Tobacco Documents Online

November 4, 1974 MEMC3RANDUN. TO: Horace Kornegay - FROM: Fred Panzer - SUBJECT: NCAB Committee Meeting, November 1, 1974 The stated purpose for the meeting was (1) To-consider the President's request for documentation and-c?arificat3on of the scientific evidence to support the l+CI-E recorr.mendations for regulation of tar and nicotine- contents of cigarettes, and (2) To consider a new more ccmFle',-;e forr.tu- laticn ef iv'CAE _ eeor,r.~enda.tions on the regulation cf n,ax.ir!un-L cigNr(-tte yields of "noxious.j"smoke components. - Members of the Subcemmittee present were Dr.- Jor.at.ha.n Rhoads, Dr. Gio Gori, Dr. Cuyler Hamzcond, Dr. Daniel Horn, Dr.-Marvin Schneiderma.n, Dr. Philippe Shubik, Dr. Jesse Steinfeld and Dr. Ernest Wynder. Jonathan Rhoads was 45 minutes late and no one was willing to get the meeting stHrtF•c. Leiore ice-errive.d. He Ynnounced that the "entire reetir,g is being taped" and then immediately went around the table fcr individuE.J. views regarding whether the fioar-d should present a wider statement in the - case against cigaret.tes or restrict the discussion to cancer or perhaps only lung cancer where the data is "most clear-cut." Rhoads was sensitive about getting into the province of the Nationa.l Heart Lung Institute. - However, as the indiviclua] views were presented, another issue assumed importarce: whether tar and nicotine levels are achieved by reF-lation or by voluntary action. Following is aa sursria.ry of the- individual - positions. - w der called for voluntary action within three years to reach the - current salea weighted average of_ 18.4 mg. tar and 1.27 mg. nicotine.- As "further inducement", he proposed that all cigarettes below 12 mg. tar rcr_d 0.8 mg. r_i cotine c~oud d te labeled a.s- "light". Wynder said "the greatest progress both qualitatively and quartita.l-1veiy, - will come throup;l, the rar_agerial process." He meant free enterprise. Schneiderman had two reccmirer-daticns: (1) continued, expanded efforts to get people to quit smoking and (2) efforts to reGUce tar, nicoticie and carbon monoxide levels to the lowest that smokers will tolerate without increasing -their clonsumption of cigarettes. He also called - for further resea.r c'r. to- estimate the effect on cancer mortality c,f differenfi. ].eVel: of tar Q.nd ricri:ine,. t1_:.:c hF dic' not ray vhcaher these levels sheu]d be regulated or voluntary, his past performance leaves little dcubt that i_e would f€•ror thc: t<nndctory approach-

MEMORANDUM - - p. 2 FPTOHIf 11,/4/74 Shubik: "I am in a rather difficult position"- he- said referring to his past staterents as chairman of the Ad Hoc Committee on Smoking and Health, where-botr he personally and the Committee itself found a lack of scientific evidence for legislating tar and nicotine content of cigarettes. Shubik went on to say "I have no strong views on legislation," and expres_sed the fear that regulation would in effect,_ be "underwriting"- a safer cigarette. "The man on the street"_ he said, "may well-start smokir_g mora-and I am-concerned about that." -He thought the best posit-ion was for the President of-the United States to-request cigarette comp,anies to meet the levels mentioned November 1. Stei-nfeld: He repeated his old hard line position: Cigarette smoking is "the most important public health problem in this co•sntry. This is a great opportunity-to urge-legislation-. Let's not lose it." Hammond was nonc <<.itta'_ on the-method of achievir.g tar and nicotine levels but he had two worries: 1)- Regulation wculd give the public the impxession that cigarettes under_the ievel were-"perfectly-safe" whereas, they were,"only less hazardous." 2) He is-not sure that tar and nicotine are the "worst" things in cigarette smoking, especially - for heart disease. "I am worried about carbon monoxide for which there is little data." If people smoke more or inhale more, he said, this- regulation might do more harm than good. Hammond added that a- reasonable level would not interfere with most companies but only the highest "tar" brands.- He recommended a cut-off at 20-21 mg. of-tar. No brand under that level should be allowed to rise higher;-those above it should be allowed two years or so to gradually come down to it. Horn's main point was a recital of his unpublished research which - showed that within a range of 20% drop in tar- and nicotine there is - no change in the number of cigarettes smoked nor "I_would guess"-in the manner of smoking (i.e.-, inhaling). -Therefore he recommended that _ any char.ge in the key tar and nicotine levels should not exceed 20%. - It was implicit in Horn's presentation that he favored progressive - lowering of the "t"-n level. - Rhoads was noncommittal but after hearing the individual views, began to wonder aloud about avoiding mention of any specific tar and nicotine numbers. Steinfeld favored leaving them out and letting the regulatory agency set specific levels. Horn also took this position, pointing out that it would be hard to change a specific number if it were in the legislation. - - -

~.~SIIyIOP,APdDTJId - - FP- TO HK 11/k/T), p. 3 Shubik; however, favored-_citing a specific level. At thls point Wynder observed-that there=wasn'+. "a-Chinaman's chance" to get-such a law- thrcugh Congress=. In any case_he=favored including his-12 mg. "tar" and 0.8 mg. nicetine-figure as an inducement to the industry. - On the_issue-of limiting-their-response to cancer or-including-other diseases, there was much-di.scussion. There-was concern about the unintended effects of increased-cigare;.te con-sumption-or-inhalation which would- result in an added-intake of-carbon monoxide and-an adverse health effect on-health and resFiratory-diseases. To clarify the sub- committee's charge, Rhoads read_aloud the President's letter and concluded: -"This does_not limit us to cancer but does limit us to tar and-r.icotine=-but I suppose we could add other-ingrsdients-at -- the end and note our concern-."= Someone wondered about how to handle the problem of people tearing off the filter to get a high tar cigarette.- Wynder again expressed his-pessimism-about passing-such a law-ar.d asked, "If you recommend this, andnothir,g happens, then what do-you- do?10 "Vote for-the Socialist Labor Party," said-0arf-inkel who was sitting in the audience behind his boss, Cuyler Hammond. - But Rhoads gave-a more serious response. "If we lose this battle," he said, "we haven't lost the_war. We will propose a variety of - things so that Congress will accept the least onerous." - Horn pointed out that prospects for regulation were now improved because Secretary Weinberger had reco=ended such legislation to Congress. He didn't add (perhaps beeause he didn't know) that the - President assured several members of Congress that the Secretary's comments were his own and did not represent the administration's- - - - - views. A note about the evider.ce presente3: Hammond's data was typically his own and typically unpublished. Detailed data would be available in 6-8 months, he said. -

M0xP1`dDJs~: - FP TO HK 11/4,174 - Wynder presented a series cif-;-6 slides and pointed-9ut that we knew the basic epiCemiol4gicaldata 20 year•s ago. At-that time the risk to those smokir_g 10 cigarettes or less a day-was relatively low, now- even those who smoke 20 or less-cigarettes a day have a low risk. Nevertheless, he said, 40% of all male cancer deaths are related to cigarette smoY.ing. He reported in another slide that not-only had risk declined but-biologic activity of tar as well. Whereas he got_40% tumors_from skin painting in 1959 he now is only getting 10-20/00. "We can' t- talk of the modern- cigare tte in tern:s of the past," he concluded. "If you szioke a lower tar cigarette you reduce the _risk. If you smoked such a cigarette f_rom the very beginning, your risk is even'-lower." He cautioned the group that they must consider the "har-mful"- ingredients which have an-effect on heart disease and er,pryilema. We might reduce the cancer hazard;-he said, and increase the--heart and respiratory disease hazard. Schneiderman also noted the change in the cigarette-and tobacco-tar over.the years. He felt that the ciualitative difference between "tars" of the high tar-and low tar cigarettes could lead to an under-estimation of the dose-response rela.tionsYrip. He also presented data showing a decline in mortality for emphysema, bronchitis and asthma since 1968; and in heart disease from 1950-1968, and felt that these declines might be related (a) to the lower tar and nicotine levels-of cigarette smoke, and (b) the effect of the antismoking effort. He explained-the lack of a similar decline in lung cancer-morta?ity as being due to a longer latent period for this disease. Shubik said that Doll had observed a definite decrease in the lung cancer death rate in the younger cohorts in England-greater than that observed_in.the United States, which may be due to reduced air pollution. Shubik said-that the-scientific evidence, such as Wynder's and HaAmond's could be interpreted in several ways and that the reduction in air pollution might also be a factor in the lower death rates. He pointed out further that the dose-response relationship does not relate to - tar and nicotine but to total consumption. Schneiderman agreed. Hammond wanted more evidence, observing: "You cannot separate tar and nicotine but have to treat them in combination." Horn thought - that tar and nicotine were markers.

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