Tobacco Documents Online

---

T_ABLE_OF CONTENTS Members of Task Force on Tobacco and Cancer Charge to the Task Force The Problem Recpmmendations for Five-Year Smoking Control Program - Professional Education - Public Education - Public Information - Legislative and Governmental Affairs Appendix Summary of Findings: Study on Smoking Among Teen-Age Girls and Young Women 3O A Supplemental-Study - Smoking Among Teen-Age Boys "Adult tlse Of Tobacco - 1975" Study Report of Anti-Smoking Activities in ACS Divisions and Units Federal Laws and Regulations Relative to Cigarettes 38 43 68 77 -!-107581575

',MEMBERSO~;,TASK IFORCE • , ;: ." . : ~ .' .;~. TI07581576

-1- N~TIONAL TASK FORCE ON TOBACCO AND CANCER Chairman: ~llan K. Jonas, Los Angeles, California Robert L. Brown~ M.Dr~ Clinical Programs Coordinator, Georgia Cancer Management Network, Inc., Atlanta, Georgia ~muel ~..,..Fisher, Managing Partner, S.M. Fisher Company, Philadelphia, Pennsylvania Donald T. Fredrickson: M.~b~, Director, Inter-Society Con~ission for FF~art-D~seas~ Resources, New York, New York Gio Gori, Ph.D., Deputy Director, Division of Cancer Cause and Preve6-tion, National Cancer Institute, Bethesda, Maryland .. Paula Green, President, Green bolmatch, Inc., New York, New York Will~am GTiffiths. Ph.D., Professor, School of Public Health, Cal~fornla, Berkeley, California University of ' ~ -~ Jerome H. Jaf~e~ M.D., Chief of Department of Biological Psychiatry, New York State Psychiatric Institute, New York, New York Murray E. Jarvik~ M~D., Professor of Psychiatry and Pharmacology, University of California, Los Angeles, California Edw#~d J. Kletter, Chairman of the Board of Directors, Parkson Advertising Agency, New York, New York Jes~ Steinfeld~ M.D., Dean, Medical College of Virginia, Richmond, Virginia ...... Philip Terman, D.D.S., New York, New York E~n~ Wvnder~ M.D., President, American Health Foundation, Inc., New York, New York T1075815-77

TI07581578

CHARGE TQTHE TASK FORCE In June of 1975, the Bo~d of Direeto~ of the American Cancer So~Lety appointed a N~Lional T~k Force on Tobacco and Cancer. St~sing the importa~ ga~ ~h~ch have been made to date by the A~ and ~ aLU~ in comb~g smo~ng, ~e Bo~d of D~e~o~ noted, nev~- ~e of smo~ng ~ begin~g to ~e ag~, ~ ~ ~e of smo~ng ~ong wom~ and ~ong te~-ag~ w~ ~ing ~ an ~g degree, and ~, in g~, ~ny of ~ advan~ of ~ p~t 20 y~ w~e in ~n9~ of b~ng ~ped o~. The T~k Force w~s th~efore given th~ ehaxge: [a) r~aken ~e ~on to ~e ~g~ of s~o~g: (b) s~~ gov~ (~ ~ lev~) to d~ ~ ~ probl~; (e) ~s~de many more p~ople, ~pe~ yo~k, from smo~ng; (d) p~d~ ~ny more smok~ to stop and provide ~ ~k ~s~t- ~ee to do so; [~) ~volue in ~ ~ffo~, mu~ mor~ ~ b~fore, ~e ~d ~ed ~of~sio~, ~bor and ma~e~, ~e i~~o~ of edue~on, a~ ~e ~s The T~k Force wa~ aZso .~ged to e~u~ne e~Lti~y all of the work of the Am~ean Cancer So~y, du~ing ~he ~t several de~ad~ in the figk~ a~ain~t ~moking, to ~ropose the ~imina~i~n of a~Liv~ti~ that ~ere not adequately productive and to recommend more effective program~ in th~Lr place. Th~ appointm~n~ and eha~ge wa~ accepted, and ~c T~k Force h~d f~t toeing on O~ob~ I, 1975. S~seque~, subcom~e~ w~ appoi~ed to d~ ~ dep~ ~ sev~ sep~e ~: Pu~c E~c~on, C~s~on Prog~, Prof~sio~ ~on, Pubic Info~on, L~g~v~ and Gov~n- m~ AfrO. Me~ng and wo~n9 ~dep~de~y, ~e s~eo~e~ broug~ in i~ repo~, ~ seu~ s~g~, for reui~ of ~e T~k Force ~ a whole. Th~ ~t me~ of ~e T~k Farce w~ h~d on Sept~b~ 7, 1976 ~d adopt a fi~ s~ of ~eeommen~o~. Thee ~ s~ fo~ in t~ docu- In the course of i~ work, the T~k Force had avallabl~ ~ number of studies and special repo~ w~ch proved to be of in~timable value for ~se~Aa£ info~on and exp~rt g~idance. Thee included the fol~wing: I. eon~lu~£ons of 3rd World Confero~ce on Smoking and H ~z~th. ~. ReporL of WHO Exp~r~ Committee. TI07581579

-3- Findings of Study - "Adult U~e of Tobacco - 1975"- done b~ Na~onal Clea~inghou$e on Smoking and Health. ~. ACS studi~ of Cigarette Smoking A~on~ Teen-Ag~ and You.~3 Women. 5. A Revi~ of the Li~are on Educational Prog~z~ to Change Smo~ng Behavior (ACS) : I%0-1976. 6. SITUATION ANALVSIS of A~L-Smoking Activiti~ in ACS Div~Zz~ and U~b~.. Thro~hou~ a£Z of it~ work, the T~k Force on Tobacco and Cancer has be~n ~ndf~ of ~e g~v~ of ~ ~d~ng. We ~ sp~ng, aft~ ~, not ~o~ so~ a~c m~, b~ abo~ ~e n~e~s ~ss of te~ of ~o~an~ of ~v~ ~ y~, and ~ ~~g~ of dlv~ing a ~og~ to prew~ ~ t~bl~ loss.. Y~, ~ b~nc~ ~ cancan, w~ ~v~ be~ ~f~ ~o of ~ co~ ~ s~g~ of ~ ~~n Canc~ So~y, ~e de~on of ~ ~d in r~, ~ give l~d~p and ~e~on ~ the ~g~ ag~2 smo~ng. We a~e confiden~ th~ when thee recommendations have b~er~ reviewed and adopted, they ~ be put into effect ~ith the c~tomary vigor and dispatch w~ah the public has co~e to ~xpeat from the American Cancer Society. And, that ~ a r~Lt, ~o~ of Am~Lca~ mill be saved f~om d~ase and de~h due to smo~ng. A~n K. Jo~ Chairman Natio~ Task Force on Tobacco and Cance]~ T107581580

---

THE P~OBLEM_. Cigarette smoke is responsible for more deaths from cancer than any other single agent. This year, 85,000 Americans will die of lung cancer; 80 percent of these deaths will be due to smoking. Cigarette smoke is implicated not only in cancer of the lung, but in other types of cancer as well. This one agent is responsible for nearly 70,000 cancer deaths a year, practically one in every five deaths from this disease. Cigarette smoke is a causal agent also in diseases of the lung other than cancer, and diseases of the circulatory system, including heart disease and high blood pressure. In all, smoking is responsible for more than 250,000 premature deaths each year. In addition, we must note that heavy cigarette smoking is costing this nation some $17 billion a year in unnecessary expenditures -- $4 billion for medical care to treat the illnesses it causes, and a loss of $13 billion sus- tained as a result of accidents, absenteeism, lost output, etc. If smoking were eliminated completely, all these lives and all o7 this money would be saved. Yet, we know that smoking has.not stopped, that. more than 50 million Americans are still smoking cigarettes, even though the tragic con- sequences of smoking have been known for many years; even though the American Cancer Society and its allies, including the American Heart Association and the American Lung Association, have been carrying on energetic campaigns against smoking during the past two decades. Yet, to think that there has been no progress in this effort would grossly misrepresent the truth. The progress has, in fact, been remarkable considering that the nationwide fight against smoking has been going on for only two decades; and considering that the anti-smoking forces have had aligned against them a multi-billion dollar cigarette industry spending more than $300 million a year on advertising; and considering also that they have been able to count on only lukewarm support from the executive and legislative branches of government.. Even though 50 million Americans are still smoking, 30 million have stop- ped since the anti-smoking campaigns began. In 1964, 42 percent of the adult population in the United States was smoki6g. Today, that figure is between 33 and 34 percent. The average cigarette today has 60 percent less tar and nicotine than it had 20 years ago, and levels are continuing to drop.* But, more importantly, there is a definite sign that public attitudes toward smoking and the public image of smoking are significantly changing from positive to negative. Twenty years ago the popular question was: "Aren't you smoking?" Today, it is: "Are you still smoking?" *To date, the toxic agents in cigarette smoke identified as the causal factors responsible for cancer, cardiovascular and pulmonary illness are tar, nicotine and carbon monoxide. Knowledge in this area is still incom- plete and several other factors are under suspicion. As these are made known and their culpability confirmed, measures must be taken to safeguard the smoker. With at least several hundred components under consideration, this is an extremely complex task. T107581582

This Task Force believes, in other words, that the decisive breakthrough has been made; that the challenge now is to exploit it to the fullest. Hence, the problem is today, as this Task Force sees it: How can we expand the gains we have made? How can we improve our methodology? Where should we be putting our greatest focus for future advances? Which audiences require special concentration? The answers of this Task Force to these questions are contained in the recommendations set forth later in this report. To arrive at these proposals, the Task Force reviewed the campaign against smoking from its inception, noti the successes and the failures, and taking account of the factors responsible for both. T.h.e Scientific .Evide.~ce Is Amassed The first warning note of any significance regarding the hazards of smoking was sounded in 1939 by Dr. Alton Ochsner, a surgeon (later to become President of the American Cancer Society), at the Internatibnal Congress Against Cancer. Noting a sharp rise in the incidence of lung cancer, Dr. Ochs found that the curve ran parallel, to a remarkable degree, to a curve showing the year-by-year increase in cigarette smoking. He concluded that cigarette smoking was causally related to lung cancer. These startling findings created hardly a ripple in medical circles and even less in public circles. The voluntary health organizations recognized the significance of the disclosure, but were not yet fully cdnvinced. Subse- quently, several other pieces of vital research confirmed Dr. Ochsner's conclusions. In the late 1940's, Dr. Ernst Wynder, in research supported by t! American Cancer Society, found among a large group of men who had died from lung cancer a very great majority were heavy smokers. Then, in the middle 195. Dr. Cuyler Hammond and Dr. Dan Horn of the ACS reported from a very large epi, emiological study that the.lung cancer death rate for cigarette smokers was ten times as great as for non-smokers; also that the death rate among cigaret' smokers from all causes was much higher than among non-smokers. In England, Dr. Richard Doll and Dr. A. B. Hill followed 40,000 physicia~ starting in 1951 and found that death from lung cancer among these individual: was definitely and directly related to the number of cigarettes smoked, a fin, ing confirmed later in the massive Cancer Prevention Study conducted by the American Cancer Society. This study also disclosed a much higher death .rate from heart disease for smokers as compared with non-smokers, and implicated smoking in emphysema, cancer of the mouth, pharynx, larynx, esophagus and pancreas. T107"581583