Tobacco Documents Online

October i0, 1973 Meeting with Dr. Cooper, National Heart and Lung Institute Messrs. Kornegay, Mills and Kastenbaum met this morning with Dr. Theodore Cooper, Director of the National Heart and Lung Institute. The meeting lasted for about 45 minutes. Dr. Cooper was joined by Dr. ~io Gori for the entire meeting. Mr. Kornegay opened the meeting by expressing the tobacco industry's interest in maintaining communications with members of all branches of government. He indicated that we had met recently with Dr. Frank Rauscher, Director of the NCl, and that we were planning to meet next week with Dr. C.C. Edwards. The purpose of all of these meetings was to establish and maintain a dialogue between the tobacco industry and responsible representatives of the Federal government. Mr. Kornegay made it clear that our purpose was not to ask for any favors, but rather to acquaint Dr. Cooper with the industry's interests in the mutual problems of the industry and the Heart and Lung Institute. He stated further that the industry was deeply concerned with the irresponsible public statements which are occasionally made by representatives of some of the health agencies; that the industry was as much interested in good research and in the reports of such research as anybody else, and perhaps more so in the area of tobacco and health. Mr. Kornegay discussed briefly some of the projects which are being funded by the industry through the Council for Tobacco Research, and directly by some of the companies. Among the projects he mentioned

was the work at Harvard University, and its relevance to pulmonary disease, and some of the research in the area of heart disease supported by the CTR. Dr. Cooper responded by saying that when Dr. Gori advised him of our desire to meet with him, he welcomed the oppor.tunity for such an exchange of views. He pointed out that the Heart and Lung Institute had not paid too much attention to tobacco-oriented research until recently. The current interest in this area of investigation, he said, ... came about for two reasons: 1--Under the recently passed PL 92--423 , more research money became available, and members of his advisory board felt that some of it should be spent in the area of smoking and health. 2--When Lung was combined with the Heart Institute, research efforts in smoking and health became more relevant, because of the association that has been indicated between emphysema and bronchitis and smoking. He then described a large well-designed statistical study of multiple risk-factors being conducted under the auspices of the NKLI. This study, involving 12,000 people in 20 locations throughout the country, is concerned principally with the ~ffect on heart disease of such factors as blood pressure, cholesterol and smoking habits. He suggested that we might be interested in this study and that we should probably follow it. Dr. Cooper indicated that as a result of the recent interest in tobacco- oriented research, the Heart and Lung Institute was involved directly

with "Dr. Gori and the Tobacco Working Group. He said that Drs. Gardner C. McMillan and Claude J.M. Lenfant were his appointed representatives to the Tobacco Working Group. (McMillan is .Associate Director for Etiology of Arteriosclerosis and Hypertension, and Lenfant is Director of the Division of Lung Diseases at the NHLI). Our impression is that Dr. Cooper was suggestihg that any exchange of information between us and the NPILI might be handled through these gentlemen. Dr. Cooper then expressed some of his personal views concerning the relative importance of cigarette smoking to heart diseases. He feels thah patients with heart problems should not indulge in smoking; that as a physician he recommends that such patients give up smoking for their own welfare. At the same time, he feels that several other important aspects of the whole problem of heart disease could be handled more positively. In particular he mentioned such things as w~ight reduction and blood pressure monitoring. He even (jokingly) suggested that the cigarette companies might consider replacing the Surgeon General's warning with advice to smokers, namely "}{ave you Had Your Blood Pressure Checked Recently." He was serious however when he suggested that the cigarette companies consider carrying the "Have You Had Your Blood Pressure Checked Recently" advertisement on a piggy-back basis. He indicated that he was going to 9 ~t in touch with other industries, such as General Motors, regarding this matter. With respect to heart disease, Dr. Cooper said that though everybody will agree that being overweight is not good, no~ everybody will agree

that levels of cholesterol and other factors involved in the diet are necessarily the causes of heart disease. For similar reasons he" does not take a strong public position on smoking, but he does advise anyone with a heart problem to stop smoking. He further indicated that the relative risk associated with lung cancer was .very pronounced, but that the risk was not as clear-cut with heart disease. Dr. Kastenbaum pointed out that many statements were made concerning the death rate from lung cancer having reached epidemic proportions, and asked Dr. Cooper if this situation was true with respect to heart disease. Dr. Cooper indicated that shortly after World War II, the heart disease rate appeared to be increasing but that this rate had leveled off and, in fact, might even He decreasing. Mr. Mills agreed with Dr. Cooper's reference to other products which might have adverse effects on people with heart conditions and inquired about the role of coffee drinking. Dr. Cooper acknowledged that_ people with certain types of heart disease should o~He advised~to drink coffee, and that he advised his own patients not to drink coffee. In this context Dr. Cooper said that he had had a meeting similar to ours with representatives from the coffee industry. He informed them, as he did us, that he advised patients with certain forms of heart disease not to indulge in coffee drinking. He admitted to having been both a smoker and a coffee drinker at one time, and said that he could In those days observe changes in his own blood pressure after smoking.a cigarette. We got the impression, from something he said, that he

has a minor heart condition which has led him to quit smoking as.well as coffee drinking. However, he did not propose to take ~ public stand on the subject of coffee drinking. He pointed out that the most recent information on the adverse effects of coffee drinkin~ was pre- sented in an article in the New England Journa'l of Medicine. This article was based on a study done by Dr. Jick and others in the Boston Collaborative Drug Surveillance Program. Dr. Kaster~aum remarked that Dr. Cooper's position in this matter was reflected in an editorial in the same issue of the NEJM written by Drs. Kannel and Dawber of Framingham Study fame. Mx. Mills asked Dr. Cooper if he was _anticipating any problems in getting sufficient funds to carry out his work. Dr. Cooper indicated that he was having some problems in the 1974 fiscal year, but that he thought things would be better in 1975. Dr. Cooper indicated that he feels the position of the Federal govern- ment on the subject of cigarette smoking is clearly outlined in a report he had recently received. Its title is "The Report of the President's Committee on Health Education". Dr. Cooper read us a portion of the section concerned with the role of cigarettes as a risk factor in heart disease. In concluding, Mr. Kornegay reiterated our interest in good research, and made specific reference to the Council for Tobacco Research and to the work it was sponsoring. Dr. Gori told Dr. Cooper that Dr. Richard

Bing, Director of Cardiology _at the ~~ton Memorial Memorial Hospital in Pasadena, California is a me~er of ~R's Scientific Adwiso~ Board. Dr. Cooper indicated his awareness of a n~er of institutions, including Hazard, whose researchers were receiving funds both from the tobacco indust~ ~d the N~I. He saw no ha~ in this, In fact, he encouraged his grantees to accept research funds from the tobacco indust~. These grantees were in no jeopardy as far as he is concerned. Dr. Cooper received us ve~ cordially. ~is a~osphere continued throughout the meeting. It is our view that though Dr. Cooper is neither advocate nor friend of the tobacco indust~, he is also not a zealous ~ti-smoking c~sader. For this reason we feel .that he is not likely to m~e ~y exaggerated, ~fo~ded, or ill-advised stat~ents ~out smoking. He se~ed to be honestly interested in maintaining contact ~d welcomed ~y exch~ge of info~ation and views between h~ ~d the indust~. He made a point of saying that he has no rese~ations, whatsoever, ~out meeting with indust~ people. He is not afraid to meet ~d discuss probl~s with tobacco indust~ representatives as long as the meetings are open ~d not secret.