Smoking or Health: Its Your Choice

Lorillard

Smoking or Health: Its Your Choice

Date: 19840100/P
Length: 32 pages
81210111-81210142
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Author: Popescu, C.B.
Type: PAMP, PAMPHLET; CHAR, CHART/GRAPH/MAPS; FOOT, FOOTNOTE; FORM, FORM; PHOT, PHOTOGRAPH; REPT, OTHER REPORT
Alias: 81210111/81210142
Area: LIBRARY/SUBJECT BOXES
Named Organization: American Cancer Society; American Council on Science + Health; American Heart Assn; American Lung Assn; Ash, Action on Smoking & Health; Bronx Veterans Administration Medical; Ca State Polytechnic Univ; City College of Ny; Columbia Univ; Commercial Union Assurance; Communications; Comm on Science + Technology; Congress; Co State Univ; Dept of Insurance State of Nj; Diebold Group; Emory Univ; FDA, Food and Drug Administration; Federal Communications Comm; Federal Reserve Bank of St Louis; Fortune; Ftc, Federal Trade Commission; Good Housekeeping Inst; Group Against Smoking Pollution; Harris Lab; Harvard School of Public Health; Hhs, Dept of Health and Human Services; Hoover Inst Stanford Univ; in Univ; John Hopkins Univ; Lehigh Valley Comm Against Health Frau; Loma Lind Univ; Medical College of Wi; Medical College of Va; Milwaukee School of Engineering; Mi State Univ; Montefiore Medical Center; Natl Heart Foundation of Australia; Natl Inst of Drug Abuse; NCI, Natl Cancer Inst; Ny State Journal of Medicine; Ny Univ; Office on Smoking + Health; or State Univ; Pa State Univ; Pillsbury Madison; Princeton Inst for Health Policy; Public Service Company of New Hampshir; Purdue Univ; Radiation Oncology Center; Rutgers Univ; Ski, Sloan-Kettering Inst; State Univ of Ny; Syracuse Univ; Thomas Jefferson Univ; TI, Tobacco Inst; Tribune Company Syndicate; Tx A+M Univ; Univ of Az; Univ of British Columbia; Univ of Ca Berkeley; Univ of Ca Davis; Univ of Ca Irvine; Univ of Ca Los Angeles; Univ of Ca San Diego; Univ of Cincinnati College of Medicine; Univ of De; Univ of Fl; Univ of Ga; Univ of Ia; Univ of Il; Univ of Lowell; Univ of Ma; Univ of Md; Univ of Miami School of Medicine; Univ of Mn; Univ of Ne; Univ of Pittsburgh School of Medicine; Univ of Southern Ca Medical Center; Univ of South Fl College of Medic; Univ of Tx; Univ of Ut; Univ of Wi; US House; US Public Health Service; Vanderbilt Univ School of Medicine; Wa State Univ; Who, World Health Org; Wistar Inst; W Duke + Sons; Yale Univ; Ahf, American Health Foundation
Named Person: Alfinslater, R.B.; Banzhaf, J. III; Barness, L.A.; Barrett, S.; Belongia, M.T.; Bergdoll, M.S.; Blum, A.; Borlaug, N.E.; Borzelleca, J.F.; Bray, G.A.; Briskey, E.J.; Byington, S.J.; Caldwell, E.F.; Callan, J.P.; Campaigne, B.N.; Campaigne, E.E.; Carpenter, Z.L.; Cassens, R.G.; Christakis, G.; Clydesdale, F.M.; Cohen, B.L.; Coon, J.M.; Cowles, S.R.; Cunha, T.J.; Devlin, R.M.; Diebold, J.; Douglass, J.B.; Doyle, N.; Eisenbud, M.; Farkas, D.F.; Felton, J.S.; Fennema, O.R.; Filer, L.J., J.R.; Fletcher, D.C.; Fogleman, R.W.; Francis, F.J.; Freedman, B.D.; Garfinkel, L.; Geddes, L.E.; Gold, R.E.; Grable, B.; Graham, G.G.; Greenberg, R.A.; Guthrie, H.A.; Harper, A.E.; Havender, W.; Hayes, W.J., J.R.; Hazeltine, W.E.; Herbert, V.; Hiscoe, H.B.; Jarvis, W.T.; Kifer, P.E.; King James, I.; Kolasa, K.M.; Kristein, M.; Kritchevsky, D.; Kroger, M.; Laforce, J.C.; Lamb, L.E.; Liska, B.J.; Lown, B.; Maccabee, H.; Macvicar, R.; Magnus, P.; Maickel, R.P.; Manne, H.G.; Martin, C.; May, C.D.; Mcnutt, K.; Meister, K.; Melvin, W.W.; Middelveen, L.P.; Miller, J.M.; Miller, W.J.; Milner, J.A.; Moeller, D.W.; Mood, E.W.; Morgan, J.P.; Moss, S.J.; Murphy, J.F.; Oldfield, J.E.; Olson, R.E.; Ostenso, G.L.; Pangborn, R.M.; Perry, T.W.; Picciano, M.F.; Powers, J.J.; Powrie, W.D.; Revotskie, N.; Ricardocampbell, R.; Roll, D.B.; Romsos, D.R.; Rose, D.P.; Rovin, S.; Saltman, P.D.; Sarett, H.P.; Satterlee, L.D.; Schwartz, H.; Schwartz, L.L.; Schweigert, B.S.; Shindell, S.; Short, S.; Siedler, A.J.; Simon, J.L.; Spitzer, R.R.; Stanko, R.T.; Stare, F.J.; Steele, J.H.; Sternberg, S.S.; Stern, J.S.; Stier, E.F.; Surgeon General; Terry, L.; Upchurch, R.P.; Wallen, S.E.; Wardowski, W.F.; Wender, E.M.; Whelan, E.M.; White, L.; White, P.L.; Wilson, R.; Winkelstein, W., J.R.; Young, J.H.; Zapp, J.A., J.R.; Zivic, J.
Date Loaded: 05 Jun 1998
Request: R1-025; R1-048; R1-071; R1-072; R1-073; R1-095
Master ID: 81210000/1047
Author (Organization): American Council on Science + Health
Litigation: Stmn/Produced
Site: G39
Brand: Camel; Chesterfield; Kool; Lucky Strike; Marlboro
UCSF Legacy ID: nyx21e00

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A report by the American Council on Science and Health

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The American Council on Science and Health (ACSH) is a national consumer education association directed and advised by a paneCof scientists from a variety of disciplines. ACSH is committed to providing consumers with scientifi- cally balanced evaluations of issues relating to food; chemi- cals, the environment, and health. ACSH is a nonprofit association exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. All contributions are tax-dbductible as provided by law. Individual copies of this report are available at a cost of $2,00. Prices for 10 or more copies are available on request. January, 1984 Second printing - July 1984 This report on smoking and'health was written by Cathy Becker Popescu, M.S., a Research Associate for the American Council on Science and Health. ACSH gratefully acknowledges the comments and contribu- tions of the following individuals who reviewed this report: Stephen Barrett, M.D. Lehigh Valley Committee Against Health Fraud Alan Blum, M.D. New York State Journal of Medicine Nancy Doyle, M.A. American Lung Association Berton D. Freedman, M.P.H. American Lung Association. Lawrence Garfinkel, M.A. American Cancer Society William Havender, Ph.D. Consultant, Berkeley, California Howard Maccabee, Ph.D., M.D. Radiation Oncology Center, Walnut Creek, California Cover photo by C. Manin.

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Paul Magnus, M.D. National'~Heart Foundation of Australia Kathleen Meister, M.S. American Council"on Science and Health Dade W. Moeller, Ph.D. Harvard School of, Public Health Sidney Shindell, M.D., LL.B. Medical College of Wisconsin Ronald T. Stanko, M.D. University of Pittsburgh School of Medicine Fredrick J. Stare, M.D., Ph.D. Harvard School of Public Health Stephen S. Sternberg, M.D. Memorial Sloan-Kettering Cancer Center Elizabeth M. Whelan, Sc.D., M.P.H. American Council!on Science and Health Larry White, J.D. Berkeley, California The opinions expressed in ACSH publications do not necessarily representthe views of all ACSHIDirectors and Advisors. m N ~ lPA ~ 1 IPA N G:

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TABLE OF CONTENTS Introduction ............................. 3 Position Statement ........................ 3 A Brief History of the Cigarette ............. 4 The Long Term Effects of Smoking .......... 8 Risks to the Average Smoker ................ 11 Women and Smoking ..................... 11 Premature Deaths Due to Smoking .......... 12 Smoking During Pregnancy ................ 12 Interaction of Smoking With Other Agents ... 13 The Smoking and Health "Controversy........ 14 Passive Smoking .......................... 17 Fire Hazard ............................. 18 Harmful Substances in Cigarettes ........... 19 Cigarettes' Secret Ingredients ............... 19 Pipe and Cigar Smoking ................... 20 Smokeless Tobacco ........................ 20 Economic Costs of Smoking ................ 21 Today's Smokers .......................... 23 Teenage Smokers ......................... 23 Addiction ............................... 24 Low-Tar, Low-Nicotine Cigarettes .......... 25 Benefits of Quitting ....................... 25 Smoking Cessation ........................ 25 2 l

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1' i INTRODUCTION The year 1984 marks two important' anniversaries in the history of the cigarette. On April 30, 1884, the modern cigarette was born in the North Carolina factory of W. Duke and Sons: On that date, the new Bonsack cigarette-rolling machine passed its final test, operating successfully for a full work day. This marked the end of the inefficient hand- rolling era, and allowed cigarette manufacturers' out- put - and the number of smokers - to increase sub- stantially. The dramatic, but ultimately tragic,,success story of the cigarette was about to be written. On January 11, 1964, the cigarette's Golden Age unof- ficially came to an end, with the release of the first U.S. Surgeon General's Report on Smoking and Health. Scientific evidence of the hazards of cigarette smoking had been accumulating for decades, but never before had the facts been summed'up so concisely and effectively. In light'of today's knowledge, the report seems mild but in 1964 it shocked the country, authori- tatively establishing the link between smoking and disease in the public consciousness for the first time. Today, 20 years after the first Surgeon General's report, we know that smoking is even more dangerous than was believed'in 1964. The impact which the cigarette has had on Americans' health has been far greater - and more deleterious - than anyone could have imagined. Yet many people are not fully aware of the magnitudee and specifics of the effects which cigarette smoking has on health. This report by the American Council on Science and Health (ACSH) is intended to emphasizeto smokers and nonsmokers the enormous risks which they, or their friends and loved ones, are taking when they light up. POSITION STATEMENT The American Council on Science and Health joins with the U.S. Public Health Service, the World Health Organization, the American Cancer Society, the Amer- ican Lung Association, the American Heart Associationd and countless other organizations concerned with pub- lic health in condemning cigarette smoking as a major health hazard. The scientific evidence indicates une- quivocally that cigarette smoking is the most important single cause of preventable death in the United States; being responsible for more than 300,000 premature deaths each year. Cigarettesmoking is addictive and increases the risk of developing and dying from cancer, heart' disease and chronic lung disease. It greatly increases the health 3

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risks associated4ith oral contraceptive use and occu- pational exposure to certain harmfull substances. Smok- ing during pregnancy poses a significant threat to the unborn child. Smoking is aliso responsible f'or increased rates of absenteeism and disability among workers an& is the major cause of residential fires. Parents who smoke may jeopardize their children's health. The American Councilion Science and'Health warns nonsmokers not to begin smoking and urges smokers to "kick the habit." This is one issue where the choices are clear: smoking or health. A BRIEF HISTORY OF THE CIGARETTE Tobacco is a native American plant that was first used as a smoking substance in~the religious ceremonies of priests in coastal regions of Central and South Amer- ica. It was introduced into Europe in the late 1500s, but was not well received'by all. King James I of England published what may be considered the first anti-smoking tract in 1604, describing tobacco smoking as "a custome loathesome to the eye, hatefull to the Nose, harmfull to the braine, dangerous to#he Lungs, and in the black stinking fume thereof neerest resem- bling the horrible Stigian smoke of the pit that is bottomlesse. "' Despite King James' efforts, tobacco use, in the form of snuff dipping and~ pipe smoking, sprea& in England'and then quickly throughout the world, serving as a profitable export for the newly formed Colonies. It was not until the 20th century that large numbers of people began to use tobacco in a much more deadly form: the cigarette. While cancers of the mouth, lips, throat and nose had already been linked with the use of snuff, cigars and pipes by a few astute physicians, these forms of tobacco did not seriouslv affect the rest of the body. With the development of the blended cigarette, howevertobacco users were able to inhale smoke into their lungs, exposing the entire body to many of tobacco's harmful substances. The great cigarette advertising campaign Cigarette sales rose sharply in the early 1900s, boosted' by World War I and the great cigarette advertising, campaign. Before the war, cigarettes were not exceedingly popu- lar; cigar and pipe smokers considered them somewhat sissified. The war changed all that, since cigarettes could be smoked so much more conveniently in the trenches than could pipes and cigars. Millions of doughboys thus took up cigarette smoking during the war and brought the habit home afterwards. 4 I

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The great 20th century cigarette advertising campaign began right' after World War I, capitalizing at first on the patriotism that went along with the war effort'. The advertising was clever, original, brazen, alluring and extremely high-pitched. The ads often featured testi- monials by movie stars, athletes and even doctors, who went'so far as to suggestthat good health and good looks were the rewards of smoking. Some cigarette manufacturers made particularly bold health claims for their products, advising that their brand could steady the nerves or even cure smokers' cough. The advertising campaigns were so effective that by 1939, a Fortune survey showed that 53% of adult American men smoked cigarettes. Sixty-six percent of men under 40 smoked cigarettes. The widespread use of cigarettes among women lagged some 25 to 30 years behind that of men. Although a few daring women had smoked cigarettes even before World War I, women did not take up smoking in large numbers until the 1940s. The first clues Unbeknownst to the smoking public, an impressive amount of'speculation - and some hard scientific evidence - linking smoking with disease had appeared in the period between 1920 and 1940. Tobacco com- panies chose not'to acknowledge this evidence and continued to promote cigarettes heavily. Cigarette ad which appeared in 1944 By today's standards, the medical evidence gathered against cigarettes by 1940 would have been enough to stimulate a thorough investigation of the matter and extensive coverage in the popular press. But un- fortunately, this was not the case at the time. 5

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Few people were aware of the evidence and those who were did not appear to be overly alarmed by it. This may have been due partially to the fact that cigarettes had become as common and as all-American as apple pie, so people found'it difficult to be suspicious of them. Also, the majority of American men were smok- ers who were physically and psychologically dependent upon cigarettes, and who didn't want to believe bad news about something which they would have found hard to give up. Finally, the nation had developed a large economic stake in tobacco and thus was resistant to any information which could have jeopardized t'hee industry's viability. The mounting evidence During the 1950s, the evidence became more difficult to ignore. By the middl'e of'the decade there was an impressive amount of solid medical evidence that ciga= rette smoking increased the risk of lung cancer as well as other diseases. And for the rest of the decade, the data continued to accumulate. As the data came in, not only was its consistency unde- niable, but'the list of specific adverse effects of ciga- rette smoking continued to grow. What had started out as just a "lung cancer scare" had become:a general "health scare." Although the tobacco industry (and articles in the pop- ular press) continued to assert that there was still con- troversy over the health effects of smoking, cigarette manufacturers rushed'to provide consumers with a "less harmful" cigarette. In 1950~; about 3% of ciga- rettes had been filtered. By 1957, more than 50 % were. Regulatory action in the 1960s By the early 1960s, the scientific evidence against ciga- rette smoking was overwhelming. Thus, when the Surgeon General's report was released on January 11, 1964, it merely made official what had been known for some time in the scientific communityBehind locked'd'oors and surrounded by "No Smoking" signs, reporters heard'the grim warnings of the nation's chief physician, Dr. Luther Terry, and his 10-member panel of experts. Smokers would have been hard put to find any good news in the 387-page report - except that they could reduce their elevated risks of cancer, heart disease, and emphysema by quitting. One week after the Surgeon General's report was released, the Federal Trade Commission (FTC) pro- posed that' all cigarette packages and advertising bee required to carry a st'rongwarning of the hazards of 6

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smoking. Although~a watered-down version of the health warning did appear on cigarette packages in 1966, it' represented more of' a victory for the tobacco industry than for public health. Instead of'the explicit warning on cigarette packages and' advertising called for by the FTC, the industry orchestrated a Congres- sional mandate for a wishy-washy"may. be hazardous to your health" statement on cigarette packages only. (The warning eventually was strengthened slightly; but did not appear on cigarette advertising until several years later.) In 1967, a new, but unfortunately very short, era dawned in cigarette advertising. When John Banzhaf III, a New York lawyer, wrote to the Federal Commun- ications Commission (FCC) requesting equal time to respond to cigarette ads, the Commission ruled that television stations must provide a reasonable amount of free air time to those who wished to present the other side of the cigarette story. The anti-smoking ads were apparently effective in~ frightening smokers - so effective, in fact, that the cigarette industry announced its eagerness to withdraw all television and radio advertising in 1969. (Manufac- turers knew that' if cigarette ads were taken off the air, the free anti-smoking messages wouldigo also.) A billl emerged from Congress in 1970 which banned all ciga- rette ads from the air as of January 2, 1971. On New Year's Day of that year the "Marlboro Man" rode across the screen for the last time. _ I ~'` `t. ` X E A~ ~ ~ ~ # . ~,~ 0 f ', ~f ~ .... __ :-~ ~ is r Warning: The Surgeon General Has Determined That~Cigarette Smoking Is Dangerous to Your Health. ~ , : r~~aLki , . . ~.~~ V~ ~ Kmgs 9ox 3100 s: 10 mg "ter. 0.7 mg nicotine-Ki r 11 my 07 mg nicotine av percrganate FTC Report Dec'81` p P Current warning which appears on cigarette packages and advertise- ments. The cigarette in the 1970s and 1980s In contrast to previous years, the remainder of the 1970s and the 1980s saw minimal regulatory and legis- lative action concerning cigarettes. The one exception was the success which the FTC finally had in ordering cigarette manufacturers to carry a health warning in 7

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all print advertising. (As expected, there had'been a rapid proliferation in magazines and newspapers of the cigarette ads which had been displaced from the airwaves. ) The Surgeon General continued to release updated reports on smoking and health. Thereport released on the fift'eenth anniversary of the 1964 report termed t'he case against smoking "overwhelming." As of December, 1983; two bills were pending in Con- gress to strengthen the warning label on cigarette pack- ages and advertising and to otherwise promul'gate information about'~ smoking. These bills were proposed in response to concerns that the public was not fully aware of the specific risks associated with cigarette smoking. WHAT ARE THE LONG TERM EFFECTS OF CIGARETTE SMOKING? The long term health risks associated with cigarette smoking are, indeed, overwhelming: Cigarette smoking is the most important single cause of preventable death in the Unit'ed States today. Four of the five leading causes of death are related to cigarette smoking.. Approximately one in six deaths in this country is smoking-related. Each year, at least six times as many Americans die from smoking-related causes as die in automobile accidents. Overall, a smoker is 70 %d more likely to die prema- turely than is a comparable nonsmoker. Heavy smok- ers are nearly 200% more likely to die prematurelyy than are nonsmokers. Male cigarette smokers report 33% more days lost from work than do those who have never smoked. Female cigarette smokers have an absenteeism rate which is 45% greater than that of nonsmokers. Men who smoke cigarettes report 14 %o more days of bed disability than do those who have never smoked. Women who smoke report 17 % more days of disabil- ity than do nonsmokers: Lung cancer Lung cancer kills more Americans each year than any other f'orm of cancer. It is the most common cause of cancer death among males, and is expected to surpass breast cancer in 1984, to become the leadL ing cause of cancer death among women. (This has already occurred in California and Washington. ). 8

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