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I Michigan Tobacco & Candy Distributors and Vendors Association Inc. Affiliated Organization-Music Operators of Michigan 523 WEST ION!A STREET • LANSING, MICHIGAN 48933 • TELEPHONE 1517I 372 • 2323 MICHAEL R. SPANIOLO WALTER P. MANER III LEGISLATIVE ANO EXECUTIVE SECRETARY GENERAL COUNSEL November 6, 198u Dr. Kenneth E. Warner, Ph.D School of Public Health University of Michigan 109 Observatory Ann Arbor, MI 48109 Dear Professor Warner: \ Given my preoccupation with completion of the minority report, I_ have only now had the opportunity to respond to your tetter of October 6, 1980. Since your letter dealt first with Dr. Schafer's paper and second with the analysis of the economic costs of smoking, I will respond to you in the same order. Your letter reveals a basic misconception of the purpose and a misconstruction of the substance of Dr. Schafer's paper. The paper was written, as stated in the introduction, specificaliy to present the other "side to the smoking and health controversy", a side that "is frequently ignored in discussions of this issue" in presenting this paper to ttze Panel, I had hoped to make its members aware that there is a great deal of scientific information that is often over- looked in the "convenient tendency to blame smoking for disease and death" and consequently that careful attention to both sides of this issue is required for an objective evaluation. Your recognition that statistical association and causality are not synonymous is appreciated. However, that you find this "Technical argument...substantively vacuous" is unfortunate and at odds with many eminent scientists. In describing these statistical associations as "overwhelming", you conveniently ignore that tney have been reported in stuaies with recognized flaws in their designs, methodologies, and conclusions. Dr. Schafer took considerable care to point out such de- fects. It is simply not just a question of "semantics". Contrary to your-assertions, Dr. Schafer's paper neither states nor. implies that "Anyone with a moderate degree of health knowledge thinks that smoking is the only cause of lung cancer and heart disease". Dr. Schafer certainly did not construct a "straw man" and his many refer- ences to published scientific papers provide support for the position that smoking has not been scientifically proven to cause disease. (Z ~ ~ ~ _Z80_ N N ~ i I I I I I I I I t I 6 L L L

Your letter does gpeak to-the difference between risk factor and causation agent. The-backgroumd paper you developed for the Panel's deliberations does not; "Smoking is the principal cause of Lung cancer...smoking annual- :,y claims over 100,00U victims from cardiovascular disease; smoking is the major cause of chronic bronchitis and emphysema...". This distinction is critical in a balanced discussion of the issue. Fa.na~~y, it was disappointing not to see anything in your letter that aa:;-:ssses the public smoking issue, for this occupied a major part of the Panel's attention. I am sorry that the analysis of the public smoking issue contained in Dr. Schafer's paper did not elicit a response. W'_;ci regard to economic costs of smoking, you offer your personal defini- tion of social costs. "1 think of social costs as the sum of private costs and negative externalities". Clearly, what follows from-hat point depends upon our acceptance of your personal definition. Indeed soon thereafter you offer several conditional clauses: "Given this definition" and "If you accept this definition". Neither I nor any professional in the economic community of whom I am aware defines social costs in this way. Medical insurance-and sick-leave*programs are areas in which double count-• ing takes place. If you count the cost of the insurance or the sick-leave program, and then count the cost of using the insurance benefits or the sick-leave benefits, you are indeed double counting. All insurance pro- grams, including social security,. are designed to be self-supporting --- the benefits are derived from the costs (premiums), and the costs pay for ~ the benefits. Finally, I was dismayed by your apparent misunderstanding of the concept of "full-time equivalent" employees. The 7b,410 full-time equivalent jobs in Michigan are an aggregate of'possibly three to five times as many people who work full or part-time because of tobacco. Your remarks should relate to over a uarter of a mi11'ioii Michiganders who derive all or part of their earnings directly or -inndirect y rom to acco products. Your letter of October'b closes by assuring me again that submission of a minority report will provide "ample opportunity" to describe the other side of the smoking and health controversy. The good faith of this statement can be demonstrated now only if the minority report that I have prepared be submitted to the Governor as promised. S-!,aSere,1y, n Walter P."Maner III Executive Secretary WP?ri/b t cc: Panel Members -2s1- L