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PH I L I P MORR Ii S I INCORPORATEO INTER-OFFI CE CO:RRESPONDENCE RI'~.CHMOND, VIRGINIA To: ,Dr. H. Wakeham Date: December 2, 1965 fRom: R. D. Carpenter subject: AMA Education and Research Foundation Fund - Tobacco and Health Committee The American Medical Association in late 1963 voted to establish a committee to administer grants for the study of smoking and health. An initial appropriation of $500,000 was made by AMA to fund these grants. Early in 1964 the tobacco industry pledged $10,000,000 support of a five-year program to be administered by the Smoking and Health Committee. Four sets of grants have been issued since that time. These grants total approximately $1,500,000 for the first year's committment. The overall anticipated expenditure of-these_first year grants is $3,600,000, because it is anticipated that the committee will allot funds to complete those'grants. The total number of grants issued to date is 43. The four sets of grants are shown in Appendix 1 as they appeared in the Journal of the American Medical Association.- Several interesting observations can be made from the study of these projects. A rough classification of emphasis results in the following breakdown of effort: Table 1 Classification Nicotine Cardiovascular system Respiratory system Carcinogenesis ~Psychology Nervous system Other - Amount Percentage $422,000 21 445,000 22 649,000 32 369000 2 142000 1 76,000 4 359,000 17 The total amounts presented exceed the total of the grants allowed because some grants include emphasis in several areas. The percentage effort here is only approximate, but it does allow one to compare the interest shown by the committee in various areas of disease. The emphasis on nicotine might seem to be out of proportion systems is also a major part of many proposals. The large Careful, study of the proposals indicates that new methodology will be employed, especially in the problems of determining blood flow. The distribution of nicotine to the various body because so much work has been done on nicotine in the past.

-2- to the five universities with which~the committee members are directly associated. percentages of effort in the cardiovascular and respiratory systems indicate the importance of those two disease areas. Very little is actually known about the effect of cigarette smoke on these systems at this time,and the committee obviously feels that these are the two major systems about which more knowledge is needed. It is interes ting tha t_only 2% of the effort has been allotted~to carcinogenesis, and this single project involves research for agents which will stimulate immunological responses in the host. Approx imately one-half of the grant money has been allotted to research organizations not connected with a medical school_-: or university. .given to investigators in Europe, and only three have been given Indiana Hickam 181,000- Medical College of Virginia Larson 91,000 University of Texas Southwest __ Medical School LeMaistre 283,000 Wayne State Bing 47,000 It was also of interest that most of the remaining grants have been given to midwestern schools. Three grants have been University Representative Amount Michigan Seevers $155,000 Table 2 Grants to Five Universities Committee Reports should begin to appear in the literature from some of these grants since some studies were of short duration and were begun in May, 1964. The research report published in when it considers the effect of cigarette smoke on respiratory and card•iovascular diseases. They apparently feel that suff icient reflect the loss at which the medical profession finds itself I believe the AMA program is well designed, but it does human studies with the remaining grants being done on animals or in two or three instances, cellular systems. Todays Health during July, September, and November, 1965, is the f irst information I have seen on the results of any of these grants. While this report is extremely interesting and revealing, it gives the appearance of undue emphasis on studies involving nicotine. Approximately one-half the grants are for

t•. .; f -* 4 y -3- effort is being expended on carcinogenesis by other agencies and have thus de-emphasized' that problem. I will keep abreast of future developments_in the AMA program and will update this report periodically. /h jI cc: Dr. Mr. Dr. Mr. R. H. T. F. B. Seligman B. Merritt S. Osdene E. Resnik Mr. Mr. Dr. Dr. Dr. Dr. Mr. Dr. J. R. P. C. W. A. J. M~. Staley N. Thomson Luchsinger V. Mace L. Dunn Manzelli Y. Mason, Jr. S. Comer