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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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- 03745010/03745447/Hew's Anti Smoking Campaign Vol 1 2 790100 - 790523.
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- Named Organization
- American Cancer Society
- 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
- Ftc, Federal Trade Commission
- Green Dolmatch Advertising
- Harvard Univ
- Hew, Dept of Health Education and Welfare
- Lancet
- Memorial Sloan Kettering Cancer Cen
- Natl Cancer Advisory Board
- Natl Clearinghouse for Smoking + He
- Natl Inst on Drug Abuse
- NCI, Natl Cancer Inst
- Office on Smoking + Health
- 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
- vxy51e00
Document Images
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
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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
darage.
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 rarning 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
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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
