntl tlc'ntc nl Is.r,.rl trll rnirl'rr,wllr w.r„J„irtiJ rtr lun!•,, t,l h„tlr ,rm. lct, .,ntl n„n ,nn~lir, S,• .,I,,, wcrt• Ihi v.ur1 nr, tl, /•rii, .d ,Irwtur.J rli."rl•jn,i.r Iwn ln„wn .r, mir.,l,l.r,ta :rnd Ilrr .r,lv.,ntt'tl 1„rnr r,I Ihr, I,rntr„ wlutlt Ir.rJ t.i//t.l I•r,t.intcrn,r, .. Ih,,, ,!,.~nlr, tht,rrn,f .r14,rutiru.ttilIs .,, Itr,l,irnt1Is ill tlu Irrr.hrd. „ hr. h n •lir, , r!t .•1" ,• J r.. v r,.l. .r i.l n h. rr ~ n~r~ . r rn~ r.h ru . r, L~n .r, i "pre canicr" antl that tu inlcrltrcl Ihem .s su.h is In rttrctl thr scrcnullc evldrnic. 11 w.ts allu reported Ihal "7he rxcurrcnce rt( Irncutnt,nl.r Ic:rdt ft, el,l'hebeI pallcrns (tissue ehanges) sinular lu thule /uuntl tn hravy smukers "'I lut tntl,rtrtanl fact proves Ihal these thenl;es are rnUrrly nt,n tl,a:dic lur luhaccrt snn,ke. 'I hc,r lacls, cuupletl with Ihe previously mentioned strong dnuF+t cl pre11ct1 hy m;rny I,nthuingi,ts concerning thr prc canccruus Srgmhtenrr uf Iltu oh,crvrtl l,nlurtrn•try Ussue th:rngrl, shake Ihe lt.rlhult,l,rt.rl luund.rtl.,n rtf Ihc Inhatrr, h7l,nthr,tl. A uimrl 1:.I.rrirurut.tiun Wt,rlcrl in thr ht•itl of ranier rcx•:.rch knnw tlc,l Ihr rr,ull, 4.1 enuu,rl eR lrt Irnnrlrtetn,n, ahrlr ihnlturl•utI, slruultl he e>alralu,l.rliri Itr ur.rn wqlr t t Irrmc t autrun 'l ltl, 1% r,lkci.rlly su ( 1) whcn Ihc anunal Itttur tldlrrv Irurn Ihc hurnan In ly(,c tut IrK'aliun ur ht,tlr :rntl (?) whcn thr +uD,l:uui, fuuntl tn 1•.r a(uve tn :rnirn:rls ILlfcr in rttnsUlnhun, crrn.crut.rw,n, r,r nr rnt•Ihnth uf :tl./,lrcattun Iturn'hux cxprncntt•tl n.uur.rlly Iry 111.111 1 ht• 1 1.1% svc c.•rnrldr uf j ot,c m whrch rnr,lt, ti nul all, rd thc,r vart.rl,IcS art• ur vulvid I, tht' sirlc% rd ntuch puhlrivrd amnr.rl lt•nnlmf, c.lHnntinl. On Ihc 11Jstt r,/ the exltrmrly in,ecwe /unnrL•tnt,a of tiuvrty ul luharrrt Snn,kc crnricnlr.rtcs p:untrd ttn nntu.c :rntl r:rldul %kin, Ihitr 11.1% I><en hullt tn extraurdneuy su/krstruelurc nf surnu,c :ultl I,ritltcw,n, evrn Irt yu.tnturuvc "ctjitnr.%" applied 1u man. l.unR F.. p. ri.nrnf. $hnr. NrKnlior Hr.ulf• Iluw rII atlvilctl antl Insecure this 1tnKeJrur ul t,vrr rrtlcrl,rcl:,'run I, wat Shuwn hy resultl JcxnhcJ hy a Kranlcc uf Ihc lt,b.rttu Intlu,Uy Re srarclr ('ttnuurttrr at Ihc I'15H Intcrnaturn.rl (':rnct•r l't,nl•rct, In Ihr, wurk, the hurl;r nl nu.e were hiavily antl rcl,iatrtlly ctl,t„rJ tn whrrIc tr,lurruc tvrrnRr rrhtaincJ fty ntctlurl, rlu,ily :rlut Ir, 1111111.411 srntdrnK ('unlr:rll tht, wtlh Ihr aninral (rtuLLing wnrl whrth u,itl thr +Am. uwally Sha.irl, ul uuit•, antl Ihe vrt.rrt.t run.rrrrrrurr ul Ivcat yrrdntlui, n/ ,rm,1r trm,lrn,rd Irt,m r ,mnktnl~ rn.lthrnr Ihrri r, nu tl.,ul,f .r, la Ihi 17t'.rlcr rr,crnl,l.rntc nl tlhr mh.d.un,n wntk tt, tlhc at lu.rl t rutJrunn, uI hrun.rn ,vn„lrnp (n Ihr rnlr.,l.rlr..n w,uk Ihcti wt ri r,l„ir,t J Ill Ihr Inn/•, ,•I nu, thanloi, dnicllV iurn/,.,r.thli lu tln„i tli,trrhrJ 1,of Ilir /,.,th„I Lr.l. rn Srnr,l i r, ,nJ m,n l t r, Ihrn, hrrwtttl, Iwr, vrt.illy rn,la.rl.,nl tlnnl•, h.rl,lar,,,l , I I I N1'Fhtn itl,mun• 111 t rt•,.,Irtti ,ntnlt• urr, ,l rhr I •I II

r.rrut rrr rhr Ir.nx rhtupprorcd uml wnc rcpLircd by n.rrrn,il rr+sur I Ilts was rnlc farwtf that they were nttt in fact I+rrcanrclrru. Ic.nrns ( 2 ) Whcrt er<lxtsure was rrrrunurcJ into trlJ agc anJ IhrtruKhtrut thc nurrnal Irfe sltan uf the aninuls, the fcsinnr prrtrtrrd hrrt nn r rrnr er nt r urreJ I Ihrs was a scccrnJ Irrtwrf IhJI they were nut lacc.urccr.Hus 'lhcre had Lccn rcfxtrtcJ previuusly negative resulls in anintals after expnsure ttt cigerctlc snutke In no previous case, htrwcver, hes Ihcrc Lccn a prrallcl scrtes of 1tJthrdngical ohservations so exten,ivrly and accuratcly madc. 'lTre recent work refxxtcJ atx)ve definitely leavcs it ule tu the adhercnts of the "tar ariJ skin cancer" hypctthesis In show why anP ubrw IhJ1 highly developed srlJ prrqraganJited theory provides as Jrrect, aignihrant and c.trapulatablc cvtJcncc as do the olnrc recent negative results Id srnukc in the lungs 'Ihe smrple IJ(ls Jre that ( I ) lung. u»ur in nute is nuac like lung Ussue In nt•rn 111.111 is skin Ussue ur nricc anJ, (•' I crlxnurc Irt trl;Jrelte srnr-kc in mlcc is mr+re like etlx+sure to cigJrcltc smoke in nran thJn rs pJrnltng wrth smmkc runccntrales tiuunJ 1'ruRrc.r Fu.rrr•rn lhc IrrhJccrt Ilrrtrry hrtrfrrrnrnls Ihcrclrrrc nuw thnJ Ihcnr.clvrs with thc •.palhulrtgrc.rl" Ihtnry sltJkcn JnJ uncnnvrnctng Furthcnnrirc. thc uttlue.t anttnJl "r.lrcnntrnl.tl" sultlunling cvrdrnce uscd Js a strunr Jtrnntcnt rs nrrw lerl;rly vtu.rlcJ Ly rnrrre tlrrcct anJ srg ruhtanl ncgJUVC t'Slk'rI111cr11JI rc.ults As a cun.cyurntr, Ihc whnlc sttu•t,rr.n IJIr cN Ir.uk to rclr.incc tur thc stlc Ilne of sl.rtt lrr:tl evidence tn whtrlt, .rs IK'Iorr ~IJICJ, Ihcrc crt,t a+ nrany IrHrphtrlcs anJ crrnlrJJlctitrns IrrJJy as thcrr t1rJ wltcn it wJs first JvanccJ When xicnusts rccugnize artJ can cv:rluatc eulx•rirnrntJlly the variuus conr wrncnl clcmcnts rr( Iung cancer c.u.Jtir,n, srwnJ prttl;ress urwards solution uf the prrrhlun will incvilJhly fullttw. Ilntrl Ihcn, the scicntlfic or lay rtvrrctnlthJ+is ttn any nnr su.lxctcJ faclt,r will cr+nlinuc In he J JJngfrlnls Ihrrat to the Ituhlic•s rhprccralion of Ihe curn{rlrrny of the situation II wtll, in iteclf, crcate a false scnse uf at'hicvcmcnt JnJ hccnmc a nurst unfnrtunJte Jrlayml, at'hon Wc Ihus fintl rrurtclvrs in I95R wnfh Jtlfcrcncr+, dhtulrls anJ crrnlltrtrng c!anns rrf stJ,rstrc.rl cvtJcnte slrll untectm.tleJ, with Ihc 1,athrdtlgitJl "rvi- Jrntc" shJlen, s~'Ir uve anJ m.rJrluJtr, arlJ with Ihr um+l rlucrl anJ rrtu,.l cvt,lrnir fr"tn .murr.tl r.lrrrrmrntJUnn tih~.winl• url••.ttrvr rr~r~ltv \t.tlr l ut .utnihrr w.ly, rllc ritlrnntnl% ,I Ilic I IrJCtu Ihrtny hJVc failed since the first public propaganJa fur Illat Ihctuy in 1')51 to pnxlucc any new evulcnce IhJt provides any qualitatively ddlcrcnt sulqturt IxyunJ the rtrnginal lyl.c uf statistical asxsciatilrn. lutcndcJ efforts to provide sound evidence havc frdcJ. IiviJcncc ol Ihe inqxulJnce uf lactors other than sruuking in the etiology of cunslitu- tiunal disease has greatly increascJ. Huth justify continued cautiun anJ .kepticism tuwJrJs acceptance of aggre»ive anli-tobacco prupaganda o/ general and conclusive nature. OLjrr•fiors lor Rescorch To summarirt briefly the general background of causation factors in constituliunel Jiscase, an analogy nlay he drawn with the o/xratitrn u/ a key in a tunddcr 1rK-k 7he key will turn the k><k only when all elcvariuns and Jcpressitrns are afigncJ irs pruper urJer and have the right drmcnsiuns It a single Jry,ressiun is IilleJ ur a single hump filed awJy, the Icy rnrry fail to uperalc, althuugh somelimes minor alterations may t.e rnaJc in Ihe Icy's pattern without destroying its ability tu unltx:k. AI present Ihe nature and iJentity of most c.kvatiuns anJ Jqucssions in the ctiuhrbtc key to lung cancer are unknown. lhus, rllurls to assign a printary causal rule In tohacco use on Ihe basis uf stJIlfllcal assrK'ialiuus ignore all thc unknrtwns and hkuxs undue aucntirrn on trthrc.u usc -Illc srrtistical rrtatiurtship rnighl c.ist under any varicty of crrnJilirrns -whrthrr snurkirlg eucrtcJ an inciJcntal, acciJcntal, rrr nrtn sftrcilic cllrcl t•r was asstki.ttcJ with hhysinlugical or psychological ch:rractrrisucs thal were inJc•Ix•nJenlly cunnrcteJ with susceptibility It, llte drse,tse. This srtuJtiun emrhasizes Ihc fallacy uf attrml.tmp„ (rrrnr prescot kmrwlcrl1-,c, to assil;n Itercenlage figures to any fHrs.rhle etittltrl;rc •agcnls invulveJ in lung ranrrr. Such ellurts neglect entirely Ihr still uniJrntr/irJ factors that arc ccrtarnly involved anJ ignore also Ihe Irussihility uf synrr gisnl ur intrr:rcurrn amr/ng farlors. It is conceivable arlJ /t/1rhJhlr thal any one uf several cundrtinns anJ facktrs, acting rlunr, will lail la frrnJuce the Ji.rase but IhJt a numher of these, when actirtg in crrncert, mil;hl rrcJlc cundiuuns favurrng tlre ahltcarance of the Ji.casc Ihe prrqx•t ublcctive rrf rescarth into lung can.er eurrlul;y rrnu.l. Ihrre frrrc, he In iJrntify anJ Jctcrrnine Ihc drutcnsitms uf a. rueny Lrrlrn~ J. Ixs.rhlr that nr.ly crtnstdute Ihe elevations und rlrlt,c.surnv tn Utr Icy I-r this Jrseax As unJcrNJnJrng tr/ lunl, canccr Irrrrgrrssc., incrr.nrnl•)y cf fcclivc anJ ItracUt.d rnc:r.urcs for Ixrvinlwn anJ rrrnlrnl nr.ry hr co,lw-r rrd Irr evr,lvr 11 r. rr.r.rrnablr Irr hnlre 01.11 .omr c/1ccUve rrrnlr"l m,ry rl~ vrl,rlr lunl; Irrfrnr t-vrr y I~!r.nr rrl /hr cJUrI rAy 11.1% Irrt•n t urnlrlc-trly t'lur r.LitrJ I hr' nccrssJry Jhrr.mun m 1Jtt' Icy m.ry wrll (unvc Irr he u+rnrl.fc nnc I1 1 5