Tobacco Documents Online

-10- The Program Let me now describe the principle components of the HEW program in smoking and health. Education In order to provide a central coordinating focus to Departmental and government smoking activities -- especially our educational initiatives -- and to give this effort the prominence it deserves, I am establishing an Office on Smoking and Health in the immediate office of the Surgeon General. Mr. Chairman, the legislation you sponsored -- the National Health Information and Health Promotion Act of 1976 -- makes it possible for this office to carry out important functions. This office will be responsible for providing leadership in the area of smoking and health by expediting the development of educational materials which can be used in the programs of states, municipalities, and voluntary organizations; by working to establish behavioral and biomedical research priorities; by serving as a clearinghouse for requests fcr public and technical information related to smoking; by serving as a liaison between the Department and'other government{ and non-governmental organizations; and by facilitating the cooperation of the Public Health Service and the Office of Education in identifying school health education curricula

I would~like to elaborate briefly on this last point. I am convinced that if we are to provide young people with the perspective they need to make a truly informed choice on smoking as well as other health problems, we have to improve the health education programs offered in our schools. _I have therefore asked the Office of Education and Public Health Service to help in-the identification and demonstratiom of improved health curricula. I have also asked the chief state school officers of each state and 16,000 school district superintendants to concentrate as well on these important issues. We must provide teens and sub-teens with information to balance against the advertisements which appear in newspapers, in magazines, at sporting events an&on billboards and which portray smoking as glamorous. .The Office on Smoking and Health will also serve as the principal focal point for the drafting of a new Surgeon General's Report on Smoking. This Report will provide a comprehensive review of the biomedical and'behavioral research ~ --which has been conducted since 1964. It will note opportunities --for future research, and will review efforts available to .assist in smoking cessation. A major emphasis will be placed on young people and smokers at special risk. O ="a C.) .. ~ ~ A rV MP+ ~=-_

. * t i -12- There are those who say that education will not work -- that the habit of smoking is too ingrained. But our experience in the years since the 1964 Surgeon General's Report indicates that education is a powerful tool in this area, even though .much remains to be done: o Health professionals, as I have noted, have stopped smoking at marked~rates. o..The percentage of American males who smoke has also dropped encouragingly, from 52 percent in 1964 to 39 percent in 1977. The National Cancer Institute estimates that those withicoLlege educations are less likely to smoke than those who are high school graduates. Our central thrust, as I have noted, will thus be on education to ensure that individuals -- and especially the young -- have the facts before them when they decide to start or to continue smoking. ) Research = Research into the biomedical and behavioral factors in smoking is a second major focus of the program on smoking and health. Indeed, fully two-thirds of the Administration's

r -13'- $30 million FY 1979'smoking and health budget will be devote6 to research. An important element in this research program will be $4 million identified'for use by the National Institute on Child Idealtih~ and Human Development to investigate the childhood developmental determinants of smoking behavior. This work should help us to understand better those factors responsible for a child's decision to start smoking, or to adopt other behaviors which may ultimately be detrimental to his or her health. Other behavioral research will be directed at studying the addictive properties of nicotine, as well as the efficacy .of various smoking cessation~methods. We will continue or accelerate biomedical and epidemiologic research into the health consequences of smoking, the redticed risk in smoking lower tar and nicotine cigarettes, and'the interaction of smoking with other drugs and with occupational and'physiologic risks. There will also be research into a much-debated and very important problem -- the effects of smoke on non- smokers. Additional Elements In addition, I have requested that all states examine their laws on smoking in~public places and in health facilities, with the aim of'ensuring, where possible, the rights of non- smokers to clean indoor air. Similarly, in order to protect I

-14- t t the rights of non-smokers, I have issued tighter rules for smoking in HEW buildings and have asked the General Services Administration to consider such rules in all Federal buildings. This Department has also formed Task Forces with the Federal Trade Commission and the Department of the Treasury to examine questions of mutual interest related to smoking. With the FTC we will consider what constitutes unfair or deceptive advertising targeted at children or teen-agers. And with the Treasury we will study whether legislation is neede&which woul&increase the excise taxes on cigarettes, perhaps in a graduated fashion. Evidence from this country and abroad indicates that a 20 percent price increase -- an increase of about 10-15 cents a pack could lead to an overall smoking reduction of at least 5 to 10 percent. We are also exploring whether a higher tax would affect the choice of the young, beginning smoker. The Reaction As I indicated earlier, much attention has surrounded our identification of smoking as 1a significant public health problem. Most major newspapers have debated-the-subject.-- I have personally received well over 3,000 letters regarding this smoking effort. Thousands more have been addressed to key health officials throughout the Department. While nearly seventy percent of the correspondence received in HEW

-15- has been favorable, we have received a broa&range of ideas and constructive criticism. For example, a recent report commissioned by the American~ Cancer Society recommended, among other things, that the warning label on cigarette packages be revised and that an increased graduated Federal tax be imposed. This is a thoughtful report and,=although we are not yet prepared to advocate them, we are studying these recommend'ations. I woul&note, Mr. Chairman, that many European countries are far more stringent than the United States in~their anti- smoking efforts. . In Sweden, a new tobacco labelling act requires a declaration of content on each package that indicates tar, nicotine and carbon monoxide levels for the particular brand of cigarette. And to encourage comparison and drive down levels, the average amount of harmful substances contained in aLl brands in the country is also noted. • Sweden has also adopted a "fortune cookie" approach_ to warning notices on cigarette packages. There - are 16 different notices which are rotated among all packages. This decreases the likelihood that rs G

-16- the notice will simply be overlooke&and also provides the public with much more information than could be communicated in a single notice. In Norway, Finland and Italy, tobacco advertising is prohibited. In Finland, a certain percent of tobacco tax proceeds is earmarked annually for health education, research, and evaluation. In Finland, too, limits on tar, nicotine, and carbon monoxide are set by the government. 17i Nor are we prepared to advocate these measures at this time as a matter of Federal policy. In anti-smoking efforts, as in so many other areas, it is more appropriate for the States to experiment with more far-reaching measures before they are given in-depth consideratio as a federal policy for the whole nation. _ > _ . _. .. _ _. Thus, twenty-eight states have adopted "Clean Indoor Air Acts" and many more states and municipalities are considering such legislaaion. These bills govern smoking in public places and certain facilities such as hospitals and nursing

KI 44 -17- homes. We are encouraging other states, and'~ndeed government agencies, to consider the appropriateness of these provisions as they mount their own efforts to discourage smoking and protect the rights of non-smokers. As you know, most federal offices currently have no policy protecting non-smokers. In short, the program I set forth in my speech last month does not go nearly as far as programs some have urged and some jurisdictions have enacted. But our balanced program of education and'research is appropriate at this time. It is also appropriate that we take under further study more far-reaching,measures that would establish new regulations or incentives to discourage smoking or protect the rights of non-smokers. We believe our anti-smoking initiative will succeed. People are ready to quit. And the most significant drop smoking occurred during,another period of widespread public -~ debate and concern when the highly visible counter-advertisements appeared on television and radio from 1968 to 1970. Finally, our greatest concern is to reach children. I know of no responsible parent who would encourage a child to smoke, yet we have not been able to reverse the trend of smoking start-up in this vulnerable group. I am convinced that we can, but it will take a concerted effort not only by i

-18- this Department, but by pareints, teachers, employers, physicians, health agencies, voluntary associations, and state and local governments. It is clear that an important measure of the . success of the program will be a reduction in the number of teen-agers and pre-teens who reucr start smoking. The anti-smoking initiative is a sound'investment that can realize a priceless dividend -- a healthier future for the nation. Thank you very much. .~