WIBNIPEG_ CARADA_ 1983 OEGANIZERS Canadian Council on Smoking and Health

Enforces laws against false and deceptive advertising, including ads for tobacco products. Ensures proper display of health warnings in ads and on tobacco products;collects and reports to Congress information concerning cigarette and smokeless tobacco advertising, sales expenditures, and the tar, nicotine, and carbon monoxide content of cigarettes.

Federal Trade Commission (FTC)

Government Printing Office (GPO)

Health and Welfare Canada

Herald Tribune

International Agency for Research on Cancer (IARC) (WHO cancer research arm)

International Agency for Research on Cancer - The cancer research arm of the WHO. Conducted a multi-center epidemiology study on ETS, initiated in 1988, data collection completed in 1994 and results were published in 1998

Imperial Group Limited (Has a 1982 patent on an alternative nicotine delivery system)

Has a 1982 patent on an alternative nicotine delivery system

Information Center

Institute for Social Research (University of Michigan)

International Union Against Cancer

John Wiley & Sons (Publisher)

Kaufman (Advertising Agency)

Lancet

Merrell Dow Pharmaceuticals Inc. (Marketed Nicorette nicotine chewing gum)

Merrell Dow was a subsidiary of Dow Chemical Co.. It marketed Nicorette nicotine chewing gum. Nicorette is produced from a natural extract of the tobacco plant, with each piece containing 2 mg of nicotine, each cigarette contains a little more than 1? of nicotine.

MRD

National Academy of Sciences

National Institute on Drug Abuse (An addiction research center in Baltimore, MD)

An addiction research center located in Baltimore, MD

National Institutes of Health

National Institutes of Health (NIH)

National Research Council

Office on Smoking and Health

Responsible for creating reports on the health effects of smoking. Created by the Public Health Service.

Philip Morris & Co. Ltd. (Cigarette manufacturer, incorporated in U.S. in 1902)

Philip Morris & Co. Ltd.., was incorporated in New York in April of 1902; half the shares were held by the parent company in London, and the balance by its U.S. distributor and his American associate. Its overall sales in 1903, its first full year of U.S. operation, were a modest seven million cigarettes. Among the brand offered, besides Philip Morris, were Blues, Cambridge, Derby, and a ladies favorite name for the London street where the home companies factory was located - Marlborough.

Preventive Medicine (periodical)

Psychopharmacology (scientific periodical)

R.J. Reynolds Corporation (second tier subsidiary of RJR Industries)

Research Council

Rothmans International

Royal College of Physicians (Monitors the quality of Canadian/U.K. medical education)

San Francisco General Hospital

Smokers Clinic

U.S. Department of Agriculture

United Nations

University of Bergen

University of Edinburgh (Located in Scotland)

University of Michigan

University of Toronto

University of Washington

World Conference on Smoking and Health

World Health Organization (Concerned with global public health)

International organization concered with public health worldwide

WRO (PM's Washington Relations Office (1994))

1994 PM's Washington Relations Office

Named Person

Armstrong, Bruce K.

Arne, Leif

Ary, Dennis V.

Ashley, Mary Jane

Asmussen, Inger

Bailey, Jeffry

Banzhaf, John F., III (Exec. Dir. Action of Smoking & Health (ASH))

Executive Director of Action on Smoking and Health (ASH).Professor of Law at Georgetown. Banzhaf succeeded in using the Fairness Doctrine to get cigarette commercials off television in 1968. See Banzhaf FCC, 405 F, 2d 1082 (D.C. Cir. 1968) (affirming FCC ruling that radio and television stations must devote a significant amount of broadcast time to case against smoking). His telephone number is (202) 659-4310. The big focus in past years has been to force OSHA to enforce smoking bans, per Matt Bars. ASH publishes Smoking and Health Review bulletins. "A leading anti-smoking activist" (Chic. Sun-Times 6/23/93). Action on Smoking and Health is located at 2013 H Street, N.W., Washington, D.C. 20006. (Castano Expert List) See Action on Smoking a Health, TTLA Almanac - Names.

Begin, Monique (Canadian Cabinet Minister for Health and Welfare)

Best, J. Allan

Biglan, Anthony, Ph.D. (Psychologist, Oregon Research Institute, Plaintiff Expert)

Boyko, Evelyn

Brown, K. Stephen

Califano, Joe

Califano, Joseph Anthony, Jr. (Sec. of U.S. Dept. of Health, Education, and Welfare)

Joseph Califano Jr. is the former secretary of Health, Education and Welfare (1977-1979), in Carter's administration (A 5/17/94; WP 4/3/85). He spoke against the tobacco industry on ABC's "Day One" program. He testified before the Waxman subcommittee on 5/17/94. He was an adviser to President Lyndon B. Johnson (AP 5/17/94). He was President of Columbia University's Center on Addiction and Substance Abuse, circa 1994 (AP 5/17/94).

Chapman, Simon ("Tobacco Control" Editor for British Medical Journal)

Diehl, Harold, M.D. (Professor of preventive medicine and Dean of University of M)

Served as head of the American Cancer Institute after retiring as Dean of the University of Minnesota Medical School.

Dobson, Annette J.

Doll, Richard

Draper, Peter

East, Robert

Eide, Ingrid

English, Barbara

Fisher, Deborah A.

Fletcher, Charles (Chest Physician)

Colleague of Sir Richard Doll, did research on why doctors who continued to smoke did so and what effect they'd found giving up smoking was when they gave it up. 8 smoking.

Follin, William

Forbes, William F.

Frecker, Richard C.

Friend, James

Garner, Donald W

Plaintiff

Giudice, Del

Glantz, Stanton A.

Gray, Nigel

Grossman, Michael

Harris, John (District Supervisor in Florida Police)

Heller, Julia

Henry, Prince

Hill, Sir Austin Bradford, Ph.D. (Medical Statistician, U. of London, worked with Doll)

In the September 1950 British Medical Journal, Richard Doll and Dr. A. Bradford Hill published preliminary report on smoking and lung cancer. They examined smoking rates for hospital patients with and without lung cancer. They did 1954 prospective studies of 40,000 physicians and concluded that heavy smokers were 24 times as likely to die of lung cancer (E. Whelan 1984).

Hill, Bradford

Horn, Dan

Howe, Holly L.

Huba, Leona

Hynd, Samuel

Hynd, Samuel W.

Ill, Jacob P.

Jacobson, Bobbie

Jarvik, Murray E., M.D. (Nicotine expert)

Plaintiff

Jones, R.T. (BATCO GR&DC)

R. T. Jones was with BATCO-GR&DC. (Source: NM Tobacco Companies Personnel List)

Jones, Virginia Cresswell

Kennedy, Robert

Leathar, D.S.

Ledwith, Frank

Lee, John F.

Legge, David A.

Leone, Sierra

Leu, Robert E.

Loeb, Barbara Keely

Loveday, Paul L.

Lynch, Cornelius J.

Mah, Russell

Manske, Stephen R.

Minister, Junior

Moreton, Wendy J.

Murray, Michael

Pederson, Linda

Pertschuk, Michael (FTC Commissioner (c. 1984))

Petersen, P. Carl

Pfeiffer, Paul N.

Platt, Robert

Player, David

Pollin, William, M.D. (NIDA Director)

Rabkin, Simon W.

Rahman, Abdul

Randell, Jane

Raw, Martin

Rayner, Kent J.

Reagan, Ronald

Reid, Donald

Ridge, Kent

Roemer, Ruth (public health law pioneer, 1916-2005)

pioneer in public health law. Born Ruth Joy Rosenbaum in Hartford, Conn. in 1939. A 1939 graduate of Cornell Law School, Roemer worked as a labor lawyer during the 1940s, representing clients such as the United Electrical Workers union. Her marriage to Milton Roemer led her to gradually shifted her focus to health law. This new direction was fostered by her role in a groundbreaking study of the laws governing admission to mental hospitals in New York state. Using the law to promote public health objectives became her primary aim after joining the faculty of UCLA in 1962. Eventually, Roemer's efforts began to concentrate on reducing tobacco use globally. In 1982 she wrote a book, published by WHO, which guided countries that wished to craft tobacco control policies. In 1993, she and Allyn Taylor of the University of Maryland Law School produced a document that outlined what would become the world's first public health treaty - the WHO Framework Convention on Tobacco Control. The treaty was signed by 168 countries and ratified in 2003.

Ryan, Katherine B.

Samet, Jonathan M.

Schlegel, Ronald P.

Schneider, Nina G.

Schwartz, Jerome L.

Scott, Kenneth E.

Severson, Herbert H. Ph.D.

Plaintiff

Shane, Fred

Shannon, Michael E.

Shephard, Roy J.

Shimp, Donna M.

Simpson, David

Stanwick, Richard S.

Stephens, Thomas

Terry, Luther Leonidas, M.D. (Surgeon General, 61-65, U of Pennsylvania, Anti-Tobacco Expe)

Luther Terry was former Surgeon General of the United States Public Health Service from 1961 to 1965. Terry was emeritus professor of Research Medicine at the University of Pennsylvania School of Medicine in 1984 (E. Whelan 1984).

Thomson, Margaret P.

Tso, T.C., Ph.D. (PM Tobacco Working Group)

Defense

Wagner, J.C. (researched asbestos and smoking rates of lung cancer)

Weissmann, Wendy

Woodward, Stephen W.

Worden, Mark

Young, George

Master ID

TI08350674-1466
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viii TABLE S~okin~ Behavior Change Patterns in the Nmltiple Risk Factor Intervention Trial (HRFIT) and their Relatienship to Hortality £rom Coronary Heart Disease (CHD) ................... 403 Judith K. 0ckene, Stephen B. Hulley, and Terance A. Gerace Early Prophylaxis of Smoking ...................... 415 Stanimir G. Penev and Luben G. Penev A Comparison of Behavlour Hodlfication, Health Education and Eypnosis Prograu~es for Cigarette SmoklngCessation: A Random~zed Clinical Trlal ............................. 419 Simon W. Rabkin, Evelyn Boyko, Fred Shane~ and Joseph Kaufert The Role of Chest Physicians as S~oking Cessation Counsellors ..... 427 Martin Raw and James Friend Smokers' Clinics in Britain. A Descriptive Survey ........... 433 Martin Raw and Julia Heller Hinimal Anti-Smoking Intervention by Physiclans and its Enhancement by Nicotlne Chewing Gum .................. 439 M.A.H. Russell, R. Merriman, and A.R. Edwards BUTT OUT! Evaluation of The Canadian Armed Forces Smoking Cessation Program ....................... 445 Ronald P. Schlegel, Stephen R. Manske, and Michael E. Shannon Nicotine C~nn in Smoking Cessation: Outcome and Withdrawal in a Placebo-Controlled Trial ........................ 453 Nina G. Schneider and Murray E. Jarvik Developments in Smoking Cessation: Trends and Observations ....... 461 Jerome L. Schwartz ~aternal Cigarette Smoking in Nova Scotia .............. 473 Kenneth E. Scott, Barbara English, and Yola~de Samson The Socio-economic l~plications of Smoking and the Non-Smokers' Rights Hovement ............................ 477 John F. Banzhaf III TI08350684

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Taxation and Cigarette S~oklng in the United States .......... 483 Michael Grossman Smoking and Health Care Costs: Plus or Minus? ............. 489 Robert E. Leu and Thomas Schau5 Taxation as a Means o£ Affecting Tobacco Usage ............. 495 M.E. Thompson and W.F. Forbes Socio-econom~c and Cultural Implications of Health Interventions: The Case of Smoking iu Ethiopia .................... 505 K. Yayehyirad VI: LEGISLATION Legal Action on Smoking and Health ................... 513 John F. Banzhaf III and Paul N. Pfeiffer Sidestream Smoke: A Mainstream Health Problem - the Arizona Response ........................... 519 The Legal Implications of Cigarette Smoking .............. 523 Donald W. Garner Lignes Directrlces pour la Progran,aation d'Initiatives Legislatives, d'Informatlon et d'Educatlon Sanltaire pour l'Action contre le Tabagisme en Italle .......................... 533 L. Giannico The Tobacco Iudustry's Polltical Tactics in California since 1978 . . . 539 Stanton A. Glantz and Paul L. Loveday Strategy of the Tobacco Industry Concerning Legislation on Tobacco Advertising in some Western Europeau Countries ............. 549 Luc Joossens Legi~latlon~nd-Political-Act~vity--in-Sri--Lank~-i~the~Field_ of Smoking and Health ......................... 555 W.A. Karunaratne TI08350685

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The Urgent Need to Cont¢ol the Smok~ug Epidesaic in the Third World . . .§61 Martin Khor Kok Pens The Tobacco Industry and the Ban o~ Advertising ............ 567 ~sbjorn Kjonstad Anti klngLegi 1 tl " Egypt 575 --~mo 8 a O~ ~Jl ..... • ....... • • • * ° ° Sherif Omar a~ H~i E1 Sayed Smoking-Control in Developiug Countries - Support by WHO and SIDA (S~edish Intern~tlo~al Development Authority) ........... 581 Lars M. Ramstrom" " ~ Experience in aCountry without Smoking Control ............ 589 Mario Rigatto Combatin~ the Smoking Eplde~c: Why Legislation? ............ 593 Ruth Roemer Non-Smokers' Health R~ghts from 1976 to Today: A Plaintiff's Perspective ................ Donna M. Shimp ...... 603 Achieving a Non-smoking Environment: The Vital Role of Individual Actions ........................... 60~ Donna M. Shlmp Countering the Opposition ....................... 615 David Simpson Smoking in Malaysia - Promotion and Control .............. 623 S.K. Teoh Tobacco Advertising in Develop[ng Countries - Experience in Papua New Cuinea ........................... Martin ToVadek and Konrad Jamrozlk .629 Campaigning for Legislatiou to Ban Tobacco Promotion: A Case Study .............................. 635 Stephen W. Woodward TI083506,2.,6

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VII: SB~EYSA~T~09S Longitudinal Prediction of the Onset and Change of Adolescent Smoking ......................... 641 Dennis V. Ary, Anthony Biglan, Cheri L. Gallison, Wendy Weissmann, and Herbert H. Severson The Waterloo Smoking Prevention Project: Nethodological Advances, Results, and E~pirical Guidelines for Disse~nation to the Schools . . .649 J. Allan Best, Katherine B. Ryan, K. Stephen Brown, Shelagh. M.J. Towson, and Brian R. Flay Priorities for Social Science Research on Smoking. Report o£ the Fifth World Conference Working Croup on Social Science and Program Related Research ...................... 657 Is Cigarette Consumption Declining in Canada? ............. 667 Neil E. Colllshaw Group Effects in Smoking Research: Statistical Considerations ..... 679 Annette J. Dobson and Gregory R. Hardes Smoking and Women's Emancipation; the Developed World ......... 687 Ingrid Eide Smoking Habits am~ug Registered Nurses, Auxiliary Nurses and Nurse Aides ............................ 693 Steinar Yolger~, lngerma Brofoss, Per Morten L~chsen, and Kjell Bjartve~t Quantitative Models of Lung Cancer Nortallty for the United Kingdom, Canada and Australia ................. 701 R.W. Gibberd, E. Doyle, K.S. Brown, and W.F. Forbes Prediction of Lung Cancer Incidence in Finland: Appraisal of Different Approaches ................... 707 Timo R. Hakulinen, Eero I. Pukkala, and Esa M. L~r~ Planning, Development and Evaluation o~ a Special Smoking and Health Pro.gramme for Pup_il's Aged_l-2r/~.~ear~ . ~ ~ ~ -_ _- ~ ~ ~ ~ . .7/1 A. Hauknes, P.M. L~chsen, and L.E. Aar4 TI08350687

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xii TA.~LE O~ ~ Changes in S~oking Habits Between the 1976 and 1981 New Zealand Population Censuses .................... 725 D.R. Hay APropos de Quelques Aspects Soclo-culturels du Tabagisme en Alg~rie ............ M. Khellaf and B. Bensmail ............. 733 SmokingAmong Alaska Native Youth ................... 737 John F. Lee A Decade of Smoking ~ong High School Students in Hobart Tasmania " " 743 fan C. Lewis, Kent J. Rayner, and Klaus M. Schwarzenholz Comparisons Between the United States and Western Europe in the Health Effects of Smoking and Related Factors .......... 751 Cornelius J. Lynch The Social Context of Smoking During Adolescence ............ 757 Michael Murray A Study of Adolescent Smoking in the Greater Dublin Area ....... .;763 Desmond J. O'Byrne Smoking Patterns of Students in Higher Institutions of Learning in Nigeria ................ . . . . . . . . .773 B.O. Onadeko, A.A. Awotedu, and M.O. Onadeko Smoking Trends in Thunder Bay, Ontario High School Students Richard S. Stanwick, Yarn Sawatzky, and David A. Legge • 781 The S~oking Habits of Native Canadians ................. 785 Margaret P. Thomson Smoking Behavlour in the Netherlands from 1958-1982 .......... 789 Jan van Reek T[08350688

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CLOSING ~DRESS Smoking or Health Activities: Lessons from the Past, ~mplications of Present Experience~ Challenges for the Puture N.C. Delarue ........ 797 CONFERENCE RECOMMENDATIONS RECOMMENDATIONS THROUGH RAPPORTEURS Health Consequences ........................ 805 Public Education and Information .................. 807 Cessation .............................. 809 Economics .............................. 811 Legislation ............................. 8~3 RECOMMENDATIONS PROM DELEGATES .................... 815 RECOMMENDATIONS FROM THIRD WORLD DELEGATES ............... 819 TI08350689

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PLENARY ADDRESSES T[083506£0

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SUMMARY OF ~OET OF k~EO EXPERT COK~TTEE ON S]~KING CONTROL STRATEGIES IN DEVELOPING COUNTRIES GENEVA, 22-27 NOVEMBER 1982 The Honourable Abdul Rahman AI-Awadl Minister of Public Health Ministry of Public Health P.O. Box 5, Kuwait The WHO Expert Committee on Smoking Control Strategies in Developing Coun- tries met to draw up guidelines that could help governments and health institutions, in developing countries, in their efforts to stem the spread- ing of the tobacco smoking epidemic in the Third World. The tobacco indus- try is indeed exerting increasing pressure to expand its markets among un- suspecting populations in such countries, thus adding the burden of increas- ing rates of coronary heart disease and other smoking-related diseases to the existing problems of malnutrition and communicable diseases. WHO's first clear commitment to anti-smoking action came in 1970, when the World Health Assembly, in a resolution, called on governments to take action in the field of smoking control. Since 1974, two WHO Expert Committees have been convened to advise the Organization, the WHO International Clearing- house on Smoking and Health Information has been established, and WHO co- sponsored the Third, Fourth and Fifth World Conferences on Smoking and Health. The Organization also collaborated with FAO on a study of the eco- nomic benefits and social and medical costs of tobacco production and con- sumption. More recently, a WHO Action Programme on Smoking and Health was set up in accordance with resolution WHA33.35, adopted by the Health Assem- bly in 1980. Under this programme, the Organization has analysed the con- tent of cigarettes from developing countries, conducted educational semi- nars, collaborated with developing countries in the implementation of national smoking control programmes, and published numerous reports on smok- ing trends and related data. The most recent activity was the convening of a WHO Expert Committee on Smoking Control Strategies in Developing Coun- tries, whose main findings and recommendations are summarized here. The Expert Committee reviewed not only the harmful health effects of differ- ent types of tobacco use which characterise developing countries (i.e., cigarette smoking, bidis or hooka smoking, tobacco chewing, etc.), but also the adverse effects of tobacco use on the economy of the countries on account of smoking-related diseases and work absenteeism. It advised on the objectives of smoking control programmes, including data collection, educa- tion and information, legislation, smoking cessation, and the role of medical, political, social and religious leaders; the role of WHO, UN Agen- cies and NGOs; research on smoking behaviour; and evaluation of programme efficacy. The Committee provided guidance on how to counteract the tobacco industrx!~S_~ ~rguments, and provided several reco~me.nda.t~o.ns__f~r ac~on~ including collaboration at TCDC level. Tl08350691

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2 AL-AWAD I More than one million people around the world still die prematurely every year because of cigarette smoking. In developed countries, it is generally understood that smoking causes lung cancer, coronary heart disease, chronic bronchitis, and other respiratory disorders, and major campaigns have been launched to reduce the rate of smoking. In developing countries, however, the situation is extremely serious because the public is not aware of the dangers to the same extent, nor are educational, legislative and other measures being taken to combat the smoking epidemic. These were sore of the conclusions reached by the recent WHO Expert Committee on Smoking Control Strategies in Developing Countries. The Committee called for firm steps to be taken now "to prevent the most unnecessary of modern epidemics", failing which the prospects for future generations are bleak. The Expert Committee noted that the tobacco-related diseases are on the rise in developing countries. The rate of lung cancer deaths has been increasing steadily in Hong Kong; rates for women there are now the highest in the world. In China, lung cancer cases doubled from 1963 to 1975 whereas mortality rates for cervical and uterine cancer decreased two fold in the same period. Other interesting points emerge from recent studies made in developing coun- tries. In India, it has been shown that filter and non-f~ILe~ cigarettes have identical tar and nicotine yield. Smoking filter-tips does not, there- fore, reduce the danger to Indian smokers. Many developing countries have cigarettes on sale with high yields of tar and nicotine. Compare a tar yield of 21-23 mg in India, China, and the Philippines with that of 0.5-20 mg in most industrial countries. Tobacco cultivation has spread to about 120 countries (63% of world produc- tion now comes from developing countries compared to 58% in 1972 and only 50% in 1962), thus becoming a substantial source of employment and creating new vested interests in the status quo. Overall, however, the costs demon- strably outweigh the "benefits". For example, tobacco taxes are "politically comfortable", that is, easy to administer and generally acceptable to smokers, thus commending themselves to many governments in developing countries. However, these taxes do not contribute to national wealth but merely redistribute wealth that is produced. They cannot, in any case, offset the economic losses caused by tobacco: health service expenditure on smoking-related diseases, disablement and work absenteeism, domestic and forest fires, use of scarce fuel to cure tobacco, and reduced food production. Indeed, while tobacco production has been growing in the developing world, per capita food consumption in many of these countries has remained stagnant or even declined. And, of course, malnourished people are particularly i11 equipped to withstand respiratory and other smoking-related diseases. Smokers have higher annual rates of medical care utilisation than non- smokers. In Canada, for instance, health care costs and losses in produc- tivity due to smoking together are estimated to account for at least "The Committee carefully examined the case sometimes presented to support tobacco cultivation and production and also evidence presented by FA0 on the T108350692

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.~ry ly en r, le .1 O g role and scale of tobacco production ~,-~rldwide. It concluded that while action is justified primarily on health grounds,~ even economic arguments ulti~tely militate against tobacco production and cannot logically- and should not - be used to oppose implementation of s~oking control progr an-~es. The Committee expressed particular concern at reports that imported ciga- rettes sold and promoted in developing countries had been shown to yield much higher levels of tar and nicotine than similar brands (and even brands of the same name) sold in developed countries, including the countries of origin. Most of the work undertaken so far on emission products has been carried out with western-style cigarettes. There is, however, disturbing evidence that developing countries have been subjected to tobacco products with even greater toxicity than those available in the developed world. Recent evidence indicates also that some traditional forms of smoking, such as the bidi, are no less harmful. The Committee noted that cigarettes with high nicotine (and tar) yields may be more addictive than other brands; the promotion of such brands in developing countries is to be deplored, and governments should be alerted to the dangers they face in this area. Governments of developing countries are urged to take the necessary politic- al, social, and educational measures without delay. Systematic and contin- uous action, through a central agency or similar body, is necessary if long-term results are to be expected. Action against smoking can be inexpensive, yet effective, the experts point- ed out. Health warnings should be placed on cigarette packets. In fact the double standards by which cigarettes of the same brand carrying health warnings in developed countries are sold without these warnings and with much higher tar content in developing countries, should and can be ended by appropriate national legislation. In the short term, taxation of cigarettes can slow down consumption. Where no tobacco industry exists, developlng countries should be encouraged to maintain the status quo. Where such an industry does exist, efforts should be made to reduce its role in the national economy and to explore alternative uses for land and labour. The Committee recommended unequivocally that all tobacco advertising and sales promotion be prohibited. In the special case of most developing coun- tries, where literacy is low, the impact of misleading messages associating tobacco with health and educational, financial and personal success is far greater than elsewhere. A ban on advertising, particularly when associated with sporting events, would show the government's determination to act and publicise the dangers of smoking. This action may be strenuously opposed by the tobacco industry - although if, as industry claims, advertising does not induce people to take up smoking, there should be little reason to object to a ban. Legislation should not, however, be taken on its o~ but must be linked to public information and education program_ues. The r~ss media have a crucial role to play in making the public aware of the dangers of smoking and TI0~o5_o9~

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