Antismoking Initiatives of the Department of Health, Education, and Welfare Hearing Before the Subcommittee on Health and the Environment of the Committee on Interstate and Foreign Commerce House of Representatives Ninety Fifth Congress

Lorillard

Antismoking Initiatives of the Department of Health, Education, and Welfare Hearing Before the Subcommittee on Health and the Environment of the Committee on Interstate and Foreign Commerce House of Representatives Ninety Fifth Congress

Date: 19780215/P
Length: 377 pages
03745450-03745826
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PUBL, OTHER PUBLICATION

BIBL, BIBLIOGRAPHY

TRAN, TRANSCRIPT

Area

LEGAL DEPT FILE ROOM

Alias

03745450/03745826

Site

N14

Request

R1-004

R1-037

Named Person

Ain, R.D.

Andersson

Aviado, D.

Banzhaf, J.F. III

Best

Bourne, P.

Bridge

Brown, C.J.

Broyhill, J.T.

Burgland

Burns, W.L.

Califano, J.A.

Carney, C.J.

Carter

Carter, T.L.

Colley

Collins, J.M.

Conn

Connolly, S.J.

Cooper, T.

Corn

Corr, W.V.

Cowan, J.S.

Crane, R.M.

Dalhamn, T.

Dalrymple, D.W.

Devine, S.L.

Dingell, J.D.

Dinkins, E.A.

Dixon, W.

Dolan

Dorn

Dunne, C.E.

Ebersol, C.R.

Eckhardt, R.

Effenberger

Evans, B.L.

First, M.

Fishbein

Fisher, E.B., J.R.

Fletcher

Flood

Florio, J.J.

Foote, E.

Frey, L., J.R.

Gammage, R.

Ginn, B.

Glisson, J.A.

Gore, A., J.R.

Gori, G.B.

Hammer

Hammond, E.C.

Harke

Harlan, W.R., J.R.

Harmson

Harrison, E.

Hart, G.

Higginson

Hill

Hinds, W.

Horn

Huber

Kitzmiller, W.M.

Kornegay, H.R.

Krueger, R.

Lawton, S.E.

Lent, N.F.

Levy, R.

Lloyd, D.S.

Luken, T.A.

Madigan, E.R.

Maguire, A.

Maher, R.W.

Markey, E.J.

Marks, M.L.

Metcalfe, R.H.

Mikulski, B.A.

Moffett, A.J.

Moir, B.R.

Moore, W.H.

Moorhead, C.J.

Moss, J.E.

Murphy, J.M.

Nelson, K.F.

Ottinger, R.L.

Painter, K.J.

Perkins, C.

Peyster, F.

Preyer, R.

Raabe, M.J.

Rhoads, J.

Richmond, J.B.

Rinaldo, M.J.

Rogers, P.G.

Rooney, F.B.

Russo, M.

Ryan, T.M.

Rylander

Santini, J.

Satterfield, D.E. III

Scheuer, J.H.

Schievelbein, H.

Schmeltz, I.

Schneiderman, M.

Schwartz, J.H.

Sharp, P.R.

Skubitz

Skubitz, J.

Sledge

Snore, J.T.

Soloman

Staggers, H.O.

Stallones, R.

Stockman, D.

Surgeon General

Twain, M.

Upton, A.C.

Vandeerlin, L.

Walgren, D.

Waxman, H.A.

Williamson, W.E.

Wirth, T.E.

Wynder, E.

Zimmerman, B.

Date Loaded

05 Jun 1998

Document File

03745448/03745915/Hew's Anti Smoking Campaign Vol 2 790524.

Named Organization

Action on Smoking + Health

Administration for Alcohol Drugs M

Ahf, American Health Foundation

American Airlines

American Cancer Society

American Council of Life Insurance

American Heart Assn

Appropriations Comm

Assn of State + Territorial Health

Berkeley

British Medical Journal

Bureau of Health Education

Cdc

Cival Aeronautics Board

Clearinghouse on Coporate Social Re

Comm on Interstate + Foreign Commer

Comm on Smoking - Cardiovascular Di

Consumer Product Safety Commission

Ctr, Council for Tobacco Research

Defense Dept

Dept of Agriculture

Dept of Natl Health + Welfare

Epa, Environmental Protection Agency

Farm Bureau

FDA, Food and Drug Administration

Federal Aviation Administration

Federal Communication Commission

Ftc, Federal Trade Commission

Gao

General Services Administration

German Heart Centre

Harvard

Health Insurance Assn of America

Heart + Lung Inst

Hew, Dept of Health Education and Welfare

House Commerce Comm

Interstate Commerce Commission

Journal of American Medical Assn

Natl Assn of Broadcasters

Natl Clearing House on Smoking + He

Natl Commission on Smoking + Public

Natl Heart Lung + Blood Institute

Natl Institute of Child Health + Hu

Natl Inst of Child Health + Develop

Natl Interagency Comm on Smoking +

Natl Interagency on Smokiking + Hea

NCI, Natl Cancer Inst

New England Journal of Medicine

New Yorker

NIH, Natl Inst of Health

Niosh, Natl Inst for Occupational Safety & Health

Office of Education

Office of Health Information + Prom

Office of Smoking + Health

OSHA, Occupational Safety & Health Administration

Prudential Insurance Co of America

Public Health Service

Readers Digest

Royal College of Physicians

Scientific Advisory Board

Senate Commerce Comm

Senate Subcomm on Health

Sgac

State Dept

State Mutual Life Assurance Co of A

Subcomm on Health + the Environment

Subcomm on Labor-Hew Appropriations

Subcomm on Tobacco of the Agricultu

the Public Health Coucil of Nj

TI, Tobacco Inst

Treas, Dept of the Treasury

Ucla

United Airlines

University of Pa

Univ of Mi

Washington Univ

Wa Star

Characteristic

UNCO, UNCODED LIST

Litigation

Stmn/Produced

Master ID

03745010/5826
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UCSF Legacy ID

mny51e00

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ANTISMOKING INITIATIVES OF THE DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE HEARING BEFORE THE' SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT OF' THE COMMITTEE ON INTERSTATE AND FOREIG'N COMMERCE HOUiSE OF REPRESENTATIVES , NINETY-FIFTH CONGRESS SECOND SESSION ON SECRETARY CALIFANO'S ANNOUNCEMENT' OF' THE DEPART= MENT Of HEALTH, EDUCATION, AND WELFARE'S NEW ANTI- SMOKING EFFORT FEBRUARY 15, 1978 Serial No. 95-107 30-498 0 Printed for the use of the Committee on Interstate and Foreign Commerce 1 U.S. GOVERNMENT PRINTING OFFICE WASHINGTON : 1978 0 ~ ~ ~ ~

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rv Additional material submitted for the record by-Continued Health, Education, and Welfare Department-Continued Policy on smoking for medical care facilities of the Department of P6gg Defense;, Public Health Service, and Vet'erans Administration_ 21 Network responses to airing antismoking announcements-______ 90 Responses to Secretary Califano's letter to businesses regarding nonsmoking areas---------------------------------------- 80 Studies on~ the health consequenees of smoking (a partial bibliography)------------------------------------------ 110 Health and the Environment Subcommittee;, Committee on Interstate and Foreign Commerce: Correspondence between Secretary Califano and Hon. Daniel J. Flood're the use of fiscal year 1978 appropriations for the antismoking program------------------------------------ 3 Remarks of Dr. Peter Bourne, from the Congressional Record} November 15, 1977______________________________________ 310 Health Insurance Association of America. (See American Council of Life Insurance.) Tobacco Institute, Iine.: EVidence to support'the statement that smoking is not hazardous to nonsmokers------------------------------------------ 90 "Excess Deaths"-Scientific Fact or Speeulation?______________ 195 Letter, dated March~ 6, 1978, from Horace R. Kornegay to Chairman Rogers, re consumer study of cigarette advertising regarding chil.dren--------------------------------------- 192 Research grantsL ------------------------------------------ 287 1976 Report of the Council for Tobacco Research-U.SA., Inc__ 200, ANZ TI Ray' pres M 4: Sino of t] A] smo] lung relat possi posu and , are : It ; smol perc, : morE how~ . who perc are T]i tion H prai for part nific proF hens T4 ing grou wer

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r' CONTENTS / Statement of- Banzhaf, John F,,, III,, executive director, Action on Smoking and Page Health--------------------------------------- -------------- 312 Califano;, Hon. Joseph A., Jr.,, Secretary, Department of Health, Education, and Welfare______________________________________ i N l C i S ki 5 ona ssion on ng at omm mo Ebersole, Charles R., member, and' Public Policy--------------------------------------- -__ 326,333 Evans, Hon. Billy Lee, a Representative in Congress from the State of Georgia-------------------------------------------------- 3 Fishery Edwin B.,, Jr., Ph. D., member, Smoking and Health Com- mittee, American Lung:Association---------------------------- 326 Georgiades, Peter, associate counseli Action on Smoking and Health_ 312 Ginn, Hon. Boj , a Representative in Congress from the State of Georgia---------------------------------------------------- 4' Harlany William R.,, Jr., M.D:, on behalf of American Heart Associathion----------------------------------------------- 326;343 Kornegay, Horace R., president, The Tobacco Institute, Inc-------- 184 Levy, Robert I., M.D., Director, National Heart, Lung, and Blood Institute, National Institutesof Healthy Public Health Service, Department! of Health, Education, and Welfare----------------- f A f i ti H lf P h 5 on o ssoc a ., on be o Lloyd, Douglas Seward,, M.D., M. . a State and Territoriali Health Officers_________________________ 326,354 Richmond, Julius B., M.Di, Assistant Secretary for Health, Public Health Service,, Department of Health, Education, and' Welfare_ __ 5 Sledge, John, presidentNort'h Carolina Farm Bureau______________ 369 Snore, John, T., on behalf of Health Insurance Association of America and Americani Councillof Life Insurance________________________ 358 Upton, Arthur C.,, M.D., Director, National Cancer Institute, Na- tional Institutes of Health, Public Healt'h Service, Department of HealthEducathion, and Welfare_______________________________ 5 Additional material submitted for the record by- American Council of Life Insurance: Discounts for nonsmokers in life and health insurance__________ 362 National Underwriter Co., nonsmoker plans and discounts_-____ 368 Prudential Insurance Company of America, nonsmoker experience---------------------------------------------- 365 State Mutual Life Assurance Company of America, noncigarette smoker insurance coverage________________________________ 367 American Heart Association, at'tachment' to Dr. Harlan's prepared statement, Suggestions for program initiatives in smoking preven- tion and cessat'ion------------------------------------------- 350 Health, Education, and Welfare Department: Estimated number of premature deaths for which smoking was a major, contributor (1977)'________________________________ 67 Excerpt from ProceedingsJ,3d World' Conference Smoking and'~ Health, volume II', Health Consequences, Education, Cessa- tion Activities, and Social Action-Pricing out tobacco: price as a factor in cigarette consumption_----------------------- 54 Excerpt from Social and Economic Issues Confronting the Tobacco~ Industry in~ the Seventies, chapter 16'-Impactof Eliminating the Tobacco Price-Support Supply-Control Program------------ ----------------------------------- 31 OSHA's authority to regulate smoking_______________________ 63 Policy on Smoking in~ HEW occupied buildings and facilities____ 14

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~,.'.'#: ... 1Cl Secretary CnrIaxo. We can provide ours. I can ask the General Services Administration; Mr. Solomon, I am sure he would provide that. Mr. ROGERS. If you would. And if there is a problem, let us know, and the committee would request that. fTestimony resumes on p. 23.] The following; HEW guidelines went into effect January 11, 1978. GSA will supply their regulations for the record separately. [hToth- ing further has been received from HEW or GSA concerning GSA guidelines.] v T l.

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18 ~ (3). Recognizingtheright~s of smokers who continue to smoke, supervisors will establish~areas inn which smoking is permittedl Such areas will be conspicuously posted. (4). Smoking will be prohibi2edin those work environ- ments in which thecombihation of smoking and specialioccupatibnal factors presents a particular . hazard to the health.and.safetyh of.employees. (5). Thesafetyand health regulations and procedures established underC: (4)',above, which~prohibits smoking because of occupational exposure, will be enforcedbyd all levels of management and supervisors. Violators of these regulations and procedures will be subject todisciplinaryo action , under~ the provisions of Section 73.735-1101 of the Department's Standards of Conduct. (6.). In addition~t~o the prohibition of smoking ih accor- dance with paragraphs C. (1). (2), and (4) above, an employee who occupies a private office is authorized to declare that office a no-smoking area. (7.). As a general rule, a minimum rate of 5 cfm of fresh.air per person~is recommended to.remove smoke from a work area and provide an environ- ment reasonably free of contaminants. D. Caf~eteriasor Dining Areas. No-smoking areas shall be established in cafeterias or dining areas under - contract to,HEW in Department-controlled buildings.. This may be accomplished by agreement between,the responsible HEWofficiaL.and the concessionaire, and then included as a provision~in futureamendmenos and'new contracts. A no-smoking: areashallibe desig- nated and posted based on an~estimate of; smoking.and non-smoking.p,atronsserved. Careful evaluatfonss should be made after designatingg separate areas and future adjustments as to size should be made, based on experience. Improvements to air-condit.ioning.or exhaust systems will also be considered in such areas where ventilation is poor.

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,g. Mr. RoaExs. Certainly. Secretary CaLIFn*ro. And I did' come here accompanied by the Surgeon General, Dr. Richmond, the Director of the National Cancer Institute, Dr. Upton,, and the Director of the National Heart', Lung, and Blood Institute, Dr. Levy, because it is important that the facts about this subject be fully available to this subcommittee,, as Con- gressman Preyer noted. Mr. Chairman, and members of the subcommittee, I appreciate this opportunity to appear before you this morning to discuss the ex- tremely important subject of smoking and the public health. You have long been leaders in the health field and so it is appropriate that you should hold this hearing,on a subject of great concern to our Nation. Last month, on the 14th anniversary of the Surgeon General's Report, I renewed the commitment of the Department of Health, Education, and Welfare to inform the American people about the dangers of smoking in a speech to the National Interagency Council on Smoking and Health. ~ ' That' speech-and subsequent commentary and debate-has focused attention~ again on the health and economic problem posed by cigar- ette use. I welcome that discussion ;, only with robust debate can~ we develop a new public consciousness and an appropriate public policy about smoking-the single greatest cause of disease and prematuree death in this country today. I also welcome the opportunity to report to you today on HEW's antismoking effort-its goals, its main components, and its limita- tions. I also hope to persuade some of the program's more intemr perate critics that their concern-like their rhetoric, is greatly exaggerated. ` At the heart of HEW's antismoking program is a deep commit- ment to informed personal choice. I would emphasize the word personal because ours is not primarily a regulatory effort that seeks by rules to change behavior. Nor, even less, is it a prohibitionist campaign designed to outlaw cigarette consumption. Rather our antismoking initiatives are primarily in~ education and research. Education to better inform Americans-especially young Americans-as you noted, Mr. Chairman-about the hazards of smoking so that a decision to start or to continue smoking is based as fully as possible, on a sound! foundation~ and fact. Research to understand better unanswered questions about why people smoke and how they can effectively stop if they wish to do so. Make no mistake, our efforts are to reduce smoking. Butthey are efforts grounded on persuasion and information that appeal to the commonsense of our citizens: Theyy are not efforts based on coercion and scare tactics. I have the greatest empathy for the millions of Americans whoo want to stop smoking, but who find it very, very difficult to do so. Quitting smoking was one of the hardest things I myself have ever done. Thus, contrary to those who charge that our efforts are somehow an intrusion on~ individual liberties, I must underscore that our primary goal is to provide information and conduct research that w tri ti!. stt tk ei s I i I

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1'7 (3) Libraries. Smoking shall not be permi2tedin libraries except in such areas asmay, be designated as smoking areas. (4) Elevators. Elevatorsshall be designated as no- smoking areas. (5), SliuttPe Vehicles. Smoking shall be prohibited' inn shuttle vehicles under HEW contro1 A"No Smoking' ,sign shall bepostedin each vehicle and the driver shouidinform al':1' passengers of this requirement. C.. Work Areas (1). Separation of Smokers and~Nonsmokers In consideratiort of the rights of~ nonsmokers in~ work areas, theyy will,, within practical limits, be given the:opportunity, to beassianed~t~o officess or workplecesseparate:and phvsicallydistinct from~those of employees who smoke.. The.following provisions will apply in makingg these determinations: Efficiency of work units or administratire effectiveness shall not be impaired. -2- Excess.i've.costs will not result from: providing physicall separation. - -3- Additionallspace will not be required. (2)~ In common work areas, in which two or more em- ployees are asaigned supervisors will prohibit smoking if an employee objects in writing to tobacco smoke in the immediate work envlronmenton~the basis.that it is having.an adverse effect uponhisn or her health. It (z ' r

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16 c: In addition to the actions required bythi~schapter,y officers in charge of all Public Health Service facilities shall implement the "Policy on Smoking for Medical Care Facilities of the Department of Defense, Public Health Service and Veterans Administration" within their respective jurisdictions. (See Exhibit . L-60-1). B. Heads of Staff 08ficeswil~1'support the provisions of this policyand,assist the Headsof POCs., PROs,and', Direetor. Office of Management Services, OS,, in its implementation. The ASMB and Assistant Secretary for - Personnel Administration will provide within theirareasof responsibility supporting funds and training guidance and assistance. . 1-60-40 Implementation Directives A. General. HEW officials are directed to implement.and enforcet'he.smoking policy in areas under HEW control (see paragraph.1-60-20) . according tothe.type of space.in- volved. B. Smoking,.shall'notbe permitted in: (1)~ Conference rooms and classrooms. Conference rooms andiclassrooms are defined as a room.designated for, meetings and training,sessionsor for instructional purposes and are not used as an~of~fice or part.of andiindividual'ss usual working,area.., Included in, this definition are multi-purpose rooms while used as conference.rooms or classrooms.The person re- sponsible for holding the conference.,meeting,,or training session is also responsible for enforcingtheno-smoking rule. Prompt action shall be taken to post appropriate "No Smoking" si'gnsin these areas. There shall be no ashtrays in these areas ard receptacles for disposing of cigarettes, etc.,,.shall be placed at entrances. (2), Auditoriums. Smoking shall not be permitted in auditoriums. Prompt action shall bee taken to post appropriate no-smoking signs in auditoriums. There shall be no ashtrays in these areas.. Receptacles may be pl'ace&just inside the auditorium so that visitors may dispose of cigarettes, etc., when they become aware of the smoking restriction. 1

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22 3. Apb 4evelop seneral health edecation activities with emphasis on apoki" and bealtb practices in hospitals and'clinics. §, 3'9 cowpejratt vitb otfie.r commni'ty groups in the development and irplenentation of coomunity-vi(e activities dealing with the clgarstte elookisg prob Ls®. st$naa by; /i/ Louie K. l.Otsae1ot, M.D. /s/Wi1Li® H. Stevart M.D. /./ H. M. Engle, M.D. s. asa ,.. an H: Stewart, M.D. H'. M. Engle, M.D. Dsputy AasistAat Secratary Sarseon CeneraL Qhief Medical Director of Dtfenla U.S. Public Health Veterans Administration (Ke`lth sed 1t.dioal) g.rvice RAtet AULI 74, 1962 Date: April 21, 1969 Date: May 5, 1969 Dir react peilo of ac Se, ment ment are 0 ently I ~. tion '' th" in al that prin Witl I mer iten 'N poi. can are: try- hea up abo 3 go c . PrC c . ] anc re( lot us .I Po, ac, ab' gE t

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.C 2 Mr. CnxzER. Mr. Chairman. Mr. RoaFXs. Yes, Mr. Carter. Mr. CARTER. I would like to share with you and the others here a few facts about tobacco in my eongressional district'. I have prob- ably the largest number of burley growers in the Nation. There are about 45,000 farm families in my dlstrict who grow tobacco, and who produce about 90 million pounds of tobacco per year. The gross income from those 90 million pounds amounts to about $115 million per year. Moreover, the value of the land is enhanced by the productivity from tobacco and the total land value of those 45,000 farms is about $270 million. Local tax revenues depend on such values. Mr. Chairman, without tobacco in my district, or for that matt'er. without tobacco in the State of Kentucky, which generates over $3.5 billion to the economy from tobacco sales-without tobaeco, there would be economic chaos. Mr. Chairman, more tham half of the farm income in the Fifth District of Kentucky comes from tobacco. Many of the people who farm tobacco are poor and depend' on the money they earn from this product to buy the bare necessities of life. The entire structure of our State's agricultural economy would be severely undermined if tobacco were no longer the crop it is today. Thank you, Mr. Chairman. Mr. RooERs. Thank you. Mr. PxErER. Mr. Chairman, very briefly, I think there is.one thing we can all agree on : That cigarettes cause controversy. I know Mr. Califano, in his January 11 statement cited' some of what he outlines as new evidence on smoking and health and indicated that for us to fail to accept that evidence amounted' to an attack on science. I would like to suggest at the outset of the,;e hearings that theree is a perhaps greater danger in a retreat from science to politics than there is a danger of foreclosing scientific research in favor of propaganda. Those of us who are from tobacco St'ates,, like Dr. Carter, have frequently despaired in~ this area of trying to get impart,ial, research, not done by people whose living depends on research in this area. Mark Twain savs it is not what you don't know that hurts you, it is what you do know that isn't so. And it is holy writ on the smoking, and health' controversy. To try to get an impartial' hearing on that subject is extraordinarily difficult. So I hope today Secretary Califano's testimony won't just offer conclusions but that we will also get the basis and evidencE for these concl!usions, because I think that is what we are alll interested in. Mr. RocExs. Thank you very much. I understand Mr. VVaxman, had a comment. Mr. WnxMn--N-. Thank you, Mr. Chairman. I had not originally planned' to make an opening statement but I feel that I ought to. I am pleased that we are having this hearing and I am please& to see Secretarv Califano here to answer some of our questions about the antismoking, campaign. We now spend $5 billion a year trying to treat people for cigarette related illnesses, and I am concerned'that this kind of' cigarette smok- ir. a ce 0 w nt pI kr ; es ~ ai J I i tl- cc tt tl G fct s". cc S+ in cc sn ~ h( ~ P' = vi ; rE ai f] u h h' n' C p tc 7 ai . tl,

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