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WORKING DRAfT -- NCAG_fECD'~,MV;D,;TID;;S FOR FEDERAL DD11ERMIHENT-REGULATIQN OF fiAXiVIUi1s CIC:AR ETTE YIELDS OF NOXIOUS Si-1U}:E-CD~,'POirEi~~TS ° klHEREAS o . A dose- resporse rel ati onsf~i p_ between nu~nbe_r of c i gaf,ettes smoked and inc_idence of cancer of the lung, of the larynx, of the oral; cavity,-_and of cc°rtain r~e-Spiratory and cardiovascular diseases, -= have bcon estab i i s ned beyond doubt by numerous epi demi cl ogi cal studies in-man~ Less clear evidence has_alSO been_established for ca:icer of the esophagus, of the bladder, of the-pancreas,- -and other foi~ms_of dis?asE: (See-reference 1)- 2. Ex-smo„ers_are kno„n, from epidemiological studies, -to have-a dimini sbed ri sk of 1 ung cancer. Thi s - -di mi nu ti on _oY -ri sk -takes pl ace afew years after cessation -of the hab i t, and conti nues to dirnir~ish with time. (See reference' 2) 3. The tar:and nicotine-level-s of commercial cigarettes has decre-ased by an approxima,e average-o; 50°fD during the p3st-20 years; this has resuited in a s-li~trt decrease in per capita-ci_garette cons;im,ptior., but also in ovPrail _reduction of tar and nicotine intake by the aveaage smoker. (See reference_3) 4. Toxic components are found in both the condensate and the gas phase of cigare--"-te smoke. Th'c primary sources of toxicity so far identified are tar and nicotine,-and probably carbon monoxide, -nitrogerf oxides and bydrogen cya-nide. (See reference 4) 5. The sales-areighted apprflximate average cigarette yi-elo of commerci-al cigarettes marketed in the United States during 1973 J•:as 19.2 r'i l l i grams of tar and 1.3 mi l l i grains of ni cot i ne (FTC standards), indicating that these levels are compatible Evith-tha current consumer demand and acceptability. (See refercnce 5) THEREFORE: The NCAB reconimends legislative andjor regulatory action by_the Federal Government as fol l ows : -

(2) l. A Government agency should be eimpc,wered to set ma-xjmuM cigarette levels _of '.:ar=anC nicotine that will become progressively lov~ter tfian the -1 973 averages of 19.2 nii l i;gran;s and 1.3) rti l l i grairs _ respectively. Such decreases should be-undertaken slorriy enough to i nsu-re- that- a compensatory_ i ncrease in number of ci garettes consumed does not occur. These actions should-insu.re that-a range of cigarettes including soj:',o witl,- very low tar and nicotine contents conti-nu^ to be ava? l;ble. Assurance _shoul d be obtai ned that no current brand would raise the current levels of tar and - nicotine. 2. Because smoking has a severe iinpac-t-on cardiovaScular and respiratory di soases, the Government- a~}ency-e~~por,ered to - r•egulate maximum emissian of undesir-able _smoke co.,,ponehts should get approp riate scientific and technical advice from- the N'ational Heart and Lung Institute to determine appropriate maximum levels of other-smoke components besides tar ar,d=nicotine, arhich siiould be 1 imited in cigarettes. 3. The publ ic rrust bn informed that_ there i s cur rently no known formula for a safe cigarette, anci that the restrictions here suggested are i i kefiy to produce-, but canr:ot- guarantee a reducti on of jiazards from _siiiokiiig: For health protection, the safest course is not to smoke at al-1. It is particuiarly important that education in the schools be-continued=and improved to prevent future generations from acquiring smoking-related diseases. 4. The-President of the Unitedl*States should make a public persanal appeal i:o-the tobacco and cigarette industry for voluntary, deli-berate and rapid effort towards preferential marketing of - low t,r and l o,•: n; coti ne ci garettes , and to,•.,ards reducti on of other smoke components that may be recognized as hazardous. O 14 ' 45 ~ In making these recommendarions, the Nc,AB also recognizes that: ~ 1. The setting of specific maximum tar and nicotine yields of connerciai cigarettes cannot be precisely determined-by current scientific evidence, except to state in a broad ti•ray that loti•;er yields are preferable to high ones and that only zero levels are compatible tlit.h good health. Total cigarette banning in the current cultural, economic and political ,setting is also impractical, -and the regulation.of maximum yields of noxious cigarette smoke

componerits in a gradual way-considers the necessity of givina- the ciSiarette in:!t:stry a reasonal}ie -tiire for uti-lization and modi fi cati on of. _exi sti ng i nven tor-i es; and devel opment of T ess hazardous products. The_con~rihution of smoking to smok ing-reiaCed dis~ases is over- whelc-fli ng and t!:e r°educti on of smoki na i ntake i n the sr;oki ng popui at i on- ;wi l l eventual ly resul t i n reduced moNi hi d i ty and mortality. The NUB ,rarns that recom:mendations for maximum tar and n i coti ne 1 e~: el s in ci raret tes shoul d not be i nterpreted as lessening the ii;iportance of continued research and preventive action `in those other factors that are known,-to-associate with snio!:i na i n the c~~r:sa ti oo' of di sease such as occupati onal hazards (asbestos and uraniuM miningi, etc.), Envircnmental pollution, di et and genet i c c!etermi nanl;s of i ndivi daa l suscepi.:i bi l i ty. Equa i ty important, efforts should be conti nued tovrard -reduci ng the risk of di;eE se in smo!:ers hy the develop;rent of pharmacolog ical aids for smotiing cessation, und-of less hazardous cigarettes acceptable to the consumer. - •