Tobacco Documents Online

and r~ctum, Sun Gynecol fffiths JD: High ligation of -ic arteo,.' during operations : distal colon and rectum, 108:6.4 I--.650, 1959, WJ. Carcy J: A ten year ,n'w in the treatment of'car- • o~the colon. Surg Gynecol -~62, Kvle K. Watson FR. et al, ndinfluence of the no-touch n survival r-tes. Ann Surg Bemgn and malignant neo- ectum. Diagnosis and man- , North Am 58:605-618. ing the adequate operations r. in DeCosse JJ ted): Large • Clinical Surgery lntcrna- Churchill Livingstone• in ]'he choice among anterior rough, and ahdominoperi- :cram. Cancer 34:969-971. real technique in low rectal t Soc Med 65:975-976. berg SM. Nivatvongs S. et al resection for recurrent :nor diseases of the colon Ished. acal treatment of rectal car- JJ ted): Large Bowel Can- Jrgery International. Edm- ngstone. Jn press. :entire screening and early wel cancer, in DeCosse JJ .racer. vol 1. Clinical Sur- inburgb, Churchill Living- JOURNAL FOR CLINICIANS The Impact of Providing Physicians with Quit-Smoking Materials for Smoking Patients It has long been recognized that physicians can play a key role in helping cigarette smokers" stop smoking. A recent study sponsored by the American Cancer Society (ACS) indicates that providing physicians with quit-smoking materials can stimulate physicians to play a stronger role in car- rying out this function. Materials Studied Two types of quit-smoking materials were studied in this investigation: 1. A Physicians' Help Quit Kit. The kit contained several elements, including a poster, a waiting room sign, a desk- top sign. and smoker stickers to be ap- pended to the patient's record to remind the physician that the patient has a smoking problem. 2. A Quitter's Guide Pamphlet. This was a brochure that physicians could give to their patients, describing methods to break the smoking habit and tips to help them stay stopped once they quit, It was hoped that by providing physicians with these mater.als, they would: (1) be more aware of the importance of persuad- ing patients who smoke to quit; (2) find it easier to talk to their patients; and (3) The survey was sponsored by the American Cancer Society and conducted by Lieberman be encouraged to speak to more of their patients who smoke about quitting. The investigation was designed to ex- plore three basic questions: 1. Does providing physicians with quit- smoking materials stimulate greater in- teraction between physicians and their patients who smoke? 2. What is the relative impact of the two types of quit-smoking materials--i.e., the Kit and the Guide? 3. Are both aids used in combination more effective than either used alone? How The Study Was Done The study of the impact of receiving quit- smoking materials was based on a survey of 494 physicians. These included 175 general practitioners, 143 internists, and 125 obstetricians/gynecologists, as well as 51 physicians with various fields of spe- cialization. The investigation was conducted in 15 ACS units in six geographically dispersed ACS Divisions. The six ACS Divisions that participated were California, Dela- ware, Georgia, Pennsylvania. Rhode Is- land, and Wisconsin. The 494 physicians included three test groups (a total of 347 physicians) that were given various quit- smoking materials and one comrol group (147 physicians) that was not given any quit-smoking materials. The three test groups included one group that was given Research Inc., a major public opinion polling the Kit alone (131 physicians), one group organization, that was given the Guide alone (101 phy- T104231008

sicians), and one group that received both sets of quit-smoking matcrials (l 15). The physicians in the three test groups were visited by ACS volunteers, received the appropriate quit-smoking malerials, and were given an explanation about how the materials were to be used. About four weeks later, the test physicians who were given quit-smoking materials were con- tacted via telephone by AC$ volunteers and interviewed to determine their reac- tions to these materials and to measure the nature of their interaction with their smok- ing patients. At the same time, the cent.tel physicians, who were not given any quit- smoking materials, were also telephoned by ACS volunteers and asked about the nature of their interaction with their smok- ing patients. Effects of Receiving Quit-Smoking Materials As shown in Table 1, the quit-smoking materials distributed m physicians fostered greater physician effort to persuade their smoking patients to give up the smoking habit. A comparison between test physi- cians and control physicians revealed that receipt of these materials had the following impact on interaction between physicians and,.smoking patients: = The quit-smoking materials increased the extent to which physicians felt it was important for smoking patients--partic- ularly symptomatic patients--to give up the smoking habit. • The quit-smoking materials increased the number of physicians who spoke to their patients about quitting smoking. • The quit-smoking materials helped make physicians more comfortable in speaking to their patients who smoke. Also, they helped increase the forcefulness with which physicians spoke to their patients about this subject. Effects of Receiving Both Types of Material Versus One Type of Material Receiving both sets of quit-smoking ma- terials (i.e.. both the Kit and the Guide) had greater impact on physicians than re- 76 ceiving only one type of quit-smoking material (i.e., either the Kit or the Guide alone) (Table I). The importance that physicians placed on patients giving up smoking, the number of patients spoken to, the extent to which physicians felt comfortable about speaking to patients about quitting smoking, and the forcefulness with which physicians spoke about giving up the smoking habit were all greater among those who received both types of quit-smoking materials than among those who received only onetype. If economically feasible then, physi- cians should be given both the Physicians' Help Quit Kit and the Quitter's Guide to hand out to patients. Relative Effects of Physicians' Help Quit Kit and Quitter's Guide Pamphlet The data in Table I also indicatd the rel- ative impact of each of the two types of materials studied. This was determ, ined by assessing what happened among physi- cians who received the Kit alone versus what happened among physicians who re- ceived the Guide alone. The impact was about equally strong for. both groups of physicians: they re- sponded better than those who received no quit-smoking materials at all. although they did not respond as well as those who received both types of quit-smoking ma- terials. The findings suggest that, if it is not economically feasible to offer physi- cians both types of quit-smoking mate- rials, the ACS should probably distribute the Quitter's Guide Pamphlets rather than the Physicians' Help Quit Kits, Reactions to and Usage of the Materials A large majority of the physicians sur- veyed responded favorably to the qut'..- smoking materials. About eight out of l0 physicians (82 percent) felt that the Ph.'.- sieians' Help Quit Kits should be distrib- uted to other physicians. An even more CA-A CANCER JOL/RNAL FOR CLINICIANS Extremely Important For Pat0ents To Quit-Smoking Symplomati¢ patients Awmptomatlc patients Speaking To Smoking Patients Spoke to smoking paj~l~ts in past few weeks l~ Of the last 10 smoking patients seen, average number spoken re about quitting Att=tudes Toward Speaking To Smoking Patients Feel extremely comfortable speaking to smoking patients Extremely forceful in speaking to smoking patients VOL 31. NO 2 MARCH/APRIL 1981 T!04231009

":. ~ - ~B S- Tuesday, Jan. 27,1981 . ___. Smoking,. Battle,: Hard ,r To . Win Than Doctors It is a good tUne, ~wever, to M~e a commitment to L.A. ~Wa~l~to~, Post • New~ $¢¢vtce . ~w a~t ~ ~ st p Smo~g. ~e inte~iew was ca~ of ~1 ~ ~ple who made New Y~r's ~luti~ ~ s~p ~o~g and ~ now ~o~g agai~ " O~ g~ Jane'Pa~ey, ~ ~ such ~ Ide~ .... like g~ ideas -- W ~y~ ex~pt ~ny~y who ever ~ I know, d~ don't' w~nt W ~ourage ~ple i~m t~ing ~ stop, ~ th~ ~ and ~: jole" and p~m~ ~at there, the~, y~ eah ~ it .wight f~ling ~ ~; you can do it ~out ga~i~ ~i~t.,. dy .... $u~. ~ ~e other hand -- ~d I've ~ ~: ~o, ~ iL -~ng-~ I ever Sd ~ my w~le ~ I felt Hke l'd l~t my ~t ~ my kmfiy, my Ne~, j u m py, ~, ~io~ h~da~y, tense. M~. ~ a~ ~ I~ my (~k ~ny~y.) ~ I got [~t ~ ~ng -- k~ ~ w~t off.) ~ ~ ~ maybe. get smoke c~ of "a carrot..). But the next penmn is ~oing need more help than that.. ' Smokenden, the eoimnerc~' ~n.,...one p~bmty, xt my plu~.~ked down all that cash 0i~75 .ior its S-week But eventhat d0c~'t ~ways do The problem is, no two people res~lve to take the first step: yourself that you won't worry are the ~ame, Carrot sticks ae- Switch to ~e '~[ the !ow-tar-i about,your w~d~ht tor attest .tually~.may~w.ork flue fo.r. nicotine brands. Don't go whole' 10 weeks. By'that time the .'~n~ ;~IthO~h'l serio~sty. • hog to the ones that are ~o hard worst of the cigarette with- doubt it. ~ pe~o~ wl~ can to drag on that you mi~.t Just. drawal i~ over andTou canstop as well "be smbhing, a carrot pi~ing out. ~ • stick. Just move • couple' of Meanwhile, it .is s.imply a.sk- notches down the nicotine-tar ind t.~' n~ch of the average llSt. They'r~ r~l]y NOT much hum~'~ beini~:to stop smoking better for you than .their big and eating at the same time. brothers, so-.don't-letyouraelf "You may not,' in _fact, ,,gain mo~ moretO ~lnpensa~; ~eight. Lots of people ¢ton t, or (The Surgeon General's report do so only temporarily. - last week coucluded that, in el- Exercise: H you don't' exer- fect, they're NOT better than cise regularly, you should, and it. And ff you care all "that meeh about mon~, Just make a bu~non~o~bet with somebody, preferably somebody you think looks down, on you a tittle anyway. • Negative feedback l~rograms .b~, helpful for.some.~nd others .may puff out via hypnotism. Then" there's Cold. Turkey. Or, the Way I .did ~it, wh~it you might call L~ew.~m (I've beech clean.~or nearly five years.) --Motivation: First, you really have to want to stop. You have to be able to piet.ure all that carbon monoxide replacing, all that oxygen in your blood; all t.hat nicotine constricting your blood ve~els, raking your bloedpre~sure; all those tars makin~ nice little cancerous beds in your lungs, in your throat, in your mot~h; that ~econdhand ~noke IM your ehlldren'a ~ir~ worsening the]r colds, asthma, bronchitis, pneumonia. And all those bther th6esands of that nobody even knows What they ~o. Okay, ~o letYs sat now t~at ym're eonvin~. --Timing. New Year~ Eve, whe~ you're ~ a bit and. enpbor~_ for whatever re~w~, is a bad time to decide NOTHING; but ~ a~.bet~ ti~,. ~ a ,g .o~d time..to. than doing .notldu~,) : ~ _ ~ ~ ~me~ing new, something ~: don't ~nk" y~'v~ d~. ~n~tpsycho~H~.fi~edwi~h' . ...:. , ~ "" ' ~tmg a ~igaret~. H you ao ~ugh. AI~,:~ e~~larly,al~ady~ whole cig~t~ J~t ~e ~ f~ ~it mo~, and ~methi~ a little p~fs and put it ~t a~. it~ ~(' $~ s~g~a ~ut a ~rd g~e ~e ~ ~upleof ~m~a w~k, work~g . nuild up ~ the ~t' ~a~ ~n .out, ~g, w~v~. ~ it, ~e wont ~ ~tive~ r~nforc~t and ~me bug ~ ~in W ~t- tie in yo~ ch~.) • m~t.~t ~a~.o~ ~ ~ke ~ngup, ~g~pr~ ~IS is the time' to stop. ~ ~ a~ ~ smokff or ~ not ~ke men~ola~ ~ga~t~ for ~e d~a~ou M smokem ~ your he,old, yo~ ~ld. wheat r~m~ate, s p o~,s Tell yo~]f that by ~e time ~nt child or silent other. youdre gong ~ want ~ ~oke~ y~ ~ have sup~ Wh~ ag~,.~e wd~t will ~ over. " ~u a~ f~g ~ m~ or ~ co~ ~ m~y o~ may ~ep~ and y~ ~oN'T have not ~ ~ue, but by the t~e you any~y to wea~e.n yo~ r~ it may not ~, you've ~lge. (H ~ble, ~a~it stains that it ~ms a w~te wi~ ~ ~~)~ ~ give up ~w. ~g~t~ a~ mo~ ~ --~rat~: ~ychel~caHy ad~v& ~ you ~nt m ~ ~lc~ F~t chocolate: S~me Studies have hinted tl~t it cont~ins a p~ w~ch ~ ~e ~ of a broke. ~ Wh~ you ~ ~ y~ ~ f~l ~e ~ ~ve, ~.~ 1S 37 anything? ~o's iwcon.t~ol, anyway? " - T!04231012

You'll know you!ve beaten It when you stop ,having the nightmare in which you are smoking five cigarettes at a tim~, dragging first from one and then from another /n an orgy of smoke. You. hate yurself because you're smoking and yo~u do.n't know,why you started again~ anyway. And then you wake up and you're still not smoki~.g. WIiat. a relief. SO Js it worth going through all this? W en you stop smoking, your respiratory system does clean itself out. ' New. studies have even shown that l.un.g cancer patients who stop s~oki~g live longer than tho~e who continue to smoke. SO. you can ,~ndo the damage years of smoking has ]aid on your system. What that is worth only you can decide. Finally, here's tIie one piece of information that I found the most helpful. It came from a lung-association TV commer. cial: The nicotine urge, theoverwhelming need for a cigarete almost never lasts longer than.two minutes at a time.. You only need to hold out for two lou~ minutes. You can do that. T!04231013

PITTSBURGH METROPOLITAN A~EA PITTSBURGH, PA. dAN 22 IS~' POST-GAZETTE Students are:b mg om school smoking.i tedines • By Bill Stieg : ~ ~ou~h .th re......The national, tread" generally P~t-eazetteS~ffWrlter gir _wlzo .s~no~.e .ae.a.vi y tnan . ~.-"; lz~lds.lrue, jn Allegheny Codnty, Rick gvans takes another drag of • k'~ienos oz smogers are muelz "basedo~'a, smallsamn]ingofschoo] his cigarette .and thinks about if:. more. likely to voice disapproyal of . ~glmini.~xator~None ~eported more • "LitUe kids suck their thumb," he the habit, . :? :.. smokinj[, hut several agreed that says. "We come down here to smoke. • A.steadily rising propcrti6n'of " ~nokiag had di~pped off. . a few cigarettes between classes, to y.onng people believes ,smo.~ is ."It's definlt~ly fallen off," said relax, calm down." ~angero~., 1..~.o-thirds o~ tae semo~ : LaiTy.: M~.ch61angelo, chair~...an of s..u~...ey.ea sal~ there was a ~reat physzeal education and health at rusk" m smorang a pacg or more a CentralCAtholic High School, which has had an outside smoking area It's lunch hour at the smoking area outside Mt. Lebanon High, School: Evans and dozens of school- mates, male and female, shuffle in 35-degree weather, sucking on sub- stitute'thumbs. It.isn't listed on their schedule, but most of them show up here as regularly as they do at algebra class. • But, says one student, the smok- ing area isn't nearly as crowded now as it was, say, four years ago. '~lq~ereused to be people all over, sitting at every planter,': she says~. $it~' in t~e classroom fl~n£ . a dmg Listening to t~e toacbor, weft, just ain't my bag ... 5"mokin" in type boys" room. The song was a hit for Browns- ville Station in 1973,whon cigarette commercials were a fr~h memory. and smoking was clearly on the rise among the nation's youth. School may still be a drag for many, hut ff a recent national survey is an aeeu- rate indication, f~wer and fewer high school students are finding sol- ace in tobacco. While drug and alcohol use have continued torise, cigarette smoking has steadily dropped in the last three years .among high school sen- iors, according to a national study by the Institute for Social Research at tIxe University of Michigan. .Tn 1977, 29 percent of the I7,000 high s~hool seniors surveyed said they smoked cigarettes daily. In April of 1980, the figure had dropped to ~1 percent, and the rate of decline is: accelerating. Some other findings from the study, conduct~ ~or the National Institute on Drug Abuse: • Heavy mioking (half a pack or more a day) among girls is declino Lug more rapidly than it is..among IS238 T104231014

T!04231015

- ,oKing among students, is. declining smokers Who wanted tl~e lavatorids free Still, the numbers axe dropping, and {Continued from Page 21) "school building. So instead of a suspen- • -sion, the student is issued a citation ~rom the local magistrate. 7' . .... " . At North.Mleghehy,'the violator must pay a $29 fine (including costs). "The mere threat .of it has cut 'down on smoking, but @e do follow tltrough," said l~A's Lyle. Fox. . .. ~,,. :. In Monroevllle, the fine is around $50. on first offense. Since the ordinance took effect in .1976, the number b! students caught and fined has decrea~, accord- ing to assistant principal Richard Laz- zari. In the 1976-'77 school year, 68 students were cited; last year, the num- ber was 36. Enrollment has fallen by roughly 500 in that same period. A three-day suspension is the .usual penalty for getting .caught smoking, though frequently the students are given at least one warning before the rule is enforced. And most schools use"in- school" suspeusions~ with the student isolated and assigned .schoolwork. One way around the smoking problem is creating a "smoking area," as Mt. Lebanon has. Though seen by some as an invitation to smoke, others consider it the most realistic, sensible solution to the litter, pollution and fire hazards that arise when clandestine smokers gather in restrooms and stairwells. Mr. Lebanon designated such an area in the early '70s after some debate. Not surprisingly, many supporters were non- and relatively .clean. there must be reasons. • "We're accused of contributing:to an "People are getting more and mord unhealthy situation," admitted David information," said Betty Kadar of the Heliman. "But the other side is, .we American Cancer Seclety. We like to discuss' smoking in our health curricu- take a little credit, us andthe Christmas. lure, and we, don't have the problem of Seals people." - smoking in the building ~nd rest rooms :, "(The decline) is largely the result of that we once had." " ~, • " the educative process," said Rick Pysh, a "The students who use .the ~moking "teacher who started a program at Dor-' are.a at Mr. Lebanon think it's a great • ide~ that could be used at other school~ with s'.un, ilar success. The biggest prob- '~lem appearsto be litter. During ,the winter, whenit's hard to sweep up,~ the place can get messy, but the students 'said they keep it fairly clean during wa .truer weather;. . .. ~ IVoon bell rings, you knovz that's my cue • I'm gonna r~eet ~e boys on floor .... Number Two. .'$mo~l ~n t~e boy~' room . .... '~. If Blondie did a current version of the song, chances are it would be more up- to-date and realistic -- specifically, "Smoking in the girls' room." The Uni- versity of Michigan study suggested what many administrators "i:onfirm: Girls smoke more than boys. Six years ago, the researchers said, ... higl~ School girls smoked less.than boys. For whatever reasons -- the women's liberation movement has been accused -:--by 1977, the number of girl smokers exceeded the number of boys. Among heavy smokers -- 10 cigarettes or more a day -- girls also outnumber boys. seyville Junior ,High in Fox Chapel to teach smoking students about the dan- gers of cigarettes. "They are more awa.re of the. dangers of smoking. They're more sophisticated, more fu- ture-oriented." . " Zolton Toth, a physical .education teacher who ran an award-winning edu- cational program among pro-teens in McKeesport, said; "The pqsh of athletics • into schools gets them away from nega- tive peer grouping. "Kids are very health- conscious -- we're in a health boom." ""I think parents and schools are get- ring to kids younger these days to edu- cate them," said Rick Evans, the Mr. Lebanon senior who smokes a pack a day. Offered junior Katie Cbnover: "In this school, there are definitely fewer people smoking. I think it's because they're moi'e concerned with health in general." .... Inflation, too, plays a part. Said one city school administrator: "Theytll spend a buck on a joint rather than 80 cents on a pa~.k of cigarettes." T104231016

GROWTH HORMONE co~u-~u~' steroid induce a premature puberb" that might cancel out chances of attaining greater adult height? That wasn't seen in the Seattle study, replied Dr. Nugent. Children deficient in gonadotropins and lat- er followed during maintenance therapy weren't yet into puberty when they reached the treatment cutoff of 5 ft 4 in., she said, and the hormone clearly didn't push bone age beyond their height age. Even if genetic-engineering labs manage to produce a safe, biologi- cally active product that could end the HGH shortage, the Washing- ton researchers see a role for oxan- drolone in treatment of children ~th grov,~h-hormone deficits. By speeding growth rates per unit of HGH, they believe the combination approach could correct the stunting defect more rapidly than HGH alone. • Still no way to pin down x-rays" cancer risk, GA O says WASHINGTON--Some $2 billion have been silent in almost 80 years studying the health hazards of diagnostic x-rays and other forms of low-level ionizing radiation. Now a massive report by the General Accounting Office sums it up: "There is as yet no way to deter- mine precisely the cancer risks of low-level ionizing-radiation expo- sure, and it is unlikely that thii question will be resolved soon." The report underscores the "un- certainties involved in interpreting the inconclusive data" that af- flicted a study released last sum- mer by the National Research Council's Committee on the Biolog- ical Effects of Ionizing Radiation. 12 The BEIR HI report, as it's "known, updated a 1972 report that pre- dicted the number of cancer deaths among those absorbing as little as 1 rein per year (~x~q% Dec. 27, '76, p. 30). Last year's BEIR report projected cancer rates about half those of the 1972 figures and gave risk estimates rather than a single set of numbers. When it was released, BEIR committee chairman Edward P. Radford, a professor of environ- mental epidemiology at the Uni- versity of Pittsburgh Graduate School of Public Health, issued a strongly worded minority state- ment objecting to the committee's abandoning its pre~dous use of lin- ear extrapolation from known high-dose taxation effects to pre- dict low-dose effects, and replacing it with a linear-quadratic model. But supporting neither model, the new GAO report says there were not enough data to allow any- one to select a particular curve. "In all indix~dual data sets, more than one curve gave an acceptable fit," the report said, adding that small population groups and corffounding variables diminished any low-dose study's validity. Yet in fiscal 19"/8, 65% of the federal radiation- research program's funds were spent on research primarily aimed at developing such risk-estimate data. In the future, GAO predicts, the government is likely to give even greater priority, to the pursuit of this information. Among many studies scored in the report, the GAO is particularly critical of those--"initiated in re- sponse to public and Congressional concern"--of nuclear-ship workers at the Portsmouth (N.H.) naval shipyard and of people near atomic-bomb test sites in the 1950s. "Researchers x~ll probably not be able to distinguish between random fluctuations and radiation effects," it concludes. A Depart- ment of Ener~" report on some ~ ~3 ~ conffnued Am~stm~ir~c @ acdon complemented by mo dec~ng~tants in a dine- release formula ~ minimal side effect. Dimetapp Extentabs INDICATIONS ~ or. a review of this drug by the Natitx",al Acaderm" of Sdences- National Research C~anc~ and/(~" other inforrm- ti~.~, FDA ha.~ classified the folloMng indicatior~ as "lacldng substantial evi. dence ~f effe~'ene~ a~ a fixed c~mbina- ti,,-n" 6~r Dimeta~p E.xtentahs: Fnr the >ympum~atic treatn~nt of .~.asonaI and perermial allergic rhlnifis and vasorr~lor rb.;nitis, a~le~ic manif~r.afions of upper r~pirator." illn~,~'s, arate sinusitis, na- sa2 co~.ge~tion, and otifi~_ Final da_~,4fi~&m d the less-than- effect~.e indications requires further irr.,~stig-afion. Coatraindications: H.~rsen~th-iD" to antihlstm'nines of the sane chen~cal class. Dimetapp E.xtentabs are c~n~izdic~ted during pregnancy and in children under 12 years of age. BecmJse of its dr)ring and thickening effect on the lower res.::~atoD-:-e~etions.Dimetapp is not recom. mended in the treatment of bronchial asthma. Al.~% Dimetapp Lxtentabs are contraindi. cared in cancu,went I~L~.O inhibitor therapy. W~mi~gs: Use "in Childroh In infant~ and children par- dculary. &~,tihist,~nines ha overdos~ge produce co.'w~si~s ~d death. Pr~':autlons: Ad,'~Jn~ter wkh care to Ix~ients with cardiac or pe.riphe,.-al vascular diseases or hvperten. siov. Until the p~tient's response h~d been determined_ he sh~xdd be cautioned affainst engaging ~a..operations requiring alermess suc~ as ¢k-h-i_ng an automobile, operating machi~D: etc. Patients receMng anfihista- mitres sh~d be ~ned against possible additive effects wkh CN$ depressants such as al~,hol, hypnoti~o r<datives, ~'anquili. zerz. e~. AcK, erse R~aet[ons: Adverse reactions to Dimetapp Extent~bs rm:.,- iaclude ~'pew~-.nsitiviB" reactions such as rash. ta-dcafia, leukopenia, agranulocy.. t~s and ~-tromtx,.-~oper, ia; drowsiness, las- sivade.giddiness.~'~ssdthemucous~em- bw~es, tightness of'the d~est, thickening of broaabSal ..~x:refions, urinary frequency and dy.-~da, palpitation, hypotensioa/hy~erten- sit,a, headache, f~intn~s, dizziness, tinnitus, inox~rdinm:iom ~ual dk~'urbanceso mydria. sis.CXSdep~t anddess often)stimulant effect, inc:ea:~-*d irritablely, or exdtement, an,~a, cau.sea. ~amaiti~g. diarrhea, c~nsti- paa,,r~ and epig-~ttic distress. ~ aad Administration: Adal~ and Chil&-ea 12 x~ars and ~er. Oae Ex:enmb ,,'rxtning and &~ning. If indicated, ore E.xten:ab e~." 8 botts may be gi~. H~ Supplied: Light blue Extentabs in hot'des af 100 ~NDC 0~1.~74~a3, and ~O ~ N DC 0031-2274-70}, and D:.~-C~~ Unit De~e Facks of 100 ~NDC 00~1.__74.60. Rev. May 1980 A-H. R:,bi:-.~ Ct~-.pa~_: "-Rkhmoad,Va.23220 .Xk.-,..ber d" T!04231017

X-RAYS 360,000 workers at eight nuclear shipyards is termed "an unrealistic goal." Ten to 20 fads is tdo low an exposure to be meaningful; under 10 fads (the largest group), medical and background exposures are probably higher; and at higher exposures, the groups are too small. The GAO says $4 million spent on studies of off-site expo- sure from the Nevada bomb tests will probably come up empty-hand- ed, except possibly for thyroid can- cer. Animal research, the report continues, is expensive, and it's not clear whether dose responses among lab mice apply to wild mice, much less people. The GAO report concludes that regardless of the reason for the studies, their inherent limitations make it highly unlikely that any reliable conclusions will be reached. "It should be borne in mind that funding studies that are unlikely to yield useful results will limit the money available for other, more promising research." Seeking a "proper balance of high-quality research," the report recommends establishing a federal research- review group to coordinate investi- gation and avoid duplication. It also suggests that molecular and cellular "mechanism" studies, sup- ported by small-scale animal work, Nevada A-bomb test exposed people living nearby to low-level radiation fallout, but health hazards may never be known. may be a better way to use scarce research dollars. Asked about the GAO report, Dr. Raclford said it is "too sweep- ing," but "in a general sense, I'm inclined to agree with it. To look" at a few cancers caused by a few rads is a waste of time. With some can- cers-breast and thyroid--you might see increases if the popula- tion were big enough." But he agreed the studies "are the result of political pressures" rather than scientific merit. As for the linear- I extrapolation debate, Dr. Radford sticks to his BEIR-report stance= it's valid. Dr. Reynold F. Brown, a clinical professor of radiology and preven- tive medicine at the University of California San Francisco and, till last year, chairman of the Ameri- can College of Radiology's protec- tion commission, also agrees that the politically inspired epidemiol- ogy studies under way are a "waste of money. To study the effects on people in Saint George, Utah, you have to find another Saint George--and that's almost impos- sible." Dr. Brown says he could "live with the linear hypothesis" even if it increases the estimate of cancers caused by low-level radia- tion. "We still owe it to our patients to keep the doses down to a minimum[" he observes. But the "real danger," he says, is that the "anti-nukes" will block develop- ment of nuclear energy and, possi- bly, the use of medical radiation. Harvard's Dr. John C. Bailar III, former acting director of NCI's cancer-prevention program, disa- greed ~dth the GAO's preference for cellular and mechanism studies over large epidemiology trials. "You can take the same money and spend it on bad research and mech- anism studies," he warns. • California stays CPR rule for doctors SACRAMENTO--California doctors have been given a one-year re- prieve from a controversial regula- tion that would have made this state the first in the nation to make certification in cardiopul- monary resuscitation (CPR) a req- uisite for medical relicensure. But while the state Board of .rdedical Quality Assurance (BMQA) was relenting a bit in the face of physician opposition to this rule, it was refusing to bend on FLEX (Federation Licensing Ex- amination), the test formulated by the Federation of State Medical Boards for newly minted or foreign doctors. After a three-year effort to get re~Ssions in the exam--and consumers on the FSMB board of directors--BMQA pulled itself, and its ~5,000-a-year dues, out of the federation. However, board presi- den~ Ben Winters indicates Califor- nia ~-ill continue using FLEX at least through June. The moratorium on mandated CPR here .was declared by BMQA in late January wheh it agreed to let the California Society of Anes- thesiologists (CSA) set standards and police physician-training pro- grams not officially sanctioned by the state. Under BMQA's original plan, only "current and valid" cer- tification by the American Heart Association (AHA), American Red Cross, or their equivalents passed muster. Without such ~locuments, continued 14 MESCAL WORLD NEWS/March 2. 1981 Ti04231018

clefs cheque and u-ave/and enter- minme~'.t card market~. "When l%fasterCard's first trav- elers check ads break 1W~arch 23, AmEx will have already intro- duced several enhancements to its own travelers ehequ e,'which holds more than half of the $30 billion market but has come under fierce competitive attack in the last year. A new AmEx campaign, breaking cig gets U.S. aid By DENNIS CHASE CHmACo---Reemtsma, the lead- ing German cigaret marketer that has been steadily losing market share to Philip M~rris' M~rlboro and other brands, has turned to a U.S. branch of a Swiss agency group to help ~hem stop the slide, Meanwhile, throughout Europe and elsewhere, private and state- run tobacco companies are fight- ing back against the increasing dominance of the U.S. brands, Last week Reemtsma, of Ham- burg, ended a year-long market test in Frankfurt and went national with West, a frankly American- style cigaret pitted directly against Marlboro and R.J. Reynolds To- bacco Co.'s Cm:nelbrands, the fast- est growing eigarets i~ Germany (A.A, Dee. 15). What is unusual is that the new cinema, poster and print campaign was. devised and shot entirely in the U,S. by GGK New York, a Swiss-based agency group largely unheralded in this country with only $7,000,000 in 1980 billings. That campaign, with the theme "'Let's Go West," shows two truck drivers in friendly competition to haul their freight across" the U.S. through the dust, smoke and heat of states like Nevada and Califor- nia. "The campaign was deliberately conceived as an Amerlcan-style one," said a GGK official in New York. "Germany is going through (Continued on Page 66) ~J~at ~'my have been lost; cashing of personal checks up to $200 if extra cash is needed with the refund; a 24-hour travel hotline to alter ~-avel plans or reservations, and a free lVlailgrm to inform any third party of a change in plans. In addition to thwarting ]~aster- Card, AmEx is attempting to parry marketing thrusts by Visa Interna. tional, which claims 12% of the Card will attempt to poach wl~n a~ "affluent card" due this July. ~hen the ~x "Exp~ ~" f~ ~ roH~ out na~onwide ~ ~e second h~ of 1981, gold c~d- holders will ga~ access to ~e automatic teBers of as m~y as 1,700 b~ks for either a cash ad- vance on the card's m~imum $2,000 credit Bne orby debit~g ~ ~ist~g account. work, at least for withdrawal pur- poses. The gold card, unl~e the miliar AmY_~ green card, offers credit and other services for a $50 fee~ AmEx is testing tv advertising for the new gold card service, the f~rst time tv would be used to pro- mote the card, which is more diffi- cult to obtain than the green card. Distillers" spot plants seed of abstinenc A bartender warns consumers "if you have any dot~bts .... don't even of distilled spirits. The tv spot, prirr start" to drink, in a spot produced for public service use by Ed Phillips & first," according to the company. I .Sons, Minneapolis, which says it is the nation's largest regional producer, account. GF drops, out of dog fo(. By RICHARD KREISMAN The new product relies on a'~tech- when it introduced Tend~ CHxdAGo--Faced with sagging pet food profits, General Foods is sdampering away from a three-way dog food fight, leaving Quaker Oats and Ralston Purina in a high- stakes spending battle for a new subsegment in the $2.6 billion mar- ket. Ironically, it w.as GF that pioneered the segment with its idea of ~remixing soft and dry chunks, GF recently pulled the highly touted Full Course brand out of a two-year test, to the sur- prise of competitors, retailers and market analysts who expected it to roll out. Ralston Purina has been testing commercials and various brand names for a product in the seg- ment and is "very close to a fast rollout," said a top company exec. world n.. ,ewsroundup._{ MADRID--Tiempo/BBDO scored a major coup last week by win- ning the $10.000,000 account of SEAT, formerly with several different agencies. The agency beat out Norman, Craig & Kummel and MM.LB and boosted its billings by almost 50% to $30,000,000. SEAT is the 100% Spanish-owned auto company in which FIAT gave up a minority interest. DUNMURRY--The much-touted DeLorean Motor Co. sports car launch in Europe was won last week by Marsteller Inc. The first car, made in Northern Ireland, leaves Belfast for its U.S. introduc- tion next week but will not be launched in Europe until later this year. LoNDoN~D'Arcy-MacManus &Masius is believed to have won a large slice of the S37,000,000 Alfa Romeo account in several Euro- pean countries, pitching against Ted Bates & Co. nological breakthrough," he added. • The company is treating the new brand to a major push, which would mean initial advertising and promotional spending in the $20,000,000 to $30,000,000 range given the industry's recent levels. Tatham-Lalrd & Kudner here is believed to be handling the brand. Quaker, meanwhile, starts sell- ing KSbbles 'n Bits, its new entry, to the trade this week (AA, March 2). In earlier Houston and Tulsa market tests, the brand was pre- sented as a combination of chewy moist strands and dry chunks. Purina apparently is moving without market tests in order to protect itself from another Quaker incursion in the dry dog food do- main. In 1978, Quaker caught the St. Louis co.mpany by surprise Chunks, which quickly racked u impressive share gains at Purina expense. Quaker, ~vhich has watch~ Tender Chunks" share drop offth year due to its higher cost, is cot mitted to Kibbles 'n Bits to fu growth. Although execs declim to comment on spending leve: pet food division preside: Richard Glantz told analysts 1~ fall that initial marketing supp¢ for the brand could reach t! $25,000,000 level. ~. Walter Thorn, son Co. is the agency. Industry observers, howev~ pinpoint Genera] Foods' decisi to drop Full Course (AA, March tested in Kansas City and Houst for about two years, as a primt reason for the sudden movemt in the category. GF's move s' prised retailers, who said F arc. So far the agency has accounts from Johnson & Johnson, Conch Toro, W.IL Grace & Co. and Union Carbide. MONTREAL---J. Walter Thompson Co.'S second agency ht Communication Nucleus, was launched last week to handle smaller tail accounts in both English and F~ench. BON~West Germany's supreme court ruled last week ~ illustrated "before and after" ads for weight-reducing diets violate d~ laws because obesity is an illness and ads for treating ilanesses are strit regulatod. SAO PAIOLO--For the first time, Brazil's Council for Adver ing Self-Regulation will make its condemnations public, insuring" group's survival after criticisms that R had been excessively sec~ti. FRANKFURT~Flagging Germa.~ jeans sales are gettin boost from a new Levi S~rauss & Co. c~mpaign that gives custome~ credit of $7.37 for every pair of old Lev.i's j.eat2_s" traded in for $ r .=w p Ti04231019