Tobacco Documents Online

THE WEBB-WARING INSTITUTE FOR MEDICAL RESEARCH (Dwdicofed fo 1h. 1tudy of Dissos.s of fhe lungs/ Gerald B. Webb Memorial Building ~~ 4200 East Ninth Avenue Denver 20, Colorado `-Xr. I•I. J. Cramer, President,, P. Lorillard Company~ 200 East 42nd Street P;arch 20, 1?63 °:ew York 17, I':ew York Dear l;r. Crarrer: In spite of ~rour official capacity, you surely must bave som:~ inn-. concern over the possibility that regular cigarette smokin- for r•.anv ~2~~ is seriously harmful to the health of many humans. ',•dhen the observations relatinE the inveterate i_nhal i nE of tobacco s:•.:., - , to various chronic lung, -iiseases first began to appear some 10 or 12 -rear:, ~, cigarette manufacturers had an obvious rirht, and even a duty, to quest;u -4t. Tow, however, if you have read all of the available evidence, bot : pro ;.::-7 ;:cr., you must at least have serious aou~)ts . It is because T feel -rou .-*~ust ^. _ doubts that I am taking the liberty of writing you t.r.°.. letter. P'.an;r people will doubtless continue to do cert.:. _n thin:-s they knoi., c::_ harm them; some will even continue to do things th.-? :-cnow •r-,_1.L ::,urel-r },^rn: nd .vi3ua~ them. In a democracy this is accentable, I think, y"^n knows what he is doing, that is, knows the risks in,ro_t: .- i"anufacturers of foods and druc,s are required by law, amonf, oth-3r t.-i- -, to label their eroaucts cnrefully in order to protect t'r:e nubli.c h~altl-. In addition, certain industries which manufacture a notentially hnrmilzl product at times voluntarily recommend moderate usage of their nro.auct, and ,yet°do not seem to have suffered economically from such puhlic service. In other words, I believe that most ,younr neople today are aware that alcurol can be harmful. At least, they are not ~:lioerately persuaded '~?y tJlevi: ion, radio and magazine advertising paid for .:-- the liquor in.ustr~.• that should drink in order to grow up, to be sophist.icated and be desirr •11e . Smoking is a source of pleasure fo ..: :;reat many peor-i :. 't is .• rt~ :cularl„v gratifying to the habitual smoker. In :i:. iaration it can eve°. - a:-efu_; ,... u sort of relatively harmless minor indiscr ~tion available to sat.ia_ .r our r. .t ral yearnings to break the rules. In stric7 ~3eration, civarette smokin -'I.L probably not harmful at all, except to with some kind :" hypersusceptibility to tobacco tar or It is my conviction that infor.matic• • . •., ;ntia.l clan.-ars of prolon~--~d heavy cigarette smokin' r* and the ways or.. ;a.rt with little or no na~,!1rd should be made available to all young p,-:._7le at the time they are under s-r•?at social pressures to start (i.e., are lG•-:.o). Public health ana school healtin officials, interested physicians arn.i parF-ats, t3roluntary health aF,-:~ncies and ,1 even organized medicine can never do tri job thoroup, ,hly without h31p. In ~ particular, they will be unable to combai. the manifold skills znd t:•.e -inll~.rs r.a of the advertising an:: tobacco industri.es workinF in a contrary ?'recT'.1. N C!! • .~ Formerly The Colorado Foundation For Research In Tuberculosis

2;. J. Cramer -2- ::arch 20, 1963 If these two economic giants were to assist in a campaiEn of public enlirhtenment about the hazards of smoking, I seriously doubt that the per canita consumntion of tobacco products would be reduced verv much. Tnstead, I believe that the majority of people would continue to take their c'.ances in return for the obvious satisfactions of smoking. But our peorle could no longer be justified in feeling that they had not been adecuatei.- warned. The tobacco industry could also point with pride to•a v3r„v rea~ public service. You may well thus be able to forestall some sort of legal restraint regarding smoking which would be most ur.desirable. And *_urthern.o_°a, unless you take some public copnizance of the potential hazards of smoking y soon, you may well ultimately be held f inanciallv accountable for fairl, lung cancer deaths in our courts. I personally think that this would be unjust up to this time but that such a finding will ')ecome just in time to co-e. A review of all the available evidence toda:r has convinced me that iunf_ cancer and the chronic bronchitis-emphysema comnler, of :iseases each have several causes, all. or most of trhich must be interacting to produce t':e:~e diseases: chronic irritation (from air nollutants, particularly tobacco chronic infection, chronic injury (i.e., chronic, severe couf-hing), an:' 3~: individual predilection. The possibility that animal experiments can be desi;~ne.: and carried out which will adequately test such an hypothesis is remote; for i.nstance, the experiment would have too many variables; experiment:::i an;_mals don't live long enough; they do not smoke the way humans do; the study -iould be too time consuming.. In short, I seriously doubt that at least for -rears to come, medical science will be able to obtain the clear-cut kind of proof of the causes of lunU cancer and chronic bronchitis-emphysema that Robert Koch was able to obtain for tuberculosis about 80 years ago. The lack of such final rp oo%, xoes not alter the facts already known today. If I were in your position, therefore, I would be seriousl•y considerintc- the following sort of actions: 1. Avoid emphasis on persuading op ung people to smoke in your advertisin~,,. 2. Emphasize instead the proper and safe ways to smoke, somewhat as follows: inhale as little as possible; smoke only a third to a half o2 ; ci( ~r•3tte; smoke ci~arettes with low tar and nicotine content; try asi,ritch to ---;rs and/or pipes; don't start smoking until you are 20 or more; be sur= i. :u ~ dowm or stop if you have chronic cou;;}-: or reneated de3n ches -. int ec 3. Researcn directed toward removine or :i'fectively raducinf- tno ::ar:i. al substances in tobacco smoke. It is quite likely that you are already ;ioing the research, a.n iyou raa / have contemplated the proposed change in advertisinr emphasis. Ho;rever) you may have rejected the change in advertising for fear of economic loss to •rour corporation. If so, this is not a justifiable reason for avoidinr. your responsibility to the American people, in my opinion.

i•:r. ;•1. J. Cramer -3- „arch 20, 1963 In ciosinF, I wish to emphasize that this letter is ent=rely n,1 o:rra i0a and contains my own personal views based upon speciUl interest and study in the field of chronic lung diseases (I am Director of the Webb-4arinr Inst;tute for Medical Research, which has a special interest in diseases of the lunrs : Tim also in charge of the Pulmonary Disease 3ervice, University of Colorado :.ed;_cal Center, and a past-President of the American Thoracic Societ,y). Others to whom I have sugPested that such a letter be vrritten have tenda:i to deny that it might accomplish any good. However, I do not beli-eve thot a tobacco company executive is by definition selectively lackinp in bqth intelligence and conscience on the subject of this letter. Respectfully vours, Rogerib. Mitchell, '•".D.