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REPORT TO SURGEON GENERAL'S ADVISORY COMMITTEE ON SMOKING AND HEALTH MATERIALS ON CIGARETTE FILTRATION Submitted By P. LORILLARD COMPANY MORGAN J. CRAMER, PRESIDENT May 29, 1963

REPORT TO SURGEON GENERAL'S ADVISORY COMMITTEE ON SMOKING AND HEALTH Y Table of Contents A. Filtration of Tar . . . . . . B. Filtration of Nicotine , , . . C. Filtration of Phenol . . . . . Cigarette Smoke and Phenol as Ciliastatic Agents . INTRODUCTION I. ROLE OF FILTER CIGARETTES IN REDUCING OR ELIMINATING ALLEGED HEALTH HAZARDS OF SMOKING . . . . . . . . . . 4 MATERIALS ON CIGARETTE FILTRATION . . . . . . . . . . . . . 1 , , 5 , , 7 . . 9 . . . . 10 Selective Filtration of Phenols ,,, 12 Phenol Content of Cigarettes ,.,, 14 D. Significance of Filter Cigarettes , , II. THE NEED FOR REVIEW OF THE 1959 POLICY STATEMENT OF THE SURGEON GENERAL ... CONCLUSION . . . . . . . . . . . . i BIBLIOGRAPHY 0 0 0 0 . 0 0 0 • 0 0 . . 15

r r INTRODUCTION This report is submitted pursuant to the invitation contained in a telegram received from Dr. Luther Terry on July 20, 1962, and affirmed in a letter from Dr. James M. Hundley dated March 12, 1963. In his telegram, Dr. Terry advised that Lorillard's views with respect to the studies of the Surgeon General's Advisory Committee on Smoking and Health would be welcome directly in writing. In his letter Dr. Hundley advised that the Surgeon General's Committee would be pleased to receive data of relevance to the Com- mittee's task of assessing the nature and magnitude of the health hazards. On April 3, 1963, Morgan J. Cramer, President of P. Lorillard Company, advised Dr. Hundley that Lorillard was preparing a compilation of scientific information on cigar- ette filtration with emphasis to be placed on data deYived from studies conducted in Lorillard's own laboratories and in outside laboratories. 1

, r , The materials contained in this report are submitted neither to prove nor.disprove any of the conflicting claims advanced by medical authorities with respect to the health hazards of smoking. We believe any submission by Lorillard relating to these questions would only be cumulative since this aspect of the Committee's inquiry will receive full and sufficient coverage from other sources. In Lorillard's view, the claimed association between smoking and various diseases is based largely upon statistics which have been challenged both as to adequacy and method- ology, and is lacking in probative physiological or clinical substantiation. We make this declaration in order precisely to position this presentation in the context of Lorillard's official policy. We recognize, however, that while this claimed association is seriously disputed, it has been asserted by respected authorities, has been heavily documented and given expansive publicity. Lorillard neither disregards these claims nor acts irresponsibly to discredit them. Thus, while P. Lorillard Company does not believe the serious health charges against cigarette smoking have been C C.: - ~ C11 ~ - 2 - `~ 0

r , proved, we are deeply concerned. We, therefore, regard it our fundamental responsibility to explore every substan- tial health charge directed at cigarette smoking -- though we do not accept them as proved -- and to strive to meet these charges through development of cigarettes designed to reduce the amount of the suspect components of smoke and thereby to mitigate or eliminate the alleged health hazards. In this presentation we do not claim or seek any advantage for the P. Lorillard Company. The developments which we describe are within the present competence of all cigarette companies, and advanced techniques of cigarette filtration are also used by a number of other companies. These companies are engaged, as is Lorillard, in continuing, unrelenting efforts to develop improved filters and to adapt these filter advancements, as they are achieved, to their cigarettes. We believe that the materials contained in this re- port will be relevant to this Committee's inquiry and will assist the Committee in reaching an informed judgment con- cerning the effectiveness of filters andthe significance and utility of filter cigarettes. 3

I. ROLE OF FILTER CIGARETTES IN REDUCING OR ELIMINATING ALLEGED HEALTH HAZARDS OF SMOKING Cigarette smoke contains a combination of air, gases , t and particulate matter, by-products of incomplete combustion of tobacco or derived from unburned tobacco.1/ The components of tobacco smoke most seriously con- r sidered at various times in terms of health significance include tar, nicotine, phenol, carbon monoxide and poly- nuclear hydrocarbons such as benzpyrene. of these, tar, nicotine and phenol now receive major attention.v ~ The complex chemistry of smoke has yet to be definitively summarized. The literature reports identification of 261 compounds by one source(7) and of "some 300 compounds" by another(27). Other estimates, which include isomers, are much higher. ~ The Royal College of Physicians considers that the con- centration of carbon monoxide in cigarette smoke is "not enough to have clinical effects in normal circumstances"a7) . Benzpyrene, the most extensively studied of the suspect polynuclear hydrocarbons, is a carcinogen under some conditions, but its concentration in cigarette smoke is so low that experiments in which benzpyrene mist was inhaled failed to produce bronchogenic carcinoma in . 0 animals(32) W ~ C: W~ CD - 4 - ~ N

r . The quantity of tar, nicotine and phenol in the mainstream smoke of cigarettes varies according to a number of factors including the selection and blend of tobaccos, treatment of tobaccos, the tightness of packing the tobacco, and factors which affect the rate of combustion, hence the amount and nature of combustion by-products. in a filter cigarette, the quantity of tar, nicotine and phenol in the mainstream smoke is affected by these factors but is a function principally of the design and efficiency of the filter. On the following pages, we discuss filtration of these substances in greater detail: the charges which have been made concerning their presence in cigarette smoke, the performance of filter cigarettes in reducing these substances, and the significance of filter cigarettes. A. Filtration of Tarv The consensus of that portion of present opinion which charges an association between cigarette smoke and ~ For simplicity the word "tar" is employed synonomously with "smoke condensate" or the particulate phase of cigarette smoke. 5

. r various diseases asserts that tar is the fraction of smoke which contains the principal suspected agents. In this view, the alleged adtierse effects of smoking are approxi- mately proportional to the degree of exposure to smoke, particularly to its tar components. The use of filters to reduce the tar yield of cigar- ettes has become widespread since the mid-1950's. Filters can be devised which remove 100•,6 of the tar or particulate matter of cigarette smoke, but since tar contains the principal flavor elements of smoke, the smoke thus filtered becomes tasteless and unsatisfactory to the smoker. There- fore, manufacturers have controlled both tobacco blend and filter performance so that the mainstream product -- the smoke which enters the smoker's mouth -- has acceptable flavor characteristics. Filters physically trap and remove particulate matter from the mainstream smoke with a high degree of efficiency. Cellulose acetate fibers have been found to serve well as a filtering material for cigarettes, permitting a high degree of control over the quantity of particulate matter removed GO. ~ C!t Cd - 6 - .~ ~

from the smoke. The filtering action is achieved largely S. f by the physical entrapment of the particulate matter as it impinges on the cellulose acetate fibers while being drawn through the filter. Filter cigarettes as a group yield substantially less tar in the mainstream smoke than nonfilter cigarettes, and within the filter group there is a wide range of tar yields. The tar content of 37 brands of cigarettes tested in 1961 by Reader's Digest showed a range from 5.7 mg. in the lowest- yield filter to 33.2 mg. in the highest-yield nonfilter. (See Table 1) B. Filtration of Nicotine Traditionally, nicotine has been bracketed with tar as the principal toxic agent in smoke, and'critics have used nicotine as a basis for illustrating the possible harmful effects of smoking. Nicotine is largely in the particulate phase of the smoke and is technically a component of the tar ur condensate. Its removal or reduction by means of filtra- tion is accomplished in the manner described 7 in the preceding

TABLE 1 Tars (Si»vke So(icl:r)' Brond 54. 1957 1958' 1959 196'l FILTER'-T1 PS Oasis King. 24.5 mg 29.8' mg Tareyton Dual King. 27.1 mg 25.3 nig 23.O1mg 22.0 mg r Raleigh King - 21.4!mg Kool King 24.1 mg 21,0 my L & M King 38.5 nig 24.9 mg 18'.6 m; 20.7 mg Salem King - 25.4 nig 20.3 mg Wi ns to n King 32.6 mg 29: t' nig 22.7 nig 19.0 nig r Marlboro Kin, - 1'9.9mg . 19.2mt; Marlboro Long 34.4 mg 24.7 mg 16.7 m5 19:1i m,; ~ Alpine Kin~ - 15.2'mg, 1Y,11 m~.~ L&M Long 24.0 mg 18.9 m; I S. II mo Kentucky Kings King - - 17.9 nig Winston Long 23.7 mg 20.4 mg 17.5 nig Viceroy King 30:2 mg 27'.7'mg 20.0 rng 17:2 m:; Parliament King - 16.2 mg 16.2 mt! Old Gold Kins. 39:&mm 20.8' mg 18.4 mg 1!6.0 mg Parliament Long 3-1.1' mg 19.6mg I5.8ms 15,8mg Newport King - 19.7 mg 1'S.6 mg, Viceroy Long - 14!.9 ms' Newport Long, 17.3 m~ 14,0 mg, Kent Kin; 30.4 mg 17.9 mg 17.6mS 13'.7m, Kent Long 16.41 nig 15.6 ms 12.8 m, Duke of Durham King - 7:2 mg 0 1 11.9 mj, 8 6 Spring King Sano i<ingKing - 18.5 ma mg 1 . 18'.1 mo . n:g 7.9 m- Life King 9.8 mg 5.7 mg I PLAIN-T1PS I Pall Mall King 38.6 mg 37.1 mg ' 34.4 mg 33.2 mg Chesterfield Kins 41.1 mg .7 mg 38 35.7 mg 32.4 mg Raleigh Philip Morris King 39.3 mg 35L6 ms - 34.9 mg 32:3 mb "Commander" King - - - 31.9 mg Herbert Tareyton King 3'6,6 mg 34'.3 mg _ 30:7 mg 30.9 mg. Chesterfield Reg. 32.7 mg 30.6 mg, : 28.4 mg 26.2' mg Lucky Strike Reg, 31.5 mg 28.6 mo' 25.8 mg 24.8 mg Old Gold Straight King - - - 24.4 m.- Philip Morris Reg. 353 mg 28.9 mg 25.8 mg 23.7 mg Camel Reg. 31.0 mg 28.7 mg 27:7 mg 23.4 mg Old Gold Straight Reg. 30.9 mg 22.4 ms .21.3 mg 18.3 mg . Source: Reader's O Digest (July 1961) p. 75. ~ ~ ~ z

. 19 / section. Both Reader's Digest and Consumer Reports have discussed nicotine in their series of articles on cigar- ettes, and both have included nicotine determinations in their published analyses of cigarette smoke. The toxicity of nicotine has been known for over a century, and its pharmacology as a specific and isolated . chemical compound studied extensively for many years(7•21) Because of the observed pharmacological effects, nicotine in cigarette smoke has also been widely studied. The effects of nicotine on the cardiovascular and central nervous systems have been reported, but most recent studies have tended to stress the considerable individual variation among smokers in these responses and the lack of significant adverse effect on normal subjects. Thus, there has been a general diversion of emphasis from nicotine as scientific inquiry has shifted to tar and phenol(9'18'27) 0 Filter cigarettes as a group yield substantially less nicotine in the mainstream smoke than non-filter cigarettes, and within the filter group there is a wide range of nico- tine yield. The nicotine levels of smoke from 37 brands of C W . ~ C,l1~ C0 ~ - 8 - ~

f cigarettes is shown in the attached table published in Reader's Digest, July 1961. These show a range from 0.4 mg. of nicotine in the lowest-yield filter cigarette to 2.5 mg. in the highest-yield nonfilter cigarette. (See Table 2) The nicotine levels of cigarette mainstream smoke tend to vary with the tar levels. Hammond has reported that "tar and nicotine content are closely related. With.a few minor exceptions, cigarettes low in nicotine are also low in tar and vice versa."(19) C. Filtration of Phenol Numerous investigators now suggest that, in addition to tar and nicotine, phenol may also be an important factor in the smoking-health inquiry. Phenol has become the sub- ject of intensive special investigation. There have been reported improved methods for separating, identifying and dptermining the amounts of phenol and phenolic compounds in smoke.A/ ~ See papers of Crouse et al., Spears, Wynder in appendix. and Hoffmann and 9

TABLE 2 IN'icot'ine f Brand Si=e 1957 1958 1939 1961 F1L.TER•TIPS Oasis Kin; 1.9 mg 2'.5 mg , Salem King 2.1 mg 2.0 mg Kool Kin, 2.0 mg 1.9 mg L & M Kin-, 3.1 nig 2.5 mg 1'.6 nig 1.8' mg L & M Long - 2.1 mg 1.5 mg 1.8 mg Raleigh l:in~ - 1.8 mg Tareyton Dual King 1.9 m; 2.0 mg 1.7mg 1.8mg Winston King 2.6 mg 2.7 mg 1.7 mg 1.7 mg Viceroy Kino 2.4 mg 2.2 mg 1.4 mg 1'.6 mg Alpine Kino 0.9' nig 1.5 mg Kentucky Kings King - 1.5mg Marlboro King 1.3 mg 1.5 mg Marlboro Long . 2.4 mg. 1.9 nig 1.3 mg 1.5 mg Winston Long 2.3 mg 1.6 nig 1.5 mg, Viceroy Long - 1.4mg Newport King 1.1 mg 1.3 mg Old Gold Kin, 3.1 mg 1.5 mg 1.3 mg 1.3' mg Parliament King 1.01mg 1.3 mg Newport Long 1.01mg 1.2 mg Duke of Durham King 0.4 nig 1.1' mm Kent 2.2 mg 1'.3 mg 1.1mg 1.1'mg Kent Long - 11.3mg 1.0mg 1.1mb ?,:r!iament Lon; 2'.7 mg 1.5 mg 1.1 mg 1.1 mg Sprin g King' 0.5 mg 0.7' mg Life ' King 0.6 mg 0.5 mg King Sano Kin; 0.6 mg. 0:7 mg 0.4 mg PLAIN-TIPS Chesterfield i M King 2.6 mg 3.4 mg 2.5mg 2.5 mg orr s . Philip "Commander" King - - - 2:5mg Herbert Tareyton King 2.2 mg 2.6mg 2.2mg 2'.4m;, 4 Pall Mall King 2.4 mg 2.6,mg 2.3 mg mg 2. Raleigh King 2.5 mg 2.6 mg 2.7 mg 2.4 mg Chesterfield Reg. 2.4 mg 2.5 mg 2.0 mg 2.1 mZ O1d GoldStraight King - - - 2.1 mg Camel R'eg• 2,8mg 2.5mg 2.3mg 1.9 mg Lucky Strike Reg.. 2.1'mg 2.0mg 1.8 mg 1.9 mg Philip Morris Reg, 2.4mg 2.2 mg .1:6ms 1.9mg Old Gold Straight Reg. 2.4 m; 1.6 mg 1,3 mg 1.4 mg Digest (July 1961) p. 76. Source: Reader's

, Practical methods for selective filtration of the phenol content of cigarette smoke have recently been developed, and a number of brands of cigarettes, produced by several manufacturers, now yield significant reductions in the phenol content of the mainstream smoke. Cicfarette Smoke and Phenol as Ciliastatic Agents Cigarette smoke and some of its components have long been reported to have ciliastatic properties. Since the ciliated epithelial tissues of the respiratory tract serve to remove foreign matter from the tract, the effect of cigar- ette smoke on the functioning of ciliated tissue has been investigated.v The ciliastatic effect of cigarette smoke and some of its.components has been demonstrated on the ciliated tissues of the freshwater clam(13); the frog(3'28); rats(ll) rabbits(ll): cats(l2); goats, sheep and dogs(l5): and cultured human epithelium(2) . V For recent, unpublished studies, see papers of Bernfeld et al., Dalhamn and Rylander, Davis and George, and Q Schultz and Bussell in appendix. ~ ~ - 10 - m O

Among the known constituents of tobacco smoke, phenol specifically has been reported to inhibit or arrest the activity of the ciliated tissues of freshwater clams(l3) and of frogs(3,28,31,35). in laboratory experiments, phenols have also been reported to be ciliastatic when tested on paramecia,:rats and, in some instances cultured human bron- chial epithelium(35)~ Schultz and'Bussell have recently reported that ex- posure to phenol reduces the flow of mucus in frog esophagus tissue in proportion to the dose applied. They found the degree of inhibition of cigarette smoke on ciliary function to be directly related to the amount of phenol in the smoke applied, and when the phenolic compounds in the smoke are reduced "to a low level, the depressant effect [on mucus "(28) f lowJ can be virtually eliminated. Bernfeld et al. reported that smoke from filter cigarettes is less ciliastatic than smoke from nonfilter cigarettes(3) . Dalhamn and Rylander have recently reported privately their studies to date on the effect of smoke from filter and nonfilter cigarettes on the cilia of cats in vivo.

In preliminary findings, it was reported that the smoke from two brands of filter cigarettes did not reduce ciliary activity, whereas the smoke from a single brand of nonfilter cigarettes caused stoppage of ciliary activity in 4 of 5 animals exposed. Ciliary activity was reported to have resumed in 2 of the 4 animals after a 10 minute recovery period but did not resume at all after a 15 minute recovery period for the other 2 animals affected.(12) Selective Filtrationof Phenols The reported presence of phenol and phenolic com- pounds in the cigarette smoke suggested to a number of investigators the desirability of attempting to reduce the phenol content of cigarettes by special filtering action.~ It has been reported that approximately 80° of the phenol in the mainstream smoke is in the particulate phase and 20% in the gaseous phase. It would normally be expected that the reduction of phenol would be proportional to the degree of removal of tar or particulate phase. Hoffmann 6/ See papers of Bernfeld et al., Hoffmann and Wynder, w Schultz and Bussell, and Spears in appendix. ~ G1 Ca 00 N - 12 -

and Wynder, however, found that while cellulose acetate filters of the cigarettes they tested removed 33-42% of the particulate matter in the mainstream smoke, such filters removed from 60-70% of the phenol, thus suggesting a ~ (20) capacity for selective removal . Subsequently, cellu- lose acetate filters were treated with various plasticizers and found to have increased phenol-adsorption capacities. Filters so modified reduced phenol up to 90%(20). Crouse et al., reporting later experiments on 13 brands of filter cigarettes, found a phenol reduction ranging up to 85%(10). Davis and George have reported the selective filtra- .tion of phenol and phenolic compounds both in dry gas and cigarette smoke(13)~ Several investigators have reported that selective filtration of phenol may be significant in the reduction or elimination of ciliastasis. Davis and George reported that selectively filtered smoke was "far less toxic to a 7/ Spears has postulated that the selective phenol filtra- tion occurs because the more volatile phenol concentrating at the surface of the aerosol rticles is adsorbed by O . the cellulose acetate fibers(3 1. ~ CJ? _ GD ~ W - 13 -

given cilia than unfiltered smoke and probably less toxic than smoke filtered by conventional secondary acetate tips..(l3). Schultz and Bussell have reported that smoke from cigarettes provided with phenol-selective filters is less ciliastatic than smoke from unfiltered or unselectively filtered cigar- ettes (28) . Phenol Content of Cigarettes Among cigarettes now available, there is a broad range of phenol content of mainstream smoke. The data of Spears, who determined the phenol yield of 19 brands of cigarettes, both filter and nonfilter, and of Crouse et al., who deter- mined the phenol in the smoke of 13 brands of filter cigar- ettes, are shown on Tables 3 and 4. Filter brands as a group yield less phenol than non- filters and within the filter group there are substantial variations in phenol yield. As reported by Spears, the phenol content of smoke condensate from 85 mm. nonfilter cigarettes ranged from 76 mcg. to 108 mcg., while the phenol content of smoke condensate from the same size filter cigar- ettes ranged from 9 mcg. to 35 mcg. per cigarette. C C.~ ~ ~ ~ ~ - 14 - W 04

TABLE 3- PHENOL VALUES OF COMMERCIAL CIGARETTES Phenol per Sample brand and length cigarette (mcg. ) 1 (85 mm. ) NF a 108 2 (85 mm. ) NF 104 3 (85 mm. ) NF 76 4 (70 mm.) NF . 81 5 (70 mm.) NF 59 6 (85 mm. ) F 35 7 (85 mm. ) F 34 8 (85 mm. ) F 33 9 (85 mm. ) F 31 10 (85 mm. ) F 28 11 (85 mm. ) F 24 12 (85 mm. ) F 24 13 (85 mm.) F 23 14 (85 mm. ) F 21 15 (85 mm. ) F 21 16 (85 mm. ) F 14 17 (85 mm.) F 14 18 (85 mm. ) F 12 19 (85 mm. ) F 9 a NF nonfilter F filter Source: Spears(29)

TABLE 4 - REDUCTION OF PHENOL IN SMOKE OF FILTER BRANDS OF CIGARETTES Code Length (mm. ) Phenol in Filter intact (mcg. ) Smoke Filter removed (mcg. ) Reduction (%) C 85 12.8 87 85.3 M 85 19.5 71 72.6' A 80 25 82 69.5 B 85 29 90 67.8 D 80 31 109 71.6 E 85 43 129 66.7 F 80 44 115 61.7 G 85 45 122 63.1 L 85 46 115 60.0 J 85 48 130 63.1 K 85 53 124 57.2 I 85 55 111 50.5 H 85 64 161 60.3 (10) Source: Crouse, Garner and O'Neill O W ~ CJ2 m C~

These studies were made in early- and'mid'-1962. More recent analyses show lower phenol levels in several filter brands, suggesting that a number of manufacturers have now achieved selective phenol filtration. t D. Significance of Filter Cigarettes Among investigators and authorities whose work is cited in support of claims linking cigarette smoking with lung cancer and other diseases, an exposure relationship has generally been asserted. The incidence and severity of these diseases or of certain histologic changes are claimed to be proportional to the amount of cigarette smok- ing or to the degree of exposure to cigarette smoke or smoke components(l,4,6,9,14,17,21,25,26,33,34). Reversal, regression or reduction of the incidence and severity of histologic changes or other responses has also been reported upon changing from nonfilter to filter cigarettes (19,34) * Increasingly, critics of cigarette smoking now state that a reduction of the alleged harmful components of smoke will entail reduced health risk. O W ~ ~ CD - 15 - GD ~

Shimkin: I think Reader's Digest had an analysis of filter vs. nonfilter cigarettes, in terms of their tar content and their mainstream smoke. It was very difficult to distinguish between these two types of cigarettes. A more recent study indi- cates that there is now considerable difference in the amount of tar in the filter vs. the nonfilter cigarettes. But we don't know the exact relationship of quantity of tar and the hazard~of cigar- ettes from other standpoints. But at least it's a step in the right direction. I think this is one of the many responsi- bilities of industry is to apply a tremendous amount of research towards making cigarettes safer.(8) Hammond : In my opinion, those who choose to smoke should seriously consider: (1) selecting cigarettes which are low in nicotine and' tar content and (2) avoiding smoking cigarettes dqlw8)to a very short remaining butt length t. P. McGrady: Several scientists close to the controversy have expressed optimism over the effect of the low-tar, low-nicotine cigarettes on public health. Some have said that the new "safe" products, if widely adopted in lieu of regular cigarettes, might lower heart and~lung disease death rates within the next three or four years or at least halt the dreadful increase.(23)

Tar, nicotine and phenol are the constituents of smoke most consistently suspected. As has been shown, filter cigarettes have been developed and are currently available which yield substantially reduced amounts of tar, nicotine and phenol. The claims with respect to these substances are largely inferential and, in Lorillard's view, unproved. But since it is asserted by those who subscribe to these theories that any adverse effects of smoking are approximately proportional to the degree of exposure to the suspected constituents of smoke, it may be postulated that cigarettes which remove or substantially reduce these smoke components will mitigate or eliminate any health hazards resulting from their presence in the smoke. II. THE NEED FOR REVIEW OF THE 1959 POLICY STATEMENT OF THE SURGEON GENERAL In the November 28, 1959, issue of the Journal of the American Medical Association, Leroy E. Burney, then Surgeon General, United States Public Health service, published a special article: "Smoking and Lung Cancer - A Statement of ~~ (6) the Public Health Service" . On September 19, 1962, Dr. cj C!t CD T - 17 - W F I

Luther Terry, Surgeon General of the United States, stated that "the present position of the Public Health Service is the position which was stated in 1959"(8)• The 1959 Statement recited the concern of the Public Health Service "with the increasing death rate from lung cancer in the United States and in other parts of the world." It noted the various theories of causation: cigarette smoking, air pollution, other unknown factors. It concluded that "the weight of evidence at present implicates smoking as the principal etiological factor in the increased incidence of lung cancer." In a discussion of "Future Possibilities of Prevention," the Statement examined the "effectiveness" of filter tip cigarettes: Present knowledge indicates that it is not possible to filter, selectively, specific compo- nents such as carcinogens. Since the evidence from both human and animal studies shows that the risk of developing cancers is related to the amount of exposure to tar, the problem is to design a f ilter that will permit the minimum flow of whole tobacco smoke to pass., 'consistent with smoking satisfaction. The filters presently in use do not eliminate, but merely reduce, the tar. It is questionable whether, from a health point of'view, any so-called minimum exposure to C such a hazard'should be accepted. W ~ C!T ED GO - 18 - O

Table 3 gives the status of filters today, as found in two recent independent studies. In both studies cigarettes were smoked'to a standard butt length, at a standard rate, volume and duration of puff. Any reduction in tar content of the smoke is accomplished only if the consumer does not smoke more than formerly and if the manufacturers do not alter the tobacco selection, cut, or packing to counteract any deficiency in taste caused by the filter. The Statement concluded that "no method of filtering the smoke has been demonstrated to be effective in materially reducing or eliminating the hazard'of lung cancer." While P. Lorillard Company does not accept the funda- mental conclusion contained in the 1959 Statement that cigar- ette smoking has been implicated as the principal etiological factor in the increase of lung cancer, we believe that with- out regard to the validity of that conclusion, the foregoing materials justify a departure from the position taken in the portions of the Surgeon General's 1959 Statement relat- ing to filter cigarettes. The 1959 Statement reported~that Present knowledge indicates that [it] is not possible to filter, selectively, specific components such as carcinogens. As early as March 1959 the work of Haag, Larson and FinnegaP-4 presented as a paper at the 59th Annual Meeting of the

American Therapeutic Society on June 21, 1959, was published in the A.M.A. Archives of Otolaryngology(16) . It reported the selective filtration of specific components of cigarette smoke. More importantly, as described above, developments since 1959 and their commercial application now demonstrate that it is possible to filter selectively phenol andphenolic compounds from the smoke. The 1959 Statement reported that The filters presently in use do not eliminate but merely reduce the tars. It is questionable whether, from a health point of view, any so- called minimum exposure to such a hazard should be accepted. This statement conflicted with Burney's earlier assertion that "the risk of developing cancers is related to the amount of exposure to tar.". Since 1959, a number of authorities asserting the association between smoking and health hazards have reiterated the view that the incidence and the severity of these responses is proportional to the degree of exposure to suspect substances in the smoke. The 1959 Statement reported that Any reduction in tar content of the smoke is accomplished only if the consumer does not smoke more than formerly and if the -20-

manufacturers do not alter the tobacco selection, cut, or packing to counteract any deficiency in taste caused by the filter. r There is no evidence to support speculation that consumers shifting from nonfilter to filter cigarettes "smoke more." This misconception has long pervaded inquiry in this field. Hammond reports : In informal discussions it has sometimes been suggested'that lowering the tar and nicotine content of cigarettes would do no good since smokers might make up for it by smoking more cigarettes per day. So far as we know, there is no solid (19) evidence in support of this hypothesis. This was also reported by Wynder and Hoffmann: Among 304 male smokers over the age of forty, 43 percent have changed to filter cigarettes, reflecting the acceptance of filter cigarettes by the general popula- tion. Except for the occasional person who increases his smoking habits, the data demonstrate that in general smokers who have shifted to filter cigarettes have not significant~y4yhanged their consumption of cigarettes. 3 These views are consistent with a continuing survey of cigarette smoking patterns which discloses that filter smokers do not smoke more cigarettes than (See Table 5) nonfilter smokers. O W ~ C11 ~ - 21 - ~

TABLE 5 - AVERAGE NUMBER OF CIGARETTES SMOKED PER DAY (PER SMOKER) Total Male Female Total Market 18.4 20.1 15.8 Filters 17.9 20.0 15.6 Nonf ilters 19.7 20.5 17.3 Nonfilter King 19.3 20.3 17.5 Nonf ilter Regular 20.1 20.7 17.0 Menthols 16.8 19.3 16.7 (22) Source: Lennen & Newell, Inc. Based on a sample consisting of 20,000 families from the National Family Opinion Panel, selected to represent a cross- section of the U. S. in terms of geo- graphic area, population density, age of homemaker and' annual family income. The questionnaires were mailed. And returned during May-June, 1961, with 17,141 or 86% of all families replying and account- ing.for a total of 34,449 respondents. A copy of the complete Study will be made O available to the Surgeon General's ~ Advisory Committee should the Committee ~, desire. Cf1 W CQ ~

Nor is there basis for presently finding that cigar- ette manufacturers alter the tobacco "to counteract any deficiency in taste caused by the filter," i.e., that manu- facturers use tobaccos high in tar and nicotine yield to compensate for the reduction capability of the filter. Tables 1 and 2 herein, the most recent reports of tar and nicotine yield of cigarettes published by Reader's Digest show that while few filter brands in 1957 and' 1958 provided substantial reductions of tar and nicotine in the mainstream smoke, by 1961 most filter brands provided a substantial reduction in tar and nicotine yield and some brands, as compared to nonfilter brands, provided reduction up to 80%. These reductions are paralleled in recent studies on phenol yield of filter cigarettes as shown in Tables 3 and 4. CONCLUSION In assessing the nature and magnitude of possible C health hazards of smoking, it is appropriate for the ~' U1 Surgeon General's Advisory Committee on Smoking and Health ~ C11 to assess the significance and present utility of developments - 22 -

in the science of cigarette filtration. Filter cigarettes are currently available which yield substantially reduced amounts of tar, nicotine and phenol in the mainstream smoke. Since those who assert an association between smoking and disease advance the theory that adverse effects of smoking are approximately proportional to the degree of exposure to these substances in the smoke, it is relevant for this Committee to consider whether the reduction in yield of these substances provided by filter cigarettes significantly reduces whatever health hazards may be alleged to exist. P. LORILLARD COMPANY

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