Tobacco Documents Online

Mr. Chairman and Members of the Cocnmiittee Page Seven I trust that these coirmients that relate to our support for.your efforts in thisarea will he of assistance to you and,the Committee. We would be pleased to provide you with any other assis- tance..

..Dear TiLr., Chairman and - - Members of the.Committee: I am Dan. G. McNamara, M'.D., F.A.C.C., Professor of Pediatrics and Chief.of' th.e Cardiology Section, Bavlor ColLege.of Medicine and Te:eas,Children"s Hosnital. I am also President of the American College of Cardiology, a professional medicai spe- cialty society representing over 11,500 phvsieians, scientists and.educators who specialize in.diseases of' the heart,and circulatory system. ACC is dedi- cated.to ensuring optimal care for persons with cardiovascular disease and those with the ootential for developing cardiovascular disease and, through educational and socioeconomic activit_es, to contri- bute significantly to the prevention of'cardYovas-

M'r. Chairman and Members of the Committee Page Six of information on the research being supported' by different agencies, this would be useful. If, however, the purpose is to provide the Office of Srnoking and Health withh authority to direc` the research of Institutes, the College believes it would be counter-oroductive and undesirable. However, authority to:conduct types of research that,do not fall clear];y under the authority of the categ,orical Institutes could be appropriate for the Office of Smoking and Health. E:cazpies of such would be in monitoring national trends of cigarette const¢mption: in dif°_erent,age groups„ surveillance of the co=osition:of'tar, nicotine, carbon monoxide and other potentially ha^f`ul constituents.of cigarettes. and maintaining the periodic reporting of new research.findings. In addition, the College also believes tiiat.the C'ongress should,review a1Z the c°srrent,material on the,connection,between cigarette s.r.cking and the.costs to society through increased medical costs and reduced productivity in order to provide a basis for further ciaarette smoking prever.tion efforts.

Mr. Chairman and Diembers~of the Committee Page Two cular disease. It is in my capacity as President of the College that this statement is made on S. 1929, the "Comprehensive Smoking Prevention Education Act of 198'1.."' One main concern of the College is whether consumers receive sufficient,and accurate information on the demonstrated relationships between cigarette smok,ing; and cardiovascular disease., The College.believes that consumers are provided with insufficient ir.::or-_ mation on the demonstrated relationships between cigarette smoking and'cardiovascular disease and that this lack of information weakens a physician`s role in altering a patient's smoking behavilor. As the.Federal Trade Commission noted _...its "'S.taZ'_ Report on the Cigarette Advertising Ir.ves,tigation" (May, 198I1) , which we commented on.(attached) , a "'substanti!al portion of the public remains unin- formed about the hazards of smoking," and' t:at F':'C tests "'indicate that.the (current) warning is neither noticed nor read by the vast majority of -,ecple." Even though the current warning indicates that the Surgeon General has determined' that cigarette s^ok'_ng is dangerous to one's,health, 17% of all sr..ckers and' 248 of heavv smokers do not know t: at s-o:kinc

Mr. Chairman and Members of the Committee. Page Five other health professionals in communicating the -risks of smoking;to their patients. The ColLegee would recommend that "WAR*IING: The Surgeon General has Determined that Cigarette Smoking Causes Heart Disease".be amended as follows:: "Current scientific evidence indicates that Cigarette Smoking,is a Major Risk Factor for Coronary Heart Disease."' The ColZege,would also recommend that "Ctrrent scientific evidence indicates that cigarette smokers are predisposed to sudden death,"-and__"Current scientific evi- dence indicates that. there is a significant re- lationship between ciga!rette smoking and heart disease, cancer or emphysema'" be considered. In addition, the.College believes that one aspect of the wording of the bill relating to the coordi- nation of research, conduct of research and the, authority of the Secretary to carry out the pro- visions of this bill through grants, may need clar- ification to avoid duplication with research on. cigarette smoking effects being conducted by NHLBI, NCI and other Institutes at NIH. If'coordination means the implementation of a systematic exchange

Mr. Chairman and'.Members of the Committee Page Three is hazardous to health. Additionally, as noted, consumers themselves agree that the current warning is. inadequate. Why not provide:the public with the type and- quality of.information sought? As the FTC report notes, nearly "two out,o£ every three questioneci during the 1978 Roper survey for the Tobacco Institute, believe that the current warning is. not "'adequate'" and indicated they preferred a health warning that.describes the speci=icc heaT_t.': risks of smoking." A 1978 Gallup survey of smokers and nonsr:.,okers found,that 32% were not aware of' t1.e statistical relationship between cigarette sr•_oking and heart attack; that 37% of smokers did not know this relationship;and that among,heavier snokers, 40% did not know the increased risk for heart attack associated'with cigarette smoking,. The 1979' C:filton Study, conducted by the FTC, found that.25% of the general nopulation and,31% of smokers did not know that, smoking greatly 3ncreased their risk of, heart attack despite research that concluded that it doubles a person's risk of heart attack. In addi- tion, consumer knowledce of the reLaticns'..'_p amm c~ cigarette s;.tokinq, birt^, control pills and heart 6~7 W hJ

Ameri'can College of Cardiollogy Pru/dsN DANIG. McNAMARA, M.D:. Pns/denbElem SUL+NNE B. KNOEBEL, M.D. ImmMbtr,Pest Fresid.nf. ROBERT 0. BRANDENBURG. M.D. VIcePrnld.nt PAUL A: EBERT: M.D. seeretery JOHN A. WALDHAUSEN. M.D. Arsltt.m SepeMr'f ADOLPH M. HUTTER, JR., MiD. AetlnD Treaeur.r' JAMES J: LEOMMRD, M.D. Charman,.BPard PI Gavernors GOTTLIEB;C. FRIESINGER, II, M~D~ TrYStels WALTER H. ABBLMANN. M.D: ROBERTO. BRANDENBURG, M.D:. DAVID B. CARMICHAEL, JR., M1D: LAWRENCE S. COHEN. M.D: ROBERT'Dj CONN, M.D. THOMAS'G. DICKINSON. MID. LEONARD. S. OREIFUS, MD. PAUL A.. EBERT„ M.D. ROBERT S. ELIOT, M.D. GOTTLIEBL. FRIESINGER, Ii, M.D: B. LEONARD HOLMAN,. M.D. J,A'NEALL HUMPHRIES. M.D. ADOLFH M. MUTTER:.JR., M.D. FRANCIS. J. KLDCKE. M.D. SUZANNE B. KNOEBEL. M.D. JAMES J. LEONARD; MI.D.. ROBERT J. LUCHI, M.D. DWIGHT.C, MtGOON, M.D:. DAN G. MkNAMARA, M.D. CHARLES B. MULLINS„ M.D. WILUTAM.W. PARMLEY.,M.D: VICTOR PARSONNET,.M.D... JOHN HLPHILLIPS. MiD. CHARLES' E. RACKLEY; M.D. DONALD E. SAUNDERS, JR:.,M.D:. JACK.P. SEGAL. M.D. BORYS SURAWICZ, M,.D. JOHN.A. WALOHAUSEN. M.D. ARNOLD M. 'NEISSLER, M.D. JOHN F. WILLIAMS, JA., M.D. Ereeulire Dir.etar' WILLIAM, D. NELUIGAN, CAE DeyutyEsecullve DireHor WILLIAM D: CGUGHLLAN, CAE'. Abcelete la.eupae Director DONALD J, JABLDNSKII HEART HOUSE 91'11.OLD GEORGETOWN ROAD BETHESDA. MARYLAND 20814 [3011Z97-5400. STATEMENT on S. 192'9 "Comprehensive Smoking Prevention Education Act.of 1981" of Dan G. McNamara, M.ID.,, F.A.C'.C.. . President to Honorable Orri:n G. Hatch Chairman Commi.ttee on Labor and Htnnan Resources March 16, 1982!

Mr. Chairman and Members oz the Committee Page Four attack is low, despite the fact that women who smoke and' take birth control pills have approx- imately ten times the risk of a heart attack of, women who~do neither. Therefore., the College agrees that the current ----- cigarette warning is not effective relative to the public's need to know and,act on the,strong scientifically-validated statistical relationship between cigarette smoking and.cardiovascular disease. The Coilege agrees with.the need to improve on the type and content of the required cigarette warning labels. Therefore, in reviewing the FTC reoortt and its conclusions, the College endorses the concept of rotational warnings as being more effective than the current warning. The College believes that the labeling approach.and specific warnings contained in S., 1929 (as modi- _---- _ - fied'beLow for scientific acceptabi;lit_) will assist consumers in making conscious„ more inforried dzci- sions ahout smoking, because they wi'_'_ have more dpfinitive infor:nation.on the speci`ic health cor-- sequences of'.smoking. This type of'in'nrmatio^, also,will assist cardiologists, other ^n_.sicians and