Tobacco Documents Online

- 12' - at one time or another, but why do.some kids keep on smoking, while o~th~~ers~ do:no,t?~ WhX~ •~d'o~ s~ome~ te~enage~rs~~ be~~c~ome~ regular ~ smokers while others are able to give up the habit with to college?' bound youngsters smoke than those who do not plan to go no apparent trouble? Why does it appear that fewer colleg,e- I requesting $4 million for the National Institute on as likely to have tried marijuana, and six times as likely to have tried hard drugs. In the Pres!ident'''s budget for FY' 19179, we are And who are the reai1 chance-takers in the child' populations, and how do we identify and help them? Among children 12 to 17, children who smoke are twice as apt to have tried alcoholic beverages as non-smokers, four times Child Health and! Human Development to investigate the childhood determinants of'smoking behavior. Epi:demio- decisions--wi;ll enable us to design more effective intervention programs, can do a better job in helping children make wise health research--to find out how parents, schools, and communities logical research will be critical to tracing the smoking histories of different groups of children. Educational 4,

The~ princip~]le~ of al gradua~ted~ tax based on tar and nicotine in our opinion deserves serious consid'eration, provide a basis for such technical judgments in the Department is presently undertaking studies in co- operationwith the Treasury Department to answer these important questions and hopes to be able to thus have little more than punitive si:gnificance. The cigarettes, as is proposed in this legislation, might encourage more smoking by young people. On the other hand, very high taxes on the highest yield cigarettes might have no effect on confirmed smokers and would particularly the design,of•the tax schedule. For . A.. ' ' .... . - . example, a lowering of Federal taxes on low yield t near future. We will keep you advised of our progress. The questi:on of'earmarking tax revenues for special purposes -- even the best of purpo es economic and tax policy questions whicli require further costs of days lost in production, and other costs. Thee revenues obtained from cigarette taxes at the present rate, or even under the rates proposed by S. 3118, do in terms of increased hospital and medical_costs, the American people should be aware of the economic bur- den which cigarette smoking places upon the taxpayer analysis. However these questions are resolved, it is the view of our Department that Congress and the not begin to approach these costs.

you feel as we do that the Federal government has an opportunity and a clear responsibility to set an example for all organizations and employers.` Congressional support for this policy should encourage its establishment whether through legislati'onlor administrative action.. S'ections 7 and!8'of S. 3118 provide for the establishment of a"'health protection tax."' These provisions would, in effect, amend the tax codes to create a varying tax on cigarettes ranging, from five tolfifty cents a paick, based on "toxic units' which are derived from the millligrams of tar and nicotine contained in each brand of cigarettes. The proceeds from this tax would be used, beginning, in Fiscal Year 19'8'1,, to support paymentss to the States in the formof formula grants to assist them in meeting the costs of preventive health services. The present Federal excise tax is eight cents a pack. The schedule set forth in S. 3118 would raiseth~is ta on (and presumably thus the price of)' most cigarettes by substantial amounts,, but would lower the price of those cigarettes with the lowest toxic yield.

Regardingi additives, we understand that there are some 300 substances•which cigarette manufacturers add to cigarettes for flavoring and other purposes. We do not even know what many of these substances are. would recommend your consideration of additional language requiring the disclosure of'these flavorings and other additives. If ingredient knowledge is justified for the products we ingest, it seems to me they are at least equally justified'~for products we inhale. In establishing the new Office on Smoking,and Health, Secretary Califano and Dr. Richmond have used as a nucleus, the National Clearinghouse for Smoking and Health, which was formerly a part of CDC. I would like to assure you,, Mr. Chairman, that the departure of the Clearinghouse by no means signals the departure of'CDC from concern with smoking. The budget request for CDC'for Fiscal Year 1979, now before the Congress, includes a proposed grant program to the States which would engage official State agencies effectively for the first time in anti-smoking activities on a significant scale. CDC will continue and' expand its development and promulgation of school health curricula, in close,~co~Tlab~oration,with the~ Office of~Educat~ion and will apply its epidemiological expertise to problems=.associated with smoking to a greater extent than heretofore. Programs of lifestyle education, in which smoking is included as one of the principal risk factors closely inter-relaited with, hyp ertens ilon , obes ity , and others,, will continue and

Section 10 of S. 3118, Mr. Chairman, is the portion which is to me the heart of the legislation. This section provides for a program to deter smolting, among children and adolescents. This is the area of greatest concern to the Depaztment. It is also the area in which we have been the least'successful in the past. We can point with some pride to significant decreases in smoking among adults -- first among males~ and recently, encouragingly, among females. But with children and youth,, the picture is different. Smoking among boys has hardly ctianged' in the last decade. Our most recent figures, which will be updated during the coming summer--show that five percent of boys between 12' and 14 smoke; just under 20 percent of boys 15 and 16 smoke; and somewhat more than 30 percent of'boys 17 and 18 smoke. By age 18, the habit of smoking is pretty well established, and I think this is shocking. Meanwhile, smoking among,girls lias increased dramatically. In the 19160's, about twice as many boys as girls smoked; now at every age level, girls are smoking at the same rate as boys. The legisliation which you have introduced recognizes the importances of research in directiingiour efforts. We need y to learn more about smoking behavior than we know now, particularlyregardingsmokingbehavior amongchiildren. Perhaps almost all children can be expected' to try cigarette

l. The final section of S. 3118 calls upon the Secretary to study and report back within two years onithe relative health risk associated with smoking cigarettes of varying levels, and the relationship ofltar,`nicotine, and various additives to health risks. :, These two questions, in our opinion, are among the most important public health questions of'our time. As I mentioned at the beginning,of'my testimony, the various agencies of the Department--the National Institutes of'Health, the Food and Drug Administration, the Office of Education, the Center for Disease Control, the National Center for Health Statistics and others are now beginning work on the 1979 Surgeon Generall's Report. This will be the most important review of' information on smoking since the publication of the original report,nearly 15 years ago. As part of this effart, the agencies will be looking at the changes which have taken place in the cigarette itself, and will attempt to evaluate the health significance of these changes. On the basis of this information, HEW will focus attention on many aspects of the questions posed in S." 3118--and it is our hope that this ;.nformation will be available before the end of two years..

But there are some 16,000' school districts in the materials developed, and close cooperation encourages country. To reach a maj'or share of our youngsters, teachers and administrators will have to be trained, between school and health officials, parents, and There is a particularly urgent need to develop educational programs for teenagers. While we are gathering new others who can help do the job. Through the Department's new initiative, CDC and the Office of Educationiare working closely together to accomplish these purposes. Iearn. Surveys have shown, for instance, that: knowledge, we must also apply what we alread!y know about teen-age attitudes toward!smoking and about how teen-agers Eighty-four percent of teenage smokers admit that smoking is habit forming,. Sixty-nine percent realize that smoking slows them down in sports. Two-third's believe that smoking is just as harmful as their doctors and teachers and'parents say. And half of them hope that when they have children, their children won't smoke. These are positive attitude's on which we caa build'. One wh~ich~ CDC has!b~~een supp~orting on a small s~~cale~ through a! contract withithe National Interagency Council on promising approach is peer education--kids teachling, kids-- Smoking and Health,.

At this point, let me emphasize that the primary goal of our prevention programs with children, as well as adu1'ts,. is to provide education and to conduct research that will enhance, not reduce, personal choice. We can inform children and young people, we can set the best examples we' can,and we can try to create an environment which will promote and not discourage healthful behavior. But we cannot take from young people their right to make choices as to their own conduct, so long as this conduct does not infringe upon the rights of others. As stated before, we believe thatif'our citiz~ens--,especially, thosein their teens and subteens!whobegin smoking for the first time--are given all the facts from Governm.ent or other sources and they still do not wish to give up a personal habit, however hazardous, then, except for protecting the rights of non-smokers, Government can properly do no more_ One of the most effective ways we have found toi inform chi]ldren and young people is through1health education in the schools. Some excellent school curriculalhave already been developed and tested for elementary school children. One of the best, I am personally pleased to say, has bee developed by CDC' _ c, . . and is now in place in some 3'S0 school districts i'n more than half the States.