Ford Motor Company's Cardiovascular Intervention Program

Anne Landman's Collection

Ford Motor Company's Cardiovascular Intervention Program

Date: 28 Mar 1974
Length: 3 pages
1003288768-1003288770
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Abstract

This interesting series of correspondence was found while researching the tobacco industry's responses to the introduction of corporate programs to discourage smoking. The first document is an internal Philip Morris (PM) memo that discusses the Ford Motor Company's Cardiovascular Intervention Program. The goal of Ford's program was to encourage high-risk employees to modify their lifestyles to reduce risk of cardiovascular ailments. PM wanted to use Ford's program for research purposes of their own, and sent Dr. William L. Dunn to try and persuade the program's coordinator to operate the program in a way that would be more useful to PM.

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Quotes: I explained to him [Mr. Beard, the program coordinator for Ford's Cardiovascular Intervention Program] the one idea we...had as to how we might obtain useful data from the Ford program. Assuming that some cigarette smokers would not be able or not wish to quit, we could make available to them cigarettes at various tar delivery levels, perhaps 6, 9, 12 and 15 mg. Supplied at nominal cost, the subject could begin on the 6 mg. cigarette, shifting up only if dissatisfied, settling with time upon the point of best compromise. Other schedules might prove even more interesting, such as periodically bringing him back down to 6 mg for retrial. Mr. Beard was...tactful in expressing his disinterest...He said he'd think about it and let me know. It's been three weeks... Following is the letter Mr. Beard wrote to Dr. Dunn in response to his offer of reduced-cost low-tar, low nicotine cigarettes for use in Ford's program: March 21, 1974 Dr. William L. Dunn Associate Principal Scientist Philip Morris, U.S.A. Research Center 4201 Commerce Road Richmond, Virginia Dear Dr. Dunn, I have reviewed my notes concerning our recent conversation.... As to your offer to supply cigarette to those in the program who find it hard or impossible to quit at reduced priced with varying levels of tar and nicotine, I believe that you have misunderstood the purpose of the program. The intent is not to provide volunteers with alternative ways of maintaining those habits which elevate ones probable risk of heart disease. Our goal is to extinguish such habits... Being a former -- two pack a day smoker, I know that anybody can quit smoking. I further know that had I not quit entirely, I would still be smoking at the same or a greater rate. Therefore it is felt that we will have to refuse your kind offer and limit any potential avenue of cooperation to possible periodic examination of anti-smoking data. Thank you again for your kind concern, Sincerely Yours, Donald I. Beard, Coordinator Cardiovascular Intervention Program You can see the above letter at the Philip Morris site: URL: http://www.pmdocs.com/getimg.asp?pgno=0&start=0&bool=1003288771&docid=1003288771
Company: Philip Morris Cos., Inc.
Author: Dunn, WL
Recipient: Wakeham, H
Region: United States
Type: Memoradum
Subject: cardiovascular disease; Health; Health education programs

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Dr. H. Waikeham March 2&, 1974 L. Dunn: .:Ford Motor Co.'s Cardiovascular Intervention Program ed'ucati've, program can modi fy 1 i'fe stylle so as to red!uce cardi - ovascular attack risk. CV'A,risk is calculiated from a multiple regression equation in which these factors are the independent variables weiighted from results of earlier, epi'dem.iological studies: blood'" chollesteroT, b11ood pressure, obesity, smoking habits, presence of diabetes and presence of electrocardiogram abnormalities. Program effecti'veness willl bie measured in terms pf reducti'oni in calculated'l CVA risk. The strategy is to, educate and persuade so as to alter life style so as to alter the rilsk factors soa~s to reduce cal cul ated ri sk so as to ultimately, and presumptively, reduce CVA incid!ence,. The plian.is to recruit over the next five years, from among Ford World'Headquarters personnel and' the Ford Credit Co. personnel. The goal is to obtain 150 "at risk" oerson& annually from among, the volunteers,. "At risk" is defined a~s some fixedlcalculatedl risk val ue which I did not d~etermi ne. The "at ri sk" volTunteers wi'1'1 be given an orientation interview and allowedito indicate which of these~ three groups to which they'd', like to be assi'gne~d: 1. An abbreviated'counseling group - receiving,oneor two lectures I have had phone conversations with Mr. Donald Beard!, Program Coordinator. Mr. Beard'fta preventive medic1ne educator working wfth Dr. Block, our original contact. I explained to him,the nature of our interest and obtained answers to ques- ti ons, rali sed'by the outl1i ne of th~e, program whiich he provided us in January of this year. The outline and the covering letter was the first rommunication,we'd had from them siince! Dr. Block agreed in October of 1972 tolkeep us posted on; developments. The purpose of the project is to determine to what extent an 2. A, continued counseling group - n.i'ne instru~cti'on sessions over a 12-week period 3'. An tntensi.ve couinseiing group - frequent instruction and a group therapy program '( F "~ ., "~ . . , . . .. < < . -. . .. . . - . - . . . .. , ~ ~ . . t ..'~~ ~~ ~ . .

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Fi rst rhoi ce wi 1 ll be honored for group assi ginment where possible, otherwiise, asstgnment is random so as to have: 50 in each group each year. .Thus there wiill be pre- and post-test measures of calculatedl rfsk on four groups, the three above representing levels of intervention and a fourth group consiisting of the left-over volunteers not "at risk."' This latter group is "'the control group."' Measures wiill be taken at entry and annually there- after over the five years, of the program, the number iln each i!ntervention group incrementing to 2'50 on the fifth and finaI year. There are no p~ans to track beyond the fi f'th year of the program, meaning-the last group iis followed for only one year, etc. Recruitment is now, in progress for a "pre-test" run. At the time of th~e. phone cal l i n early March, there were 28'8, vol un- telers. Mr. Beard estimated that about 145 of these would meet the! "at risk" criterion,, andi most of' these 145 would' be tobacco smokers., u.ndesi'gnated as, to type of smoker. Subjects used i'n pre-test wiTl likel'y be thrown into the first year group, i.e., this is not really al pre-test. You have probably by this time become aware of serious des,fign problems. There is a lamentable absence of'controls: 1) subjects are allliowed to choose their group assi'gnment, 2 there is no placebo group, among the "at risk" subjects and 3~ the control group so designated by Mr. Beard is the "not at risk" vol',unteer,.s. The design begs for a randomly chosen non-volunteer group upon whom: should be made concur- rently with the pre- andl post-test measures on the experimentall groups. I tactfully diirectediMr. Beard's attention to the control probl em. HY s reply was a shrugi-off, "We are i nterested i n evaluating the effectiveness of' intervention, so we dion't really need any further controls."' Hiis further comments suggested that he had not b~een i'nsensiiti ve to the probl em.. The deciston to go this way was apparently deliberate. I expl'ained to hiiim the one iidea we here have had as to how w~e milght obtain useful data from the Ford program. Assuming that some cigarette smokers would not be able or not wish to quit, we couldl make available to them cigarettes. at various tar delivery levels, perhaps 6, 9, 12 and 15~ mg. Supplied at nominal cost, the subject could beqin on, the 6'mg cigarette,

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shifting up only i'f diissatisfi'ed, settling with time upon the point of' best compromiise. Other schedul'es miqiht prove even more intoresting, such as periodically bringing him back down .to 6 mg for retrial. Mr. Beard, was as tactful i'n expressi'ng disinterest as I was :tactfal'. in.caiiling his attention to his control problem. He said he'd think about it and let me kn!ow. It's been three weeks'. I' have corncluded that the Ford project offers us very llittle to grasp onto as a research project. I plan not to pursue the matter further u.ntess you advise me of some imperative other thanresearch that sh~ould impel us to hang in there. jh cc: T. asdene ,J'R. Fagan P.S. Since writing this I received'the attached letter from Beardl. We concur in the belief that little i's to be gained from further pursuit of collaboration.

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