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Part 1 CIGARETTE LABELING AND ADVERTISING-1969 HEARINGS BEFORE THE i COMMITTEE ON IN TER STATE AND FOREIG N' COMMERCE HOUSE OF REPRESENTATIVES T IKETI -FIRST COT GP,ESS FIRST SESSION ON H.R. 643 A BILL TO AMEND THE FEDERJLI. CIGARETTE LABELING AND ADVERTISI\G ACT WITH RESPECT TO THE LABELING OF PACB- AGES OF CIGARI7P?ES. AN'D FOR OTHER PURPOSES (And Similar Bi:ls)' H.R. 1237 A BILL TO DIRECT THE FEDERAL COMVZIICATIONS CONSVIS- SIOX TO ESTABLISH REGULATIONS PROHIBITING CERTAIN BRO-'`DCASTItiG' OF ADVERTISING OF CIGARETTES (And Similer Bills)'. H.R. 3055 A BILL tPO STRENGTHEN THE FEDERAL CIGARETTE LABELING AND ADVERTISING ACT (And Similar Billa). H.R. 6543 A BILL TO =E\-D PUBLIC HEALTH PROTECTION WITH RE- SPECT TO CIGAR}YTTE Sl•SOfiI1G' AND FOR OTHER PURPOSES (And S1miihr Bills)i APRIL 13, 16,17,18, 21,,22, 23, 24, 25, 26;,29, 30, AND MAT 1 Serial No. 91-10 ~ ~ Printed for the use of the Committee on Interstate and Foreign Commerce > . . . - ;, U.S. OOOERA'Z.LENT PSINTITG OFFICE WASHINGTON : 1969

- 180 it there rather than get into the problem of whether or not the lar• shoul& require a person ocho is trsin to sell this product to use thev resources to educate a position which you have taken,,t,o which the., mac cio]entl}~ disagree, and I can't help but conclude that there mu~ be some disagreement R'hetlier that disagreement is soundly based or not is another mat,ter. ~/ "-Dr. STeu•Aar. There is no question that there is disagreement. If it t .cere poss:ble, 1.could like tb see the conclusions of the Surgeon~Gen eral's report printed on the side of the package but this is obciousl~, impossible. ButYhatisthe fact. . Mr. BaoWx. I don't know again,if you are competent in this area, andino slur intended, but'to sac that we should require a person who holds one view to advocate orit)r their own resources another view, to n•quire that by ]an; I can see it is perfectly proper for ti^ou to advocate the position you hace taken but I question the requirement for one, who has a different position to use their resources to adrocate thai~ position. The fairness doctrine as it applies to communication media is an- other matter.. But! this business of requiring it, in advertising seemso t.o me gets into a fairly serious question. Dr. STEn•afrr. It seems to me, Mr. Brown that if one is eoncinced that the product itself' is a hazard, then telling the individual througl, advertising which obviously tries to sell a product that this produc,' is satisfcing and what not, but is also a bealth hazard, gives the indilvidual information necessary to make an intelligent choice whether to consume the product Mr. Brson•.N. Apparently some cf the adrertisers who are peddling the product are not. Dr. STEWART. This is true. The CHantMaN. The committee will stgnd adjourned'unti]itomor. row morning at 10 o'clock. At that time we will have t.he Commissiones of FCC, Mr. Rosel Hyde. Dr. Stewart, I had some questions I would have liked to have askedi you, and I will give them to our counsel here and maybe We can ge:' answers for the record, I d - h i ~ Rantz to know .r s at act ities or programs are being carried out bj HERT to combat cigarette smoking among the younger persons, and among adults, and how much these programs,cost and }iow effec- tive theT are. I will have my counsel give you those questions. ThanL- you so much, l'ou~ hace certainly been helpful to the oom; mittee: Dr. Srax•eftT. Thank you. (The following letter and attachment were received by the eom~ mittee:), Hon- H.at.cx 0. Br.ocns, Sou.e ol. 12et>Tetentativea, WaaAinpton, D.C. Ds.a Me Brsoosis: Tbank you for your Ietter of dpril, 16 concerntng mT tedtmon5 beforetbeCommlttee on. Interstatee and F'o.retgn (2ommerce during Learinge . on the labeling andadverttefng. of cigarettee.. To completee thebearint reoord, you have asked for answers to elgh't'puesttons, and I am pieased to submic tDe follosring: 1. What aetibtties and pr»yrama ore Deinpoorrted out Dy tbe Departmento~f $eottth, &daoatlon, aRd Wellore to oawba ofparette ea.okinp-

Is „ lndek'M 771 ~. ,atre ~1 ~'' ~ - 160 into the problem of n-hether or not the latc who is ti1-inr to sell this product to-use theit osition Rhich you have taken, to tirhich the~~ tnd I ca'n t lielj, but~concludP that there must +ement is soundh• based or not is another no question that there is disa€reement. If, it ke to~seethe conclusions oftheCut•~geon Gen- the side of the package but this is obriouslt' e fact. now again if you are competent in this area, t to sar that we should require a person who tte R-itli their own resources another, view, to i see it is perfectli proper for t-ou to advocate 4en but I que_tion the requirement for one' tion to use their resources to advocate that as it applies to communication media is an- usiness of requiring it in advertising seemg rious question. ; to me. Mr. Brown that if one is cont-inced a hazard, then telling the indie•idualithrougli, tslr tries tr, sell a product'~that this product it, but is al•;o a health hazard, git-esthe indi- tanr t o make an, intelligent' choice whether to ly~ some of the advertisers who are peddling rue. ~mnlittee will stand adjourned until tomor- . At that time we tcilPhare the Commissioner a questions I~could have liked to have asked 1 to our counsel here and maybe we can get't tt activities or programs are being carriedi 2arette smoking among the younger persons. 1w much these programs cost' and'hoc~- effec- tS counsel give ~ou those questions: ou have certainly been helpful to the com- u. md attachment were received by-, the com- or $rJLrB, EDUC.r7o9, aRD WIISAaL.. Yay'1,.1969. : you for your letter of Aprii 16 troncerning mc tee on Interstate and Foreign Commercrduringidvertising of cigarettes. Tocomplete the bearingg a'ers to eigbt questions, and I am pleased 4o submit 'mnj are being carried ortbytAe Departmewt o1e to combat cigarette emokinp- 181 (a) aaonYyovnper~personsf - (b) ornonyadulta' To reduce the toll of death and disabilitc associated orltb cigarette smoking: theDepartmenPs obiectires areto~ (1) reducee thenumtier of peoplesmoking eigarettes (2)', reduce the numberr of youngpeople taking up cigarettes and(8) helpderelop lessbazardous smoking for those..rhodo not wish to quit.or are unable to do so. The Department set' op the National Clearin€house for bmoking and Health toaehiere th'ese:ob)ectires: T~be Clearingtiouse:actsas.cen¢ral source of scienti5a, (nformation, carries.on, a national program ofpublie information,.andeduca- tional projects, and carries on research In amokingg behavior and methods of oeasation. ~ Some 20 contracts are now t:n effect'fritE national and local organizations aimeda. . Toptng and carryingg on specific programs. Among tLenational groups are..the national Congress,ofParent-< and Teachers: The Sational4-H. Foundation, The National Education Association'sAmerican Association for Health..Physical Education andRecreationr: TheAmerican Dental Association and The American College Health Association. Among theunirersitp orStste groups asethe San Fernando I'alles State College. The Unltersitc of Nebraskr,. ,J'be Unirersitc of Oregon~btedical Schaol~. The Universityy of Illinois. and the '1. Oalifornl! State Depar~ent'of Education ~ Attactiedis.a complete lisfof contract5for research proSectssupported b}° theClearingDonse:. - In addition too the Clearinghouse program, the. National Institutesof Health carry on biomedical research directly or indirectlcrelatedtoy cigarettes and tbe(7fo:ceof ComprehensirePlanaingcarries. onn a grant program. The Otiicee of, Education is tnvolredin~health education on smoking as part of other actirities. buntcitb noo separate.budget or program; theCbildren's Bureau is alsodarolredo but~ again .ritiiout separatee budget~ except for a*;0.000allocation from tbe Clearinghouse. 2. Botc much,.dotAue propraena.cotrtt. TLe cost of smoking and health projects supported by the PubllcHealthSerrice is approzimatelyF4,405.000. Thisrepresents.$1,956,000 from theKational Iustiitutes of Health; i8i4.o00 from the Officeof Comprehensive Pianntngand~ j2,0:5,000 from the National Clearingbouse for Smoking and Health. The Clearingh ouse funds are allocated approiimatelcas follotra.: Oommunitc program development---------------------------------- f,500,000~ Educational programs--------------------------------------------- S00.U00Professional edueat/on------------'------------------------------- 200,000 Research and eraltrbtion------------------------------------------ 400.000 Public information and educatton--------------------------------- 400,000 TecGnical fnformation---- ---------------------------------------- 275,p00 8. Hote effective have they beenf? Anumtier ofdeeelopmentLin the pest yeer suggest that ttie. Department'R anti-smoking program,, together with ~ those of voluntar,r health agencies and other organizations, bave had measurable effect. In 1965cigarette consumption declined for.the.8rst timesince1969 snd a national studc ah.oared that the pro- portion of, young people smoking was lower~ than ln earller studieF ofa n:umher ofdiCeren~t youth' popul6tion:s:In addition„adult smoker~are giring upsmol-ioc at the rate of more than one million a year; health education programs in scbool~ ba.re increa.eed.;..dentists and phT'siciansare.becoming inereasingl.-.iarolred in anti-smoking programs; and aeren new member agenciess bare joined the iYationaliInteragency Council on~Smoking and. Healtb~ bringing the Councll'stotalimembenhip to80'nationalhealtL, educational and youth leadershtporga:- altations. Buteand'1oca1 interagencycounclls on smoking and bealth increased during the year to a total of 150. 4.. 9ave yovany'evOpesfioru a" toawy otbereDectibe meawa of Combating the eiparette smokinpAabitf A new.metLod to help smokersqutt smoking ts being tested tbrougb the Insight Development procedure developed by the Cleardnghouse. At' the same time. the ClearlLghouse bas.alreadg begun todevelop program a2tess hazardous smokiog for amokers unable or unrcilliag to qait.. It is.hoped these programs ma y belp. slgni8cantl,r to redumth'et,oll of, death and dlsability associated with cigarette smoking Steps should be taken to implement3be policy recentlr affected by the Veterans Administration~ .theII.S. Public Health Bervice, aDd tLeDepart , "-$a6 O-Aa-ot. t-15

r 0 182 ment of Defense to restri¢t cigarette smoking. In all medical care facI].ities aadc tEeir jurisdiction. Increased resources and Snancial support for both research and eduativ, arebasicto achiering new and tontinuing goale on smoking programsthroagy'oy the country. Increased federal taxation on cigarettes 16 one posadble trai st' derising this support:, b: There hass bcenoomment to thc eJJect that cigarette emokinp4"phytialosi oatiy addicfiroe." Doyou aqree or disagree with thief We would disagree.cith the contention that cigarettcsmoking is."pbysioloF, ~ callS'addictive."Theposition of the Public Health Serric+ee on this matten y~ stated in the 1964 report.of the Surgeon Generailb ddvisory Cornmittee on 8mok- tng an d,Health..TGe. Report sa ys (page 354) : j The tobacco habit should becharactertaed as an hahitaaSionratDer than os addictibn, in conformity with accepted World Hea1tL Organization dn>1mi• tloas„dnceonceestablisbedthere ia little tendency to Increase the daee; psychic but not physical dependence fs developed; and the detrimentaL effects are primarily, ontLeihdiciduel rather than societS..l\o characteristu i abstinence syndrome is developed'upon witLdra.val t: 6. dreanyother aountries mrryinp out' proprama todiaeourape eiparetk ' atnokinpf +' Ttiik question was asked lsst year of countries in Europe, Anatralla, 7apat . and Canada, Replies received from 22 countries indicate that all but a fev had taken, or were about to take, action on the smoking problem. R-hether this action constitutes anational"program"'is subject to loterpretation.. For ezample ` In Austria, Canada, England and Ireland and Ita1S, programs of edatation ton ~ the health hazards of smoking hare been reported as undertaken bS the Ga, Iceland and SReden Iszael F~ance t i ottbi di l I th , ; er coun r es„n rect S, h o ernment S anti•smol7ng programs of a more limited naturee arereported as.being tnrrieG out by private organizations with Government cooperation. Bomee restrictions o0 thesalee of cigarettes as well as on cigarette adcertising.and promotion are is e8ect in most countriea A completesummarye ofanti-smokingactiritrta the 22 cotmtrles„based on information gathered by US embassies at the request of theI: ational Clearingbouse.l6 attaebed:.. 7. What hat their expt'riencc.6een.in those propramaf From replies reported in tEenttached document, the ezperience ofcountries with smoking programs varies from eountrSy to country. OnfortunatelS, precise evaluations based on changes in~cigarette.tronsumption and on the taking up of smoking byy young people arenot available. In Denmark, for instance, edam- li i d te m onal campaigns it schools, have been reported as baving some, but o n a ti l impact.oncurbing.smoking. but have been credited with deterring to allmited extent6 young people from taking up smoking:. In Sweden, the educational pvo gram appears to be maisingprogress.ihre.ducingcigarette smoking among young peole. In Austria, ma3or emptiasi's to reduce tLe bealtL haeards of cigaretteF on,,' program emphasis is tilms nnd apot announcements for radio and televiston 1 witLeffects not.yet reported, Inaome countries, for example, Germany and. ~ Englend, the tobaccoSndustryo and thegocernmeut cooperate to a llmited,eztent In research profects and statistical studies. 8. HotardotheydiJJcr Jromproprama oonducted herein the.LnUed Btates! 8omeofthe differencee between amok-ing.and health programs in the Dnited Btates.and in foreign twuntries.aresuggested In,the atteched'document. One of the most obTiouss differences Is cigarette advertising and promotion, .ehich are much more restricted in other countries ttian in ttie. United States.. There appeare to be a greaterr degree of cooperation In the U.S. between government and prirate organii•ations on thee smoking problem than 10 other countrtes; for example. 1be Natlonal Interagency Cotmcill on Smoking and. Health, which Includes on ita membership gocernment.agencies, professional medicaland health organizationsw healtLagencies,h youthsercing groaps andeducationallorganizetioos:d voluntary appears to Laee no:counterpart elsewhere. Another point af differenee is tbee degree to which the tobacco tnduatrS In tdis eo'nntry resists and rejects the rlentSllc evident4 llnktng cigarette smoking ta Iang cancer and otherr diseases. Such opposition to a ma jor health problem is notE evident in teports on the amoYiug problem remeived from other countries. Ifadditional information may be needed tot,cerning these qnestlons, I r+roald he pleased to provide it. 8ince.relyy yours, . Wnit.r H. Brc.r.rr, M.D., Brrpeon Qeneral' `_

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