Tobacco Documents Online

H KO0894G97 ~~ Revised JOIMf COA~QITTEE ON TOBACCO AND KEALTH San Francisco Hilton Thursday San Francisco, Calif. June 20, 1968 Present (See attached list) Purpose of the MeetinR Dr. Endicott opened the meeting at 9:15 a.m. by stating his understanding of its purpose: "Recently, otticials of the Department of Health, Education and Welfare met with executives of the tobacco industry to discuss areas of mutual interest. Among other things,'tbe group agreed that there are gaps in our knowledge about tobacco and health. ~ It was decided that a group of esperts be asked to identiiy these gaps and to recommead appropriate action including work to be done, estimated costs, and priorities. "It was further decided that the Department should invite repre- sentatives of the Committee for Research on Tobacco and Sealth of the American Yedical Association Education and Research Foundation, and the Scientific Advisory Board of the Council for Tobacco Research to meet with representatives of the National InstitutM of Health to plan the Croup effort. It is hoped that such a meeting will develop a cooperative effort of industry and government to fill the knowledge gaps." Senator Clements read the tollowins statement: "Doctor Zndicott, we concur in your statemsnt and join in your hope for a fruitful and cooperative eftort. "we agree with your observation that there are gaps in our knowledge about tobacco and health, and recognize that our initial goal in this continuing dialogue is to identify these many gaps. We must seek agreement on what can and should be done, and follow through on recossiendations made in mutual good faith. THIS DOCUMENT SUBJECT TO CONFIDEHTIALITY AGREEMENT. '~~ CT' HN 0 149-

~ ~ ~;C ~ ^ C ~3 Joint Committee ~ , . ~r ~ ~.8 t~ ) on Tobacco and Health - 2 - "Representatives of cigarette companies are here today. As you well know, these companies have for years funded independent research grants administered by the Scientific Advisory Board of the Council for Tobacco Research -- U.S.A., or by the Education and Research Foundation of the American Medical Association. The interest of these companies in scientific areas pertaining to tobacco and health is a continuing one. °We genuinely hope that this meeting will be the beginning of meaningtul cooperation to find the needed answers." In reaponse to Dr. Seevers' question, Dr. Endicott elaborated on his statement. It is his personal hope that a continuing liaison group will be formed to provide communication of the research supported by the different groups and possibly to stimulate joint planning for specific projects that might be sponsored. 8owrver, the present meeting was called in response to conversations held in the Secretary's office during which an industry spokesman proposed that a joint government-industry . program should include facing the problem squarely, attempting to determine what needs to be done to resolve it, and then getting on with it. The Secretary indicated that he would welcome a specific proposal of the work to be undertaken, the priorities, and the cost in order to i determine a budget for the government's part of the program which he might propose to the Congress. Dr. Endicott thought it implicit that a subsequent meeting between Department and industry representatives would be held after a scientific group had assessed the state of the art and had recommended which part each group would undertake and how they might work together. Gaps in EnowledRo Dr. Baker questioned the meanins of the word "gaps"-he understood it to refer to establishizg associations between certain conditions in man and smoking, as well as modifying cigarettes. 8o asked Drs. Little and Seevers how their respective committees had approached this problem and whether they sought applications or funded the best of the proposals submitted to them. Council for Tobacco Research: Dr. Little stated that as the Scientific Advisory Board had evolved and accusulated enough information to define its targets, it had begun to initiate and to seek projects on this tar- get. At present, a sub-comtiittee of thres members is reviewing previous epidesiolo.*ic studies with respect to the specific probla of exposure to whole tobacco smoke and measurement of inhalation, working towardr YHIS DOCUMENT SUBJECT TO CONFIDENTIALITY AGREEMENT. CTR HN 014971

Joint Committee on Tobacco and Health n r~ HKr~. - 3 - i development of an animal model as well as experimental analyses of results. Comaittee for Research on Tobacco and Health: Dr. Seevers indicated his committee exchanges information about Frantees with the Council to pre- vent duplication of support in this area. He stressed the need to recognize that there are lnrQe and small research gaps. Although the AblA-ERF Committee has supported a few lung cancer projects, most have been in the areas of respiratory and cardiovascular diseases where it could find Erantees who had the knowledQe to attack a small piece of the problem. The Committee considers any proposal submitted to i't but has hatd a certain amount of success in soliciting interest in the prob- lem of smoking and health among investigators with ongoing studies in such fields as emphysema and contributing enouHh.additional funds ao they can include tobacco in the program. Dr. Seevers pointed out that the Committee has been confronted by some proposals which are beyond its financial capabilities as an individual granting aSency, and suQaested this group consider recommending support of such projects on a cooperative baais. Nhtional Institutes of Health: Dr. Endicott replied that NIH had pre- cedents for providing partial oupport of a particular study. Over the years, NIH has received a rather limited number of proposals that are riHht on target in this area, although many have had tangential relation- ships. ships. Their most effeetive device for obtaining specific answers has been the negotiated contract with the person selected as beat qualified to solve the problem. Establishment cS Priorit:Rs To avoid any possible confusion, Dr. Endicott listed four areas identi- fied for intensive research by the Task Force on Lung Cancer which was established last spsing at President Johnson's request: (1) clinical management of the disease; (2) long-range fundamental approach to assess susceptibility and resistance to determine if there is any practical means of enhancing resistance or idenYifyins susceptible individuals and taking appropriate action; (3) industrial or occupaticnal hazards including atmospLerio pollution; and (4) exploration of the possibility of reducing the hazards of the cigarette. He felt that the present meeting was concerned with the broad problem of the biological effects of tobacco and tobacco products. However, since the Task Force has a group which will report in early October on bioassay and its extrapolation to effects in man, he proposed that the Joint Cosnittee on Tobacco and Health incorporate their findings in its own proposal to avoid repetition. THIS DOCUMENT SUBJECT TO CONFIDENTIALITY AGREEMENT. ~, ! t'~r 1 ~ ~ ~ ti..~ .t `' ~ t` ~ 2

J oint Committe on Tobacco and Health - 4 - Dr. Little noted that the Scientific Advisory Board has been concerned primarily with various factors of diseases in which tobacco is implicated rather than tobacco as such. Because of this and the members' great individual differences and strengths, he advocated proceeding surely and slowly to determine these narrower fields of interest and then face the problem of priorities. Also, priorities will change while they are under consideration. He felt differences in emphasis would emerge and each group should have the right to its own working hypothesis without criticism from c•thers. According to Dr. Jacobson, the problem of determining priorities and, secondly, the amount of money to be spent and how to accomplish them, will prove more difficult than outlining the areas that require work. Their experience suggests this will demand a great deal of staff work, but the groups represented include the necessary talent and expertise to attack the problem of priorities in several areas. He doubted it would take a long time to produce such an outline, although he agreed it may - not be possible to prepare a budget by August. Dr. Bing noted that this committee should be aware that individual research is the foundation of its effort and no amount of direction will guarantee a solution. Dr. Bickam agreed, pointing out that this / research has long-range app•lications to general problems of buman disease. He recognized the value of cooperative planning but emphasized the need for a continuing supply of ideas and investigators. Dr. Endicott assured the graup that the proposed action programs would not interfere with or interrupt support of the individual investigator who applies for funds. Procedure Two possible approaches have been submitted by NCI staff: that the Joint Committee sponsor one or more scientific meetings at which invited scientists would review and discuss the evidence and then set up a smaller committee to digest their conclusions and draft a document for consideration; or, that a working group consider the different areas of the problem and address themselves to this task. Dr. Endicott said he had no particular brief for either alternative. He agreed with Dr. Little's notion of the constantly changing scientific picture, but pointed out the time element in terms of submitting a budget. It is unlikely this group could reach a consensus on a plan for the Secretary's consideration by August, so he would prefer to take additional time and submit a supplementary proposal. THIS OOCUMEiV i SUtt1ECT i0 CONFJDENTIALITY AGREEMEIyT, , CTR_ HN 0149-73

~ ~ 111 1, U Joint Committee on Tobacco and Health - 5- Desigcation of Sub-Committee: It was agreed that the most effective plan would be to appoint a working sub-committee composed of representatives from all the organizations concerned to prepare a program for the consid- eration and criticism of the larger group. The following were selected to. serve on this Sub-Caasmittee: National Institutes of Health Carl G. Baker, Y.D. Associate Director for Program, NCI Paul Kotin, M.D, Director, Div. of Environmental Health Sciences Ian A. Mitchell, M.D. Assistant Director, NCl Scientific Advisory Board Council for Tobacco Research Leon O. Jacobson, M.D. Dean, University of Chicago School of Medicine / Clayton 0. Loosli, M.D., Ph.D. Hastings Professor of !ledicine and Pathology University of Southern California School of Medicine Sheldon C. Sommera, ILD. Profeisor of Pathology, Columbia University College of Physicians and Surgeons Committee for Research on Tobacco and Health AMA Education and Research Foundation Richard J, Bins, M.D. Professor and Chairman, Dept. of Medicine Nayaw State University 8chool of Medicine John B. Hickas, 1t.D. Professor and Chairman, Dept. of Medicine Indiana University School of Eledicine Paul S. Larson, Ph.D. Professor and Chairman, Dept, of Pharmacology Medical College of Virginia Role of Industry Scientists: Dr. Jacobson recamsended that the Sub-Committee consult with the technical people in the tobacco industry. In the dis- cuasion, the representatives of the various tobacco companies THIS DOCUMENT SUBJECT TO CONFIDENTIALITY AGREEMENT. ~ t t ~'' 0 1'~ 9 "t`~'~ CT:

P -, r/ V Joint Committee on Tobacco and Health - 6 - expressed their willingness to furnish any information that mieht be helpful but noted that these men are primarily physical scientists and comaorcially oriented. It wao concluded that the Sub-Commlttee would consist of the above representatives from NIH, the Council for Tobacco Research, and the Committee for Research on Tobacco and Health, and that this group should feel free to requast information from or invite participation of e.tperts associated with any of the tobacco companies. / In oummary, Dr. Endicott stated that the mission of the newly constituted Sub-Cammittee is to plan how it will prepare an assessment of the state of the art in the field of tobacco and health; an identification of the important gaps in the different areas of knowledge and recamomendations on how to fill in these gaps through scientific investigation as well as speu:fyin8 priorities. A second consideration is determining which areas are ready for exploitation in terms of the availability of the seiantific tools. It waa his understanding that the Sub-Carmitte, will' decide wbethir to develop a statement themselves, draw in consultants, or hold additional meetings. When this group is in a position to communicate with the Joint Committee, he will contact,Senator Clements to discuss the next step as agreed at the meeting in the Secretary's office. Dr. Jacobson added that the purpose should include establishing liaison between these three groups for essentially the same objectives and to correlate their work. Rather than making specific assiRaments to each group, he understood that the general areas of work would be outlined and that such liaison would prove beneficial to all in terms of reaearch expenditures. Dr. Eadicott agreed all three groups certainly would continue to edJoy freedom of action and there is no suggestion of compulsion to accept the forthcoming recommendations. '4 y On behalf of the industryi 1lr. Rams emphasized that the Council for Tobacco Research and the Co®ittee for Research on Tobacco and Health consist of outstandias scientists who view this problem impartially and have a great deal to eoatribute. He assured thes that the present meeting in no way negated their importanee as groups or as individual scientists, and that the industry needs as much expertise, ability and independenoe of thought as it ever has. Their functions are essentially as they always have been. The purpose of these discussions is an attempt to encourage additional cooperation and possibly to find answer* faster by the pooling of abilities. The m"tins adjourned at 10tS0 a.m, to permit the Sub-Committee to meet before the iarler group reconvened at 12:30 p.m. for a luncheon. THIS DOCUMENT SUBJECT TO CONFIDENTIAUTY AGREEMENT. C T R7- -k H N 0 14°97' E5

il {~ L; V V - 7 - List of Participants JOINP COM6ITTEE ON TOBACCO AND EEALTH June 20, 1960 / Tobacco Industry: Sarl• C. Clem.nts The Tobacco Institute Philip Grant .Lorillard Corporation Frederick P. Haas Liggett 6 Myers Tobacco Co. David K. Hardy Shook, Hardy, Ottp.an Mitchell & Bacon Cyril Hotsko As*rican Tobacco Company H. HOnry Ramm' R. J. Reynolds Tobacco Co. Paul Smith Philip llorris, Inc. Addison Y. Yoaman Brown b Williamson Tobacco Corp. Tobacco Research Council: Richard J. BinBi 11.D. Wayne State University CTR/AMA-ERP licE"n Cattell, M.D. Cornell tlnivorsity Leon 0. Jacobson, M.D. University of Chicago Clarence C. Littl., Sc.D. CTR Sheldon Soam.rs, Y.D. Colmsbia University / THIS DOCUMENT SUBJECT To CONFIDENTIAIITY AGREEMENT. lr TR nI"t 01"Z' 9'i`,G

N K 'J ~S54 , ' - ~ / List of Participants-- Joint Committee on Tobacco and Health National Institutes of Health: Francis R. Abinanti, D.V.M., Ph.D. National Institute of Allergy and Infectious Diseases Carl 0. Baker, M.D. National Cancer Institute Kenneth g, Endicott, M.D. National Cancer Institute Paul gotin, b(.D, Division of Environmental Health Sciences Gardiner C, Mcltillan, M.D. National Heart Institute Ian A. 14itchell, M.D. National Cancer Institute 8 AMA-nF Committee for Research on Tobacco and Health: Robert J. Hasterlik, M.D. University of Chicago John B. Hickam, M.D. Indiana University Paul S. Larson, Ph.D. Medical College of Virginia Maurice H. Seevers, M.D. University of Michigan Ira Singer, Pk.D. AMA Recorders: Hiss Susan.Kotleba Mrs. Barbara McClintock THIS DOCUMENT SUBIECT TO ,COMFIDEHTIAUJY AGREEMENT. CTR H~`~ 0~.49r`~~~~

^~. '~ H K ~`:i ki ~1Vy`' i l - 9 - SU8-COMMTITEE of the JOINT COMIPI'PEE ON T OBACCO AND HBALTH Present Sub-Comaittee: Drs. Baker, Hickam, Jacobson, Kotir., Larson, Sommers and Mitchell Observers: Drs. Abinanti, Little, McMillan and Singer Dr. 3aker called the Sub-Committ.e meeting to order at 11:00 a.m. The Sub-Committee discussed the possibility of sponsoring a scientific conference, but felt that such a meeting would not be necessary to prepare a statement. Dr. Jacobson reiterated his conception of the purpose of the meetin8: it is recognized that certain areas require investigationj therefore, the Sub-Committee should concentrate on outlining specific priorities and estimating the costs of undertaking the requisit/+ studies as well as encouraging inter-committee communi- cation. However, it was emphasized that the mission of the Sub- Coemittee includes aore thrn a liaison function, and that atudies of tobacco and health should provide an opportunity to investigate broader problems of disease. Dr. Baker raised the issue of how to deal with the question of association betwoen specific diseases and rtmoking. It was decided that any docum•nt which may evolve should briefly summarize the findinas of previous studies to avoid duplication. However, the Department will attempt to keep this effort separate from its continuing public education campaign. In discussing how the Sub-Committeo should proceed# Dr. Jacobson auaested that each of the three groups prepare its own outline of the fields that require further research. This would perait the Sub-Committee to discuss the relative position in terms of priorities, ete. and prepare a combined statement. It was pointed out that the different emphases which emerge will effectively identify the saps in existing knowledge. With regard to the direction, Dr. Larson asked if the report would be concerned with the production of a safer cisarette. Dr. Baker replied that this approach would be emphasized in the Task Force's report. THIS DOCUMENT SUBIECT TO CONFIDENTIALITY AGREEMENT, Uk" [IN 014• 971B

H Sub-Committee JCTH - 10 - Dr. Jacobson expressed the hope that a virologist would be consulted to explore the association between respiratory viruses and smoking. The Sub-Committee agreed to meet again on about November 1 in Washington, D.C. or New York-with the understanding that it might meet earlier if the stateaents of the individual organizations are available. At that time it will discuss thase documents and attempt to prepare a combined statement which can be submitted for the consideration of the Joint Committee on Tobacco and Health. Further contacts with the Council for Tobacco Research SAS and the Ab1A-ERF Committee for Research on Tobacco and Health will be through Mr. Hoyt or Dr. Hockett# and Dr. Singer respectively. The meeting adjourned at noon. It was subsequently agreed to establish the following schedule: About October 23 ltach of the three groups composin6 ~ the Sub-Committee circulate its statement to the remaining two groups About November 15 Meeting of the Sub-Committee to meld the three statements About December 10 Meeting of the Joint Committee to discuss proposed final document About January 1S, 1969 Submit final document to Secretary, HEW THIS DOCUMENT SUBJECT TO CONFIDENTIALITY AGREEMENT, CTR M~~ 014~i'~~''~~