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P . •~~p.~~.~,-.. . HILL AND KNOWLTON, INC. Confidential for Members INFORMIATIONAL MEMORANDU~'i, Re: Phblic Meeting on Smoking and Health at Stamford, Connecticut As has been noted previously, there has been an increase in the nunber of local or regional anti-smoking meetings jointly sponsored by units of some of the national volunteer health agencies. Although the meetings differ some from community to community, the general pattern is quite similar. For this reason, you will be interestediin a first-handlreport on a meeting for adults and school children held on the afternoonlof October 30 in Stam- .ford, Connecticut. The report, made by a staff member informed on the tobacco-health issue, follows : the Stamford-Darien-New CanaaniHeart Association, Inc., and the Connecticut . A"Ftegional Conference on Smoking and Health" was held at Stamford, Connecticut, onlOctober 30, 1962, under the sponsorship of the Tuberculosis Association of Derien, New Canaan and Stamford, Inc., The Norwalk ArealTuberculosis and Health Association, the Greenwich Christmas Seal P"innd, and the Connecticut Thberculosis and Health Assocfiation,, with the cooperation of the American Cancer Society, Stamford and Norwalk Branches, Norwalk Area Heart Association, Thoracic Society. Doctors and Educators...presenting the late t facts on: 1. How smoking affects the human body 2. Why people developithe smoking habit 3. How, "Critical for Teen-agers" and "Vital to Adults." It continues: "Noted An advance poster says in large type: "Major Health Decision" followed by beginiuntil 1:40 p.m. and ended shortly after 4 p.m., withinot more than 60 Scheduled to be held from 1 p6ar. to 5 p.m., the Conference actually did not and a uniformed patrolman. and a photographer, tWo elderly physicians, a few teachers, alpolice lieutenant. 20 identified NTA, ACS and like workers, a few housewives, five reporters , One woman with five children stayed throughout. In the audience were 15 to group. The last, a handful ofboys, disappeared ebout 3 p.m: group had! a"turn-over" at 2 p6m. and only about 40 repl'aced' the initial . adults and fewer than 80 students present at any given time: the student straightforward. report, saying "about 60 persons attended. There were few stories about the meeting, The Stamford Advocate carried a there was an obvious lack of school arrangements for student body partici- pation. The meeting was in the beautiful auditorium of the new Rippowam ~ ,A steady rain may have had something to do with the poor attendance, but CfI' High School, which could have accomodated 750 people. , . . . _ .

Pamphlets and reprints stacked on a desk outside the auditorium included: An American Cancer Society list of films, publications, reprints on the subjiect of cigarettes and health -- available without charge -- "phone your ACS." "Teen-agers and cigarets" from the Kiplinger Magazine, March 1962. "Modifying Smoking,Hebits in High School Students"'by Dr. Daniel Horn, from Childreny March-April 1960. "Cigarettes: Are the Facts Being Filtered?"'from Redbook, June 196o• "'Summary of' Proceedinge, Conference on Smoking, and' Health," , October 19, 1961, Connecticut Tuberculosis and Health Association and Connecticut Thoracic Society. "`• •.and' keep~ everyone safe"' Christmas Seal leaflet from local Tuberculosis Association. . . •:+. .. at•rY7~ _ . ~... , . . . , - . .. . .. .. . . , ~ - .. .. , . . , . , .~ .. .. , ,.. .... ~.. There were sanded cigarette receptacles in the hallway, but smoking was forbidden there, at least for the day. Plarticipants in the two parts of the meeting did not mingle. Part I con- cerned'pathology, with Dr. N. D. D'Esopo (West Haven, Cbnn., Veterans Hospital)'and Dr. Oscar Auerbach~(East Orange, N.J., Veterans Hospital) the speakers. Dr. F. R. Coughlin, Stamford surgeon who~trained at the Overholt Clinic and holds "25 diplomas and 10 degrees"' was moderator. He presentedithe two speakers and transmitted the questions, with a few 3 Part II'concerned psychology and education, with Mr. E. G. Van Bibber, director of physical education at the University of Connecticut and personal comments. Dr. F. L. Rowl'ey, Stamford psychiatrist, the speakers. Dr. J. F. Rogers, Stamfard surgeon and former local ACS'president, was the "moderator.".- Mr. J. A. Swoml'ey, M.H.A., presented a"summation." a. ` Part I. Pathology D''Esopo, member of the American Thoracic Society committee on smoking,and ~ active at many National Tuberculosis Association meetings during the past ~ year, declared chronic bronchitis is due to some irritating factor in the atmosphere, aud!princ3ipally to cigarette smoke.. He said emphysema is a complicationlof chronic bronchitis -- and that it is best so toiregard i't although it does occur without bronchitis. Without citing authorities and with use of slides borrowed from Auerbach, he asserted that chronic bronchitis" increases the number and size of mucous cells, the rate of mucous flow, and.:, ;C. eventually results in precancerous cell formation in the lungs. In emphysema ;` the small air cells are broken down and are destroyed., preventing,air exchange:' in the lungs and causing shortness of breath. ~ ~ n In addition toltwo Auerbach lung slides he showed two statistical charts, ~..f; one from an.unidentified British source,, the other alleged to be a U.S.._ Public Health Service product, which he said showed higher bronchitis : ~ mortality with tY e rate of cigarette smoking, but.-the numbers and their.-- ''meaning were not.yexplained, _ and_ im a,s1ip of;,the tongue he said these three ;tl t ..r Y . . . • . . . ~ ~ . .'.`.++ F i ,r. P .~, .; r. .1 n S;.'.1rt. l.

; studies prove smoking causes lung cancer, He finally showed an artist's strip starting with five smoking high school boys, continuingwith the one out of five" who gets chronic bronchitis subject to frequent in- fections and finally complete disability. the majority of patients do," he concluded. "Cigarette smoking,is not the only way people get'chronic bronchitis but tearing of the lungs" used instead'of "chronic bronchitis," and the term, Auerbach opened by saying he wantedithe terms "scarring of the lungs" and "lung cripples" instead of "'respiratory cripples" used, for_purposes of greater clarity. ,. -. . _ _ _ -, . _' , _ .. , slides as well as the statistical charts. He showed alfine indifference smoking continues and increases. He included carcinomalin situ in the which purport to show the increasing disorganization of lung tissues as He then ran through the slides frequently usediat other meetings, all of years, representing 208 taken from each tracheobronchial tree studied... for facts by stating that he had.examined 100,000 lung seetions in eight -- (which he stopped doing several years ago, cutting back to 55 at (while actually only two, three or four specimens were taken.from anx_ of alveolar septa and!arteriole changes were part of'this series --.~_• Hammond's suggestion) -- and allowed the implication that the slides: scarring, and in tearing of'the lungs." that "'cigarette smoking is the most important factor in lung cancer, in effects of "scarring and tearing from c3garette smoking" and concluded one lufsg,studied).' He'repeatedly'described'each slide as showing the the floor): Random quotations from answers to questions (handed up~ =cards, none from D'Esopo: "You won't get lung cancer from people smoking around you. , Auerbach: "Stopping smoking improves your lung condition." , ,. a;W D'Esopo: "I won't comment on what to do about ci arette advertising. g ng• It weakens the doctor's position to talk about ads." i R-Auerbach:' "I've never seena man who died'of'lung cancer who wasn't a smoker: If you don't smoke, you don't get lung caacer."'.,_ :,.... , .: s D'Ei3opo: "'I have no special data on filters. Noneremove all, particles; if they did, there would be only.hot air.: Filters I are probably useless." t e G _ 5 tyJl h4 b , ~ .. Auerbach: "You get filteredicaneer from filtered cigarettes"(whi'ch brought claps from six high school boys in last row) , ~l.k= '' .:,`,}.. • I;;; .. J~. -. : .. .,•. ... ,. . , -, .:-.- ., . . A D'Esopo: "Most doctors noa longer smoke. -There is a small group of_ :.) M.D6,.'s who are not convinced smoking causes lung cancer." c` ... Both ; 8Peakers conferred on question . of - smoking related tm P rematu , a a~tY ,LI , , .`__~..,~ •, .__y_ V nd Auerbach said.there isno adeqt:ate data on that. _ • G- 7,V .' '~! . _ .; .. . .ii:' .t',' .. . . . .. ... .< . . . .. .. : ,. 'ti .. . } y z

Auerbach quoted Hammond and Horn as to pipes and!cigars not being harmful, saidichewing tobacco causes buccal cancer, said womenistarted smoking later than men, inhale less, still smoke less. D'Esopo quoted Hammond and Horn on smoking association with heart disease, and also said diseases caused by smoking are affecting men at ever younger ages, not only heart but lung,cancer: he has two cases under 35 right now. Part II. Psychological and Educational Aspects - -- - . . ~ - ~ incontrovertible data ") he said ''all physicians are not_intelligent; some refuse to accept the they accept but disregard', and quoted a line from the movie which says,. "This cigarette will only give you cancer." (Later, in closing remarks,. Rogers bewai'led the public''s apathy on the lung cancer-smoking data, which ,_.. . ...: _ _ :., . . . , .,,_ .. : :; By this time,, virtually no high school students were present.:=~ for abolishing cigarette advert3:s3ng aimed at the young, and' the _"after 91' rule onitelevision. He held upia full-page Camel ad showing five Yankee stars after the recent World Series as an instance of how the U.S. industry tries tn woo thel youing. -"ACS and NTA can't afP©rd-such ads;" he shouted., . He believes emulation is the main factor in starting to smoke, and that you have to reach dbwn to the 4th and!5th grades to educate the young not to smoke. He praised the Air Fbrce ruling on cigarettes and said the Navy Van Bibber, a U.S. Olympic Committee member in 1951;- praised'the British was following and he hoped the Army would too. He quoted Section 10.19 of the Connecticut Statutes as providing that the boys" talk, andia disclaimer as tol"prohibition, which doesn"t work.". action_in this area. There was a good deal more of "the coach andithe-_: under discussion i'n Connecticut ought to take into account the schools' in the law." He also said that the questionlof school accreditation now, schools above the third grade" and said, "'TYiis dbesni't cover smoking, but is smoking habit Porming,, a drug? I should like to have tobacco included "evil effects oP'narcotics andialcohol on health shall be taught in the ' wishifor self-destruction" (inithe question-a:nd-answer period; he.regretted smoking into conscious and unconscious ones, among the latter citing "a usual reasons made familiar by like works. He divided the reasons for paper on why people smoke, and why they cannot or do not stop, c3,ting the Rowleyapparentlyr 'laboreid 'long`-arid earnestly to -prepare -a-comprehensive'~ having gone out on a limb as to that statement). education and persuasion were-the only roads to Pollow.; "The-only way:' He pointed to parent opposition as often boomeranging, and felt that romance was among the subtle but powerful reasons for starting to smoke.. He believed advertising identifying smoking with heroes, happiness, and_- to give up smoking is never t4)lstart,"' he said. s . _ , . - . . @' ~ . .. . ~.. . .

5 Impressions Although it was declared that this Conference was planned at a series of "stimulating" inter-gx'oup meeti'ngs, one can be surprised at the lack of attendance, and one can wonder if the speakers were not discouraged at the apparent slight interest shown. Auerbach certainly did not cover all the ground' he came prepared' to talk about, yet there was plenty of' time allotted. He and D'Esopo were very late i'n arriving, but so were the initiall group of high school children whose buses took them away at 2 p.m. Something must have gone wrong somewhere. There were no suggestions of direct fund raising,"possibly because "rival"' societies were associated in this affair, but it was clearly a Tuberculosis Christmas Seal enterprise. This was shown by the posters and prograais, wh3ich carried'the Lorraine Cross and not the ACS insignia, and by the anti-smoki'ng-statement by the National Tuberculosis Association of February 27, 1960, printed omthe back page of the program. This apathy is not necessarily helpful, however. 3:'here were no challenges or critical questions -- nothing to prevent the organizers from presenting this Conference as "unanimous and successful." There were certainly no indications that the Stamford or neighboring school systems are preparedd to question anti-smoking campaigns, w'hich appears to be the ma~or goal of'- coiaferen~ce~s. „ this and' previous similar Hi'11 and Knowlton, Inc. Pub]1ic Relations Counsel 150 East Forty-second Street New York 17, N.Y. .4 .,~I:.4 ~. . . . . cc : ' Members Public Relations Reprc-sentatives- 7yegal Representatives r ... . . .... „-., .. '. ":) .,~~._ -. .. . . t.,.. . . '~ t.,~ ~. ~. . ~ ~ . ~ ~ ~ .. " ~ . . ~ . ~ ~... .. . . ,.. .,. . .. _ .... . ..~.;~ ~ ...~. .' :. ..,. ... s- ~ _....... ~ . _, ..., . .,..;,,~,.t i 4 t r