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TESTIMONY On Behalf of THE AMERICAN CANCER SOCIETY Before The Committee on Labor and Human Resources U.S. Senate March 5, 1982 For Alan The further Davis American information, contact: Cancer Society O 777 Third Avenue New York, New York 10017 W m,. (212) 371-2900 W W

D The American Cancer Society, a.voluntary health organization with over 2 million active volunteers dedicated too fighting cancer, is privileg,ed to submit Testimony today. Because of' the mandate of the American Cancer Society it is most fitting that we offer our testimony in strong support of S. 1929, the Compreh,ensive Smoking: Prevention EducationlAct of ~ 1981. We,would like tod commend you, Mr. Chairman, for your leadership and.your foresight in sponsoring this important preventive health care measure. We are pleased~to present testimony as part of the new Smoking,or Health Coalition., The work that the American,Cancer Society will be doing on this bill together with the American Heart Association, the American Lung Assoc',iation and the National Interagency Council on Smoking and Healthiis just the beg,inning of the work of a coalition dedicated to,educating Americans. to the dangers of smoking. We are all extremely excited about the potential impact on the smoking problem in this country resulting from the,joiiniing of'forces of our organizations. The reason we are presenting testimony together is to undierscore the amount of energy that.our organizations are willing to exert to encourage this vital health effort.

s e I know the labeling provisions of' the legislation raise some questions. I cannot say for sure that six rotating labels listing exactly the ill effects of cigarette smoking will make the difference. I can say that in 1979 13.5% of boys aged 15 and 16 and 11.8% of, q;irls,tfiat age are regular smokers. I can say that at ages 17' and 18, the incidence increases to 19.3% for. boys and 2'6.28 for. girls. Also, the.percentage of girls age 17 and 18 who smoke has risen sharply since 1974. One further point., by 198'3, according to statistics from the National Cancer Institute, lung cancer will outdistance breast cancer as the number one cancer killer of women.3 Our children are risking their lives, possibly because of clever advertising, combined with the various reasons that influenced so many people to begin smoking years.ago: peer' pressure, peer imitatiom, saying it looks so sophisticated, grown-up, etc. At the very least.,-we must give them the best information about the hazards of cigarettes to permit them to make an informed.decision. An FTC staff study came, to the following conclusion: "...many [smokers] ar.e unaware of the existence of the relationship between.smoking and some of its most serious and widespread health.conse- quences, such as heart disease...Some of the

The reasons for our dedication are clear. Today, 54 million Americans will light up a cigarette and we know that smoking' will contribute to the death~of over 300,900 of them this year, alone. 4'3©,000: Americans will die from.all forms of' cancer in L9!82. According to the February 22 Surgeon General's report on the Health Consequences of Smoking 129,000' of those deaths will be caused by the use of tobacco products.1 85% of the 111,0©0 lung cancer deaths this year will be smoking related~. We.know from, the Surgeon General's report that the overall cancer death rates of male smokers are. approximately double those of nonsmokers and for female smokers the death rate is approximately 3,0 percent higher. The Surgeon General found that cigiarette smoking was a major cause of lung,. Ilaryngeal,, oral.cavity, and esophag:eal cancer. It.was also found to be a contributory factor to bladder, kidney and pancreatic cancer. In addition, he noted that epidemiological stud:ies suggest an association between cigarette smoking'and stomach cancer to a possible association between smoking and uterine and cervical cancer. What is even woise, those cancers most closely associated with cigarette smoking (lung, esophageal, laryngeal, oral cavity and pancreatic cancer)~, can be the most dif.ficult ones

J$ 4 -7-. Further, the OTA report adds;'"tobacco is know to contribute more heavily to the number of cancer deaths than any other single substance." • Members of this Committee, we urge you and your colleagues in both Houses of the Congress to pass this measure into public law as quickly as your considerations and processes will allow. The American Cancer Societv believes this bill can makee a difference to the health o:f' our countrv. We look to you to help us'in this crosade: I/The Health Consequences of, Smoking -- Cancer --, A Report of the Surgeon General, U.S. Department of Health and Human Services, OFfice on Smoking and Health, February 22, 1982„ p_, 4-7. 2/ 1982 Cancer Facts & Figures, American Cancer Society, Inc., p., 19. 3f Dangers of Smokingi, Americ:an Cancer Society, Inc., 1980, p. 57 & 66-68. 4/ Staff Report on.the Cigarette Advertising Investigation, Fbderal Trade Commission, May, 1981, p. 3-45.

health con.sequences of 'smoking, such as lung cancer and emphysema,, are more well known. However, even for lung cancer, the most-well known health effect, some substantial gaps. in consumer knowledg,e are evident."4' We have an.obligation to fill those gaps, especially for the young.. How many 17 ' year old girls who are ligihting up a cigarette today comprehend that they could get oral cavity cancer, and would have to undergo the difficult and painfuL rehabilitation that is necessary to overcome the disabilities associated with that disease. Not enough! Mr. Chairman, the Congiress'"s own research agency, the Office of Technology Assessment, in its ASSESSMENT OF TECNINOLOG'SES'. FOR Il7ETERMINING CANCER RISKS FROM THE ENVIRONMENT',dated June 1981, states that tobacco~ smoking "is the singie most important preventabIle, environmental factor contributingi to illness, disability, and death in the United States.," The OTA, report sites a WHO reference stating "smoking-related diseases are such important causes of disability and premature death in developing coumtries that the control of cigarette smoking could do more to improve health and prolong life in these countries than any single action in the whole field of preventive medicine."

-3- to treat, the cancers with the least hope for surv:ival. For example, the.overall 5-year survival rate for lung cancer is only 10'8; for cancer of'esophagus, 9% and for cancer of' the pancreas, 2%.2 When the Surgeon General reLeased.his report on February 22' of this year, the President of the American Cancer Society', Dr. Robert Hutter, said: "When we hear of a bad accident involving 20 or 30 people everyone is horrified and offi- cials start.clamoring for more consumer pro- tection. Here we have a situation in which two to three hundred peo:ple a day are being killed' by tobacco-related cancers and these people. have been. given virtually no protec- tion at,all." As an organization working with the victims of cigarette smoking, we can state with conviction to the.members of this committee,that dying from,lung cancer is one,of the most awful e:eperiences a,human being can go through. To permit people to kill themselves this way without making the hazards amply clearr is an irresponsible act that ACS, as a voluntary health agency, O ~ ~ and you, as legislators, must not allow to continue. F+. W G3' TJ

-4'- The American Cancer Society urges the sponsors o.f this legislation to,maintain a formal Office of Smoking and Health. S:uch an office dedicated solely to educating Americans to.the d',angers of smoking, and, in addition, working to eliminate the American smoking habit iis vital to~ the voluntary health sector in real terms as well as symbolicallv- We need a group of knowledgable professionals at the federal level in s:uch, an office committed to this cause. We are also pleased that the Chairman hals shown an interest in adding to. his legislation an amendment which would require that all cigarette companies: list with the Secretary of. HHS all tobacco additives. We are not asking that.the trade:secrets in the tobacco industry be revealed. However, the ACS questions why the. cigarette ind'ustry has,-firr so long been-exempt fromi any requirement-to liist-their additives when most other consumable consumer goods have not had such an exemption. in addition, we are well aware that cigarette smoking is dangerous. It is vital, that at the very least, government scientists be given an,opportunity to test the health impacts o£burndngand inhaling suchiflavoring additives as cocoa husks. The scientific and medical communities mus.t also be aLlowedo to test,these additives so as to protect the,54 millionn smokers and for those other milLions whom we are not 'reaching throughleducation efforts who may yet start to smoke,.