Tobacco Documents Online

" 2. F'.!B. ell IT'. FI i..~ .............. ., COPY • . ..o •. ,.o°..°. ......... °.°.,.~, ............ ° ..... • ..... ..... °°. .......... ° ..... J P.H.G. 1 6NOV1081 FILE ............................. p ........................... HOLD ..................................... C P;' ................................. : ; iii , RLOEIGFT .13th November 1981 Or. T. Lambo, Horld Health Orgnnisation, IIHO Building, IZII Geneva, 27 Switzerland. Dear ToB, Rather belatedly I write to thank you for arranging the meeting on 3Oth October. The fact is that like you I have been away from my office for quite a lot of the time since we met. I think from our point of view we found the meeting ~st helpful an~ it seems as if there was common ground on which ~e could base further dialogue. My impression is that you and your coi~eagues felt the san~e. Apart frora thanking you for making the arran~e~ent~, the objec~ of this letter is to confir~ our invitation to your G,'ganisatlon to visit us here and seeoour research establish~nt, Pernaos you would be good enough to pass this invitation on to Dr. Ch'en, ~r. ~!aslroni and Or. G1asunov as seem.s ,,~ost appropriate to you. Apart from anything else, may I say what a personal pleasure it ~as to see you and I hope that it will not be too long before we can ,,,-ee~ again. With renewed thanks, Yours~er61y, R.L.O. ELY _r~ b,c.c.C.H. Steu~t Lockhart~=r~ Dr. L,C,F. Blackman~ c2~ L~ 0 r~O -..j P.S. Since this was written we have arranged by phone for your colleagues to visit us in December. Great news.

RESTRICTED MEETING WITH THE WHO, 30 OCTOBER 1981 - GENEVA PRESENT : Dr T A Lambo - Deputy Director General, WHO Dr Ch'en - Assistant Director General, WHO and Member of NCD* Dr R Masironi - Specialist on Cardiovascluar Diseases/NCD Dr Glasumov - Director of NCD [* NCD is a unit entitled Non-Communicable Diseases] INTRODUCTORY COMMENTS Dr Lambo said there had been considerable internal discussion as to whether or not WHO should meet BAT. The subject of smoking is politically highly sensitive, and many people would see a meeting as weakness on the part of the WHO. Indeed, Dr Lambo had already received three letters from England, two from members of the BMA, which seriously questioned why WHO were going to talk to BAT. (Neither of us know how the leak can have occurred.) WHO had concluded that open discussion could only be of mutual benefit. Dr Lambo warned, however, that if the media were to get a premature indication of the meeting, they would almost certainly set about to destroy both the people and the organ- isations concerned. BAT STANCE We explained our basic stance viz: Hundreds of millions of people worldwide smoke, and we believe vast numbers will continue to do so despite the anti-smoking campaigns. BAT acknowledges the epidemiological data, and does not deny the statistical associations. BAT does not, however, accept or imply that causation has been proven. Industry has responded quickly to the emerging medical opinion about low delivery products, and the consumer response thereto, by developing and marketing a wide range of products - so that the consumer can make an informed choice. Largely because of legal constraints, the tobacco industry has to date said little about its changed products, and about the opinion of third party medical authorities as the reduced associated risk to health. C~ t~ t~4 CD ~O OO Ctd/ .....

-2- BAT now believes that more open dialogue with Governments, doctors, consumers etc, is in everyones interest - provided care is taken to state facts regarding products and the epidemlo~6I~gical statistics, not to interpret the facts or to offer opinions on the primary S&H issues. WHO STANCE Dr Masironi said that, despite the arguments as to causation, WHO has no doubt that the link between smoking and cancer is proven. For other diseases, however, the link is much less direct; certainly for heart disease, smoking is merely one of many contributory factors. Apparently on the previous day Dr Richard Peto had been with the WHO at Geneva, and he had made it clear that he was convinced that low tar cigarettes are very much less hazardous than high tar cigarettes. Dr Masironi said that WHO does not regard passive smoking as a significant health risk - although he acknowledged that it can be highly irritating to people. THE MEETING Against the above background we presented a brief summary based on the Smoking and Health "Blue Book" to Dr Masironi and Dr Ch'en (Dr Glasumov and Dr Lambo having then left the meeting). We were surprised and gratified at the very open response to our presentation. Dr Masironi in fact called for two WHO publications "Smoking and its Effects on Health" - 1975 "Controlling the Smoking Epedimic" - 1979 and pointed to statements that supported the development of low delivery cigarettes. He said that the 1975 statement was only made after many years consideration of the evidence of studies such as the Royal College of Surgeons and the BMA 20 years study. Dr Ch'en said several times that he would like to continue the dialogue, and suggested a follow-up meeting in early December in Southampton. This will be confirmed after various WHO staff have studied the Blue Book - copies of which were left behind. In passing, Dr Ch'en said WHO recognised that industry has profit as its main motive, and said this was quite acceptable to them. CD CD kO Ctd/ ....

-3- Dr Ch'en went on to suggest that we may envisage the day when the WHO and the tobacco industry jointly supported research, eg the development of tobacco with desirable characteristics. SUMMARY MEETING WITH DR LAMBO Dr Ch'en had informed Dr Lambo briefly by telephone about our meeting, including the proposed visit to Southampton. Dr Lambo expressed total support for the idea - but then stressed again the need for care lest either party should damage its position. He cautioned making any announcement on the lines "WHO supports BAT's view" or "BAT has convinced WHO of £heir stance". Dr Lambo also said that clearly WHO cannot continue for ever merely talking with BAT - or indeed with the tobacco industry from any one country. He urged, therefore, that we try to get other companies to accept the BAT approach so that one day WHO could talk with 'the tobacco industry'. We explained briefly that we had already spoken to some major companies and planned to talk to other companies when the opportunity arose. (We agreed that at this stage no mention would be made of our talks with WHO.) Dr Lambo said he hoped that in due course the smaller tobacco companies of the world would also hear about and adopt the BAT approach. Although Dr Lambo stated more than once that WHO is not a political organisation, but is concerned with the "science" of world health, we do not underestimate the need for extreme care in all dealings with WHO. SUMMARY Unless we have grossly mis-judged the situation, the meeting would appear to have been very worthwhile. A point of importance is the fact that we were dealing with highly informed people (much more so than the BMA) who seemed to accept the underlying pragmatism of the BAT approach. Hopefully a follow-up meeting at Southampton will be agreed. This should give the opportunity not only to show the scale and scope of our research, but also to underline the integrity of our total approach to smoking and health. The ultimate aim, however, must be to create an industry approach to the subject, which allows a continuing dialogue with the WHO and other organisations. L C F HLACKMAN/R L ii November 1981 O %,4 :.2~ O Circulation: Mr P Sheehy Mr E A A Bruell