Tobacco Documents Online

SHUDII{ CO".KilTTr,R- M=TI:;C OF K?~P.'I? 25, 1973 Dr. Shubik ~onvened his committee shortl~ after 2:C© g.m._ on March 25, 1973. Committee members in attendance were Shubi',:, Giori, Horn, I:er_s ler ,- Rho ads ; Saf fiotti and Wynder._ b•' Bn-fant of.-NHLI_ was prF~ent. "Advisors" Ililt (ACS) and Brauniz~ger -also attended, as did bso (Agriculture). Advisory Board members Ogura and-Krabbe;lhoft joined the meeting later in the afternoon. Of those who had attended as in-_- -atte:.d- d'.ls ~-"y rC.~3°"eSent a:1~'t:S on February ;; .~:1 , thC follJ:'iillzi iIC?~C in ance:- Panzer, Hughes, Spears, Jer:kine-and-Shinn. Ghubik called= on Dr-- Rhoads. _ Rhoads -said that -lung cancer =- had skyrocketed over t he- ras t 30 or 40 years ;that the_ evidence con- ~~y coo3 necting sroking and lung cancer was-„awL Fu,~ °,°_an~i-that members of the "Board" felt that sr;rc},ing should be eliminated if possible not= ; t'--+ a-, n ^ the `Jsi res of the tobacco ind?.,~-ry, the- ir1pac_t on the economy or "the ^ongress? o;iai record.°" It was not entrrely clear about whom Dr. Rhoads was speaking but he _::fas- probably referring to (so~et members cf the_Canicer Advisory : oard.- - Rhoads said that tobacco is outsi de ° the purview of the FDA = and asked t.;hat could bz done to give the FDA power over tobacco= _ Ber= - ALUp.J 1' 11::?~ *ir~ ~ ,]l.a L- u - •..v t_:i. -~n_~-.s -wa7.'._r -+t:~--'•~t~-~~fi"7i pl-Sr' 4:1 i.fl m(~.~. ~.~ ._ i~.lUll=- ~i_ r"ver...: a.-, - . stringent regulation over all to coir:e ~n the future. The "stragg].ers"_ are the high "tar" and ni-cotirle brands: "if we can't abolish ciga- rettes at least let's try to-mal:e them safer:"- It was obvious-that Dr. Rhoads had appeared at the meeting in order to urge the committee to get off the track that it-had , started on at the prior meeting, i.e-., a preference for voluntary action (at least on the basis of present Shubik reiterated his concern that anl~ recon.m~endat~.on have a sound scientific basis. He also e:nphasi zed the ir;jnortance of know- ing the effect of changing cigarettes on all diseases; he called the Brauninger i-ras called on to tal'.•_ -about the FTC position. f€e ,~~.c":1: •'- l,iJ. , 11e bV1J_ebTl:..~ ta:a,t si _ ated that, s~Jf .:~ cr ic>r ,.; r, ~1~ t l ~~ i ., .~~i. .i. J .-.11 .......,..- .L 7. , _7ti. s~.,6-.-'. O~a:_1\• ~ Frr 1.E'. . LI1tr 1''1C ~~ 1lUG I: t~l V jc .~'' :1::: C~L~~.',~, not ~,:ete~:?1`s!':` today ," - '~ the effeci:- of-a reduction on rish nor was it prepared to say what level caould-pruvide an acceptahie product to most s:-:u':ers. Iie repeated that the FDA believed it had no jurisdiction over cigarettes. Kensler pointed out that the comipanies have been doing a successful job of lowering tar and nicotine whiLc still meeting con- sumdr d-esir_es.

~~~ynder -s~id- 1t was hard _ to set= a speci Fic limit based on _ present k=•,ledye but t-hat- the. Government had to make many arbitrary decisions and this might be one of them. fie seemed to feel, however, Vhat a r,iore_ "practical" _ approaeh--as needed since- it- did not appear- that legisiation wouid`be passed by the Con;ress. _ .~.- -'~ [At about this point in the discussion,-Dr: Ogura--joined the group at the table s Dr. Ogura= is ar-~~- oFtelaryngoll-.oqi st -from- ti•dashingtorv Llniversity and-r~e~ber of the Cancer Advisoiy Board.] --Wynder r••ientioned- a study he wasdoing=-on women saying they were to much less "vI'•?o'XC- intensity" which might "explain" ' i: u C 1C2r death r at£_? iS one`C7'ac~rte? °c~rte?° t::at of =I'.?en- _ I:ensier` went back -to (?i scussing the question- of an arbi- trary limit and said that -anv 1i mit set might ' appear- to ':appbove`-' al-i cinarettes- below that- level. _ R^:)ads ee=ented _ori--the_ "seem inc; failure" Qf the lower tar an0 . nrc,ot-i-e ciaarettes to reduce the deathh rate from smoking-associated diseases. -Shubik said thiis was Part of the basis for iii s oon~:ern that more scientific research be done. I~ yoou- I~a.ru rGs=-urc :r.^..s'.lltz- %'.'erCL forthcominy- the_y :niqht be able to show how to- make cigarettes "much much safer. " Horn said that there c•,-ere very compl-ex "cohort problems" in- vol-ved. However, and for the first- ti:1e, he fiad-just recently noticed one cohort with less lung cancer than the previous year: the white -nale cohort under for ty years of age was down- about 2 1/2%. - Milt (ACS) asked why "if we know so little" the companies had voluntarily reduced "tar" and nicotine. Kensler explained to him that they probably made the reduction because some people had C'r`^.';11""^r; ].C.'••.,aZ "tar" and nicotine cigarettes - and the cor.lpanie~ :~~e i ti~e t.ei.l .nd T~~_+fn r'--1Cl +"}i°r? a"C:iC7SE 2'Es~-)onse" but-l.t was harcd to to I•,IyI1C'F?r rE.'1'Cr:I:at.erd that to set r-1:'r u': ? _S . .r:~c; :o ~~id i he- aues- tion is: 1?o%a do we get- indusL-rjs cooperation?__ (l:ynuer aopeared to be concerned also about. =t!-ie "str-agglers", tho e cigarettes that were above the "norm.")_ Saffiotti was concerned over a voluntary approach "not work- ing. " He asked if enough interest could be generated_ to form gside- lines- (which might even be acceptable to industry, he -intimay-ed) that would have some force behind them. -2-

Shubik ask-ed how the co:nmittee could intellic;ently address- the political question at all.- Fie-said--the consensus at the _lyst meeting a-ppear-ed - to- be that vol ar.tary - r-eduction %cas - the _-better_- rresen_t course. - I:L was not ready- to` cate~zori-callyi say what level_might -c:reate -3 • - a''_si.~_.~r1 ._ c3.Cta`"c tteH - He- _a gr€..'-ed ti~l:a t it seEs,.,~`d _ i',`:E,-' a 11 _good idea,13 bli*- believeG that a solution -baseet o_n=addi-t-ior,.al- kriowledge would- b e "better. lie also_ stated that :a:ni-le -he --would like everyone te=-quit s:~~o~c- ing he knew that the ~ot11_ en~riron::~~~l~t i~ras ch_ anging and was not sure what the-- effect- on overall lung cancer rates would be if everybody did p: rsonally hopes qt.; t s3::.o~:ing. Shubik Lavors furtizer research an:;, 31 that industry .1i? ~. -take-a mcre active part by providing more funus.3i _'-s~~ ~ ra sf ~ci the c;~,~oS i i o?7 of ~•7'fla t TJ~-o~J.'~e i: uld do ` if you - R~r_e:_ ~ - - ~'u tried to eliminate their cigaret.tes. iivnder made a plea for more, emphasis on prevention-grograms. 't}e wants zhe Cancer nGvizory Lloctr-l to I:'.ove-in thi3=6irection. ~,e-says ~ aL Y' there is too/apathy with regard to smc•kl ng and health research. - Tie_ Sa,,'s that .::o:':: ,~ ' a?'ld-_ rese3rchC'rs_ are_ needed. He also -sa~C~. that attenti_o:- ro„lu not be limited to lung cancer but irdclude-many other- disea-ses '_aciu'ai i::: m_'oc3rdial infarctio'1, periphera-l vascular diseases and emo:1-vse.=_<<.~ . tivnder wants to 71 st"eaP.?ll.ne11 the TobacZ".O t'dor}:~.ng Group various diseases. to mak e i t.3ore sait~.blc for deali-n i•ii lt ur;°d the comrr~%ttee not to forget that primarily what - is ne-eded-is "curtailment" of smoking. Shubik replied that if he knew an effective level for a "less hazardous cigarette" he would probably agree. (He was obviously referring to curtailment on certain "tar" and nicotine leveis, not overall prohibition.) Shubik asked if the comjzittee could agree as one of its con- clusions that "tar" and nicoti ne reduction is _tre mu jor way presently to design a less hazardous cigarette. Everyone seemed to agree in pYi^^i_n?.e ~•rith this noi nt. -[P- oint 1] On the-question of se;.tinG a level with certainty, Dr. r h-,~-Cter. Saffiotti and the los;1~. -'r the . . sn er.c i to want to use or^~;ent c;.•::,retce rnsu? ts tocJetner with sc;:.,e l?a to Ci:t o'... L and X:1.Co- LeC G:i : i:a. tine ratings. -RhoadS pressed rlara' i.or uP.L cJ::Lr'.lli:Lt,t', Lo th:af: those ciaarettes in the hic,i-ier- le vels be rei~oved from the market by legislative means. Shubik stated as 1-iis- second point (and most of _ the -comnittee seemed to agree) that no arbitra>: j7-safe levels could currently be set; that both ° tar"- and nicotine have been deci easee? ; that it is- hoped- the G O aa ~ O? _ 3 e ~

Ih decrease will be more ocnsistent- ar_d across the =boa_rd; that it- is hooed -tho-decrease_ continu^s;, a.nd-that_ othEr -~f €ect_s such a3_ possibly- increasing potenti_al ris'~cs -_,hould re- kept _in- minci.- [Point 2; . Rhoad-s seemed to warit _t-o aboli~r, cigarettes _over _?1 milligrams - of °'tar." .~ , . Horn sald persons ~4ho change to lower leJel s_"spo~~tar.eausly'' do- not increase their sm~oking. Kensler made it cleaY,- that Horn was oniy re-ierr-ing to- =t;le- nu:ih= of ;'iGf_ S=etLe s , I'1ot 1necC-sl:-+Y'1ly -whethe`'- _ _ t,ey inh aled ~iore , e ye . cor Saf1 iotti sur,a-esteci that t.'~e co: ~~ittee recor.-~:ie.~d to the Can- .JVry ioai.-a ~.ZZtJcoL7l"Lnl.ii_ny_ ..~ii,..uay:Je ~ i71 the proS-l.ieiil-. - Shubik said that -a comamittee could be- forma-d to _continuous_ly Yel.Ti e;I t=_ ~•~~115nt~rv -aotic~r .. ~avhc~er Guge`oted= the co~~ittee includ~_ the F'iC-, tnu FDA and the Clear i nghouse .. Rhoads con tiriu ed -to- sugges t iegrslatic:i similar to the t4oss bill-. ~+ynder pointed -o-ut that the Moss s ac r•or:Iing to i•ier=li:~. -~.-ierL.i~ had to' d Wynder that bill cow~c: ^-,ct paa- it _coulf._:''= ev-en _uat- out of comamittLe, Shubiv pi-reLers to be real5 _ tic. and right now eould not- tel]L t :. e!~ :.e cc::panics ;•:^a~ to do. r~+ ~~ ?n he is ~le to tell the c~~g~., anies what to do, he mi ,ht t_'r:en recommend that they be mat:e_ to do -it. Satf iotti _ urged that everyone make it clear they accepted the "smoking-cancer link." He said that future legislation may be- more likely than one thinks. He would like to see a strong statement- of principle. Rhoads sugcested that the con~.it;ce ~,_,a setting up too r.lan~~ research reauiremients that taould~take too long. Horn said that the reductions in tar and nicotine had slowed do;,7n after the ' 50' s and were now rather small per year. smoked. Wynaer is doing a study on disease by "type oi cigarette" D'-• Og7J}- ' i1PCl no definite - on what he had heard during the precedi:ig hour and oneVhalx. I Wynder said not only is th.:-:~re less tar and nicotine in present cigarettes but the "_Lar" is less carcinogenic. Shuhik adds as one of the-propo;ed recornmendations con- tinued surveillance with- regard to :•:hether or not cigarettes- are bein4 mac?e less hazardous. [Point 3] 0 ~ ~ -4- ~ U1

. Rhoads suggested the Carcer Boctety- dv the survPillance! Th2- cor:-LMittee approsr'ed- in pri3-iciPle (apparentiy) a combi,ned researcr nro,ra_; by an e.~panded Tobacco t:orking Gy-oup. ;ioint 4] Rhoads said he was i ncli.ned to go further than the committee on a legislative reco=.--.endation and thought perhaps the Cancer Advis_ o_ry Board will wa^t to go furtheY t-oo. = Baffiotti criticize& the Gori sub^ission. Bh,.:bi:r, said -he €v~as- going to report= to the Board but postpone f inal action to the June meeting. He would circul ate his points to the coz~,mittes. iiil:i'ti'eS of first ?avetlng w^re circ'.alatE.'d.-)