Tobacco Documents Online

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~op•iate: "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. C

C 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.

r C 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. C ca j iZ1 ~ 0 ~ ~

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."

C 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.

c " 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.

r 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.

249 Page 10 The results of the free market mechanisn should gratify thcse wh: believe that "the less 'tar' and nicotine, the better." (See F:gu-e 1) o In slightly more than 20 years, the "tar" and nicotine rating of the average cigarette purchased has dropped by more than half. From 36.5 mg. "tar" and 2.61,eg. nicotine in 1954 to 17.1 mg. "tar" and 1.15 mg. nicotine in early 1977. o Cu-rer.tly, there is no lumerican brand on the market with a "tar" and nicotine rating as high as the average cigarette sold in 19544. o Sales grovthiis now concentrated in what is called the low "tar" segment, 15 mg. or under. In,1976, one out of six cigarettes sold was in this segment; in 1977 it was one out of foir; by the end of 1976 it vi1L be one out of three. In the light of this trend, can we be sure that government tax regulation will out-perform individual choice? Is it a sure thing that the tax collector will prove to be more efficient than the free enterprise system? In other words, if the legislative purpose is to encourage the consumer to smoke lower 'tar' and nicotine cigarettes, then this legisliation is not necessary. 7D-576 0 . 7a - 17

C 250 Page 1I, One example of the government's regulation of "tar" and nicotine suggests a degree of caution. In the late 1950"s the Federal Trade Commisslon banned a.l advertising based on a brand's "tar" and nicotine content. In 1966, the Commission reversed itself. Thus, for over six years, Federal regulators denied the industry the opportunity to advertise and make fuLly availlable lower "tar" and nicotine brands to tobacco consumers. Therefore, it might be argued, Federal regulators postponed for years the decline in "tar" and nicotine yields. If the principle of a"Nealth Promotion Tax" is estabIished'for cigarettes, the field i!s wide open for similar taxes on other consumer goods which have been embroiled in controversy -- for example, alcohol,, automobiles, motorcycles, sugar, dairy products, and foods with higY. cholesterol content. The transformation of our tax system, from revenue-raisi'ng to behavior-control purposes is indeed hazardous. The concept of using the tax mechanism to control personal behavior is also highly unfair. It is a regressive "Rich Man, Poor Man" tax. Its hits cigarettes while it exempts other forms of tobacco. In particular, it hits hardest at those cigarette smokers, such as blue collar workers and working women, who are least able to pay for the right to smoke whatever brand they choose.

251 Page 12 8y placing a nex "hea.'tt protectior" tax or, top of the present cigarette tax burden, it comes perilously close to de factc prohifitioc for millions of low and middle ibcor.•e Ar.e-icars. Like the other "Noble Experiment,"' this measure also has the potential of encouraging bootleggers and racketeers to supply consumers who are priced'out of the leEi:ir•.ate market. New York City tried a "ter" and nicotine tax in 1971; and'gave it up in 1975. A city councilman summarized New York's disma: experience: "Ttis tax has not only been a total failure--it has enriched the bums who are killing us with drugs and the rackets. It has not yielded anticipated revenues. It has not changed smoki'ng habits. It blatantly discrimi'nates against the poor and it has forced thousands out of business." The Tobacco Institute, in Senate hearings on "tar" and nicotine legislation in 1972 and 1976, made the following additional points whicFh are as cogent today as they were previously: o Neither "tar", nicotine nor any other ingredi- ent or ingredients in concentrations as found in, cigarette smoke has been established as causing disease in humans. o No one has estaLli~shed that any particular lievel of "tar" and nicotine is significant.

252 Page 13 o Reduction of nicotine content may cause an increase in smoking. o A dramatic 1!nerease in price may cause a smoker to adjust his "tar" and nicotine intake by smoking them down to a shorter length, by puffing more frequently and by inhaling more deeply. REGULATION OF SMOKING IN FEDERAL BUILDINGS _)' This provision could mark the return engagement to the American scene of two sooial tragedies: Prohibition and Segregation. Ironically, the Federal Government, which was the locus of their death, would become the place of , y. their rebirth. Ironically, too, Federal employees who are so well protected'agai'nst discrimination based on their race, religion, sex and age, would be singled out to suffer the new di'scrimination based on their taste for tobacco. Of course, this proposal would inflict a sym.bolic o:; wound'on government employees who smoke. It would reduce their status to less-than-Sirst-class citizenship. But, what public health purpose would it serve?

253 Page 14 There is much more to indoor air quality than someone's tobacco smoke. Other factors are building permeai:lity,; weather conditions, ventilatiorr and, proba:ly most iRpcrtar.t -- outdoor air po.lution concentrations. Why is 11 silent about any other sources of smoke inside or outside Federal buildings -- such as the automotive parking lots surrounding the Pentagon, for exa-.;:.le. Hanging up "Kc 5moking" sigr.s and segrebating,er¢ployees whc smoke tobacco products will not improve the quality of life -- environmentally, psychologically or socially. The public smoking issue is a red herring. The apprcpriate tocl tc clean up the air would appear to be the Clean Air Act, which has already been enacted. Careful examination of the scientific literature lea:: to an unequivocal conclusion. Many physicians and scier..ists gree -- including,those who have conducted research on public smoking, those who have reviewed the medical literature, and even those who believe smoking is harmful to smokers -- that: There is no health hazard to the normal nonsmoker from exposure to tobacco smoke in everyday si'tuations.

c 0 254 Page 15 Here are some relevant examplies: o Drs. D. P. Bridge and N. Corn of the Graduate School of Public Health, University of Pittsburgh, PennsyLania, stated: ..our resuCts suggest that concentrations of COlfrom cigarette and cigar smoking do not preseat an inhalation hazard to nonsmokers. o Dr. Gary L. Huber, Harvard University, pointed out: No data are available to demonstrate health effects of physiologic response to ni'cotine levels reached in adult nonsmokera,,and carbor, monoxide con- centrations in nonsmokers are far below levels that are of known health hazard. o Dr. David Owen, who was Minister of State for Health in 1975 and 1s now ForeigniMinister, said: A number of research papers have been published on this subject. I am advised that they provide no clear evidence to show that tobacco smoke is harrrful to normally healthy nonsmokers or that a heavily tobacco smoke laderr atmosphere has other than a transient effect... o Dr. Jonathan E. Rhoad!s, Chairman of the National Cancer Advisory Board, and former presi- dent of the American Cancer Society, concluded: I do not have any hard evidence in that direction [that there is a harmful effect from:smoke on the nonsmoker). To my know3edge,,it is not in fact, actual4y harmful. o Dr. Ernst L. Wynder, Presi'd'ent of the American Health Found'ation, who has been a pioneer of research or. t:ie alileeed :C'verse health effects of smokicO1 stated: Passive smoking carn provoke tears or can be otherwise disagreeable, but it has no influence on the health~. In that case, the doses are too smaLl.

255 Page 16 o Dr. Reuel Sta:lones, Uhiversity of Texas, whc was an Advisor to the 1i95L U.S. Surgeor, Gene-al's Advisory Committee on Smoking and'Health, said: In very direct terms, there is no medical proof that nonsmokers expcsed to cigarette smoke in ord'ina,y relatior. with smokers suffer anyy dar„age. o Dr. Gio Gori, Associate Director of the National Cancer InsUitute, pointed out: If you want to remain with fact and not with fictiorr, there is little danger of disease to people that stay in the room where people smoke. CHANCES IN LABE:.LI'NG The proposal to present tec different warning labels is  Swedish import and has been calie: the "fortune cookie" approa:h by the Secretary of HEW. Swede- requires sixteen alterneting warnings. Other countries have a single warning, with different wording. F. ince, for examp3e, requires the warning that "Abuse is dangerous." The current United Kingdom package label reads, "HM Government Health Department's Warning: Cigarettes can seriously damage your health." Our own country has yet another variation. Iceland had a compulsory warning but later abandoned it. Some countries have no warning at all. These national differences demonstrate the uncertainty and confusion surrounding the use of warning labels.

256 Page 17 An essential feature of any warning is that it must be factual and'meaningful to the ordinary reader. A warning that lists specific diseases supposedly associated with cigarette smoking could be interpreted in two different ways by the public: that smoking alone causes these diseases or that smoking always causes these diseases. Neither interpretation is supported by scientific evidence, hence the warnings may mislead the pubLic and prompt skepticism about such government messages in gereral. The rational,e for a warning Label, Swedish atyle or any style,,is the conttntion,that the public is nct informed about the asserted health risks of smoking. But can this eLain be taken seriously? The public has many sources of information about tobacco products: m-ass media, specialized publications, individual health professionals and a delvge of reports and bulletins from both private and,governmental agencies. As early as November of 1968, the director of the HEW'a National Clearinghouse for Smoking and Health conceded that the public was well informed on the amoking and health issue. "You could stand on a rooftop and shout 'smoking is dangerous' at the top of your lungs" he declared, "and you would not be telling anyone anything they, did not already know."

257 Page 1E The SweGi'st,-type r•arning labels could have an uranticipatec effect. They have the potentia/ of becor.inE the object of a teenage hobty, like co1- 1rcLinE baseba_1 carCs or coric books. THE SCIENTIFIC BASIS S.3'1b rests heavily or.,a "'single cause theory" of disease. That theory, however, can not support the huge reEulatory scaffoiding that its architects have desi'gned. Reeent resea-ch into environmental and occupational factors, for exaT~rre, is developing new• data indicating that chronic disease cay no longer be so readily and si'mply attributed to tobacco smoke as some have claimed. "Oc^ipatibnal factors may very well play a far IDore sigr.ificant role than is presently realized in the eausatiorn of the major diseases and'health protlems that confront us," according tc a report to the Ford Foundation, whict added that: "Heart disease, the leading cause of death (accounting for.., about 750,000 deaths), is only 25% 'explaineV " by known physiologicali and environmental factors, such as excess weight, hypertension, serun,cholesterol, and cigarette smoking. An unknown but quite possibly sub- stantial proportion of the 75S of heart disease risk that is presently unaccounted'for coulid be related to work and its attendant hazards, particularly stress." (Crisis in the Wsrk lace: Occuati'onal Disease and Inur~v. A report to the oro oundati'or., Nicholas A. Ashford„ MI7 Press, 1976, p. 1A~J 1

I C C 25S Page 19 Indeed, some scientists are growing concerned that the preoccupation with cigarette smokn6 as "one of the principal contributors" to the incidence of certain diseases may be ill-founded and dangerous -- 511- founded because the scientific evidence on many critical points is conflicting, and dangerous because attention has been -- and is being -- diverted from such suspected hazards as occupational exposure, environmental pollution, diet, heredity, and the like. Despite its frequent iteration, the statement that . "cigarette smoking is the single greatest preventable threat to our nation's health" remains an allegation that is not supported by "al'1 the evidence." In hearings before this Subcommittee i'n 1976, the tobacco indvstry subr_itted'a detailed response to the U.S. Public Health Service's latest analysis of scientific evidence on smoking and health, entitled Health Consequences of Smoking -- 1975. That response, which was printed as part of the record~ of those hearings, marshalled evidence showing that smoking has not been scientifically establistied as a cause of human disease. Since those hearings, no study has been published' which would requi're a change in the industry's position. Indeed, many recent studies demonstrate that "all, the evidence" does not support a smoking-diaease causation hypothesis. For example: l

C Page 20 -- A 1977 study by Coher,, et al., strongly suggests. • comron famili'al compor,ent in bott lung caoce- ar:d chror.ic obstructive lung diseases independent of smokinE. [Lance: 2(8D37):523-526, 1977.1 -- A 1977 study by Forde, at a1. found an increased risk of myocardial infarctior. in persons with fanily history of myocardial ir,farotions compe-ed with persons without such familry history. The authors also reported that "cigarette consur..ption shows only very little vari'ation in the different g.roup=, and thus cannot be responsible for the disagreement." LAmericar. Journa: of :piderrieloES 1C5(3): 192-199, 1977.) -- A 1977 study bry•, Parkash fcun~ that the incidence of liung cancer in Vienna has recained ccr.stert since 19~2 despite the fact that tobaccc cor.surrptior, haE beer, steadilly - increasing. The author eonclud'eC'that "there are other factor: which play a more important role in the etielogy of lung cancer" than tobacco consumption., [PesGi,ation 34'(5):' 295-304, 1977.J -- A 1977 study by Lawson, et al., found no association between thromboembolism, smoking and duration of oral contraceptive use. The authors stated~that their "study provides strong evidence against a major effect of smoking on the ri'sk of thromboembolisrrm in a group of otherwise . healthy women using oral contraceptives." [British Medical Journal 2: 729-730, 1977.) c

260 Page 21 -- A 1977 study by Stolley, et al. was unable to account for geographic differences in the incidence of stroke on the basis of smoking or other well known risk,factors. The authors concluded that "there is a strong possibility that environmental (both physics: and social) factors other then the presently known risk factors for stroke and atherosclerotic heart disease may account for the observed geographic differences in mortality." LStroke B(5): 551-557, 1977.1 The claim that "fes:, if any, self respecting scientists or physiciar,s in this country" hold the view that smoking has not been established as a cause of human di'sease must be disputed. In this Subcommittee's 1976 hearings, we listed some 46 eminent scientists or physicians who had either testified or submitted statements to Congressional committees in 1969, 1972 and 1,976 questioning the theory that smoking is hazardous to health. A list of these scientists and physicians, together with their ecaderzic nd professional, affiliations, can be found in the record of the 1976 hearings.

c 261 Page 22 A review of recent scientific literature reveals that others, both in this country and abroad, have begun to dispute the asserted link between various illnesses and'smoking. For exam;le, in May of this year, Professor Philip Burch of the University of Leeds 1n,England, in an address to the Royai Statistical Society, questioned the causal relationship betweenismoking and lung cancer, ane made the following observation: "As we are a11 well aware, many eminent persons, comri'ttees and comr..issions have unarimously conc:uded'that lung cancer 'is almost entirely due te cigarette smoking.' I once shared thet view,.but having now studied the evidence in more detail and' from new angles I feei unaE;e to reach a definitive conclusion, apart froam reject- ing,the 'pure' causai theory. Accorcingiy, I find myself forced back to Fisher's (1g59!) earlier verdict: the data so far do not warrant the conclusions based upon_ them.' To make valid deductions about the causes of disease the rules of statistical inference need to be strictly observed; I hope that intereste: statisti- cians will scrutinize the frequent and ofter, strident claims that a given hatit or dietary factor causes a particular disease." One final point or, the scientific evidence. The smoking and health controvers_ is growing in intensity. After twenty years it is not dead; it is risir,E like a Phoenix. As an editorial in the American Journal of Public Health -- a publication known for 1ts anti- tobacco position -- put it:

C 262 Page 23 "Tne pers:stent controversy reEarding the role of smciang in lunE cancer cannot be resc:ved merely b~ esca:atin6 the force of argume^ts prc anc cor.. TGat these argur..ents are becoaing increasin5:y soph'_sticated and more vigorous serves to deron- strate that the Sssue is hardly tri'vial. Ltt us, therefore, carefully exasine the nature of the problerr.s we confront and seek to idectify meaas of approaching thea in tht best interest: of both the scier.tific commur.ity and the genera:' popu:atior..• (Itrahia., M., The Cigarette Smoking/Lung Cancer Hypo- thesis. American Journal!of Putlic Hee:tk 6E(2): 132-133, 19 There are additional arguments and still sore evidence on the less popular side of the controversy. We respectfully request per¢issionito subait for the record sore detailed analyses essential to a better understanding of why the tobacco industry is 1n opposition to 5.3118', and believes it is unnecessary ir; its purpose and un:arranted i'n,its premi'se. P orace ornegay President The Tobacco Institute July, 12, 1978 r

CC 263 U.S. Sales•Weighted Average "Tar" & Nicotine Yields "Tar`ntps 37.0 A 3.1 Nicotine mps 36.o 2.0 I t I 1 1 35.0 ZJ 1 1 1 31.0 2 6 11.01?SD Ati branac ont U.S marne:. i 1 1 I I 1 i 1 L .~ htic otine \"T ar " ~ 1 . ~A %t, , ~ 1 , ~ 1.1 1065 t07C1975198CData eompileC by Prsillp Monns In¢. - Jain 1978 ti 2.6 2:1 20 LG 1.3 1.2

264 iA- -hI E~`"h 17 .'/•^) : ; 968 1969 1970 19711 1972 1973 1974 1975 1976 1977' SUMMARY REPORT - SURVEYS OF STNDENT DRUG USE, SAN MATEG CUUNTY, CALIFDRti1A ALCOHOL - AMPHETAMINES - BARBITURATES - HEROIN'- LSD - MARIJUANA - TOBACCO TRENDS IN LEYELS OF USE REPORTED BT JUNIDR'AND SENIOR HIGH SCHOOL STUDENTS This 1s the last of a series of ten~annual surveys of~levels of student usage of drugs and alcohol conducted by the Research and Statistics Sectior of the $an,Mateo.County„ California,.Department of Public Nea'th and.Yelfare unde• the direction of Lilian St. Clair Blackford, Biostatistician. These annual surveys„ funded'bythe National Institute on Druc Abuse„ have been~eaoe inn cooperation with the San Kateo~Couety School!Departmer.V„ and the prdirate, parocnial and public sChoolsin the County.. The ten repeti:ions have produced~ a series of cortqarable rates ShOVing Independent trendS.for each ofthesurveyt: subs:ances. These are basic data on changes in patterns of use for each of the seven substances surveyed. The addition of thr 1977 data to the series strengthens the findings of tne 1976 fumrary.report - that severa7 Substances appear to be reaching their own~indivi- dw1 plateaus, levelling off, and possibly decreasing in~use. The ori'ginal preRise of the study was that each drug had sone levelling off point - a ceiling Of use - and that at some point In tiee this would be reuhed. Inspectior, of the dltailed tables asade 1t appear that this levelling off point was reached for barbiturates and aaqAetamines as early as 1971!. Significant differences betweern rates for nales and fewles of one school grade, and between grades were deneonstrated in the initial, 1968, survey. If pooled data which inaludes awre than one class/sex cell 1s to be used for rate cormparisons froRm year to,year It i's necessary to standardize so that changing proportions of the class/sez groups do not produce false directions in the rates. Since no precedent was available. it-was arbitrarily decided'that the standarEized rates used in the tables would include e4ua1 proportions of each~of the eight grade/ se: ute9ories in grades nine through twetve. This brief sumry report eephasizes annual trends. The data can alse be arranged so that the build-up of use In one particular group (cohort)',can be traced beginning with its seventh; grade tRrough its senior year. There are any possible arrangements of data available showing various eoa0inations of drug use, such as correlations between drugs, clustering, over the ten annual surveys. Sunmarization of this extensive body of data in a manner that is reasonably clear, and which exposes the aore striking findings is difficult. Over the years a very slsqie prediction device has proved useful. Thirty-six rates are produced for each substance each year - three cunutative levels for ead+ of twe sexes and six grades. A rate can either go up or down. If. there are .ore than eighteen rates that are higher than the preceding survey, there is a strang tendency for

. 265 the upwa"d pattern to repeat Itself for the drug the next year. As an Index ,rade, the elever.tr. gradi has appeared to be .ost satisfsctory, since tne R is a consideraDle droC-ou; aftt-tne Jurior year. Thesee drop-out studer;s have more then.,their sharTe ofdruS anc alcohol users. Therefore the eleventh gredt! /s ellette0 as being eost representative. Although thi's repcr; dwells upon what has happened'over the past two years, shifts /n usage must be conside^e1 in retatior to the total ter, year picture. The follo-inc taDle selects rates Of.ust at different levtls.for Junior, studentsto fY1n:YriSe tdjcr, trends. .. Any Us e Ten,or More Occasions Fifty or More Dccasions Males Females Males Femalts 114lts FeRales 196E 1977 1%8 1977 1%e 1977 1968' 1977 1970• 1977 1970• 1977 -V coho1lc ` ieverages 70.7 90iY 67.4 89.5 39.(r 63.1 24.0 56.8 23.4 34.5 12'.9 29.8 NArtphetaeines 17.9 18.5 17.1 20.5 7.0 6.1 6,4 9.3 3.9 2.6 2.9 3.4 8arbiturates 17.3 11.6 15.0~ 12.9 6.6 3.9 4.5 3.4 3.6 1.7 1.7 1.0 M-Meroin 4.9 4.0 3.3 2.4 2.4 1.7 1.1 0.3 1.8 1.4 0.7 0.2 LSD 14.6 17.6 9.2 11.6 5.7 4.2 3.6 2.4 2.6 1.7 0.8 0.7 + 14rijutne '*.9 65.2' 71.7 62.8 22.5 46.7 16.7 41.9 2?.5 31.2 14.4 24.6 k` tobacco - 56.7 53.6 57.4 61.9 39.4 30.1 35.4 43.3 28.9 21.9 17.6 3/.4 ot avae ane or c. " 1970 data subsa tuted., ~" 1971 data substituted. ;:XCDHOI usa has definitely Increased. Not only have thirty-tAree out of a poss o e tnirty-sis class;ses level rates increased; but the amount Of the incneases were Qeneraily larger tnar had beer esperienced since 1971. This was a surprising finding since the data tnrougn 1976 had shown a pattern which had been construed as indicating a levelling off. The eediar, un also be used to Show what a student who says that half, the guys drink rone frequently than he, and the other half, less frequently, did in the tvretve nonths preceding the 1977 survey. A eiddle-of.the-road eale Junior consueed alconol on about four occasions in 1968, and twenty-nine 1n 1977. r

41 e*s 89USv4Efl SM MA1E0 COUMTY, CALIFOItl11A, SURVEYS OF STIlOENT DR11G USE CIMOM7IYE t)91:IS OF 16! IIEnN17En /. JIM11111 AN1/ Sf.N1fN1 n1/7/ SOl1(N, s700t?Nli, 116/-1s77 /T S/]RR)L Gnw ANo SF; Oi RfCrifR1FMT, Srlflrli_ RA71:5 PFR iRIMMIn R/SMfVt1C. Yllul M t -Rt t--- m t t - t~~6~ -~ t t- t SI/RVF.Y Gpd. Gr.d. Gr.d. Gn_d. GrwM Gw_dr I Gr.M Gr.,N Gr.Ar Gr.d. Grfdf Grwde ReZnr11w0 .w7 use .F .ICOqo11r trewr. ef durin rtcediw r.r, _---_ -- _- _ IiMO t//1 WA 61.0 e1.S 70.7 )6.S NA 1Y1 l7.0 00,1 07,A 1l69 3J.3 60,7 N.3 73,7 71.! /J:0 )/.+ so.• e),7 61,6 71./ ' 1!)0 1~,0 61.A ee,l 7s./ 7s.7 /0.• .?.e Si:1 6].w 7).3 71.0 /9)1 )S.1 e1./ 7.,0 76.5 /J.. R3.J I).0 63.6 e1,J 7+,1 77.6 1l1J S/.S 70.5~ 7S./ 01.7 OI,S /LS 1/.6 67.T 73.7 M.S M.! 1l7I lY./ il.e /7:1 /S.~ /6:e N.1 61.7 1t.7 1I.S 1!)+ 7J,0 01,6 /..A N.9 /7,6 /9.S 70,7 71,1 /7.2 /1./ H23 70.0 79.7 /7:7 /7.0 /).! 19.3 61:7 77.1 OJ:J /6.T 17,7 1l76 e7:9 7e./ /1:! /S.s M:9 67.1 w.• 7+.r Ro:3 R/.6 //a 1911 71:/ 7/,7 ti a /..9 70.T l1,e 6}.S 13.0 ua /7.,i N,s tA~.rtlg M..i aedh.llc Mwr.N9 aw tw er rw .rrninwf Irrin/ lrecedlq y..r. 191/ /M NA 71,. J6,7 n.0 6t.. NA /M u.. Is.t 70.0 /9e! w.9 n,i Je~.9 .N.O 13:6 sT./ /,7 u.t J1:0 n.s 70a /!70 11.7 JJ,• Je.s 3R./ aS.O +9,R 6,7 I,O 20 0 ! 11.7 35:0 1l71 te.6 30.e 16.J .S.o Sa.7 S/.! ts.7 7).A J/1:/ H77 11./ il.+ 77.1 S1.e 56.6 66,11 1+.e 77.7 35.1 N.o H,/ 1173 75.3 3l.T 17,6 S..S e0.7 6J,0 1R.1 )7,9 M,. g,/ 30,+ nll J..! »:S +s.s 3..1 .1.7 u.• n.7 ».. u.r SO.e s..7 Il/S n.e li:) a.S s+:7 67.A w1.1 H,/ T1.s .n.. ds.e SI,S Is7. 1/.J J0.7 n.o H.0 61.e A+.1 It./ ».3 .1F.6 e9.3 56.0 1}77 Is.) Jo,6 41.1 15:9 61.4 6R:! 11.1 7s:J 10.e se.9 50,1 "rtlw0 w. .I .1caAo1lc O.wrwpf M fifty .r .or. ncc.dawf rrrlN lncdlwg post. t76/ NA NA NA NA NA 11A 116! NA NA NA NA I/A NA 1l70 NA NA 11.3 17,9 J3.. 71.0 %.6 Il71 NA MA 17.6 T+.e 32.3 Il/1 /rA NA 17.6 7/.3 3T:S )9,7 11T3 1o.s 1/.7 Jl.+ SI.J 37.a 31.9 _y7+ 10-.4 M,6 )J.3 Jf./ 1s:3 .e./ --19/S /.0 IS.) 70,0 77.7 35.6 A1./ N16 e.7 IJ.1 17.7 a.z )l.f )7.e 1911 7.1 13.1 70.3 25,7 34.5 39.5 NA NA NA NA M NA NA NA NA NA NA NA 6.0 I).~ 17,iT NR MA t7./ 17.0 11.1 NA NA /1.. 11,1 ~3,7 /.I IJ.• 7e.1, 7).! J7:i ~.N 10~~ fA.S S~.t N.6 13.3 73.0 19,/ AICONOIIC 1+FYFRAGES 71.1 61,+ 10,77+ 75.T 77.6 JS,/03 77,0 7r,0 i5, trll 7l,/ fA.! ~S, 701 /).7 00,0 te,l 31,751 Tf,3RR IO,J72 R7.6 N.J T1 S07 OR.e s.~ , 70,/IR 91,5 N.0 7T,0n t7.0 27. N 1/ . 31.3 , /eJ ~ JS 1s.7 , ~ 15,110 ls,7n1 S?,. SR.1 31,751 )7,JU sl.0 7R,7/T s9s . 7/. M11 }6 ;e Tn, Ru w7,7 71,n77 IM IN1 w MA 1/,77+ TS,R~I 13,! IS,O JS,11R 1/.S JS,O Jl,+ n.l T/.e 1%. Inl J1,TS/ t1,uR M• ?~.T 79 ) iza 76.JV 71.• JJ,0/7 fiwlir7rrA7 /ilef-r/ we Fwr frw/nr MRR lrwnnlf .nr rnqwrlri M1oR fy"l ry.Ul-IYf IRr .wr.-w elrn/s.. IraTs. T.is el/wiwae. dFrtnr1lww Are.we pr.f...rriw9 f elu.rf wr f...1 OAr+ rA.,.KI Iyl.rrw rt.n, •`Tot.l najohrr of nsrnefff wed In LMdwt/ewf inr IM r..r fpr/i/.l J/7/77

690Sv4Ep SNI MATEO GOIMTYr CALIfOFA1/1. SURVEVS OF SIUOEIFI DRUG iKE ArMEtAninB - G1MNAt19e IL9p13 Of I/SC R[MIeRO et J1611(M ANe 3lN11N1 N7® qrSReN, 51110rN11, 19611.1f17 fr SnNr11, GIUON ANn s1I Of 6[SMi1NNr, Srrctrlc R.lf's W.R IN911MfN OI-c1Yr1[rs. T -~ fe n a rq TlAR Or 7th 110, 1 1 t t j t~Ir It~-~iT~ et r' 1n7c1 , 7 nte1•• 7UNY[9 Crtde Credt Gr.d. Crede Grede Gr.d. 6redr Gredt Gr.Ae - f,r.Ae _- Gr.A Gr.Ae -- 6rn des 9.17 e rlpnn,.6 R1pr11n0 6M M. nf etphetNINr durl~Lc.dlnt y.er. ~- - - I9N IM NA /7.0 IS.S I/.e 70.5 NA NA 11,1 16,1 11.1 10.1 16.e l e, 77d I+M s,l IJ.1 ts,s 11.1 27.1 75.6 S,f 10,1 79,5 70.1 71.7 Lf.9 70./ 2S,6e{ 1970 7.7 9.3 13.0 16.5 20.7 114.1 1.8 A:7 11.1 7/.. 77.) 20.2 1+.5 35,116 1171 S•3 10.0 1e:o :+.s 7..6 2e.7 s a u:l 77.5 26.6 7s.6 71.5 )):3 )5,7n1 Hli S.I 17.e 16.f 71.0 ' 7 L e 75.6 6./ 11.6 71.7 27.4 25.1 24.4 23:6 11,151 1+1) 3.6 73 11.6 70:3 SI.S 71.1 2.7 7.6 16.6 21.4 73.9 70,1 N.9 17,1tR 19/. ),1 7.5 11.1 17.7 70,7 71.2 1.1 7.4 15:3 70.1 27.0 J).0 11. 7 76,21) 111S 7.7 S.S 11•0 11.1 11.3 71.2 2.e 6.6 17.6 16.t 27.1 77.3 17,5 1f, NS 1976 7.6 S.0 e.0 1J.6 1a.3 If.A 2.0 S.S +.6 I5.• 71.7 U.6 IS•S 7n,61N 117/ 2.7 4.6 7,1 17:3 IS.S 70,6 2.7 S•1 7,2 11.0 20.1 20,9 IS.1 77,07/ f. Rqertlet w9 6f ..phMNIMr w NN or .en occnlonr durlrllraqAlnt 7..r. - 196e 161 NA 1 0 S 0 1 0 e 3 MA NA 1.7 6.1 6.• 6.7 a•a u,n1 N 196f 1.7 3.4 , S,1 . 7.2 . f.S . 11,1 1•1 1,7 6.1 6.7 S.0 e,3 e.e 7S,Ae3 Q) 1f7o S.6 S.2 i:e 0:1 1•1 S.. 9.3 S•) 7:e 7.1 35,116 ~I 1971 Ls 3a 6.7 l.e to.c w.7 1:1 s.0 7.6 u.o 11.7 so:. 9.t 7S, 701 1072 1.t 7:/ 7,3 O.S 9.2 lo.f I.1 ..7 6.S 11.1 i7.f n.1 9. 7 11,751 1s 7s LI 2./ S.) 7.1 7,e 7.1 0.6 1:9 s.0 6.s f.7 s:9 7, 7 n, 11A 19)1 0.7 7.0 7.6 6.1 7.t e.0 0.9 1.7 S.7 7./ IO.e 10,7 7;S 7e,777 1977 0.6 1.) ).6 t,6 7,S 0./ 0•7 1:7 1:0 6.0 f.1 10.4 6:+ 76, IQS I+t6 0.l 1•7 1'.S .:o 6.1 6.6 0,7 1.7 2:e 6.. ..1 9.0 $.e 70,t111 nl7 0.6 L s I.) 7.~ 0,1 1:. 1.7 s.l 9.3 R.1 S.s tl,on Mfertlnt we af lleph.tNlMt N llft7 er wre ocNrlN±t durint rncodlnt je.r. 1960 NA NA NA NA NA M6 NA NA NA /NI NA 11A NA 16,771 196+ MA NA NA Nh N/1 NA NA NA NA NA NA NA NA 71,665 1970 NA NA 1.+ 7.0 ).9 1.1 NA NA 1.6 1.e 7.0 7.7 7.e 75,116 1971 NA NA J.+ ).0 L e 5.6 NA NA 7.5 1.0 t.6 1,) 1.0 1t,7n1 1977 NA NA 7.) 7.6 3.6 S.1 NA NA ].I t.S S.7 I.f t,l )1,751 1973 0.0 1.2 7.7 1.1 ].6 1,1 0./ 0,6 1.3 7.3 /,1 t,l ).S 71,366 If74 0 .s 1•1 1:e 2.1 2,6 l.s o.6 0:l 2.0 S.o /.7 s.e ): 1 771,)17 19/S v.d 0,9 1-.7 7.1 1•1 3.11 0,S _ 2•9 10,SnS 1976 O.S /.e 1.2 1.+ 7.9 3.3 0-,7 /.e e.9 2.1 3.7 s.+ 7:1 70,e.6 tf77 o.s 0.6 e.0 t.s 2.6 :.7 0.7 0:. 0.7 7.1 3.4 3.) 2.1 2),n n • r. • rau n we r un nr f s[ on r nr. roqN,Pr -e. nt rqu. pnpu .1 anr . rtt s .. R tl.rs/f9r ~raqn. lhls tll.lattrf dlstnrUen heceoa rrporllnns of ein.or ar r.te7 hevr chmRrd het .rrn 7rer+. ••tot.f nueher of n.pemes •,•.d 1. tnhnlnllnnf fnr 1h. reer .prclfled, 1/7/77

f.• . ~ W% 1111Eo PWtr!lALtFFlA1n. WAvErlWlk S11ARNr qIAIG IMN •• M •• ~ •IFOF,+W M CIMNA719t+ IF9r13 M 11if Nr.MN7r./1 NY .11M/0N ANN SENIINI N1/71 Sf7NMN. S71MNM7t• 19AE-1f77 N7 C(;l/p1L r,'NAOr ANI/ ir! or NrCrnNM.NT, SCrf'!r![, NAlTS rrN INNIMIO N7CMNCEC, TEAN M l 1 SINIYF,I 6r.de C.r.de Crndr r,r.de f.r.Ae f.r.Ar f.r.de f,rrde f.reAe f,rAde Gr.de f.r.Ar Nqortln7 .N7 w. eE MroIN durlnE recedln e.r. _-_- _ _ --- _P____ 196N NA NA NA NA MA MA MA NA NA /M NA NA 1969 NA NA NA NA MA NA NA MA NA NA NA 11A 1970 NA NA NA • MA MA NA MA NA NA NA NA H11 NA MA 3.7 ].9 r.f S.f PA NA 1.9 7.0 !.7 2.0 1977 NA MA . 2.7 ,O !.7 1.6 NA MA 2.! 2.• S,O 7.7 1975 NA NA 3.1 4.1 7.7 /.! FA NA !.1 7.1 7.6 2./ 197/ M MA 3.3 7A 7.1 /.2 NA NA 3.7 !.• L S 2.7 1975 NA MA 2.7 7.7 4.0 4.3 NA NA !.3 2.7 1.9 2.9 1776 7.7 1.8 3./ l.11 1.0 7./ 7.7 1.0 7.2 2.1 197 2,/ 7./ 2./ 2,7 1;0 1.1 1./ 2.s 2.0 2,/ 2.. 7.9 N.~Ind q. sf Mrols ttN or ~Nt. eee.+l0N1 durlq precedlnVeor.-Ib0 MA NA NA NA MA MA MA NA NA NA M IM I9A9 NA NA MA NA MA NA NA NA MA NA IIA NA 1970 NA NA NA NA MA NA NA MA NA NA NA NA 1911 NA Not 1.~ 1.0 7./ S,0 NA MA 0./ 0.~ 1.1 1.1 1977 NA Wt LI 1.7 Ls 1.0 NA NA O.E o.0 1.7 1,0 1975 M~ MA 1.5 L t 1.9 7.0 NA PA 0.9 0.0 C.O 0.9 t17/ MA M~ 1.9 LA LS 1.1 NA MA t1,0 Ia7 0.~ 1.2 1971 MA NA 1.1 1.7 /.~ (.~ MA NA 1.7 O.O 0.6 1.0 1920 0.0 1.0 1.2 1.7 I.E 1./ 0.2 1,7 0:/ 0:/ 0.9 0.9 1917 o.S /.2 0.9 1.~ (.1 7.1 O.S 1.1 O;3 a O 0;! 0~.A ~o~.rtlNl w/ of N.1.1N fIFl7 Of Nor9 occo+lwrl dorlNO NrecodlnS 7..r. NA M\ NA NA NA NA MA NA 1.! 1.1 NA NA NA NA NA NA NA 0.2 0.2 NA NA NA O.! 0.0 N./ 0.7 0.0 0.2 e.A NA NA MA 0.7 0. 7 0.0 O,S O.S o.s e, 2 .np..nlt.n N.ee• 7or.l r...Ms o12 NA NA MA !.S 7.2 3.1 7.1 7.0 2./ 2.9 NA NA 1.0 1.2 1.! 1.3 1.7 !.o 1.1 Tot.l•. Nr.pnn.r+ NA 0.• e./ o4osv4Eo •SIMd.rdltM rnt.+ nr u+• /nr *.nlnr N1NN NcI-l+ .n r0'wed ranr eqoolIN~.pY 'I., eight -' cl.++/+er Nrmq.. TAI+ e11.1n/1r+ Al+tnrrlnN Mr.r+e prnpnrlloN. e! CIA••e+ wr +.r.. F... rF.ntqA Mr.rr..n 7e.r+, "Total mr•F.r of n•Onn+.. o+rd IN td.olntlnw+ ror tNe 7eor rryrlrlyd. 7/2/77

SAII MATEO COU11Ye CAl•IPoRNIA. SORVEYS OF STUDENT DRNG IISE IUIRRITtlRA1ES L100/Utt9F. 1791L•9 (f1 11iF. Orl'INITFN 119 JINIM 6Mn tFN1/M 14101 VINOIL ST1NK-N93, 196N-1977 NY S111N7L f.N6M' 11N11 tF1 M NrSIY1NiNN}, ~Tt/,ll IC N6//t PIt 16a/7MFN Nr~r'tlNiri, 1 -1TAFIT". YF.ON OF I Ti t • r t r.l inl.t•• SINIVFI Gr.M f.r.de G.de G..Ae GrndT f.nd. GraM Gr.AT f. I f....AT fude Gr.dr Gr d 9_Il .r.rml.y Nepertln( .nt use Nf MrAltur.les durln(irereAln3lr.r_ 1760 N6 N~ M/1 M6 M6 Nh 6 M11 Nh Nh N6 M~ M N6 10,771 1969 M6 NA M6 M. N6 N6 M6 N6 N11 N6 N6 NA N6 75,6.3 1970 3•3 9•6 II.S 16.6 11.3 1~./ l,t 7.1 11.5 10.4 Ic,O I3.9 It,116 1971 i.N 11.0 16.0 16.0 19.0 16.i S.d 17.7 16.n 19.1 17.9 ti,0 17.7 ti, 7/11 1977 5.1 10.7 11.9 16.0 Ic.l 15.6 c.N 11.1 11.6 17,7 16.0 1..1 11, 0 t/,751 197! S.t 9,0 13.1 11.7 1i.1 19.n c.l /n.. I3,~ 1..11 IS.O 11.6 t1.9 77,ta1 197c 5.0 9.0 11•S 14.6 14 .5 Ic.7 d,l O.N Ii,O I1,9 IS.I /~.) I~,c 7.,717 1975 !.0 h.0 IO.S 11,1 13.~ 11.1 1.1 7.9 Il,i I~.d 11,/ /6.1 Il.n 7a,lnt 1976 ].3 7.7 10.0 11•1 17:d 17:7 7.7 6.9 100 1i.1 IS•3 II:N . u./ 7n,111N 1977 3.S S.N 6.6 9,1 11.6 I7.0 1.7 6.7 9 ,9 17,7 17.9 17•9 It.O 77,nn 0 rtln( us9 e/ b.rblturcln en len of .on ecc.s/ana durlnI precedln( 7e.r_ 196t Mh NA MA Na M/1 Nh MA M6 N6 N6 Nh Nh MI1 1N, 77l 1969 MA N6 NA M: NA MA M6 N6 N6 N6 N6 N6 N6 1970 O.S t.3 3,0 L0 h.a S.O ~.d 7.1 4.6 1,7 d.3 1.6 i.t 1i, l ln 1971 1.7 3.7 • 5.S 5.1 7.7 1,7 I,N 3.S S.t 6.} 6.0 3.3 6.7 lt,7~1 In71 1.7 3.0 3.7 S.S d,0 i 6 0.0 7.7 3.d 3.1 I•6 ~.0 31,751 I911 1.3 7.5 3 .7 1 3 ~,3 1.0 6•} 6.} 77,v16 791. 1.7 Lh t_6 1.i 44 3.6 0.9 1.9 3.. 3.3 •.1 3.6 3. 7 }/1, 7l7 I9/S 0.6 I.i }.6 l.1 ~.t !.0 0,9 1.3 1.7 1.4 3.6 l.i 3.d }6,101 1916 1.0 1.6 1 .1 7.7 1.1 !.t 0.1 I,0 2.3 ~.. 4.5 4.3 3.~ ]n,.4 N 19/7 0,6 1.1 1.5 7.1 !;o !.5 0,/ 1.7 1.6 1.0 3.4 3.7 7.9 77,n77 rt1n0 esq ef ANrblteraes eN LlftLer wer. ecuslnns dllrlnt1.rec.dlp(jecr_ t1eC _ 1l6t M6 M6 N6 N6 NII N/1 M6 N6 Nh N6 M/I NI1 Nh 16, )U 1969 M6 N6 M6 NR N6 N11 N6 NII M0. M6 N6 Mh li,a6l 1970 M6 - N,1.0 7.3 !.6 l.d M6 N6 I,S ).0 1.1 I,S l.l 1i~1.N 1971 N/ M~ L h t,S 3.0 3.7 N, Nn 1.6 7•3 7•7 t,t }, ) 1i,7n1 1977 N6 M6 1.a 7.0 }.1 7.N N6 MA 1,1 1.9 1.3 t.1 1.9 Il,lil ~'. 1973 0.N 1.2 1.9 7•3 7.3 7.7 0,3 n,9 I.d 1.9 1974 0.7 1.4 1.4 1.9 1.0 1.3 0.4; O.7 1.! 1 ~ 1.1 1.3 1,. 1975 0.3 1.0 1.1 1.6 1.7 1.0 I7,5 0,3 1.3 t,l 1.6 1•3 1.6 76,1n! lo7a 0.5 1 .0 1.1 1.1 1.5 1 .t 0.1 1.1 n,/l I.d 1,7 1.0 1,3 M,6.N H77 O,3 0.9 1.7 1.1 0,1 1,1 17.7 1•7 1,0 1•0 1•7 l1,n77 H •. re. T9 e! O IN• nf 1eN IIT ( }r M. 1R tiN ll(-Mnl. Ofb11 • Alf 9r e O •• elnf/ua tfOUOS. 7Ab sll./mte} dlanrf/nn M<.nar Ornp..rllowa ef rl.a.e.. nr .e.ee Awe TA.n6ed Mlw.q 7e.rs. •.•Tnt.l n1.A.r of K+Mnaes usTd 1. toMllalens for tAw 7r.r areclflTA, `'^oSvllyd(.o

: 270 a:~------ ---- ---- -.-«-..--- a~=------- .17 ..:. «.-« ~;=--•--- -------- « .««....... _ = -=--- _ «« «««__ ~-------- I ~::.. .. ~=- - - - - - :5i:=,,, = ;I '_.~+ d ........ FI ......__ : m :I .M1...--.-° Rse------=:~ ts-------- .

SAII MTEO C0111iY, CALIfOR111A, SIIRVEYS OF STUDEMR DROG USE (1M7UIT19H LCITIS 00 16! RrM7RTE0 07 JlIN70R ANO tM/1f111 NIl2N Sf7N1fN, ST1NIMf!• 1960-1171 Bt 5(711111.PAW ANII SPR OF RfSW111N-.NT, SPIt'IFI[ RATrS M9 1RR11Mf.0 RI':1'fNSFS, MRIJOAMA --f1A~Fa -. . G.e d:~dl~ad 9lNlllf t t =-t.- 7 e t t tS~- -- -+ Ont e• Tnt.l 81RW[T Gr.Je f.r.do Gr.Je f.r.Jr Gr.de GnJe Grsde Grrde l:r.d. Greda Or.Ae Gr.de f,r. des 9-17 Re~~60 Oeprtlq r7 r6 ef rrllrn6 Iurlq pr.cad11~0ey -~ -- 19L1 NA NA 26.0 32.3 36,9 11.0 MR N6 22.9 20,1 ]1.1 11,9 51.! 10,771 196f 10 1 11 ! 31 9 11.7 OS,S 50.1 I0,7 71.1 31 9 n.s 3R.7 ln.l 19. 75 lR 7 I97U . !.L . 17.0 . 31.0 11,! IR,9 50.9 7.1 16,1 . )1.9 12.1 I1.L 11.1 U.3 , ]5,110 1l71 17.6 7l.1 IL S 19.7 57.! $II:! 17:6 26.4 eO.S 11.1 50,7 1R.3 N,1 SS, 7111 1971 17.1 53.7 1).! 51.0 S9.S 60.1 /1.1 79.3 39.0 50.0 51.1 51.0 J1,251 I9/1 20.0 34.3 51.2 56.1 50.5 61.0 15.6 31:3 17:0 $1.9 55.3 57.3 51.6 77, 1RR 1971 71.1 5/,7 10:6 $1.3 59.1 61,9 10.0 ]1.3 /7.0 f1.6 56.7 5R.7 55.5 7R,717 1f7$ 71.1 $7,1 19,2 S6.S 61.5 67,0 IA.R 79.f 4 1:1 S1"9 57,3 SS.S 55.0 1R,)n1 19/6 71.7 36.S 11.0 11.5 61.R 61,1 IS,6 ]7.1 16.1 56.1 97.9 56.0 S5.) 10,INR 1971 12.0 19.7 10.1 59:3 65.1 61.5 IS,3 30.9 43.3 SS.1 67.8 61.1 57,5 71,nn Repsrt/n6 us6 ef rrlfu. w. on t6w or rr. ect6rtonr hrin recedl •.r. IMR MA MA ILl IR.I 11.5 75,6 NA MA 10,6 11.! 16,1 I1.1 17.5 1~,771 1969 1.1 II.L 10.7 25.6 10.1 36.0 1,7 7.6 10.1 71.7 77.7 11.1 1'1.1 75,OR) 1970 ;,} IO.l 10,6 7R.R 31.1 11,1 1.1 6.9 16.7 26.5 26 7 111.1 76. 7 t5,111 1971 S.3 11.6 76.2 ]].S 1 L 3 .1.3 1:1 12.1 73.7 31.0 17 9 1n.1 37.0 35, 701 1971 5.6 97,1 76.6 36.L 11.3 11.9 1.6 11.1 23.0 $2,2 )S.7 35.) 31.5 71,751 1973 6.7 16.1 ]1.9 39.6 11.1 15.1 5.7 11.0 77.0 37.9 .]A.6 31.6 16.0 71,IRR 1911 1.1 70.1 79.9 39.1 17.9 170 , S,L LI:S H,) 35.6 ]R.9 70.6 31:1 70,757 1975 6.9 11.9 29.5 36.9 13.0 I5 .1 S,0 IS.7 75.7 $1.6 10.6 )7.1 3..! 70,fn1 19/6 1.1 11.7 77.0 7e.7 43,1 ILO 1.5 11.6 2.:5 36.6 39.L 16,0 ]S.1 10,RrR 19/1 7,R 1.2 1T:0 7R.0 16,I 17.7 1,! 17,1 71 a 13:1 11.9 10.1 31,1 77,~17 OeM9SIn0 099 6f rr1Juen6 on IIff or ~nr. ororlon9 durln rec9dln 7e9r, 196R NA NA NA NR NA MA NA NA NA MA NA MA NA 10,771 1969 NA NA NI1 N6 NA NA NA NA MA NA N6 NA NA 25,~01 1970 NA NA 11,1 19,2 I3. S 21.0 NA NA 1.2 11.0 11.1 /S.3 15.1 !S,1e! 1911 NR NA 17.2 23.7 30. I )1.9 NA NA 11.6 11,0 19./ IR:S 71.1 15, 7111 1977 NA NA 15.9 75.5 17.L 11.6 NA NA I1,1 Il.1 21.1 7n.7 11.7 11,751 1911 ]. 3 !.L 70.3 77.1 31.3 32.~ 1.3 7.5 16.7 10.0 n.s 24 .1 I/.1 17 , 111R 197• 11.4 19,6 76.) 31.. 14 2 7.~ 7:0 17.6 77,0 77./ 72.L 71.5 7R,711 1975 1.3 9.6 19.9 79.n 79,6 10.7 2.6 7.0 IS.7 10.9 21.0 70.9 72:6 76,Sn) 1976 3:9 9.6 17.0 21.3 79.6 10.0 7.7 7.6 IS.S 19.7 11.f• 71.3 27.1 1.,nIR 1977 4.0 11.1 16,5 71,6 n.r 34.3 7.0 6:0 11.6 19,1 71.6 7/.2 21.3 72,077 iS1.~dleedr.t~t ar o9e-for +rnior hiRh lr6nnls 6re t.»luted u+InRYq.H-yepu1.71onr rer r.rh 6r ihe eltht el.++/re. Rr.nS.. Thlra•Il.lnae+ dlstortlun haua+r propo,tlonsof rlnres nr fe.e. h.rr chanred 6elrrrn 7nen. •• inl.l n~w~Fer ef rerp~m+e+ ured In f.hnl.tl-r 7nr 1he /e.r sireifled. ' 3/2/77 n E~.OS~i~EO

k SAII M1E0 COUI'ITY, CALIFOld11A, SURVEYS OF STUIIENT pRU6 U5E TOBACCO 06+"'AT111e 119l1t 0t 115P. OFMAITIM OT .NN17n11 ANO [F.MI(M 111171 Cf3RMIL S/11NiNT3, 1f6A-1f77 67 .'Irlfll. G6.IIF ANN 51/ (K 11i,ir',MINNT, cl'7flilf, NA7F-t VFM /6nNMr-n eitl'.IN[ri, 7[AN lli - 1 r 1, h t t - t O.tr•. Tnr.l 51/NYE7 Gr.M Gr.d. Gr.d. f,c.d. Gr.de Gr1dt G,.d. Gr.de Gr.Ar fr.de Gudr Gr.dr rr.A'7 9-~2 0..~.xs6f Mr~ InA w/l 060 of tMrcc g drrlxg Lneed1/10 Ienr, _ ~ 1960 Mt MA 57,1 51,3 $6.7 50.3 1ht NA f7,0 SS.6 $7.4 SS.1 SS-0 10 774 I90f 13-6 51.0 51.7 50-0 SS,O 30.7 39.0 50,1 S1.6 SS,S 51,9 ST,1 51,7 . 75,F63 1970 ]0:7 51.0 A9.9 S1.} S0,S }1.1 3N.0 11,0 St.l ST,O 51.6 53.0 51.6 .l[,1tn 1971 11:1 56,1 St,S 51,1 S1,! $1.1 36.0 10.6 56.7 S6.S SS.O 53.1 54.4 35,ix1 1971 1l,1 51.0 SS.S 51.7 S1.1 SA,S ST,S S1.0 ST.7 S6.S 511.9 SS.O SS-6 31,751 197! 30.1 57.1 61.1 50,1 S6A 51,7 16,7 57.0 63.5 61.2 S7.S 56,6 56,1 7 7, 3A6 197~ ~6-7 511,6 56,0 56,1 54.1 S6:f A},O 60,6 $4.6 61.1 50,0 $0.7 SO.S 70,237 1975 ~¢.! $1:3 56.5 $6:7 55,0 St:7 t6.1 Sf:O 63.0 61:6 M.6 $7:1 SA,9 76,3n3 1976 11.1 $1.6 51.6 $1.1 6t.0 11.6 63.6 57:6 63.6 6A.1 60.9 39:1 $7 2 10 ~.6 Nit ' .10.6 51:3 S1.0 51:5 53.6 51:7 10.9 SI 7 61.6 63:0 6t.f 59:3 . 56:7 . 07 77,7 060orttx0 w6 .f txA6ce0 ee t.N 0, .ere xee.9lon. LrtwO rnreAi6 .r, 1960 N11 MA 31-0 36,6 3f,6 61.3 MA MA 77,3 31,0 35.6 36,7 35.1 10,771 ~ N6f 17.6 7T,f 31,3 33.7 36,6 17,7 li-0 15,3 30,3 37-7 37,1 39.0 33,N 7S,OOt ~ 1970 17.3 23.6 29:1 31.5 31.1 36.1 11.9 21.4 79.6 36,9 35:1 37.5 34.3 t5,1t6 ~ 1971 i1:0 7S.7 32:6 33.0 30.3 37.3 14.3 76.2 33:7 37,6 36:1 30.0 36.0 35,7n1 1972 16,6 21 .7 31:7 31 .0 31,6 37.0 16.1 30,0 31:f 3..3 3A:0 H.1 ,16.1 31,151 1073 17.f 70.5 33:. 3..A 36:6 $1.1 lA:s 31,0 3.:0 37,f 19.0 39.1 37.1 17,3A6 1571 16.0 ' 70.5 30.4 33.3 73.1 35.3 19,3 71,0 11.1 3f,0 36.0 d0./ 36,5 re,711 lfis 11.1 73.1 19.A 33.1 31.1 33.1 17,0 ».S 39,1 39,6 40.6 39.6 36.0 10.103 1076 11,7 20.0 75.6 70,d 31.1 30.0 13.9 31.1 3e.7 13.5 I7-S 40.1 35.1 20.P4 11 1977 10.6 19,6 11-! ]5:9 30,) 10.9 13.0 75-6 31.! 39:3 13,3 41.4 31.1 1O OT7 OdLOK1e0 w..( toA.etO en f1ft7 er .Ore ocenlon. Ixrln recedlnM r.Nr. - 7960 MA MA MA IM MA MA MA MA II~ MA IIA MN NA 10, 771 1%9 MA NA MA NA NA M/1 NA NA MA MA IIA NA NA 75,~N,1 r 1f70 MA MA 72,0 17,7 76.f 3x.0 NA MA 70A 1/,1 77-6 M.0 27,0 75,t16 1971 MA MA 71,7 76,0 31.6 31,0 MA nA 73.0 30-1 31.9 30,1 76.0 3S,7x1 1977 NA NA 72.f 77,0 70.3 3t,7 NA NA ]1,6 30.1 37.1 31,0 16,6 l/,Itl /977 10.3 1. 3 7.,3 x.3 70.6 30,1 9-6 7t:0 27_0 31-1 37.0 76.~ 27,3A6 9.7 11,~ /9:e 7l-9 15.2 1N-1 10:0 If.S 79:6 29,0 11:1 31-1 11.6 1~,1t1 IY75 7.S 16.0 10:6 73-7 11:6 71,7 6:! 27,3 30-0 37.1 31,6 76.A 7A M\ 1976 7:! 17.7 7e:1 71.1 13:0 73.! 6:7 IA.. 77.1 31.0 31,1 33.1 Ih,6 , N16 Ix 1077 3, 7 11.3 13:0 /N-7 21,9 72-5 6.1 iS-1 21,3 30,6 34.4 3.,7 75,7 , 77 o77 - St6ndcrdlred-rar. or we (ar sewlor hith-1,rhn01; .re-coiT.Ted ~n0 aqu~l..~olaT n. or ..r N.eslYec RrOxpe, Thle e11ae.1.. dl..lartlxw M<.xa. p.0portlewa s( tlneea or art. h.ve rM.ntrA Mf...e 7.a., Z_IL0SV14(1Q . '.7ot-1 m~.rr o( fee/+~w.a x•eA 1N rMxlalew. (nr tM 7e.r sp.c5(1.d.

SNI MTEO COUNIY, tAUfORAI/l, SURVEYS OF STUDENI DRUG 05E 'THE MOd-OSERS' S6aOSv4EQ tJ?YEU Oi •9M7 115Ex ANO ^NO elOI/FlcAllT ItSt"••• tM ANY 00 ALL fN 111F. 70LIAIM6 SI/119ra71LY37 A1f:A0M., A11/71FTMIIMF:S• LiM, W1e1./1IAMA, /1MM 71N1Af1Y1 III!INIOTFM M7 .11MIrN1 AMM [FMIfM /11t31Sf1MNN, STMIFIRS, IOhA_19~7 :r?MCIC, NY .'d7MVM. f.MA1N. AMO Sl.t r/F rFRtMMNt, SV.F.- IFII-. IIAT15 PFN 111N716FM 91 1. rr TlAM t7f t r t 1 r t --~- ~iF -~ r SIIMVET 6rwd9 6rwM Grwde Gr.An Gr.Ae GrwA• Gr.Ae f,r.Ae f.r.Ae f,raA. Gr.de Grede LrwAr. n-II Ile~.e~ MeOSrtlw~ Ua tAe7 A.d e rlewceA we wse 7:n ot____t'-7~r_fprciTfr _uh.t.ncef x,TT-rM~eer Pr+ceAln the s9r.el: 1960 M11 M/1 l1.6 t1.1 1l.7 IS.7 MA NA 33.1 76.1 22.1 10,! 73.7 t6,77. 1969 36,6 1•.1 16.1 lo,l Ie,1 17.1 /7.0 36.1 311,1 11.6 20.9 1/.9 20.9 75,e13 19/0 39.9 21.1 75,6 1M.0 It,3 N.r 17.9 35.6 2M.J /9.1 111.1 16.1 19.1 ~S, IaM /911 )S.1 24.7 19.0 17.6 11.4 i7.y th,l p1.2 !].6 19.2 16.6 15.7 1L1 Sa, 761 1917 31,M J1.7 111.7 11,1 I1.5 }.1 17.3 75,1 20.1 15.9 IS.7 17./ 11.6 t1,7S1 /•/.7 71. 0 I a.3 I l: 3 I 1.1 14 9 16. 1 7 7, 3 1A.0 1 S. 6 17.1 12.. 3 16. 3 17.1 7/,~9a 1971 l1.7 13.1 12./ 17,7 9,w 6,S 21.1 16.7 13.6 12.5 11/.7 9.3 Il,t 7M,117 N 1975 77.1 17.0 I3.1 IO.S 10.0 11.6 79.5 16.M 11.7 11.2 10.1 9,7 Il.w 7w, .M t 1976 7s.s IM.1 l.:a n.l e.• It7. r 32.4 /9.5 1S.7 12_0 9.2 11:1 11.3 70,A16 W 1977 t1.0 16.2 17,1 10.3 6.S 7,~ 30.7 7d.o 11.3 11.1 0.3 7.3 9.9 27•~77 t . rtln h r ~d •a rhnc.d M'bljwlflrMt Yf~:•• - • __ o.n 9 t rTe - f f L TTn ~~ ~rAl . Ir /.Iwnce I ~ n t e ~. fur.e ~ ____- . . _ _ 1969 NA MA Sa.9 46.5 I0,S 32.A NA M6 6/1.3 36.9 N.1 IS.S IM.M }S,eM3 1910 60.9 65.1 S7.S 46.4 39.1 16.7 61,0 71.2 61.17 Aa-,1 U.1 11.7 177 . 35,1/1 1971 74.2 Sh,a 56.5 13.3 14.2 40.7 61.6 51,1 A5.9 13.1 /1,3 11 .9 75, 701 1977 71.e 55.3 IN,6 3..6 71.1 21.7 77.7 59,7 51.6 41.4 36.9 36,5 39,e 31,751 19n 6e.6 St.a .2:1 N1.3 31.. 7v.A 73,6 45 E 46.7 11.3 37.7 35.s \LM l7,~66 19/1 6M7 SM.7 153 35.1 313 77.3 . . . 71.2 c6,1 11./ .79.9 36.6 31.7 36.1 tll,7t7 1975 .M 76.! .0 31.6 31 .1 51,0 t6 71 75.9 60.0 16.6 10,1 35.9 52.5 37.1 1M, Tnt 1976 71,7 59.1 $1.6 11.3 3 1.4 29.0 19.1 So;S 19.0 3A.0 31.0 3•.6 3a.11 10,1/6 1977 ' 73.5 59./ 19.1 3•.1 30.3 75.1 79.4 63,\ In.3 40.3 33.1 30.4 37.7 72,p77 - -- u •r t. . ef o ofe er..w wr w-fc n9 •.n rn.t•o r . na eqxr ~ra . owf nr rr R I tlw+s/fea ~rorq+. Twlf ell.lneles Alctartlnn hrcnw. prr,~n.lloef el r/w•crf or •r.7s Mre eh.nReA Mr..rn 7rwr.. ••lntd wuwher wi rr.7onle.. x.rA In Lbrd alnn. 1- thr 7rwr .prrIfleA. •••s16n1/It.nt u.r. A1cPhol - ten 0, ~rr. otcwflmr.; Tw6.ctw - _ trn er won we9e.lew6; MMrI/oewe - tew wr -re 9ttr.lonr; LSO - Ihrrw er w9rw oct9+10n.; ~rphwtw•In.. - rhree 0, wnre nccw.lenf. 3/7/77

1 94OSp4EO w. r >. M .•..••....•" s.w w~- /.+1w fw IF+ Ilw 1}w UWApf M1 nm +w4l. PiI cun:m arl /n~-~-~n M Mn Iln 11. LEVELS OF MARIJUANA USAGE SELECTED SURVEYS SAN MATEO COUNTY. CAUEOMA. STUDENTS m. >a. RI awr:Au,mn :,-_:.. 10% yw l t.~ A ~ s m k. e4~

0 0 0 t y ~. . 0 7w © •~~w ................ .n nre ~ - 'r f - ...».....'..'-......-.,,_-..... ~.- .r' --- -.. Iw M nrl - M7! - IN1 nN nR nn nn fifCffii a w ~f. ~r.ti....wr. ... . I ~ .. _ ~,..w.... ~ • ..,.....rr ... '.. f : u .u. I flr ~ . f- - r - ..-..-.«JI- L~ ....". © f,. 1--f" © r nn w/ nn nn nn nn nn wr .rIMItr LEVELS OF MARIJUANA USAGE Fw/ ~ YMMKS 1n11~ q~n a RIlrt . IN111 mlln: INI/./n 1968 - 1977 SAN rAt[o COUNTY. eaFORMA. lfuo[NTs 11 ® ral. wl Ml lay n(pUR ~ ~{ //t •sl ~1 rM1 1 u 1r sl. O/in /AA. 1~1~'1.~ IM311Y/11~ k- L4OSVLEO

4 276 lledtan~occaslons upon vhich alcohol was used by eleventh arade males and females: 1966 1969 1970, 1971 1972 1973 1974 1975 1976 1977 Msles 3.7 7.6 8.5 18.3 20.9 27.6 27.8 28.5 25.9 26.6 fwles 2.4 2.7 5.2 7.1 9.8 10.6 16.8 17.0 18.2 22.1 MIPMETAMINF usi eontinued its dornward trsnd rith 22 out of 36 rates decreasing. The standardised rate for any usage dropped frvm 15.3 to 15.1. 61ris still tend to have higher rates, grade for gradk, thar, boys, whtch may be due to the non-prescription use for weight reduction, The highest bracket - fifty plus - sr+doubtedly masks sorte heavier usage. particularly among swles and does not show whether administersd orally or directly into the bloodstream. iARF1TURATE usage which 1s linked with that of uqhetamines shows 26 out of 36 rates .ovins downward! The standardi'¢ed rate for any usage dropped from 12.4 to 11.0. {kage had apparently peaked in 1971. IE ROIN usaoe cannot be evaluated by Inspection of rates fran this survey. The percentage of users Is so small that even rounding of rates to one decimal point tauses dtserepancy, plus the various randon, factors otJien than real heroin usage that' can influence the survey results. This data does not pinpoint ssylliresur- gencies In specific areas. LSD rates continue their dornrard snvenent with 25 out of 36 rates lower than n 1;77- The definition of LSO in the original survey, which for reasons of eosparaDiiity it has been necessary to maintain, 1ncluded4ome other occasionally used haitucinogens including PCP. Many of these drugs when analyzed turned out to be LSD. YO would have been interested in a eore accurate count of PCP. The 1976 survey which was expected to eontain numerous n ferences to setnaqualude contained only three. The 1977 survey showed a consistent sprinkling of .entions of qualude which have not been analyzed yet. 11s.RIJUANA rates produced by this series of studies are of e.ceptional: interest since they prori informition that can be used in seasuring the iipict of California's new sw rijuana law (5695). The li.ittd analysis that tiee permits shows the contrast beta2en conclusions that would be reached with only t+ro annual surveys as coapared with an observation of the ten year series. IWO SURYEYS ALONE • 1976 and 1977 - rould for. a basis for saying tlut s,rijuana Nsage i's de initely up. The standardized rete for grades 9-12 lncreased from 55,3 to 57.5 for any usage, and from.22.5 to 23.3 for users on SO plus occasions. Twenty-three out of 36 rates were higher in 1977 than 1976. We could also note that there was very little increase 1n the lorer grades, and progressively larger incn ases in the higher grades. lnJact„ usage decreased~amon6 fer.ales In grades 7-9. The trend of graater differentials in olfer groups parallels the fAndings en,adults as shown in the January 1977 report of the State Office of Narcotics and Drug Abuse.

I ( 277 TEN SURVEYS - 1968-1977 display the fact that the 1976-1977 increases art not rnusuiT:- In almost all class/sex ievei cells the average annual percentage difference between the 1968 and 1976 surveys was greater than the difference between 1976 inc 1917. This is surtsnari¢ed by arranging standardized'rates: . ILnCer of, Date of Survey 1976 minus 1968 1977 Octasions 1968 1976 Total Average urve 1977 einus 1976 Any 31.9 55.3 23.4 2.9 57.5 2.2 Ten plus 17.5 35.4 17.9 2.2 37.1 1.7 Fifty plus •15.9 22.5 6.6 1.1 23.3 0.8 +1970 figures. From the detailed series of marijuana data, together with the graphs supplied. It is evident that iw rijuana usa9e Increased between 1976 and 1977. However the impact of the legislation could hardly be considered explosive. In fact, unless a trend observed in 1976 that inplied that marijuana rates might be levelling off hadnot occurred, the amount of increase involved was of a level that could have been considered less than average, in light of the preceding years; experience. JOBACCD usa continues to follow an interesting pattere, whi'ch began in 19701 en ranges or females exceeded those for males and~started a consistent cliab. Simultanecusly, rates for males have dropped consistently. The standardized rates of usage on more thMfifty occasions which~have remainedrelatively stable e,ask the fact that rates for the sexes are moving in opposite directions. Nowever, there are clues this year that rates for females are beginning to plateau out. NONUSERS who reported use of none of the su-veyed'substances to any degree becaee e, with ten out of twelve rates decreasing. The same is true of the pro- por:'on uf students who reported NO S1GN.FICANT USE. Significant levels were arbitrarily defined as tne use of alcohol', tobacco or marijuana on ten or more occasions, and LSD or aaQhetamines on three or srore occasions. Students who did not exceed these limits for at least one of the substances form the basis of the table which shows a standardized rate decreasing from 38.8 to 37.2. It appears that tnis is largely due to a more general use of alcohol. IN'SL*!+ARY the series of surveys show a rapid rise of rates for all substances since 1568, There is recent indication of 'peaking out' or plateauing, partic- ularly for AMP.yETAMINES, BARBITURATES and LSD which have shown, rather consistent downtrend3 since about 1971. TOBACCO usage continues a downward trend for nates, and the 1977 figures give somc slight indication that the upsurge of rates for females may be diminishing. ALCDNOL rates made decided and unccpected increases over 1976. MARIJWwA rates while increasing, were in line with the findings of the Report of the State Office of Narcotics and Drug Abuse in that the influence of the legislation became progressively less strong, the lower the age group. urveys are un e yPF1 esearc' rant Prior to November 11, , additional copies may be obtained from Lilian, Blackford, Biostatistician, San Mateo County Depar,ment of Public Nealth and Melfare, 225 - 37th Avenue,San Miteo„ California 94403.