Tobacco Documents Online

, S THE SECRETARY OF HEALTH. EDUCATION. AND WELFARE WASHINGTON. O. C. 20201 c The Honorable Thomas P. O'Neill Speaker of the House of Representatives Washington, D.C. 20515 !=!`"' Dear Mr. Speaker: . As required by Section 8(a) of the Public Health Cigarette Smoking ' Act of 1969, I am submitting the 1977-191S~revert on the health --consequences of smoking. The report includes the "Bibliography on Smoking and Health--1976," the "Bibliography on Smoking and Health-- 1977," and "The Health Consequences of Smoking, 1977-1978." The report -bears a 2-year designation in order to return the series to an annual timetable which was altered because of the time required for the clear- ance processing of the 1976 report. The Bibliographies are prepared -annually and routinely to reflect the new acquisitions to the smoking- and health data base which operates at a cost of $200,000.00 per year; the health consequences of smoking report, which is a review of this new current information and prepared specifically for Congress, this year cost $9,800.00. "The Health Consequences of Smoking, 1977-1978" includes recently pub- lished data from three classic prospective studies of the mortality re- sulting from cigarette smoking. These studies, involving almost one and a half million persons, continue to document excess mortality among smokers as compared to nonsmokers. This part of the report also includes data on the established risks of low birth weight and increased perinatal mortality for offspring of women who smoke during pregnancy. In addition, the new evidence is reviewed that shows not only a high rate of heart attacks among women who smoke cigarettes, but that this effect is particularly critical in women who use oral contraceptives. The data in this report indicate that former smokers show lower death rates than continuing smokers and within 10 to 15 years after quitting come close to the low rates of those who never smoked. O W ~ W M N Mr

r Page 2 - The Honorable Thomas P. O'Neill One study supports previous evidence that there is a partial solution to the health problem in the use of cigarettes with lower emissions of "tar" and nicotine. As a result of public demand and a responsive industry, there has been over recent years a continuing decline in the emissions of "tar" and nicotine in cigarettes in use. The data in this report and in previous annual reviews of the health consequences of smoking have established cigarette smoking as a habit re- sponsible for an overwhelming level of premature death and disability in this country. To reduce this preventable and costly mortality and morbidity, this Department recently announced a new antismoking program. The program is one of public education, regulation, and research with special emphasis on children, teenagers, and young women, and on occu- pations where smoking increases risks from occupational exposure. In undertaking this program, I have invited the cooperation of the major broadcast networks, State and local school officials, the major corporations of this Nation, State Governors and legislators, the Federal Trade Commis- sion, the Federal Communications Commission, the Civil Aeronautics Board, and others whose involvement and cooperation are crucial to the success of this program. In response to the evidence linking the combined use of oral contraceptives and cigarette smoking, the Food and Drug Admin- istration, Public Health Service, HEW, has recently required that a warning statement to that effect accompany oral contraceptives as they are dis- tributed to those who use them. To provide leadership and to coordinate this program, an Office on Smoking and Health has been established in the Office of the Assistant Secretary for Health. As one of its first tasks, this Office will coordinate the production of a comprehensive document which reviews not only the biomedical but also the behavioral and control data about smoking and its effects on health. The report will be submitted to Congress in January 1979. As the principal health officials of this government, the Surgeon General and I are committed to fulfilling our responsibilities to provide infor- mation and direction to permit American citizens to make genuinely free choices about smoking and their own health. In this regard and as I am required by P.L. 91-222 to make such legislative recommendations that I deem appropriate based on the scientific data about the impact of smoking