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November 20, .197I+ 1AMfORAIdDLP'+I - - TO: Horace Kornegay FROM: Fred Panzer SUBJECT: PZCAF Response to the President (11/18-19/7,4) Rhoads set the stage by pointing out that-the action to be considered' by the Board is in response to tFfe-Prdsiderit's letter of October 1$, - 1974 which he read. He also read the section of the NCAB Annual - Report dealing ?;ith cigarettes and the two smoking recommendations contained in it--one calling for "tar" and nicotine numbers on cigarette packages and another calling for federal regulation of "tar" and nicotine content of-smoke: Rhoads then turned the floor over to Dr. Gori who read each "Whereas" section and referred to the appropriate sections in the reference appendix. He also read each of the "Therefores", pointing out that Number. 4 was "really an alternative" because both the group which met on November 1 and the earlier Ad Hoc Smoking and Health Committee under Dr. Shubik had felt that the chances of such legislation passing were extremely limited and therefore favored the "Jawboning" approach instead. After this backgrounding the NCAB dealt with the positions that emerged. Rhoads Dosition: (1) To stick with the recommendation made in the NCAB Annual Report. As he put it, "the President has asked us to provide him with scientific back-up; he didn't ask O ~ us to come up with a new proposal. Zf we expand or contract our forMer recommendation we are not in as ~ , C~5 strong a position. We can always take a new position another time. ~ (2) To focus on the strcig lung cancer/cigarette smoking correlation and only allude to other correlations such as with heart disease.

Page 2 1~b10RAI; DUIi FP to HK 11/20/74 (3) To change'the format from resolution to a letter to the President. - Benno Schmidt's position:- - - (1) Stay with the resolution formaY, (2) heep=-"Ther-efore'`- A$-but revise it to say: "Pending ttie- - accomplisl-irnent--of- the above through c.hanges--inn the existing law, the` ddC1AB- reconmends -that the President consider making -a public personal appeal to-the tobacco and-cigarette industry for voluntary-, deliberate and rapid-efforts toward preferential marketing-of low tar and low nicotine cigarettes and-to•wards reduction of other smoke components that may be recognized as hazardous." He also felt that this recommendation should precede Number 3. Rhoads argued that this recommendation would weaken the message to the President. "dawboning is-too easy," he said, "it would not be a response to the Board's request. It would-de a retreat from the- NCAB recommendation for legislation." Shubik, however, said that Schmidt's suggestion was "excellent," noting that he himself had taken no categorical stand on legislation, but rather believed that the most forceful action the Board could take would be a clear statement that the lung cancer epidemic could be prevented by cessation of smoking. Dr. Murphy, Director of Roswell Park Memorial Institute, supported Rhoads, saying "We don't need Number- 4; it doesn't strengthen the resolution." Dr. llrr~os of the Harvard Medical School also supported Rhoads, agreeing that Item 4 would weaken the statement.

Page 3 MEh10Rl'd+DTei FP t o HY. 11/?0/7k Unexpectedly, a new member of the Board, Dr. William-0. Baker, President of Bell Telephone Laboratories, began to question the nature of the reponse to the President. He pointed out that-the President mentioned no less than four times his desire for getting scientific evidence on this question. ":-+e have reflected the convictions of scientists in this document," he said, "but not necessarily the scientific=evidence." Regarding "E'hereas" T`3 in particular, he wondered-if the scientific basi s for th at would be sat:isfyina to the President. Recently the President had been given "-'•rery- faulty" science infor.mc.tio:n regarding the Skylab, he- sa.ia, and-warned against more of the sane. Many of the basic parameters of -physics are controversia l, and he pointed- out, those being discussed tioday-are "far_ vaguer" than tize types in -physics_that the scientific community has been trying to tie down for.years. "We-s.re deal_ing today with areas that-ar-e-far less certain. We cannot- support, t-he,t is, some of us cannot _suppori, -a categori cal statement of this sort on the basis of scientific evidence: Dr. London,-Director of the Harvard-MIT program in-Health Sciences and Technology, generally agreed with Dr. Baker. The first "F.1Y:ereas" is a mixture of conclusions and evidence, he said. The-third "Whereas" is evidence without a_conclusion, the fourth is both evidence and conclusion, and the'fifth is a puzzle. Dr. London felt that the President requires r.?ore than citation of references--he requires -a statement of what is in the literature. "If you are going to cite references, you must say what is in the references," he added. At thi's point, Dr. 2•iurphy moved to accept the sense of the draft and limit the discussion until a revision could be agre-ed upon later. Rhoads promptly grasped this suggestion and called on the group to work on a revision tonight, and present a new draft plus an annotated bibliography on Wednesday. Dr. Burger, taking advantage of the confusion, proposed to delete "the last part of the-last paragraph on page 3" because "The second sentence weakens the rest of the paper." Burger wants to take out (without saying so) all reference to "the need for continued_research and preventive action in those other factors that are known to be associated with o^cking and the causatiorn of disease such as occupational hazards (asbestos and uranium mining), environmental pollution, diet and genetic determinants of individual susceptibility." The effect would be to isolate smoking as the single cause of lun6- cancer in our hiohly polluted society.

Page 4 ~`~ORANDUN; FP to HK 11/20%74 At the break, Dr.-Rauscher; director of NCI, was_inforrced of the problem that Burger's deletioz~_would ;,reate__ior him with-_CongreVs, _ the environmental activists, and labor, since it would undercut their_concern about occupatior:al and environmental health hazards. Letting Burger's deletion carry would put_ tYie-NCI and the Administration in the irresponsible position of-disregardir_g any other-health problem but cigarette sm.oking_: Rauscher said the point was "well taken"_. Also at the-break,-it was pointed out to Rhoads that his idea ofg getting a group together at- 8 p.m, to, work on _ a re-draft ,ni_ght not be-in compliance with the Fed2ral Advisory Committee Act, since there was no advance notice in the_Federal Register in terms of time, place or-agenda: He shifted pla.ns-, called for the redrafting to take place_after completion of the day's agenda,_ and had me ir,'formed of- the change so that I could be present. Consequently, at 5:30 p.m. the attached draft was agreed-to. It was approved by the full NCAB at 4:25 the next day (Tuesday, Nov. 19, 1974) after about 5--minutes of "deliberation". This document with Reference Appendix also-attached-and an annotated bibliography to be prepared will be sent to the President under cover of -a letter by Dr..Rhoads by December 1. . FP/pgd