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Disease Prevention and Health Promotion Act of 780000 Hearings Before the Subcommittee on Health and Scientific Research of the Committee on Human Resources United States Senate
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- Named Organization
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- American Health Foundation
- American Journal of Epidemiology
- American Journal of Public Health
- British Medical Journal
- Comm on Human Resources
- Dept of Public Health + Welfare
- Ford Foundation
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- Harvard Univ
- Hew, Dept of Health Education and Welfare
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- Memorial Sloan Kettering Cancer Cen
- Natl Cancer Advisory Board
- Natl Clearinghouse for Smoking + He
- Natl Inst on Drug Abuse
- NCI, Natl Cancer Inst
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- Respiration
- Royal Statistical Society
- San Mateo County Dept of Public Hea
- Stroke
- Subcomm on Health + Scientific Rfse
- Surgeon Generals Advisory Comm
- TI, Tobacco Inst
- Univ of Leeds
- Univ of Pittsburgh
- Univ of Tx
- US Public Health Service
- Wayne State Univ
- American Health Foundation
- Request
- R1-004
- Named Person
- Ashford, N.A.
- Blackford, L.S.
- Bridge, D.P.
- Burch, P.
- Carter
- Cohen
- Corn, M.
- Fischer
- Forde
- Gori, G.B.
- Green, P.
- Hamilton, J.L.
- Huber, G.L.
- Lawson
- Owen, D.
- Pakash
- Pinney, J.M.
- Reilly, M.
- Rhodes, J.E.
- Stallones, R.
- Stolley
- Taylor, D.B.
- Thomas, L.
- Valeo, J.
- Wynder, E.L.
- Blackford, L.S.
- Date Loaded
- 05 Jun 1998
- UCSF Legacy ID
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Document Images
Ki
DISEASE PREVENTION AND HEALTH PROMOTION ACT
OF 1978
HEARINGS
BEFORE THE
SUBCOM3iITI'EE ON
HEALTH AND SCIENTIFIC RESE ARCH
OF THE
C03i3iITTEE ON HUMAN RES'OURCES
UNITED STATES SENATE
NINETY-FIFTH CONGRESS
SECOND SESSION.
ON,
S. 3115
TO ESTABLISH A COIiPREHE\Sri'E DISEASE PREVENTION AND
HEALTH PROMOTION PROGRAM IN THE UNITED STATES
AND RELATED BILLS
MAY 25; JUNE 7 A.\D 9, 1978
Printedlor the use of the Committee on Human Resources
U.S. GOVERNMENT PRINTING OFFICE
30--536 WASHINGTON : 1978
i
C
240
SrRTEMEnT OF
THE TObACCCr INS T ITUTE
RE S.3'18
SUBw.T?EC TO THE
SUBCOKH?TTEE Ot+ HE6LTH hNy SCI,EKTIFLC RESEARCH
OF THE COM!!ITTEE OA HUNkN P.ESOURCES
UN:TEC STATES SEI+ATE
We are grateful for the opportuni'ty to comment or,
5.3>>8, w.,1'ch pertains to tobacco and'tobacco amoking,
and to be able to dc so under conditions which are rela-
ti'vely free of the emotionalism that often surrounds this
subSect.
The legislative process is better illucainated by the
light of reasoned deLiberatSorr than the heat of inflam-
matory rhetoric. The level of public discussion would be
improved by strict LS¢itations on the use of military
metaphors in dealing .i'th complex questions of disease
causation and prevention. Indeed'the nation would'benefit
if individuPls and groups atandoned the myth of "waging
aga:nst diseases or their all1eged causes.
Nature will not surrender her secrets to propaganda
war"
barrages. Nature will yield her secrets only to the steady
advance of knowledge. Basic knowledge does not flourish
in a locx-step society. It grows best under conditions
of unfettered investigatior, and free, fair nd full
discussion.
_;~
241
Page 2
The fact is that at present we simply do not have
encuE`: basic k-o:.ecie o break through to the solution
Oi a 1'8rle:)' Cf major heb.t.h,probiems.
D-. Lew:: Tr.or.as, presioer.t of the Memorial Siioan-
Kette.-in5 Cance- Center, put it we:1 recently. "The
solidest piece of scientific truth I know of, the one
thi'r,g aDo:;t wtict I fee: tota:ly cor,fident" he said,
"is that we are prefound:> iEnorant about nature.
lndeed, I regard'this as a major discovery of the
past 103 yea-s of bco:oEy."
"Ir, ez-Iier times"' he addee, "we either pretended
tc under=tar.c' ho. V%:.^,gs worked c, ignored the prob:er.
or simply made up stories to fill the gaps."
He with a statemer.t that is particularly
app~opiate:
"We wili so.ve the problems of heart disease,
cancer, stroke, arthriti's, schizophrnnia, senile
dementia, and all the rest if we car. just keep
learning."
Unfortunately, a favorable cliimate for scientific
inquiry does not obtair. in the field of smoking and
hea?th. The scape6oatin6 of tobacco constitutes a
diversion of attenti'or: from the gaps in our knowledge,
which do, in fact, exist and which must not be ignored
or eovered' up.
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242
Page 3
It is high time for decision-makers and guardians
of public health to stop talking like generals and start
talking Like leaders interested in getting at the truth.
To craraeterize tobacco as "slow moticr suicide,"
to call it "public health enemy number one,"'and to
hold thi~s single lifestyle behavior responsible for
more than 300,000 deaths 1s not likely to increase
our understar,ding. It very likely will have a chilling
effect on sci'entists who would prefer to j'ust keep
llearning,." To others it may be taker, as a signal that
federal funds will flow to those who don't mind reaching
preordained and offici'ally-approved concliusions.
The Secretary of HEw'said that smokers who ignore
his advice are "whistling past the cemetery." He has
cha-acterized those who disa6ree with his initiatives
as "a self-interested minority." No wonder the press
headiined his program as a declaration of "War on
Smoking."
This type of inflammatory rhetoric !s an unfair
and'unjustified attack on millions of American
citizens -- farmers, blue collar workers, manufacturers,
wholesalers and retailers. It suggests that they are
the "enemy" who can and should be punished in good
conscience.
c
243
Page A
The truth is that mer..bers of the tobaccc cor..munity,
their forebears and their children have beer., are and'
will continue to be a proud and productive part of
Ameriean society. Presider.t Carter, for exar..ple, in
rejecting,the use of government authority to prevent
people who, after notice, desire to smoke, went on to
say:
"Or~ a number o.` occasions I have expressed my
views concernir,6 the importance of the 600,000~
farm far,.:lies that derive their income fror,
tobacco....The strategy which we adopt wiil,
above all, be one that works, and dea::
rea:istical'ly with the industry and'social
fabric which over the years has b:ailt up
around cigarette use."
Now let me make some comments on 5.3116, and its
various provisions.
SHOKIRG RRL 70UTH
The tobaccc industry,recoEr.izes and hoid: to the
position that smoking is ar, adult custom.
Its policy
has beer, that smoki'ng, should be deferred until a person
is mature enough to make the decision in the light of
all avaiiable information and on the basis of individual
freedom of choice.
The i'ndustry's actions taken toward voluntary
self-regulation substantiate its statement of policy.
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244
PaEe 5
For examF;e:
0 In 1963, tobacco companies stopped all advertising
and promotiona: activities in school and college publica-
tions and or. campus.
o In 1964, they established arn advertising code
prohibiting advertising, marketing and sampling directed
toward young people. And they still adhere to its principles.
o In 1959, the industry offered to cancel a11 radio
and television advertising because of the broadcast oed'i'a's
unique appeal to young people.
In addition, the tobacco i'ndustry has taken a variety
of other steps to provide information to consumers; these
initiatives are germane to your deliberati'ons, especially
xit!h respect to Section 7 on "tar" and nicotine and Section 9
on labe:ling. For example:
o In 19E7, member compar.i'es begar, a continuing program
of scientific and technical cooperation with the Federal Trade
Cort:cissior., vith res;ect to the Comrzissi'on's "tar" and nicotine
testinE actSvities.
o In 1!97D, they began to include in their cigarette
advertising the FTC "tar" and nicotine ratings of their
brands.
o In 1971, they volunteered to depict the cigarette
package in a11 advertising in such a way as to legibly
display the warning label.
o In 1972, they entered into an agreement with the
Federal Trade Commission on uniform terms of displaying
the uarning label i'niprint advertising.
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245
Page 6
Everyone agrees that childrer. should'not smoke,
Including, as its record demonstrates, the tobacco
Industry. Few people, however, kno6 why they do amoke.
Yet, this legislation calls for a"shoot-first,
ask-questions-afteruard" approach, proposing programs
of deterrence before the problem is understood.
The Chairman and the Secretary of HEw single out
the role of tobacco brand'advertising. Others are not
so sure. Several witnesses at the Subcomr.ittee's May ?5
hearin6<_, reflected'this uncertainty.
Paula Greer., president of Greern-Dc1r,atch Advertising,
who has beer active in aiding the American Gancer Society"s
antismok:ng crusade, discounted the a1liegeC power of
advertising. She testified that:
"It is wrong for us to believe that people start
smo~cin; today just because of advertising. Today,
advertisinfi,is only one factor."
Moira BeilLy, a high schooi student told the
Committee that young people start smoking because of
"peer pressure."' As she put it:
"Your friends start to smoke. And then it is a
choice of whether you want to be sort of left out, you
knoc, by people of your own age."
James Valec, another high,school student, said
that smoking became his way to "defy authority."
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246
Page 7
On a tt:evisior.,program recently, John M. Pinney,
the ne:,-y appoi'nted director of HE'":'s Office or. Smoking
anc Nealth expressed the fol'lowibg view:
"It is quite correct not to make ads the culprit
i'n~ te-rt;s of wh. teenagers take up smokng. Advertising
certainly is not the culprit. If we ear, understand
why they take it up then we can do a more effective
jot of trying to change that deeision."
But to the Secretary of HEW, St is a"pernicious
fact" that young people are being influenced to smoke
"by half a b:llion dollars worth of advertising...
designed to convince ther. that smoking Is glamorous,
adult and sexually attractive."
Fesearch funded by HEW casts doubt on advertising's
alleged power over youth. A ten-year study looked intc
the use of a variety of substances, including alcohol,
marijuana and tobacco by 7th through 12th grade studer:ts
in puG'_.c and parochial schools in San Mateo, Cal,ifornia.
The results run counter to the theory of advertising
sserted by the Secretary of HEW.
The stud y revealed an alarming pattern. By 1977,
store 11th grade students were smoking marijuana and
drinking alcohol than,smoking tobacoo. In tact, be-
tween 1968 and 1977, student use of marijuana had in-
creased more than~80 percent -- without the benefit of
any advertising -- while tobacco smoking remained stable.
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" 247
Page E
A copy of Sumra-y Repcrt, Surve.r= of Student Drug Use,
Sar. Matec Courty, California, San M:teo County Dept.
of Public Hea1tYh anc Welfare, 3/2/77 is attached to
be made part of the record.
AithouEh opinions may vary as to the relative merlts
of the substances focused orr in this study, one fact stands
out: Advertising bears little re:ationship to their use or
consumption.
Support for this view comes frort a study funded in
part by the Ameriear Cancer Society, which states that:
"Economists gene-ally have concluded that ci'garette
advertising in the U.S. has beern a competitive weapon
that eomranies have use!'tc divide the rationai ciga-
rette market among the-se,ves; it has not been used
as a means for expandir,g that market." (The Effect
of Ciga-ette AdvertisinE Bar.a on Cigarette Cor.sur..,ptior..
danes L. Har..;::tcz, P^.D., Associate Professor of
Econorics, wayne State U.^.iversity, in,Proceedin _ of
the Third World Cocfe-er,ce or Sreri- z^c ;ea_tr,
: c~ pub_icat.cn ho. ~_r.~ -1 1S.
_o ot.^.cr words, scap adve-tisinb, for exar;3e,;is used
to persuade people to buy "Lifebucy" rather thzn "Palmo-
live" -- not to persuade people to take more baths and,
therefore, buy more soap.
It is tempting to shoot at easy targets like
advertising and smoking, but the truth is that the
any influences shaping the various lifestyle behaviors
of young people are not clearly understood. It may be
unwise to overemphasize just one.
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Page 9
For exampiie, when state school officials met with
the Secretary of HEW in January, they supported his
prograrn to curtail smoking among young people, but
1'ndicated some concern about possible neglect of others.
Their spokesrsar., Daniel 8. Taylor, Superintendent of
Schools of West Virginia, urged the Secretary to give
"equal attention to such things as nutrition education
and alcohol abuse and similar kinds of preventive health
measures In which school can play an important role !
It may well be, as the Chairman of thi's subcom-
mittee has himself recognized, that the fundamental
responsiEility for the behavior of children rests with
their parents.
HEA_TH PROroTION TAXATION
It should be noted that the Industry has also re-
sponded voluntarily in a number of significant ways in
meeting consumer demand. Through the operation of the
free market, it has established a responsible record of
performance wtich is particularly relevant to
provision of the pending bill.
In the United States today, millions
sumers can walk,inte hundreds of
armed with information about the
of cigarettes and with assurance
the taxation
of tobacco con-
thousands of retail outlets
"tar" and nicotine content
that a broad spectrum of
brands will be available for their choice.
They can express
their individual preferences through the democracy of the
marketplace -- without any nudging from the tax collectors.
