Lorillard
United States Senate Transcript of Proceedings Subcommittee on Health and Scientific Research Committee on Human Resources Hearing on Deterring Childhood Smoking
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- R1-038
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- Ahf, American Health Foundation
- American Cancer Society
- American Heart Assn
- American Lung Assn
- American Thoracic Society
- Amtrak
- Army
- Ash, Action on Smoking & Health
- Baylor College of Medicine Natl Hea
- Bethesda Chevy Chase High School
- Center for Disease Control
- Comm on Human Resources
- Commerce
- Demonstration Center
- FDA, Food and Drug Administration
- Federal Communication Commission
- Finance Comm
- Ftc, Federal Trade Commission
- General Services Administration
- George Washington Univ
- Gonzaga College High School
- Green Dolmatch Advertising
- Heart Center
- Hew, Dept of Health Education and Welfare
- Immaculata High School
- Intl Ladies Garment Workers Union
- Natl Clearinghouse for Smoking + He
- Natl Heart Lung + Blood Inst
- Natl Inst of Child Health + Human D
- NCI, Natl Cancer Inst
- New England Journal of Medicine
- Niehs, Natl Inst of Environmental Health Sciences
- NIH, Natl Inst of Health
- Niosh, Natl Inst for Occupational Safety & Health
- Office of Smoking + Health
- Princeton
- Public Communications Center
- Public Issues Comm
- Public Works Comm
- Subcomm on Health + Scientific Rese
- Subcomm on Smoking
- TI, Tobacco Inst
- Tobacco Research Inst
- Univ of Houston
- Univ of Ky
- Univ of Wy
- Wall Street Journal
- Wv Wesleyan
- American Cancer Society
- Date Loaded
- 20 Dec 2001
- Named Person
- Adams, M.
- Banzhaf, J.S. III
- Barham
- Bourne, P.
- Boyer
- Byerly
- Cain
- Califano
- Chafee
- Daugherty, R.M., J.R.
- Debakke
- Dirksen
- Evans, R.I.
- Foege, W.H.
- Ford, W.H.
- Green, P.
- Griffith, C.
- Kennedy, E.M.
- Kretchmer, N.
- Leffall, L.D., J.R.
- Mcluhan, M.
- Omalley, M.
- Pertschuk
- Pinney, J.
- Reilley, M.
- Richmond
- Schweiker
- Solomon
- Surgeon General
- Swinehart, J.W.
- Valeo, J.
- Ward
- Wolff, T.
- Young, D.
- Banzhaf, J.S. III
- Master ID
- 03603272/4564
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Barham i ARING OQd DETEARitdG CHII.DF3~7 SMOKIIQG
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3 T"rIUP.SDAY, MAY 25, 1978
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United States Senzta, "
Subcomm-i'ttee on Heal2h, and Scientific Research
of the Co:maittea on Human Resources,
' rvashington, D. Cv
The Subcommititee mot, pursuant to ca12',- in Room 4232 of.
the Dirksen.Senate azf?:ce-Buxlding, at 101:14 a.m., the Ho.n-
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ozahSe Edward M. Kenaedy, Chairmaan, presidiE.g.,
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Present: Se;nators Kenraedy, Schweiker, and Chafee.
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Senator Chafee. II.adies anc7 gentlemen, we will now start
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our hearing., Senator Kennedy is unable,to be here until latAr
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as a statement.
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(mhe following was received for the record:
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Tran .
script`of Proceedings
SUBCOid[°IIiTEE ON HEALTH AID SCIENTIFIC RESEARCH
CON111ITTEE ON HUMAN RESOURCES
HEARING ON DETERRIIdG CHILDHOOD SMOKING
IVashington, ll. C.
F'tay 25, .1978
EIOOVTeR. REPORTING, COMPANY, IAIC.,
ffcial' Repamrs
W ashingeon,. D. C.
546-6666
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am not a Sosor of this part.ieular brt.. S' did; agree to
sponsor th® bill on the hoalLh education program on which
another hearimg will be hold, so I would like the record to
show that I did not cosponsor 3115, the'coraprcSaousive bill,
or S. 3117 or S. 3118, because I have soase uaresolvcad problems
an both bills. I am a sponsor ofS. 3116, a bill which ex-
pands formula grants and project grant progrruua attdcreates
a Leew program ots hsalt"h pxomotioon and disease prQvention:.
I com© here with amopen mind and will ba glad to hear,
the test:.mony today.
Thank you very much, Rir. Chairman. .
Senator Chafes. Well, thank you, Senator Schk=®iker.
S
Co.tdmEH T s Jcraf
STAT&MENT' PAG$
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A panel consisting of:
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Tsa5aL.7.o D. E.raffal3, Jr., Yd.n., Preeidcsrst-elec$,
Amarican Cancc3r, Society; Bor.al.d Young, M.D. ,
Alambe.r, 31mertcan Thoracic Sociefy,"aad Formsr
Misdicax Director, AmFSrica.z Iiii Association;
fdofiert Mi. Daugherty, Jr.., M.D., Ph.D., Chair-
man, SubccsemiWtem onSr,aoki:ng,. P..rnrican eie;art
Association; _SaIm S. Ba~i3ahf,. 1110 Exacuti,ve.
Director and Chi2eE Couszsel:, &ction on Smoking
and ISFaaa t.h 105
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millions of'dollars.into anti-smokiag iaigiativms and puni-
tive legislation which have no guarantee of success.
14nothsr ap.;esti.on that must. ba addressed fs why tobacco
has been singled out as th8 focal point of'this Subcom7.itt®e:'s
preventive heaith program.
Why aren't similar efforts being ddirected towards the
thousands of, aste chemicals which are poured into tho environ-
ment each year? _
Why isn't equal enthusiasm boiaig directed toward~ tha
estimawd 1,500 suhstancLs in tho workir.g place cahich Idsh*
suspects to be carccer-causing?
i'm all for finding new ways to cut dowz tho high inci-
doace of carccr.in,CYfis country, but i'n not convinced that
the approach you have propossd will produce any substantive
results.
A third and fundamental issue at,stake is tho quasYioa ..
of individual freedom ot~ choico.
As: Presidential Eealth Advisor, ;Dr. Peter Bourne,
pointed out last year: °1Yo matterr how much one may favor
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I prohibition of tobacco products, uch,a move.is 300 ysars w
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too, laba. n. ~-
Thc chof:ca3 rests--as it shouZd°-withths, individhzal. ,~A
Those Mhc want to u_^-e tobac; o wi1.i--'chosa , who prefer not to,
w*oa't. You oatsiot lcgislate choice--rhat:`s what roiving in a
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; ds:aocracy is al?'l about.
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SLATEMEIdT OF' THE EI47fiORA8LE WENDELL $. FQP.O
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SOnator' Chafea. And now our first witirzQss, is a Senator
of grQah disginct;ion Who I am delighted to n:alco_ here, from
the state of S{en :ucl:y, SEmator Wendell Ford«
Smaa2or, we are, so g].ad' you are hore and look forward to
your 4ksstimoay..
Senator Fo:d. Tl:a_a;c you, N,r.. Chai .rnan. Ti was expecting
f.he distinguished Sarczforr from Masaaclxasatr,-hs to be here, and
some of my s'hatemerat is couched in tkta vbin that he wouid' be
chairnua.n, and. so a ycu, will forg,ive me I wi13l not let you
look like E:Y.e Scns:tor from giassachvs%tbs.
Senator Chafeo. t;o11, any brcadside!s you icose at him
I will be glad to absorb, because I am a cosponsor of tyhe
bill.
Ser_ator. Ford. I usderstard th,fi, but I. jusC,waated you
to know that th_ te;rms of my sya3emcnb were couched otherwise,
because we have beeu adversaries before--ar,d you aro a ucaw
one.
(Laughter )
I havcas'b sttsae:C 3 your tact;f_cs yet.
Senator Cha2ee. Well, I don"8 wai.t to d!ivprt- your fire
anyway, but a,£ Vh4rc are any sh.a£tEs you wish to +utirow this
f di=cctior I eai1l be glad bo rocoive rhWse.
5eas3bor SchweLkex.Th~--y are both from NCea Es:glano1, if W
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goverrimsnt. And. here, with only th° ad3ff.ion of $4 million
for research,
I think this is the ansorar--rt.ot billions of dollars. And'
why tax one crop. --asbestos, for iustsncv, that is can,cea-
causing--and let this be a preven:ative measure?
. Senator Chafes. k'ell, I think thai tha i®videnco is very,
very clear that 90 percent ofi lung cancer derives from smoking.
Senator Eard. What about asb sstos? What's tl:s figure
on that? .
Senator Chaea. Well, it diTrides up tha balanca of the.
ten p2.rcaat. But wheu you have got a figure
Senator reFd. You can get any rese,archer you want--aszd
I th.iaek you can fird, sag thi$g to, reLuts that. There is also
a plus to,tobacco, if you will recall. There ar4 many pluses
as relates to heart attacks and, other th3uags.. And irouw, have.
to take into consids:rat:on right now: this is a protain-
short country, and fsactiou 1---
Senator Chafes. Sxcus9 ma. I miss ,d that--did you say
there asci pluses to bok+acco?' .
Senator persd. Yes, sir, the rasearch says tha4: smoking
is halpf.ul, ahd tfsre are pesceutages, and.I can tive you the
staE:.istics:--i doea "a. ?:avr them with ma-°bu^ I cer: aialy will.
Asc you familiar wig:;: faaci:ion 1? 0
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Sereztor CesaL-cn. Null, thoe~e i.sarf~.xags ara goisag oan for W.
set~+ral days. ~.
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° Se+nae f Ford. , Yes, sir, and tYieyC ilI bs in, one of my
committees.
Senator Chafes. Aasd . we have invitodd a reprras®ntative
from the Tobacco Iastituts and the aotice, which they felt
was too short Seaaator. ?ord. Well, notified cn 7,'eiosday to be here on
Thursday is a Iittid short for"me.
Senator Craee. Well, youare prepa~:redia this. srabjoct. .
Senator Ford. T hope so.
Smrator CTa3fes. But if there is evidence that tobacco ia
baa.Cffici:a]i, we ceTeaa:nly would bz glad' to hear it..
Senator Ford.. I would be glad to bring it' to you, Sana-
tor. And~nort only is it bsa e£icial--are you familiar witb
fsactioa 1?
Senator Chafdn. itali, I'm not.
Scsav.a.tor Ford. Okay, "ere12, fraction 1, you seeR is the
protein that has kx:en d# s:cov3red in tobacco.Aad tF,ey r.rQ
moving forward wif:h that right now in a, protein-shoit couatry.
It is esv3.:datedd that you ca:. takz.ths protesia from tobacco--
you can take care of 60, LziL3ion f.air~±.lies wa.th what is boung
p_roduaed now by tobac::o,.snd still have your cigarettes. And
so you are trying Va camagQ a crap here and pu.t it out of
busir_ess that has rsa oppozLu.nity to solve maz.y of the problmrrs
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amiW relates to hsalth in this.cai:ntry. ~
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Senator Chaz'ao. Well, this bf.lJ:, as you kricsf, is ~
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ing a solution rather than abolishing the industry, which, in
?;f Chairruas., The shearr econotucs of this situation dictate fiQd-
411 ®ffact, L.his legislation could_ do.
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There is one final point that neecc3s to be made, Mr.
Tobacco,is a multi-billion dollar bc.sirr.ess.. Mor&than
600,000, farm fami':lies f¢ore than 90 pefca:t of small family
farmsn iirs my state alone) derive much. of' their $ncome from
tobacco. Throughout the yw2ars o eahaustive dabata over
tobacco, no osfe haB coma forth with an alterga5:ive crop that
10 these fam3Zies: could grow whichttould kesp fi.h2.m~ seelf-
11i sufficient.
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hundYtsd;ss of other c,ops uould:hrive3 in the rich farmland of,
my stata a.zsd elsewhere. But the cash receipts to, be derived'
from any of thessa alterzaakives urould be .ar from sufficieat
to suppo::t es::.hzr a famiiy or ".:j%e farm. -
bSr. CYeainaan, T_ doh°'k want to see thcs Ce,ngress, throaagh
this 2egyslat:.or, be awi lz3irc acwYssory to th-3 further demise
of ths f«s2i:3} fa..^m--bzcause unless 4fe find a, suitable alterna-
tive, that's -whara will happsr arictthese. peop3:e axe going to
I Fse left with only two eh:o..ces: ?cave the £a-mzhy hrm or ert.d
up on welfaro.
[The fol2o!.ring was reecsived for S:he rFcord:
7.
Is it hat unmaconable to considar EuppoTting--instsad
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of undexsaining--what I perceive to be a sincere and.intense
effort to save an i.ndustry that provides billions oE: dollars
of' income; fcor millions of Americana?
As I have reminded.my distinguished colleagues many times,
tobacco is a pliable produ_t, a,product £ro.v which impuritiel
can be rembved in as't short a tiaa as two groaiing seasons.
That flexibility facilitates resesarch such as ty+z kind
which is now being conductadonn smeking and hQa?tht at the.
Lfniversity of ite<ztacky's Tobacco Research wnstitute., Since
the Tobacco Rpsearesl, Institute's creatioa in 1972, mcre tztiaa,
$3.7 million annually of state funds has bsen direcfed into
massive research a^d study. That resQarcTa helped' deveToped
the current lou--car and. -3s.cotine cigaret-Les which are now
on the market.
L'mt my rcpeaY.ed calls for increased research initiatives
at the fE:disral level continue to fall on deaf ears. According
to Health, Sducatien, and'. ktmlfarer decretary e'.ali£aao,, the
only budget incroase fcr research on. htaalth-relatod aspects
of sxo::i..~gi will amount 2o a more 1,M mi711ion in fi ~ca?i year
197Q--an anuount just slightly more than what is n&a bes,ngI
directed to research in one s:uta--with szon-fed.r-ral dollars
as well!
p ,
TYee difi:dvttids to occur Eram this rcisearch will ba, far 0...
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rtor.aa retiara*ng ana p;:ouuccaVo eciaar_ av _PLLap 1uziJ1.aVsiU Gau
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but throughC ec9lerated research.
s.
Through research we can work to identify harmful e3enaenLS,
if ¢hey are found to exist in tobacco, and.then.reaove th®m.
Through research, we can make important strides toward lessen-
ing any risks found to be associeted with smoking, while at .
the same time maiutaining.the economic stability--and I a1ght
underscore "e~oncmic stab~lity"--of this industry which i~s sai
very important to so many states.
In fact, I find it ironic that f;a have to ev©a consider
a re3nawa.l of governns" ital assaults on tobacco at tha very timc;
the na.rketpl'ace is' so rapidlly dealing with the problems that
smoking advsrsa:eies talk so much abotvt. Tar and nicotine
yields have baen cut in half in r4eont y6ars.. The cigarette
industry is involved in the most vigorous an,d, expensive com-
pet'_iti.on~ in its history to convert: smokers to the lora-C.cr
brands.
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ihe end: result is that we are seeing a classic illustra-,
tion,of the value of readam of,chhice--Z-he
free choice of
smol:ers on the one hawd to smoke o'garetfaas that critics say
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ce safer, and the fr.cn choice of the rarutacturers on the
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Ncv, it a.ppears that the federal govG>rmarmt wants to ~
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eff'orts to pzodLco a sa.e_ proctuct--:aitI; punitive leg:.slatian.
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, Why rcsst this be '~he dMrec'.;.f,ca wz tzhd9
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2Yow,, you give ths;-n a substitute, ar.dttten you start relating
to tobacco~producver-aud you ga intoe the mamufacturixxg ot
those products. biow, i..:"sa far-rEaching rippling effiact-
you stcop the growth ' of tobacco, and you look. what, you have
dona: you hava'mot only eliminated the best income for small
farm:fayailies that they can have; you have also eliminated
industry, and probabiy soma d.nd:usi:ry i:n your s'kat= wIsen you
have'unr-iaploym,:nt and you wouldd like to have it there.
Senator Ghateo. Well, we era very conscious of that,
although, as you know; from this bi1l, it. doxts: not 'c9sliminaP.e
tize indus&ry--you have obvicus.ly lookod over the bill..
Senator E?ord. 8 undsrsgattd, but if you look at what it
is trying: to do, and you . look at all four bills, ar.d you get
intol aPl the3 ram3~.ficatioszs of the 1, gislation, then it is
fzr-r.eacca.4ng and it does do dsnago to thoe industry, and to the
p:op2e--tho pacpla I repreacaaat. .
Ar.d, i3r. Chaj':rmas.t~, t wa,,.t, you to take one ide<aW uncer cou-
sidaratioa. Ma have been trying to solve: our owaa problems in
Ke:ntucky c~-~i.thotie a dime from the fedaza3 govesrnment. And
whars erH put a.+r ave:rage since 1972 of $3.7 million into re-
search. Find. the C'hasxwa-m of tlais S:abcommittes actfaittad itwhat0
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wa had .1s9 top pmcple not only i»n this couniry but probably O
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in the world heading up that research institute, trying to
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noPvsi fib.o prcblo:, without fede_al dol2ars. 7te are trying to
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solve tha2. Senator, without Ant~v~¢ion Lroan the federal
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Sstaator 8ord. Mr. Chairman, I will be daZighted to at-
tempt to answer any questions that you might x+fiisif to pose to
I think the last point you madQ,, cf course, ahout,the
your tltoughtfcu3' and perhaps not surprising testimony.
Senator Chafee. Weli, thank you very much, Senator,. for
me this morning.
family farm is something that concerns the entire Congress,
end, indeed, the aountry., I think it has born shoum by cor,-
stant votes in the Swnate that the mafo$ts are to preserve
the family fhrmto avery escteut possibZca.8ut somehow I
think the cho,ce you prsc.srs`bad at the end, thatun3ess they
ara g,rouring tobacco Whe ctro3ce is to give up thm family Tarm
or_ to go on w3ifa4e, is a. little 3amitead.
Senator Ford. Well, Senator, 2et rae ask you. what crop
would you suggest that the 6,00,000 far4ters in several statess
start producing to substitute for tobacco?
- Senator Chafes. Pi+a3Z, I susgsce that thasre are many
famiLy farns ia thiss aation that are not solely d"mi*zg wi*h
tohacco..
Sc.aator Ford. whI1, let i,a,- give you ot;a s:.:t2, Sc3nator--
I am noL sure thatyou undr,rs'.:as:d tohacco~ and, tobaccoo sCatcss,p
W;
because I doubt: ser;iciuwly that you,, raiWc too au:ch in your q,
sta.te.. Sut ian m,v, state ttcarG . is 165,000 farms:, that repre-
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se_nts I_65 ,000 faza=lies. Gf that, I~ 03, 000 of thosae Ezrms raiae
tobacco. af, that i03,o00, 90 parc:at are small family ffarms.
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dare say it won't ba the last. I don't Jilaow hora much enjoy-
"Soaator For d'. .dkay, I will not put him. on my petard
this morning.
t3r. Chairman, this isn't the first ti*ua I"va foaand, myself
sitting across the aisle from you to talk about, tobacco-and I
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:cent you get ou1C of theae sessiena, but I can guaranGea you :.
that as long as you maiatain< your. strong inte;restc in.this a.:ea,
I'm not going to 2tave . any troukzZe: at all convincing my con--
stitussxcy that idle tiuus is r_on-e.:ister.o- [sicj in the Ser:at-.. :
Quxte franka y; I do reot c3:zpsct you to be swayed by any
argumerats. Im.ig,ht make this morning, but I do hope that you
rewogaai:.a the subcomm i.ftea's responsibility to ensura that
the points I raisQ.arc carefuzly considered and given their
due process as you move forward with thisltgisial:ion.
. .,
i.et me make it clear at the very beginning that I have na
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I prGblcros with the intent behind the provisions of'. this 2egis-
la%ion which psrtain to children and smoking. I would support
legislation to this efoct--i.f that wsre its sole intent.
Ctnfor'cv.aateZy, that is r.o: the cas®, and the legisiation
wHn3ch i'.s now before Ltais S4bcomaniti:t,Ge goe s far beyond those
lutuits.
I will be the first to adnYit that serious questions con-
tisei:.Q to: persist about tobacco. But I will also ba thw first
to declare that tho p_op3r and 1ogical response to finding
~ an>xaers to M.t`zsst quGZtions is not varougfb punitive legislation,
i
S2'~4^H!++~?b"Y"
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TFeQ Honorable c:onde&I Fi. Ford, Democrzt, I`u--a2acky
A panal ropressentizg the Administration:
Disease Ct+Mfiao4: Normal d¢r4&cianer," Ai.D. ,
Director, National Ins ti2ute of CFsa kd &2;alf.h :~?i .'
and Etwnan DevQlopment; and John PSan®y, Director
Offic.- of SmoE:ing s.nd IieaZah, Departmeat of
fiEaZ eh, Hdi:eatr:on, and fi7©];`are . 27
A paT31: oa. high.4choaE. st,udonta:
T: erese Wolff ased : Maira ReLTlay, ti'==celata
Claar±ec+ Griffit9a, Gonvaga. College Hagh School;
gigh Schoo'3; S^a°i.a1lc-)y', VarY Ada^a,j and
and Wamos. Valsar, Bstlhasda-C::eey Chastr High
Scb.ooll
pcu3ua con st.sb.ing of :
Ri.chw:rd T. N:ra:a$r F~a.D., Fzo.;easar of Psyc.hology..
CcatCr,. Pel"eaw-n kLa: o=, Lvaw, ?o:.k;, af<d Paula Gseeza,
Frcsa:demt, Grtnan o1n4s, ah Ae'.vc:rtzsts3q: Inc.,
Swirlehaae, Pa.D., Directcr, Puhiic Commnw:fic~zta.oas
University of 5buston, S3oeast_n, Texas; James iT:
te"w '.rio:."i:,~ i?F.-`~4~ 'LO"i16~~ .. . ~TI5~'. .
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this cota.°~try that is prot49.n-s'uost.
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So instead off trying to be puuis,.: ivQ horo, I think you
ought to find some way--if nothisegg else, if you . ar.r going to
tax just c5.ga.rettcss--lut soma of the o..her industries that
will have stronger testimony than against toba,cco as relates
to cancor-causiazg prob3ems:--1®t them share part of the load.
But im.the Senate,you know,y you put a. tax in thg bill, the
only way yottu can tscn i;t on--you tiav4p to tack it on. to a
nouse bill; th.e Finance Ccamittsa can't aven consider a n®w
tax, in my opiniod.
Senator Scht;aiker. MayFae you didh'°underst,and' my qucs-
tf.on. TMT question was ---
Senator Ford'. ho,+ sir, I would object to~ tha bills if
the tar was out.
'SCSaator 9chcasik4r. What particLiarr featuas: of thm.bill,
i' th3 tax 6as.mmot in it, which you say is punitive (and may
w'ell ba put3itiv*a)-whxzt padticc;3ar features of the bi31 do
you object to?
Senator 1'ord. 1v'a1l, you
smoke in various facilities.
ass ®?'iminmtirg being able to
You
anG
O.
saNingittaat peoplo ar~+, Q
not fzea : o do this or to do that. You are suyrin4, no# you
can't. F.atd that in part of t?se bc:lb.
1think naApe c onght to hav©' a free choice. Anc3 if yom
dor' :: c3ra:aat to b3 around a pisrson . t.t_ag siaor..vs:, move; if you
don"S, Frrnt to 17k a:ro°.a3 a'i'fa11oL; that dr^fpJ_s.,, move. You knotia,
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Senator chafes. I am a. cospot:FoC f this bill which
we are considering today which prilaarily deals. with the
area of provention. it see?as to re that there is soaathing,
off-kilter in our whole syste3mofm expenditures for mssdical
care in the United States in that we pour billions of dollars
inYo taking care of people who are ill--and.thatis proper
an6right--baat we pour about two perc-sxtt of that amount into '
i:ryfi.ng to keep people hszithy, in, the wholle area of preven-
tive medicine. And so this bill, which Senator Kennedy was
'the.primary sponsor,of and which I am a cosponsor of',.dcals :
wit'1 this. particular area.. The bill has several sect.ior.ES.
The area we will be considering today deals with the subject
of deterring; smo2:ing as:ong,s¢ our children and raIlating,to the
whole problem of cigarette smoking.
N;ow,, over the years this Subconlnittacs has heard testimony
on hundreds of health issses, but it se:.ms to me few of them `.
have concesxkrated in the area of preventive medicine, and. wh3*
>r,: .
we are considering today,, as I saifi,d is' the subject ofcigarett~
smoking and its damaging effects as we see it on the health
of our entire citizenry, and we are particularly concerned now
wiS:h the youag people that are going into sToki> g`=ia incxPas3ng
r_umbers.
03603388'
We first have a. stw.texentt fron Sezatcr ScnweikQr.; and tY:en
re will pYocer.d with our first.dis.wiaguished wit.~.$ss.
Sena_tor Schwraihor. Thank you. very much, Yx. Chairman.
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adding it on to wha4:. vou aZrBady have. F=3 it brings about
$6 bili'zon in--it 's $2. billion hasbring th© balance of paymumts,
and that's bad enough. .
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6s,nator Chafso. If I could just clear the rcaco,rdd herc a
bd :. The federal tax current2y is 64. 7En this bilY, some . of
the tax gacs down : to 50.
Senator Ford. That's righa:, so iv's bound to bs--Lti:at"s
what I said: no maC;.ger how loF,r the tar and uicatimis, i'rr's
still 54. I don't think my stat:r-.mea¢ Was. rarrong. So the ae-
cord is: clear u:3tii the 54 :zx tFzen, regasd3ass oi tile ta.r, and
#co~.t;atam.
Scscator ChaFaa. Yus. But c,na rarely find psogbe eho, are
dissatisfiedd with the t:an going domm.
SLnat=r Ford. No, but the 5V- on the ot=cr end is bor-
raatdcsua..
Seratoa, Chases. Wall, ha hope it will bre--if~°s a dabrar-
rsa:t,,
obviossby.
Senator Ford. 6tali, ?'e:ant: to u®lI you, I aca going to
se-s if I can't ¢: ::er you frem2v3ina a da`+o?rrcnt.
Senator Chafes. Clh, Iexgeci: that. Firta. Wal.i, tttar,k
you vory much for comargr, ese apprcciate it.
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t~ two wevks.. And' you can fuse netaTs that you cannot fuse here
on ezrth. And so mayba:tha.re is an opportunity for us to
3. dovolop soms:research.. It is an opportunity to try to save
an industry instead of being punitive to it. .
5 Senator ScFr,aebkax. One of the provisions of this bi12,
Senator Ford, is that it daas segregate smoking and non-
7' smokar.g, areas in lQungos,.public dir_ing , faci7lities; ancld re-
8 crea_ion areas, . -
Are you opposed or supporeivm of' that?.
M Senator pord. I, am eppos2,r1 to it. Abnut the only time
i 1' I gQt to rido on an asrpZ.ar_e. is a 6sat by tMe lavatory with
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no windo4ai under the mof:or. Now, 16"* us :d'to have problems
about segregation in this country--and we are gow being
ssqrcga'ce3 in a different area. But if a crying baby is
sittir,gr next to me,, that's fine, thatdoasn't make any dif-
fore:acc. The fellow that has other kind of problems sits
ncAi: ":o you, tha`'n all right. Bu:,you kn.oer, I can't sttt
equal on the airps.anw, for instance.
S.natcr' WcIr:rniker. Of course^, a baby may give yosa aW
little noisra pollu'cioz. 0,
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Sanai or Ford. 'a^Iiat`s right, but I can uc.ders~artd that.
tu , you know, I, have se-on gsflplet just raisa :'ain becau:a. the
baby is crying; the baby is going to cry, it has problems.
But we know where w-s are going Uahcrn wa got ori that airglane.
And I tls3nk tha=it ought to b? oaua2 on both sides.. And the
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vta4 of how to help. industry and how to help peopla. And 2
don't believe taxing an industry to tuan around and spend
that money to try to put that industry out of busia0ss is the '
proper procedure. Yf that busxness is causing a problsm--i.e.;,
automobile industry--I don't wantto put the automobiles off
the roads wa can't affcsrd, to.
But in a s:aiallear scale, you can't affor3 to put;600,000
ffarm families out of business sit.h2s. And i£ you view the
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farm probZcnm inthis country in the last few atonths,, and if
you taYQ a surv.cg 'of' thims count...-I aad the crops 'cbiat are not
in the grcud yet, the farmer is not going to
fare very well
112 axis: year. And. this. is one crop--ons crop--that they can look
1!3 foi^cuard to, borrowing sdme moraay at tha bank, being able to
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buy fertilizer an3'do thoae thing3 for other crops on their
115 £arfa. p.nd tobacco is the vehicle to. save the small faria.
16 Now, iSc', they did not have: tobacco, that may bring them,
17 as high as Y3,000 an ac:.e--substi;:iztQ that for cucumbers,
ti8i xhzt wi'11 give then.a.bouL.$G00 an acre--then what are you
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119: r,oing to do? .hera look at tt'torippling, effect that would
20 hwvca on the: tota3'l industry.
21 So I thin.Y th8, procedure h¢are, that what yau!', ought to do,
22 you cughd to, put itin desrsarch and try to isolat& that prob-
8.3' ?:em. 61a ara~ going to }xav® the Spa,:c Shuttle bnkore long, and
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onq of the fi.-1p things aF;outt the Spac2 Ehuttl®ir as I under- ~
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etansi it-; ou can i so3.a.te ce3,1 s, And you rill , be tiuere for W
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STATEMENT OF' A PAT_dEI. REPP.ESLN'3PING Ti3E AD-
2+SINIST&ATIOiCn 1dILL.IBiN1 H. FOEGE, hi'..D.,
DIREC TOR, CENTER FOR DISEASE CONTROL;
E1OBFqFLtd', E0.RE'F'CM'R, hP.D., DIRECTOR, DtA3"IOLiAL
IDTSTiTTSTES'. QF C'FYILD HS&£,^a8 .'lieTD HfEMN
DE4'ELOOPM131dT; AND JOHN: PkltidE%?, ' DXRSCTOR,
OFFICE Q7'9' SMOZ.ItvO hSiD' Iima.L`A:H, DEP.APs'"tF.TNT'
OF' EiEc'k'?.,TIi,, EDTi.^..ATIO-H ISaID V.23UTARD
.
9 Senator Caafeq. ThQ xsevt pam1 will 333 wade, up of Dr.
10 V1i11iam Foeg:2, Dire.:to: of ttie Ceater Eor DisDasa!ConCro2in
11 At2anLa, and Dr.. Norman' K.etltcl-mar Erom tLc3 Natior.al- Institutes
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' a~tfla and SusaU DCvesopMent, and John Piauey,.
of Ck~ildt~0
Dir
ctor of t3?SOE::ic
esf' Smoki
d H
ith i
HEW
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ng an
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14 I4ofl, gQnt1emaa, we welcome Irou hero. It is my privi-
15' logo to have known Dr. Fcegs and saQn him b3gore. And Why
16 dosa°g vas st3z`s off rr.ith Dr.. Foagc3, and then we will take 4he
17 others.
53 Dr. Fo3ge. Thank yo~s', Fr. Chairman. With your permiss.ion
19 we ,,rraePd, insert t},:ie fortha racord ar_d' read' only selected' po±--
20 tivns of our 1K^a5:.9:m3say..
2t Wcna%op Chafea. r4 m. ~
22 [Taa ic3?oeaxng was re:cawved for thca rscosd'l
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a c=-tain fuleagce, thay got taxed. Kon°t Frant' to refuto
wPi'at staff is telling you, but iS:' Msy be that there is some
tax If they don' t meat the air pollv2ion standard. Xthought
they took. ~.'1m ' off tfaiti ma:kek;. I thought that the tax was if
they didn't rcaucEs a' certain mileage.
Scnatar Cb.afes. ho, I said ws requira_d ghtio:a:to moeit
ccr$airn,standarcis. 1
Senator Ford. But, Senator, yos @i.dn°t ban fihz autosaobil;
there''s no at;.Qnapt to ban ' the az;touobi.lQ:
5en e: tor Chafee. Ar_cL, thora's : o banning esg,a
cigaraCtes
in this L-iZl.
Senator Fbrd'. S kaow, but '::ta p.rocess that you are fol-
lonysag h::re will ban--why doa't you put,." ha aqon2y into re-
searchaur3 try to eliminate a problem that, as Dr."&1'ourne:
sayes, has bes.ai wit.h us 300 years, if it's a problem. And if
you wan-t to start btio3a..ing $cbacco, it she,aldd have sta.rtcd
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k'h.ad I am trying to szy.'to yOe S.s. let's pu; kh-a aoney
i.nto rerscs..tch; le;:'s tr3 to siad a p:.:oblc:m., f f:.tu3xcs is oo'3.
.
aobacco is a- plimalo~ pruduct',, ycu, can gro*sr amy iTarnaiity out
. o'Ti~L iXd zF:`.3' g?76R3iIie SsesC;sq,j.; yoF.' C2- tak4' ft. to r}VRc.,TIR cai".
. Late an:d do it :Ln . 'cwe+l-re months. Noo, these .. ara sHZitstics
that I doW':: t'reixi, ra.aa be rc:fu';ed. w
iM
So iuspvad' of bei::g, p:n:Aticu, why doxz°'t you ar3d the O
.A;
ruo*:ac y 4ao resaaxch 3s:-ztead' of pu;tir.g it:int^+ an ec,uoe.bional 0
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emphasizes thatt an irdividuzl who smokes and who has been ex-
posgai to asbeatos has up to 90a t31aes Y.he risk of contracting
lung cancer as a nor,-siaokor who lias not bean eucposed , to as-
. 1asstos.
The Food and Brug ABminas't.rat.ion is now reaieningrr the
published repar@s on the intesacfiaUon of sFnoking with 'Chera-
peutic drugs. - _
To coord3uaee this ©sfort, the Secretary has ®staYili$hsd
the Office oa Smoking and I;ealfi,& znd has appointed 1ir. John
L'9:nney as its director. AL. Pinney b:.#.ngs to this position
f.cu years experience as. a manac_sv and analyst of health pro-
grataa, and possessc3ss a knowledge of and eo.mmitment to pre-
vent'ioas aau3d heahCh e4ucction. .,
^ah2a first provisions of 3118 deal with tiaa, regulation
of anokir,g in fe3laral faciliti,es. TLssa provisions correspond
ve:cy closely witish the new regulations already promulgated
within HEN, xrhieh F am suYmitti:g for the record. tte have
urged orher: duparuwe^t and agency h9ads. ---
Senator Chafeo. nr. Fooge,, could I just interrupt one
Eeomsnt 4hera.. Coang back to Cae asbDstos thing--the point
c. 0
you mzke about exposure to esb::ndos a.ad ba+::.g a citgaratt® I
smoker ircrcasas the chances of lung car.cor 90 pGzceat:.
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nnsfi say thaa: isa shocking i=.gure. N
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( But , t~ oppenunks of th-s bi.2l ui;gh'c wc;l l say, oJgll, that's
~ the ashastos sid®`'s fau7 W, dca't expose pcoal',a .:o asbestos.
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aigarett_, smokfsxg. Tt was because of the hesaaau, and dollar
cost of smoking $hatSecretary Califano announced the Depart-
ment's 3:nitiaaive on smoking and health on J:'aseuary 11. Under
this initiative, a number of stepe have bss..ry tal:ea.by the
Deps.rtment, all of wh;ch wo believe are consistent with objec-
tives of 3118.
R'oaa"ct2er with ;'?ss Federal Tr: d® Commissi:on, tha. Depa.rtment
I has p^.;tii;io:zed the. Pederal Communication Comeaission to open
more broadcast upportunic.ies for public service announcements,
including prims .^.soo, ahsaYce the infcm-mas.ion ~.*acad be made
available to the widest audience. This petition is ncw being,
considear<ad' by the FCC.
Sacre::azy Cali=zi.°eo and Commi+sie3tr of Educa4:3qn Boy`=
are working with the 16.,,0010 schooA'l districts to provid® edu-
catio31 mavari.als. We hav3 circulatecl a uaodal °Clean Indoor
Air° bill to the fifty states for their cop-s'.darat.ion in ®f°
forts taprofi.ect the aaon-smoker.
Dr. Richnor:d has as s Lgue-d ress onsibi Sities aaong the
agenciss and work h: s brsgun on tha preparation of the 1979
Surgeoa Gvnc?raI's reroxt. Tiais, will bc. the most raxt-sasiv®
revirex of the ,:_cc2ical and 10, haviaral aspects of edokiag since
, the orig3.4a1 arrnon, C~,r~al's report of 1?6A.
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T'r.~, Dapartasertis notr ezzgaged in a. natLv ewide effort 0
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to no; it-y World F3ar ZT shipyard wor :ars and c:hsr aslriseos _0
.a
workers of the h,2a:eth ri:s?cs eieey face. Th is campaign h+
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prim4larily f islformatioa bil'1; it*''s J put'£ing people out of
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Sens#:or Chaffae. The moz:oy. is coming froma t~ ~ederal
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Saanator Ford.. So you , are taying one industry for prsven-.
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tative3 informal:ioa on all areas. thfiy don't you goC f.`brs other
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SossG.to; ChawOc. With maay bra.zds thn ta:: will go down.
Senator Ford. t?eT~.1, the industry is. doing that now with-
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business.
Senator Ford. k7ellr where are you. getting yoar money,
'r.len,, to put out the information?
g©vernment plus soax.~ of i$ from an i'ncrtsased tax an high-tar
cigarettes.
areas, ia and let tY,za share t2ao paoblem, if f;hers is ous--
automobites, for ine~anco.. Bow r.rach are you going to tax an
aut=ob3'TO to holp? Fow much arc you going to tax the as-
bastos peaplc?
federal gove.rsiran; iaterv+ention. There is competition
7aetwaen indus~trfes. :fn the open and free market, and you are
trying, by tax,,, to force psopla to do something that industry
out
is already doing.
Sexaator Cbaftko. VFA11., we
opniosz har.e., and
--- y
obviously have a di,.f.£erence
of
Scnawor Fozd. 17e c=tainly do, and I will be dQligiked
to d: -?:x:fe it with you, 5^2ator.
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24 Szaato_ C3',a.£es. 7L~d wa are goLng to hac*v £urlThQr wit~- ~
r.zsscs, and ua look foWFraid to havi ng witn2seess cn that. X16
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partiicuJ;aCubject,, the protein subject that you suggds'ted..
And we are grateful for iCho views that you presented. If
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there are any other points you would like to make.
-Sctriator ror3. WeYS, S4-nator, I will 7ustsay I look
forward to your com;ng and testifying before me at my com-
miCtee; as acospon.sor of this legislation.
Senator Cha£mo.~ Fina. We1l, 31 hope 7ismarge as wel1 as
you have here tod'ay..
Senator Ford. Fiata. Do you have any ftLthar questions of
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ms?
Seeato,- Ghadoe. Have you any questions?
Smzator Schwei:ier. I just have one: v,uest;on, Scanator.
Ff the tax on tar and nicotine werE not in :.his bill, would
yrour views about the bi2l, change to any extent? ?n other
words,
--- .
Se;a+.ator F'ord'. That is just one part of it. The labelling
you, get i nLo'--3 rIiitz.k that is isi three o t&e four bills that
I have bad an oppor :urA2y to road. Tha2"s onereason it went
to vra::mwseri, the labelling and' all the ra.a.ifications. You set
up a mur saction--?' balicave it"s 305 that you refer to--in
t*~c bi7:1. Amd what we LEad is to try to ha4p ttteJ,3.nd~:ar.ry
that ca.n be very Izelpful to thi3 country instead of,f trying to
put 600,000 farm airilies aut of business, thosethat are
O
~.-p I oyod by praducts mada frc?a~ that crop. A2d you have theti
O ..
potMne3aL of this great protain 'chatt will be availa]:Pla to ~
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Nbw, it seesas to me that the-ksay thing we are dealing
with hera is the risk of those who s&o3:o cigarettes. Aad'I
guess the point you are making is.xhat th~ra aro other factors
iaavolved which. increase thisactor by the squa.re or geome-
SYically. But I do have a proFrl.ean with bringing in other
fariors, like pills.or asbestos, because that feeds ammuni-
tion to the opponea :;s who say get rid of the asbestos, for
exarnplo.
Dr. Fo.ge. We think iS:'s importatzt--raopl;Q who have
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other risks ea%ich may be additive or synergistic should know
a.bout.those risks. With asbestos, for insCao.ce, a non-asbestos
hworker who smokes will have about a tenfold i;ncreasa in lung
ca:ascar as co:mpared to a non-asbesto3 worker who does r_-A, sn!~k^«
If you take asbastos workers only, asbestos w . orke.rs whoo do
not sua:cA have. only a. slight iricraase in Ilv.:ngg cancer, as com-
pared to reon-asbastos raoxkers who do not smoks.But it is
the combination of cigaratie smoking and
asbe3stoa tbat in-
creasee the risk ¢x.or te--dbld' tio ninetyfold.
Fad we think it's important that asbestos woikers know
bhad, kacsuse fi hst is ztie one thing they can do right now is
to s:oa smoking in ordr to redrccv Y.Yiat . risk.
SE,natoz: CPaafe-0. MA1r thab second point you made there
abouht tbo non,-suoRCx's CW:pGSUxo: to asbest-os, his cbafivige fer
C
lung czncar you said ga up vC-ry slight3y. ~
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Dr. Focgo. Ve:y slightly.tj
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Senator Chafcse: 2n othsr F:c--ds, the asbQstos alone is
a minor factor.
Dr. Foege. That is right. But i°. is the simerrgistic
effesctsomehow of cigarette ssokiEig and asbe3tos that makes
this very daatgerous.
SeSnator chafee., And that -comes the same with oral con4isa
ceptivns rand' so forth?
Dr. Foegss. With oral conEraceptives, th.2rQ i;s-a s3ightiacrease in cardiovascular ris3t ia waman
over the age of about
35, even if they don't r,makc. But this becomms great®r if
thoy do sr;vke..
And it is in this area where poople do not know about
.
the add!itive or sy-sxgistic effects that we th;:=..k we havo xn
give iaforMa,4,;:ior.,
&saato-r. CTaafea. Tie12, now, t:izare is a caficlee series of
ttese syr.Grgi~:stia ofr c3c~ss with, say, im, pregnatz't wonten, rsmoP.ing2ztd liquor is:
damagfi'.ztg? Or is 'tiia:t not, so? S=Ai.ag alone or
the iiqxoT a1on+e i's the riamag:,iug factor in the f"'us?
Dr. FoAga., I t.::irl: we really don't know how many areas
therea'mxiuse ba s;,n©rg;ist;'c a.£Ecc.:g, and vs aro just ?' believe
~,
tine bu~~i~ing, the threshold, of this sort of }>mmowledge.
at
Wa ksorx with coal er.iners, uranicim miners, and so forLh, that
there is this additive and synezg,istic effact, but {th.4rFs srav
O
be m,=y o4t2s-r ritiiugs also. ~
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Sem-ator C:zafoa. Th.arlt you.
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5rn3tor Schweiker. Doctor, lo me interrupt there one
minute and ask--taa have,haasd alvrays about tar and nicotine:
rahat is the scientific indications in terms of monoxidQ and
how does that compare injsaricus-wiee to tar and nicotine in-
juri®sa
Dr. E?oeg®. It's dif±cult to guasitify how much injury
carbon monoxide causes, but -thflre seem to be both itmuodiate,
and long-torm effeci:s. The immediate effects are that carbon
monoxide levels a:e inc_aased in cigarette smokers. Catbon
rrionoxide has a, g,ea£er afuyity for iae~ro,og,lobz.n t11mnn oxygen
ait3, thFSrefcore paxt of tehe oxygm-cacryingr ca.pacity of the.
blood is removed because of carbcsa monoccids. This cuts d'oc3n
.
on t"a;? amount of oxygc.n ava?labae, thQrefore, Eor instance,
totIS@' heflLtmasc?e. And it is exxpsctedby same per,ple that this may be one
of the contributing factors inn coronary occlusions, or iaz-
sufficiesxt oxyg8n to aho haart musc]~:e. This is an iamediato
effect.
~
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T_r;err appoars also to I-e along-3.erm egfcct wbsre the
mixt.zra of carbon moraxide in hemog'sobin may help increase tla.ee
laying ¢1ov:*r_ of pl!ac,zes in the arteriss which wouA promo4ta
the r;woIlapm:,utt of' artarioscSerosis.
So there aprsars to h3 bo~~h a3 im-ediats aed a aong-Ssrm
iaanur# ous mLfect on health.
Senai;.or Sctarzziker. Do any af ~hm pres=at' filtor
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to subsidize smokeri ; by means of in.creasOd health costs, in- .
creased i'Ftsuranc3 prc-r+i'ums, and is~cr©ased taxes.
SecCion 9 of 3118 would require that all cigare:ta
pactsages list the tax and nicotin: yield of the cigarettes,
and provide taEu different w-arnircgs, each of which would be
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required to appear on a.ten-psrcent sa.ipls of all cigarette
paclages.
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Tar and nicotine levels shou3d, iu, our opiniott,, be listed
on the cigarette packagOs. ke wouZd auggest, hoFaever, that
a provision 7rs made for inclusion of the information in all.
advertising, as. well as om the package, and tho lists.ng of
oth6ar' haaardous cospotnds as they may be identifiad ia, the
future by the Secretary of Health, Education, and W$lfare,
i
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and determined th-ro-agh appropriato:tsatiag r.rel:hodology by the
Feds~::a? Trade Co.'masssio1..
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One of the element3 in cigarette seoke that mair, have
siga!ificaut a{fscts ozr iacai.l^h is carbonmowo.Yiden grestetrday,
Chairman Pertschuk of fi.ba Federal Trade Gommiss3.on ihformed
`
SccreWary Califa.^o that the Gommis>3ion will begin testing
dosest3.c cigarrwt::es for 'fhesir carbon mnnoxid4 liseels, and W
05
will begin. pub l.ishiag '1eH!e results ea,rly in 1979. `'Thee Chair- w
.Ly
man''s let,tGr anraora*±cir.g tni , important action will also be d
subm.9..`ted for the record. The E}eysas"_,aca::, through its Ou¢ic0
oa Smoki.^.gi and 5FaLtti., will. give wide publicity to thre resu]Lts,
09 thesa tests.
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program. Ifther® is a prniolien, yon can prevent it by re-
soarch.
And We .ara trying to do our part in Kenducky assd not
asking for a dime fromths federal 5overna®nt. It coic2s osst
of the tax money colbcrcted in Ken9:ucJcy, and the last £ive
years we have put in something like $2D million. And so aee
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are trying to find ttis3 areswar, and you are trying to prevent
us krom dven having a ehar,cs.
Senaa.,or' Chafe©. W©L'l, I don't auifi.s sea why you say
that. Part of this bill looks. into the very effects of re--
ducod, tar and n+c.otine in cigarettes and does Aesearch.in
tha<~s areG,, which is cucact2y what you. ase aaki: g, fd:,;.
Seniato_ Ford.. 3ut tho resc:archh in FiEC1 is only 4 million
more in '75 in this related ieId.. And I don't bolieve E,
daFeet in herQ that the Money fs going into Z~saearch, it's
goi.txg . into studies, and preve:`:adLvo.T-rc1l t3sem ho,j not to
s.rnoYe, you know, how to get: off of
cigarE'c~s. {O
~, .
Senator Cr aic-a. Yes, there is oeaa sec.tion on that. 0
Sen.ar or Ford. So thsre, is really no reaea=ch. QO~
Sez:ator Chafae. No, the.ee is one section . on that. Thore
is also a section on a study fox the heaIt'i xivks`assoc;ated
with s.-nbY.irg cigaree-.',.en of varying ?!avelss of ^«.,r aiad nicotis.e,
ci1lach is exactly tns sul)4Ccot ycu ar~,
conaernc d rai'.h. In
otli^r words, what ar.o the offocts o£ com=- zcia7.Zy manufactured
c'5~.,~`ZrEf:.tL3s otvaS:,'{i3'bg ~d.r 8i341 L'C2.c:.e:.7..ne..
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industry.
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Senator Ford. You cex-taim3.y are--fvr taxzngp you ce:r-
tainly are.
Senatox ChafeS. 9311, you catt. just sea what. we have done
in. the Public Works, comnittea in dea3,jag with the autcmotiv®
discFsarges--tha ci'ischarges from automaSiloa;: the tax has gone
an tk:sa. The whqlia effort in tha~.-instanee,is to try to clean
up the air that could possiblv be caracGr-causir.g, and now we
are dea?ivg with an industry, a pLoduct, that cia?rky has an
effect, cancor,. on t°zose who use it.
ETew, we can throw up ou- haxidB and sap,, v,Zl, it's a
maLter nfcho.i.ce, and if sone-body waxat3 to 'cowia suicide
that's their o.n busiresa--arA forget about it. Or we can
worry about it aG.d rez3 ixG that "-..P:oss who bsccme sa ck becoms
a burc;ua an society in general, as wzll as losing their own
health. Atow,us can. say forget about it and that's a matter ai, iree choice--it's a damac_acy; or
we can worry about it.
I pexsenally think it's a mabte..- of conccrn not just for the
individual, but for the nation as wall.
Sauai~:or S+ord.14e1L,. Suuator, let me say this: we didn't
ban the automobile; u:3 tr:iEd to :GSSC.arch .ta.at Co put certain
Q
w
Sc2s,atcrr ChafE:s. *.°I.;:W?z a Ca:y. on the autrm;obi.Z'a.
W
SG;I_.tor Ford. Not on railcagc,--I doa`4 th.t.nk on the FFi~vs:rcasm~r~~al problem; I°vhink
~.t1?cr er 4.Y:4Y s,cre abc,a or below
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Sena~.*'o~ 5chweik~r. 1dQ~.1, Saaato C~tc}rs.cdy is go.iag, to
outlaw Eir$t class anyc*ay for t,a : reasoms.
Senator For-d.. TrkalI, I am for that. I doL't: mind' that..
I'iY, be gxad' to voto and support that piece oE lsgisiation.
SeBat:or ChafaQ. tv'all, obviously, this is the firat round
zi'fteon-roindESr.
[La~:,P=t~r] .. .
And e;0 look £ouMrd to hearing tos;:3'moaxy ftom the Tobacco
Is:s :ituta vahich will cama along lat3r, snd wa appreciate a
great deal your EorccSui arg=atsts and the zala azg+sm3nt-.&
that you 2zava made hare..
Senator gord. Mr. Chairman, I thaak youi ¢or your cos;r4'e-
sy, ar:d it' s going tfo be an interestiag' fcw months in froMt
of us, andI look Lorward to you coming to my committe3e and
discussing iE' there.
I jus$ want to ma:cg e;:8 closi.?g point. No matter how low
tha tar and ni.cotinv misiluw be in the cigarette, this bill adds
a. ascdsol.. And Ithin?: it's still a five-cent tax--I ba4ieve
ths;t' 3 correct, unless you, have amyaded i t or c12a.nged it.
You d.oa': have a, zora figure in the bill.
Sa3?ara'.or'L'i'Fs^.:i1w. Yes, but ttE£iic'§7.5a.. tax c:3'.rbady, So'. N'oar4 starP.:ir.g at a
point--and sone. aLw gpi.:g c©;cm--yers, ttaerm
ia' a 2erU tax ----
Senator For d.. WsS?, you sYi? 1 have ths fECe:-aa' tax oa
cigar.e';^~s--t~cW in . this bill; this is aeldiug it on; this is
i?'
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they aIlvmy[ have 4`hat opportunity. EcC z i£ you have to go
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face of problems I doma' htai nk you
outside. You take in most of the schools now, I think that
they have an area for the kids to smoae. Back w'rusn X was
going to school, you had. to get eff the p-t-opaz8y to smoke.
But now, in our educational sysste=--a.nd, this may be.Ileading
to what , you are trying, to do--but thG,y. provide as aMa,, or
ttey can smoke on school grounds. This is their reedom of'
choica. And that is tha res:soa tthQy aSl.owcd' th®m to do it.
So you ara flying in the
have thought through vary well. Not you particularly, becausa
,
you dielsa'tt cospa'nsor it.
Senator SchFrv$kor. Yes:, it's not my bill.
Senator Ford. Thah"s right, it's not your bill.
$ena$or Chafae. Obvipusly we Inave got some difficult
orohlams hares. Wh.;ch-e,rr you agree witta tha statistics or now,
I, tUask tliat, it is Uesry apparent that the ove--whelaa:ng--and ..
9'1J p~3ac°an.t, say thosa r.i+.a is..ow--90 perc:nt of cancer in tha
t
2uags, . is czuscd by Wroi::ing,. You look at this chart here
that showra the in.cWma:sec2 idcidar_ao cf smoking among tekestnage
gi°is, the ovezazh increase of srcol.ing a;:r:ng, young praoplo.
Ydow wz can say Ecrgat about that "p1:ob3en, kecause we have
got the innl3upts°y, tdisIaflors, of 6110,Oa4 pGoplc3Q as you suggest
an
= invo?.vad'.. Bu4: alsfl we havQ got the h.rslGh of
poop).e in this nation 'i'avolVed.
awful dot of
And it iaa't th&.t wo are siuJiing out Y1?u tobacco
25
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Senator Ford. WCSl1R ifc', you are praposiZg that we go to
low-taic a:nnd. -nicotine cigarettes, that's exactly what the ftme
and open market is doing today without punitive damage by the
federal govosnm~ent, or intervention. That's wha:'s wrongwitli
big brother today. I havo 1x2a.rd you stand on the Sm.,nata3 Floor
and fuss about rGgi:Satiqns, getting into privato bu,siness;
d'oascg thinas. in our lavosd-aad you are opposed to that vicery
vehcrnegt].y. But no~3 you aro coeaponsoring a piece of 1«agisla-
tioe2 that is~ gcsing to usurp whzt private industry is trying Y.o
do for itself.
And I' thi.n.k in f:h.av voin a?one that you are making a mis-
take. I thxnk you are flying in the face of trying to eZimi-
pate federal regulata:eaa, but, oaa the Other baaad., you are moving
in that direction with tha3, otlamr hand with this piede of
legislation. "
Senator Chafee. Well, as yorA kr:okr, thera~ are taxincese-
; ives to achieve haro the , very goals that you axe discussiaag. -
Senator Ford. Yes, but why tarr a f®1].obr to do it when
fra* sntarp.zisc gs daizg it thrmse3ves2 C
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Sena.tor Chardc. But pha tar_ incc:aaivras hopefully will ~O
aneousago-as has bs;:n pointed out, masly cigaro¢zbb Man.ufac- ~Q
bura6s will have a.rrzduced' federal tax as a resu.a2t of this.
legislation. Now,; I shVulcl think. ";ha:> that is sr.ms: ing yru.
v;ould enccurag2.
Senator F'ord. tdeiZl, Srnabor, you and I have a diff«5rent
39
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of our prcvC ian programs with chi&dr~C, as ws1Z as adults,
is to provicte e3u,:ation and to conduct research that wi.ll
onh&nce, not rec.'uc®, p::rsonar cHoica. we mus : undsrst3nd that,
an a:J-yflar-oYd.smoksg dces not necassariLy represent free
Kill. That smoker may well be tha rep_esentaticn of bondage
du® to insufficienb information to mak;a a deliberate iaaformmd
choice. Do our te.aziagers truly r..uderstand, as emphasized by
Secretary Caliiano, that cmo2sis~g is inde-od slow-motion sui-
cide2
fSn'0 of the mosL oftective ways we have fougd $oo inform
children and your.g; pWoplra is ttlrough, haaltYa pduca'tion in the
scboo3.s. Sosas =ccl:lczt ac%ocZ curricula have already beaa
dvzo2o.p~d and tas"d for al-~c3:antary school clmildren. .
There is a particu]!aY3.y urgezt aasd to devc3lop education-
al prog,aans fwr baenagers. F3'nile ere ars gatNaring neYr know-
.tedga, s*a must aZsso applyy what kne aiready know about 4.eenage
atWi:u3es tonzrd saolt:.rr.g and abiauL how ves'bag¢zrs learn.
Su,-:vGys 42sx'3 s2to:'ir-i, for f±,stansa, that:
°°niChty-fea.x pvrE<:n of f.~e.enage eso:.ess actmit that
smokiRg is habit-formirdg,,
....Sixty-nine p&trcenaa rea_1$ zo that
6Lo6.m in sp!]rtSr
--'i`t:o-t1i3.rd's 1r<rtisva
that
smoki:g
L'iuo'-¢i2tg is~~.
IIlOE3a t1SSn
just as hazmful,as'l
ut`tsir do'4.'$c:"J;'s'&nQ? ti.:aC'rh.~^.rsc3nds parfv=:33 s2]',,
- Aad half of tSF:x hopa that khau uhvy have children,
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issidiousiy, .3:t' hzs..no4 b3an fully appzec}ztad... And yet -it
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is a madera and totally preventesbl© plague. It is a health
crisis, and.yat every 22 saconds another teenager in this
country takes up sraoking.
We are pleased that you aro providing the leadership to
identify and cour.teract this tcmntieth-c'esstury cp3dsm-4c.
Thank you.
SanaitoL Amne3y. Thanl: you very much. I apti2o3iae to
o-ar hritntissas, and the : revious wita:>ssss, in part:.cu3ar my
co].Ieagua,, So-aator Fbrd, 4rhoA I: aZs.ays e+njoy exchanging: views
with oax vhis . subiwet.Ard we appreciate your cosmuenvs.
The ?xlmr~nis'cratiosn, as I rsadars:ar:d, rcquested $3'0:nil-
lion, is that correct?
Dr. Fcags. !®s.
&enator ICemedy. Dr.. Poege, I fi°st eff all waast to i4ro1-
com'-;~ you very vaarraly. vig ::ex2mber our v.®ry iatsrest:.ng visit
that vzzmbers of thE Ccomaitker-a had down at tihQ Cazaer. for
Disaasa:ConL-ro1 ea.rLf.er on 3egionnaixt3' t disease,, and I think
i.is aGally one ef the oe:tsta.atdisg czn4.<srs in tthe world. I
thitk at : a tims; when p-acpla ar® wor.dariaxg about the relatiioa.-
ehip b~,^Iwaesn goverr.°sweaW assd science and rcsoarch dnd health,
3 thirk.k you s`-.eaci ona or a iz3 trilIy caetraa,:cZinery cxaraples of
c:,cailc.nco in -; h!a govWr;acc=S:, and I cGnm=z,-sd. you and t: oso wao
2re ass^ciato-d , with i',:. ~
So you ds~,n°t mi~:r~:d tsoc, if erW go o;ser a feF poin:s? ~
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h,hah you aikoj~riaB;ssd yestsarday? $850Cdd million ---
45
Smna'~.or Schwaiker. we gave ihe.~ $10 millioa oi totally
taeta seomey they hadu' d asked for yas4orday, and 2hafi is. arhat I
an'tryiscq4o Eird out, wl4ore Whay are going to wamt it and
use it.
Senator P,anredy.. Well, I think that is commendable, but
I aa trying to find out tas!actly where you got tr.Iss:sa other r©-
,
souress. Is that the only usonsy in the cancer piogram that
was boing directad tosrard' sm. okiag?
Mr. P9sruey. Yes, sir---spccifical2y identified for smolr-
iang. NoAe, the problem, becomes one of other research that is
being carried oa which will in fact have value to the ques$ioas
that Cander, for etainnl'e3, or Child Lealtti and Ilumz4u D~~.evelopn,ssaC
are exploring. Child Hcalth and Human Dcae%opmant, Ithiia:k,
gieres an i1Zustra£cion of ra,`ecre a grEate deal of their rssearch
--anci' Dr. xre;:cr..~~ can . speak " this more accurately than I
c4n--z great dca? ot thezr rescarch is inifx~ area oi' pre-
natal impact, aaad so thesv will have a spillover into qunctioas
re.LEL^rd to 1&~e mfz:cc4:E of' smoking on the fetus.
&eszaftor rsm;ceay. 63e1.l, we are to un3r-;rst2zbd, in terms of
ttts, P3m,~suistratioa's rWgucst', that it waa really 3vst for $6
O.
millionraw moex'.&Jy. ~'
P1
Mr. Pixsney. . she total iss.cr:asg over P`Y ' 78 is $9.5 O
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mill io:z. ~
5tnatoT ScFawt °skor. Eut for which cat--cgory of wka'e-?' You
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know, We've got tFarc~r dirfcrW.t cz.:egcries h=e.
Nbr. Pinney.
95. 2 ai? lion
46
A little over $4 million in rQsear.ch and
Sexrator, SePswOf3;er.
Child ffiea3tk?
air. Pinney.
That
That is the
Health , and Fiumaa DeveloFment,
bearr, lung, ar.d blood.
fis Ia the National Imstituto of
rational-Iasta,tcte of Child
and' minor incrOasos for cancer,
St3saatoz Schmilaas. That's $4 million. But the
lion s nce in tEFat.
$6 mil-
t3r. P3intay. P,o, L3:W $6 mil'±ion, is in the Ceator for
Disease Cose:rol and for Vift- OfS-ice on Snsok3;ag and Eealth.
3enator S;,h.wei!kaa. For tI2agrand program to It1e ci:ates?
Mr. Pinney. Right, yrs, sS.r.
Senator Scizereikux,. Aad that's wber® wca took it
$20' aaillionn yasterdzy.As+,d .ron asked forr how much?
Mr. Pinasy. 6.1.
f'+.`.ii.cetfaT. eYt:LtwraiIte^..
oY,ay, you
Szraton I:S=C'tJr. YdeZi, you
are ug to 20 on that.
gave ua a
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bEeal.deiiny but I N
wculd like to kstow just in k:he . dalbars whoree t'.iaqlhsansger comes
th.:ougb eacbi of thase agmclas,, iT you scill, au;ply ~ that for us,
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okay?
Br. Ea+: gee.
I aAg:_t Lay, t5r.. Chairiaa_-a, cnrs of tbe problemcs
up to
with do'.ac3 t-x£c-r;:he t7atioa~U InW;it-nr ..Q, of Occug=.'Uexnal Safety
25.
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Smatox rAznsdy. Shouldn't that apply to all fscleral
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bui.l'dings?
Dr. Foege. The S®crsfiary has, in fact, writtett a letter
to GSA te3:liz;g them m%at our rules are and sufggesting that
they look at this,for all federal buildings.
Sen.ator 8s3anmdX. Well, if he thinks 1t'$ a good idaa and
he is putting rules out in texms of GSA, is 11~here any aeasoa
that you caotsldza° `support legis3agion that would reqaviro it-
ia. tisorms of ieftrai buildings?
Dr. 1'0a;m.. T- thaakk that this is in fact avary^ good stop
to ta:kc'.
Sezator Sc:adaYka~_ . CaFan wa i.ncludc Scna"tm office building
hdarirg; rovras in that?
Senator Renze-dy. i'"7hich part of'the room is gotag to be
smoki~g? . .
Senator Schwaiker. This is a ban, a total b4a.
. . .. ~. . c.. - .
SemAtor XcmnsdkP. But, in any aivetit, on the 3iasue of' the
nz::its on this, ckcariy frorr u.hs.t^t thei rule, rqguest- by thca
Secretary--it's complc:cAy coasistent Kikitih what we are tryiagg
to do in torms offcdcral buiiding,s,, olcswators and-others.
Pnd in terms. of 4:?4= approach, wivh.o*at rogard to the particulars
if fota have suggasticn,y, obviously, specifically wi'sh regia rds
to E.isd la*~g,uagr-mbu°s in t:ssaa of apps.eac*a :.t M,,_ICOs senSe to
O
TSr.. EcGge. I',3s, sLr, a very e:;`; nitely. W
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mcch:znis:nss impact at all on rFSmovingn caxboa monoxide at all
or no'L?
Dr. L'odge.. If thay do, it is not a sufficie:a,t 3unpact to
elimisialecarbon moaoxido as a problem.
Seba4:or Schweiker. But it redec®ss i't som®, you. say?
Dr. Fmsg®. I am not sure on whe.ttier it reduces or how
much it reduces, but I would bs 41ad to go: this fos. the re-
cord.
Senator Schwaiker. All right.
Senator Chafe-rs. Dcc.or, is it clear--and I am rott sure
that Sesnator SchwcAker, I may 7Cax duplicatfasg his quostion here
--but is it clear that . the reduction in tar and' rstcotine does
reduce the incidenca oE ce.ucer?
Dr. Foage. TYre anstsor oa this, a dafini2ive answer,. willl
be soms timci in coming,bum it appears that mortality rates
do decrease about 15 perce3ti 3.r. . persons who arS smoking low-
tar lmw-nicohine ciga=e'otys as compa:red to persons who ara
..~.-~okssg hi3h-'rar higki-nicoWinm cigarettes,, so' that we think
wo aro already $aaiaag a, reduction in mortality rates
of' lew tar ana low tsicowine..
.,
Senator Ghafeffi. A1Jl rig3F, tha:n3: you.
Dr. Foage. it is w:-~re:a2ly d'iffs.ciz?t, of course,
to as-
sess ths imoa;^t of the warning 3abP2, bo4.ia on cigere2ta pack.-
ages and' in advart4 siag,. Soma gorm of oxficial wasning is not
only approptsate, but ncccssar.y: isa~ discha.rgi eg the governmenG's:
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taova, leras is a secoadd public hofth issue which you
have rs:iseod, in the bill most, appropriztely, and'that is whe-
ther or not, from.a public health point of view, moving.mmoker
towards ioweac°tarr lower-n+_cotino cigaxettas is in fact moving
them to an area o'redacedris:k--and your bill very appropria-
tely taly aecognizps that that is somfthi'ng..wg don't have a].l the
answers on either.
So these things must be 4aRea, I believe, in concert. . We.
will ba studying thQ emoking habits of youth, though, with a
high priority to s.-~s: if k*ecara do something noFrr to keep d:een-
agsrs from starting up smoking.
Senator *.ivnnWdy.Wsll, just finally, don't you have the .
scientifi'c information about the high-tar high-nicotine and the
higher issciden.ce of cancer?
Inr.. hin-ney. There is no quQsf:ionn that thoro itss a dose
responsts, based oaa tar ard nicotine coht.cnts. Ths questions
come at the iower levels, and the questions coma in terms of
compaxsation, as smokcrs move dos,aawards, as f:hey change their
smoking habits.,. Tihere 3s data on that; there are some studies.
We believe there is not enough r or. to design a tax which will
bz efft~crive.
Senator Rcr=n.s-dy. Ldallr couldaz't w.o agree that it is
O
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wisar for them to smoYW tho lon,°ear 2ax and! nicotins until we ~
gat the facts?
W
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H?s.. Pinney. ab3olstc;ly. In, vS-_ zTasos:ccae of conclusivo
25,
i
kaorz, moving the mortay aroin:7, so I =,C it's just important
we. Ilay this out, and we find out wrhere:e you are getting it:
it'sd oZd money that is re;prograsm..d aE ifi`s --_
t9r. Pinney. No, sir, tLc $6.1 mix.l.3.ion is now money.
Senator Ka..+~anady. I am rrzlkis:g about ths other uwasyr the
$24 million. 1~'a2se did ::ha:; como fsom?'
gmmator. Nar,nsdy. That's new noney.
Mr. Pinwy. Yes, si$.
Eir. Pitu~ay. The other money is. cr.naiuuation aaony plus --
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Seu~kLr P.cannsdy.
C4.tiruatsea moriey?
8:.:.. Pianey. YEa, sir.
Sersator R: snedy. It really isa't cosnt3.auc3 until ho rL-
appropri'ato iW 3sa, the CongrCss. What srou?'.d that mosc,y have
bssn used for 3:f it uv.sa't usc3 for this program? :4:hat kind
of research would it have baan used for?
Xr., Pinnby. It would ba used for smaki:ag research. It,
is nomgr identified for smoking-rer2atzed research in those izt-
stitutms.
5enato.: F=naay. Are thosa :h.3oIIlg zea*sds that wssa a!-
Jescated for tttoso, typas o2 ressarct: in tlre leastitu'saa?
NL. F:iakney. rFioss a?-G tha $uad~g that have htaas ideati-
fSed for e::,aI.<?:g rescarch in --..
Sc a~4cr Ks=Ccly. 6Ial3., how wmcra i'?adsa Canca?
itr. P:':rnny. I bA_evu it in M2 rai.Z?iou.
Swratcr R~~e~y. you ruaa of2~.:he ciho3G~--suhad is it,, Dick,
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and tisaltlx, for instance, wi'thh oveary cri;.asria doc:imrnt that
we put out at this poinz, we do look at the smoking effects,,
so that monoy is not ablocated there specifically for smoking,
but we have vo look at s~.oking. Likewise, w~Ci2h ovwy occupa-
47
ticn.al study now dona, wa have to correct for s~oking in order
taknoer what would the rates have
sFs:n
in smo3eers aind non-
smoksrs, so that a ca..*tain amount of' monay now goes into siao-
king from thoso scurces.
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Senator Kt2nrtsdy. Piow, you, are familiar with tb,3 provi-
sions of t_Ha bi1L `tF2at rsa~,airo in federal faciliti¢s that t,hsr,
be areas set asi3a, smo}c.i,g areas a`2d noi-smoking areas. Ars:
you £axailiar with that general provision?
Dr. Fo,sgra. Yss, we axe. .
~
Sranator Tesaae3y. Mat is the P_ "*nislexation's positiott-- I
oz tell us wha+t your po3iti.on is, aaad' dhan we will ask you
a..^ut tha Rdn;nistsatio3.
Dr. Foege.aMis is very close, b'Y. Chairman. ---
3enaCer Xerxaydy. If you've got a diffsextzt position.
Dr. FeaSfa. --- to the rules E;,.fiaw HEW has now put out or
all M?, buildiugs!, that t.hore will zr3, sep3rate are.as for smok-
ing and , aou-sn:oking salamevAer pofi:ibla, so~ t:hat w. "kre in favor
of th.is,d
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0?
SE;nator K73n:.cdv. Does that nake : cznsm to you? ~
.ia
Dr. Fo2g4Q.. 1t C.oes: r1aic3a senSxh to us that non-smvTiers.~~'. ..,
should have tiis; yr:ntdom to have areas e:hei~e tetare, is not smoke.
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sortswhat more than 30 percwniC of boys 17 and 18 smoke. By
age 18, the habit of smoking i.s we31'--estabZishcfl,, and we
thitak t.his is unfortunate and shocking.
Maaneinile; smoking among girls has incrraased' d..aaatically.
In the 19fi0's about twice as many boys as girls smak.d; how at
mvctrK age IoveIl girls are smokiag at the same rate as boys.
Senator Schcseikar. Doctor:, do wo have any inFnrmation or.
evidence at, all to. ind.icate why, w.hat"s the reason for the
upsurge among teenaga girls?
Dr. Foaga. We are not cartain of this, but we thintc that
4:his,is due pas2ia'y ly to 'cisg new esquay idy of th® ssras that
we are saoing, ard we are hoping, tihercPore, t:hatnow that
they are squaZ, they iri12 both go down. together.
Senator Schwe:ckAr. :q+jal right to get lung cancer to-
gGther?
you have
Dr. ge6ga. fhat`s s:ght. bh3 Zcsgis3atioa whiclh
inR;roduced.recogaizos the importance of research in direc:iag
our efforgs.&?e need to rearn more about smoking behavior
than Yra know now, particularly regarding smoking beiiav3or
among claildroa.
Znn the Presideaa's budget for 8Y '79, wo are`-requestiag,
$4 iri3licn for S:lza ?9atioaa:. T_nstit:ut-e on child. Hrsalth aad'
HLmaw Development to invusLiSato Uh3 childhood
of _= etii±ig '.x?ha JioY .
detarxainants O
At Sw129. , gcin£:, lat as3 emphaai.za G%at the primary goal
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" ASSss Wolff. Sninaculata.
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M,i:ss 8o±i1©y. My name is Moira Reflley, I am 17i and
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I hawei just graduated from Immaculata High School.
Htr. O°6+ta.?lay. I am MaTtln O'Malley, 15, II am a, rashmaa
at Gonzaga College &igty School.
Mr. Adsms. I am Mark Adzas, S' an,15, I am also a fresh-
man at Gonzaga.
Mr. Griffi~-.. I am CharlGs .Griit.h, I am 17, IaAt a
junior at Gonzaga. .
Mr. Valeo. TI am Jamss Va?..rao and I am graduating ffrom
EetFnesda-Che,wy Chase H.imh School.
Senator Rearaedy. Cau2d you ?o11 us, maylss, by just a show,
of hanczs, hoar many of you smoke?
Nsayb,2 we could sLa,rSit with you, Therese and Nlofra--whan
did you start?
ATf'ss Wolff. hwotsad 14 or 15.
SenaCor Leo:ely. What about you, uoida?
F?i ss Rs3331'ay.. 15.
Sc .ator Yzrnsdg. 3e.:s?
~`.t . Va31cs. Yes, I was 13.
Sb*ia.4.or Ken:,edg. Mz.r3c?'
E~.r. A.dams. Z, was 13.
SeaGtor x~ensx,^dy. I know `;aG°s a few year3 ago, but doW
you fih.iaY you could try and raayLe tell us about why y.ou. do- O:
G1;'
c_d~d to s4:Li:t to smoY,© or not to smo::e? Sdb.ss it sort of a~.
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Dr. Pa&go. That is correct, and we do in fact end up
with non-smokars subsid3ring smokers through taxes and insur-
asce .pre.miums., .
Soaaator tieasssedy. Wall, do you feel aa a mattez of prin-
cipls that there should be at least through thEa financial .
incentives--we are not talY.ing about baaning, obvi:ously, smo-
king but at . least reachi'ng bhe conclusion that if 4ho:restt of
the society is going to pay for it, that it isn't uttreasonabl®
to. aea~.:r.e that smokvrs khems+s3.ves ought , to pay iorQ for it?
Do you.havW trouble wit.~ that as aa kheme or as a philosophical.
point?
Dr. &`oega4 No, we do not. But this eztbbres area we have
the feeling that we havo to get with!:h:a Traasury Department
and study thaa2tsrsatives bafcre wacan really definitively
say what our position woubd be. For,inaatance, sie can sea some
possible drawbacks if' one would lowar the pri'cQ for low-tar
low-raico2ir.e--i's thare is any way, :.twuy an e=courageamat
for teenage,rs to sa.oke bDcuug® therais a cigarette they can
gQt at lower pricta. F's think crm h:ve to look at tthose issues
eo sea--care we find scientific,,svidencC, one way or the other
befo2e s.e ma:;Q a state:mzat? `'
Senator genneay. Yda"sl, do you know Frha_t typ* of ciga:r-
cstuos. tha Wasaaga:rs ara tis.ot_ing? You m9an- exen if they aro
sra}:i3g h3.gtta.3r pricod cigarrt~~_:; acw, you think ?f wC: would
pau.s this kind of i:eccnki, stEaaR: tIi .y may switch to biie~ other?
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Dr.. Poege. We have urged other dcpartmentaad agency
heads, and. org ~atazat :ions, such as the Geaaral: Servicss Admia-
ist:ration, to adopt and enforce eirsilar' restrictiono in the
facilities under their control. Acopy of my latter. to
Adiaiuistrator Sol:oman wi2l also be submittedifor the record.
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Clearly you feel as xe do Vlat the federal government has an
all orgat3isatioaaa.ad employers. Comgressional Support for
this policy shoul:dencosrage its asteb3.isbrss3nt ahatts:r through '
y oppoTtunity andi a clear r®uponsibility to set an example for.
legislation or zd3izuistra!2ive ac£iAn..
SsctiAns 7 and 8,oi S. 3118 provide £or tho esWablishrae.nt
of'a Ohealtla protection tax.° The principle of a graduatad
tax based on tm: and nicotine in our opinion deszarvos serinus
ccnsideration.
The question of. earmarking i:a.r revenues Eor spacial pur-
poses---~vea the basP: of purposes--raisss many ecomomic and tax'
policy questions wu3'c1t require furth4r ana3ysis. So-rmver
thess gz;estions ars resolved, it is tha view of our Depa
that Congress and the Fmsrican-perplA chrna?d ba at-are3 of the
~_conOMS.c b.U2rd.C.~ c73licn. cigareatg sMekir.g places upon the tax-
LI
payes in tarms of incroas;d %cepii;3.4l r.d ei medical 6osts, the *
W
cost of dayss lost ya prcduct+cn, aa.dd o<rber costs. The rve-M
O
nn,'.r]son°1tc3.nads from cz.[ja,.°~.`=s'iw.1e'.s at the prG.,''8i:nt . rate', or iA
Evcsn urader the ratas pToposad~by 3118, do not bagin to ap-
~
~~ pro4ch thssa cow'::n. thus, in ©ffe,ct, uon-smak;,ers aro =er_uired'.
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bir. Pifney. 4re don't kacw, Mr. ChCairmzn, that's one
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of, the quest3'ona that thei initiative that the Secretary
launched is going to, try to find out what kind of cigarwttes,
and th=eforo what kind of incentives could work on teenagers
to keep !:hSSe from bscocaing smo?:c3rs. .
. Senator. Y.ennrady. Wai1, we ares going tor haar from soaa
o£, the teenagexs later. 3ut with regards to -the high-tar
nicotine-say xro sl.e-,+ed it in such a way that the tax was
Increased in the higher tar and, nicotttts, and those revenues
were used in terms- of either rcw^.-xch or in the areas a£
supporting the Poca.'l communidy activities in encouraging or
.
coping particularly with thistyeiage smoking.
Do you have any conc7:usioss on Chr.t?' ~
Dr. F'oEgs. PFe don't have cosac2;usions. W e think the idea
of a graduated taxis an attractive Ono that iae do want to
study carefuT2y and bry to giva you as much sciori;.e as we
can. But we are not preparedto d'o that x3ow.
I
Sc,.a.tor Ven*andy.MeZ w§ "s2 you. have recommendutionsa We
isep-s to raove this bi3l along.
Q
Vx. Pis:r.ey. M?. CBuzirn2n,, as part of' the SecrEtary's C)
pr
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initiative, _T.X am iaeg iru-i.=~_zsg now a saries of 3tudy afror:nd the 4b
V:hole issue of coresuuption of ciga.rattes, whic2i inciual.es this
element, te'?e asfectiver.ess and ttaQ drawbacks, possible draca-
hacks, to using a graduated tax as an ince,n2Lve to movo towards
Iower tar an& lower nicotine ci_garet4:es.
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and why she~ " s, because pear group pressf_:.re seems to havee
worked in complvtely contrary reaI:ms, and you are obviously
geared to that, so that wouldibe part of your survey, I would
assuaa. .
Oae of uky questions is--structurally, wiih your new of-
fice in HEw that Mr. Pinr.ey is going to head up, is that cor-.
reCt?
; Nr. Pir.a+ey. Yes, uir.
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Senztoi Sctstr3i2,er. fiiow . wial. :+ou integrate, tFhough, with
tiia National Snetituto of' Child. ~~alt.Y:,o because they have
very eaparates procedures on peer revieus of projactsi like
this, and S am all for the int.gra;g.io>a--hut isn't that a prob-
1en2'
eFr,. Pinnoy. It is not a. problem, Ssnatesr. The philosoph~
on which tha office-is mass.3 is one of project managc:maut. ynn
essenca, ths Secretary felt that thera was 'hot' canoug,h attQar
tion at his leval on the px:cbZo:za of smalsing and health. Thera
eras a,lot gaikg on in each of t.*6 Institutes, but the question.
best
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was:: aro we directing what rQeouscns we have to thot
poEsiblg xv-aans and ends? A^ d, for es;:am.pla, with t.he National
Institute of Child Healthh and E3aaui*Qa Developmcat, ray role would
be Ma of dLscussa:a:g Ifik1a. Dr., Kratch_mer :cl:at, his progra*Q
aY-1.iounchmzrt would say intW=s of Ealicitiing good soundrv- p
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s'.":tax.ch in t1?us c"u"<?aY3 :ha1: LSv have idC4i2tit"ied as top, . priorigy. Q.
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Z1#s ucG:ual co::tenG of thardsearch pNoposa?.s asd tho peas: ,"D~
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S~na~lrChafQs. Has it aaussd much confusion and re-
action? w1-iat have boan. the results as far as the peopla ar®
.
CflFic@rIIBd? Dr. Foego',. cX= exporie-acm has besm, par'sitularly at the
Ceintor for bisease Coss.Mrol, that this Bias bsen a very smooth
tsansitioss, and our understanding is fz'om othor bui ldiags in
RE47 that tfaere 2iave not basnn reajox probl=s. . ,
Senator Sasaondd.y. Mov, 6a also--as you are aware, last
yyaar--E Y3aialc it was last yc-a!---bad the amsud..~t on the tax
r~s-ora,, ''i6 tax r-2orm,, on the tax bill wi4aa-rcgards to the
f$nancial in.°.entw.ives to try e:ud provid® additional iedaral
recovaries on taNss for high-2R.r and -aicoL-ire and lower tar
asd' nicotina,.
Do you have an eRtimato of, the cost- to the federal gov®ra-
i sueak. `or Lospi'l:wlizawian for 7}4op1:o that go to the hospital
frora c.cmplexita.es in ths lgags atEszcs;xtat3le to smoking? I'
zaaars, is t7ieW^e aaty ©sM;m.a4:a oa that?
1Sr.. Po3ge. There. was a-- as~icle tVo r.ont'txs ago in the
Uv.: Eu=*la.rd Jhuar.aa of Nc-diciz:v.
T4-i~y estimated t1aithe total
dfrect health coets in "is ccuntry %mre $8
billion
pes'year, w
so that about, S F=oea4 of ta e enti:rm hWasth
attrtYratcdd directsy ta cagaretto smo.'{ing..
c,
eosSc could be
5e?±atssr ron=dy. Who: -cacis up payir..g for t3zei?' I ica3gine
that is ia prcnai=ar~.:g a:.ri that as also general reveuues., the
aVe:rage tarpe:yor.
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ST 1R't'EnEDfiPS dF A PrYi^dEL OF HIGH SCbipOL S`s^GTDqM'$St
aTdEP.SSu FdOI,EF AND ASD1Rk REIE;IiEY, lrl iACiJ'F,ATA
tiICH SCI'Ifh'SL:, A'r'.f~R'.L'ZTr] O'NF_LF.S;Y'g, I7ARff. RD124Sr ALID
Cf9AMP,S 'GRIFFIazt. G0UZAGA d;0&T:F:G$, HSfa[i SCHEiOI.f
2ih"D aYAtMS VAT.Ea't 8E`a`'`fi:St?A-'L'F3EV1F CtASE HIGhF
rz< fr il
SCHOOL
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Senator Rz=4dy. kda will have a panel of' high school
stssdOa4s from C-ondaga Collegg High SchooL,. 7sa*naculaWa School
am3 :ha Bethesda-Chevy Chascs High. School. TFxrough 'a.n over-
sigh., t?ze Tuu^na:cuihta and Bes6hQs3a~-r,1Rsvy ChasaSigh Schoo2s
were not mearcionc¢3 on the formal witnoss list, but 1hey have
bow. eacaznaous2y c,operavive as the young stadents have4
.
1:'e vaanL to xrcZcor..3 you to the Corraidtnn. Ithiirek, the
Cesmgress of the IIn; tcd Statss ge" its iaforre a: ios from a
varieCy of soearces. tvc have in this legslatioa that we have
before us ao,a--we arLa trying to c3-Yal wf.t..h an , issue which I
think is of enorWosis coLcarn to pare.°*.ts all over this country,
perhaps all ever the wasld°4parokts whose pearhaps first ia-
texest isthe,s good, health of their children, pare33tswho ar.s
i.a^.reasing?y concarued abavxt w.hL n spaogian in terims of the
cw=aption of cigaratias. As so many scientistsreseasch-
e3rs and fa.mily c3octors as:ve poiated out, VNn aciezGific i..~for-
maticn is ve::y cl-~ar that hcr axee rGally Heac'V1 for a typa of
healmh catastrophe xaa t:lis ra.tioa if tho kinds of' grojecCioas
LItat 9avD ta;sexs pvacz r'.v'2:.a :.u6S azad 19?4 amo.g young psop2Q,
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among 2oeaagers, in.sm.oking continues. 5~ think all of yom
must have besn inpr®ssad by what some.of ouy d3stinguished
ressarchQrs and doctors:hav® pointedoufc to this CormittGO.
I
And wo are trying, as we should, to find ways and msaas
oS worki.ug with local communities and working with you, and
your associates in the schools to :r5y ar.d find, out,if there
is some way wa caa work in par¢aership to ra].iavwae this gonera-
tion, this younger ga:neratioa, o2 th,3 burd¢a of smokicig. We
realize it's compTe:cJ '0a realizs it involves a variety of
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different c.*_umstiona that affect young psoplo--aafd 16-a want
vQry o.uch , this s.orning t,o hear from you, roahaig' you Whin1 is
the nature of ttis prnblem and the ways and. m.cans that we cac,
best deal wf 41-i it.
So we are venry, very grateLul to have you join Lms hmre
,
t3xis morning.
So'd many of you have ever teestified iiaforo? S1Ql1, St's
nothing to bs conca+--ne:1, alaout, we want just to hear from you in
yaau:c o-ar words.
your a.Mt;vatiom to the charts that we hav® over
I draw
hegQ that show in t.,'^oas aour difLercny segLen~-~d aroas tha
very significant g5oEauh in . Lhe nauat,:;rs of rafular's<noi:era
»
. betw::sII 19'6&ardd. 1974 ' hby various age cctegiorzeQs. And we can
sre in the yoangest age, from 12, 13, aud 14 year ol'd, an ~:
6ighf:fol'd iAereasa,~ coares=ouding iu.croases, porlaapss not W.
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_r.,orcentagewise, bYxt cozta'snt.y fPom , the numbsrs dramatically W;
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Cr.. Po3gC: pib3'k, patl~. Chaixx.:z,Z~, Sacsta4asy Caaifano and
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Assistant Secretary Richmond have askcssf m.a to corgratulata you
for the Ze:adersA_p that you have shown '!o, this axaa. We shaso
your cleep interest in fmproving the proventi;^.e componeuts of
our health strategy.
_
Today I would like to speak to the particular heauth prob-
mem of cigarette smoking, and' ey7p:ress my own p,-3,rsflua.l gratifi-
catS.on for the endorseim=at, as 3118 WhicEt this provides to the
Department''s smcskiagr and health 4 ci~iativo.- As a comnittc4s
coaarai;:tcd to provoa:tlouF you a=s aw,aro that cigarette smoking
rc,.'aains the single me..s' ubg=t and poNcutaallw rcWardiatg tax-
got for preventive actamu.
As Secretary Caliiauo L:h;:ascd, it in his address of Jaa°
~
uary 11, wlaon he a~'_:oti.ac-~d' our Aeg?artnont'a slssotkirg and
~
heaiS:?z initiaai:ve, it is Publ;c Y..eazth }3..rsTay .1unLer 3Ae. W
~
The probZem of smoking arc'a, h¢ alt.h i:s urgerxtr b<acaussx of A
ca..Eacr,r deaths, ca;_dicva4e.u3'.a_r d'ca"3ss, a::,~d chronlo lung disease..
These statf.skics can bv reversed.
Nor do Fra read to corkiuud t:c aufror tnee t notmous ecoaicmic
Wonse-q,-aeaces of cigarotY-u srtoiting. Just two months ago, an
4,
mryicleo in the F:Lvz Er.qZaaae Joursxa3:_ of Yc~da:c1Do suggested' that
the c..sS:s of ci.garc:-tde sme.cs^.g arc3' more , than $8 billion an-
aua:.ly in direcg: :nedical.l cos`,:¢ and;, r:eas3:y $20 k-,illion mo:ce, is;
1osC: croducLioa anc2d ot1:plr cos<:s. T: iu :asaoas that aluaut five
YDarCf-::1'C.oft our C:Oit8s r17Ce ' d3:re:c.'~.-`wy,attT11.7Lito.'a+`~..Zh] to... .
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'op:bor--MlT ian health e-3ucaaior.: on =oking.t thought you arould,
.bo glad to know that.
Dr. Foege. That certainly is good news.
RegardiAg add'ityves, we 1.ndurstandd tFzat . there are som0
300 substances cab3ch c4garotte ma afacturors add to cigarettes
for flavoring asd' ot.er purposes. We c'ro not even knoW k'kxat
m.asay of tbutse substances arP-.. We Vould seseommer.d your cosssi-
dsratioa of additioual ZaunguagQ reqairi2g the disclosure of
these flavorinsa and othe-r additives. Yf ingredient ksaow-
ledgrs is:jsstifir.d for the products we ingest, it.saems to
me that they are at least aqually Jasti:fied for products we
isrhhale.
In:n su.^~..mazy, i+Sr. Chairtna,.u, the. Depcrte.ent is desply grati-
f_'edd by the cos,tinuing support of this 6vbcommitt:ee for di-
seasa praveni:io;a, pazticu2arly ekforts a?irasd at smokitagr and
health. F1s you imm=, the Dapartm,a2L presently has broad
authority iII. '}aY.iss c.5aa c'aEldhc.es rE:ca:,Sr'f,y 1Ld4rmvt}LC?~.,I]a ]4ajor: .
iait;ia;;iveaaneni at objectives that close2.y parallel those
of 3118'., 4ahiYe in, many irs:auccss, spacific s:uCyh.ority rsay not
be rcquired to advauce our nuLLal goals, this expressioa of
suppo et ?^om~ khe Ccngress will s+_gnificantly aid dtar efforto.
Ig' bshonic pa.aguca w+onld now stalk o%= ccuntry and if
at would kill 900 p?oplc por day in the Ui3! ted States, the
G
pL:bi ic u0uPd pszcv,.ivotLis, to ha a crisis and deaaffid, ac2iou. o
IP-..^.a1.?:33 th6 p£QblkaT.1 of cig&ret°~:.h3 smoking tRw:.dQv&iloped _w'1_..
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responsibility. _
The ten s&aparato warn3ag r:ss4agas would attract greater
interest,, through both novalty and variaemy, than the single
message now eased.. Savesral oi*.tlse.m--for example, the one vn
daFnaga to~ the unborn child--would have tt~,A further advantage
of ca2ling attention to specific threat's that may not yet be
rridaly recognized.
If the decision is madm to require a variety of, massages,
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the specific wor.ding' of each nat-dis to be careL-ulry considered.
I.would hope that.tha cosd;i:iona! °saay bZ" could be avoided,
znd that in eirery case where the evide;zce is supportive that
the force of the statsm®nt 01is dangerouB°' could be: reta.inmd.
Iwou3dI eaphasizee that warnings should h2r r.~ired in adver-
tisi.ag as -*reSl as on packages.
Section 1O, i3r. Chairman, is the portion which is to us
the htiart of the aegisSatioal. This is the area of greatest
concern to t3ae Dopaatr:xant. It is also tha area in which wca '
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have been t3xe least successful in the past. wa can point with.
som2 pric;,- , to significant decreases in smoking among aditlts-D
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I first:s-mong males atizd, recently, among fesnades. But with
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~I chil::ren a+sd gauth, the picture is di'ffereat. ~~
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5mob:i; :g <riorc3 boys has hardly cbar;g3d in tY'~c last decr.dm.
Qur most rs.^.eant ftc_izaes, ths,e:h Wi2:. ba updawarl during the
coming summar, sh.cw that fiua pes:cesii: of boys bet~.~eaas 12 and
14 emokp; just undc?r 20 p,_ceni; of boys 15 aud 16 smoke; and
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review syst&n wou'sd', ren-sin totally fnt act. and I would have
no influence over that.
But w® would bm influencing those researchers wsw we.
hope arouyd turn, for example., to doing quality research in
the areas we are interested in. We aretrying toy
identi£y
mainly the gaps in our k.no:ti l'ed5re abaut:f smo ;ing,, and target
our resources towards thosa.. - _
Senator Scnweikey., Doctor, ma~yaa:you want to comment on
the same question.
Dr. Rre:.ctumar. ~ don't have too much to add.. We havc
bsen isacorxtp:ctt with Mr. Einnay and we do relate to 1~ha Depart-
rnent's activities, in smoY.ing. Our area, of course, is research
as it. relates, as you know, to mothers and children. And in
the behavioral ar=3' biomedical ficlds. Mr. Pinney is aware
of. our ,issuaac® of. requests for applicatiosas in those parti-
cular areas.
Sosaat-or Schwa:.kdr, I didn't mii:a'tion, but we: a]lso approved
your budget ycWtexd.ay. YQ did give you that mon3y for the
$4 million plus, so you should have tise; wherewithal to do the
job.. I~ anrn just glad to sao tzs,i3 working so u=esl.lcoordinated
and in",:+3gratod. in this area, a, a I corvaotad you fok it and I
certaLlly promise you my support.
xhat's all I havc:r 1Ys. Chairn~=.. . Q
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Se-aaa6:ar P.caa.r.4dy. Thank ycu ve,r,y much. ~
Cy
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The final section off' S. 3118 calls upon the Secretary
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their children won't smoke.
to study and rsport back within two yaarson the ralative
health risk as$ociated with =okiz.g cigaretfi.Gs oE varying
lssvoTs, and fi.hee re7:aticnship of tar, nicotine, and various
additives to health risks..
Ttxesa two questions, iar,; our opipion,, are asong "tha : most
isapoafiazxd public Yzeaa:.Na Vaesti.Qrss of8' our timw. We are noW
t-aginnf:xsg work on the 1979 Stugeoa G1;nsra1 `s.-Ragort: This
oril]l ba the most inporsa:r,t raais-r of informatien on rmoking
sis!ce the ' pubii'cazioa of the original sapos@' nearly fiftenn
yeaxs ag~-).
2!s part of this effort, th« acgeancies will b.- loo4:ing at :
the changes vrhich have ta7ce,a place in the ciga.rebts itself,
and wil:];, attempt to e.caluate,tPa.aa 12sa1t3:ti siug, nificaace of those
ctanges.. t1n the basis of this information, HE6d cas:lt, focus
abte..ntioa on many asp`.ats of Che ccestions posed in 31180 and
it is our f?ope that this information will be available before .
tf#ES en3oF two y0ars..
Sttnator uchS m~a;.er.. A4ey _T interrupt j;ust ' oa.e mi,-aufra? {3e
jGse marked t'p tha La-hor--HEW biT]. yc:st-orday, s.a3 Cw.t'he2_.o:a7.th aCusaiicn xaor,i«g
zaction x :Iiia.~k the Fd-m±Mistrat ::on--
s.ot cn ch£id! health, but the othLr-W0 took ib frcm 8: million
seqc.c:C abcae t.h.a 12 u.Ulioa the HousoW,
C'a
put in to 20, milJ.ion,. Sc wa did pct 201 . million in. th3 w,
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diffe;.ance? 'tahat
Yh~,-Y discourage it7. Does that. s!aake au
about it, Moira?
'
Miss Rgilley. Post CaYholic highschooi3,I wauld say,
allow it for seniors. Our fiaigh,s,:hoo1 didn't allow smoking
at all. Gonerally, most public high schools,' ther®'s so ffiach
amo'ting theera is nothing you can do abotit it: But Iwauld
generally sa.ir that. most, schools allow tt; there's not acuch
you ca4n do, so maay pt~opla smoka.
Sanator. nersmfly. What about this health iasue, Thotzesa7
Do you think that many oftha youager people that get start®d
givQ that very msch 31::tentioa or much t:hough., or do you. -".
find out when they get a littl.e older that t. bpy hegin to give
ft Mo_se and then ar® fitiey hooked on it, or What7
l.iss. Wolff. tdhsn you firwt start smoY,ing, it doesn't--
at least with re,, #tc didn't take effect unYil, 1i3se 'a, couple
of years after, li:ke aow I can sae that I ca.Yr't run`'aa aauchh
or cazwicipato as sush in ac ;ivitwes.. I don't i:hinY they
..~
xaa.3'ly lcok into it, dhe health GoadxtiG.ns of it.
Senaf:or Ife-ace4y. Hari:, what do you think? Do you think
crie_v ti:i,uk much a.4~out tha health factors in tha s,_~oking?
PFr.?sriara3 . W;n I sircd.t sta* l:ed, yes, L: fihouarl ; about
that, L-at I fig,arcd, Yoe kszoka, that I wouldsa't be smokingg my
whole life; I fdgured! Ukc3 wh,as I turned 18 S woul.d stop or
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2omathing like that.
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But nov, as taree goes by* you ?cn,o:ar. .~
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my ability to run any 3;ar:qfih o& distanco, you know, my win:d.,
Senator Kernmdy. Are you an. ahhle+ts?
Mr. Va2ea. 4.~al1, I used to ru,m t.Eack, I usad to sprint.
V71aen I spzinted, it dislh't smakaa dif£arence, because,. you
know,. a huo.dred yards--that's nothing. But I am talking about
going out to run two or three miies--r, doa`t know wZiether x
could do it aaymor&wi6.etout; -huf£ing and puffing at tho ead of
ik.
But nowy you know, I have made a vasa to rsys2lf that I am
goi.ng' to quit smo]ting, because I can sm tht offac~ that it
,
has had on aza as far as that goes.
Senator. SchFaaiker. Fsre you goiSg, to qui<,, cold turkey,
or how are you going to qui::, Jim? .
1"w . valoo, BsaIl1, I have tried to cut dowa, and itju.st
doa3n'r work, beca,use th=e are too iaaay kimes when a cigaretta
tastes good--tha.t"s what i r tao3.Is down to. But I am just going
to go all ghs wa:y, quit cold turkay with it,. w°',~an" I quit.
Senator Chafe®. Charles, I notice that you don't sFsokr
and hath your gareatss sa,oKo. Now, are you involved in at,hlo- .
t3ics or what particular .rcason do you not smohe? .
Ais. Griffith. I didn't eaoJs+n--a lot of my fk®ads startodto siuo?.e 2k:ck in 7th and 82: gradcs,
and my parents emoke;d, ~
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and F just ne4ta; ed ' to h3 dirfsrent_. I hi::B to b4 ir.dependcsnt. 0
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s; uator fie;r.Fa?y. LLc;t no ask. you abau:: the attitude of ~
tkw schools ahouit tho smok=o:g. Do your sct`,oaZs gr.rnB t ixt,# do
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conscous ftcision?.
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Miss Ri;i].ley. Well, basically when puople start smoking
cigarOttes, it is irscauso of. peer pressure; your friends start
to smoke. And then it is a choice of whether you &,ant to'b®
sort of l®ft oat, you know, by people of your own agesif you
don't start emaki'ng,s you know, thety sort of look down on you.
Senator Chafee. what percentage of tfi® gir] s in
class.sIIOYa, would you say?
your
Miss R2illtzy. Zn rxy aZass I wou"ld,szy abokt 85 peresnt.
Senator Ke;,anady. E'hat about you, Thtirase, st+hen you
started to maoze?' .
A?ias 1Gclff. I st:asted smokir.g snostly bscause 2 like it.
xwo-ald say I sta:rtad s~^.ol:ing probably to fit in with th9e
.
crowd.
Svr;ator IGe.u:z_ dv. T;et me, zsl: the ones who do smofie--
could' I just sec your hands again? How many of your parents
smor e? . Both ycaar pare,m3.s sanokH?
Ma,. Valco.. tlrse of mine.
Sona 4or ttenn;2dy. Onoe of yoi3s;, pareaats. How about tho
ones that aon`t . s!soiaex, do your pare.wts smoke or not rieokca?
hI-ar4in, what abetlt that?
Mu., ©°Itmlley. Ors of ray paras.ts smokos, but he is not C4
a causi.nLs-nt, smonta*; ha just hws eoe12 evury ©nc* in a whila. Cj
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vx. Grif=i.'c8. . EoLhh of miwa smolc3. Oa
Sa*.aa.'cos rv.-r_nccay. A:,d you don°t Wrc, e. iSask, V?uat about
' D?^. PoCa3. Thank you very mucn-C .
43
Smnator Mansdy. You ha©o $30 million in . the fidministra-
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tios . budget recisesh. Now, as I uaderstao:d: further, $241 millioa~
of that had alroady fesn.y previously peogr, e , only $6' miliio~
t5r. Pss.8ny. $24 million was primz>ily in res,aarch;,
rouccsly $19 milli,ean of it is reses;rch in hho National Insti-
is rea+a snonoy, am I correct? .
A'.r. 8inney. Vtr .Cisairman, t.ha2t is corroct; it is a$6.1
million iracroase.,
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8ana.{:or Meennedy. Tal:, us whera the $24'' milli.on came
from?
tates of Hsal£:h--hha Diation.a! Cwacar Institute, tFtsc National
I Heart, Lung and 8lood' Yaxsti¢ute, National Institute of Eaviron-
mental Ec:a3th &ciancvs; and a$y-m{lliora i.crozsQ for the
..
Naticnal Ihs;;v.tu:aof, Child 7,4zalth aiuc? Hum3n Der®lopmassst.
Tho additional $6.1 aif.l`sios. is for the Office 4 Smoking ar.c3.
. . .
Health Eod' f.or the C;;r.t^.:_+- for Dtncasa Control, primarily in
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the ar;:<a of funding opwaticns of. th3 off3.coand in funding a
progczam . a£' gr.;.n.t% to statua tas.gct,;:3d on easokir;g and health.
Srna4or KE:.n,?ed.y. We:El, you took some of this money from
the ceswar progra^a and £ra!a the heart progTam andi.frasm the
--
Mr. Pixney,. No, sirr, tthere Easn hse..~ n.o chahge«; thor.¢ has
3a e?ga a slight iscrcase in each o£f the r:esQ arclx institutes and
a FG@.]wila increase -.
Fr-iaatcr Y.c=- sdy. ti,'ail, it's obvicus]Jy a stvall gams, you
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dsvelop a habit. And then it wouldn't be. as hard' to stop.
Senator r.ensaedy. I think you put your f inger really oa,
the key qnastion, and Lhat is, you know--are there things
that can bra done taprevent young people from getting started?
What suggeations do yon have on that? Maybe cre will
sta-t sai4:h Jim.
Mr. va]oo.. I have iihought about it; and it would ha:ve
to start really at an early agm.. Wwn I was young I w as
totally against smoking, and I got my father to quitsmot-.ing.
S2.'natob, iCesk,6dy. Now youcg was that?
lSr. Va3:eo_ I am talking about 9 and 8, in that area.
Because I' had tezcharsbzck than also that would say how bad
smokiasg is, ende you t;,rsow, what it could do to you as you got
o3der., and so oa.
But then as I got into juaior hiah,schoolr tha emphasis
on wmoki.ng--tho only thing we h.aardd was you ca:.:' 2 smo.3 in
school; that was it. Bta"r he never heard why. Andd so it al-
;
ffinEt:-lr-,caT=--just to defy authority, we would smoke. And if
tho3a t:ept tt43 eraphasi3 up, because, you know, it's a pretty ,
impressias.aa3:o, age, ever. through hig,h school also--if the
cu3phag3s asas, kept up on why you ghou2dsa't, smoke, 'rsot just
that you caxx°t smoke, z t:h.iuk : c:--t ..Sr would mal:e a big differ-
c~a:c~. . p
~asenator Sctraaiker. J3.3s, hou did you get the money to 0
support youar hab+!t? Imot.her words, that can run several
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continue in th-9 15 and 16 and 17' to 18--and this is, as we
can see in tkie' chart that ic aush behind it, at thisipoiaat
the girls are virtua?ky mves..wath tho boys in terms of use
of cigarettes.
But nonetheless it has hecasi described as anexplosion
in terms of. the us@.of cigarsttes, aad's.~ would like to try
and sort of,gain your viows ahout ¢?ia issues.
We woul'd like to 1~~r ; rom you your orm views about. sma-
king,. k?s.are not trying to make any Aora1 judgmants obvious-
ly, huScese are ''c,.-yxasg to find out about--yoa can start off
wita your names, your ages, and wii= you go,ko school, and
thesa, we would like to ask you ahou+Z:uhmY.fer you smoke andwhoa. @'id you sfart , and sczm ottser
questions.
Ithirk Ye will gs*d starteed may>'e ovar herm with Thasesa.
TA3k into the mikea, if you would, and give us your aam.ca, age,
and where you go to school, just initially ww will introduce
oursalvos.. I. am Tod. y.e;ar:Wdy from F:asaachu-setts., Senator
Ctaafr.-,o from RYiodo Island, and Senator Schwaikas from Panasy2-
vaMia, and wa aan all P-imbers of tho Health &uhco.asaittee that
is: con:4rEeed with: t:yis legisuation. - ..
s.
S.o, juet gis=ial us yourname,, your age, your school, and
tter, wo will come: to sor.e of t-zo questions.
R4iss 67o1ff. Z.m Ther$,se F!.'olff, I am 17 yea'ro old, audQ
W
I p?'an ou qo.i:.g t.o 65sst Virgiaa's. FasAeyan nwa year. ~
q.
~
sa^a"-..rar. Chzfeo. Azdd you 3ust r,=adua.ted Zl'cm x;,,'~ra grag a
`A...
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evidenc$,. oC policy and our posstiun tTas besan:very definitsJ-
ly to encourage people to smoke lower-tar lower-nicotine ci-
gexetcte,s.,
Senator Men_nedy. 02aay.. Stsnator chaSre?
S+sn.a:asr ChaFc3. Dick, do you tsavec any ciuestions? .
Senator Sc3iweiker. Just a couple.. 'First, I do want to
com=nt CDC and HTTo-ty for their w.or?: in this area.. I aw strong-
ly supportive of the bil l vah2rFi vr.a t,alkk-3d about clean indoor
I
air sc.d aon-sw=kers° rights. I think this is lon,g' ovozdwe,
and whilo I havsa some problems with other sections of tha
bill, I don't have any prcblems with that and Y strongly sup-
port it. I assure you that in terms of the appropriations
asp©.c2s, we will give you the mozey to do the job.
I would like to ask one or two questions. Dr. Foege,.
you ment3on2d, on page 12--or you ask the qt:estion, which is
a darn good one: °W`iy doos it appcar that Seaer college-
bound yos*~.,.~gstcxs ssnoke vbs.nn thosa vrho do not plan to go to
coll®ga?"'
O..
~
I was astaunde:3 recEntly to sc-.3 a survey at Princeton,
W
at vhs small parcnr_-daga of cn'.l 1--gs guys who sm-oked coApased W
to tv: en I was i'm colkagc; I 3ist could.n'tt beli9ve+hho statis-
tics, b*a`c apparervly thsy are tv-ue. A;ci Lle,.quesizion I guoss
I txacre is, it $ee;ns to ma tF-:re is an awful lot to learn about
the pear group pzessurrs of the college male and why he isn't
sa4? :1,ng,, and: 4::iz psarr grc;ap pressure of t?aa young 4.F.,.:naga gal
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far'off before you.wZ]:l start to geel the effsacts of it.
And I think if you saw a. young person not much oldar than you,
the effect it has on him, it would have m.ores impact than some-
body who is si:xty years old and has cancer.
Scan-atoa scFxwei&tir. I would: like to ask of the paople rrho
smoke, when your paresnts found it out,- whag was their reaction
Did th+©y try'to talk you out of it? Didthe3r say it,'s your
decision? Or did you hav© an argtiment with t14em?' ylhat reac-
tioa did your parents gisre?
Jim?
Mr. Pa2gow Wa11, my parents:n4var told me flat out I
can't smoke; and I nE,vex kept it from tthea ®itl`!or.. They en-
coers.ged aas not to s.Toka, and they E:ept using the example,
well, you s6:opped me from sauok.ing, wYsy are you smoking now?
But they just vold' no wP..at it cou23, do to me, but I didn't
really pay mzch attent;onn to it. But they dida'tt just put an
iron hand dou-a and say no., i caa't.
. .Senator' 5chc;*Diner. Mark?
bftr. 15ctaass. idfjen my parents first found out, thsly really
kind of sa3d, it's your deciston; if ycra want to hurt yourself'n
you kxtaw, you can do it. But they On,:ouragad mg`,nofa to, not .
to start. ~,
0
S~~atcr Schz:eiker. .ThWresa?'
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1`Sise. B.oIfi. They e_,^ouraRc3 zz aot to definitely. Aiy'~
pairanLs, c:e:rea't pleaaed, at all,
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huudred bucks a.yess. Did your folks give youlyour mosay?
Didn't that geta little cucpeasiva aftc+r a while?
tsr. '(+aleo. I dasD,'t like to taks an allowance from my
parents unless I have to, when I azn not working. I try to
work at ski shoros, whatever, as ofgrrs as I can, becausra I
justt think Ewould ratb:er,, you kaos, be a1Gleo to support my-
self, a.:t least as far as spendLng~ money goos or anytiing
along those liws.
Sonator ChaEes. Ccu2d W© just hacw a show of ha.nds--hox
many of you have sver snan in yort- schools aducat3onal filmss
on the bad eEccts of s¢toY.3.ng? But you are in the same
sctiool.
Miss P.ei'll®y. Differant classos.
3OUa$or Ckafc.. Di;ffertaatt classbs.. What did. you see, a
f31m? . .
Miss Reilley. A film, in pl:ysiology; it vxs on the body,
things li1ae that. And occasionally ihey would have topics in
the science cauxse wTZere, they seview ¢ancer and smoking and
things lilce that--:I2at's just one fir3mrst®Z, out of the whole
year.
Senator Cha:ffew. And ;t you didn't happ2:n $o`take that
coursa in p:y::iology, you wouldn't see th® film?
23iss F.Gillay. Right.
Seatatoa ChafQe. Ar_d' nonsa of thc3 rest of you had any edu-
caf::ion,a.1--zsa e.sseaW2zs o= eAl-this_g lil:cs that--on ---
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ve!:tilat:_on of kh3 ai°~plr:uo is much 1otCar, and~ the stability
of the pgar.s is. mnch~ be4tc:er, if you have tlx:~s side by side,
in the . circulation, rather tha+n haus it all in the Iaack.
Seaator Sr.hwalaMr. Walk, if you don't have seg;regatSd
areas, . you certainly dsan't have froedonum of choice,, which you
say you advocate.
Senat:or E'ord. That's right. .
Senator ScEiweifis:r. So you are advocating fEea3mm of -'
choice, but if F, as won-saoker,, sit next to a snoker for
a four-hour flight to L.A.., I have no choice.at all. So
your frsedom-of-c2zoiee apg;'wmsn2: dossa'X hold up o;a t4'-bat oze.
Sura,.^.r Ford. 5>ril].,it may ncb, but 2 think rather th&:a
being segbag.atad to th;-i back of' l.ha plana, undezneath the
, otor.,, by' the Ia.vatofy---t4aah is soTataing eTs.. And I don't
tYainit tBsaf:'ss rlghi;'or fair.
Ss3,aaBer Schwaiksar.. I would rati::err pat you in a front
seat anyway, because thc~ew s3ats in froa; r:s;xaJ.3.y hit tho
worse in a carasl2. You can have the front, as far as I am, W,
Ch
conceicCed. W'
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FLaughtGr)i '
E
Sonamos Ford. Ij,a~.1; to t~:12l y~:~:, Fcnatcr, t'raaLt may be
f3 z±, hu¢ I c:a.calt a. ,c e rirs'c-e? ~:rs, so it's ejoi^.?g La be , Lar,.k
in toLZa st !escro tihvy ga to ati . ~.44 I:ecF:t to fai.Y you, if
~;htt is tr:ha= youb coacer:a xs, I will serap smoising areas with
you.
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Senator Schweikor.. Or phys. ed.or b:aa,lhh,classes?
Miss Reilley.. A7o.
Senator Sem;nedy. Let mss ask you--what would bsr your
reaction to sort of the school providing thirx information?
Would you consider it, well, they doa°t wanCus to smaico, so
therefore t.'amy are jamming it.down our throat. you kaow, a
ccutirued plot of the faress- of a.uthori'ty in our liVess or
do you thiask youszg. pgopl® tsould realSy, if this health mes-
sagd wssre providad in a scicnSabiclar,rl kind of uo-aonsanse,
way, really laid out the facts in gsrttsoz' yuutzg people, do
you . think itocould ma.P:Q a difference in. terms of their dcci-
si'osss?
tkask, what do~ you think?
Mr. Adas;s. Well, I th3a1c that would make a big differ-
eaace, because most people who start smoking doa' h rc+ally know
what cancer
,
is like, and. if they were givoa maaa a:ua.ap+ as, abke
aho-ding fi7mSat an earlier age than junior high school,, Z 0. W
hhic3e thaC, that *on3d: really pzevsn2 a lot of smoking.
Q
Senator y.crunedy. caarles2' ~ "
w
t;r. Griffith. :-w32, I think if you had fi?a,s or sornvthiag
of pcapls wz;o aro maybei in thsir 21° s or so, Hhi.'chR"is uoh far
off from our agrs_-and, s.,os ks^:cws wo: the effscks tka't it has
had on tbzm a?deady, liP:e irso3~~~ra and T1+rircso had trouble running,
or Jamco--azd seu ttxe:e loug-tarm ef:'ccts, Sth:ay ara there, but
the sisarit-tierm effects: are h.h2xa, too. You krow, it's not fhat.
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CATEA1Etv'TS OF RICXARS7 I. EVES, P1d.D'.,
PROFESSOR OF PSYC1i0I,OGY, UPdIVERSITY OI"'
75
NOUSTOtt, HOUSTON, t'*r_*:XAS.: JWtr S: W.
.SBs'Ir7Ef3'ART,. PYI.D. f DIRECTOR, PUBLIC
.
COOi1JNICATIOhS CET:TE'Rf FEZ:.tiM A3UOIt, NE
NE'W' YORK; Ab1D PA(7ga GRZEN, PRF3SSDENT,
G11E£td DOLFIATCH ADVERTISING, INC'., XEA7
YQRR" NuN!' YORi4.
SenatorXWn3dy. tPa have yot our uext pasel:, I 1SeLigvs,
with Richard Evans--YAr. Eva:ns, Nr. Sw3.nthast, and Paula Groan.
Dr. Evans? .. .
Dr. Evans. Yes, first cF all I would like to comm,.ad
the Senators on thQ3r cgczemtious of the be!3nagerrs.. I would
like: to invite you all to joira our reeezrcaehaEf, hscause
we are do;ag exactly the same thing.
Seaa9tor ICtsnreodg. I just thought of a good one aEter thA;y
.
loftz how many of 4:.hoffi would have not started if tlaay k'new
wha6 they tsei'T now?
Dr. Eva4s. WOiL, Z,am not going to rQad aformal state-
mont here, treauso It.''lsu?~ a nrmmbar of things have come up
which I couic' rGsAoc.d 8:o the:.8 might ba amoa0 effective use
of my t9.m.
First of all, I would biTm to point out that I am current-
ly the director of the Smofiiag. Scction . of t,?~a Eay3or Colkeg~
Q5 .
of hTcdi'ciaa natio^.a7. H; ar4t and: E3];ood Vessel R-saarch and " W'-
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have these commerc.iial clinics aad so on $hat claim a lot of
things, but really, the data is not really available. But by
az*.d.large, backsliding occurs. Et's only a very small percent-
age of people of the ones who are addicted.and sop. So this
fs why I caamend this Committee. I think it's great that you
~
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recognize, as we have research-wise now for about three years,.
that the real, most.pror,.isxng,way of going about this:might be
;to prevent the,onset of addictive smoking.
Senator SchwAiker. One part L'don''t quite understand, if
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you look at the statistics:that the Cancer. Society has here --
and L guess they'11 be presented a: little bit,later -- it indi-
cates tfiat if'you don't go to hi;ghischooA you have the lowest
,.
rate of smoking amang young peopLe.; whereas, if you go t© high
school:, you have, the highest.
But if you're g.oing to college.,.
it drops off again.
Now, obviously peer group pressures are working at all
three stages.., Why is the high school peer group pressure so
important, particuxa.rIlX whee here you're talking about the sevent
~ighth and ninth being some formative?'
Dr.. Evans. Well, I think that the pressure begins to take
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n a di±'ferent type of magnitude. For example, :'-at.early ages
e peer group pressure has a kind of conformity that.is chaaae-
teriaed by small groups of pecpl'e doing something and the kids
R
~ae.Laeve everyboidy is doi:ng it wY.en,they~re realAy not daing it.M
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11his would not only imc2a*de clgarette smoking, but drugs and
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alcohol.
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As they get older into high schools and college, particu3.ar-,
ly in college, peer group pressure here is usually independence,
~
to be yourself, to do your own thing ffiore.. Obviously, the psych
logicalxaature of that pressure goes through evolutions.
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What perhaps I am really saying
about peer group pressure.
is.that you can't generaliz~
it varies over time.
What I argue, of, course,: in our research approach, and whic
.. . . . . .. . . ' ' ".~:._'.:I
I'm delighted'to hear this Coumittee discuss, is the fact that '.
probably we could address ourselves to this particuiarly vulner-
~
able area, this seventh, eighth ar:dninth grade vulnerable,, to
p.er group pressure to smoke.
Now, there's a British study that Byerly iphoneticy did,
which I think is very important and I hope this Coymmittee looks
into it. This is one thing I have not hear so far. But this .
has shown some evidence that if children beqin csmoaing, they are
much more likely to use alcohol heavily and move into other dAug.
It could v.ery well be an addictive entrance ticket. Now, that!~,~
should be researched a lot more, but the British study suggests
. : t.i.
this rather strongly. So that would be another very irportant '
reason, I' suspect, to deter the onset of smo?sing. 03G0346
, Shnator Sch.'zeiY.er. But couldn't that also be -- and I'nti no~
disagreeing p3rticuAarly w:.th you -- bst,it cou`d also mean that
people who tend to axo?ce are a little higher risk-takers,-a lit-
. . ~;
tle more .zi1liisg to depsxt £rom the establishment, a little more
84
vtillirig to depart from.the establishment, a little more willing
to thumb their nose at what their parents,have told,themand
therefore they're going to respond in tho:.e ways?
Couldn"t it also. mean that?
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Dr. Evahs. Well, Senator, I think that issue of risk-takin
is a very interesting one, and I think it's a very subtle point.But in soms cases, for a seventh or
eighth grader, for.example,
this risk taking nnight be the ability tO say "'no" and be able :
to put up with all these other kids saying you're chicken and soo
on, or you're a sis'sy or whatever.
Risk taking, of course, takes on various dimensions.. There
is no~doubt about it, it would vary a great deal with each child
Tn sozre cases you're takiny a risk by saying "no"', you see, be.- l
cauWe the whole group:is going to,fall down on you. In some
cases you're looJ:ing,et the cigarette and you"re taking a risk
because you think it might cause cancer.
iae have demonstrated, for example, this pressure: gets so
But from the sociPl standpoint, the risk is,to. say °no", and
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Senator Schweiker. I don°tthink yo undsrstcod what I'm
3aying. If it's the persona2ity of a person who tends to be the
Eirst one to ss!oke a cigarette, his personality r,.ayf-also:be that
fze''s the first one to take an e..i e.rir~..ental drug or take alcohol,
ahich s,xa.y not be related to, whether : he's addicted to something at
i11... It say be a~:ereotype person
-- 03603470
Dr. Evans. Oh, yes. I see what you mean. You're talking'
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educationaC apgroacles, krut for the nc a.cd e: tal educational
tools of today.
(The following werm recoivod for tho record:
LAY Ild
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sion effect.. What really happans with almost every drug --
alcohoh, nicotine, what ha.ve you -- is thatwi't'r.in a year near
8'0 perCent fall back to where they were, backsliding. In obes-
ity and weight cobtGrol,, it`s probably 99 percent after two year .
811
are
very dramatic, are just early results. kIti have to be very
cautious with this type of research, because -- por e:canp7.e;
in addictive.habits, one of the most commonly found finding
,
which is very disturbittg is what we sometimes call the -ragres
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I want to oaution thatour earliest results, which,
so in this type of, research one has to be very cautios.
I hasten to mention this. We should not be prematurely emoour-
ag2d by results,. Sut at the raoment.thS.s --
Senator Schweiker. How long a timeframe 6vould, you nsadd
to see that you go t to that bac::sliding,stage?'
Dr. Evans. I woiild say in the case of -- What we`re talk-
._. _
ing about here is n.ct stoping children from smokiAg,.but sLop-
pirag the.m from becoming add'zcted. In osar particular study S'
think that we could see continuing evidence where we're now
finding at the end of the' ninth grada and preferably into the
,.
' entli grades that we probably have somea conxidenco-`ith4t these, tJ
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typcs of cos cep:io.,s may have some promiee. Ca
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iQot3,, f1'odA. t:7F2 s'~'?nd't.7t1.7.x1t'' of aG?d].ctiv23slHoiiers-- a3ldwe4
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haves.;ust reviewsd' the litaraLtlre very eXtcasively, 'about three
months looking at it, it's. a very, very disturbi':ng area. 6-e
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you.
Mr. Adams. Neither of asy parents smokes. My mothor, used,
to, but sho quit.
Senatoa R,mmsdy. Do your friends thin-kk at a12l about the
health implications of smokingo or do you sort of think about
it and think it is not going to hapi ma? 4:`hat kind of
a seaso- do you or any of your friends have about whot.her it
really is going to ma3ce much of. a df:ffor6Aces in telrss of your
health or not? Both your~ o*:^n viecl and what youhearsoma of
your friends talk about.
ri4r. 0'Lallasy. W°7~:1, Iwonld' szy that k?ds my age aren't
r®a17ly conrornad with t!i®.health issuos, you know; they talk
about it maylro.. Sut the main thi: g that tley a::e doing it
for is, you knosa, just to:f's:: in withithe crokd. Smoking
is something that most a:dus ts do. So 1 think the reason why
the kids do it is just so th'ey can . get a feeling of,you kno~r,
?~iss villey. Mat*sr3i4:y.
Fi;.. 0°1,i Yes, matur3.ty.- But I don't tmir+tthoy axe
really comsarm.^d tha:ai mv:ch . Fai-th , the health insnes. .
SCs1atox P.onr.e3y. h'hat about it, Jisa?
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t2. '4taiso. Wall, whosa I firet ntarted to smoke, you know,
I uscd to thinla it coLZen°t uatpisa to me;, I couldn't get 3i11 p
W.
from it, I' r7ae 'y=uno to it or so7,4;xti;ig. But noaai that I am O
W.
oldW., I i3ava b&M- ti;--i can see how it has afffcctcad!
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they are lkagi in the . prasent.Thesy see other kid;s smoking
that aren't dying off ismediately.
Also they noaa bacome ia:fluenced by paerr prossure, which
was brougE:t, out by these youngsters ax2remely welb. This
paer pressure is very important. For eacauuple, wa have pro-
duced soifto films which actually show wtbatrhase pressezres are
like and how, for. example, some youngsters learn how to say
no to ttsQra--for oxample, they might make an ercuee likw I
hs.va got a:rt alltsrgy not to smok©,, but the pressure can be very
hirgh and very inYans9;ve; thEiy wan.t to baloRg,e tley want to be
accmptc.d at this aga. AZso, as was already pointed out, we
found--which confirms a lo : of othar dmta---tliat if both
parents srnoke the likelihood of children smoking is obviously
very high, and only orae smokes it is eotnecvhati less but still
fairly high;; if' noither smoke it is somcwhat lemss.
Another thing that casr3 out, which I, think is very ira-
porta:at:,..cvertly, coasciously, 'Lhey uaexally are not.really
aware of' how the ma-dia aff6cts thane, how the cigaret" ads
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work. For example, we produce,d some information, gave thma
sorQ:, of a°:r.o.z'~: co.:rse, kind ofan oaxly Marshall VWLuhan, '
trying to gWt tham to ur:d_astamd how in gact the, mddia worked,
how isbGy ar% ripped off by the maaia--t31is is part of our
fiZrs:. 3^:d most of fs~:ue conscic::sly say, wall, a7o know tlSeyo
W
are foflTing us,, and so o:z--b:at, asa maS;~=- of fact, tr.are's ~0
,no c?oubt a.°ici)t it, thar_e is a; ccverN iafluancei collcotiv.?1'(n
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86
determinants of a problem.before undertaking efforts to control
it. In the case of smoking, our present knowled'ge provides an
adequate basis for progra~n planning but needs to.be expanded.if
control prog,raas are to be made more effective.
For ex&mple, we know that modeling eur.d' pear influence are :
closely related to smoking behavior. `"rhe boy or girl most 33ke1
to begin smoki!.ng has. tsao parents who su*ke, an older brother or
sister who smokes, and a cZose friend who smokes. The presence
of a.nonsmoking parent.or sibling, or friend is associated with
given most often are not in, the ;jargon of biomedical or behav-
markedly lower rates of smoking in chikdren.
This suggests..that adeterrence effort shoul,d.address par-
euts, teachers,_and other adult role mocels, rather than.focusin~
,
excclus:ive2y on children and adolcscents.
I .
As part of a Froject cai-ried' out by young people in San
~
Diego, teenagers.were asked why they smoked. The.eight reasons
ioral research, but they cover a lot of ground and provide ob-
wious clues for tNs design of control programs -- and here are
'iZ'ht yaung now, why not smoke? T cs,n quit later:
the eight;
~
°I don't.inhale,.sosmoking can't hurt me. °
"My folks smoke; why shouldn't I?
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"''If I don't spend the money on cigarettes, I'd snF.nd' it
on something else.
n
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C7:,
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25 ~~ "Smoki~r.g aakess me look gror:n up ard~, mature.
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76,
DamonstraLidn Center. I am principal ihveoti.gator of a
Haarf: and Lung-rupportcid projc;:t which is really directed at
d,tes:rixig, the onset of gmoking in children. And happsnn also
to be acadenicslly professor of psychology at the Uaiirersity
~
of' Houston.
Now, working with, Dr. DeBaF:ka (phorivtic; Hea:rt Center
and trying to look at sonts of probably t.ho most well-
0stablishsd risk factor number of discases, I lsegan to realize
that dsalfuagi wiSr1i the add3:c: i:ve snokar is probably a lot lCtss
; of a payoff than probably going into an area that has beon
urser_ralored ralasiv©!y and trying to deter the onset of smok-
llbg.
tioa., what we found is: through our research by inter-
vicwir;g large groups': of pra-t:eC :.agers and te.,naga s, and
looking at the whole range of smcking, a mod9l bogan to emora_a
which, intereatiraglyy en.ough, is prQtty wall supported by
the t3exagers that. you jus4: izaterviea:rd. It eems taat by
the time the children roach the 7th grade, virtually all of
i
them kaa1. 4_:cva srnoY.,ing is dangerous. It sa~.~~ss that before l.hair
I teen. years they 2aS;e this vcry co:acregely, so they 1:ifi.erally
IVean`- it can k;ill somcc2c and tEky try to do 'r1a; nigs like per-
~
suade their parents not to smok®. But on reachirg 7th grada,
differcz,t thiIIgs begin to happ4.n;: they become very p,resent- ct~
W
oriorated. ror examplc,, messages which aay you are going to 0
wA
get c--aerr vhGn you ara quits old don't msasl much to thsm-- ~
~
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79
this type ar ~.assa3e, say, over the per pr.essure message.
They seem to. gradually shift away from : tha paer pressure.
To suuinarize what tae are doing, in effect, is to try
and nurse them through 4IY9se very forauativa yea,re, when they
axe very vulsu3ri:b3.m to those pressures--eay,, 7th, 8th, and
9th grados--and we belimve, upcn enterf.ng high,school, uhen,
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they beccoava a goori deal mor® indapsndoset and can now maJce
individual choices logica] lyy,; based aS th¢s rea1:l fear of' the
disease that may be caused by smoking, that presi:mably ns can
cut into the.rate or odds. of addictive smoking.
Now, witho-a+Z: gsttimg into all of our data so far, we are
rather encouFaged that in a pilot study--aadattarhid to the.
ts;.st3.raoay are soma charts--a test-vmssk pilot study ehovas that.
cse were able to actxally decreascs, by about fifty percent the
nmmpar that boga:.^n smokiug, and following this through to fihas
end of our tiio-year data, which we a:ree just beginning to ana- .
lyzsr it: also looks rathex proragsi.o.g--thti data is a little
too povrer£ul, we don't quite bskiWve it yet, but right now
iW shoias like: about 8'0 pn:.cent oafthm-n claim they were in-
G;?
Q
f1u6ncAd by our films not to bis.gin smoking:.
G.7`
But really the real returns ro:a this type of rasaarch 'A
. . ~ ~~
are not iffN.t Y7re find along the :nay,'aZvhough it is very cm.-
courag+'ug,; it is v.haWvxa vrill raally find out van~sa vro look at
thozso children in high scisooz., to iea how a.aay fawa= have
seally ue cc:ne addic$ivs amokors. tco;~, wz fiad that virtually
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Senator ScFswei~ir. Moira? C
69
1Siss Reilley. Well, my parants--thare's not much you
can say wh®n you smoh@, you know--you are.setting a bad
example yaurstlf. . I mean,. they can't tell you not to do it
if they do i'tr.. So a'll thery can say, you know, is.it's your
dacisionau ymaa makQ the. choice. But itfs not what we would
want you to do.
Sona4or. SchweiS-.er. Gadting back to the question that
this panel is reall.y asking up hmre--ssh.att is the most effec-
tive way that cM ean it-put, on that decision? T' gathcr if
ssc were to ask you the questiosuwt1a: hgr an input from your
parents; who would ta3ce a strong stand,. veres:.as educa:aoa aad
films and input from the school., what £s your ans:aur as to
which would hc most affective in your j'udgngnc:nt for. all kids
to stop smoking?
FLiss xaill''ay. I would say that it would have to come
fr©a,rchs school and oducation aad the media socu.csa,, things
l:iltt~ that. I maan, your pazCauts will play a role in your
smoking or not smoking, but mvus if they say not to, there ~.i
~l1
. O,.
aro so many $inrs that you canjust go ahead and do itany- W
bill
CR
csay. ~.. ~
SeH.ar.:o'_" Scki'fai2'tei'.. Eight, and that ifl u(?f2ally aninvita-
taion , to ao. it aAyfray, right?'
x5a:ss R.eilY.ey. Ycss'.
ScnatorYeessady.o.z thits point, what do you think is the:
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74.
--ha"ve no Lect ou.your consumption?
ttiss Roilley.. No.
Srsaaitor Chafeo. It doesn''t seem a heavy burden to. you
to pay now 60 or 651cpats a pack?
Miss R®illey. Ls'ell sore, packs you can buy. Wem 504;
other places it's 750, other placas it'.s 6SC. So yau j'ust
pay whatever you have to. -
Strnator uclhereik®r. Where,. +do, you got the money to support.
it? Xour paronts?
Miss Raiilay. I work.
Ssuator Reanedy. That''s a pretty strong indication of
~
!¢:1scE dogrge of, I supposa, dasire for the cigarette that you
pay just cahatevt3r f he price is in oxder, to smoke. I mean, I
think it is probably a:ceasonabl3 measure:aGnt of the drcagrerrof real addic sioa to szeoIcing that,
you kaow,, young people
have, probably evGn mora important why we ought to try and
encourage people not to get started on it.
O3:ay, is there anything else any of you would like to
say?' tdh vrznt to thank all of you,, a.rr.d thasnk Father Ward from
Gorsaga for his he3.p 3;a1, coordi.rxating taose activities.
Thank you rrery, very mrch. ~,.
Miss Reilloy. Thank you.
Sa. ator Chafee.. Good luck, Jimo -A4s.. Aacl.a.ng
C
ttao ha:bit.
perio3ically rather than only once,. efforts to support this de-
cis3.oa should be provided on a continuing basis or pariodic
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basis fron the primary grades through high school.
Prograas; which provide i.nformation about physiologg and
the specific effects of.sno]sing are appropriateas part of a
general education, but they are clearly 'inadequate as. a means
of deterring smoking in adolescents. There is a need to supple-
., .a.
Ment this i!nformation with non-health appeals,, since most tean- .
agers who start smoking do:so because this,provides other values
which seem to ousweigh the perceived health risks.
Nine cut of ten teenagers believe that smoking is harmful
to health, but they are in a conflict situation because they
also see smoking as,a source of peer approval and a symbol of
adulthood.
The rlesiga.of control programs in this area is made espec-
ially difficult by the fact that the positive consequences of' :
s*no:Sing -- such as peer acceptance -- are immsdiate, while the
negative health conseqs~encP3 may not appear until years latez.
It may be necessa.ry to devise forms ofe irm~--diate reinfotce:aent
of ' nonsnolcing behavior if control p'rograras are to becorte genu-
inely effective.
k
P<ew cocraa.nity-based prog-asr.s should involve gLeater cooper-
ation on the part of school sy-ste:.~s, health d'epar4ments, of=i2-
iatas of' voluntary health o,:g2seizations such asthe 1hmerican
Cancer Society, AsaArican Heart Association, and the h.inericaxs
. 036
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c , c
6:csmmercia2 udvertisers typically piaae their materials
where they will be seen or heard'by persons in the market for
their products. It makes sense for smio::ing control programs to
do the same,.. Som9 escamples of media which reach children and
adokescentso in addition to those..listed~ above,are.comi'c books,
posters for schools and for kid's rooms ati home, shorts'or
®trailers° for use in movie theaters, placemats in fast-food
resturants, bumper stickers, buttons, milk cartona, and T-shirt
imprints. All of these could be used in a comprehensive commnn-
ity program, not to-pxovide detaiied infoAmation but to serve
as reminders and perhaps to help establish nonsmoking as a norm.
p special note should be added here regardi:ig the scale of
advertising and related elements of smoking control program.
In an envirormrsst where a tabacco company can spend $40 million
to develop and promflte a single new brand' of cl-garette, andrrher
-vxell over$250 million a year is spent to advertise jast the top
20 branda, the odds are slight that a s;raall counter-effort can
h4ve r,ach impacton the °cli:mate" regarding smoking. By the age
mf.l2. a child has expeFienced a long period of exposure to cigar
i3tte advertising and the exasp3e of adult s;r.oking; thus, it
seerss unrealistic to escpect significant results frcift fragmented
,prcgzc-azs c¢ smal.I size or dkaration -- and' in the past, that has
beeat too often what we've had. . . 0
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Yebatevar the nature of the interventions employed, all O
nrogra.>s funded under the proposed bill shonld be re(raired to
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and over tj( , the same 3kills which acr rtising agencies can
sffactively use in selling almost any product--and often
selling the produWtt without thea coaaeus,er raally knowing how
they are being isaflucncsd'--obviously can work in the area of
initiating smoking.
i8ow, vrhat ssa have doseo ar;d what w¢+ ara currently doing.
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is engaging in a long-term invest.l.gation,in the Houston,
Te.vas, school district. 43a are following children, beginning
in the 7th grade--anei te will hofollowissg '.`.1E= ttzr6cgh high
school--and' 3za.r© produced eome fiims and r~A_ssagp.s which in
fact are di'rccted , at training the children how to resiet these
gr8sseares. Rather than having adult authority figuros preach-
ing to then in these films, ares have children @hsrmsalvss pro-
senting the im: ormation. tie actvall-y have lctaraad from ths .
chiidrean how thay say no, for cxanple,, how thcs®linflu,g,aces
uzrk--aa.d .7a att~mpt to transmit this smver<aal tirases during
Che year.
Ano thx thir:g t3aadurs found is very,, vsrry imFortant--.esyd
it Faasz intores4:ir_q that it wus brought out in tha f.cstimony
from the c?*i?drea--Es L-hat if you can make a xassaga: indicato
i
to the that tlrs,, is an physiologi,al Oyfcct
~
of the emoicing,, rather than empha;sizs. that at some later point
t?'*^y arQ going to get cz^.cot or heart d:is::asa or cFhat have you,
that s~-ms to ba ac-cttiing that is not owly rsact;ve, but O.
o'y:r, study shows th?$ 09th g<"~:dc_T'~ ~' , - for FT1
e::amo1a, would p~, _afer O;
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Eanator Kannedy.
vrhether to stop?
You are thinking more about i'G, about
Wiwt do any of you think would bs--have some of you
thought aboufi.stopping smoking? fo®t ma se3 a show of l5ands.
How nany of you th;oug*at about stopping smolt3ng? J#aa,, you
thought about it.
Senator 6ctawaik®r. lis's,go{ntg to do it.
Senator Yenaody. tta's goingxo do it. S4haido, you think
are roally the factors that vsocldmake a digfr,=nca in whether
you can stop or not? 1s it agaaa what is happening with your
fr3:essds, your co].leagu.cs? 02: do you think thu fact that you.
Y.nos.z more about ghe health implications? Does that help you
or enca°a`age you to stop smoking?
&12:a;t do you tokink are the things that can hcZp the mosC
in termss of "ga`st9.ng teeanagsrs to stop?
H.:3s R.eillag. Most fttnagcrs areu`t rcaz ggr wall informed
about the itgalth problc-sm.s. You see wcs=aeEcia_ls: and ads tlzat .
Q<y, you know, in t%enty yeara you, might deve2op, lung cancer
or ser-as©thimg lilke tlzafit. But mhea. you sre youug aad you. start
smo3:ing, you don't t..hy:alt o¢' the long-torm offccts; you are
E
juFt thinking about aew . and' you ara t;hi<us.:ing about--I, trill,
just try sitoYl.2g for awRx3:Se aeci' then quit.
d
c.~
~
p
BUt you wau?.d havo to s; art at eh4, schools probably, bor p
~ catzse that is, whazm mo6i: people start. Astd i~if you can stop
paopla from smot:ing at scrool., ttxL~; t;Z2oy are just not going to
I
"8mokincan't hurt me -- I smoke fi..ter ssigarettes.
"Smoking is better than putting on a lot of weight.
"Ala my friends &mo]s.e, so i&7 shou7.dn't I?°
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These cotmnalvtss confirm the view that teens" understanding
about,persortal attraotiveness,, being accepted, being "normal",
vf smoking risks is often superfic3al, and that they are concern~
Given sone knowAedge:o,reaaons why children begin smoking,.
and becoming independent.
what shouldbee done in ccrmunity programadeveloped'under the
proposed .bil1? Eow_would they differ from programs now operat-
ing? Opinions on these questions wi~.11 vary, burc I believe most
health professionals would regard the following answers as reas-
onable.
Many control programs are now being implemented in school
~I
sys-cs sns throughout the country. Soi:a of theae, particularly
the ones, which cover sro?cing as a part of a gsneral orientation
. _ ,.
to.Yiealt.h, have shm-x:n promising results. New progranas should be.
er:ccuraged to~utilize.a wide variety of approachss, including
the development of copingi sLiils whicYs could euab3e children to
res!st pressures to engage in vayious other behasricrs harmful to
iaeaath.
A number of current programs cffer only a single Mrief ex-
d
gaosure to infor¢tat±on about smoking, presun*e.bly ca the assuxptio~
that thi's will scmcho:r °innoLu?ata' children against subsegnent
pre.ssares: to smoks. Since
036034*)'3
the dacsisian nrt to saoke mt?stt be made
.._._..._.........._._..._............_..._.........................................................
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_....._. _ ........................._........_.........,._.._.._,~,_..,...---......... __....__..
....._........_.._-~.-..,.....___..
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J3.m" :osntioning that you need the support of your parents,.
71
you.nesd.the support of the sahool, you need the support--.
soms health messages within the schoois I sulppgose what.you
are also talking about is other kinds of community activity
4h.a't you are involved in as wtsll, whether a boys club or a
girls club or various kinds of organization, that t'usy ara
conscious and ttcry are taork$'n.g on it. I' supposes sousa young'
people would be ifapecasod by those activities as weill.
B7hat you are talking a-bout, Jim;, S suxjy2ose,, is a really
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pretty sa^.sitizer3- ccemunity and local effort about the health
hazar3s of smokisag.
Would you all agrea with that as a thoug2:t?.
het me as?: you just fiatally: what is the impact of. tolo-
vision? You. ss:a, you know, all the advert;.sing--ez:cuse ttoe,,
it's not on television, but you see the ofi.1u?r advertising in
reagasinss' and nerspap~:,Es--do-3s that have much of an fmract'r
You arE al«;ays, Ssw:".ng a big rugqcd
a cigarette?
Fr. Adams. S don't think the
enough to get piopte to stop; Ythin3c if they mnl:e it
s!~rious. :
raa.n or wor;Yan lighting up
vdvertising. on TV is serious
.G
more W
.
SWvator Xem^Wdy. Do you thix:k if you had! countear
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adve_tssing on ei4hear radio or te.ievisioa, that that. would be
of soj~_r va'suer 'cco? Probably atoLgh quWstion.,
SWs?alzos ScYarraiker. Z:;+d mp ask, how rauch of tdtca
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72
advertising about pro-smoking that you sse in newspapers ar.d'.
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magazines and biI'lboa~ds-how much do you figwro that is a
factor? I mean, does that make it glamorous? boes that look
like it's a mature grown-up thiug to. do? Eow much of an impac
would you sayr--what you might sco in an ad in a nwspa.par or
magasiaaa or billboard?
Miss.R'i1ley. The ads themselves astis pretty ridiculous
as ar as. iaakinag yau , start to sraottcs. But just the fact that
.
you sea ads mvezysshsiro for smokiug--averywhcr®, it's. isp~assibl
to got away from it. It reminds you of, smoking, it mJkes you
4szt to have a cigarette--things like that. ?'here`s just so
much of it, you can't g®S; away trcm it.
Sonator Cha:feo. Jim,, what. pronpter3 you to try ard par-
suade your father not to moke.'
Hrr. valco. Y:al1, I could sea then . w:iat it was doing to
'.
biaa. I maan, Fie just eraBSa't agila: hw couldse't run anymore,
ho couldn't run upstairs or anything lika that. H$ just .
couldn't Lead a rcally zctive Iia"m until ho stopped smoking.
And my 4a3acher thsn had said, if your parents smoke, you
should ksy to get them to stop, beaausa it is rea]:ly bad for .
:2:am a`d: so on.i3Ctt:-ah thoseo reasons, that pro,al5..ed me to ~~
0
heLp--9:o try and help acLyway. ~
, tlY
Senator Kc,nns3y. Gxe12,xa than-k . you for baing wi-th us CO
this morsin.g and for your answers. 7s thare auy:hing~ aay of
you wc4ld like to say to us?
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(1) cF4aracterize in detail the ssethodsd approaches uspd= (2)
use evaluation designs which meet specifi.ed' cra teria for
appropriateness and scientific rigor; (3), use outcome measures
whi:chiaclude behavioral assessm~nts as well as self-reports
from childzen.
The purpose of these requf.reaents would be to make program
~ .
results cumaxl'ative. That is, to maY.e possible'aan accurate
detmrsa9.as.L-ion of the relative va:lue'of various approz0tna so
~that those forsr.d. L-o,be most efxectivee can be irg2emented on a.
t,rider, scale.
a
Ia swwa*y, the following should' charact,arize n.ew community
programs :
+Flans bas:d on accurate and currcat kaowledga of ch:l-
dren's beliefs and attitudes rF>gard.i.mg snc.king (dorivad
from survQys, focus gwoups, etc.)
{-Usa of .spec3.fie objectives, so that efforts ca.n bQ S:ep4:
on track and resultsevm?.uat;od clearly
+Extensivo cooperatio-a among school syst:ems voluatar_v
anrl publie health agErSc3es,, and otrsr intWxested groups
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+involvv"mcast os: hca3:th psofession_ls, particularly prac-
ticitta, physiciaxis and dentists
+ase of a varica:y of ir.e.d-ia
:"=Emphasi's on i,mr.iediate psxsoz_a]l amd social rainforcemeat, d.
.. . . -{;7..
of noo.s.aok_:zg behm,ri, r, .arad avoid.a32ce of 2-r.hortation or p
ser~crizfo
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most effective in preFrvnting,this msaeaga to the s:udmntiac
in thm schools,. Are ycu batfor qatting it from your peers,
your coll43agumes, your olassmatcsa? Are you battas gatting the
messaga from at ttiacher? Are ywa more impressed, c2o you:tchink,
if you got it from an athlete that is kind of-wp21-known?'
Wuat do you tYv3r.l: really makes the most inpressiom:? Or a
doctor?
Hl3ss Railley. I would say your pe2rs, and someone with
a little authority, you kno+r, a little o1c3=r, maybe could set
an exampld. But, you know, scr-oosat's who has gone through smo-
king and has escera o. ceed it and can rola;,e those experiences
to yoL,, scrosono that is mormyoLraga--you would ba more apt
to liet= to ta'~Gm..
Senator Keruizdy. 1;ra:at aE+au£;.. the rcet?
10s. Va.leo. h'e3:l., I feel it kouLd rea21.y be a combination
of all of them. Y arm impresec--d by athletes; and when I was
youLg, if I had had an attsles:o cc_ees up and say, you know,
corna on and be like ma, don't , smoke--that would make a big
impx©ssw'on. But ? would also need the support of my friends
and tirbatever; if I did sa.pke-, Ewould nssLd ttisir sugg+ort to
4
`eelp ane stc:, you knowP to t:cap mr3: off of a;hca for a w7Rile_-
O
Ga
because it °s a hard. h«.b:t $o. braaIs. And tcactidrs and paro, ts 4
both also. vve:rybodl*"3 input #olps.
Seratsrr Keoa,sdy. This is a, good point hyra--and. I would
just in the rctact.ion of the rest of you to it--
about'really the kind of. --
Senator Schweiker. I xeean, that couid.be a,factor more so
,
Ithan the point of the British study is what I'm saying. Here i
la stereotype who tends to c3o thesethfngs because they are a,typ-
lical, because they do
then vre can. come back Nithh further questions.
I Dr. Swfnehazrt3'
Senator Feennedy.. Let's hear from our other witnesses, and
Ibs ruled out.
Dr. Evans. I see what your point is. Certainly that canno
Dr. Swinehart. `T"hanY you, Vx. Chairsstzn.
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search for public service coa.mnnication programs. During the
past 15 years my work ha3 invclved teaching, research and prac-
I'am_ a social 5sychologist and I do consultation and re-
~
%V which concerns the d.eterrenee of smoKing ac+.ong children and
I.favor all of the prowisions oFthe bill under coasiderat-
. . . ';~
ion, but would like to ccmment particularly on that partoi Titl
~ .
tice in the field of health cczraiaications.
~ii~h Dr. Bvans or the kids who were,oa eari:ier., yod w-ill.hear
Llt2iough the fo3lowiug, statement was not d.on.e in. collusion
a~.o2escents
aome echos as va go along. 03603471 .'
Thi3 sFct{oE1 of the bill proposce research oa the determ:Ln-
7rvrs. Ideal?iy,of' cos:~se, one rhould know a great deal about
ani:w of sa,oking aad s,apport for ca=cuxity and school-based pro-
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.+Usm of, a4hlcates and other valued figures as nonsmo:cingexemplar3
+Use.flf multiple appszls, includiug social and pc3rrsonal
themes. uairolated to physical hsalth
+InvolCanent of children and a3ola:.ce.nts irn program
planning and design of,materials
+Protmstisrg of ma:*riaEs with revisions mado as: needed
'eCoatrolledd p] acement of a3uertise=-cnts in priat and
broadcast media
.
+Reinforce¢e3aat of basic ns3.sszges oveera a period of years
+USp of. rigorous evaluatiore techuiquas which pexmit com-
parative asscssm.ant of different approaches and programs
it has been estimated that one-fifth of the cost of
medical care,today arises because of tobacco and alcohol abuse.
Even if saoking-related proble.2s accounted for only onor
hundrsd.th of the Slu0~ billionsps:nton hWalth ca<einthis-;.., .
country last year, that ,Yoti;:.ld bc $3,.6 billi.oa. Glt2arly thG
pota,~.7tial cost savings that cculd result from Offactiive °'rahiag
19 ~ ccntrol prcg_rams, apar'c from thn valuas in terms of personal
'
1 health and praduwti.°_ty, afRs o;aorrsous.
~
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Senator Kazs¢acdy. ThaxOks very much. Paula Q?-qaa?
I1s.Grcaza.
I am half vempte3--4hrre are:, so many things
I think Z would ].i}<6 to answax, bu;;I thi:axk. r' will go ahead
with the prep3red 4;antiintor.y aayesay. I eall this "A New Leaf.
it is wrong for us to bsYiew2 that pcople start s:1okiug
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. tx.r. PaTaso. zn 1isteniaag to you all discussing adding.
the tax to the higher ta.r and nicotia:e cigarettes and ];ca`esriQ.g
t.'i8 f.a:e on low tar and nicotina cigaret tas--wQ1A, too me per- '
soaal2y,.it wouidn't.make a diEfrsreace. I mean, I smoke one
brand a.nd it . is high . in tar anei, aicotinc--I am going ta stick
w!ith tlnaft brand bcscause I like the fiasor--I' have been smoking
the same for threa years, because X like the ;lavor and S'
don't like Cha flavor of atty' other cigarette.
S2aator SsEzm.iker. You. are saying it th!5y raise !he tax,
you would pay ttte, hoe©y for the t.asfe.
RL. Valgo. Sure, yeHs. IC wculdn''t make a diffcrencm,
bscause it's already gonOlup; I can remgmbar when they were
500 a pack, now it's 650--aEad I amsti7i1 paying the price.
Sesnator Kennedy. Whzt about any of th:e oY.hor.s on the
coat
---
Mias l¢silley. I agree with what h0 said. It doesn't
matteer how much. you pay for cigarettes, af you smokea; you.
7
ar® just going to bwy bbom anyt:~ay. Aad I doc' vt1ink that
;
too tsaay peop?e, looY., at the tar and tnicotizo quantity of the
,
cigarett3 Ahs:a they btlyr th: ir pzct-a;, you know, it jum8 d.epr3rsdis
oa the taate--iL' f.t's got a lot of tar ar.d saicofi,~, then youl
will s^osa i`k with a lot of ear and n±coUrs*,» If those aro
t:oo rarsh, thez you sieoke. low tar cigarettes. Ti.aM is not
uuch difFes'ance.:
~
SWaatcr Ciiafe?.Doas :Tna prica of sir.c3;iug--in oLhor Words
10
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Lung Aesociafion, and.other appropriate corsnunity groups.. Not
that there has beenzexo cooperation, but it shou;ld'be greater. s
Whenever possible, children or adolescents should partici-.
pate in the development of new prograA ma,terials directed to th
and such materials should be tested for appeal and effeCtiveness
before being produced in quantity.
The number of anti-smoking spot5 broadcasat on radio and
~rograms should be perip:atted.to purchase time and thus. control
the frequency and t3aees of placement. Persons responsible for
I
Ratger than relying solely or~ publ.ic.service time contribut d
hy radio and TV staLior,s, orhich is e-.tremeely iimi,ted, especially
l~uri..g time periods cshez a large audience is zvailable, communit
television has droppe3 sharply over the past ffew years. And th
following conanent,rnight be subject to change, depending on what
:happens in the cu..-rent FCC proceeding, but it's urritten in acl-
vance of any outcome oa that.
shows, documentary feattures, and special childrens' programmisig.
aapropriate use of taZk shows, es3atorials, szgsnents on nerrs
these progra.*os should seek to su.pplementt paid commercials througl~
In the saree er4f, loca]l control pr;;gttams should be ab.e to.
pur_chase, spaoe for ixisp_.ay advertieing in newspager's and in p.;;
W
~ -
wettropo3.'itan magazin_s.
C3 "-
Ccmprehaiissve p_agram.,, s2ibuld also include atte~ijts to %I CJP' Y
utilize other vahicles in the print media, such as nows stories,
4~1
feature artin'~:es editorials, ca:;i:oo:Zs, ar.dletters to the editc
- `.
105
~ TM~.TM12`S OF' L.ASAF.TiE D. &EIC tJ., Ja'. ,
RS'.D..r YRjSI,DEk.nl''-EA.ECT', ANLrRRSCAtd CANC3R
SOCIETY; DOP FLB.D YOUlbG, M.D., 1lEM3£R,
AKIBL4SCAN THL3RACT_C SOCIETY, AND FOE~".Bit
=DICAL DIRI:CTOR, ANERICAN LUt4G ASSOCIA-
'i'ION. ROBER'1' M. D1tUG13'd?.'t'Y, :TB:.,, M.D. , _
PH.D., CH.AlR2.lA.N, SUBCOMIT-rEE' OAf, SMIOY.ING,
ANERICP.tt 13Es'.RTi ASSO.^.I?s.T2'ON;. JOHN ' S. RAf33A1:F,
III, LXECUTYIF± DIRBCTOR IWD CSiIf*` COUNSEL,
ACTION ON SMOKING AI3D BEALTB
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Sauatow Reza.nedy*. We have a i3r:al pamale LaSalla befffall,'
i
presid:nt-alech, A:melicanCanc©r S.c=ety; Doaald Youag, member,
Amerycau Thoracic. Society, and forhmeas medical direc'cor', Ameri-
can Luz+_g AssociatioatF Rahert Daug;hLer;:y, Cizaiaman, . Stabccfmmittem
or. Suo}.i:egr Aner3can Etaarl: Association; agd John Ba:nzaisf,
e:ecutirrc, darcctor ard, chief counsel,Action on Smoking a:n3 .
Health.
Wa w31l, start with Dr. I.Ofyall.
[The fo3lo*.:.ing was rcaccsived farr tife rscard:
ill
Simultan,jously,programas which have been test®d and
proaatti, se:ch . as tF:e . Primary 6rad9 Bealth Curriculum Projeot
which the T.m.erican Lung Association. has 1iolprcd, dovclop, can -
be much more widely imp1.~ coiobed. F.n e¢oraous aa.oaast aeeds to
bas2:: C
be learned in the areas of prevention, espacially related to
the use of tobacco products. Wi de,J.y applying t3ii:s knowledga
will be aeE, even qreator t"zsk.
Title 4' of tJze Hatioaal Diseane Prevention andiacalth
Pso,uotios Act of 1978 is a good. begieaniig.
f
I will bm glad to anssv--r any questions yosumay b.sve.
II.RY' ItJ
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Sonator fiC=Gdy. Bsfora WID gc2 ghGra, let'ss hear from
oth3r msmIaess of the gan02. .
Dy. IIaugherty?
QTize follQ;aing was r.cvivrd ior. tha reco_d:
2s
one in Ncavc C rk and'. so on--and oue of I( 3 things that ofxen
happened a;zs that th© wheal was constantly being ro-invsnted.
If we look thsougn th9 litsraturc, for example, we are now
r
preparing a section of ths Surgeon C-emeral's report on prs-
veation ot' smoking in childr«n--onee of the things wa fi;nd
`
in that literaturG is ev®rybody re-invents tho,wktcel. And
it seams to me that,it vrould.be very, very important that the
fundiwg would be so focuse~d so. that it wouldn't becon-,ea
a
bottomless pit of every single coraautai.ty having to,do it oyer
and over again.
I thisk the testi.ms+ny of tho. children haxra, was very re-
vealiQg. Hero are sorao children in Washington, II. C., or
whar6ver they wese, this ge..~;eral area, who are say{ng thirags.
prescxsgly what %-a rsow knowcha].'drau are saying inHouston, in
23h.arEeapolis, and in L?a3o Aito, California. _ Thes® is a lot
of generalizability about theso influoasccas to smo7ke. So,,
therefore, I would say that it -would be very important to try
to focus thW^Q e£iorts, d2velop materials that could ba
distrihvfijd azCie:a31y, a^ed posaibly not go throu,h this vary
tedious ar_d s3oer-soving proce.5s aE Overy co~^.znity, you )uaow,
@oir.gg it over and over again.
Fszdd so in ttir.as of zesources,3.n . 'Ik~.~rma of dol3.ars,, I
v;o+±y~T say t'~a"~--z.~.5 Z~>sz~ it's a k~otto~l.ess pit~--Z sas~~:~;d'~ argue
that t%e Ilc-gisiat:c-N you p::oposc waiuid scen to ba a vegy, very
. goad bWxg:.rztirg. But also I thin'c critical _,:vicrrs to make
"les,sons" IC plan our sch¢dLlass, targd. our "students."
2~.
24
kZO are not opposed to buying othcr uoatcria7.o for ©ducationall
purposes, why not t,fien , buy time? aQd let our "lessons"' not
be pedantic, authoritarian, establishment, or (forgiva me).
"health.educatoz" lessons. Lst our "lossons° be as bright .
aad,smart and mwmorabla.as the most engaging adv4rtisiag.
aaound--yca, even as good as cigarette advertising.
Y.ast us apply the Sbsams Streat experience(nhich by the
way took its cue from Tv com-A*rc3als--thc ri-ht le: gth of time
for the at.terationspau of kids, and =ight in kmeping with
erEis.tt.l:ey're watching on TV anyway). And let us schESdul®e
our lessons on the right programs at the right tim6s, let us
great newcFassrocm--surely the critics of sV do. consider
tt'a sex a,ted violcaca coztrovs.rsy that rages right now, the
`
repeat orjr leasons, rawaanberi'sg that @hsre are aeaa* &id'ajoirs-
ing the audience every day. Lat us thir~k of teSeviaioa as the
au.gared cereal, the idea of ban.-sia5g TV advertising to kids
co::cplctely, ` eSnd, let us st.-,rt soma naw idoas' about smoking
ceraiFag iui:.o k.`<.ds' 3.ivQs, l'ot us giva them counsel and support
a nwyr clbmatc,- a happy, infor;.d, non-punitiva noa-smckizag
heaith e.nviro;=2:at. L-sM us bauld a gosad' habit aq~ the cQ1Z,-y :
.,: respoct and eQ' x-caoith ;:ha't go ~a wif Fs it. G#
That mGams uahfsng rirsa, plaamiag schedul0s, creating 2'V ' N;
camDaWgwt3, b@Intj° as p?'C?fGssiona:.an(<. Ctffirce..I~.vG jaa,, our efforts
~ 25 I~ against smoking as the cigar[~t~c:3 peo.a3c arc in promoting it.
.
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wfll -ar=perimQn'Z:--scaokiseg
fmw cigarettes is not
all childr
tha iss.ua. But the raal Ching that has to be done, we believe
strongly, is to stop~ the accc3lerai:aon toward` addicY.f.ve smoking'
-that's the point. In other words, gradually they bagan
smoking experimentally an d then tchey would smoke a little.bit
more; finally they* would get to this point whtr* they are
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1s
~ really hoo'ked--and as we hsazd hors, a.L7'-yoar-o1d can a1-
ready be hooked..
Senator Schwaik+ar. Dihsnare th8y hooked? In other words,
packs per day? Q,: , how many mon.hs of smoking? h*ha.ra is the
hookisg point?
Dr., Evans. The hooking pof.nt is probubly--probably ba-
gias to move when the rc-yumatcy ouso begins to approach,
for that ago groLp, about half a pack a,day or more. Now,
.tha.t, by thge way, isn an empirical quest9:on that I would hope
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that' Rfr. p' . ianey,'s reseLLrch sulpport, wou`sd' Aoo..' into much nore
carefully. I think that wa Qught to probably know a good deal
1
li k3~+ds offini-
lca?:e3 in vaxn tFsrough srhmtesratszc~ for vj=. d~
~
i awrs3z aooue tsaz parr-3-cu iar . zssuc... wa in our own researcn
'
'civ$ da.ta on that very point. Sv.t: it saoilci ssem fxam our W
~
preliminary data that tY~..:.s is what it seems to me :",if you can w
I . .~
~
, sort of stop that acce3'cretion bmforo sAokf.-ag' gets to th© p
i1
zrequa*ecy where it approaches about half, a. pacYk a day, and' you
[ cars mairta:n that or have tl:c'a drop kelow that, or pcr.haps,
~, obviously, more desira;bly,, ^ot to star4: in the lirst plac3, we
I
Dr. Lc~ all. Thank you, HIr. C2+.a.it ?n. A clear need
c+r' prevOnt~':gc mQdicinfl is shown in official statisLics oa
cancer death rates.
Among patients diagrasod dur#.ag the years 1950 through
1959 ' aand included in the tdatfonali Cancer Institute's end r®-
sults stualy, white fiva-year survival kas 39 psrcQa*, but
black was only 29 parcent.
The sar.ee th:.ng sha"d iip mit:t pa :ia.nts diagnose3 during
110
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tks yezLr3 1960! ti;.hrough I9'SG- white fivo-yda,r sarrvival was
4'0 parcent and black was 28 parca.nt. I, incTurles a table hore
which I would liks to submit, but will not qao2ea it e3ntirely',
just,say that 4:hc survival for blacks was csrnsisteat.a.y.:7.ower
tham the survival for whites.
Alr. t:haisma.n.y I pazsonasly hzpplan to hawo bsen involved
imm a.study compariag patients ?uere in cur country and in
Africa which shows that these excess black deaths. are, ia-,
fact,, not racias, that is, not rel.ated to t,hse+r' genotic
make-up. P~-_therr sosastk:wrg is happeniQg in tho Uc.it3d S:":ates
to black Fmcracans k*hich is not tza;p,e:raing vo. United ZtaGas
whi; ~s to pbe:iuce a C3nceT' effsct t_hat is greatc3r among blacks.
Spdci'~fically,, measzircaum:: of all cancers in tf:© U. S.
~.
oa a sanplo basis dur;.nG thayr;a?a 19.50 to 1969 sho,,rta that
`~he d!oa..'h ra6a fro:a cancer a,~eong white mzies was 174.04 but
r,oncahi~'*e malee sufiored a death ratz from ce:.-scer of 3~.84.28 d
G9
or , 5.9 p:>.xceti:, highc-z.
.
103,
Dr. Sk sehart. I tsin.k that aa:of , of rconey is not un-
'
reasoneble, since somc°.h:,ng on the ardflr of $40 million a year
is spent on the advertising of f3.uorida toothpaste on talevi-
,;
sfosa alone. So this sGeass a rai:Lat ively modezt scale, I think.
7 asa not sure I wsW:d agree with t3s. Grean, however, on the
national scopa of an initial effort. attl may not be at the
If Taa psss this Zegislatioa--you say it
is an iFCOartzxi~
17 (il!
18 U~'i b7g:=ing---hota are wc going to do iQ this battle? Hvor sLccosg-
i9 ; "uZ wilB uz bc inretiCrs
~
poimt where we ts.AicF4 ' cuough to do it wcll aa& consisten4"J.y'
wall. It might b3 Prozth it to try a p3zotprograci in a numl'aer
. . . .. . _ . . , _.#I _hA
of commn:zities on a rsore li.+ritcd basis--dividfl °sat goszay, say,
ten ways,. that emo'ant of mo;ey, for a one-ycar pericel. Eeyond'
that poirst, wher© wsl lca:.n somethi''ng tsom'the variations t?eat '-
~.
craud d occur naturally across thoso commmunities, I would agree'F '
tlaatt a program. natiocal in scope would' be r<ore likely 'to ba
efecfi3.ve «
S..~ator S=rmecdy. E,~°; se ask you, D,. Fva_^.s, just a fiaal
Dr. Evares. FLll,, I Lelicvc--of cot=a3^, we, could spea-~: on
the 'aaso of otx data in a huge city, Hoa.Nton--T usCl4rsta:nd. you
4
Warss cZo= thare visit3ng vae Ce.;xter , and ycwu coLld see tha
Mskss:ivea gccgrap3^sic arcw i.lais r.ity ccvers--aoa, our eF2orts are
ftaking k*iw..~,h all of tho schoaZ3 in thiu arca. at the ma=nt;--
I a:2d If we can at leasm mak'e vc:.'~: projectlonss from the relatiucs
s;
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109
~ .
report of ~ ~ young stvdcnts who wore ~ re this morning. it
has also reco=eruded' endorsasmant of strongar death and disease
warnings on cigarette packages and in cigarette advertisffing.
Cur uull Public Tssnss Coaimitte® uv;11 consider these recom-y
,
mandations the ©ecosd week in Juree.
. .
There is no questfonin my mind that ¢he_,AmrtYioan canc+sr
Srsciety wiil, in a number of. ways join with this SubWa*amittee in
ssrking to strQa?a}t.sa 110 prevoat4ve mGdical measures that have
baza.paovesn efftct2ve in Iasts or daaonstration.s and which .
should now ha proliferatad.
We c.omand grou . on , your s.neroaah tathase prcb3em . Thanlt
you,25r. chairwaxa. _
senator Kennady. Dr.. Youaga
[Ttue" fo3~.lowing. was. rac$ivDd for the record:
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success we ( 7e hadso fas aad assutms C at--and by most stan-
12.
23.
dardd this costs rather mulc3st, as a mattor of fact--I would
argue that we would have a vwy, very good' succEtas. I think
the goals would not bave to bc ovetrwhalning. Zwould say we
could reduce the ousetof sssokiag:fiv® percont--that would be
already a verzy po.resEul effset. So if the goals are fairly
modesti, if you doa'tuRSCSaalistically believs.you can stop all
children from starting to smekQ or elia3aatie-a11 addiativa
s-oking, but bvgia to cut.into Phis, it will bogin to oad on
it6o3f, a new cl"Ss will. besg:.aa to msarge and it will becoma.
a low nose "'i.n°' for childran not to sao:ce than to s3oks.
So Y am saying that if the goals are ttodest and we don't
--fo_r exas~~pla, in 9;a14 a?-aa of daliac;xzency, the gov6ramCUt
agancl begins to say we are going to eiim;''aate de':iuquom.cy,
and that'stYze wholaso point of tha pragra_Tn,. $hat's rid'iculous--
but if cra talk realistically and, fox szsasnpl.e, suggast modest
ga<_as and project thosa and mova a'sor:g that way, I thxxsk we
.. - . - . . . _ -'r
wouLcl~ hwPC gu3te s., high probability of success based at lsast
,- on our data so fa_. .... .- ., ~ .
'/j Seuator IGoosaed},r. Okay, thzzil:k you vmy mLch.
today just.lacause of advertising.
Today, advertising is only one factor. We've been a
cigarette culture for about sixty y8ars now. Three ge.nera-
ing other people smoke., And considering it a perfectly ac-
tions of Americans have.grown Lp smoking themselves and watch-
We only learnedithe worst fourt.een years ago. Fourtesa
years ago the Surgeon Gencbal issued his famous'.repor's, and
- `~
we found out thax cigarette smok3szg, one of our dearest plea-
ceptable3 pleasure and habit.
to do:mora than,sell products. We learned to use advort:.siag
commercial techniqtites to "tell Americans tho F.exrible naYrs and
snras, was a thieg of heal..hp a dsstzroyer of lie.
We also learnQel soma :hing elsc in . thesee past fotirCmea
years. t4e learrEd; thafi' we could usa telovision advertisi.ng
get thwa-m to act on it.
And for as long as.9:he Faisness. Doctrine
.cigare.t¢es ware also adve,.tising on racis.o a.n,d TV, we were
25,
highly visible and vory sucasssiul. We got millio:,s of peoplo
STta..nn vre b3.nzac-d cigF-r®ttes from radio and TV, wa: lost our
i:a stop smo..ireg, cigax=t`~~,o smo:ti.s.g waclin.,d.
ms.ndatea pr'mo-tiIo vs:;.Fosuaea, our mab,c}~tec3 srequc~cy, and ws
.
A ,
lost a viriloQ:Q ene-.my to pit osr=kves , aga:.nst. And cigarotte+
dY.
~
~,..
~ $:.L2cQ~ %?±e23~~.a: s_T'..~.^'.:s have fJiiG+°ln basically "'0~
..
canEin.. a ~ ^ ~a to ,~o ~.th-3 gh~L~o ~ . c. of ~ rar.~.s ~. Late . St.~acr.~ .~'7..
f ttL~ v . catch as catch,c,.,
smo'tiLIg ru~ga:n to cliurb.
machines, particularly the unattended vend'ing,machines. As
soon as a kid is old enougn.to reach up to the coin slot of
a.xWnding mchine, he can buy cigarettes.. He can't buy a1-
cohal,, he can't buy any other dangerous product--and there is
no excuse for that.
Fven more effective, I think, would be again what we
have suggested to the FDA, would be to l.imit the sale of`
ciparettes to drua stores.. cigarettes contain nicotine and
a variety of tars, all of which are drt.qs. G:e Eir,ut the sales
of far less dargerous products to phar.nacies today. I see no
reason why we cannot do the sar.e thing with regard. to ciga-
re,ttes.
rettes.
We have also asked the Federal Trade Commission to require
in the ads as welIl as.on the pack a warning to the effectthat
cigarettes may be addicting and/or habituati:ng. We think the
evidence today is clear. but this is never mentioned in the
ac]s. And indeed it has hardly been a topic of public discus-
s.ion.
We also think that additional effort should be directed
toward helping people--not only kids, but all adults--to quit
once they have been hooked. Smokers--and this should be
emphasized at a hearing on s,-aoking--sauokers are not the eneacy;
smoking is. hE`,y tells us that nine out of ten szm',-,ers wouLd
d
like to ouit, six out of ten have made a serious attempt to
dC? so. Yet very little research goes into how to help. these Q
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110 .
Or.. YC ag. Thank you, Mr. Cnairr( s. If you will e:ccues,
at the ahd of my pressaatation--ttris aftsrcoon I an speaking:
on prevention in. Ba.ffalo,, and I have a pia.n.e to ca4ch--i will
ba leaving.
I ara Dr. d3ona2;d Yovng, a mamlar of the Araericasa Thoracic
Society and fozsuerly medical director of tho P:merican Lung
Association. I Iaav®ia statement which I will submit for' the
record.
The Puaprican Laanrn Associa&.ion strongly saapporttss t:h* di-
seasa pzawentiov provisions i:~cludsd in Title 4 of the National
Disease Prevention and. Iea,lt..h Paoyotion Act. of 1978..'
The Al..a has long supprrrteeZ the right oL' th® non-smoker
to hrae4:es air. Chad: i3 not pollut,:d by the s:no3ta of cthMrs.
kTe 1oliGve that thQ fcderaZ govQrum,,.-tt should be a lead.er
torrard this and by rsand.ating s:npe.xate areas in its own gaci-
]iifaes.
1-76 also support ar tar. on c,* gasGttos which is related to
ti2e toxsc units in the cigarett:a. In addi'cicn to tar and
nicotine, ve are of tLa opinion that cancen mozaoridn should
also1e consiaercd in any coEepLgatton of thess toxic units.
F:a are espr.cia2l;{ plcaEFd to note the ~nphaais on smoking
t
preventien cf2oi4s dircctsd torca..rd chilcdrenn and adotescen^Yah hiuch moLc ief~m:z.4ioa neo3s to
he gai.^cd to impreve7 our abili-
ar:
ties iza, this diff.icsat u arlaa, amd tk;L cor.,<3aeion off racearcldw
all
~
and Zemons'-rGtion wi_th walWae'~'^~, .JiZI add to t~in b.rowlcdge3
ing and useful st"_atesaut_
Lo~ me , aslt you about--if we do what you sugges:, Ms.
Gr8ca, Ds.. Evans, what ra wa talking about in tc.rms of r®-
sources. ft aro star'~~g off xather modostly.ou 2Ynis.. I'
- 100
, t.
Se¢a9:< nearsedy. Thank you very C.cti, a very i.nterest-
T.
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mean, we get to a poixst WlierG era are staztisg off so raodastly .
we are not going to. make any impact and peopie ar6r going to
say we failed. a2naiounl;n we have got to walk before we rua.
But to do tne kinds: of, things that you are doimg, wiaaaA are
Dr. Evana. ft31, of cours&v, like you sugg,essls®d, one of
the things that would be very, very fsaportant is to develop
we talking about in teams of, resources?
films, wfhatieaer, that are maacieaZiy oaparY:able. For exaiaple,
acs a, result of, my aQpearas;co ork the Today sh4ta, savcra2 wseks '
ago, dS:scuss.a.ng our projec" erW have gc:;: an averagc of forty
regassts a wuuk . Eor various sc2icol dicLriots around the Untt+sd
States e-anting '4o um ou._, films. We cs~aiously are not prs.psred
yet to say wa <sn distribubing unt.i1Ir3 really haVa our r®-
searchb data in.
But it aeems to u:m tiaa:: vlc co lc3 do 4.his fairly modestly
ir', M'-- , thfn1; in terms of trying to duvea2cp Lh3sa types of ra&-
tes ials that could b3 na:rizzPZy dasvri: utz3 uatoioaa7 ly, that
is, 4:F±e biggas., p;:oblr~m of fece~°a2 pragraas over ttao years-
an3 I go back to the aime c:hn vic had the a azga d~.IiucZuemcy tj
0~.
1p?~ogcaras--ar.r2 uiract-d cc.c:i a p=ogra,.: ~n Houston; S~iay had ~'0
~,:
~
35
flioir msssagess flowing, kc3ap their ca,.-~paigs:s coming, keep
their product visible in every miediutn opea to them. They tar-
get,, they schs3Lle, they decido what tzey should say whpr®.
They repeat and repeat and respeat. They know every cigarette
is aA implicft ad for smoking. They build image and reinforce
habit. They are the one constant presenc3. They put us to
sha...a.
For somehoFr--probably beca:x3s wµ.3 call.it advervising,
~:.:.:..
,.,.
23
prosper, wraaCe delaying our ourn fighKO
Noy I don't believe they have a devilish secrct. What I
do believe, ieade2d'what I knola, is that they are devilishly
good,. vmry smart and very professional: they know what to do,
with what they know, znd they've lrsen willing to invest ~hua-
,
I dreds of millions of dollars doing it all these years. They
advertisa, advertisa, advertise. They never_.quit. They keep
24
25
Wh{ch in m2ay ;uartsrs is a dirty icord.--wshav& been unable
`
to get the monay to make a concartied mass-m=dia,attar.k on th-,
smoking habit, or on a p3rsuasiz:a pre3entati.on of an aIlterna- ;;
ti_cga hahit, the habit of no2. nnohi_ng.
I thit9k we sh:oE,i.d chw.:gEt~-ee eord. bot`s not, for, the
sal:s of our childrea, call it "advartising.° Let:s cal~l it
.
?<~
°e3uca:"cboia"-- °heal.`.;x eaucatieca,°' if you wlll. And then let
2s tcik® a lQaz fror the ::nbacco peoolc :~ le t us scC:edule Q
30-s,ra.^.oild. °1r33SGn9p°60`scico_.d 1'~4'esoTts," 1Q'-sQ,7cOFkd °l@Eudnsn-~
or 2-minr.`e '].assons:." Lct us buytYce tisae to expose our
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e1'::d 25
cigarettm C-iikeWa numbe:cd about 12 pit,lpr_t, of the wh:.'tles
maYcs compared to 2?3 percent of the blacks. So you caa see
tl:e real exc3ssi.we hazard amesg black A.sxf'.cans.
The Ataf-ricast Cancer Scciety has sc'aeduled for n"t Janu-
asy a conference on t4%e subjcct e:` canier and b2ackPs=ricaats.
At that tire we think wa will lnarn a great deal more than v7e
now know about the dismasrs's irtpaat on aaioorities, and about ;
the gascaptiions of minoritS:ea wi;.h ro.gard' to caaeer cause and
pravcni:iaa. h*o will no doubt Yiaya novr insights on the prob-
`
bea of~ cigasette-rel.atmd canr.cr among blacks.
Meanwhi?e, vr«3 eea in buses, in magazines and' nawspapexs
cigarQtte;advertisi3zg a=plicit'iy dirsctcd by contm,nt or mad:ium
to tIzo black com:n.uUty. "ihe data already cited represent
stror,g, avidence that this advertising is efcctivc3.
Mr. Ghs,iraa..+s, our Society has just receeYay received a
report : zo:n a sp.-.ial commi ssiaa3l haadwd by a form.er ftFN Assis-
tan4;. Sccretary for Hz-i oxath& subject of cigarette smoY,iag.
With. study of that report, co=it1:ees of cur Society have al-
rcac.y bagun adopting sa:.e of 'tihss racomacndati:ons of t3to com.
aissicn, which he3gd hearar,,gs iz3 se;ccral cities to get cucpert
testir_onv on tk:a smskirsg prcblUcm.
- c,
For ins`aancc:, a sub,^cmc!it{;ea of our, ¢coi Pubz ic Issues
Cos;ai4tes has already rcce~~~ncad, for 8ocifaty esdorsasmEnt a
axfforcrsftia7 tz c on c3lgarettiss a.coo;,dAhg to ttae;r tar an.d
ntcoti4a conte.+xt.. I make this stlitcmant having heard the
2?
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24.
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112
D~. D~;&ar&y. -2ha:a,k yoa, b?I. CiC..rnian. I am presently
the do3n of the College of Hunian b?sdicine at the. IIsaivessity
of Wyoming and ctlairman of the Stibcomzcni.ttee on , S7aokl:ng of
the Amet;fcaaa kc:art Association.
I appscciafics the opportunity to appear before this Sub.-
comaittcra aa behal£ of the 11-maxican Jiaazt Association to testi-r
fy in support of tlss+, Ra: ional Disease Prevention an dRealfh
°
pzamotfoas Act of 1978. 1 pcrsonally cor~.-end you, as a madi-
cal educator, I am pleased to Qtia som:,c+na take soae leadership
in the area of preaon:;ion, as a.~ look afi, the nation of health
professionals tLat we have educatsd who axe c.oro interQated
in th%r;r?Xgancy room acd cororasy caro ta.ui4:; where the heart
attack victim coses ia.. Tt is pleaskag to seo somsane take
leadership in h;alping us pPcve:.Q il1r*ss a*ad, iAn fcacfi, main-
tain health. . . Senator &ennec1y. We might got ycss
issue affioyhov time, on tha nanpru*er.
back aex2 on that
0
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C~.
Ds. DacMaC7yy.. Cigarette smoking! has be-ra hald rsspou.~~~l
sib1e tox many tho?: eEn3is of pr2mwturb d;,asshw aaacw yeas. Total
mortality is'arica as high azmnong ciga.re'etw smokezs as atuong,
szsaokess. Ma;:?.y of G1ieso s,r.o3:o.:.s d'eee of casonarv heart
dsacass--t:a4^t is, Y.m,<,.ct atta^ :, which is the ?ea.di.ng cause of
prL%matiare death zJn this cou;.s'ary. Hcai:t mdtac.l'.t kills more
pacp7,s than any si..g3,'G diszaso in this .:ouatrs. 2;1e majority
of th,asi3 p--opl4 a?-G mes in the prim-a , of t.hsir livzs. They are'
94.
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45
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3$
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#, cray, while c:c ar,;~ waiting, vrts are netsimply letting thcm ~~
25
can, to cosUtp not agaiost cigarsttos} butagainst zoos and.
adoption agcuicies- and awhote passe?'of other worthy causes.
The irony is, the cigarette compa.n3es caixt:ine:o to spend
garettes, while Pabt'ic h©a2th is a beggar, depending on free
millions and millions of do1lars ave$y year zdvsrrtising ci-
campa#.gn against smokfsyg, unable to targst.a market or build
hand-omts.fom the media, unable to mount a serious'steady
a schedule, an audience, or, mostimportax:t, the non-smoking
habit i*self..
Etow it is very temptiug'to bel.ieva that somehow the
c1garat.wQ companies have in thEir deap dark fiics mys°.erious
secrets that Gnwb3o them to mazipulate us into smoking. I
don't beiiavo it.
I bslicva we knoFa as mtich about smoking behavior, smoking
appesls, p;rar groua pressi:ses, social leaders and followers,
c+mot.ion£, at al., as they do.
Thsz National Clearinghouse for
Smokiag acd H;;a7:th has been collecting data, the.Amorican
Cancer 5'ociety has been col?&ctiug, data, tho NCl a.r.d all scrts
of social psa°choicgi sts, socioZogists and other int W*Qs :zd
parties have iateraisw3rg, surveying and coRkcptingdata.
For y,:ars. F.;nd we have our own obsrs;vati oaes over the yesars
~
to.go oa. Amd S don't believe that if we ever do geW the
, cigaretto cc-,epasaies' studies we will suddL-n?y havca tiio Y.eys
23 Q
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to turn ,g cf?: a.u habit in t:cin Air-ezicac pun'.ic. (Hy tb:Q M
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. 113
Che xatherk nd tlie hkeband3 of fam 1.13C . Its intereat3xtg
to no«e this mm,-niag, in Senator ]?ord°'s prastsntatIcu, ho
talks about 80!0,000 familios involved in the Caba~cco. ins3ust.ry.
Y'gtis is slight b®ss than the total ntmber of peopla killesd
each yea+ in this country from heaa.rt attack. tasost of these
are the husbands and fz'h3ecs, many of tlze,m of families I
sa:re that raise tobacco.
In facg, ci.garattesmoking groa.;ly increases an indivi-
d:aal°s risk of doValopieg cardbocasculr.r digcaaasQ.
a-care of aa~ty res@e.rc,tt th<^.t shews a pYes: for dobacco regarding
caadiorzsou.]:ar diso2se, and ce=La3.zsly not isnn heart attack.
Cigarc{:te, smoking is No. 2I o4 tho 2ist of risk facWrQ for
Extart ahtack«
3ens.toc Rsna2e-~cey. Now, do you all agrep csiLFh that state-
Meut.3
(All nod. asseat2
!~Ot the record sYeoaa that they all agreo.
Dr. D'augherty. ..T.n . the past favQ yru.rs, ke have sem a
dacrea_Uca: in the number of deaths in this couatry :.rom heart
zt~cl:.. The raj<srr dccrc:aso has cecvrxed in males whore
cigaretto smoking has urereaeed.
. WE3FzC63 steiei!tg2:n i12:.Z'er.1ss nf'iw ir~"i.di'.e C's-laths f'+"QI3m hzart
atf".,acRE 'a'.~^o: g 4io,?uns S2hiC?'!, 23y03 know, if8 where BFBS 2SEd'e s£tf'!i
t:xr iroreacZ; pa:.IZicts3_.rly 3s :aasag r.o~1iE:a, in amak.+_xg,
viwca :iic; f: rs;: Sucgea G;:?z=a1'as res;; crt, aa s::.otting in
I ' v9.ll . givC 'You an o::amp2'a. "'Caacer ~^ resute from cigaretto
smok9.Dg." 1£. is ve . rr d_ff-icult to pwovo a causal relatioaaships
attd ' yet the "may" may incite a dbuht in smi^.:body's rairsd. "eau-
Senator 14enzaedy. P~ll, isa't it axi accurate statsmgut?
cer of the lungs, moutta, ansi Y.nroat aay rasult frc:n cigaseitt®
Is it an '- acc urata' staEeneat?
Dr. Young. :as, 3 thissk it is a very much an aCcssrat®
G:-.:_
14
sit~.toment, aasd' the qusstioa is, is tha "naay° straaag snough,
is theire anoth;r -walr of plra as9z:g it that is evmn r>tc:,osigsr than
tha "May."
Senator :[ezaney. I see. 1i3.1 right.
Dr. Lef£a3:l. In tho Cancsr Sociotyp vro thir.ak that it is
an accurate . stG.tcmwat, a,-d also wa ; hisik that pDrU.aps $7is
~
15
attack, fhzn we ought to say it.
~~
LFsrs best sts:te<a:cnt nctv, vased on e1hat Eiva 1tnoEr..4cnator h~,..d},. Al:3 ri ght.
Dr. Daughczty. yesR I think the odds arL--you know the
. . ... . .. .. . .. . . . : - , .. ,.r..~
oi,ds crc3 high that if you seoko you are going to tEave a heart
Q
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.
raseearch to gain a he`ctsr undcrstapeling of tha mochamism
lb
We also supphrt the in.ftiai: _ve to cantinue biosedical ~
tztr~c~;gh which cicarptCS s~cyAzxg corst-riErae,.rs to wM develapme,nt
of czraiesasct*3 y d'sscass, ba't a'so to caut:nuW rosNa-rch on why
peola3;j e~ol e, czpoc:.al?'y yov--tg E,~or"s'a. Fs re haard har© today.
67t3hflara' lot oi rC-u'so:iYS, but we ;.$"-^_-d to CTosuiwa6j our research
10
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i.-a that aaroa.
112
And aortainIly the ~asEablishra~t, of programsdosigned to
deter smoking azsong ci~ildr:an and s.flolgac~znts. As. w&havrIIe
heard here today, this is a major problem and ons [e3c] that,
we a1Yolehearteclly support.
The A*nerican Lea.~ Association st~3's ready to assist
this Si~bcom;nitt,~ and tYtca Bxparta^~ct o'Elealth', Education and
e~Ql£ar~ in your QE£orCs to improve the hcal`dh of this nation.
Thank you.
SaRator I~c~dy. . ^ha~t~ you v~~6xy much. i3:~:. 8ac~zahfc7
#t. Ha.uZaab£. 74'~tcsaii you', Soaato'r .1Crrez3dy. My name is
Sohn Panzahf. I a~ a pro£ossor o£ lawo Gcargo i~ashi~egton
tEaiversiy, and also ~ccutiv® director of Actfon on Smoking
and HE:3ldh. r
To paraphrase an o].ci ciga.rot~.: e.:e ccmmsarcial,, we are legal
mc~st not m.,dical men, so my tsestimo'ny will be slanted a little
'
I bi°~ di fea~xstly £zc~ that of my :a'l co~ lcagu0s. I also do
not hPh'c3 eaz&ras'f~--d ?~mark, sio salkn_ S was told that .-2 was 4A,
caI.3 and xCa.ct to zsYaati: i saer hsr0 this morning, I thouu,ht it
wauld, be scn:Zc+;:tiat p,esumptuous to psaoara thcm ba¢orahand.
..
So I. vrez=.d d like to eLriply skaara ' svue of my thoughts with you
on it.
?', ;rsti, fd=a~or, , S+tY?~ir.l: you a<:e to 1:G ' comg~ratula4ssd not W
0!Y
only for intruduv~irg this bill, but also £orYceldi:ng these
hoa.zizgs osn the most ipo-rS;aEZb and, to me, the most tragic
119
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4his is very high, yat7C believe ws spsnd somdtiing like $150
mill'ion already with regard to,tti3 problem of alcohol; wis are
budgeted at MY7 for $]:75 million wth regard to trasnage preg-
naacya and aven of the m.oney w:ch is currcntly hs;ing budgeted'im moking--and here 2th.ink the
discussion ss f.lluttinatiug '
this morrs:tng, becausa nobody is guiCesrire how muoh is
there--most of that is going into resea.rch, very little com-
parat.tvmly i~;s going, into education.
Seszator, looking at t again, in parv from a. ):ega1 point
of vicFF, it v:ould- be . my conclusoxc that educational, programs,
altho zgh , valuable, cannot solve the provlc.m--dgd that is. Qd4-
catienaY programs both in the schools or on,radio and to2evi-
sioff: Much.as I att in favor of £MQ ans?i-smoking m®ssagas
and having :hen~ return and condinuo, and much as IthinkI they
are effective, I don' t think that we can have an effective
an4si-snokizg proc_rr am azsd', solely rely on mducati:on, whmther
that is 4za tei.e clas3xoaa,,, on. radio and tW1avison, or vncerover
Maj,ox prohlam+. Wo don't . simply try to ¢duca.to our kids
.
alse. Irsdeed, wa d.o not with rega.rd' to many of our other
.wegard' to sexual activity cor_f:racti.s ard otharwisa.
do the sWm0 thing with ragard to porcographyl uve restrict W
ths3 ewcisyon-maakizrg , pouCr of chn lelren iuso£ar as w0 can uiCh U~i
variety of d'rczgs, we re2L.rica the sal- of WdioNe drugc. We
about alcohol: r.e restrict vhe sal's as best taa can oi alcohol
products. ka du?s°'t . simply wern p~.Iopia about ttss'daagers of a
:a
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5.
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pdhy 's'c R7hy aotjest fi.he . olassr4f.i? Fie have sc3x edu-
cation in schools and'yet our unwed teenrga mother papulati.on
grorrs. FQ® teach hyg,lon.e in schools and VD is on the rise. Wo
teach the dangers of drugs (and hids today Icnose more about
s druqs than-the>r teachers, I'm sure), and our drug problem
persists, and is now reaching a youzgar.and.youeger populia-
tl.on.
We may not 2it.a it, but school is no` whe:-e kids learn
thal:r basic values and ideafs. As a ma&ter of facfi, it . never
was. We have always 1earned from o zr home and our friends,
aaxd' today 3~;n the hame,T'g is pe:;.haps. ;he~grGa.ffiest~ influ^.,nca
of all. So 3.f, you wanfz to got to~ the youngsters, you've got
to go kther.e th.9 ,yoisngsters are.
Cam youk °se31° a health habit theiway you sell a pro-
du:c:t3
I ba1i®ve~ thzt2 too;.hpaat;r advozt, uin5 has don$ more to
build the habit of brushing (and witkkh it b3'cter dsatal health)
24
25
bodiGs to our hoaee--build pears.oml hygiene and' with lt a kiad
of socis.l coz+txol ovcwsr comuna.cabl'e dis.^,asns than schools and
c.
_ t.
.
than al2 the sc::eols and dc:atists com.riinmd. I bvalim® that
;.: .a
soap adtart.isirg has dQtzt aore to bla£ld elyarelr'neess=-from out'
P_nd I kaow frora my c-n p~scral w-parievue with the
,
.'kmrzicr<e Ca..*..oEsr' ycciC:y and tH s F",atioara.l Cleti?'inghcuse for 0
CS ,
.
S: oF:znq and 3ea7.f:h thz',: you can ina;scl iuilc:Wuace h~~alS:h W_=-
114
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19f>4', the c~ kribti4:ion of' ciga.reh2r~ szfi'eg to the dcvClopaent.
of'hQar.G attack and coronary ia-sarh discaso morkality has been
fvn rkhx canfixuadd astd s7zm_ngWhW~.Zed by additional opideai.olo-
gical',, clinical and anatoraical eridenca. Cigar®tte.smokirsg
has also now been firmly cor.nected eriiYh tho one3g of paripher-
al erterial disease. Ths risk of cardiovascular diseasa in-
creases in praporki.ono to thm:aum33ar of ci'garattes snoked asad,
the duration of ex_posurat to the habit. Aa a matter of' fact,
a parson who stops smokiag immadZ akely reducas his risk dowrr
.
v®ry close to the prrson wko. ha3 nsvor mmo ,ed at all.,
ThT Cffect, thgs, of cigarette smoking on cardiovascular
discsane 3.s in.dper.dat of okker major risk factors. s^h© risk
a s g=EeUy aggravaahad, how4ver., if you havo a high cholesterol
and a?rsvac'.cd blood prassuxp or dia.bsetes. Such high-risk
p3rsep.s who also smofte a3acaa, kI':.emos2vas in serious je,opardy.
.'reo smo:ncr can reduce : 1'sic hcal,;..'s risk by srao:t{.r.g fer;ar cigar- .
G4:tas.- but 4.:.,.o _cnly sure way is to stop .moYing. A shift to
cigar a~d pips =-eki3g is not effective if the former cigarotto
saao_cer co:el:..f:nc:®a to inhale.
In vin o&' this evid¢nce, iinkir:g cig,arctte snoking to
cardiovaccular disease, the Americaaa gea_rt Ausociae?Joa applauds
w
yoc, tir. Chairman, for ir,trodr.cang Legislstian aipo3 aS:` rs3du-"
c:;ng h..~~~s, ffieylth, ccascquzece3: f rmm cigasai:ke s*r:oking. And we
csou?d supL:ort the foS.Zcz=dng pzcp^sad ' init iati'vee: 0-:
Lj
.
1. zhz isstitu~~:5.on- of a; diii'are:l~'..aZ fsderal i;a:t on.
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you think? C
.
122
Mr. Sa>tizahf. . Well, if I can fia£sb, Iwi11 put them all
tssgea,:aar. They are appea.riag on what is pqrhaps the oaly
coaip3Q4:ely uzypoZluted baach in the United States--I see not
even a grain of sand distarbad.
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S®nator Kennedy. Tt°'s off t4a~:ssachusetta. .
[Staughfio.r,'
Mr., Banzahf. The Y:ae,:E?r bahfud is crystal c2.ear; the ahais, cl:eaz. All of , which togo:hczr
doe3 tv:&things: k3.rsL, it.
und:ar'.nincs that health taaWniag:: if you look at thc rtotality
of that ad, tkaas: ast 3;s sayitag to yos it its asscca.atmd wit's. .
clean outdoor activity, it ira asseoiated wi'b, haz38:hy robust
peap3e---tcat°s the kind of guy wuaZooss likcse he could tai.e
off,, ;.mdd probably with thai arcicau, run ten miFe s:dosra the beach.
And that is tha kind of . imago that the people have.
ttuw, if yoc , could hold it up jtist s littlo bit further,
Senatcr, tE:o nG=t point S@.hizsk, ia important. That is a di
I, play ad. Faom h~ro,,and. I think probably from the back of.
tho rocm, most a,erybcdy knows wtz_> ts baing e.dvsartis2d and
cca g5a t%43 picturo. Hut eveu from h©ro I can't seo the health
I can see whauro 3 think it is. I ccata.inly ca3°t
ssse iL cr read i't..
Tind, tt'w p3&xal skede : C-=xa3BE:ou again has hc:ld tina after
'*',2'.::`a.A ie:lc':c: a'~.'l~is' ^c..2 unfair aSt}dcc.~'.p'.^,.iVfl'tF:c:dG' pT_ac~.':ica to
o.d"-
'; vsrtie3 a pr¢+dua`:. wst.hvut- rr.nroalip-g a raateriax fact. Certainly
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aspsc4: of t2ze problem of smo2cisfg,. thai;is, thoc-pidcr.-ai.c of
smoking among childsea. Aaci. Ithir7TI this appaars as a very
dramatic reactiosa t.o thu inatie+ argurn-an:.s of the 4obacco in-
.duo2ry about free wil'l., tiiat Secretary Cali$ano's program
and your bill and otFe=s will attack fxtse taill. We saw hsro
this morairag# the data ara very cSeBr, -Aiiat when 10-, 11-,
and 1a-yeax-old kids take up; smoking,, when taey zrr3 hooked by!
13 or 14 o~~.~s 25, 'rra ar3 not halk+ng about free will. I was
r.mused by some of Senator Ford's rcat:sks on how his industry .
is about to go ouW- of business if wo do anything a4ottt thG
pzoblsa of smol:ing. - Ono thing hti didsx' d msntion, of cs5ursm,
is t2ta:;t the tobacco industry i.s rapidly diearsffyf:ng and also
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more axsdmore tobacco is bei^ g shspprd overseas, particLlarly
to coeaumrics which unlike the LTni tCd States ar.d' som,3 off tho
e4ms;era Eezraptan countries do naL have or are nct d6aclopa:ng
e!'fsctiva programs of publ;c health Yrith regard to smoking,.
xthink also it is rrortM,h;la conf.rast3.cg what we do or ~
w]?aC, wa hava, talked aihiut . doiagi w: eh rer,a.xd to 3rnoTczng vith . r
what we do about other problems, locaaszo orhen we: look at tvhat
+ir
K*e do abm:art pornography or alcohol or ~.zage pre.gnrnacy or
ot3e3'Ti, 4iha~." W"Qdo, e'Vw°awhct w°pwoposo . to do, abbut smoking
.
is so ve::y, very fmalZ a^o3a?.mvst minuscule.
You v,re ea?.'egng laoi'ore about how =-actt umsoy crould' it take
to have an effo,cUvE a.tl-srWok.ing pPog=:M, and f1guxr:as of $30
Y~..
and 940 raitlion ti,ore tt,ic-tia around, a:nd' rrcenla werca thinking
a[ focused so that the
certain $ift ` these typos of efforts
products could be usod nationally.
Senator iezmx-dy. K*ca11, cwn are still, if you are going
to puarchasO the tiMa in couate=-adss and the other activities
'.
--Usn't you tal.kiag about ten.s of snilli'oss of d+ollars, azea't
Ms. Gron. Well, I thiak U~a haw® to make a coumitmeut,
too, sosnewheare down the line. I' would tta+nk that: wha they.
i¢a4sad.L.c®d the latest brand off ciga:rottas'-I think their first
si..q-month introduction was $40 mMioa--it csouldd seem to ma
that a budgo-t, if it weraa-aEd. I think it shou3d ha, by thw ',
way, national in its scnpa rather than cctnmusaity, Ytcaua® I
think co=zuaiYy cauuot use 4ff2ctivQiy,, first of all, thQ
Imedia, can.^~o4t buy ft as offect3:vs1y, and you. do not establish
sa sams kind of c3i.-natQ as you do if Irou havo a national ef-
foart,, aud eveFybody kaaous thsy are in it a11' at the same time.
So it WauYd ss~t, to 219 that you could mount a national
camps£gza cc-rtazrsly for as l9..:tle or as much to cover' it, where
you want to c2aoos3. 3t, as the cigarcatf°.e cszmnan-fes are doisag--
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so so*se:ah3.rg: like $30 to $40 million on a--wc ouc®. I bEe3.ne,
prepared sozzel:aincg for Sihe Cleaziughoasa, and I&.'SirJc it was
very modosh; it bcaan scm,,~wbere like $5 million aasd' mo^rsd ugr
to $50 M4.13ion Gvµ .:ua31y, soT vnang o F:aes s!o-t.
nue: I thzuk yeau e.;.xr,°-a~'dd you cam~ seesQ:;L?ts from what yoti.
7
Dr. 1t .gieerty. YCs., the pre-fesfmd $esnagctr.
Senator Kenne:c3y. Olcay., v7e have invitecl $hs Tobacco
;,.
Xnstitute to fsstify. They w5ro una.'olo to g2t their uoata-
rial 'b:oge4aaBar"for' this hearing at this time, bu : wa will
leave the record open for whatseer commos:t that tkeay would
liko to make.
ift want to than2k all of you very much. _ A very, very
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helpfu?l and iszfozsza~.ve *e¢arir.g.
The Sr,lica=it~'~z standas fn rra^..ass..
[Thr, Solrc=-$ttse _e-cossed at 1:10 p.m.]
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And', ( ;ond`a_, that, thare is no _C.c :ming social amffect
of smoJaing--tio you all agree on that? With the eitcaptioA, I
suppose, of' the isxceuae to. the paaticular iACustx`y, the profits
on it--but in terms of. other social impac£s, yrouu woulcl' agree
a¢ith that.
Aa.d that it is, so ¢ar as. your own.pxofessional and
Scia2xtific judrmCnna on, St, thztt it is tha most important
health hazard that we are £cci_eg in terms of oYr r society.
Dz. Casahor sy, erou2d you agree w4th that?
Dr. Daugh:eri:y. 7fes, I a-ould.
S eaator XenaEC?y. Aae1' D'r. Leffall?
Dr. F.cffail.. Yes.
Mr. Baazahf.Cgataimly tho mcst importa-at and correct-
ible oQO.,, 2 L-hinl. fsa terms of where we put our dol2a.rs..aad
our efgor4ss, Senator, wo have to look at taa ^4:hicg ac one is
~ - the im-gortaacei of tps& problem; the second is how can we have.
,
a iong-term affect oa it?' Thers aye, raany di'soas*s-and ccndi-
i:ions over wbach wa may not b3 ab18 to got co st.'ol in tha
short ru.*. Smori..g is nu one of'thoss. Itss r.ot only the
rioat irapfrtant,bw;_ ora of tlse mcst easily coiroc.:ibl.e.
SeLwtor . XcrulaQdy. °io:aily, wauld you also ag~ ~. that at
Lcast ii: fr__lm-a of cur acc!edy, 4:1}e area of very suDstantia2
~~ coaCWY'ta~, r-`3rhaO:s~. o»F3o'n'n t'.'ut$~. T]4ut,, oug13'Lt to ,^5-e d2.rfvetcd ~~ toeld^d
I childhood smotsicg d~ a lo~ u~ni iw3 ozr sociafiy:
Dr. L,.?Ebal'1. FGS, defi2sit37.y..
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Fsnoag C xwhito females tlba cxcosac L car4cer death rate
caas 7 percent.
Soma of the big probisn areas are in prostate cancer,
pancreatic cancer, stomach cancar, and canc(r of the bladder.
Now that we have definite data that at least in cancer
sitsss studied so fex.thd excess deat;hsamong blaatcs is not
gene$ically bassd, it is c2"r resmarch~ is needed tofind the
cauEe so that preventive aadicire can be uaed to salvage th4sa
liacss in the future that are trasgic.ally lost aww. One area wher® wor3: .a_ebng all ethnic groups
is ae=d®d,
wherG preventive msr3ic.`.rre is nesd:cd,, is cortainly in cigarette
smoking.
As this Health Sub.co=mitt" knows, lur.g cancer is~ the
most obvious cancer corollary of smoxiag,, but bladder aad'
other cancers are: rcaLata3: to sraang as well in s°,.atistical .
degroas that leave practically no. room for doeabt.-
in lung cancer, the whita and aon-white dsath, rates
are aory closely sinilar, thra ereessiv9 w?:its rate for mam
hoir.c,t 3.6 porcena and for wcmsn .3 perr.ent,
But it ia clear that special efsorfis oiasmoY.ing must boe
mado . among black graup_. Tee P:merica:n Health E'oundazion in
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1976 pubiia8:cd da''sa showiig that a.5a~~at 29, pca~ceat of wh9.ta
ra"sQs wore nor.-smat;.ery,, but o21y about 17 psrcent . of the
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blacks. About 26 nor4etst of thn wliitE ma1cs "Wa ex-sr,okers, 0
W
CM,
but only about 16 psrcant of tha blacks. Fn3 ncn-£ilt®r
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it is a materfal fact wiv.h regard to tIaosa ciga:at:es that
they can kill you. And yet that warning is not claar and
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conspicuous. And When wa look at them on billboardo, Senator,
it is oftsn A.chal5:cngo--S think even in Massachusetts, as
well as Sn all tU2 o"+:hc+rr states--to find the healgh Naar,i'ng:,
much-less to rna.d it. TY~is problem is,those kinds of ads
should' not be alloemd to continue uaslQss thea health warning
is made clear s.rttid conspicuous--a_^.d r.3Ye Iaa spea.;iag about
thn billboards, the pointt o£'f display, the onas an tha sid:ess
of buses, and so oa.
B:mo°,.h.ar thisg we can. do~ no4-j--a,o can do it todav, ws can
eve»a: do it without leagislatioa--urould bc to limit various pro-
motional tactics. Virtually not a weai: goas by when you can't
mlip a coupon out of a fzsally a¢ussspapar or magzzisas aad ssnd
away for two fre3 pacl:s of this, that orr lwho other thing. Now,
yes, s+ou c®rtify that you ara 21 . years of agQ acd . already a~
sreoF2cr, but hids are cmt ozough to Ynora that E.hoN can seari
away for it and gWt fres packs of cigarcttea. More and more
cigareti:es ara oP£erisng premiums, premiurss r'or buyisg fi.ta
;
product a::.dfoa mai]a::g th2m, in. F.nd incraasiQglg i;:hosc3 pro-
aaiums asn a!r`3 a"C a yo»wh abdience.. r'I.ca you hAve a surfboard
with as'c.ii?: on a`6:r V]hW.R9. you rs^eva3 a'S'-shirt:,. wh-?3' `y-oil, hav®e a, . .
besr coolcr a#s:,e3, at the L^-;:+ach cs:okd--cihon you have tEr.es© J:inds
of th£a:gs°-obvious?:y= t..+agse arc of' an',:erast to kidc, and hers
this venv difficaJ v de4; efon ta-a` Lho^e t~zpnagr?rg outlincd for
03603509 .
124.
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us tlsis mo Cing, schsdl:a-V to amoko or nod, whether to go to
lower tar and nicotine, is influenced by the idea that . if i
buy a fow moxe packs of Zilch cigarettes I may get that sail-.
boat. That, to me, S=ator, is unfair and'deccptiva.
Certainly I ticou.ld ffzzorr a retv.rn to the asati--smokiug
messages on radio and Co2Evision. .
Z' thinls s.Zso somethi'ng should be done about ca.udy cigar-
ettes. Many candy cigaxett-as are uov, bciug sold in packagss
rhich arQ virtually idcnMical to those of tha real thing. And
these obviousiy sre used by your very, very young kids. Ela-
aenN,.ary psychology t-wlSa us that the orall gratificaGioa Y.hat
Ghos+3 Y.ids get from sroking thosc cigarot~as is going to ba
carried over. Asad parestanably th,o oaam reason why the marsufac-
~
f.~urer3 a2low their trademark and trade namas to bs used on
tffiose packs of cigarettes is becaus3 they hope that so3as of
2ha.t will . s4.ay with the kid and he will buy that pack whaa he
~
gets older.
i
F'h3O hk +.e prs.c:>tod a pati.tion t.otIso Eood and Drug Ad- . u
ms:r%ist~sa tioa to limit the sale of cig,aTMc ~wss. First, we think
's7W': ouCti3t to get 6h-sIR cuo of thu123"~^ttS1n4ed Yezd7Slg m7:chlA$s.-A. `Gr.y 3mNortant
qiestion was uor asl:;Ld tkis rswrning,, Sanakor:
o-tr.w4 do tI:Msca kids gett the cigaraf.tes2 ]C.°s i1l~.~3a1 in a11,6
Of
the arca jurisd;ctiows for kids to b:2y t:hem and for t.ht?m to 0
c1t
be sold to. thr.~. They custi bizi huuR cg, ¢s.= s4sssrhara, L.nd 6A
:ccr,* :..~aicataain sc;.ms to bo---th~y get uhrm out of tL1® vending
.. 115
cf vre2tes according to. kt~.eMC.ar and nicotine
content. S}n" the curz¢nd treact among, scsokssfs is
to purchase lowar tar and nicotine cigar.+aLtas, such
a system would not only aid smoTMera!'in selecting a_
Icass haza:dous cigaxe:!ca but would provide a
£inanciaIl i'aGcantiva.
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2'. Utilizing ghm atroxtge!st possible stztengmt regarding
th9 ttaalbh r3.sks of smo'.:ing, consistanC with ecian-
g; 4ic eti=z~~.yance, as ava..~ni.ng ]:abal to bo placed on
cigarette packs. ^chiss cerCziA,1y could iatclud;3 2he.
'saaa?v£ng, 3abal` which is being used in Swedesz.
Senator YennG3y. Are you satisfiad that the labels in
this bill are sci'esar^.ifical'iy accuratE3'
Dr. Daugherty. I@hi:nk that the labels Ctaat,you have in
the bill aFa' scientifically accurate, II think they could be
narie . sWroager and' still be scisr_tifically accurate.
8enaaor Yanetedy. k?.zI'?,, if you wanb to mak® soae sugges-
tons, Ws' W©uld' lrc glad to conside:; Viv3m.
While wa, are oa4ha@; point, do the rest oiyou, in looh-
. ,
i1sg oVnr 9oi w laae
,l prov3sions, agme3_ ?ra te3rres of their scien-
.
tific accuracy of, the labals?
y
Dr. Ycsv^g. 'yi±o probre7a of scyewtSfic: ac_-Uz'acy is diffi-
cixlt wit..~:o: t sof= Eied.'gaa such as "nay" and' czlhatwar:. I think
O'z
b!ir4:, the is.I)c3 s i-.ha :. you ha ve cor,t:.iv2cto hav~3 a queetion as ^~
:o~ the fcirmness of da4;a. Pnd it is Gery di4ficult to sky-- ~'
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b3Y.avior. ~`ve parguadcd' tvom2a to haf pap tests, to learn
broat salf-®.:am.i.nation; sraoY.ers to quit sn okimg. sr, okers to
25
A.~sd I know frog my okm personal experience with, tho.
-nicotine products.
cigarmttES,coxpanie3 have taken in dcvGlopiug Aow-tar and
and aven, I boliQve, have immf?a, esaced t_he dzrectioa that
cut dotm on smoking, to look for loss hazardous cigarettes,
oci.ose labal, and oeo get t1kam to sieg, aa union , song.
got a new and diffico.lt and nens'stivo message across, that
you . can got gaop?.e to listen to a union znessage; look for a
IInteruational Lac"uiQs ° Garmas.t worlccrs' Utaiecn tY'iat you can
cigaratte companic;s.,,, using advErLis;xsg professiozals, ths.
Yes, you can. Yes, wa caza. Provided that: (1) w®
do our job as prcfessioaally ac.d as dedicatedly as the
Can you "sall" a health habit?
w~at we cz.-a get; and (2) we are. Lxf:llaseg to do what th3 Arney
to t=~ge:., pla~n, schs.Fau].o, and sus:aion oar ofSorts in the
ar.d ;,haG is treat thc problem seriousxy asssi budgFat wri.a monay
and A4 eR:3_ am3 the ci5a.:ratte compaxaie3 and politicians do,
rtiza.ia.
f.
radio to pet rocku, on a snastai-ne3, co.,.xai;;~nd. 3aasis. if we
I've spokQze mostly of TV. Bwt I include a:nythiag., from
boli:ewcn cie have an srgcnt job to do, if we're to pac*ro.nt Y:hs
disoasas of smsa?ci-sa_ by crea.t~S-g a good ncz-amo3:ing g,e.nosation,
wc Should be Fai7_liz:g to pay for it. Not just for r.onvcatio.aal
121
seuatif Koxaredy. Is thi3' the kiud of ad you are Y.alkis g
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about?
[Seaator P.Qrnedy holds up a cigarntta ad] .
S16r. Ban«a'hf. That would certainly be cno of t31s kind
oP' ads, Senator. ,
SCtzator xQuinedy. It's ozQ of a kiad.
bFr. Dazzrhf. Assri I am very glasl you are holding it up,,,
because ttiat, 3:ezds to Y.be um't pojsat, and thab i s---
Smreatos. Kennedy. E4a! 1, Wbat's Wizong caitlx that ad!,, as far
as you cac1, sse? - . ~
Mr. Eansats;. Just about evorything. It feaWures'o
t*.ao
peopl.~o wh,o aar® ths k#:ud who won3.d be' looked uap to as image,
as iu:FZg@ bui3.dc-.ra, as 1eadQrs *_'or ycz:ng cla,ilds.-m. .,ho; man is
very robust, vory mascu,linsz the woman is obviously very at- '
trac,,3vca, a role modrsl or mar-y womott. The tgro of than are
obviously 2navirg a v:;..y gpod' re3.ationsTaip. Ono may asswnFS,.
S.Q fact, tt;at tha cig,arstibe iff has mouth mi:Lgts5: evon b$e the :
thing that sh:o is loak:.ag' up to him rzith such an adoring loo9c."
t:.
's'hey arc ssatact oa -°_
Sena.tod Ken-rcdy., 1k:a11, why isn't 2:Sxa :jtast good advcr`i-
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.s! aa policv? 1rt14* shouldn't manut'ac2urers Ya3 e_b1o.to get *h--'_
, pY3Auct. 457.."OS'-~sS.TS'tPn{3 most a'U't'.:aC~°..iC'('. way? 4 ' :
t¢s. ~asaa~f .'r7v]LR, I tisirk tboy shou, d,. e:xcept . 21iat if
vFa Zookk at that --- W
- ~e
Sauator F,4:ruZciy. What is doc ;ativo aboLy tlnat wd, do ";
~i;
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Smoko:: i!!l. At,e Licking 0ut a Dirty C(. Ashtray. °
Kids ars so,cortcerncd about succQ,s with each of-b,5
about appoaring popu].ar.--I thu'rk in the ]:or_g run that will be
very important.
The final th;,ng is we saouldcoY.~=d you £or the diffFSr-
eat#.aT tar sud nicotinm tax as a first sgep in Y.ln6 long direc-
tf.osa of shifting back to the smohmr the costt ttlat fe places
on the backs of all of us, smo3.sza and noa-smol:cra al.ik®.
And if cigare.:B:Qs vmra taxGd' at anything like the to; aF
cost of @haiL aseCo the Uni:sed States, caQ wouJ:dd havs mora
tr.haa snough monsy for all the ducational pFogra,ns, smoking
withdrawal nrogs.ans, e.nd evt3rytisimg: plzs. Yb ware talking
a.bout $29 bwllion of cos;:.wtaich fairly should bo borne by
those who, qe:.ote, cnjoy the actf.vity..
Sasati.or Ra.;~ndy. You think f:t's justifia~.i Jusw from
tha racen*_s-zatss n;, mvasuxGs asad Whcs --. -
P°s. Bamsahf. . More G6as anough. Seazator, if I had cott-
Lro3, I Y.ou2'd take tho total cosvt of smok+.g ard set a, tax
on snolki^g, so that theiscoms frcm thaht?x would. equal the
total oos#.
Dr. YoLI.na. Ee:aato.:, I aM goi--a,, to 22avT co SUc9sO iayseIf.
;
I c.^ou1dd be happy to: answ ~ any cgtestiors for tha record.
Seyator 1:»nns~dy-. Yes, Lkea:~k you very ua,i.
t:ou2d'% a11
of you agic~3 that smo,cir_g has an aexarss hcaluh _mpact? Sou W
all &grci~ cn that.
PaoPSQ quit there are virtaally' no Pk4resas,, eitlher by the
g,overmsneut or the various major health organi¢ations, ®Pfec-
tive programs to LQ2p them quit. TEnear,e should be more of it.
Find, indeed, the goverrmunt should subsidize it through its.
medicz:;!' programs and the private health orgaaizatioas shoul'd,
subsidize it through theirs.
Ssns:tor, I think today the moot egfcctiv® program against
age smokiag is the groctaug non-sma9sers' rights movemont.
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it is aime8..at Protcctiag.ths rights of non°smokers, and for
this rQasoar akcae._we ozlerse it. But I 4:hink,, evan more
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'I iPiFt.:3Yitaa'2t, every tj,Hta a sILoker,, or ®v.~',~,n8.. 82oX1-F.m^J}:Ez, rE2.^~Ogr
e.ve>n' with those charts th; ro, even aTaaag tee.r+,.gers, a3i:hcug
a:nc? they rouI:d rat.hrx they o:cu3.d stay away fsa-a. tha:ia. And
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sec. Iaed~,.-~c3, most Psepie don't like aa'aociati..Rg eaiahh smokers
uizes that tbero''3 a sToking as~cticu over therQ ased' a nonr-
smoftistg' section ovQr there, it's a nat:wery-subdlo resiadar
to. him or her that smoking is not aEiabit P..Z?.ai: makes you
sexual, sracually sophistica":ed, and attractive to th~s opposite
20 a.r-d 30 pcrcant s=ke, which is a vary serwous figure, the
gresi; majoLity do not s'~moIco. An.d as ¢;.iioez kids realized,
b4ing s"moP,ca;.s co3s aa, tta:F:® thea afitracti've to~ tP3p majority
og aca-=ckera'. I think that is going to havo a ve4y i,uportant
terms; Ssaator:
And our' best.-sOllfng st,icker reads t:!9.is arayr
cffecL. Kids are aSrcady, put_i'ng, it z?s ta.cs3
t,*a.y ' are m?ycsig smokirsg is uo korgor "cool."
I
120
Sena=C Itiraredg. 13ouldd you do the saraa vith cigasetces?
t2f. Banzahf. I wou].d, Senatar, and I would li}uo to sug-
g®sZ a number of th #gs. which Ithiast: caroaasd 'should be dons
ar.dvaould have a much quicker impact and a much grQatcsr impact
i .
on a Cost-'affectivencos basis.
The firsi¢. YrouZd bia to limit the ads, all of the ads to-
10
12
14
i,5
tC
17
ii8
9
19
20
21
22
24
25.
dey,, because they hava suvch ,a dxamatic impacf: on childrcn.
Faar after year tha f'edoral Trado Commi.ssion,bas reported to
this Cor.gress that cigaestta ads coat3mue to bo uz3aixarad
zad'o Co.=ission uor t':a UnitMc Smates Coagrec3s ha:,> takc35wA ac-
decee°iva trade, pre.ctices, yet to datzj.r aeithmr the Federal
t4cu caa:h rc:gaad to that. >:1R haua propcsad to ths Ped'eral
I'sado Commgssjon t?+at they sube4:a.:atia1ly lini'E; the adsitt:
one of two fcrms. {luca, the proferred ou4, would be--and this
d pun--`.t.ha 1:omtsstone variety of ads .. You see
s'hGm- frca_e+.3u4:ly in ilia G9a31 Stxeat . 3ouraal azad, other arwspa.gc°.rs,
][f such an advereising format is necossary to prots.b sopiiis-,
t:.caftA , investors: frc.:r boiW aisled,. I think it is not unrea-
sonable to restrict , cigartD-cto ads to the samca form.
If, cr~ ca~raot do that, Sou.tor, at least VY0 can prohibit"
£°.2w.m from putting in a varicity of pictures, as: diUcussed this
aao=aiag., fcsat;ariug hwr_d3 cz3 virii~ men, soswc4:9.ve looking
cq,.
crom=.w.., ou~3oo, scCnc-s- e^.:°avs vj;ach ths FTC F::te ho3d' aga?n
!:S
and ag~-in to demr4c<W ¢rc.m eha keayth message ?a b12osm ads, 0
rc;ar.taIes3s of cal:af; Ws.)sc r=.;=.ssa.gcs happe-nto n--. .
