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THIS DOCUMENT SUBJECT TO WIDENTIALITY AGREEMENT. CONSUMER SUBCOMMITTEE oF zaE COMMITTEE UN COMMERCE UNITED STATES SENATE NINETY-SECOND CONGRESS RECON'D eESSION ON S. 1454 TO iME.\'D THE FEDERAL CIGARETTE LABELING A_VD dDVER- TISING ACT TO REQUIRE THE EEDERAL TRADE COMMISSION TO ESTABLISH ACCEPTABLE LEVELS OF TAR AND NICOTINE COI:TL5NT OF C1GeRERITES FEBRUART 1. E. AND ]0. 1972 Serial No. 92-52 Printed for tLe a.e of tDe Commlt0ee on Commerre CTR HN 014*705

THIS DOCUMENT SUBJECT TO 140 CONFIDENTIALITY AGREEMENT. the ndvertisement of the parts per million of tar and nicotine be- cattse tlte' v said stop this tar derby. Now, Rhat you are sa\'!ng is that thP mnnttfectnrerc ottght to get back into that btisiness. .klr. STEr1tAXO. \o. what I am saving. in'terms of the newshnrrr= which you aaw. which you probably did see. they were prol,nLl, v back around 196i. The recent reports of the tar and nicotine con- tents as released from the FTC have not been receiving any Pul,lic exposnre. We have a clipping serr•ice. and it is minimal. Iwould ro.• limited in the last time to perhaps three or four newspapers natint,- al1v. Senator Ccnx. Well. I can only mv. it seems to me that if thi; i= an inteernl part of the promotion of vour Product it would not t,tke verr mnch to have R few hundred thousand printed and ask cigar and cigarette counters all ocer the United States to post them so evervbodv can seP it. It jnst seems to me that we have enou~h inter- ference with the Federal Government. We have some 30 odd hills Le- fore us that in some way restrict this industry. I hope the Federal Government doesn't get into the business of telling consumers Athat products to bn}•. .%Ir. STerxaao. Again. just to correct that. We are not telling them to pick one product over another. But I belie.•e that if this ma- terinl has potentiallA•, an}- implied importance. that the smoking public shonld have acces~ to it. Senntor Ccxix. \fY only disagreement with you. 'Mr. Stephann. i= that yott took the time to quote high tar content from the Surgeon General Steinfeld. and high tar from Surgeon General Stewart. and then turned around and said that we are Rav down close to the l-ot- tom. So. it seems to me vou want to utilize the fact that government officials have said it is bad to smoke high tar cigarettes and theY ought to publish this because your prodttSt fits into that cate"ory. Nfr. Sr>;rAttxo. Anyone could join us in that categor.y. Senator Coox. Thank vou..Mr. Chnirman. cenator NioFC. Thank ~ou. 11r. Stephano. We have a live quorum and then a vote. We will recess until 1:) minutes past 2. and at that time I.rill ask Dr. Sommers and Dr. Hockett to be available to answer questions that Senator Cook hn=. and we will proceed. and if I am not back by then, I want Senator Cook to go right ahead with his questions. Thank you. ( Recess. ) Senator Coos (presiding). We ask Dr. Sommers and Dr. Hockctt. if tltev a•ill, rlease, to come forward and we will kind of take it collectively, if you don't mind. FVRTHER STATEMENTS OF DR. SHELDON C. SOMMERS AAD DR. ROBERT C. HOCKETT Senator ('cx)x. Dr. Sommers. in regard to the tectimon}• I am sorr%- thnt Iwns not here this morning. However, I read .•onr t;tntement. There nre n number of questions that I would like to ask you. and Dr. Hockett. Dr. SommerA. nre you in honest disagreement with the Sur~eon Genernl of the t'nited States! C! R f E ! ''1 0.! "'t' "7c..s 6

. i of tar and nicotine t,e- hat you are sax •ing is that it business. , termr of the newspapers sPe. they were probably :he tar and nicotme con- )een receiving am• pulrlic t is minimal. I would sa% • • four newspapers nntion- -~ems to me that if this is nrculuct it would not take id printed and ark cigar I States to post them so ,nt we have enough inter- ta.•e some 30 odd hillc be- tstrn•. I hope the Federal -f telling consttmetF rhat. :hat. We are not telling I believe that if this ma- tance. that the smoking th you. AIr. Stephano. is ontent from the SnrgPnn ron C;eneral Stewart. and nr down close to the hot- tlte fact that govtvtment : tar cigarettes aM the% ' ts into that category. at category. 1. We will recess until 13 ';k Dr. Sommers and Dr. _ that Senator Cook has. by then, I want Senator hanl you. -)mmers and Dr. Hockett. we will kind of take it LDON C. SOIdliE$5 CSETT the te-timnny I am sorr% • I read vour statement. ould like to ask you, and ement with the Surgeon -i& I t ?HIS DOCUMENT SUBJECT TO 141 CONFIDENTIALITY AGREEMENT. Dr. SoMxen.S. In regard to smoking and health, sif: indcrd I am. In the public press he is quoted as making statements-which I regard as immcxleratc, as going be%•ond the scienjtfic facts, as making a kind of a publicity appeal, which does not scem to me fitting for the oflice of Surgeon (Teneral. . One of his statements is that those who disagree with the Govern- ment's position are actuallc doing harm to heople's he:,lth. Ivvu= tnvht that a doctor never does an~' harm. I am a physician. I don't believe that a free e:Pre% ion, in my opinion, lxtsed on my expcrien, P. research, and reading, if it is the truth, is going to l,orni an~•lxoc:t. The truth will set us ftrP. Senator C'oot:. Dr. Sommere, did you hear Senator Slxmg'= statF- mcnt this morning? I)r. SOMMERS. Yes. I did. Senator Coox. For the record, I would like to read threP or four sentences back into the record again, because I think thev are .1n im~wrtant. Scnator Sror.g said this morning, with all respect to the motives of those who support the pending bill, "the mensure in my view represents another example of the mistaken nttitude that the F`edernl Government knows what is best for all citizens nnd sliould l,e em- powered to make all decisions on their behalf. The bill is a sl,lendicl example of big-brotherism." It prohoses nn introduction of the Government into nn area of decisionmaktng that rightfully belongs to the individual. Do vou believe that Dr. Steinfeld would not ascribe to tltnt basic• philosophy? I)r. SoaatcRZ. I really don't know. I am nfrnid he mighr not. Senator C'c-ac. Do .•ou think that that could be l,vtially ful- stnntinted hv his remark in delivering the 1973 repott, nhen he said there ir no longer nn honest disngreemeto ? Dr. CoNf.NIT:K,. Slr, that is manifestic untrue. Senator Conh. In vour statement, doctor, von usc thc l,hra=r smokers and nonsmokers are self-selected. 11'hat do .•ou lnean whef, ~•ou s.~r that ? ~ Dr. ;oat~trn~. So far as I lnow, no one is forced to smoke, and no one is ab--olutelv prevented from smoking. Ordinarily people deride for themselves whether thev will smoke or not smoke 1\'lien thc•.• elect one or the other, it tells us something alout that pers-nn, v,nw:- thing about this 1>s~•cholog~•, their physiology, nnd their antl:r~~- pometr~• and so on. Senator C'cKit;. Ikmtor, does thP recent report by Dr. YeruzlLalmy hnce an%' relationship here? I asked some HER' t~ittiPsaer alirnu tl:i= study earlier. and who told that it hsd lken criticized. ancl thcre•f(,n. there is no reference to it in the report. Dr. Soatmcns. It is 'wssible to criticize almost anything. A mn,t interesting finding in tlie recent ~~crushalm~• rcllort o~t uinther whn smoke or did not smoke, and the birth weight of their inf:uit= %%:is that wotnett who did nnt vet smoke hnd smaller infant;, signitic,uttly smaller in h•eight, than worocn who did not smoice, although thc women had not Wt takPn up smoking. And thic indicated anutlu•r aspect of diH'erence between tite smoker and the nonsmoker. CTR MN 01470'17

THIS DOCUMENT SUBJECT TO 142 CONFIDENTIALITY AGREEMENT. R'hether or not this is re.ally a health isoue is undmided since the<e smaller babies survive just as well, or perhaps sometimes better, at infants of normal birth weight. Senator CooK. HE\1' said thev were aware of the Terusltalm~• report, but because there was critrcism, they made no mention of ii. And vet in the insertion of chapter 9, relative to the ingredients of smoke, on two occasions they footnoted their report and said that there was not unanimous agreetnent on thicz point. On that basis, they should not have had chapter 9 in there hecauFe there was an honest disagreement between people in that 1-day seminar. Isn't that true ? Dr. SoxxExs. That is true. Senator Coox. But thev felt compelled to put it in, anva-ay. Do rou believe that the 1964 report of the Surgeon 6eneral's adcisorp committee and the reports to Congress presented a balanced revieR of the evidence on smolongf Dr. Souat:Etts. No, sir. I believe they represent selected ret-iews with editorial comments, with deletions or failures to cite studies that didn't support their oonclusions, and in some cases gem:ine inac- curacics. For ezample, there is a study by Iieys, on factors related to coron- ary disease, and in the 1971 Surgeon (`ieneral's report, on page 310. in discussing the monograph, it sza}•s that smoking was not considered in the two Japanese populations. However, if you refer to the article itself, it turns out that there i~ conciderable information on smoking of the Japanese population. Senator Coos. As a matter of fact, to buttress thnt up. Dr. lln\-a' mentioned the fact that Japan was one of the countries tljat hc• referred to in his remark;, and the chairman referred to Japan as having done extensive study in this field, did they not ? Dr. So~tattns. That is correct. So, vou see, we not onlv have onti=- sions, but we have editorial comments and we have errorj in this report. Of course, nothing is likely to beperfect. However, I think over the years, tha~e reports have consistentlv showed these trends. .''~.o, in my opinion, they are not a*balanced report, and they do not reflect a fair representation of the state of the art. Senator Coox. Do rou feel that thev intentionallv nerlectec' to state the facts that the studies thnt were made in .iapan werc found to be br far the heaviest smokers of any of the other grouPs rtudied. and Set they were found to have the loRest death rate from heart disease 9 Dr. Soxvans. I think. sir, that is 1ike1v. Senator Coox. Would it serve the purpose of the antismokine tenor of the relwrt since 1964 not to report that ns a mr.tter cif stud%_ '. Dr. SouxEtu. They always emphasize com•erging evidrnne. There- fore, the~~ are inclincd to ignore or to downgrade any evidence that doe; not converFe. Senator Coos. Do you think that that mw}• also have somethin- to do with the fact that the 1969 and the 1:17U studv b•: the KA-1 relative to smoking and the contamination of air in an aircraft Rns convenientlv not delivered to the Surgeon General until 1971. And. therefore, not made a part of the 1072 report even though it R;is reported in Jack Anderson's column in 1970 ? CTR HN 014~r'`06

0 0 I'HIS DOCUMENT SUBJECT TO 143 WtiFIDENTIAUTY AGREEMENT, ue is undecided since these ^haps sometimes better, as • iware of the letushalm% er mnde no mention of it. 3tive to the ingredients of heir report and said that point. chapter 9 in there becauFe !en people in that 1-dnv -) put it in, anya-ay. of tJte Surgeon l`retteral's gnss presented a balanced esent selected rerieRs with tlttres to cite studies that some case_s genuine innc- -n factors related to coron- ral's t{eport, on page 39. in ioking was not considered f. it turns out that there is Japanese population. lrtress that up. Dr. Du\'nl of the countries that lie nian referred to Japan as id they not ? e. we not only have omir- id we have errors in this However, I think aver the -d these trends. >d report, and they do not )e art. intentionall%• neglected to iade in Japan were found the other groups studied. est death rate from heart e of the antismokine tenor i~ a mt;tter of stud~~' '' n~•erging evidenre. There- ,ngrade any evidence thnt a}• also have something to 19'.0 stud~• br the FAA of air in an nircraft Rns General until 1971. And. eport even t2ough it was .} F \ . Dr. Co3tatznc. Yes, sir. I have learned of that. I think tlint is rather surprisin=. Senator Coos. I.rould have a notion that even Dr. Steinfeld might rcad Jack Anderion's column. f L'auFhter.) Senator C'oox. Dr. Sommers, I was concerned about vour conunent in your prelmred statement that scientific informatiou or data li:,, been kept from the scientific ootnmunit.•. Now. can ~•ou comment further on this, and if possiWe, eike es- amPles of some utstances which have occurred in the sn,okutg an<l, health nrra : Dr. aoat3aLr.s. In epidemiologic studies, in the ]nst fe%r rears. it ha;z turned out that new techniques and reevaluation of old data will show that the original conclusions should be changed. and this hn~ been permitted by all of the major investigators in England. I understand. and also •:ome in the United States, but some in.Tsti~:,- tors have refused to release their data, the major one being Dr. Hatn- mond. Now, that epideaniologic study probably is not balanced for the whole U.S. popnlntion. It evidentlv had 'verc few \egroes. so the conclusions could not be applied scientificallv to Negroes. N'hntever else may be in that data, on ree~aluation, it is impossiLic to ascertain because he has refused to release it. One wonders if lie has something to conceal. .Vso. in regard to the smoking dog studies, you probabl}• knnw that anerbnch has refused to pennit his microscopic slides to be examined bc an independent panel. Senator Coox. Don't .•ou think it is rather strange thnt the Snrgeon General and the IIE1C shQuld continue to refer to the Hamtnond-Auerbach studv when in fact it has lpen di,~credited and its results have been refused to be printed by any medical journal in the i'nited States, which. br the way, the S»rgeon General con- t•enientl}- uses en masse wheit he wants to utilize them for the pur- poses thnt fits his bias. Dr. SoMatExs. Yes, sir. I don't believe one should continually repeat the statistical epidemiologic data from the 1950's and 19f0's. as tf they were Fospe1, when we have learned considerably more about tlle teclmiqnes and about multirariant analyses. Senator Coox. Let me nsk both of *rou this question : Don't yon believe that ther continue to refer to the 1\'vnder mice study andthe Hammond-Auerbach dog study because they haven't progressed anc further than that 4 , Dr. Soatattt.k. That was the major work which seemed to support the conclusion. That would be mv answer. Dr. Ilocxrrr. I would say the sarne thing. Senator COos. Do you believe there is any pressttre on scientists to nerept the SurFeon rencral'{ vieR thnt smokmg- is dangcrmr' Dr. Soat.rraa In terms of research grants, many scientists arc• del~cndcnt on government for funding, and there have been examples where heople would like to appenr before congressional committm; Presenttnv 'their own reAearch which didn't agree with the conclu- sirnis of the Sut geon General's report, where they have been ]mevented bv their ndmintctrative superiors from appearin~ under the belief that this would jeopardize their research support. CTR HN 0 1 4~f0~9

THIS DOCUMENT SUBJECT TO 144 ppNFIDENTIAUTY. AGREEMENT. • V- Also, there ore cases of articles on various aspects of smokinl- and health that have been in one case accepted for publication, and then after a note from a former Surgeon General, had been rejected by tio• journal, and there is another e:Ktnple of a raper a•hich is coming out now which was refusetl publication on t)te basis that in part tl~c information was nlrend~• knoR•n, but this is not the truth. There i< considerable new eriderice in this paper which I think will influrn(•: our understandin of this part of the smoking and health problem. Senator Coox. ~oR, there was a mention by Dr. Gori of the tobacro working group, and I believe some HEI1" toLacco cooperation p•oul)=. Now, are there tROgro ups or is there one, and what generally ts being accomplished in this 6eld 1 Dr. SoxxExc. Well, sir, this mornin . I explained it in part. but the real point is, I hace no relation to the tobacco working group. This other group is called the Suboommittee of the Joint Comrrcit- tee on Smoking and Health, and it involved an effort on the part of representatives of tlte A.U-ERF, that is the foundation of the A\U that undertakes smoking and health research. and then oflicials of the NIH and representatives of the Council for Tobacco Researclc. We were asked to see if we could develop a document that would explain gaps in knowledge in the smoking and health field and priorities for research to fill these gaps. We labored hard at this. and as I ez plained this morning, we never achieved a single document. That subcommittee is still in ezistence. It has meetings at the call of Dr. Gori, who, I believe, has now become the chairmmn. From tintr to time we exchange other information nlx)ut grar,rs that have been approved. lt is our wish to cooherate with the AV.a- ERF, and with the government. KIH. insofar as this is possilde. ir: all fieldc of smoking and health research. We are soniewhat Lnncii- capped because the present chairman, Dr. Gori. shows little enthn-i- asm for this committee, altd is inclined. I think, to put otT calling nieet i np.. Senator Co-»;. Is this basicnllv because there is a disagreement of the beginning prerni,"? Dr. So:%txcrc.c. Sir, if we were to have a joint dncuuunt. in e-scenc,•. we were required to nccert the contention of the rnvertcrnent tlcar :c cnus:al relntionsltip between cigarette smoking nnd ]nng c:tm•er mcc<• be arreptod. We -were not, of coutsc. able to do thic. nncl that wa= tlcr chief single point which prevented a sincle document. The Qecond point war. that in the gntionnl Institutes of Ilcalrli'= draft, there was frequently a budget pn,-c, so that iu es:cnce. iu th.•i; minds, thc• problem is solved, and now let': gct on with l,udgrtiri= ctehs we will take to implement this. And this is not thc rntcclvrsr;ticcl- tng of the state of the art on the part of the ANlA-EI;F or t:w ('ounril of Tobacco Research representntives, and that is tlcc• rnain inhibitinr fnctor•. Senator ('cx)s. In other words. there reallr Lac been no prngen•o.= madc• Lmcau-zc• soure of those who had leen asked to partirili:crc• and associate with the dehnrtnicnt, would not agtre to begin mith th:ct the verdict is nlrvmd~• in on smoking nmci henltlc c]rr other ei~+rtrettes c~ius,• dise;t~s. so let's start frnrn there is the attitude of tl,c Surgmn (;eitoral's Oftice. Ih•. ~u~tatr.rc~. Yes, sir. C~`R M~`~ t~14"r''10

0 . ® ® ius aspects of smoking and I for publication, and then a], had been rejected by the peper which is comini, out _lle basis that in Part the is not the truth. There is hich I think will influence king and health problem. b~' Dr. Gori of the tobacco obacco cooperation groups. one, and what generally is I esplained it in part, but tobacco Rorking group. ittee of the Joitlt Commit- ed an effort on the part of is the foundation of the rescarch, and then officials Incil for Tobacco Research. op a document that would ing and health field and e labored hard at this. and •hiered a single document. has meetings at the call of he chairman. inforfnation about grants cooperate with the AV:1- ;nfar as this is possible. in We nre somen-hat 1landi- ('Tori, shows little enthll-i- I think, to put ofI callin_ there is a di_ngreement of ' joint document, in escence, of the Government thnt a cinF and lung canror mnst o do this, and that icas the document. 'mal Institutec of Iiealth's St, that 111 essellre. in ihwlr get on R'ltll l,udgating the this is not the nnderstand- nf the AVA-FRh or the vez. and that is the main •a1l.' has been nn rroglr•-~ :: asked to participnte and . agree to begin with that i henlth? In other n-nrr1-, there is the attitude of the I 0 0 THIS DOCUMENT SUBJECT TO 145 CONFIDENTIALITY AGREEMENT. Senator Coos. Thank }•on .'ert' much, Dr. Somniers. Dr. Hockett, are you in honest disaE*recment a-ith the Sur~F•nn Gelleral Steinfeld's report on the health and smokinA:' Dr. Hncsirrr. I am in disagreement riJso. I have filed sci'Pral statv- ments before these committees, and I have spelled out snnll• of tl~~-r things, and this mornintt I asked leave to tuni into this cnrnl.iitrl•r :1 paper that I presented at the University of Kentucky InFt \I:1y il, which I detailed matn• of the reasons R)1%• various erl~erts cons'ider the e'lidemiolo~ical e~idence to be inconclusi~'e, or the work Ritl~ w~- called tar, to be inconclusi~-e with respect to any incriminaril•:1 iu relntion to human health. I spelled these things out, and to save time I tunlyd in thi= ]ml•cr Rhich goes into more detail, and I didn't repeat nll of thi-. Senator Coos. It is in the record, the chairman tellS rna. Dr. Hocxrrr. 1 es. Senator Coot;. Now, in the present state of scientifir- klinwlecl¢e. Doctor, could I characterize the setting of tar and nicotine in ci:a- rettes, mandaton.- limits, as possibly meaningless and perhal,s mi=- leading ? Dr. HocRErl'. I think they would be completely nteanil;glessn because as I said this mornin~• I sce no incrimination. either of tar as such. or of nicotine as such, or. as I mentioned. carbon n,nrnnxicl~ . which for the first time came into discussion in this Year's r*l1nrt. I think these hare not been incriminated with re~,Met to hunl;m health. And again. I went into some of the reasons. Tar is not wilnl•• smoke. It is onlY a part of the smoke. It differs chemicall~' in physical properties from whole smoke. and it does nnt cnlcain 11.1 the ingredients of whole smoke. and this hns largelY lx•cn t~~rod with the ski!l paintinf_ by mice. and,the mice Scnator CiM,h. But let's get to something more imhnrtant. Li•t'< ftet to the very painting itself. How do thrl' extl•aet the t,ir ' Dr. N K-htnT. It is not estracted. ~mnke comes tl ro l.^.L i c~~'~l h'nJr which condenses it. catchPs it. S'n the tar is F/aoko. ( lf cnnr,r•% it is completel' v incorrect to speak about the tar °contenr" of the cigrarette hecause there is no tar in thP cieatrtte. The tsr ic smnl:r. Itathcr. it is a p-irt of the smnke. It is t]Int part tllnt can 1w• if von ~a« the whole smoke through a cold trap. nu<l it lnnk- Sonil•- thing like tar. Senator OKu:. 11'hen it is taken in thnt artificill] cmlditirn;. whi-ll is a collditinn thnt tvould exist almnst tu1(h•r nn nthl•r that extreml• cold. nnd it is laintrd on tho h;lrk of :1 lu i= Dr. I1:K-htar. Painted ou t1le mice. Senntor ('oot:. 'Now. that mncenttntion of t:u•. wLat wouill tL:lt rerrescnt to the individual in his slnokin~ hnhits? Jh'. HcK'h}:~rr. 1\'ell. carirnls estimntes have lx•on n1adL•. 1.:It th,• anlnunts that arc painted on a small l,ntrll of thw skiu of tiw lur`I:-v alr reullv nstronomieill in relation to what n hmu:ln ik•in, wnulli absorb iii tlormal smokinr. RetnemlMr. tlnlt thi, illtlv•n;ll surf;wo nr, a of thee lung is verv lnr~r, and calculations ha~'e b~4•n nla~l-• to thi• effect thnt it r•otllc~ tnk(--a man would have to smoke ln;l.% hr J11.0-1 cigarettes a day to get companll,ll ;C)IHtM' C(K)X. 50.4 M.9 clgal'etteS da\'. C TR HN 014711

THIS DOCUMENT SUBJECT TO 146 CONFIDENTIALITY AGREEMENT. Dr. Hocscrr. Or more. to get the same relative q- uantit} of tar. so-callc+d. on a similar area of the inter~rtal lung surface, un)css you assumc that it all goes to one spot. Senator Coob. Give me the medical difference between the texture of the surface of a lung and the texture of one's skin t Dr. Hocxr"rr. It is quite a different tissue. The lung tirsue ic. coated with a mucous sort of material. a water soluble material. The skin is covered with a scalv laver. and there is an oilv sub- stance that protects the skin. So it 'is a~•er~• different l-ind of a tissue from the lung. Senator Coos. Not the same at all? Dr. Hoc'r.Err. \ot the same at all. And we have had actual experi- ments where smoke condensates have been put directlY into the lnn_s of animals. and the responses are not the same as thev are on the skin. The lung is much more resistant. That may be because it has such efficient deutsing mechanisms. Tar is carried aRa}•. Senator Coos. Let's get to the smoke in another instance. b,ecause I read a report last night that in many instances tests are made on the streets in many cities throughout the tnited States, where it is not uncommon to come up with 100 parts per million of carbon monoxide in the air. .Nnw, Dr. DuVal in his testimony made a great to-do about the smoke and said that thev had tested some smoke-filled rooms and came up Ncith the horrible conclusion that the monoxide in that smoke-filled room averaged from 20 to 80 parts per million of carbon monoxide. Would this disturb You? Dr. Hoc'xrrr. It would not disturb me ren• much, becausc -onie of these committees on standards have set 100 partspe r millioi, of carbon monoxide as a safe le~•el. or a safe maximum level. for con- stant inhalation. as in industrial situ[tions, for an S-hour dav. Senator CooF. Aren't some t.S. health standards higher than 1ix) parts per million in an 8-hour da.• 1 Dr. HocRrrr. Yes, the Air Force has set up a whole series of standards. The safe levels are related to time. The shorter the time of exposure. why, the more (higher level) you can tolerate. They will allow roung men to go into an area where the}• know that the carbon monoxide is 1.000 parts per million for a short period. and this carbon monoxide comes back out of the lungs as soon as they are exposed to purer air. The hemoglobin is undamaged. All that the carbon monoxide does is to take over some of tlte space in the hemoglobin that otherwise would carn• oxYRen. It does not harm the hemo.-lobin. It just gets into the vr~.• of the oxygen. Senator Coox. I have heard about this. and if You have am• knowl- edge of it mnybe you could help me in substantiatinF it. I do jint know. It is mv understandin~ that one of the tests that thP~• have relied on in relntion to blood levels and monoxide levels and smoke levels was that they put four roung men in a\'olLswagen. rolled the windnwc tth, ench one of 'them smoked a pack of cignrettes inFide the Volksancen, with the windows clo--ed. inside a closed Faral-r. Is that trtie? Dr. Hncurr. Something like that. It was a very contrivFd sinma- tion. It does not seem to correspond to anything thnt Aras likoh to f~ H~~ C~~.4~r ~.~ C~'

relative quantit% of tar. lung surface, unless you rence between the texture ie's skin P .ssue. The lung tissue is : .rater soluble material. .nd there is an oil.• sub- .•ery different kind of a e ltare had actual esperi- -ut directlv into the hines same as ther are on the at ma}• be because it has carried aR•av. another instince. because st.ances tests are made ott 'nited States. where it is :s per million of carbon a gteat to-do about the ~ srool-e-filled rooms and it the monoxide in that ;u parts per million of verr much, because come 100 parts per million of , ma=tmum level. for con- for an 6-hour dav. :andards higherthen 100 ,et up a whole series of me. The shorter the time j vou can tolerate. The,. • : here thev know thnt the . for a short period. and he lungs as soon as theN • indamaged. o take over some of the ild carry ox' ygen. It does ~ the way of the oxygen. d if you have anc knowl- bstantiating it. 7 do not •sts that they have relied e levels and smoke levels Voll:swatren. rolled the nacl- of ciRarettes inside inside a closed garage. s a ven• contrived sitita- thin;; that .cas lil•e1,v to 147 THIS DOCUMENT SUBJECT TO CONFIDENTIALITY AGREEMENT• happer. in real life. I am sure anybody would be uncomfortable w~der those conditions and would open the.rindoR•s. Senator Coos. I think that is a•hr the genius of automobile manu- facturing gave you a handle to roll'the window down. [Laughter.l But it is my understanding that this type of test was conducted. Is that vour understanding? Dr. Sox5tEtts. Yes. :11y understanding is that a rather unrealistic test, with whole packets of cigarettes smoked in a closed automobile with the windows rolled up was one of those cited. It is an old idea that one takes a canar}• into mines because small animals with th~ ~c metabolisms are more sensitire, and one would imagine a canar.y would show signs of distress before human bein~+c. Senator CooK. If thev had four in the VolksR•agen may l,c they did not hare room for the canary. [Laughter.] Dr. Hockett, is vour ability through technology to identify ingredi- ents or trace elements or whatever greatly improved o~er recent years? Dr. Hocatrr. It certain}.• hss. In the last 10 or 20 }•ears enormouslv sensitive chemical methods of identifying very small concentratioris of substances hare been worked out. So a feR• ~•ears ago. you sec•. if some of these questions had arisen chemists .rould not h;ive been able to detect any presence at all of some of these things. N.'ow thev can be detected cbemicallv. but this does not answcr the question, the biological question: Is there enough present to be of any real consequence under real life conditions? You can take almost anything that we use and consume and sul!- ject it to modern methods of analysisr and you will find infinitriimal traces of things that are classed'as poisons. They are erer}•where. But now we have the question, what is the biolo~ cal si~ tificance? Our bodies are able to handle or detoxify and remove and ezct•ete these things. So that we have a whole battery of biologica! problems . succeeding the purely chemical finding of somethinF in traccs. Senator C*c+s. :1fa'~•be we should all ascribe to a•hat \Ir. Stephano said. '.NIa}•be the way to get our side orer is to adopt the law to have those who disagree to have their publications printed by the Feder>>1 Government so that information can be disseminated on both sid(•s. Uavbe that is what we ought to have. Dr. Hocst:rr. Equal time9 Senator Coox. We had that equal time on television one tinte. Doctor, a.nd that was taken awa~• from us. Those that have eclual time with us now have all the time. You recall that? Dr. Hocr.crr. I recall that. Senator Coox. Does the fact that something may be identificd mean that it is incriminated as the cause of am-thing ? Dr. Hocsicrr. It certainly does not. It requires very extensive and ingenius biological research to find out. If it really does hartn. why. generally that fact soon becomes pretty evident. Senator Coox. Aow. we heard a lot the other day about Fmokin~ causin; this and smokin~ causing that. And one note I matle R•a= smoking causing pcptic ulcers. `Thnt about this? Dr. HocsErr. 11'hen the statistical studies came out. peptic ulcer was one of the diseases that was statistically linked. or in othi•r aords. occured more frequently in smokets. CTR HN 014713

~S14S ~S DMUMENT SUBJECT TO ~ ' CONfIDENTIAUTY AGREEMENT. The Council conducted rather e:tensi,•e studies along these liuc.s. and people who had had attacl-s of ulcers were subjected to qttirc sophisticated measurements to see what hapl,ened to the gastric secretions when thec Butoke.d cigarettes. Sonic nine different factors were studies. And t}rere was just no significant effect of smolcinl- on these Paramr•ters. which almost forced us to the conclusion thar. a= already had been suggested. ulcer is a kuid of psychosomatic disHasp .chich attacks people who have a predisposition reflected in the they handle te)tsrou. frustration and the like. and this ,•er~• t~•lle of person who is ulcer prone would tend to use tobacco perl,al~s tnot~• than other people because of its tranquilizing effect. It. tvas quite unclear that there was any causal rt•latiunsLil~. I think the weight of the e~•idehc•e is against atn• such concept. Senator Ca,t:. But if cou have sontcone xvho smokes a great d,•:,l and he hns a peptic ulcer, then you automatically assoc•i:,te thf• smoking with the ulcer. and not the fact that smoking•ma}• give him an outlet which could trlie~•e tension that causes u5cet:s. Dr. HcM•>;>:•rr. Yes. If we could develop n sophisticated studY it might l,e shown that smoking would reduce the possibility of ulrer: in l,eople thnt the predisposed to it. But this has nc,t been v~urked rna. Senntor C(K)):. Did you make your findings of this stud,• a,•ailalde to the ro,•rrument ? Dt•. Hnc•t;err. Yes. these were all published in the litc•ratur•. A1; our studies were published. cc•natot• ('cK,tc. Pul,lished in „•lLnt literature? Dr. H•Kxt:rn (ietreral literntute. Tlre.v published itt ,cliat they hleascd. Seuator Ccatc. Were the.%• picket up and uriliz,•d in at.Y wliv I„ the Federal ('.o,•ernment in its report sincc 1Qf4 ? Dr. Hoc•srrr. I do not even remember „•hctl,c•r tlu•v „•,•t•e rc•f, r l,•d to. I know we dalicemd thetn to the ~Izur; eon Genor::?•s corn:iiirrc•~-. Srnator Curnc. Have you read all of the trlx,tts ou smckiug :;:i,l health sit-ic•e 19t'.•1% Dr. Hcx•t•:r.rr. Yes. CPnntor (•„clt;. 1Cac thrrc ever a.,,• rPferetu•e in th... fnrc thit t!I,: ori-in:a r•laim tl,at srnokit:;; canst•cl hel,tic nlc~r:. t!:at thnt rnn,• lw,•c• lxrn a state:ncnt : l)r. 1(~~ ,;trr. \.,. I cannot tr,:,ll thet it ever outit;,•c; it•••11, the clrr.t•ts on nc•c•otu,t of this k:ncl of work. 1ctintet• ('cNn:. In n!l1vt• „•orcls. it is still stnntlarcl nl,ota! il:= l n- cednv1w•r•:;ttsc' tluVr (1o nnt trr.llr Alatrt tcl acltait tlt:a thcv t~:;icl ., ily nnt rnr,rct ? I)t•. Ii-M-acr:rr. TI„at• hac not becn an.• m•rr: rc•tra(tio,i. )1,,•t,l ttlcc•r l,a~- t:ot b,-en n,i•ntiotretl so tmtch lnti•Ir. liut tl,^,• LaVv 1101 5:6,l this h:t: retno„•cw3 from the list nf sttsj,rwts. so far as I Sc•nnt„r ('cN,r. It, other words. IiI 1\"s 1Msitinu is wliat ~ul l,tt. i nI%• bacis i, relw,rteci. but h•nat contrac:irts n:~~ basis is lint I),~ l~,th of ~~uu tliitilc that thc•t• c~~ has ]x•etr a t,c_li•rt on tlu• l~:,r! ,-f tlu.sc. tr1Kn•ts tn rc•fer to v6cntific and medieal studirs that r,•futr tiiv prc•,•irnrs t c•lx,t•ts nf the Srn _rot, Ucuet al'~ of5c•c• ? I)r. J- -aat:t::. I think it'is vcr,• difficnlt in a ttumlx,r of .1mrr medival journals to get n puLlicnrian acc•el,tt-d that dors not f-,:! ill line «itlt the c•on,•lusiott of the Surgeon G.ttcral'a r,-port. I t! it.k ~''~.~ CTR 4~°~N (~~.~~''~.