Tobacco Documents Online

36 CTR HN 011360

It 1: 1' (1 It ii/ r~~r ti 1: I V' N'1' I F 1(: I I 1 It F;/: 'I' (/ It ~ tA ttt:Nf I? 4 f )1 )t. t.ll'1t 1', SO .t1. I I llt %( / 11 IN1/1 114 1 Itl It1:S1:Altt 11 c//11f111 I I Il 1:-.11 1:o.I 1!itJ ~Vi . .I. Ni•%, l ur I. 1 :. N. 1.

ti(:IF;NTIhI(: AIWIC(/IIY 1t(/A111) to the Tohacco Industry Research ('ommillce . KI:NNI:1'll MURRII.t. LYN('F1, M.t)., Sc.l), 1.1..1)., C'hnirnran 1'rrti.frnt, 1)ran of Fnrulfy anQ 1'rnlrtrnr nf I'mhnlnqy McJical ('rdleRe of Sou1h Carolina ('harlesu+n, South ('arotina RIC'IInRI) 1. I11NG, M.h. I'ro/etJ.rr orrd l'hninnan. Department of Mcdicine Waync State Ilniversity Collese of Medicine Ik(mit, MichiPan McKr1" , N CATfPI.I., Pn.D., M.D. I'ro/rt.rra F.rnrriwf of Phnrmorolrrgy ('nrncll I lniversity Medical (b11eRe New Ynrk, N. Y. ful.luS 11. C'OMR(1f•., la., M f). INrrrarr, ('nr(linvascular Research Instilute University of ('alifornia Medical C'enler San hrancisco, ('alifornia (.1?ON 0. 1A( Y)IISI)N, M.D. Pr.,/rrmr .r/ Mrdir inr, llniversity of Chicago I)i.rrtrrr, Argonne Cancer Research Flospital ('hicngo, Illinois PAU1. KO11N, M f). I'rofrrtnr of I'nrlrnlogy Ilniversily of SGrolhern California. School of Medicine l.os AnReles, California C'I.ARrN(-f ('CN)K I.Il-11.r. Sr.n., 1.1. 1)., I.ITT.f) Srirnnfir I)irrr-rnr, Tohaccrn Induslry Research ('nmmitlee I)irrrtnr fnrrrine.r, Roscoc Il. Jackson Memorial Lnbrrralnry Ilar Ifarhr+r, Maine SfnNt fiY P. Rf;IMA NN, M n., S(' h. .Srir.uifir 11i.r.t.N /inrrritn., The Institutc for ('ancer Rcsrarch 1)i.rr rrn Fnrrrirrn, 'I he I.ankcnau I Iospilal Rcseart'h InstiNrlc F'triladetphia, I'cnnsylvania WII I.InM F. RIFNIIOr F, Jra . M.h. .1 rtrH ialr 1'rn/rrvn n( SurRrry )rdrna tlopkina Ilniversity Schnrd (if Medicine FI.iItirurrrr, M:nylanJ f:hWIN It W1/ CON, f'rr 1) . I 1. 1) l'r.+frrtrrr lrrrrrilrrt o/ I'Ilnl PMrttir 1 I I.rv:urt I lnivrr6ly ('~mhri l~e. M.res~thuc~tls Ittrltl'ItI (' It/x Kl I'1, 1'rrl) 4 r1.,i r,ur No rrrrrrh, Itr.r~ hn

CurrClit Statiis of ''o l~~~ccc~-I Ic~iltla SIiiclics Preface lhc cllral Ir+ rrl•I.rin new km+wIrrlt-c r+f Ilrc rnil•in nnrl nalnrc (if the tn callcd cr+n.titulinn.J rrr chrnnii rli.r.rtrt it wiJc tl+rcarl \vlrat ,rr Ilrc I+rr+hlcmt~ Wh.rt h:+t t+ct•n arcrun/dOhcrl :+nd wlrat rrr rn.nnt I++I•c .r+rrl•hl (r.r, rlrttr+vcrnl :rml .+n.rlv?rrlr Vrry rvrrlrnllv n++ cr+n+l`Ictc dnlNl'rt tr+ Ilrctc yrrrtlir+nt t':+n yet hc rrvcn Onc n+.rv, hrrwcvrr, cr+nrrnr.nt r+n t'cr/:rin cvidcnce nf hrn/•rctt snJ drantt trcnAt :+nd Ivr+al+ct'tt th:rl tccrn tn thc wrnthy nr aIlcnli+rn It it hrrl+cJ th:rl Ihit Rrpr+rt will srrvc Ir+ m:rinliin am1 tlin+ulatc inlrr- ctt in, and .nlq+rnl rrt, Ihe vaw ~nrnmrl yd retr•:rr+h Ihat ttill ncCrls In hc rhrnc hrhrrc r+rrr knnwl+'rll•t' -.1ml tctlrni,lnrt c:m t+rnlrrd t+r ptcvcnl tht-tc ditratet At Scientific 1)irct'Ir+r, I thr+nlA Irkr Ir+ :rckm+wlcJl•c Ihc dcvnlrrl and untcllivh c/furt. (if rny attr ci:rlct t+n the Scirnli/ic Arlvitury Iln:rrd Inrl :rltrr Ihc crw+l+cralinn anJ crcalive cr+nlrihuliuns r+f (nr granlcet anrl tcicnlific crrntullintt I thrnrlJ :rltn likc tn cmphati?e 1/•nin the vilal I+art in r+ur whrde cflral plivrd hy all mctnt.crt rd the lr+h:ucn Inrlustry Rctrirch ('nnm+il/cc in rrnvirting crmrf+lttr frrcrlmm ilf rl:nurinF and :rrtirrn In Ihntc whr+ :rrc rctrr+n.ihlc f-n its tr icnlifii rctc:nch I+rr+r.r:trn (• (• I iltle Sticntific I)ircclnr 1 he r:rt/ ycar Irat rrrxlucetl an inleresling and prr.vtx'alive Si/ualirm arisinR frnm thc activilics uf different rese7rch wnrkerx indrl+endcnlly in- vetligartinR Ihc prrttihlc trde ttf smrrking at one nf many Lrcturt hcing t/udicd in human health prrthlcntt. What haprc•ncd in 1V54 was the aprearance of many mnre retearch findinRt anJ cnnmtcntt clearly thrrwing the uncertainfies anJ Jivcrgcnce nf npininn amnnR dnctnrt and scientitis in rcgirJ ta tuhaccu and hrahh. f)ivertily (if resc'.11rch pnrlrlcmt and tf,eculalir+n ahnut Ihem have rxitlcJ tince 19Sq, hut in Ihc patt year they became more rnarkcd in :rrliclct anJ ditcutsirmt rrfrrrinP frr tmr,king. lhcte Ihinl•t, nf cnnnc, t+/ten charActerise nny phate of a cnn+IdrR rctc:rrth lunblcrn :rnd trcnr In atise esrecially at the slarc whrn the urge Irr srrlve :ury rrul.Icm cr<ccclls the knnwlcdgc neccstary hr enahtc ns Irt dn tn. 'Ihit it m+1 a causc ftrr alarm t+r fumlamenlal ditlurhancc nf any kind. It it Ihe rt•flcclinn nf natural cvnlutitm (if trur knnwlcdge .rf the prr+l,- Icnr and ilt cllcct npnn Ihc Ihinking nf the f+ctqde cngagcd in efinrls tr+ fiml ilt tnlntit+n. TIIF.I)RIF.ti ARO11T Tn11AC(:n nt an eRanrple (if snch cvrdutirm, we may cile tcveral Ihrnrics Ihal have Lccn f+rrttul:rtcJ in ancnrrtt Io eapl:tin the limilcd J:rla Ihat alry.c:v In indic:rlc the tnf+fMrtcdlv harrnful eflca'Is nf tmttking, esrccially wilh resprcl Irr c:rncer rd Ihi• lung On prescnt eviJcnce• any tine nr somc cmnl+inatirm trr Ihctc crrnct•ptt, r+r (if rHhcrt yet lo he nffcrerl, ntay hc Irur, r+r m+ne (if Ihcm m:ty Irc. nnu+ng thcse Ihenriet are: 1Yrrnry 1. Thrrr are tb.nse rrlrn nrgRi.t Nrrrr rnnv br rnrrin.r• Rrnlr .rrhatnnrr. In roLnrr.r .nnrfrr t/rot nrlK/rr rnnrr lirrmnn /unR rnnr.r• by rlirerl nrllnn, f'rnclically Ihc trnty tufif.rvl for Ihit theory is Ihc rcaclinn nr Ilrc akin nf snmc I:rlwxatnry animalt, nnlahly certain mice. In the af.plicalinn (if crmct'ntr:rtcrl cr+nJrntalct (if trrhaccrr tnnrkc prrahrccd I+y r+nr nrcchanic:rl rh•vitr nr anrdher I Inwever, nr+ .rrhuancc h:rt f.ecn fr+und in f++l.act'tr smt+ke in yu:rnlitirt suflicicnt Irr accrrunl /r+r cven Ihc rntrute tkin rcaclirmt that h:rvc hccn rc fwnlcd AIttr, /hcrc atc many rr•lanlt t•t runutc akin I+aintin0 ct/rr•rinn•ntt th:rl dirl n+H rctnll in Imn+at 6

i Repeated etpcrimenlt in this cnuntry and ahrnad in which laboratory r.nirnalt wrre induccd to inhafe trrt+.rccrr cmnkc I„rrr fnrlyd n, pr,,,h,1 r n tinqfr IunR cnnrrr of thr rypr that it prrvnlrnt in mon. It it Rcncrally accertcd Ihat IunR titwe rrf mice ic mmore c'rxnfi:uahle in lunR littuc ..f man, anti that tmr.ke directly a(+rlied to the IarRrt titauc hy inhalatir.n it mrnc like the actual pnK-ctc t+f huruan tmr,kinp than is Ilre arpGcati,.n rd heavy thnet of amoke cnndencatet tri mt,mc skin '1 here hat been growing recognition of Ihe irnfautance of nce cn<alkd negative evidence r,htaincd from inhalatinn cxrerimenta. flhr work of Pattey, described in the report af the 11ri1ich 1'mpire Cancer ('ampaiPn, iuued in the summcr t.f 1959, made this clear and gave aclual inctancec nf the ea(+crimcntal work th.ne. Scicnli.ta and the puhlic will recrrRniYe that there is mrnc dirccl and applicahle evidence in thit inhalation re"arch than in the mnuvr tkin riinlinR lyf.c nf wrrrk 7lvu.~ 2. S,.m• r.rrans hnl,l thnt rnrohe nury nrt no nn lrrl. fnnr rnntrlLufinR tn N.• in. rrn.r.f prob,,hifirr o/ n.nflRnnnt rlrnnR.r fhnt pr1mnrify r.urlt from nth.r intrnrsflrJnr /nrtnrr. Thit ther.ry, e+.cnlially hated r.n Ihe atsumptinn Ihat tobacco may have a cnntrihuhny effccr, hat not been cfudicd In any Preat degree and therefore nccdt further etplt.ritir.n and tcttinR lhc varirrut methtklc r,f actayinR the cRectt of tnh.ccn tmr.ke mutl he invcttiFMcd furlhcr to find nut whelher thc rearc,mrt of the larpct fitsur are q•rcific for tobacco .mr.ke, or whether they rcprctrnl a Rcneral rcactir,n that may he ttarled hy a number of different inrernil anrl!t,r rtternal aPcntt Thrnry 3. Snrnr ruRRrrf thnt rtrr.ar. .nrnkintr prn,lnr.• n "Rrnrrnl .frLifity" fhnt inrrrnrro thr prnlrnhifity nnrl Irn.frn. Ih• npprnrnnre n/ n whnle nrrnv of LnthnRrnir plhrnnmrnn. lhe lerm "Reneral dehility" is r Irx.ce nne, and tuforlortrrt ol thit idca are unahlc tro rkfine it 1)chility may be cnutcd in different Lce.ple at different timrt f.y different circurnctancet and difTerent aprnrc 11 nrly dcccril.c diflerrnt types and dcRrrct of internal dicturhance and unhal:tntc Altn, "etcetcivc vnrrkinR" aml "ctcccc" in any other human hahit arc furlher vatiahlet Ihat niake this Ihcory difT'icull tn prove r,r to di•prt.ve, nr even to define in a concrete anti analyyahle ft,rni What rnay t.c °eitcet." for rine pcrtnn may nr.l, in any eppreciahlc way, anerl fhe phycinlury nf another If tnhaccn is t.t be clittifird in the catepory of ar.rntt that pnalnce "Pcncral dchility." it will join e whole hr+.t rJ r.thrr arrnta and inffuencct that prr%urnallly can dn thr tame. To .rf..rarr t{hr I rflrt tt rd Inhat, ~, fl,,m rllrt It .d .+thrr thingt will (6 he a must dillicutt latk and will require a great deal c,f planning and ac- cumalatirm of fundamental rrsearch to find out what really are the fxst mcthr.dt of ataay. Thit f,arlicular concept secnn Iu have originated in an effort ttr inler- firel the reported claticlical ata.clatirm between tnhaccn use and various ailments ftir which there wat nit satitfaclrwy evidence of direct caucation. TRrory -1. Th. rlr/rr.e of u.e n/ fnhnrrn mrry b..IJnRnnrtir n/ fyp.s of p.r.nns orhn hntnw dfff.r.nl health ri.kr Lrrnu.o n/ their fnnnle nnlur., or IIr.Jr rntr of fir- InR anti r.nrFlnna to fR• rvninna pfry,lrnf, mrnrnf nnd •mnllonnl rbnfl.nRr•s nnd alrr..rp of li/.. The data concerninR this theory have been accumulalinR rather raf,idly and frr,nr a nurnhcr nf diflercnt aourcct One it the cnntinualinn r,f ctudict t.f fhum;.n Iwint, h,rlh idenlicad and non identical, that indicalc a c..mlifu- lirrnal factor Ih..t may influence smr.kinR habits. Recently f..ur Swrdith tcicntitti puhlithcd a ttudy Ihat in many ways parallelcd .rne Sir Ronald A. Fisher ref+ruled lact year.'Iheir study cante In the cirnc cr.ncluciun. Ihat he did, namely, Ihat irlenlical twins more t.ften had the same tmr.kinR hahilt than did nrm-idcnlical rwinc, even Ihough Ihc degree tt, which hrdh lyrct of twint encountered a tirnilar environment wat cascnlially thc sarne. Other dala have conic from tcveral types nf psychohoRical lesls that are heinR Riven in "captive" pnpulatinnt of people to find oul the mental and emotional Irailt nf smokers and compare Ihem with thr+ae of nnn- tmnkerc. A recent paper reported on certain significant mental and cmn- linnal differences between the two categories. AllhouRh ilt nuthur did not interpret it ac cnnclutive Ihat Ihe type of pertnn is an impralant faclnr in Ihe titualinn, 1he fact remaint that a difference was demnnctratcd. 17rit difference will have tr) he e.ldained and evaluated ahmR with other aacn cialionc of a clalialical and semi-alalitlical nature. 'fhit last Ihrray rcally indit-alec thal "e><ceaaive" snu,kinK is aymptr, matic nf a ccrtain type nt types of rersnn and is nur a fximc fact,.r in crealiny nr ealahlichinR the types nf f•crsnnt wh.o are had health risks 1 hcrcGae, il is nrH an arrcalinq In Ihtne wht. arc hlcJl•cd Ir. auhtl:.nti:rtinP a caucal relali..mhip We find Ihat we now have nt Icatl thete (nur theories, Ihe ahar.lute and relative inrpontantc td whith is uncerlain ru unknown We dt, n,.l Arrn.r•, and rhnt iS Ihe inrla-tant IhinF tu rememhcr, Furllrer rrtrarch il neede.l '1 he far.rnr .ituntion indit'atet Ihia UrrerlnlvnCally, nn.I it lanvr. Ihe witd.un nf tlir a11r1uJr rd ..irn/ific c.marrvntianr I 7

l)ftSF;R1 ATIONC l)N llF,tiF:ARf.ll In the 1VtR Rrp<+rt il wat fx+intcd <+nl thm the prnponentt of the Ilhrtxy td i Irrhaccrr link 1<+ lunp t:urcCr hit/ rCatcd thcir t'Iaimt nn a"Irifx+d" td d.ita - ttitklica, I+;+Ihtdow, and animal c.l+crirncntatinn, In file patt «vera ycart r.1th IrR td Ihc "Iril+ud" Ihac hCcn arhjccl In mrrrc an1 ntnre uC~~ncttct• analytit by inrlcl•rnJcnt invetliRatnrc whtr havc I+oinlcd t+nt thr dcficicncict nnd ctcn crmtrnditliuns in the recultt Rl.ti.tir. hurinF Ir150 adrlitinnal slatictical mnlrri:rl rcpr+rting in atax'iatinn Lctween snu+kinR intl certain ciutct t+f de:Nh aprcircd Itr t+c muth file tame ac earlier dara. Ihcre wat ctmcitlctahle criticitm nf the ctmtlucir.nc drawn frtrnr Ihic tyf+e nf tlalictital w<rrk whcn file nriginat dala al•liearcd antl /hit criticitrn hat ct+nlinued. l wn intlivirhrat in parlicular hivc fnr urmc yrirt been ch+trly .nalyz- inR and cnrnmCnting tm Ihc tlnlitlical wnrk arnl thc trvcr intrrl+rctati<tn t+f it Iha hat f+rcn t<+ writ (+uhlit'ircd I hetc are 11r 1rnCl+h Flcrkarn, head n/ file Section nl Iti<+mrtry and Me<Iical,Ctatittitt :rl thc Miyo ('linic, R<x hecler, Minn , and Sir Rnnild f ithcr, a horrncr Arthtrr Ilalft+ur prnfcctt+r of genctict at the tinivertily nf ('aml+riJFc• I:nl!l:rnd I)r Itctknrn, a rnctnf.cr tr/ the Amcrican ( ancef Stx:icly cnmmitlce that crtmcnrrrl a numctic:tlly I:rrgc .t:tti.tic:tl ctutly nf sm<tkirrR antl death rttct, h:tt puhltthcd acvcrnl ll:q+crt rcl:<tinpi tr+ clalittit'a) invcttiRatinnc nf Itrhaccn antl IunF c:mcer Ile h:rt taid Ihat il wic ptemiltne fn claim <rn file hatit t•f tlaictical fmttinl•c Ih:tt tnurkinf- c:rutct canct•r rd Ihc lung (:nnrrr IflrrlnRir 1'rnhlrnt, lV.rr Srnri.rirnl ('ancer, :iccortlinR /n I)r Ilcrkcnn, it hatically a hinlnpic, not a clalit- /icil, rrnhlCnt, antl the ttnlittical c<rntlutG+ne wrruld have 1n hr t't+trtrbn- r:rtcd fully by ctl+crirncntal antl tlircct t+htcrvatinrtal tludict Ix'hnc they ct+uld he c<tntiJctCtl It+ I+c etit•ntilitilly ett:thlithcd l here it, ttc taid, virtually nt+ cuhtlantiat clinical, rathtdr•1•ic <+r rrthrr dirt•t'I cvitlcntc that tm<tkinR it Ilhc t:rrr•r <+f Itnnl• tantCt Sir RtrnalJ, in :r rcccnt paml+ldct c<+nl:rinin/• Irit v;trinut Inrhlithrtl fsapCrt nnd Icctutrt tlcaling with trnrrkinp, ctrmnrcntc fxrinlcdly rm file ttalittical wnrk t+r twn Ilrrlith /nvctli)•:rltnt wh<+tc <I:rla inrlic:r/crl Ihat in h:rl:rtirm td ci)-ircltc crn<+ke :rclrr:Jly tt'cnrcd In dirrrini'h thc chancr trf Itmp cancer in Ihc I+rq+rrlitinn tturlirtl Cir ITr•n.thl, in crmnnentinl• un Ihit, hat t:rirl "lhrre it nrrthiny 1<t m V1 tlrrP Ihr+tC wh<+ t•rt•:tttv drtirc it Irnm Irclit•vin!• th:rt hmr. c:rnccr it t:rntctl ~ by trmrkinr til•.ncrt t tltry tlrrnrld :rlan hchr'vc th.0 inh:rlinp tip.rrrttc ~ vrr••tr it a I•rnrr,trr•rr In 1•rlirvr rilhcr, it, h••wrvrr, hr run Ihr ritl yd I I failing In rcc<+pnirc and, thcrclnre, failing to prevent nlhrr and m<rr- Rcnuine cauccc " •Crnti.rirnl I)nrn 'L.rRlrnlly Inrorn prtrnt' Other f.ertinent remarks on the siatisticnl studics have cnnre front I)r. Ilnrace W. N<nlnn, prnfettnr nf stalittical aeaiRn and an:dycit at the Uni- vertily of Illinnit (l+I1cRe nf ARriculture, who dctcrilxd file present dat• nn sm<tkinR and lunp, cancer at "h+Rically incompelent." I lc further wrote in a recent puhlithed communication: "I m:tke a f+ka for integrity on the part ttl Ihnce afGrminR that smokinR cantes lung cancer 1 rt their vari<+ut papers and puhlic slnlcmenls include ( I) a lrank ac- knnwledgement that any such aflirmative conclusion is a mere nl.ininn and (2) a familiar ct:mdartl of comparicnn, chrxninR tomelhing trver whit'h we h:rve, or oujiht ttr have, strme vuluntary cun/rnl, such ns the death file natn- cielcd with file use <tf the nuttnntrhile " Addilianal cihnifit'anI cummenlt have hcen made hy I)r ) Yenr- thahny, St•htxd <.f Public Ilcnllh, l)nivertily of ('nlift+rnia at Ilt•rkeley, and I)r. (•nrrnll 1~. 1'almcr, (I.S. Public Ilcallh Service's Tuberculosis PmRram, in a diccusti<m u/ file slaticlical wnrk in a recent nrticle on thc nrcth<xhrhrpy of invedigalinns of etiologic (:rcltns in chronic diteatet. l hc I:nge nunrt.cr of tmnkerc who do mN have lung cancer "•tcttify to the inarllicicncy of sm<+king as n eaute nl file diteace," they wrtste, noting Ih:rt "Ihe exiclence t+f lung cancer palienle who have never tm<rketl cle:rrly indic:rlct that cmnking it not a neceeeary came" Agrcil deal t+f retcarch rRYllt to hc done to find nut where the truth licc- if, in facl, it lice in nny of Ihe eltitlinR ennjecluret, which it very writ mny not 'I hcrc it yrnwing suRfxrrt for the point trf view that t/hc ttalic- tit:rl accrtci:rlirrn rLtintCJ hy vutionc tludict hat an cwplan:Hitro t+r cnrlana Ii<mt tlrnl ruiy tlill ntrt Le aliparcnt Imrn our pretcni knt+wlcdpic rwlf.nlnRy lhc cccontl Icli- <+f the Iri/xxl I+ath<dr+Fy- hat retlctl tra vcrv Iirnirrrl m:tlcri:rl ()n thc I+:nic of a relatively few c:nec, it w:rs cl:rirned Ih:tl Ilrc hnrr,t t+f vtutkcrt trmt:<inctl ch:uactcridic Icsitrnc, t+r tl.<dt rd tt--ltt+nrcrl littnt•. Ihat wcrc cnnatlcrctJ Irr t+c Irrcc:rnccrtrac contlili<mt In /acl, 1hc.C t(.r+1t w(YC t:rllcd "t:utinrrm.r r.t vrn•• (h-c:tliicJ eancer) - in ittt•If a cnnfutcd and tnnlr:uliclr+ry Icrrn Vrry rarly, the Stit•ntific Arlvittqy Iln;rnl Irr file Irrhacc<+ Inrlutlry Rc.circh ('r•nunittt•c y,r na•rrtl :t Inty timc tln<ly <d ifrC f.:rlhrrlnl•y <rl hum:tn Inn/•t hy 1) Ir:rrlrnr I+.rthnlr+~ittt in di/fcrcnt f+:trtt of file crrnnlry nll Ihc,r I+ithrrhr/•ittt lnunrt v.nnrut Ic.itrnt frcynrntly in Innr~t r+f nrrn tmnkrr} it wrll R 9 t• t"

at in tmt+kcrt, in f+ertnns of h.+llh acxct :rnd r+f all apcc and of di/lrrent placet of tetidenceI l hey did not believe that thetc Ictinrn were indicative and tlinpnr+dic nf iirct'ancernut crrnditirrnt ('nnflrmatirtn of Ihe need for cnntinn in interpreting such tludies came thiq year frt+m ('unninp,ham and Wintlanlcy in fnplantl In fiathnlnRic tludiet of human lung tittuea, they were unahle trt confirm fintlinpt of "car- einnma in tiru" or of an ata+eiatinn of certain nlher chanRet with the tmnk- inR hiattrry nf the ratientt. Animal F.xl+erlmrntwllon 7he third leg of the lrifxxl, aninral exrerimentatitrn, hat rrlicd rnnctly on cnnlinucd.turlret in a few lilxrratrrrict It hat hecn reported thal repeated painting nf crrmlcntatet of anrrke nn the skin of certain thaina r+f mice wat followed in tnmr nf thece animalt by overgrowth of the sk in and, arrnetime, hy c:+ncrr of thr tkin Frnrn tuch dala, il wat arRnrd fry a frw .h.1l there mipht be nrMlincct catcinnRrnic It+ people in thr tmnke ctrmtrn:alrt nnd, tlherefrrre, by inlerrnce, in thr tmr+kr of a ciP.rrtte aa cnnturned hy a tmnker On thr hmit of Ihcce animal t+aintinR c>trcrinrrnla, Il+r Ihcrrry wat pro. f.rmndrd In the effect that if the adirtt in cipireue. tmnke were teduced, the arnnunr of tkin cancrr tin mice wr+nhl lie rrrlncrtl, and the chance r+f hune+n IunR cinter wrrulJ hc tin+il:+rly rcrlntcd llrrwcvcr- an atlcrnill at quantila- live cttrarrdarinn (rrmr mitr I.r n+.u+ ur.nlrl cltcctl ctientif+i linritc 7 hr crmrinrrinp rrl-nr% ..1 /.uturr tr. rn.111r r Inn)• t:rnr rr in :+nim.tlc with dirrC'1 inh~l.rln+n t,f trt, .rrrlrr.ru.. ~rrr., I/ .rrr r~~n.nlrrrrl hv rn;rnv I.. hc rUrrr(` tipnificint th:+n alt+n p.urnrn+r• hrr.rrr.r vrr„Ir~ rt.rlf n utrlrPril :rnJ Ihr titvrr challcnPctl it lunp. rnrt skrn, rr~•nr ln :+nv cvrnr, IFhr.r rrcrrht h.+vc c:rllcrl for a re evahnurrn td the vm.kc tr,nJrnt.+tc. .kin I+ainlmp ar/'rnncnlt trn which, tip to nrrw, the whtrlc "HrirJ Icp" of anin+al ctlrctirn+nt:rtit+n hac retted. (tr.f-.tlon o/ Air rnrrnlhrn F.aretimental work hat indicaled that advertc eflet-It on hcalth may retult frnm the rorctrnce in rnan'a environment of "tmnR" or c++tnhutlir+n f+rrxlucrt of Rattdine. r+il, Raa, crt:rl, nr nther air fx+llulantt. Of ctrrrce. the cxittcnce of thcsr factntt thrct nnt rncan «icnlitlt ahtruld ditrcp:ud tt+haccn and r+ther facltrra- eithcr intcrnal or c>atcrrral - in their invrttip:+tirrnc Ilnw- ever, the f:rct 111.11 Iherc :ne trlher vnl+ectt in lunp cancer, cardirrvaccul:rr dice>tae. and r+thcr ailmcnlt fitruld crmteivahlv aflcct and nnalr/y the t+ver- intcrprclalirm with rcPard tn H+hacct+ A recent ttmly in Struth Ahira .nppr.tt air rr,llnfirrn may he invnlved in the cant:rlir.n r+l Innr cancer A rrfant f.y I)r Grrdiley flean. pnhliahrrl in rhr ID"nJr ltl.,lr,.rl /,.rnn.rl nr,tr,l rlt.rl wlrilr nrntr Srrnll+ Arric:+nt havr I long been tha heaviett cigarette tm<+kert in the world and yet they have a relalivcly low InnR cancer mortality rate. Itit study, hated on IV17-36 male lung cancer deatht in the Union of South Africa 6y age, country of birth and place nf residence, shnwed that hritiah immiprantt tu South Africa had much higher lung cancer mortality ratet than Uninn-htrrn men or immigrantt from other eounlriet. f)r. I)can .aid: "The relatively low incidence of lung cancer generally among Ihc heavy-ttnr+kinR Snuth African men, the higher and rapidly in- creatinR incidence in the growing eitiet, and the high incidence in the yrnmper age Rroull of immiRrantt from I/rilain found in the pretent study, supRccl thal the air fxtllulinn which rtccurt in mrxkrn inducUial life -- tmoke, sn,nR, traffic fumes, ete.--may he a major factor retf+nnsihle for the alarminR increaae of (unR cancer in South Africa and Ilrilain, and prctumahly eltewhrte.° 11r. Ucan'a findinRi are timilar to Ihote reported three yrart aRn hy I)r. 1)avid F. Fattcnll, nttidanl directar t,f the Natirinal Ilenllh Instilute of New 7ealand I)r. Faqcott altn frwnd that immiRranlt frnm the I/niled KinRdnrn had a higher incidence of IunR cancer Ihan native-Ixtrn l+ertnns nf the same tttrck and that diflerencet in tobacco smtrkinR did not seem to be involved ll+ere it. therefore, an nhvinut and prettinR need for invediRnlinR the Ixtccihle role of tuch air I+nllulantt in IunR cancer and other diteatet. The e><ialence of these and other sutpected factnrt juttifiet Ihe atlitude of hal- anced tcepricitm toward claims that the problem it srrlved and the inti.tence nn further retearch adopted by the Tobacco Induslry aetearch ('nrnmiltee and nthcrt rI'lic rt'.1.R.C. Rcsca rch I'r-ogram Il A Sfr rRfNrlt M.f+;.S ('erlain hatic Inincirkt influence the 1nnR range planning of the Sci- entific Advia+ry Ilnard, which it re.fxtntihle 1nr Ihe recrnnnrrnJNitrnt fha dittrihulinn of rctr~rch hmdt from Ihc T.LR (' lhcte principlet nre broad and preaurnahly admittihk by all Ihnar interetacd in adv:rncinR knnwledRe nf the eause and prevention of thtwr cnnctilutinnal or chn+nic diteatet allrihuted by arnte, nl Itatl in frarl. ttr tobacco nae I unp can( rr and cardinvatcular di[ente are :1t roretent ernt.hn%irrrl in Ihe TI R(- I'r+rpr:+m, hnt nrhrr di.cnact anrl rrtr:rrch frrrJrlrmt altn air inr lurlrrl Ir) 1 1

(':+nccr antl cardir+vaccular tlitc:+te arc Jur It+ chanFct in Ilhe cclls intl tittncc r+f IivinF f+ctqde Ift+lh cnnrmr+nly t+ctur :+flrr a Lcra+n hat livctl fnr a nunrher r+f ycart, nnr1 tr+mctimct afler a prr:rl nnmhcr 'lhere are wide and uncwplainetl in+livitlnal vari:+tir+nc am) cuacptihiliticc in Ihic respcct. ('anccr ic usually rnicrt+ct'r+i-iitally Ir+t:rl in r+ripin, i e, in a cinplc cell Carrlinvaccular rliacace cr+nnnr+nly rniprn:rtcc at a rt•cnll (+f chinpet in titcnc nr tyttrm r+f ticcvcc, i c, Ihr+ucanJt t+f millit+nc td ccllc are cimull:rncr+utly t+t cnr+rtlin:+lrly aIlrclctl '1he nririn t.f e:vch cateFnry it extretncly cr+mpres and is untlrmhlcdly dne Ir+ m rny inrlrl+t•ndenf and inlcracling t'antcc II mucl l.c rccr+pnircJ :rrnrl adrnittctl flrit t+nr knt.wlcdpc in tlhcce fichls is rn:ukcclly irnrerfcct and tle- ficicnt I Fn• mnl6lde cautrt antl inllnt•nccc nray rq~crale in rliRcrrnl dcprccc, in rhrTcrcnt nrrtcr, antl with diflcrc•nl tclalive iml+r+rlince in diRcrcnt hurn:+n intlivirlu:+lc 'f hctr pt•ncr:+l laincildct thr+uld cv+nc/antly hc ht+rne in mind by Ihncc tul+lu+rlinF rt•tr:rrth in cifhcr firl+l, by Il+t+te dr+inp and infcrl+rrtinp Ihc re tcarch, nnd hy Iht+vc infrrrminp the I+uhlic aF.nul Lrcvt•nlit+n, cautalinn, Ireahucnt r+r cure • Itecaucc r+f Ihc nurnl+cr anJ v:trirty nf Ihcce forincif.ltt, rescarch rn+- Rramt cht+uld fx• divcrcifictl in rnrlcr In atlvancc nur tntal knnwlcdp.e with Ihc Rrcalccl rsr+ccihic tf.t•cJ and h:rl:tntc Any t+nr phate trf retearch nr re• tearch al+f+n+;rth it, hy the very n:tturr rd llrc rliccaccc. IimitrJ in ilt pr+tcn- tial valuc anrl in itc appfic,ti.n, tn Ihc trd;rl Prr+hlcrn. F'A(:TORs; IN l:IN(:F:R-I: 41Ifl/l1)1 fu1//. 4R I/ICF:ACr: Ilrt+atlly cl+cakinR, t-anccr anrl t':+rrlinvaccnlir rliccacrc invt+Ivc at Icasi the fr+Ilr+winp ficldc I llrrr.filv what rflccl tlr+rt il Iravc r+n thc I+irKh<mi•.':+I and fenclic nalurr td Ilrc inJivitlu:rlr Sr+nrc inJividn:rlt in Ihr s:unc cn. virrmmcnt tkvclnp thccc di.c:rccs whilc r+thrrc drt nr+t 2. In/rr, rr.rn hrrw orut It tlr+ hmclcri:r antl lnr virutct, cithrr I+rccent tx frcvi.+ntly t•'<frrirncr+l, influcnrc t'cIl nr tistue ch:tnl•c1r I r+ wh;rt ettenl tit+ they inerca.e thc rick uf I:tter diceace? 1 Nnnirrnn - hnw mnch tL+ thc v:+rinnc nnlritive nt:rlcrinl. I,kcn, al+tr+nc~rl, cN+rcd ur ctcrrlctl hy Ihc in+lividnal aflctl ccll r+r ticcue ch:utpe-0 ( ln.leslrrrd it ++ne .ul+vlant e nnw unrler e.tencive in- vctlipatinn, hut vil:rmin rlt•lit icncicc :nnl r+thcr nnh:tl:mccc nc+y f.c iml++ntanl 1 ll.•.rrr..nr• ht+w mur Ih rl•+ thc I+rrtilrrctc rd Ilhr vari++uc I•Lrntlc r+f intcrn;il cccrclir+n. IramrnillrJ hy fl+c L+.Jv Iluirlt, :dlct I t cllv ++r li.arrt cith+r hy arn.•unt anrl r.rtr r.f a'crrti+.n nr hy +rnl•.rlnn+c' It ic krn+wn tlrrr Il.rv havc :+rn iml-nr.+nt tnl+• in lut•.r•t t:+n+cr :+n.l a+Ircn:+l d.n... 1, .~. L..rr 1•. .i. Irr..n. .r•. n+n+l+ Innl• ..u+. rr aa S. Nrrvnrrt trroin or rension-how much do thcse factnrt in- fluence thc at'livily and hmt'linn trf cells aml fianet rd varitrut sycleruc rrf the ht+tly nther Ihan the nervtws syttem ilcelf? lllcer ic rccr+fnircd at a ditcavc in which ttress ic imfxvt;mt. Slrccc it arriarenlly af.u in vrdvcd in carthuvatcular diceace. 6 l-nrirunmrnr--hnw much do phycical nr chemical cr+mpr+• nents of Ihe envirrrnmenf, intn+tlucetl as foreign nnn living aRentc, allcc'I thc ccllt tn licsnec'? Air ptdlutantt, irratliation, humidity, tent- (.craturc• tr+haccn, rx'curalional e><pt+cute >•nd I+nstihly t,lhcr faclors are rnvrdvctt in thit yuesliun. ~ Slutliet nf these fields are important in obtain a better and, evenlually, a cnnrplcle untkrclandinR of cancer causation, and all, or a majority of them, are tirnilarly to he cnnciderrd in the causalion of cardirwaccular diseate. 'Ilre 'fnlracco Induslry Recearch ('ammillee has oq+porleJ and initialetl retrarch in thete fit•h)t and will e><pand its activity nt nl+p,+rtnnily ariset r+r can Ibc crcalctl. nr:rF./.71PIN1: I.rNF:.c 7rF I7F:SF.ARf:/l In the pact, ccrtain lines of retcarch have been mentitmed Ihat seem In give prnmice t+f confrihutinr km+wlcJge essential to the umlcrtlandinR, analytis, and evenlual soluliun nf srvme or the majnr prohlcmc relaleJ lo Ihe cause and Jcvelrrhment nf Ihc cnnctitaliunal nr chronic tliscacet Thete linet r+f rect•arch include~ /. 17..n.• 1 rdFnrr 1 hc Iraininp nf fclhiwc and the dcvelnpnn•nl of tcchniyuet in in virrn cullure trf human lunlp tittuc have prncectktl satitfaclnrily al )r+hnt Il++pkins Ilrtivcrcity, the Ilrnivcr.ily rd Nchr:rtkn, the I/nivercity t+f Ictat. amI thr AIf.crt Vinstein Schrad nf Mcrlicine 'fhe dist'rtvcry by a retearcher nf nl Ieasf one entirely tynllretic cnlture mt•diurn frn mamntilian liceuc is n wckome and InnR•awailerl key that thr+uld nfa•n Ihe dnr+r trr a whr+lc new t+rder of qualitalive anrl quanlilafivc an:rll•cic t+f thr I+hrnt+mcna t+f Prnwth in MHh m+rmal and nery+laslic lisaret 2. Il i..nttnv Oictintt adv:rnct•c havt• Iw•cn madc in iniliatinp I:rrfr te:dr reccarch tleci/-nt•rl N+ prt+viJc the c:trt•lul e'r+ntrn/s eccenli•rl tt+ sut'cesdnl, tynanfil:uive clantl:ntli»tit+n nf such wirlcly ncrJ mclhralc r+f ascav at tkin painliny nr injccti+.n with v:uir+us :ycnlt Aa:rv I+y r.+lt• rd fruwth nf, ru rrat lir+nc Ir+, lransl+L+nlrJ nnrrnat antl nr+q+la.ric tt'llv :rn+l /i..uct r+f knnwn I•cnrtic n:Hrrrc in /•rnctit:rllv t•++nlrr+llyd hnclc it nlhn wcIl unJcr wav Ilhe cllt+lt d Am+wn r h:+llrnt•nn• :+t•, ntt in the snrviv•+I ..I 1•+ur r I.+nrt ++1 I'nrn.rrr. rrnn .rrt :+I... I•rin/' rnvr•hl•:+tcrl in Ilhr hnl+r th:+t rrt h.+tN:+v n+.+v I1

I+rr+ve to hc a r.f+irl, rflcctive, and cl+nvrnirnt adjtmct fit other tyla•c nf nccay ('+nnfrlrilivc rrcultc nf «•vrr.+l Ifitlr•rntl lyl+cc of :+c.:ry, wl+rn Il,r c•unc ilrnlt i . rc• ucrrl in cach, may well tlmtrihute ciKrtifit.utlly to c/ur :thihty to anrlerctind thc Ir+tal fxt+cctt of accay nlrnc cnrnplclcly, 1• Inffurnrrl of 1'..nrurrrnf nr 1'rrrf..rrr Infrrfi..n •1hc qvrcti/+n whrNher nenf+llcia m:+v r+ccur it or near OrraM r+f infcc- /irn+ hat hrcn raicrJ hy many in.cttiRalnrc r.ver n c++nciderahle f+crirrd r+f yc~rt. lhcrr are af Iract two broad fic)dt nf interett involved thil are l.rinp invettiRated both ctl+rrinlent;llly and clinically at prctcnt. A. f)r+ nrcat nf tittue, dintaprd or allercd by prcvinut infectinn, hccnnte suhject to malflmctinn nf intert'clhllar t+r inlcr-/iccuc c><- change7 ('nuW this in turn lead to chemical unhalant•e recultinR in intracellvlar chanRc or ntutatir+n hrnn a nnrntil to :1 nrnfd.lctic• lyf+e in arlj.iccnf nr tnrrnnntling fittur't It Ih• invacive apentt, tvth at non f+athr+prnic or lalrnl or (+ar tially, inaclivatrll virutet, ctitt in non ne1q+I,tUc ccllt nnd, if tr+, what caf+.city +h+ Iht•y fHncctt for Irincfnrnutirut In an active ttate within the cell Ihat Iradt t/+ ilt uncnntrrdled divisir+rl7 '+• r 1yrlll)r/lnlnllr In/f1llnrre lhere hac been a cnntirnrinp prr+wth of intcred in the ptychr.a+matic atf+cctt of tmnkinp 1he number r+f dittnctir+na >,nd puhlicalir+nt in this field hnc incrcitrd mmkcdly, at have I+I:rnc fr+r, anrl inception nf, rtew rc- tearch. 'This indic.llct that the rmtf+ut fit rccrarch and itt imrr+rlancc in t+htaininR a wcll rr-nnrlrtl I+itturc r+! Ihc cnrolinp h:+hit will prr+w lhere are and will t.c ntnny rli/ficnlliec in thc development nf thit field on the hacit r+f tlircct, nhccrvalir+nal, and eRl+crintcnfal mcthr+rh Snme fit thccc dilfrcultict will hc inherent in Ihr nalnre Id the humin material ucrd, tuch ac dre cttahlichment and maintcnancc of adcqn:+le fnl- h+w up technirlrrct tn neccstary to hmPitudinol ctudict. OIhcrt will involve careful cvaluatirm nr v3rir+ut methrklt of recc.rrlinp• am1 atsaylnR varinut 1.cychldr+Ricil or rscychc.cnntatic charactcritlicc and prra•ettet. Even now it it f4+ttihle to rcach crrlain penrril cnnclutionc on the relitinn of behavioral traits In IFIC incirlrncr, tkvelnpmrnt, nnd crtlrte nf the crmctitulirmal or chrtmic ditricct It ahnaAl be rec,llyd that it it t'hirfly in that grnup r+f ditt•atct that cert:+in atalitticiant h:rvr reported nta+r ialilln between "cxccccive" c•ip.irrrte tmr+kinR and pilhr+prnetit S. (.Inlfff 1n,f11rnrrr lhe r.rnctit- rnllrrrnrr ic r+ftcn nricrlnrlcrctrH+rl :tnrl Inicinlcrt+rrtcrl I I+r rt:+rnf,lr. il trrnra trl t.r .+ t nrrtnu+rn rrr/q h+ c tf+rt t Ih?1 Ihr prnrln ( inn.+/r ) rlr rnrnt r.r /ar t.rr ir, Il'i, r r+ml•Ir. l~rr~hlru+ wrll hr :r cin/•Ir. t Ir:vr rrt, Mrn dcli:+n pcnc fr•r ' vm•kinR.' or "nrm crnlrking"; fr+r "IunR cinccr" r+r for "no lunp t:mccr"; for "cardir+vatcul:lr tliccace° fir for "nu cardir+vaccular diccase.° I he nhcervcll hc•hivinr ttails of individualt in relation In Ihccc dis- r.ltcc prccturlc the ecictente of a simple uni-gcnic relation as hcing of prirnc in/l.rutant'e. Slatcrncntc rd Ihic kind reKrcttably have led a number of individuals to Jitcnunt rdf genetic innnence and It+te interect in the evidence of cnntplet hut nr+ncthclccc real pcnclic influcnces at wtlrk. This is, of cnurce, a tragic error in analylical Icchniyue. Studicc fit twint, at well as of various pcychtdnRical end emotional Irailc, shl+w thal there can he strong genetic firedeliclinn to certain ahililics, sk illc, and reat linnc. l heu genetic inlluences oflen diflcr in strength and in tenacity r+f rrcurrcnce and of esprettinn-even when envirnnnunlal f:rttr+rt are hchl tl+n.tan/ Intlividu:rlc may tlill tlirTer in recfa+ntc hec.utc fit their innatc charactr•ridict. 'In cnml+lic.+le rnattrrt hnlher, tlte cnvirnnmcnt, and Ihe t'h:JlrnOet thal it pretcntt tll in+l+lcrncnt or to r+l..trucl the development and c.l.rt•t. cinn fit innatc th:v:tclrricticc, ucually change radically in varirntc wayc. Icmf+l+c, intcncilicc, LCrcitlencc, and dcprce• Stm+t• prnctic rey,rm.cc tlccur with cL'vity and tlclinilcnccc when Illc cnvinlnntcrtt Lrrccntt a t•Icar anrl fi>ted ch:tllcnpt' 1 hit citu:ltinn ia, hr+wevcr. Ihc rnarkerl cu'cptir.n. Much more r+ftcn there will lie ctwnter- f.Lly and intcrplay r+f Ihc innate nnd fit the cnvirtmmcntal influences. re- cullinR in a ch:tnping, living ct+mpelitir+n. At one :lpc :utd unJer r+nc ccl ot circumslancec the innate inllucncct mny lie in c+rntrr+l, while at annthcr age and under different circunlctancet, cnvin+nntcnt:tl intluenccc m.-ty dctern+ine what nccur.. '1 here it nr+ dt+uht that differenl individualt havc difTerent inherited Icnrlcnciet trl dcvehlp a1 certain ra1et in various tictucc and nrpant lhere are ht•rcditary trnJcncicc fnr different urKant and ticaret fit ape al rlifTcrent ratct All of 1Ftic cr+n+f+lc>< internal balance and cnnnter halancc aflcctc cucc•critil+ility In l+:uh/+pcnic t'h:trlget antl ditcate. (.. SIrn7n rrr Trn.fnn I hc atrt ~. r•r Icncirrrt f:rt trn it fw•pinninl! 11+ actnrnc ru/ne in+f+r+r l:+ncc I hit I:n Ir+r :+Iqvr.rrt :+t tnuc. Ir+ hc :+ccr+ci:dc+1 with thr cnu+kinp h:+bil A1c1+• it it wcll rcc/ rnvc+l :+. .r I+rcllia/M+.inp tnrl/nr cnrHrihufnry f:nl+a Ir+ ccr t:+in rlicc:tcc• In cv:Jrratmn of Ihc cu:+in Icn.ir+n Iaclrrr, it k well to remrn+hrr Ilnl .rn.itivily I++ r++r r'I+iti .n rd clrain v:vit•c prr:rtly in inrlividnitc Sr+ rh+ rrtcn li.+n I+f Ilhr cllr+ l. +d .tr:nn :+nr1 1+1 nC+nr+l+flytinhq•ital Icaclir+n fit it I Is 1d

tn 0• i• . j r) lhe pencric maltrnp nf Ihc inrli.irlu:rl anJ thc lyl+c arnd ctrcnFlh r+( cnvirrtnmcnt.d atnnnti m c :rp:nn tl.c f:rtlrnc Ih:rl drNCrnrinc ht•Itwu+t re:rc- In+nt Ir+ Slf:rrrl, Icnclr+rl, flt/l•nt•, frn.tr:rUrrn, Inmla'Irln+n. :rml :1 twhnli hr+.t of Ihe irvnl+rmrnt prt+hternc of nnnrlcrn Irfe. lhc rate anrf amnunt uf cif+.ircttc cmt+kinp ft+lluw very ch+ccly Ihc etfr+sme of t'rrt:rin inJiviJualc anJ rry.utatirmc Ir+ cihcrlitmc invr+lvinl+ int'reacinP of rlrtrracrnR crrccc and ctr:rin I t+r ct:nni+h•, in Wrnld 1Vnr II Ihcrc wac a rn:rrkcJ rice in per caf+il:r til•arcltc tr+n.urnl+tirm hnth :rmr+ny civiliinc anJ rnrht.rty pcrtrrnncl *1 here ic cviJrnct' arfl-c.tinF Ih:rt thr vm+kinp n/ :tn inttivirhr;tl ic tlcrcr mineJ hy hic inncr rrat'tinnc ac charctl by eutrcrncly cnmplct inJ varicd Fcnrlic r.ntl envirnnnrrnt:rl f:rctr+rs In t+thcr wnrdc. Ihc cmt+kinF Ir.rhit m:ry I+c a rr/Irr rirnr of Ir.titc ralher tlr.tn n rfrtrrrnirrrr of Iht•m 'I hic carlrjrt t t1e ccrvt•c frntht•r t tl+lnr~linn l 11~1(l,vc Srt,filr.4lrt, 4n'n r 011 It will Irr rrarlrly accn Irnnt 1ht• rh•,r uccir+n of v;trit+ttc 1cluclc of In h:tct't+ and Irr:+lth tlh.tt thc cnl+iccl ic hrr+aJ ,ml the pn+hlcrnc cnmplec 11rr inrl+rrrlrr.rr fh+rnr it rlrnr nn m r rrrnulntirrn rrf nrrvrrrnrt of rirrrern- tlnnrinl or irr/rrrnrurl rfnrn it nrrr n tulrtnrurr, frrr rt/+nirnrnrnl nnrl rfinirnt rrirlrncr hntrrl.nrr dirrrl nh(rrt•nri.rn On f)cccmF+cr I?. Ihc lr+rrrnnl of rlrr Arnrrirrrrt hfrrlit'rrl Attnrinrinrt, cnntmcntinR etlitnri.illy nn'•Snnrkinp :mJ 1 nnr ( inccr,° cnitl "Nrillrrr Ihc rrty.r+ncntc nor Ihc t+phratcntc nf Ihe cnn+kinr thet+ry h,vc cullit icnt cvitlrntc In warr:rnt Ihe :rccnmpUrm ttf an :rll r+r nr+nt• authrait,uve rt+ailum " lhcre are rnany (+erct+nc, hnth intclly't•nt Lryrnrn anJ atitntict., wihrt will aRrce with that clalt•mcnt.'They will ntrt accel+l :, citnl+le cance anrl t•fTt•ct rclalinnchir in canccr anrl cnrdir+v:racnl:n rlictacc unlrcc cuch a rt•t:ttir+nchil+ can he proved f+y srnncthing mnrc than tli.rutcJ ct:Nicticc. IrancfeneJ inlcr rrclitinn frrmr anirn;rl wru/, nr lirnitctl :rtttnpcy /inJinl'c Neither will Iht•V rejt•tl a prncihlr rr+lr (rn trrl+:rttr+:rlrrnl wilh nlhcr t•nvirrrnnrcntal rtl+rrcnrr unlii cvirlcntc Iwnuifv :t Irtue cv.rlu.rtrr+n Ifrlirf. (llrlrrlrl f1y I'n.l f..lrrrir•n.r. Ihe cxl+cricntrc r+f the Lict cix ye:trc :rnrrly jndify ;tnd cul.l+r+rt Ihrtc hcticlc hcld hy tlrr Itd+:rccrr Inductry Rc•r:rrth ('rrmrniltcc iml r+titrrc I Any rr+lc of tipmeltc cnu+kint• in luunl• c:+ntrr anJ rt•rt:rin nthrr rlicricec Ir:+c nnt ht•cn I+rt+vctl nt rmrtnnvr. ? If hrlr.rttn h.ra :rny tnlr it i. nntt'rLrin nnirlcnhlrrrl. :u rl rrn in.. 1 N 1ur Ir rnrrrr rr•.rnrt Ih ia nrrrlr rl In hrllr t Inrify ;tnrt rlrlinr Ilrr I lr cipnilit':rnt I+rr+hh•mc, antl Itr Jctertninc thc hcct wny Irr liml the ancwcrc tn Iht•m 1 ,411 cviJcnt'c• int:ludmF th:tl which Jcnumctr:rtec Ilrc P.y+c anrl unicrlainticc :nrJ ct+nlrYJiclitrnc in txur knt.wlctty,c, chtrulrt hc rte scnlctl ttr /hc puhlii httnestly and (ally llre indivincirl can It+rm his nwn cuncnJcrt•d r+l+utirrn tmly un llrr hu.h u( .rnrrfrlrlr nrfrnnrrrlrr.n A Iln/nnrrd Aflirude l he l nh:rccn InJuctry 1(ccearch 'Ct+mmittce hetieves in Ihc crt•atittn and mainlcn:mce of  h:JanccJ :utiluJc ItiwarJ the ttrhacco and heallh cilualinn. It Jtrcc not hclicve tlt:rt Ihe cittr,rtinn h:tc ht•cn ctrlveJ, that Ihc prnh- Icm has Irccn lakcn carc of, and Ihal tlte :tnswcrs are kntrwn. We Jtt know Iltat Ihc prttblcmc in cancer anJ cirJiuvascnlar Jiccaccc arc Ircrncnrltnrcly cnmplic:UCJ :rnJ the chancc ttf ftndinR a cintplc ancwcr is cmall t+r non- eR1{1enl. I.ct uc Lc l+irfctlly wrr ttf wh:d we cnll cstal.liched t'iuca) I:ttlnrt, and let uc f+c huncct in r.ur cvalu:rtittn t+l whal we >1Jvtn•ate ..l Ihe tnundnctc anJ value trf eviJence---hefnrc wc altcnrfH tn ct+nvincc Ihe puhtic of :rny proven Fuill trr lack of Ruill in any widespread huntan uc:tp, ta cudr+m, whclhcr It.hact•n ncc nr cnrnclhinR clac. Whilc this illilude hac hccn crilicirctl by a ft•w ac hc•ing tnktruclive, it is actnally, frorn the InnR-limc (N+int of view nnd fnr thc ptH+J of ccience anJ hurn:mity, f:rr Irt+m hcinp cn It is ntuch hcltcr to prt+icctl nccuralcly :ntJ cltrwly ttt rcvullc thal will l:t.l. Ih:tn it ic In (+rt+icitl a•nc:rtir+n:rlly :rr.:! r:rl+iAly Irr tcnt:ruvc rnnt:luatrnc and l+atl-trullt. thal rn.ty I:rtrr havc Ir+ hr ah:rmlt+ncJ llre lt+h:tccn InJuttTy Rcccarch ('t+rnmitlce will incid nn t't+ntinnnlirm of cttncerv:rlivc, t+hjectivc, :tnJ painct:rkinr rccc:uch trn whith Ir, cct:rl+ Ii.h :rnd cxlcnJ hum:rn knnwleJhc in lihhting Ihc ctmctitnlir+n:rl ncm-accc '1 ht•cr Jivcact c:uc :rntl will I.e rn:m'c yrcal Lcacclimc cnrviv:tl I+tt+blrmt i 11