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Of An Attack On Advertising That Failed I dr'" J

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F F C0NT] ;N-DS Paae AA editorial November 10, 1969, says American Cancer Society . =-- - . The American Cancer Society's Anti-Smoking Advertising: A Question of Credibility" :anti-smoking commercials are "untruthful." d I- L. I- .Tobacco 2nstitute-advertises the editorial text. , • - -= , - ~ , __ ~ . . ~ William B. Lewis, ACS board chairman, insists the spots are" not untruthful, calls AA editorial "bitter, unjust." . II.. The Society's "Smoking-Dog" Experiment: A Further 4. 9. ACS holds a news Announces probable Lon ot c,reciiuzlity conference February 5, 1970,,' at the Waldorf: 12 cases of lung cancer in 84 sntio7~ing dogs, with "reassessment of advertising. claims andpolicies of the cigarette industry." Front page publicity begins to make the "12" dogsl famous. us y. e a n 11. The first :zint of trouble: An Amhcrst biologist writes to the N6~,,7:York Times February 9 to say the announcement "cannot serio ke l ° - b t 12. . Joseph F. Cullman-, 3rd, TI executive committee chairman, writes Lewis February 27, 1970, as}:ing for experimental data to be evaluated by independent ex.perts at TI expense. 13. Lewis writes Cullman tlarch 12,-1970;, saying research will be published "in the very near future"and denying data request:. visibility to 12-dogs-g.ot-cancer claim,, suggests readers urge- • Reader's Di.qest; in April 1970 issue, provides greatly expanded U v intervention in czgarette a vertsing. f

- Culiman writes Lewis Mai -'-: -?''?, 1970, repeating, TI's data request. F " former president of Americ;=.^ College of Pathologists Congressional Record March 26, 1970, carries letter from questioning ACS' announ~R-._-.-:,-,_esults. Lewis writes Cullman Ap'i-i;L 17, 1970, saying ACS ,-TI "or any other group ":.xamine data. _Tony Curti:;, chief spokesman in ACS "I Quit" anti-cigarette I I U I L L ~. . a x . L ' ' . . r r ' ~ }~ ~ ~ ~ x r '` ~ -~ ~ ^~ ' n,',r -~.t a. ~ -- 3-' i ' 7!~ _,~ _ ? `K~rt ..<.'C:~ '._. . :'%c a t.: ~ # .~ ~.,~ ,.Y ~'-. ~ y ~ z ~ ~ r~ ~~ Y - ~' :~ ~ ~~ ' *:, r ~r '/ '~ ~, < ~. i, ~ ', , ~:Y ,~ l -}'~s~.:,;~r advertisinq, - is charged :"and on April 27, 1970, pleads -guilty to possession of pot. 20. Cullman writes Lewis April 29, 1970, saying ACS "exploitation of this unpublished'work for publicity purposes is truly without precedent in the scientific community." 21. Cullman holds news conference April 30, 1970, at Overseas Press L!ub- Discloses racts or rl-f,~5 aispute. 37. ACS issues news release April 30, 1970, disclosing a change in-position: It will make the data available to the U. S. Surgeon General for analysis. 39. TI publishes Cullman-Lewis correspondence in newspaper and medical journal ad's ;jeginning May 1, 1970. 42. New York Times editorial May 9, 19i0, says ACS made "an error of judgment.," 43. Lewis responds to TI ads with letters to editors of papers which ran them, beginning May 13, 1970. 44. Medical World News reports Nay 22, .1970, that the prestigious New England Journal of Medicine refused to publish the dog manuscripts. 45. Tobacco Reporter report-s-i:n,its May 1970 issue that Journal raised "questions" abo.;;':. evidence of cancer in the smoking dogs. of the American Medicai Af:sociation manuscript reviewers have_

I I I I I I I 46. U. S..Surgeon General writes ACS June 12, 1970, saying he doesn't have to review the experimcntal data--he's satisfied it's reliable. Text of letter is released to press by ACS. 49. TI, rebuffed by major, nationally-circulated medical periodicals (American Medical News, JAMA, Medical Tribune, Medical Economics) sends copies of Cullman-Lewis correspondence to all U1. S. in effort to place May 1 ad(',Net•r England Journal did accept it), physicians by direct mail June 16., 1970. 59. 'Culiman write's AMA president June 22, 1970 asking disclosur--~! , of resultE of JAMA review of manuscripts. Cullman also writes Lewis renewing data review request, saying it's "li}.ely that none of the dogs developed lung cancer." 64. AMA holds June 23, 1970, news conference for manuscript authors; networks ask TI spokesmen for filmed comment after authors make statements (now claiming only two cancerous dogs)- but AMA asks TI spokesmen to leave press room. 82. ACS' Cancer News magazine under "spring-summer 1970" dateline says 1Qof the smoking dogs got lung,cancer. 85. Manuscript authors report "findings" to scientific session at AP7A annual convention Junc 24, 1970. 144. Chicago Today editorial June 26, 1970, says Larring TI 0 spokesmen from AMA press room is no way to get at the facts. O 145. Eye, Ear, Nose and Throat Monthly in June 1970 issue editorially questions ACS position. 147. Lewis writes Cullman July 2', 1970, insisting experiment is "accepted by distinguished pathologists." 150. Wall Street Journal reports July 8, 1970, that JILT,,A has found manuscripts unsuitable for publicat.ion and returned them:to authors. 151. Ti president, Horace Kornegay, delivers speech-July 8, 1970, - .calling ACS' report a "hoax."

F Page IV 1520 United States Tobacco Journal confirms July 9, 1970, the Wall Street Journal report of the manuscript rejection. 153. United States Tobacco Journal reports July 16, 1970, reduction~in ACS claim from 12 cancerous dogs to 2. 157. American Medical News July 20, 1970, quotes JAMA editor I I I I I I L to "return," rather than "rejection." reason for special expert review of manuscripts leading saying "enormous" ACS publicity on smoking-dogs was 158. New England Journal of Medicine, in July 23, 1970, editorial, defends right of TI to advertise smoking,health information. 159. Health Bulletin July 25, 1970, reports manuscripts won't - be resubmitted to JAMA. 160. Congressional Record Aug~ust 14, 1970, carries M.D.- Congressman's strong letter of disapproval to U. S. Surgeon General on the off-handed way he prejudged the smoking-dog results. 162. Widely syndicated columnist, James J. Kilpatrick has pub- lished in the Washington EveninqStar, September 15, 1970, raises the question: "What Became of the 'Landtnark' O Cancer Study?" O 163. Winston-Salem Journal, September 16, 1970, reports that Archives of Environmental Health, an AMA publication will publish the dog-study, "possibly in December." 164. Roche Medical Image and Commentary, September, 1970:, issue reports on Auerbach-Hammond dog-study. 4~1 169. TI President Kornegay writes a letter to Congress, October 9, 1970, calling the dog-study "one of the great scientific hoaxes of our time," attached is Hon. Tim Lee Carter's letter"to the Surgeon General as reprinted in the Congressional Record. :<=-=174. -Louisville Courier-Journal and the Chicaao Trzbune_ nctnber g y • ongress and quote an :.~ -13 report on the Korne a letter to C }~"~ °"~' AMA spokesman who said JAMA had not rejected the study,-but' returned it to the authors with suggestions for"'revisions. ,,~ fi

IT F V Page 176. Raleigh, N.C. News and Observer editorial states that -"Cancer Society Was Wrong," October 21, 1970. I I I I I I L 177. SUMMARY i

ADU];I:T:_SING AGE -. November 10, t969 P. 14 [{ (~ t~5 t4 ~~ ,^ 'a 1 rw. 11 5~ 'A II I~`w~ t4L~14.a' This is not an attempted dcfense of cigarets or cig; ret sdvertising. It is a simple affirmation of the belief tlic,6 the rules of fairness, accuracy and truth in aclverti.im, silouk? to Of cludinsf the A ii e ic: ±r, C:ra4cr S,,cie_v and the American lieart :1sm. ~. ~:-.,:•. ~ .~, ~ . CCn~mcrcials c<<r:en;lv app<<<i-ino on the air on bchalf of' t:ncse o:•- ganizatious-and1 the',- are Very commercials, as we have te_tifiec3 Lrqucntl_y-mokc un!rn'.?if il andl misleadin, statc•!ncnts r;hich no eon-j- ..,~s.T,. merciirl advcrliScr coralci hope to t;e2 away v: ith. 7 hev SCOUIp no swpjwu. These cornmerc;t,ls say, without any qn; li';icztion, that ciearet smol.- ing, omthe avera.m reduces a s:nol;er's life by 8.3 years„anci that every cigaret you smokc take5 a minute of your life. Tl:~sc are wild, umup- portcd~ allegations. They should not be permitted on the air. The theory that "anything is all rinlit if the right people do it" holds no water at all. llll' advertisinF; ~:lioralci be tnutllful, in ftrct ; nd iro im- plication. This par:jcrrlhr staternent is 11,eith.er. It s:YOUltI not be per- mitted.

E~ ~. I Z yr ~i ,~ t' } ~~ ~ • F... ~' 4:: 4.~ t•. .,[. ~-: :~ ~-,~ • . ~ r l ;L:r r' s L- ~• nted deiense of cigap'lS ~on Of the belief that the i a~v 0~scrsiicii, This-is not ~n.att I~~l it is a sirnple at'firirat~ nl,r•, to, al a ociet5~ and the hmericarl ljeart pssn. ccurac}' and truth in advertising should t 2 or- ~ tl~ e Amcric., ~.n canccr S alr on l~c~lti~,lf of the, t:esti;ied a ~carin~ on clud'in" " ~~~ehav have ntl~,Pi ~,s 1s ~ f!}~ ilsr!'`1~17''~ 4!~~ 1 l. <S'' i.5 W isS i.r• [v: a..: b ~- ' i par lc~ ion. lnis ip a ~ no ~~jztpr at all. neitl er. . cular statcnient is t ~ ~ , '~he theor5' that: slzovlcl l~e trt~. dvertisingTt should not Ue p°r- i . ~ P j~ ~ St0 1 a u ~w~ s':ou,,C; ,er~ e~ t t and th2 Tl'10'Sr' ~'~ Tld, L1nSUU- reCitlces - {:~ l~iOSE a1'E oi ~'o'lr ]_... he aV erat>c1 _ lir. ing, on .-_ rni7u e ~ I Gt You STTIOtie lc.i.C, ~ a not ; i 1'1 ~.tE'C~ h0]dS cig^ ' shoulo lao~ ~ n- do ~o it t-ons. T.ze}' if'_ t]Zr: tje.-7 , ~ ~-t r, fart anc~l in im- ported ~.lleb<^. ' ,~ 'tlsilic is all ri ~, shl in ia 1l cc: rner¢iaT ~_c!r,Terti~, _ ~r ;,rolt- , Ci~c r l . tln;3 that + ' l ' ' curre Coininercials cotl~rrlel c1~ , ~1,ich no corn- ai1e rery • ~ood aiid they ,- ~statel z,~t5 ~~ ganizutio. .~s-~ Y11J1~ ~~:na ~ imal~c untrutlfuL and i` frequer.U ti'- d Lo~e to ~ ~t av. a~' mitti.e>d . ot C-4 dciC7l.',•~~,t:i?'Ui S1110kII1 ~.:.~..... r ~3='r ~"" ern'~R ~ ez~~ . w.;~ DC -M t • ~ ~ ~1':(: r1~:i:iOlY~zl 11f ~:,S~?iof r .4~C ~ .. 1li Tt cc,nstt nt c1i«n]p?.on of t:rut-111 in aci~'Gz•i,i~in~

hdvc]'tiising Age f ^_ l l ~ t I ~ ~ I L I I L D~,c. 8, 1^.69 t et,;_ /1 T - 1 c l~ 1- ~ The A'a1~~iee of 6..:10 1~_c_T,~i: :.- . T111S (7El'AI@If.rRY 1S41Cf"AIxf:'S r01,0,4, LC13C95 M'C YfEI.CO7.tE flboiit Afi''f:onesty in Anti-Smoking Ads' I:clitorial' To the I:dilor: An ccfil riid ill the Nov. 10 issue mal:os lie ex- -tt"aot'dinary charFO that Utc :lmeri- can Cancer Socirtl^ and tliev\nn•ni- can, lloart Assn: are includin ; statelncutsin their anli-cil!aret comnurcials"u'ittwut'an' v citwli- ficalion" that arc "•lt-ild and un- supporlcd" and "tmtiatlllful and misleading." You then defend tnathinad- vorUsinr: And there we afircc. .Aut'>:rcrnSlNc Aes has r-ported' - the cigarc•ti controversy with acw- mirable calm and fairnc:::, has explainadour t'ie):IloinO often and j}utl. \I are A rcvl It tliisbittnr, mittoe tchich joit:tll•rrcognizcd the validit.of his method. \'s'hat Dr: ISamn:nccl didwas to apP1X acinariaI tccliniqncs, bas;d on447,0J"J men follourd for sl~\ yc:rs, of n'hom 3407E ciic•rl b~-11': oce *i:lY 1, MIG0 and Jur.c 30i, . 19n5 toda:..:..,,,... ;:... r.: cigarct srn~king;Ile foamdi Riala man of 25 who wasa]icm, smob:cr (Qtcooc' moxc pack:l,rsc•fcigarcts a dap) had 3.3 tcicl•r yc:asof life cxFti•ctanc}' thanlhosc who h.^.dncvcr sruokcd. . Of non-smokers; 7 i,7 ;, may be cx)xclcd to li(-c to 65 )c:irs, but on]l 51^,,. of ntcn tliio sn,okc 40 ,or mo,c cir:arcts a da' may be calx•clr 1to livc to{hot ase- 7n apa)rn in ilie Jounm! (f the n'trtlono( CancerlnslillttcD . ]IannnondAnclioatc•sthat the l,ro- ccdures follGl\cYl in this stucl+: i114:llt tvell' ^biasutv esain,rllosiil (hodircction of tuldt•.rt,hmahr,;• the diffcrencc in lifocxpeclancc lic(n'ec)) cietuct smuldc•rs and non, .cmul:cr.• ^ ThefilUrreofthclossof! a min- ttte of life for a rninute Of snlol;- in)'t•rasdct•old;feil by our epicir- miarlol;ical ctcl,ullmenl. fror.t 111eR.3?olrfl luo: IGc.-l:c•1 clrcswvk r no,;o nli.utIlvro-qtu:n'- Icls of :, mllliuu u^•;,1 ~•Is:din oo;: hts lifrliinc. As atr..ull hc lo°,s.liunp 4i4(l0,W1(1 r111111I1Ls If..i 1l 1":) of hft•. ru:n;,.vr r'I' l,itlr uou s nohrls:.. 'fhi+ . malcd:: to' aloc>: uf :,t:noel sixnli~lnltic I,crcif:crrrl stnol:cd__ :I luinu;c. of lifbfur a toinutc of sn,p4:in ;. . Tiro two ctatclncnls to whii 1: you rcfcrtt,ithoul incll~;,t:n~ lfritthcyrcpovt zixcificall)' on hcr,r.q cioarct srnoL-ers crctn', inU':o cur- 1'outlN•. u•idclr=u:cd ~;e,fs. lt't.c,l' "llbuvr ci(;,uet s:nrd<crs, outlleavctaKC,losenliout(.nc tninutc of life for overY minutc•lilqlsmoi:c.., and I ill atlcl:hc•:; "T:1C hcavycir.arct su'ralcor culs 313 yCarS Olli of l:ls ]lfl•:" The statcntcnt onS.3ycarslo;t o)tthenccrarcily lic:a~~v :nw6crs cainc frorn lnc P:CS C:ulcvr fh'r•- t'cnliot. Study, a 1nFaz!)c. rescarr'1 prujccb lastin; rn;ray)c:ns:'rl partict,:ar selurc:mlu,r l~ as c'•c- lit•eced att!tc 1`67 ti'c.ld C:onfcn- l'ztc3c 50 (•ncc on Smr,:anql, a 11c.1IUi, a'hu~c pru,!ralnu conunillce, (icp- lc^cliliirU', snmu Y2 goee[nnicnt, ruLlnGrrp; hc:dlil, ;nd ec(tuation- :l ~roul!s) liad askcd Ctp'Icr Ilnnonoud, S:.P:, :1CS\!R, Frp'dc- ndolorv anct Statistics, to sturt- laarizc the cnstcofcigarcP sntok- IJr.Ilammol:&ac•txcYion condi- tiow that a conrmitlcc of dltliil+ f.oi~!,cd cGidcroiolol;isls from nu,nvcnuu:Uicsbe anpoiutcdlo rcl'icll• and ci,nsidcr this p:-ololom triJx liiin: The rc, rc<enli+tivo= oftfieram.rnillccmet i':i;h Dl'.Havn-mond abraadi ancev . lhen for two iTrn'sbeforc the confcrc•nee. \CLilo theICsc:ux'hontcnich the 3.3 fi,^,- urcisbasedv:.^.s condtucti•d by Dr. II:,ri:nonci and his staff, his fhtd- ing llclc app.ct-c•d by the co:n- Dr• Ifammnnci'sc-,nmr pocl cn- tion stuth.'hns& c•n roc'A~,n.zc.d art,ul,cl the vrortdl as :1 brilli;,n; cotaribaait:rn lh Iic•:,I111 Confcrincerclic.t"cf he coa:!±incd lcisdom of a connnil:rr incitt(!iug: J 1- ncs c.1F - n U. . :. n' c- 1I).ni~hC. 1,-. tC r•cnl n11:, r~. C Ib. , , l; l. MI' 11.• ",t,-col ,:,d )I-ln; Yre•;:r:en,. I1„t;,rt,i,enl n. n:.l'.Ilr.l:hnrr lrrrcrr. on:.,•:,,: e,.n,,:: CI . Iis r.r 1 , C 111:_ ,ltn.. Y316.,grenru,IC 'MI,cal s r-IJ . ll',lti.,,n ~ .il. +.~-<\+..A.• C4irr,.lli- ni, O.,:ncrr lnU- Iwh 7 1 ar.i n n v)s . cLi,[ tlm- l c. U .rom. ~1 nall Canre, tt•. Sc-. nnlr.,na. A11]. nSa. n^.r:.rt: mcntlnQh,.ad 11-1il.,: AI.•dre:,l .`~clV. I1 .,!, . S. I:nLr~:. IiLU.. ~nB Il.. Jolronnos. Cu. r0olt':,nr,sit:% ?t.,inr. c.•,n:y:,v x„t„n . ! . n . c>rirc c kprot,n nr ruldi:nr:ltl,. urr'ol:tn. tritOn. cn` JSn. nn; uv,. n c+ 7-ilnn, ~ .r } tl.,lv.u. f>r r. O,li, .Ir•rr)~ Ct.,•.>c,.~~l:l,. :,1.7).. ln.tiln:C nf a 1 (l 1 lt' t . .1 , , I t ,ch !•. f . Itn, ti t.' 1 ~ I n.t~ on .r, c 1:, InriUn I, r h t l.r<.n rn rlirb) 1 Vcli~nll 11:.1I:.I.t .1, 19i1t iil!'n^l~n:!! i,c C. 11: \l'nikcr of dula I. nn lh^ir rr.rn llrit;~il:n:,i C':rn',rliar II:-1...~olict zlrc!Irr{.ihrii•. (~ailn:d•snf'.. Ir:s~ c.'Llr. (Inc rt ht.rr';)' <'i,t:rnl v.rr., nln c• P. U:. 11:,1..ni,.rnr.'s: r-linl:,f•.:: Iarr. GI),1171 i,•I I,':1I1 (";:::,. Tlie\t'oad Confcrrr,ee asldett IDl: Nc,m:nond to dcl'c!oaslrc;lic data to cell) iilth.e cciucational pro,^.:am,Ile provided t!tcm-:.r.d tuc•wc:a!cCbe nntluc to oarotih- galion iotilC• lnllllons 10145t:Il sm .S:ihg if •scci id not use t!a•m. Thc l:orld may notyetbc atcLuh:n:'s t';Ila::c u~ith in;tr.n:a- ncoul=rtanmanicatiun;. but the Ar.lcrl n C:,nccr Society Is oalj a tcicl.l n:lc call' al.:c~-' from An- t'cl:11:1,,G :\cC. Ectore t•:ritinf; yoatr oditorual Itr-ichvuvhad, cltccfcd v:itll usor tlic.hcart :rs- socic,llani to dt.o:mine t Iretlrerindcoi'ilclc lc rs suplna t,, cl'i dcu;c foroar, stalcmmnlk crnc` I lcnsl Vou e'illlnin,: lhi; iilfonta- tiarn to 3au-i reac ii< aL'cnti(u. 1l'illt lnt It. l.cttic, Chairntan;].oardofDircclors,.. AIncricauCaucer Snclcty, Now yoL. 11 flic c'onl,acrritds An,i tfltdli- fit•d if,cir stntc/nenr~, on .14r. I-ctr- is htrc (1?rrilr;lcd his, :3:1 tttr:rltl_ )int'c tto r,uc.rrcl ir•ilrr tiriv:, )ffhcl/ f„ICi xnirl; for r•jr;r!c'"l;rti- nhla>r>i,urlr iildicctc,(I,ct rt tnrnl t t who t n 11rr.r rl, r Jrr (luor r. u n t ) wJn.r-.<r c- I.r.rs a d n 7 , ) 1 rJcuc r mi .r c) li)c• c . r l rv . f I r 1 I t : u ~ r Ir i r rn L,ac 1rnncr ~li] r;ol'!d )uri'cuoq.r,t.r,rl irl.Av:hc ~ f.~ ."_.. ©

I F I i . . . . r CJ~1'i\C~I!i ~ SG.,1 C71' ct ~f=l'~'S S~I~~~iC ~[~ f0 -4 Ct;& 219 EAST 42nd STREET (IEIS' YoRY,, N. Y. 10017 (212) t1G7-3700 . efI'1E EFFECTS OF CIGI~i E'CTE StiOhING U?n.y DOGS" I I i I- information and interpretation of the reports by Dr. E. Cuyler Hammond, Vice President, EpidernnioloZy and; Statistical Reseurch, timerican Cancer Society, and Dr. Oscar Auerbach, Senior iiedic23_ - ,Y.n~~estigator, Veterans A~mznistration i'Iospital, ;ast Orange, T,J., and Professor of Pathology, New, York L'lleda.cal! College, at a special scientific meeting held in con,junctio-n with the meeting of. the Americ~n Cancer Society Board of Directois, February 5, 1970; Waldorf Astoria Hotel, New York City. to the same research pi oGram: "Effcdt s at Ca_UUrette S:rrokina Upon Dogs." Dr. HarLmond presented data on the design of the study, mortality and findinus in lung tissue. Dr. Aunrbachpresented findings and d-*--scussed 1,: nc-- tumors and carc:inio:niq s The work was supported by the American Cancer Society and. the Veter«ns Administration. The e-xperirnnnt was carried out at the 1jA I11jospitat in East Crance 5 N. J. Scien.tific Si.,,lif.J_cance of the Study_ 10050916'79 . . . (1) For thc *first time, scieni:ists }.latre produced 1unQ c~--'v.,~..~°t.+"v- ~-•"t.,.-"•+- "~~--`~~.........~,.---•-~..~..--.~-~- . . , . ., ; cancer iri a si~nif~_c~=nt`.ly 1argc e;cperlir.ental animal as a resu of heavy cif;arette 'siinoMng. _'.The. lung cancez' was - -~- . ~~ ~..o.~;y~^'i.rRar~~-.«f~~'~"'.''C~5'. ~•ti'?'.- -s. •- ~ a~ r

, group of pure bred beagJ.•, dogs by haviiig them . . :t cigarettes through tracheostomS_c.s. The r_csult- smoked.the cigarettes, inhaling the smoke and taking the srnol:e into their lungs xn vich the ..humans do when they smoke. (2) ' It demonstrates. for the first* time that cigarettes with . _ , fiIte-r. tips capable of reduci_ng the inhaled tar and nicotine content of the smoke by at least 49% of the tar, and by at least 37% of the nicotine are less harniful t:) smokc (in dogs) than nn- filter cigarettes. - (3) The research demonstrated dramatic differences in the incidence of malignant tumors in the filter s;r~okir:g; and non-- €ilter smoicing dogs, The fiTtcr.s used w e r e cantly reducing levels of tar and nicotine, to reduce other elements, such as gas. smolec non-filter was that the d'ogs "puffa.ng," thereby same way that effeciive in signifi- but were not de sidned higher than am:)no, the control do~s (do ;s wh-5_ch did not. smoke). However, the death rate of those dogs srnoj:ing filter cigarett.es was lo~aer- than those which smoleed the same number of non-f3l_ter cigarettes. l~~lthough Jogs fiJ_ter ci&arctE:es cxper:'1:enced less extensive dam.abe to lung tissue -- in the form of,ernphysenia,

were still a-l.i,ve and smolting filt-er ci~arettcs to the end of the study ;demonst7atcd signif:icant lung damage at auto4psy. According to Dr. 1Iammond, who reported the findings in 1ung tissues, "since the, degx•ee of such dam;xgc progr_esses with- dur2tion of smoking, thL~ euidencc indicates that lung parenchymal (tissue) damage advances less r4pidly with the smohi_n; of filter-ta.p .: . '~~. I I ~ cigarettes than with the smoking of non-filter cigarettes." He referred to this pheromenon as a"d3se-respon~se relationship Production of ',,una Cancer in Dogs 'Turnors classified as 11non•-invasiUes' were fo=d in the filter smoking do~s .. No "invas ive"' tu~~aors were found in ttiese dogs. "Invasive" twnors (cancer.) were fo111id in 12 of the heavy ,.~..~.,.~.........~-~F.,.~~-•-~..~,...~....~:~,.,..4~.-,........,~,..,a~.....-.~.~~ -~,.~~-.~..,~:~,~~.~-...~~,.,a.x..~~.~._.~ s, snnokirg non-f7_I.ter ci<,-;axette:s.-Dr. Eiuerbach stated ' smoj:er-doe in his : report that in two of the non- filter smolcincg, dogs early invasive sq,uamous cell. carcino,-,a was found in the bronchial tubes. In ca.r~!ful pathological_ e};arni:nation they were histolocicall]:y indistinoui_.shable. from that same, quite cosmon form of 1_uizd czincer in huma ns . 1005091681= L Poci_tion or tlle A:rerican Cancer Sociery (1) The ~nerican Cr-:ncer Society recogn2,Zcs the si(;nific~ nt ~;,,,.,-.._...,•,_ -~.-~..,..,.~,.....~._.~.-•-~_.._.....e.~,..-...~_....~-..,....-x.......-.....- --- .ea... nchievement of Drs. Atierbach and, Ylammond: in producing lung ,~,...~.~......,~,._. .~ .~ cancer in ~do~s sriolcin;; cigaretLesand the'i uT:pori:ant role o more - 4

the Veter ans'Administration in this joint project. Tlea_r findings should have a significant impact on the ~.a.....,._~.~...a.....~..,...._..,m..a,.~..m..~.~..~,....- smoking of cigarettes in this count-ry," and will probably lead ,.... ..~._,.,~ .~y..d.~~.....~~.. . - to a reassessmi,nt of adver_tising clairs and policies of the (2) The reports by Ih s. Haa-nnond and Auerbach demonstrate =that smoking fil:ter" cigarettes, with certain degrees of filtration, ::educed the . in-Adence of actual lung cancer within a relative:.y short ti.nie (the dogs smoked for approxir;atcly 22 years. This approximately 18 years of hum~sn life).-However, initial examinati_on of lung tissue of filter arnnkinc> rina.q w11n smnkPd fnr 27S dflvs shnwed lung tlssue damagc: 'very sa..milar to that found at an earlier stage in lungs,of dogs . smol~ing non-filter cigarettes. The latter were in the same' groups in which lung cancers later developed. Therefore, the filter cigarette cannot obJective]_y be ea:IlIed `safe" cigarette. Ho;le°~-er, cigarettes with effect.ive filte~.s are demonstrated to be less harmful than non--filters. OO CJI . O (3) The repor ts by Drs, Harr-mor:ci and Aucrb :ch are zn~ full accord with the conc.Zuive epidec11i_o7.o.2;ical and pathol.oUica1 studies in humans which led to the det' ermznution of a causal ~ .. y re3.ation^hip bet~~~e.en cigaret:te sino?:.iizg and lu:~g cancer x

.5 (L~) The findings of Drs. Aue~~l~ach and HU:~nraond eff.ect.i~>el}T ,a.,_,,.,....~.~---~- ~...•.....~...~-~-~°""°",,,,e,_•,,,,,,o----..,.~.,,.,o.~, reflite contentions by cj~~_garette manufacturing interests that ~ - . i 1' I~ and zn claims to the con' .gal ette--canec:r ~n - .,......~~...~ .~.,.~•~...o..~,~,.~.. -.~ r t (5) Filter--tip cigarette smokers should', not be Iulled into - . a feeling of false secuxity by the report of the fil.ter-tip t . - . that filter-tip ci.g"arettes s, if they ef :;ectivc.ly re-duce tar and smol:ing Portioiis of these two stu.dies. They should realize nicotine in the mainstream smoke, are, at hest, only less trary were only IIst~.tistical." ,.,o......,~...._..o...,~.~,.~....~... .~.<.._~ damaging to lung tissue than, non-filte:: cigarettes, As such, ho;~7ever, they are better than the non-filter tyPes. _

----- - '~__--_......_._ -_ ... _ _ . _ •'- - New York Times _i+cl>ruary D Ci1Gtn, p L U'; 2~ CGm=• . ~ l ~ . ~ 3 ) fff In G ro~~,z~ c! C .~~r:..P;; h L 4 c~ By LA~':ItL-\CI: K. ALT:Ii~u\T Twelve of SG bca ;t_ts that were e7hc dc •led to smoke:dcrtlop^,dlun,^, o esscs nee , two seicntists reported knol in b tH 5•' :d i }• r . T e} sa s stcrd t was ir st trmt rh b nr.nt umcrs had en pao:uced tn,lar anir,tats cxp; sii:g the aaimals to e :;arette smokc- The xientist; arc Drr E. Cuy lr r2zead, an cnid miologist' -.,o_rated with the American ~ce: Socie:}, and Dr. Oscar G,- zrbach: a patholc-ist at the erans Administration Hospi- nt Fzst Orange, N. Ji They 'r'i. ~scloscd their findings at a ~c•:s cadcrcr,cc following a reatific session of thc Amc.- n C2Wcer Society at the 473t3crfl~stort..lto3el ~ The cicty said the f r-'r;gs r 1cti c•} rc uto co.n.,.n.corsl cl„a,ctt_ manufzciur:r,g in tctrsts that ti:crc v:=s no c:gar- the tr . o tom orn, t•res con r I to 1 u rettc hold- Cri 'It:c dors ~+c;c lraillcdl to t grad;:, Ilpsmc, c,i to a ma~:i- mmnof nine ci~^rcttcs a day. All were the same brand of Frce of iirn rrrm't;;e; ci rttc, 1R ch ile res.zrchc:s rtf duration efl u linrd to tI-1 . ~t I ut t ic evid nc~ ln•~ Tnc}t' c ltl;cir tt:!c and hin I:ates t':at lun p ran h nlaij Au 5.,'r.l for s a c, arctte, "D:, (ticscc) ral ta e ac.tar,ces 1es- lr'ssu J dvna 'cav;:n [s ) c,~l The rescR c' crs rcmo, fi!tr. .~ cr~arutts ih:n .:U7:,', t1 l y do2s f o nd-a (;rousof 97< the smoking of non-fill : cig- II defo c thecs c. in%Lo;al tf iOl 1thc f arcltes." 94 rc.,l..:n 1 .:-: t tti erc Tlie srnof m r:; n_nti clcecl, as co .i: o!c 'iat is, with he 21~s t a m n;l ,ou„1 ,,ey had tr,:ch~nstor;ies„ May, 1967 at t c:ans, t::c:v dia not sa:;ke. The minis 1 tr tion Ho ^:tal in I-ast' t ro' c s'n cd in ca,cs in ~'Jrarv nd' is s~,l con i ui ^I hc c, ci r s v:herc theS6 accordm to DA+.erS c 7 Of, o , do st ved. the 91 braglcs i no:ced mhc; ~ 7 dos r^.d' con 'ctCrably cxicriment: all r~E a c-... r , 1tic.;,~a: The 33 ire. icst t;etc ~~rouq of c:g t ucre ta ,r.t to nct in oa.o gr?u,~ "t:•ith the in• 15-r:okc throuon an incaroa intent:cn cL} staok• ihci o ts. in t-lt' il c ually dicd;' In Pr ~~io,:s ~so b ot .cr }h c st J. e~:nenr rs c'c .s diod lt-I f c c: atnrlt <a s:nol;ing~ [cr 1 in b cn c res i to a c'0 v c d v d ra ao nly rc; o o: ls Ci2sz c pen ~ ti o h p: s T eh'e r_n 1 c c u:~s s. le cd G,1~3 f cr tip !rls-:[ as to v::^ .rcr li.:[-• c..cc., r. _._t~'•;,.1 t.._ C7oe__xsoi !had' bec-n in du:e.i by the . c..,,:.-i r^ lt ':i•e 36 o:ccr -n-car ccrlint-: and -:t o;aimsl } lct - . y t'ce con ary nzrc oaty I D 7 i 'no d? a T~r. 1[ hr:r e !> nn; nt )zidi _ isiict ' : I u,u auu n;ecal 11M1:O Pt.PJ..S Ode[r m nr: - „v a , sr^o I Z 7epy, the T[UUaL2v rnstt• 3 an o.a nL:.Btionspon o:ed the tobacco indts.ry, said tl•.tt it was inte:ested in the r r,fed relts of ih~ c>••p cri- m~t. hut ta~uat it t':as pos- si to ".Jta:: a m niogfuf I :par-let bet s en humz•r smok- ;in~dog.s Sicctcd to ihese m t stresfnl iaharatory coridi- liazs The stud) by Dr. Iiar.trnond (h~ Dr. Anerbadr also; foand ti follo vu : g . ._ IC-CiZarettes vrth faer tipsi ti rc::urc Lie rrhalcd tar con-' tc o`'the srt~ e by at lcastt 4 _r ccnt and th_ mhaluf nicr~..[re content by. t]cast 37 r•s ccnt are less L•trmful ti~ r t;e [11 da s] tha-[ non fl c c'cs rr rr z c..matl:. d;ffcr- cr.c tn tbe rnc,d ncc ofrn~h- - filter sntol: ;a :cnd non-fittcr smoking i~tc , • I SDcath rilcs for t'lc c.o;s l); a; snlc;c3 ssere "si ;.^.ifirnt- ly~;:;crl"ti:an ar.:o..;..iec enn- r. that [Cr..5:nei:_•.. t; , a lng nxtl tr,r_ter ci; rc "sj s ac ' , l c c a. eP; c ofv:'ltl[ on ctGcl i fi!tcr is 1 5 f Cr lt:p It harmful: tr:csc 3g [•, re cl s,ticd as li~ht than 5TO) 7:i' pI , are, es but sc ti~ lt t i= fi s."'.okers; they s.ao;:e 3,103' ci- znd "to as;cts::r n,.•_,.^.c.i Ezrottcs in the samo pcriod. s:noking ciearetles for t%co They 2; o;her dos s:'nokcd p•ear or 0 1 r%[ ll produoc G-129 no:[ fi!ter•tip c bi c!tes. lun~c.n erndo in an ta.i?: vr Dr. Auer : D1 '; the S75 dat s, "thc bach recall_1 that pitot s 1 s' dc `l rates were in 11' nmcnt done rt.l ,: m d 117aU'sc`to ,cdi itiitn oosar of lcr ard tueot'rte .1r rc!_ti[e to bodl' Ilt"' ihc C.oC tica••Ies dcv°toped Ju, diseae ucit as ec p 1}c ,~ lrescarchers c iJ ~b of the t:ad pu!m ary tib o s, as ncl!~i,c^ltrok[tied dl trisr riud as ch1n . tct t :•h^1 c~ u lt 2S of the SG c;or ilf, dog; amire I cndM a mcicscn r Ildiccf of thcse discas_s that secnbl d esrly cri cn Fn 11. . Y Ull co s thc_: sZid. Pema involves destr.c.ion ofj The lim^ d s s~s, ptdmonary air, s:1cs. Pt.lnlonar[ ubro •s,in•!~crlph3se na and fibrosis, and colirs t!m c!:vc!o?c:cr.C of fi-"t!:cirresuitnnt str,.in on tl:c brousL suc in th lu^5. . 4honrt, r..!led cor p•Imona!r. findin ' ti e re- 17•~ccr tl:e rrincipal c: u_cs of <carch r rc;)or'od At• s l~".catli tliat b a(•I6 do sv c s t > . t' d-i)• fi, iho rcvci rchcrs for ~rc p.irFa, t h..c ~7 , 1 zn p lthri to dhi h the riacd t i cot' 1`+2 1-en t! i. aops 11. I froL:,I; c• o pt fh^ for a c irf, n' r z,t!Y o !I;c t~ c~',a li ,Ics sinul.tir 4o ob i- c IUn^, tnr,u cfic t.onfiltu iir rctt r. 1 Ac: ~ c:~'t !y, the tasc. icl isj Auto lcirs uc:e p^ifon;uit bouy I t 97 yd cd m; 1 l ,,an all tl:c r'c d doi• Slidts p,les frorn tireccre svr [ ?t t rurc of t!lc lui crclio,lsicerc 1\et•r YorL nnd o. c.cn'cd tl,~.rtcn!: cl fhrn t} _Y v.Lrc resd by for' :.ca•c::.! r:cc•r., in :,lurrhlrh l:hn lrld no Ornn;:c. \V::en tt:cY b'e;.ln ;i:c-- .---_-_-. shrcl)., th'cy rn~d c a c:: nii i~ir, thrun; Ii t':u ffo:lt of cjahi do;~'s mock into LIS lrlc,:e.l, a n[innr Jlr;medurc l:no•.~n as a ir. chcoslun:y. ~ A l:cl!i,;v inhe, Mcdto 1.(4) i knowledge of c_ct[ do;'s idclitil%% IIcni z^.r,d r^a'i uu ~lo s were fcu .d in tf lua< rf o` lltesr do g. 1 0 of t' ar cS. in the control group h t cn . n. tttmots. t: e m i~n:.nt t lc.,, or cancers, were found r n 12 or the heavy smol::rs of mo:ar!tc: cig rottc . Thc t ^.;ority of mai~onant tumcrs fc'_nd ia the dogs were of a type F ov n as bronrhic-alvcot r which c s the bro-tchi and the lu 's .:, sacs I! Th sl.dcs that D: A rbach intcrprc. cd : s r7sl.~aa cc: in•r e rc ,:e'i t r Or, T` -r~-d CYcs er a,,~t o b r~ra 't \'et- erans A !ni'1 5 :1ion r:~paalin West Y-asen, Conn. I'r s,!d he „rcod with the -n ations. Tri_ msearcl:ors ss.d ...cc ; %:'ould stud' otir iiss::c;sa,c`7~as rtcn s i a-y j 4; •~ ~'~a s to c' c rn in t t r l...l 09 : s r'L lt h t rM-•t iau u_e,:n_.e -11 Lt_ sCllef-::1 ting dc ic-s. tt :fel ! the A -cln~fi Car er Socety ti[ rr.ed t-: tip a, re, ^~ s^l,:ers r_ t h~~ "1u !Jcd into a feciing of falsc; securu; by the report c:` ttr_i fiitc tio s-no:ono p,art3or:s.'o these ud c Fil er a er a f cs. if ther ctfc ti Jj rc u. tar ina n:ca•~'' (Inc in t e n [i.carn - e, ;are t b t o ly hcss utn t gi It t.::.,.u .,.an nu !t :i c:5-rc Its ' t:ic socicty so::d.

r-- r r-- r- r~~• ~. ~..~ ~.,., r r r~~ r r r~r v!vrLS!v 1 HE IdE v/ YOP.K TIi/ES, FRIAAY, FEBRUARY 6, 19i0 . - ----- -. ., y - -------- -/-•~ --~, - ---~-~--{-- ------ --ry - __- ~~'- ' ~ 1C~~~~ ~~ ofS~ V ~a ' l k~ ~JVL &l.JU LI. Y.L`lJ1l1A..j VV I'D 611l ~v: . - . . . .. . C%; 43a:tizc,i:ion ancl PlesuiEs e(- E>:;,erimonL • ' C01CNT PER . .17 Ct'A!1_'•TES "~.~eTr: • .. . . ~. ~SMOI<FD~ ~ Onr..;llh;'d:rs) OtiOI:P$ NO.OFD0G5. PcRCOG 'F.:r (vico:fnC D£ATH$ pCf'O,t " CAY S73 GROC/PC-GONT6OL5 - ' - ~- - --- 0 0 0 O . • (NC,Nsnllo is .rs) ~ - ~ ~ G. iCUP F -- ~ --- T--- ---~ ~ (S.yOKE] FILTER CIGARETTFS) 12 E,143 17.3 1.17 2 ' G r Ur'L ( Ir ~r-cr c, •0•<CRo ' OF 12 3,133 3.4.13 1.85 2~ . • _ Ou ( (F VI R~•0~(En5 CF 2,q G,729 • ( 3-3 8 1.L'5 rc IuEr,s) . PER CEO,:7 C' ,'.:JTOFSY SECTIO'S WITH .`,c`dCRE FIBF0515 G,?OUP C: GONTROLS PER CEUT OF 41-1T°^SY S?CTIOtiS WITH SSV.-Rc EuPHYScMA PEfi CENTOF 83cf ti":iiii ('i,;,Z (.1n~u~ ~ A1C E\! N Tli': ~_93 \\\\ \\ \\\~ , ,. . _ "cS^;tYOrkTi.r.r.: SoCI:'a;!crI cd ?71. ^ c~ t:r::o*o•:> tr ^ tisc¢c at scs51on. S89T60S00T _. crtaJ ic n tcaoa on crfcc: of cr- r, ,_ sr.:^f c.i c:^ -....: c:cclactc: ' c:~^^ oa ~ . [, ,~tms:: ..crc r a ncrro^s.r !. T.,.y : e 1, ^ c . ...c ,

NEW .Y D. 595;50$ - S. 1,446„507 HE%y'YOgr, CITY N.ETCOYOLtTAK /VU% Smoltin~'ari~ Cance~ To the ~;ditor: I am writ'ing, in refcrenc the Feb:,8 The e to NVcch i t lteti ietiv zrticle by 1Valt er Sulli van en- titled he L 13 ea~le Sznoked t;te ca~l e 'T Got Lunn E, Cancen. Z~'C are toltf th at 97 d o~s were used in ihe caf1eriment, iheseancI 3<et evidence on 41 ot is noi given. «'h1? pI are also to1di that the ~ heavicst do~S v;erefe e`t pu on th h~~ Slna1'l'~ scie Inlett, ntifically cedt: unso;;nd hroy :e: the ori;inal sh 97 c+ dn< ouiti }:a~~e 1:Ictn divil;, d ia n, dorn'; arno n~ the nunsmoker and tltree snlol:cr ;roU Ds b ,e- eave, the Pa,sibilexists that 1 dass are more ~ror.e t,o tutnors, irrespecfi~e of t=;ltcther they sn:al;e or not . Sincc th^ c~pe;i;;3cnt fails to rule out this nassibiiitl~ the conc•l~lsa~ns as lr c L -.6 1s not on attcmllt to eiri:;ic, ic the tob:zrao indu<t31 (I on;, no, stocl, tlicrcin), n'or docs it r.t: tenlnt' to justiR, mv a•,~: rt hahi`s sen,~cd arn not bc tzlcen sc I rlouslg, t;l;othcr criticis;lr of the c,,,;., . ..~ , aua.iU1°. Cqr~it'Clli.•r')l':', t' too small to iic usedi,r a.ta;;;tical test . cce;ltah)c Fuith.arnlare tl efo cri~;~tists. that int~licl`;on the fi, ; ~ter-tip tr;,ahcrs a higiler incitlc:nce of tunr.~ns than thclion- no};ers i; pletely co. mu;,su'i;tanti ;ted. nq) rcanal}sis of thcsc 6r pt¢ritaaicalbclic;s. (!i(1o,:rot' smolcc lr-'cause I should r;'thcr Spend my moncy on other ac- tivities.) What docs bother lne I;tho misuse of so-callcd scicntitic results by one group 1:;th vestc~t! intrrests to attacl: Prl. othcr. All this e:•:Pcrimcr,t proves i'st ~','hethcr or rot smokin" causcs JUn~; caficer in bea„Ics is as inconciusie•c now, =• ..rs it was before the cxhcri- mcnt was carried out. J.INCOr.N I'JEi:SO*1 Di;oR'ER Professor of Biolo, Amherst 'Collc~e Amherst, b4ass., Feb. 9, 1970 . .

PHILII' MOR-RIS IM.CU.lfOAAffU 100 FnRK AVEInUr_. NCV; Yo ,`K. N.Y. 10017 .Tos)i1't) 11~.('iC~r"L?LA\.aR1D CHAIRMAR 6FTH[ I30ARD Mr. WilI'ianb B. Lewis,,Chairman of the Board American Cancer Society 219 East 42nd Strect - New York, New York 10017 ~ Dear Mr. Lewis: February 27, 1970 On Fcbruary 5, Drs. Oscar Aucrbacll and E. Cuylcr Hamniond prescntedto the press at a special mcetin,; held in conjunction with the mccoing of the Anlcricar. Cancer Society Board of Dj ectors the finc:in`s of their stuciyr on "The Effects of Cjcarette Snicking Ul.on Do-s." The Society t that time issued a"Liac;;groundcr" press release intcrprctir,.; the results of the expcrilnent as a si; njfic.:nt achicvt ment :"epresenting the. first time that scientists have produced lling cancer in a)arge espcrilnctttal animal as a result of heavy smol:ing: TL-c Socjc.ty's release furthcr clainlell that thcse findings should have a si.- ,nj'ficant iurtpact on'the sniol;ja -of cig:;rettes and wili probably lead to a re; ssessl;iela of advcrti:ine claims and po;icies of the ci~arctte i'ndustry/. The report and these interprctivccolirntents have be lat ijven wide publicity. As you may l:now, there have b.:en ~rt*~~iocls st~u~'es ~1~itli cigarette snol:e in wlliclt tlie:. initial report ~ has clainleij that Itln`, Ci ncer-resenlbiln2 W11l' Ca111'Cr in hbnn,,ns-Was inC!U.r.Cil Jll CXi I11I1C:11i;1i ;1I11tn iIS. These!\'el'e PrOVt'd eltn:r\11C?_?.~~ 0, (^~ ti cjr'llrlr+ Il?lce -Iftzr t!1C recrv~C 11"f'C.' SWI ICCted,t0`lrqlit:Ol;r SClel J C C] ' l !i. U4iTC,. CeVC1op;111illtS 1i11 Cl)'lil.:etlol W1:^ Si130}i1nP.:;nU 11Caai1 nClVe soir!e1111a'S u4::;1 A.nnotlla'0j L Ililer)liihrc'.ssll'i:' IluspiCes-Sucl,l as a major universlty°-;ind,af tt'I evaluation, I1:iJe been found l0 dis;til1 olnt tilElr s1)o,IsOrs. • Since the American Cancer Soci; ty asserts that the pre.sent studh is of considcrahie import to smo}:crs, I heljcvc thatthe inllklstry is entilled to have a full undirstanding of the nature and signifirancc of the findings as duiclJy as possib,e. In U!a: intere.st of accol;lplisliin.g this ailn, I r: olt est th"ttllc Socic.t\r11rt rl thorour}l e+ tl; ntion of time e." ~I,crilnCnt cn~ it< reslllt,, hv < P;lne +.e 1 c{ nt ! of ...._.e.,. _ _- .. -. ..•. „a,_-~_ ,..,..~.......~.,,.,.«.~.-:~.~~ ~.o sCICITl15ts 1-,It1l 1t'j(lC t.\l`ir;cllci in :?9"C:1S rCI.-C•3'lt to tile (l;it;l. 1 stlr~Cst thc.foilo"-inn procellurc: 1\ hen 11ic Amenjcr,n Canr;~r Society notifics me th-lt they and! i"le invcsti;;ators have agreed to ipcrmit access to the reltvrlnt niaterials and data, ]\N-il1 nonain , r1. ,Is revi. v.rssr?yc1•:I_~ti ~ Il l l,r,h scjentistt 111o111y <tu r(i,~rl ln th•^Gcldc of ex~;erimow ! I\i1 }:,tr l:o~r pat3tolo_y and IualJdj,._ases. I b:liL;e thes; selentjs,s \;lll be recor nlzecd by the So..l,t}' : nd bytileir co).lcagues as rnen of outstandjn ; com;ntence and intcLrity. If the Socict'y should, for pod reason, rcject any of the men whosc namcs I o;ter, Iwould'appoint a substiture. The tobc?cco inr{ustrv \vjll, of coarst: bc;lr alCcosts in conncc tion with this rc\,ic\%r. J looh forwai~.d to ancilrlyfavoraLle ll~c:sponse front }',ott so that this work may Cotnmcltcc ati til, earlicst possible d'L1tC. Yours very truly, + ~! t ~~:7 tir" ~~`' 1 "•' ,.\ Vvle' E/.N ~wr JoSCpll 1. Ctlllman, 3rd Chair;nan of the Executive Comtnitlcc The Tobacco Instltutc, Ltc - • y ~ 'sa'~#,* ~+`.~ -y~~;~*~e. *~;; _.,. . . r..;~~_;..:

~~~~~r, C A N C A r~TC 1-743 Pll~ S 01 c~~~T Ys I r~TCo 219 EAST 42ND STREET • NEW YOR:, N.Y. 10017 •.(212) 867-3700 R E f:37 A kL C I-1 EF3LJCR.TIOIN SERVLCE Mr. Joseph F. Cullman, 31d = Chair nan of the E-xecu'ive Committee The 7 abacco lnstitute, Inc. Philif, Morris, Inc. 100 Park Avenue New York, New York 10017 Dear Mr. Culhnan: WILLIAM R. LEWIS CPIAIRMAN, BOARD OF qIRI'CTO7:S This Nvill ackno;~ ledge receipt of your lett&r expressing interest in the research work of Doctors Aucrbacli andHaun:nond asreported'at a spccial nrcetili~~of the ~ln,erica:~ Cancer Society lioard'~ (~n 1"e?brn3r~. C 19 'JfY Your appraisal and su, ~cstions are based a summary ~~•llichi~ti~as l~repared for the edi;';catyi~n of science «'rlterS. It is C\peetrJd that tl;c t P ) l pej?CIrt \ i ! ! l t1 n[11)]!si _~"1 li2 the ~'Cr~~T;t':,le' f! il rrC~ ~l~h;s \':Ill ~ ..-. ._ -,. _ .L~-.~ . . -_.r . _ ~. ,. $110~~` the ldlet!C!1101IS \t'Ofl3 t l~ti \ti'Clit 111tC1 t~ 1S,1: tiSt c;,~:ni ili, CXp.111]]ialt \'.'hlch we t4<;hC ve U7CCtS the hibhcst traditions and protocol of scientific invcsti/atio::. Over the years and in this latest experinient these scientists have contributed sih,,if cantly to the l:nowledCe rcfatin« to the eftects of ci«tirette snrol:M3 on do`s and humans. We suggest a study, of their fonnal papers will satisfy any scientific or other questions rcL,zrding their find'on~q witlhout = further inv.csli~!ition. ., o.. ®..,,, ~, ,.,...,. ~.~....., ~ Sincerel}; l :LLB. Williana B. Lewis

I TEhT-'iR' S IDICEST APRIL 1970 N'Cve11 aU In can the tob:tcco industry hicle behind its'inost-uscu defense-that no one has - induccd'' cancer in lxl5oratol-y anlnla S with clga1'Clite smoke :LJaS . Ga~~ f0~°. V.i:gc reUCS ~ -: BY STEY}_; ]yf.SPrtCER;_- oE "luarning,° dining which thcy oec tsionallt cc u; hed 11itt; and were dtzzy ar,d 1.1t sealed the dqgs bc- clme accus omcd to srno}ciitg and \vit!tout the were ablc to "pufE" pumping device. In factl ss•ithin a (esv months tlie dogs actually ha& the hahir (!2itrinp the second study, one aniiual frcttod and n'hinc& whcn, he ll:xc!I to be kept off ciga-- rettcs lor a fow days while a new traeheostotny incision hcalcd. An- other u•ould snap each time the at- tendant rcmoscd the cigarette from its Itolc!cr.) • Iu thcir first rcport on the stnok- ing dogs, presented in tcfG5; Dr. Auerbach, and'. his col!caguesre- vealed that every one of the five an. itnals that survived at least ,23 dstys of smo!:inp (at a rate of: lz ciga- rettes per day)!had the abnormally dilittrd air sac, in the htngs which are characteristic of cmph}'sema. No sifns of emphysema were seen in the ten control doss.) But there was ntoret!tan emphpsetna here. In every one of the dogs that had smoked for y?o da}•s, Dr. Au^_rbach foundth samel.tnd of p ccanccr ous cell chrngcs he hrdseen in the broncn,at lintngsoi,tw„s,.... , .. . None or t\tc<e c}anges v, ereseen in the non snio`<in-_ do-s. "Still, n•c were only on the thresh- oldj" Dr- At:erbach recalls. "The smoking was dcarl}' producinS ehanscs in, the direction of e ncer, but Nve could not yct call it cancer, So v:c sct up a second cxp--riinent, bcginr nt, in ;\1ay_ig~7, tll-lt v:ould permit th c dogs to smakc for a lonf,erp°ribd of time. And after about ttto yc:trs tte be; nn to sce rc- sults tLat no one could c!isputc." In cscr}• p.irticulnry the ch-tngcs in the lui,:;s of a ptou}t~of z{ hcat}- smnkin rli, ti(tt nc cilparctt s it day th,• n u•h dail)c(luit,tlcnt oflttto p-l:, loi a ntan of avcragv size) lol! .trrd thc classic pattcrn of dc- t!r ttin; c'tnccrc hro!if•rntion of the h t t;, cclls if site hrr acl,i.il hniny. bi; nt aiz~ tl nuclci, anrl; (lita!h, the brn, tli t r ltirtutrs ,lb thi It ,'ut it clir u!el he uwq-h'a- sizcd tlct Al u('tlW t c11'cin tt Lnm 16c c:mr! i`,r7 °."" __- _ I, nt !l I _;' r l. . - I~ 1 I11 li ll-Vl I th c_ ~.r i t, ., tl tc ~ tr11 c tl , c~n tl(),c t.t!isonihto,wh:r Sonnl;- n ,rn il, uC t d<c i h, int IncJt uu tna!pnant !:.nl qtl,r:uttl. Uoe• };rut.n tnn.;xicd ofIi; Lt u: c,l~n.~" (tLa ctit:ircilint n;.'ai ! r: A pugnacious last-ditch dcfense tobacco industr}•, and, it is holxd, in ^' of its product; a tobacco com- thc smol;inghabits of its customers, pany last summer published a The report is based o.t a ser.es of uel.page ad in the New York,Tnner ~u,fiiilg at all',. medical evidence agatnst cigarettes. "After 15 years of trying," the ad proclatmed, "no!wdy tac induccd lttna cana.er in an mais .\il,ili~~Ar~trC s:i,Vl~C. ,~c U~III-•c that the anti<igarette theory is a ~Sum rap:" This "bclisf"b3indly, ignored the evidenec from thousands of dLetors and public-health experts that has ~crsuadcd miny mill ons of'sn~o''crs :o quit the habit. And now, nna11}',, it'hashecn proredfalse-liy a kenncl rf smoking dogs. Aftcr Zr to 3o months, of' daily sntoking, of' non-filtcrcdl cigarettes, _at a ratc rou.L,'F.!y cduia•a.lent tWttv- jlthat cigzruttc stnoking was causa!ly, l s a day, for man t drrrsiq- related to lung eanccr-a co:rclus:on [ a t d - n~ to~n~ nr~roa, r rvel hs ~-ii~~ , tat te tcacconterestsunty hhb i bll - Oj;_.I n~~l:^ n ant turnr e vlr.~•it1~,.. _ _ ~ SI :~11~ O I f: C t Cr. c fl1'Ul,f tlie tilmor]ltere ' . tl~c t}~pe most. eorumoa its hu. mans. (Three quarters of the (rj,ooo ; tunoan limh canocr dP•tths per year • Lrc Ir licvcd due to smoking.) The dc,j tun;ors ra.nred in size fron\ the tnicrc. cupie to two th. t werc as big Lts a l trEc m: rb!c_ 7 hcsc drarn..tic find, .rs were re- poticd to~thc famerican Canccr So- ,n Pcbruar}' hy Dr. Oscar ~n rl ach, scnic.rmcrttc,l inresti- ~;ator at she \"ctcrans Adminiktrattou; 1:nsptl & in Past Otaarc, N.JI, atld' I)r. I Cttyirr }I::mn onc! of the. 1CS. Jl;cir resentch is alntost ccr- tain to evu?:c r.-pcrcue.icros in the ;,studicsbestn in 1964. Although rc- searchers had long been able to p:a- ducc skin~ eancer in n-.ice and other laborrtto-y animals by ruh'~ing t!:cir ba I s tt ith tlit co tdi.n dltarrp dis- ttttate nttonaccosntol.c„tuleycoMa not get large a;titmk to ir.h,ll; smolieon a regular b:sis for a lons et;ough time tolinducc lung,canccr. But Dr. Auerbch; a patholo; i,st in his mid-Gos, is a patient and paius- taking, man. It was his tror}: on chanRcs iti smokers' !un s that pro- vidcd the stronpest pat".olooicel sap - port for the Su-bcon Gencral's I famous 1964 rP; ort, "Smokinb and 1 Health," and for its fint conclusion rcfuscc!'to acccl,t. The initial stttd}' in 6 - scrics in- eolredlao b c.t s: ten s nolccrs and ten non-smoking "eon.rois." Siuce' the smoking dogs could no, bc taupht to hotdagarcucs b:tv:ccn thcir li!ts; the titvcstigr,tors madc a simp!t± trachcusto:nv inciziotuih r:uh annn"t! cnlct and 1111 epire, :tnd th n tmcrtcd a euncd I I anitul,e: •1'hts, v:,s hcld in by a padcL°d crossl irce sn:tphcd to a s - cial t 1 hc•r. cc lt t In mrncluc, tl,c d tn ct, .tr•_ttc s-mo'.ti\r;, thc was a.tacL°c; tu an thi>>r:uu t hich I tn ju•d srr !.c tlnuut•h the at.trcuc t, int, th:• 1ba,s. At:cr it sl.ort II• rtnd .

r I I I L ~.' L r I i ,ack ,,t nnttlt rcd ctl;arottcs a day itea etttr.); the o h.r of do,,,s %%-ho sntnk«1' nnlb f t c.cd cit;an:ttcs (at the rrr-tgh huntan cquiv;ucnt of twti packs is dac): "1-hcre svas also a cnn- trufgrnup of eight dbgs that snwkcd no ci_--srcttcs at all; and in tvitich no canccrous changes were seen. Two of thc ra dogs with cancer were in a grorql of lictvirr beagles who are stillismcking under obscrvation. Drs._ :luerbac!i and! blamntond point out that these results do not rncan thatcithcr "lightsmoking"br the stnoking of filler-tip cigarettes is "safF.° Rather, it is "reasonable to suppose that smoking filter-tip cig• arettcs for_alisnqen Icnl th of time uould cventualh• have resulted in severe damago to the lungs" of the dogs, and that some might well have dceeloped'cancers. - i In aav ease, the difference in patho;ogical findings betweeti dogs on ftltercd and unfiltered'cigarettes was no surprise. Leaders in cancer rescareh have been saring for more thantcn ytarsthat reducing tar con-. tent in cigarette smoke-s:•hich cf- &ctire filters undeniibl¢• do-would rcduce the'risll of lung cancer. Wln; are the implications ofthcsc new mdies scitii rel;ardto adter- tistng and to govc:nmer,t jFtrisdic- tion over the sale of cigarettes? For some time there ha: been agitationi to require publication of tar and nicotine data on the cig garrr,e pack- age and in adccrtisinr. Since tg57„ b'oth the Federal Trade Commission and tl6c former Surgcon Ccneral;, Dr. \li?liarn H. Stewart, have been urging _uch action:And somc com- nirs 1 ave G, -veral m~ic h~,c t t•cwtt~triii^mrr_ti__ «ta.~.acdmcn- tine cntrnt in their als.~f'~~a -.~-•--,.,e uccrnrr'- -irnt aiti4~m trrr1ryrrrr 11};~intormatirml!avtct becn ta!:cn. -lport l,c new -.~-.-..-r..~...~ li..,ie.h.~,tos~~,u.a. _liRrtt~~t;~tc itons....d p t~ltct tnat losv-tar cigarettes are lcu likely, to produce lung cancer, sl:cnrhlt-i'cim: n!st+,thc<~c~itn,l rccnr,r.:~.ncl;And they could well ch: nhc the smol:ing habits of eownlcs: .lntericans: Many brands of filtc-r-.ip cigarettes arc now hcing sold >sith tar and nicotinc iontcnts close -o, or ld,sver th'ant the filter-tip varictr u.ud' in the cxpcrimerrts. But these brands cotnmar.d only about 22 parcc:rt of ttt. Glti:r-tip ntatfe.-ancl onh t' 'ut 17 !":rccnt of!t!ic ttIntl U.S. c~.,r-,tC i.,arla•t. liht tllc Auerbnc1l-11'.trr.mond ftndinn; raise a i..r mutc basic quc,- tion. P.aat fill, tvhcn iltc Il'oud and Drub .ldhiinistr,ltion issued its now-fitmnus ban Oct the artiCicilili sn'uctcucr callcdl c} cl.t n;itc, sevcraC erities ac,_used the I;ovcramnnt of being in onsiitcnt in, not taking similarly su'ong action against ciga- rettes: 15r- Alton Oclisncr, the New Orleans chesnsuracon who has carn- paigncd relentlessly ag:iinst ciga- rettes for more than ;o cears, callcd attention to this incnnsistcucv in an editorial in thevVed:ca!7SvLrt,:e. He pointec! out that RuL:rt, Finch, the Secrctarv of Mcal'tft, Educatdon and \ii'tllarc, had ordered the artificial stvectcncr off the ntnr;ct b~causa it had cc used b!adt3cr cancers in rats,cvcn though the dosages gicc,~ were 5o-Su tinies thosc rrcotnmeud- edJor human beings;"Yrt the same govarnment supports the growing of tobaceo-the use of wliieli~ has been stated by atleast two Surgeons Gencral' to be our grratcs.t hcalth hazard. "Thurc has nevcr been anv evi- .t....,.. ,t..,t .t. _.r,..,.t....._...- t--: humanr, cvcn thot:gl n::l!ions have usc? :}:_... r_ . ct has eucrcattsed eancer, Dr. Ochsncr said, "and yet it h~s rcpcatedlv been proved thit tobacco is by tir the most impnrtant causc of lung can- eer in fact, if no more toh.ceo ucre produccd, canccrof t!I lung would be ahnost complttcly eGntinatet: tci liia lo yto s' Thvre arc many "v ho know z r i atl: .it the hcalth h.t:.ards of t,,hrico u..z,." Dr. Oclis- nc•r couclutic<I! "it•Lo apparently have no regard Cbr littntan sacrifice, coudbning its use bccause of cco- notnic si~nificancc.'" Federal taxes on ctgarettes, hc pointed out, amount to ilrnosc:G miilion it day. As our P.tc^s are presently constii tuttd, there i; no government aacn, cy with clear jtnisdiction over the he:ath aspccts of cigiirettcs: The Fed= cral 7rzde Commission can act only ort matters of adsertisirtg and pack- age information. Thc Food and Drug rldministration concerns it- self onlv with foods,drugs; solids or liquids which are eatca or drunk. 76bacco is nciihcr a lood nor a drug, under eurrenelegal dcfinitions. Nor are cigarettes catcn or d}unk; thcy are tnhaled.'.-hus Secretary Finch's anssrer to critics lil<e Dr. Ochsncr is siinply topoint out that the lawgives him no jurisdiction. \T'ill cigarettes reannin legnlj and continua to cause cancer? In the . Gnnl!:tnalrsis, laws are changed to fit the desires of pc:oplc. If a suffi- cient nuntber of peopie let it be known that they want something t - .~... _ t....,...,.. one 1 osstbilrtti for es nple, would b: to t;;: .:ndc,- contro: of I-IEW'-thc tasl would by no means be impossiblc. But, it takcs,a lbu of pcoplc, making a lot of noise,to off- set ~_G million a day. - ,•t~t For intoirr„tion on tepri•as of this a h: -. -e G-Z. 28 /L L.

Josl;Pri F. CLzr,~iaN. 3xn CI/AIRMANOF THE DOAf.p A1r.Wil9iam B. Lewis, Chairman of the Board American Cancer Society 219'Last 42ndiStreet New York, New N'orl: 100; 7 Dear 14,"r. Lewis: has ref ~scd~trllynlit the il~a 1 tin1 r ec i Yw of the ~>;:uerbach-l-Ianlrnond dutai\vLich, 1 requc:.ted in m}~ lettcr o. ~'ebraary 27. Sinc~ th4 Society has called upon the aretteindustryto reassess its lrolicks in ligl)e of thefindiilgs, it is only fair and proper for the So;,icty, to permit us tohare those findings evlaluated 'byindependcni'c~rerts~andi111ul~cdiatcl}I. You will recall that I propose tonominilte as revie\\'crs sevcraliwc11-l:nowu scientists highly qualified in the fields o`'cxpcrimentaU\\,orl:, tumor patllolon.y and lung diEeases.'I11cy will all be subj,ct to }c)ur rejecticn for gooriicause. Your reasons for dcnving'iny requcst, ail enderstandMcni from your letter, arethat th: fornlal papers will be publislled in the very near futtlre and that it study of tilenr"ill sntisfy any scientifi:, or oth:r a~L..,l,IVi.J L~.jallulll;~ tll4 lltlullg.. L\IU lPtll 11n1U 1110 1C.71C1M lU! 6111}'!1Ig I1q i[iCiU::\I' [llllll C.11;1\{IIC.II:g. First, pu1Y111Ciltlomin a sclelit'.i1r jollllla t\\'lH not occur Unt9l many n]nntils after the VQ:1Clorf-f,stOria press conference of February 5. _Sf'cond„t113 A111cTilcan CIIidcJ.l' Society at that press Co:1f:rCnCZ made S°r10tIS allC; FitIG'ru ag,i3ntit this industry and its prodws. The Society said in irs ftessWi°ase that the f\uel'o;;ch-Ilarumoarl findings "shoulci have a siUnificant imhc:cUon the siaol;in`, of cigltrcttcsin this cot.nt'r}', and will probably Il:a dto a reassessment of advertisinS clainls and policics of the clgarette industry:" Thcce findings have been t\'idcly ptibli'cizcd in nc"opallel : and the medical p;tss. How can the Cancer Society say that serious analysi:. of the. \vor1: nlus+ be dela)cd until fornlal!; ablicatibn! Finally, the published prapers cannot satisfy qticsti; ns about such m:attcrs as the prop^r in'xrpre- tation c f the patllo'ogic n-raterial, the :1p,;aln tha: cigarette smo':e produced various eflcc.s in the do_s, the valiaity'and adequacy of the cxp:linrental G.aif.,n and pro.edllrc, and im gcneral!whe,ti>,c , as you asscrt, the. exp: riment "meetstlne hi gllust tradi''iio:.s and l;roto: ol of scicntifec invi`stiS;ition:" These matters can only he resolvcdiby exar.;ination;of the. p ertincnt ol:a : and Irr:lteri;;L_ It the. Canc.cr Societ'y does not accede to my rcc;uest„\vc plan to use every clCans at our disposal to see to it that the ntedical and laypublic are made il\\'are of our resPecti\•c positions iin~this rnattcr: (l t?;`~Ctti1~I 1'urtilCrmolc, \\c intcnd to coil 1 wGC to t-7C C`(l lir~(Ii+iCl f: ("j1OSIPC hl1 C`-1'' l lrleilt t `I - ... .~ $Cll'ntl'f!C SQI L:'il\'t 1111tiC II...L...:r S11` ~_UStti.t.lt1? C~lil t 1 ~S.~I . CCllt l it[)C ~.~1\y iFCIC sC to t11- \ t?11 1 1 LIIA \ C t101~ (!il `~ _C~C(1 1\ 111 1 il 1,11 ;C: t(~' MI h~)I I 1\ ~"rl (CI 'IIt! t l?!t t=) ry __ _ _ .._ : __ ....,.~..: 1 !ll'l1 ~1~C11 i l . 1 1 9 l , 7 O i f I i t . l • \ _ I I I I not t.l!I)I~) t i ~ G 1 1 1 1r 1;?nS l 1 9 Cl at t } t S,^cI,_t CW~l( i l:l ~ 1. t(l .. . ...~ ..~-~~~..~...~..~..~..~..c,..~........ r.` ,...-...._._.,.e..:.~,...~...~. ,....- .~..-+.~.......~.... a~.. :.. ..~... ...-.- ' . COllfCI[!ICc.. March 20, I9M I have your lctter _ fWch 12, 1970. I am 2reatly disarlpKn'sd that the 1\mericanC~rc~r S~cic~j I'HILII' li~OR,'RIS IWCC..U",LV100 PARK /1\'ENUE.NEV+''itOr:K, U.Y. 10017 Yours vcry'trnl}; 't `U ~'. ~' •c~E~+~•,~' t incrn'r l-' C'llllr.rin 'Artl "=tik rfit~ Chairnran of the Lxccutive Comztliticc 171c Tob;tcco Tnstilute, Ictc ` -6~~

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Sts: itr)1c11u11„ • ~ \'Ir;na}l.):vl!r.rs,`. /'afiiolo,dif. 1 -J Si)rl.'0)t'1' ):'C}Jt l.`C2.12:1tiL NtrN. 31 iiiu ~; l i (i' +ul lPv . 01, ):r171-o.): }XTI!E 1:017`.:Il Q?' 7:L')'rt 1:SL\T -!YIIt'::°. 7l'1 tcc+, V[rth ~.G J•50l:tr...C.i~L'l.r....... r. lTtoyyn- liol ] n:ctcao' lt:rr } 1 w , : 1h dc- tal'.:: tt..+lt':c•. !a ot:; ~:t ,.. la tou:' 1'r.crto Lt:c..Cat[. ),tce )ni lE = 1:1[:dlc ) t~. )) Lr l.l thc c l l n t'\ P- ,iblc. t LLc 1 r 1 will 9r : c~. .nnuci 1 t. MI rli 1 1+ lcc t[ t)Y sL.v- (l!(•- nJL )CCt Y1, 111 p (o ';llti h, :lrlni tl 1111rc 111 ?< t t~~ , 1 r co.111t11 :1 )I l.r. ,1?:.CI/ C11 r`l .. Y!- 1lt:' t:'lc.ntl thc c.n.la: t,, l..b•c. a .

'1~r._.1 ~J~~ ~ ~` ~~t s_~ ~7 C..'{>> ~? C.t-.~.~{_, L~ ,`--`~,°-~ ' '„ C~~ ~ ~r ~ r, ~~.l~; ~C. .L~.~~;_ 219 EAS-T . RL- SF:AIRCfF EDUCATTON sERV I CL STREET • NEW YORK, N.Y. 1001I7 •(21',2) 867-3700 WILLtAM B.1-L:.WIG CHAIRMAN. [SOARO OF OI°tECTORS .April 17,1970 i Mr. Joseph F. Cullman, 3rd - Chairman of the Fxccutia<e Conmiltce T1icTobacco Iilstitutc, Inc. Phi'ip Morris, Inc. IOU Pm}: Amnue Ne, v Yor1:,New York 100 17 Dear \4r. Culinlan: - The Veterans Adn;inistr:ltion, the American Canccr Societ)r and Doctors Aucrbach and -Haltlmond'canmaccede to the rcqucsts stand in vour lctter of Fchruary 27 and \larcll 20 for <tn ev.a;uation of the tluerbach-Hclnlalac1ndlstuijy on ";-!le FfTccts of Cii~arctte Smoking lJ}~~~n Dc~gs" by a Pan,l of ind_}oertt]cnt scientists choscn.h)- you. - ltfttt tCliuCJt N VNUUUItrs'cltUt:"llll LtOCJ.:ICilA IUCC-Villllltldlit.\•. IIIC StUU1' 11111tC'.11t111~J11Un\\aJ 131C restilt of We and :iilalf \'c71rs of (;lie9:nt allil irri!ii:111t "at-i+ by two t'iilillClltly c)l:llinKscientlm, mihose findin,,s have been v:!lidh,;:d by disti;l `aioletl pat!:ul l~ :sts of \,;orlclv; i:!c r.pu;atio,-. }'n a.'i!.tioa, othcr lcac.!!ng l,atllolo,;ists, Ili.g111y rag:lydccl by the scicntilic community, have visited Dr. Mcrhacli`S 1aboratory, seen his sifties :lnd hr:lWd tl,c work. - We do noi lil,cllcl tc, M tha; t'yri•:c t"t> emingnt nlen stll rit tttcir fl~tliltos to ala~ l cf„f CCIi)lniltitl'Chkc..11 tl\'tl't i ~lli Il;lJCli 1: -tit "1!]cl]- \Ct_ ~fr~ . \\'II1 r L. >: )~ll. {,~n ~ 1 ll__ ( /i'.1 n i~l tll .l "l in the l:r na:;nt.~l ol :~nu-ric:nl sci+~ nec. \\hcle fit;cn ; are l~res uted. discu>sed„acctl tcd or rejcct:d by scicntists and pllyMcialos \cliose on!ti• motivation is the t'rut!t Poctors :lucrhaclt and I 10m1torld wol ked:freel)' and n•itllout res"mint \\it!i fundl fuMnis!iccl by he federal eover:rnttnt and the Alne.ricctn Cai cer Society. They are beholclel; only to IN scirntific comnlunit)•, tlU large and wlle int,grit)• it rcpnsents. - - -- If the To.lacc.o in6titutt:. or any sciclot'if'uc rcsearcll ^_roup, has d'ou1ots ahout the f.njiiles of this StucO; the Way it was colrKducted, or the cri:delotials of to il mstigalms. t!lerc is a tinoc-honorccl and _, scicntifically accepted \ray to proceed. Lct your own or ano;l:.:r goup of scit-?ntists repeat the ekp:'rlSnCiltsln a l:lbllra tllrl•tt7 ~'1rC)\'C 111;11 slll(\':I11g (!tl-, \\ll!nOtSUfl,Cr ll»lli,c!allT tgc; e:ill)!11sC111:1 and }unl;canccr.lltc:-~tlcrh,:cIi }'}antmc~rnd tttctlto,ao?o, y is rcar-Iill ;traiLlhl,c Slclu. And I presume that in the Council for 7bbacct, Research yoi!rn\•e or cmsct tlp the noccL;listu fc,r con<!ucting such a stuj•: }fyou carr)r, out your nltrtmpttb!icizc Nur ru!,:cbi\v posit'i;,ns" to tl;t n;cai,:al and !,l`, public, you have our permissiott to usc this lcllc:r ,is the position pahcr of the Anlcric;tn C,tncer Society. 4 2 N D Sitocercl); I,El, [ J; 'L S : titrilliam 13. Lewis

[•7ASHIhGTON DAILY P:LL'iS 4-27- W> )'agc 1 - ]loaclilimcs ):'age 2 - Story 1 ~1.tf.jr~ .~%" _ ~(Jt.i' , ~'i/ 111,11`a_ ( t t r ~~. F "' .If ; ~ LC\GOY t'ir:V - Aca.r 7osy Curtf~ p:eadcd m lry ic: 3y to po>sess _ e+.arijuara and was -' . . . -- Efined 50 pauads.-$I2;, .. .. ~. - I I Afc Curtis, Sa, was arrested at Heathrow yec;er'rrv aftcr cuz:orns :i F ttors Airport found ]2ss than one ounce of raanj t...~a in a fx:uch inhisluggdge. The actor a--..='_red this morni^g before the w L'x5ridee \1ae:stratc. Crn-r -a °t . a,A guilty.,. His Gritish a1torsec„7tdiree Leach„to!d the 1 L I L three magic;rates 11r. Cu: tis did not use ^.. juana hi:nself our had~ been m{vea it by a fricr-d before leavino t:i:,c York for LondCn. Mr. Leach c%p'.aisct'_' tt,atCur;G was inlon- don to ma]:e a TS';eries andx;cu~dbe nere aC teast a year. The attorney explained Mr. Curtis teas "up- : rcoti ng his life" by co:aiitg to Locdbn for: this ~ ;T Yorl: at>-,>_rd a: ll0'rC irt his third wifc, Etitish,t;otn to:mcr r.;oael Lestie Ai'.c.!, 75. ]ong and! as a resutl %cas"under difficult stress and straim"' Mr. Curtis, a Erunx• tt:Y., rativc •c'lose real name is Eerr.ard'Sc;' artz, arri4ed from ctr Both Mr. Curtis and lcs u•ife, vzhr,nt'ie mar- ried L+•o years pp¢zr in the U.S. on a. nalionally Wc~i;•_d peblid service adi,crtise- I rner.t spr2nsnred by the Amcrican Ca,;:er So- cicty in whioh they sptak at;out dnngeas of S:nG]<'no: . .. ' t He has m;dr nun;cr•, : ;sn; !:ia^ c!,a ,.;t. e w `.,~.~. .:. :.,..., trct tacro_ci•.e? aod }::nrl ds- casc if they ':1sc His lav:}er foid ll,c c;a.rtC¢rxLc ras in effect °starti.'•!!7.nP1o f.c;ci1 }old".i`Cis r.:,t a n:cn ct 'o sr'.oCes e~,~~ Q asz) ardn,:,nt•nttlj airc 1 otal i ti .. r1 ar~: <e.- ' Mr, Leach s:.iJ' t!,e fri^cd ~r5*m he,didrot idcrdify, tu!d :Sr. Curtis t:~zr~ thc actor was lur,;"jtate •~ndl strange. T'a^ fticnd~ ttitn ga~'c him the mariiamn.s„tlre cttcrney said. The arrestinc officer - id mr. Curtis was "hompictC;v oo:^c•rative" tri;h l;olice andicus- tctrs o`fici::?s. He s2i3a scaruh of the actors e totncd up "a . small a:r,o~jnt of mari- " juona in' a p.ouch." The detectire said . the arinu: t %vas "iccs than ae or.r.ce." D4n Lcach ap;r.aicd to the magistrates for 'rr,enc_. s i-~ ~ c cr::c:y is "the pc;cc such l;cr ...s as ',Jr. Cu , s may have to pay to: the f_-' ,. cy recui.e. The m. ,-'^s, -ttco r.:=y and cne t:orr.an; rct;:cd fo ..~o m:.aes to cc;i rzrote sentence. Thc•: irr.oos d' the finc comroent„ the 1M:ct' p, b.c pcna!',y t..-:::c the danr,ernss drt:g F:ct::or tl'?tC , . - "t l"::n V1u," CLrt'i said .'Cd. 17rUl:e ltlt0 a sr.:a!1smia• rs he ]c`t.

~~~~ ~ ~~IP i`~ORMS iecorro+A,' o .. 100+'AFiK AVENU[. NENI YORK. N'.Y. IOOll7 10sr.ru r. Ccr.ratAv. 3ren CHAIRMAN OF THEGOAHD Mr. William 13. Lewis, Chairnian of the Board Anierican Cancer Society 219L-ast 1211dl Straet! New York, New York 10017 Your lctter of April 17 states that the Anle0can Cancen Society is'wn.iilingto Fcrnli' an impartial review of the Auerliach-Hangmond data by"any Wccted colllmittec chosen by the 7 obaccc Institute, or any -)ther grouo.,, You say our reduest Is "Ithout precedent in the scientific comuiunity." I subniit that the Cancer Socicty'4 exnloitatican of r lir?d w !r}: foi~ +~lhlicitn~ptirhoses is t'~~ul ~' ~~~itl~out~>rcccd~~i%iil thc SC~ E11:IS coll]nlullltV'. Zhroll2h~Its use of plibllulty, tuch)llll,l:es rath,:r ti7.IP: the tltiu: 1 scleIlt!IILClballi?::~~ it )s ...,~~.~,..,,,_.r-..= ----• lhC' ( riliCc l' JU~;~Iy'-IlOi the tobacco 1ndUstrl'-Wch, contrary to the traditions of American science, has projcctedthis study into the aren l clfpubl2c di;cussion. 1=urthera,iorc, in the scientific connnlu:rity, cxhert review palaels are often convened to rnicw inIhortant questions r, llich dellend uhc+:r the interpretation of research rentlts: You claim nathnlrnoistc hmw rh'taci Dr.: ~iicrhar.il's l:l}inrntnrv. wrn his ~liril>c an;l rnrr,isffd the xvor'k_ Wh j', t!Ieti, do 3'C1t1 riSfuse to loorllilt all'In;j ilrb1Fil r:1'1Cw by dis.iPEi:isiicd scitil?i6sts,11iccl4311 ' In'\'iz\1` of your clalnl that this \\'o11: is of ~,'reat' significance to the sill qlallg hlVll:iC:ltld the tobacco industry? As you say, Doctors Au.rhach and 1lalninond worl:ed with ;Iunds furnishc.d by the federal rovern- rnent and the An:cr:can Cancer Sociitl'. Stllcc',tlles; are tln t"tti ('uA'i:d'lrOnl ptlbNc Snl!reCktl,e l, lTy i entitled to a fulll^1df ii+c.:Otallt of til~-'resU1tS. Tlh. Aineti,:an Cancer So..Iety canlnot presutnctubctl:e ,,..,~.,._~.~.,---.-- _ - -t...._._.~...,..,_........_...., soic custodian and int:.rpretr'r of the wow. You st'atcd tha t these scientists "are b;,hoNt•Il only to the scicntific conuaunity at laMc andl t'o the Intebrlt}! it rCprl'sen.ts.°" l>utthe Allli'ricatl'.Cancc>r SoLiety', an or"ani7atlOns101)j hrted by 11ttt.lllicdoilatiCl:s, is certainly also "he.halclen" to its conti•ibiators and to the public at huge to hrodde complete info:'matiolr .about the research wllic}7 irfinances„espccially- il mcw of the fact that you have released nows of the study U the hui)1!c I11cdlal \Vhen the Socli-ty is t;u +,siIo11Qd about its iiltcIpret4it!ons Of suclli I1esea1•ch, it should feel a responsibili ty to disclcase. We data which, ib alle ~c s, support its interpretations. You sug>;csUthnt the way to resolve any dot!hts about the stuaa' is to have another research organization rcpe.at the work-Ahich yuu say, \wF cornducted over a p.riocl of tlh;ee and'a h::lf years. 1ihis, suggcstiult o•d,erlocrks the fact that the American Canccr Socic•ty- has c:tlGcd ilporr the to!+accu industry , - torcilSSes Itsl;ollcltslnllglltof tl!1eprl'sCnt flll illlgs.,lf thl'Is iSthCS{)cIot\'"sIDCiSatloll,it shotlild n 1wQxl)ector'want the ci~arctte ihc~lustry to go throur;!i tliree and a half ye,trs of research to d~~ttrnlii~e alt~,~rers which the Cancer Socictyasserts arc availal>l;. to;'ayr. In de.w of thc'Anlerican Cancer Sociclti'''s ho•ition, we are hroceeclill" to' lbrin~ this Illcitler to the ~ rtttentii+nlo(tlte, public. -10U5091695 Youo'~-Veryt truly„ j ~ f p t11 }I~ ~ J l d oscl, l P. Cu5itn:11, 3r (:!lairnlan of theExrcutivr Cotntnitto'~ ..; ~ The Tobacco lnstitute,lnc.

17 FRO:d: The Tobacco Institute, 1776 Y. St., N. W., 1•7ash:ington, D.C. 2000G. Contact: William Klocpfer, Jr. 212-CA G-7160 202-29G-8434 t FOR IMMEDIATE USE THUI;SDAY, APRIL 30, 1970 claimed resulted in production of lung cancer in dogs with. cigarette smoke. Cancer Society is withholding significant dataifrom scientific scrutiny in connection with an exYerimcnt vhich the Society •' NE<4 YORIC--The Tobacco Institute declar.cd today that the Americz,n scientists. disclosed that the ACS has turned down two 'requests from the Institute to release the pertinent erperiment+al data to a panel of expert Pointing out that the American Cancer Society said the tobacco industry should reassess its policies on the strength of this experiment, the Institute disclosed: it had called upon the Cancer Society to perrit an impartial scicntilic review of the underl}ing data. At a news conference Joseph F. Cull.man 3rd, chairman of the Institute's executive committee and chairman of the board of Philip rtorris Inc., C 1. I L L the d'ogs, including two of eight which did not "smo)te, had c:e'velopad lung tumors. -: Hotel news conference last February, ACS announced that al number of The experiment involved nearliy 100 beagle dogs, most of them forced! to inhale cigarette smoke through surgical throat openings, at the Veterans Adhinistration hospital at East Orange, N. J. It was financed by Cancer Society and federal funds. At a[•+aldorf-Astoria Mr. Cullman said the Institute told AC£ it was prepared to .establish an impartial scientific revicw panel and to bear any costs . of their investigation. The Society could reject any member of the , panel for good cause, he noted. He pointed out that the Society, supported by public donati.ons, has an obligation "to its contributors and to the public at large to provide complete information about the research which it finances." He addcd: If the Cancer Society does not accede to my recruest, we plan to use every m2ans at our disposal to sec to it that the medical and lay public are made a:rare of our re_:p`ctive positions in this matter. Furth•eirmorc, we intend to continue to pr(--ss our renuest for exposure of this e;:pc:rin;^nt to impartial scienti.r -;.c scru:.iny by qualified experts in the manner :,ury~es~c:3. If the Cancer Society continues to cirny accers to the wtsr):, ])yeli.cve this scivc as convincing evie:nnce to the public, lDy and scicnrt'.:ifi:c, that tLe.. data x;*ill not E.apport t) c alil-~r,r(r.iono 1nadc at the Society'.~ S•:aldorf_-I.stori< conic)*o_ncc. "

iobacco Institiute to nersuade the Acc°_r':ccn Cancer Society to agree Overscns Press Club, t:c%a York City t;pril 30, 1970 pcndent scientific review and cvaluation of the results of ;- announce>w.nt today concerns the efforts of the I an experim_nt entitled, "The Effects of Cigarette Strol:ing Upon Dogs." feYence at the V;aldorf-latoria }iotel to announce the results of this Rematl;s of Joseph P. Cu11m.-An 3rd Chairiran of the Executive Coo:nittee T1IE T08!tCCO I?iSTITU`l'E , INC. _. - I 1 expericsnt. The Cancer Society press release stated; "For the. fYr<~.t ti=, scientists have produccd lunE cancer in a si:Eni:f.icantly. 1'arEe ex.p^_ri:rt-nt-:-1 anii:rl as a resul.'t of h_a\y' c.it;arct:tc srolciriE " 1/-.st cance of that cJ.<i.tn be lost oa the toLacco industr}•, the Cancer. St:icty r:dd~-d that the fi>rlinLS "tchould hav.~, n sifnific. i:t ni,d' vi'11' i robal ?Y icrpact on t.he se:u}:inz of rii;t:rcttes fm t hi.r, countt•y.

--°- -----~ s .2 ~ lccu to a rcassessD=nt of adc~crtisin•I; claiLw and pol i.cies of the cigarette industry." The press relc:ns•, also said that the fi.ndinge "cffectiv41y refute contentions-by cigarette manufactul:ing interests . that there vas no Gig4xetti-cancer link, wni any claiess tothe contrary were onlystati:stical'." I don't need to renil;d you that the Can-ar Society's atterr t to obtain m :xi-rcum publicity for this alleged "brefll hrouFh" sf.ori;es in uuny nUwsl?4per.s in t-hi.s country and other parts of the zm£ highly successful. It resulteu, as you I:rLo"!, in prominent world. J:ie popular nl:C,c.zi-ne thi's month~ heaM.ne , its story on the "SLSOsf.inst' dot,9: "Iiev er. again can the tobacco i.n(.'us t.ry hide bchitid its T1rJf,t'•used Ciefe2lse that no on.`.. ani.r.sls F?i:th cigarette smorc." Let r,' emj ?I asi.ze t as inducce, cancer in laboratory i 11 of tlll.s I7ubl.i:ctt}r concCZlis a _. .-.o~ - .. .~,._.-. . ..- ._.w.... k'ich has not been T,ub)~.is1`~~d Jr, a;,y scf-c-nt-i'f.c ~~zn~:1 ~t,rr4t. 7C~G p or t~~.v.....,,._._...s.e..,-,,- ......s..---~r--.a•'.-. _'°'^"'"' . ~..-........,r-~- -•~. • . icccdreh vhiclt h~. ,..~^s not Lrnn 1;1-,C;C i;.t'i1Jlc f>lC for G2.scuf,.siOn or GxaiD"J~L)n'.~ ......,...,....~~.. _,,.,,. ....._........-.,~.-.~--'°--„'..°".."" { L -r.~ •tr T"'.''. , - .. y, :1 .+ 6.y A i.7 Z.; _ ~ t. y,a, t~y. +~ ~ Y~•+z`~ .,:Y ~ •\ i"'4~ i., .'.~ r . •:.- ~. . r . , : Y. .7' t±',.. .~ ~C.y, . . presentat9:o» of the woik was in,dc hy~ • ~- >z . ~. ~ ; *~~`''~'~~ fic cv:,~n~-tY• ti £ " ' -~'t ,: . en thc sc 'ti}• . t~•r.rr~~w.i.w~"~ :;F :_ 's.:.._:,-r~. ~ .R+t il~M~c~rf~'tr4; ~a~ •~,•' ~ ~~ ~r ;~~~ _- ~ F~'~'~~ ,~,b~~ :• . . . : it A '`~ "~ ~ , ~ ~ -~~~.. •ci:~C. 1" n. Y~i.:~. ~±a T4 ~ ~ ~ ~:. ...~.

investigators to the Cancer Society £oard of Uirectors,on February 5, and t e Society i~~diatcll aftcrxard i.esued their I I reports together with an interpretive "Caclasrounder" to newsr.r_n. .scudy. . of eaferivental results in the lay press before pubLication iman authoritative medi.cFl 1c.urnaL i's consi.c,crcd ourstPonab]e - if not an ic:proper -- prr.cticc. A discussion of thc inpropriety of this type conduct appeared in the New Englend Journal of Mcdicine last year. You have in your press kits copies of an editcrial and tuo letters reputable rc.edical journals have been review^.d by co;npetent editoria1 boards before they are in the pubJ.i.c cio:_tins The Witer noten out it is difficult to sueta_n i.'rt;tci,rily t•hcn an e>:pcric.^nt, goes direr.tly - from the n•.cdic: ?.' proponent to tam lay 1>mas. In rc"onse to thf~s cditori: 1., under the }:caJinf; Of "Gcpnrt-r. 7iu:t M.p the Cun",

doctor writes, "Isn't it about time that medicr,l t:cientists realized i ~ ,'_~ _*: ; ~,: the iraproprie::y of giving,preliwinnry eapcrimental results to lay journals, neFrspaoers and even radio andtclevi.sion reportere?" -articles should not have been submittedArpubLished elsewherey reported in lay journals or •through publir information mcc.ia. _serious science-ne4s reporter uses an.investi_gator's failure to appcar- either in a proi'cssion::l journal or on the pro&ram of an established ceys regard his wrork as of d'oubtful value and hence to be treated {]e :crtzd_i71y subscribe to this tioutlit. We bclieve scicntists should report: their wrork to their pcers - at scientific reetimgs or in scientific journals -- and' tiiat such presentations sh<.uLd"ba open and

relations effort, the Cnricer Society has ciLeyi the public the ------------- fmvres:ion that the Society has 1ci.:o;nnili:nccc' sor:,ethinS signi'fi•- havE raised witir the Society in our correspondence, and the The Tobacco Institutc dozs not -- and -the public ° should not. -- accept at face value the claiu:s 'm-de by the Cancer . As I have alrcr:uy said, the prescnt accounts are, to ri.i;orozas ii;c3chcnc;c~~t sci_cnti_f:ic revi:ca:. 'I'hs histor.y of tobcicco and hcalth r_es earch co;it<:ins tan)' eX4r:ples of cxPcrirnutc ybich were inftially, , .M•~%~ ~ ~ J ~ ' "~J.1L w N ~ < X~., ~' a .L.* 2 r ~ ~ x r f-^c P { , ~, ~ - : L7 .. :._, - . .-.-,- - - -_4 • ` atar;~ cal:t}~rou~hs but on ~ lai.led as scicnti fic "b - ._ _ r... .~ _ . ~ ,~~~#

'of thecc rcrorts werc We undcr irapressive nucpiccs. ttcx sure that we all re::=cuScr the Stficku^sn filter C- l fiesco, the role of agreat Uiiiversity in it, and the ' hearig&s beforc the Senate Comse:•ce CotLVittec occasioned by the announcement of this so-called scientific breaF- annoiincerhent of these deve2opments makes neks, but the - 3 Kter criticism of the c or}: rarely comss to public attentf.on. Over the years there have been many r..;n) empcrSceritc in uhi.ch sc;r:ntists Oa•.e tried to induce WS cancer in anir3a2s NO ci.grrct:!: sr.;c`.;c, Yhesc e+>i,cri:rer,t^ have result:cd in a pna•ristent f;ilure to de;a3:,sl:ra;c. - -._ _-` ----.-----•------ Zui;r, cnnccn in hur.ans, in any of LK ..

_'7.. who ve believed wou1.d be thorGuc-hly acceptable to the . • . , fnciependeiit cvaluata.on of the exper-icsent in question .:- and its results. tlc said «e would propose a Q re- Socictv. t.e also t tat.cr f.h:':: i£ tt~-,e So::i.ctr should . to bear all costs r~c.cc:t.cl :'or this i.»c?c:pcndent F:na}_ysi.:. The Tobacco Trnsti:tute has twice rco,uc:sted the. 7.'ne Ci;ncer SocS_et:y`s icfu;;al oif tiii_;: rcquest -l:ai_ccs a '~. ses:.ious c;uestxert €:1>cIut the valic,i t:y of the da ~.- .. ..~---~--- - - - .....-.~...........~...,._,_,,,~ ~._......_.~.....~..,,,....,........,..,.,...,.......~......,_~...r...... nUCut t.}tc: t.inlic:-lty Of its c}:<:510a, f.t. NN"u}c1 11<Ve. t-F;):c0d t.o our ~ ..e.:.~-....,--.,... ..~.e,.............-....n.ti,.,w r,.~...n~... _ .,.._..._>,.,r..,.~...~_..F viewers r,--n of outctarncdin;; coTp etence and integrity, with v~i.dc experience in areas relevant Co Oa7: Lc}.ici i_s tl:~L i; Ll:~ C: Fcc~- Suc(ety ti:erc confi(lent

-8- proposal for the ncicrti'fYe-review. The fact that the Cancer Society chose to announce the vor.k at a pr channeLs, is . ... y ._ . . ... . . . . - .. . . . _ . . . in reactio;a to announcer:_nts about new scientific f~.nctins,s even uhcn t~v believed -- as subsequcnt events proved -- that the sci'ence~~as probably questionablc. }toa~e~•er, the Cancer Society`s cxrloitation --------------- exas:ined'~, leads us to conclude that %.,e should bring this nbtter to public notice. ecs conference, rEthcr thsn throu£h the usu.a scientific the Society'a first refusal to garmit this review, as' you can sea fr-xn its letter dited 1Sarch 12, is based on the contention that a full report of this tiorl;, wi.l l be publi;:lied in the very near future and that a study of the forr._n1l pupers will satisfy any - c(ues tio'ns 'EriC;Out fi:rtl;el investi.F: cion." 0.:L' ans5Ce1' w:s~ that takc place for so::~:: Cin= and that cvazr the public::cd p:pzr5 viL'i not Ln~:;e>_ CFcc i:u;;o; , nt c;ucsti'oa~ ~1~ouC

thc.t in or`er to dcci.d-^i v:•tiet::^r t; c c;o~,s actually c:evelopc a lung 0 cancer,'..they Naould have to Ioolc at the a.ctual. tissue specimins . or microscqpi_c slicies. They do not f.eel.that they could forril an accurate o;,inion on the basis of exaoi_»ation ofphotoraicrograptrs, which is" what woul~d appear in an article. .. .- -. , . : which 'I wonld!, like to discuss. Notice that he no longer says in " this -letter that the article will be published in the "very ncar future." He no°w* says that our request is `.`vithout precedent in the sci.entific co:::muni.ty." I have b:.cn under the irpression that tt:e sci`ntific corw.:ur,ity is an open society in. which scientists are understand also that expert review panels are often~ co^vened to settle important questions which depend upon the interpretati.on In his letter of April 17, Mr. Lewis raises some new points M

rescarch resul:ts. As. I said in my l.atesi: z.eply to, 11r. Mwfs, "I submiC that the Cancer Societyts ekpl.oitation of this u:npubl_ishcd uork for publIcity purposes is truly wit-houL- pr.ecec:ent In the scientific - coi--aunity. Through its use of publicity techt;iques rather than thc

• . ' --- ~~c~ the Cr.ncer Society now choocec to close the work off from fus',hcr examination b;. r; oup of dist'ino.uished s cientists who c:ouldl have tuo eminent men submit their findings to any selected cor^iittee then, the Cancer Society is simply opposed in~principle to any kind of review from any quarter wlzaterer. Yet, Dr. Luerbach him- expect E certain amount of skepticism and that it is extreeely izlportant that hic colleagues in the scientifie co=anity not only see tfe raterial but also have thc opportunity to voice their opinions. Berliaps there is a; differencc of opinion between tl e Cancer Society an4 Dr. l:uerbach on. this point. Acco:dinp, to }•'o.-. Lewis, the r.cientists "are he;;ol!c''en •onl~y to the scientifi:c corrnuni.ty at large and to the intcgrita it rep+_'ese»ts." it r.neila: to u!s that the /,rcrlc:n Cancer Secicliy, ' t . .. an or,;anizaCi_on t:upported by publ ic don :t.ons, is nlso Lel,cld:n to t1i'; lau',11.c at la±'i;e to p:'c-',-!cit. co;:q,lQtc i.nio-;:,rtio:i rt,nu(. the

=12- rescaich u•;oich it fi.nances, expceinlly in vi-ew of the fact that .the Cancer Society has released news of the study to the public media. Since the validity of the Cancer SocietyRs public com.ments of the work, it see-,z irresponsible for the Society to refuseto that it should permitthis independent review. Accord'S.n&ly, we . The Tobacco Institutic has preparedandplzced for publicat'ion tomorrow an .:dvcrtiseme•at s,*hich describes our di.sagreer.aent with ths Cancer Society.' This adver- tisement concludes with the statement: "if the Cancar Society continues to deny access to this recent eork, . . . :.. .. -• .-F"'~ ve believe this will serve as convincing evidence to . 0 . • ~ th(! i)ub1'ic, lay and scientilfic, that the data will not -r-ui;>>or.t the c1LcSsti:unc ezde at the Soci_ety"s l:aldorf-Mttorie conferc:^ce." 1?c beli:eve ti,at this in a fair i:nference mici tloai: the public ou,f;l~r to be given this zicti perslccti:vc

on the dnF SLudy, The Tobacco Institute will. explorc other aVcmrco .- . ~ . . by uitich this data may be obtained for expert examina- a proceed'ing under the Public Information Act. We are _ .,;a:_. . . .. • We intet.d to counteract f ny further publicity iuc tobacco industry has committed appro>:?s.ately - $35,000,00) for r.esea.ch on tobacco and health. We have estiablish•cd excellcnt research programs through the Council for Tobacco Recearch - U.S.1:. and the ljcericun hi^dical Asr:ociation Education and Research Youndat£on. Thece two organizati'ons have'distri_buted researclr grlnts to some 300 .cicnti.sta in mediovl schooi's, hospitals and research ir.stitut.<ons. The tobacco 'i.!udustry rcco;iri.: cr. and rcccptc: a resi,oersi- bility to ;:r.osptc the progrncs of ind:p"ne?cnt r.cicrzLiti.c rur;c=rch I

that rccPonsi 1flrE = cnd he~lth. In discing the £iead of Lobacea n ~~ s~c'nt s and coti has elieve that the to spen are enlarging. r.----~ th i s ar ea • ,itnents in oo* Che U;~ited Statos. ticrn than un)~ organizAtion in T for such xesc~rch ~rone} _,----- ind ef forr, VILL- exist about e gaPs in 1.novleag the pl J`,ate,to f il l ~,a,.... - . . : , - _.r------° . .~--- • sr,o:i.ns ci gaxett:e 4tn pleasea to bavv. sts with brocd, eYAerxence in . -- st~:r.guj S 1 _ . . - . ,......h Co ).wnb , Southcrn C~lli.fol-nia Sc:11:,o1 oF of Univcs' ; nc~' cn.. etcaYCT~ cLn~ h~ s bcen ~- . . .. p~ Son,a ;l.l. G - -._ -` . ~ x trse pa,,t 4i ~-..~t ~ti..~ .fe `~2 ~'~:St ~....i~.°~ +~~.s• L'aZ~~r.h• : £o Toacc reIt the.4un~~ lcd 1 ro~acbly' unParal.).c:no~ ; e~ge • rese4~.ch ar~d P. . ~ _ , _ : . . I. c 1);:rector of 4boratol-ics So;,trer~ She).2,on c D; . 1 c T.cilox" lzj )1 )~o'`'p'ta7: i.n l~c~,, 1'o~k al:d Cli_nicca PraScssor. c, . t1 `nd ~ tt sllc (;o~:).c€,e o£ lt~ssix<<r,s c ?'~t

- 15 br. Arthur F-sr&t is a vl)o f:r, I)i.)-cctoI• of the Iitstftutc~ of Chemical I;ioloCy at the Uni.vcXSity of Sxn rranci.sco. t1e is prescntly on Icuve from that post and is a Research Consultant

Cf'1~~CF~ i SO'_' IrU Y . lF' ? NE1'-FS SERi!iCE c- _ r~ © 214 E,;$T 42nd STREET NEW YORK• N. Y. 10017 (212) 567-3700 issuea`by the'.three top offiters of the Fsnerican Dr. Jonathan E. P.hoads, D;>ectc:r'of SurEery, University of Pennsylvania -_ . - .. . ` f. . - S:chl-ool of *Sedicine and }>resideL_'.os.the ~.uerican Cancer Society,; {Iilliam-B. Lewis, Chair. w:-of the Board of the. t1.^nerican Cancer Society; Dr. 11.1•fav•in Pollard, Pro`esso-r of Intarnal 2ledici.ne at the L`nivcrcity of ?ichigan School of ;'ed'icine;. ^resident-Elect of the A>Lerican Cancer Society - and currently Chairman of the Medical and Scientific Co::cnittee of the Society. Thr r~,iecr9._•e of the rLtaer=_- u Cazczmr Socicty ar.d its 2,000,0001vc1i_rteers throughout the United States is the eradication of cancer in man. The American Cancer Society stands firmly and confidently on.the mass of evidence, statistical, epide,-~nioliogical and bioloEicsl, that the smokino of :-_efEarettes is. the major carse of 1'ung cancer in man6 The culh.:inati,nl; evidcnce de>>eloped in the Aunrbach-Ha.-^•;:-,d report denonstrates that dogs can get - - - - - - -bmerican Cancer Society held in conjuncti.on:wit-h a r..eetiug of its Board of Directors. This was an open mecting to which physicians, other sciez:tists ---nd represcntat ives of research and cducati cnal inst'ztutions were invilted to attend. The Societ:y had licld i:my such scientific meetings in the past and will do so in t},e future. One of t':o reasons for a pre:,pt prescntntion to the Society and throaSh it to the public t~as the rca:sr;:3b1y significant d: ta c•btaincd 5-n support of the t.heory that the less tar and ni.cotine in the nainstrc::;:~ of

sraoke, the lcss the risk of emPhyscna and ]ung cancer. In other words, where effective filters were used in the study, to cancers were produced in the dogs. For years some segnnents of the cigarette industry•have attacked warnings f the dangers c:f cigarette smoking and prot~stcd. that no one had been --ble to This finding secns to be more important to.the cigarette industry than to the ACS. produce lung canccr in aniL:als.wi t:.h cigarette sr.ioke. This has nosr been done. • - . - . The ACS and most scicntists believe the Ha=ond and Auerbach findings are ~ interesting and significant, but even more important is _ - _ . - - ~ - . -. . - - - =~ of cigarette smAing that exist in what hapj ens to man, the proof of tha risks in.the analysis of riortality-rates and in the changes in Iung tissue of human beings. . . _ - , Bec4use of the great public interest in the link between cigarette szioki_ng and lun;; cancer, the ACS is reqtiesting the Surp,eon General of the United States .......e. _ ~..,.._.~._ . ~ - ~.-~ . - :.~- - The Tobacco Institute attacks the Amer~:can Cancer Society for zts use - of publicity techniques." This comes from an industry that for years has relied - on publicity and zdvertising to obscure the basic fact that cigarette smoking is the znain cause of lung cancer in man. VIe are naturally gratified that the -industry which has so long resisted scientific evidence apparently has now been converted to the principals of scientific validation, at.least in this instance. with Drs. Auerl~ach and Hamond. A 1iumDer of distinSuJ.s'ried scienti5ts i1aJe alrea: •There never has been any restriction against individual scientists visiting the Veterans Ac minis tration Hospital at East Orange and reviewing the research revim?ed the fi.ndinSs. .`Public llea7.th 3:.•rvice to conduct In analys':s of t:he Ifia; ~:,o;id "nd Auerh.:^li :tu~ .,.-

I p;io ~. - _ ---- Tobacco lnsiitute Ads CI.vlPenqe Cancer Sociefr• The Tobacco Institute, irked at the American Cancer So:ietv's latest stud~, linking cinGret smok- Ing with cancer, has mounted an advertising campaihn aceusin.g the soeicty of: ",rit:hholdi::o si.-nificant data" pertinent to the studh-_ The -' study demonstrates that cigaret smoke prodUced lung cancer in dolgs. The institute's campaign broke - 7r.... t w1„ - Vn.L- on.iVlach_ - - - -.. . . instoa, D. C., duilies and in "se- lected papers" in Kansas City, Dallas, Los Anacles and 5•.. Louis: ; The headline was: "The Tobacco Instihite believes the American public is entitled to complete, authenticated information about: cigaret smo'..in- and health." R&F Intermc-dia Inc., Now York, is the , ' agency.

I ° C ... - J J -a ~.' e-~ . ~'-1"!"S~`r f~ j- - / f .~ ~~ Z .~ y !~t_ ("~ /'` ~ i ~ ` ji` ~~'t f ~j~~i~i.t ~•-y'V. ~.~~.-.~ ~ '1 ~! ~ t ! o~.. If M~ yl'(.y f + , ~' '. . • . .. y~~ - . ~ I I I I- iih. \' r.r,n..•,~.I1 iy,i k\*.1.1. • ~ tr ~,~ ~ • l,-, ci ,c^ a. ~ ° 0 4,~ ~1J,~ ~:V ~ii'_lr~./t-`..~.` ~.!\4+~~:,`~..~ '1 \>/L~ '~ •1•• ! }•- _ . . .` "g' ~~ ~ C•y ` - r~ ~-,~•.~! ~:r• y •~'r ..1 • i i... N " '•a •/ rl /', .~~, l 1 ~ -'~- 1r ~ •~ '°' ry t < y Fy/ `< C ( ~f\ LQ.~ ~. ~a .~ ~~`~~ 1-`>/~JL ~ ~'..1~ J v ~ '•..t•~ ~ l \ ~ R S ~ ~ ~r ~~ ~ ~, ~ •. ~ ~ e ~ _ _ -. --- ~ ..- ~ ~ v ': ~ /~ •({ ° + ~ ~- °. ~ ~ - ` + /~ •. 1 1. ~ f ^ ' t 1 ~a~ , ~~`~, (~ •i y~~ t~1 ~ ati ~.~} T ~ ~ ,~~ .+~. c /~'~~ 1~ ~>- . •,~i:~ ~:l~ -'s 1..~ ~ ~ '`~.~, ti ~ ~: /,' r , V ~ - i ~i 1 i ~' ~' ~ ~ } ~;.' ~ ~~ti1 ~~ ~,~L °.J i/ ~ .~ ~L.~ ti1 •1 ~~c%~ ~f .~/2.i'r~ 2 ~/'~ S.1 ~ (' ~ ~ ~~ ~ 1 y_'~ ti T ~ (. ~ ( \ ~ ~.1 ~~ i/~ ~A~ ~ ~~ n ~ ~ic^ `~ - ~.+~'./Z 1~~ L/ ~.t/ ~ = / ~,•/d/y' ~ ~i./1,~ ~ .<~ ~. ' E..; ' } 1l~- ri - - yL k!~ P :, ~~`?/_y<~'^~p!• ~ F ;i1/l/~`<f ti ~.~ • /~ ~ J. ° Is the public entitlcd' to co. lplcte, alliliZ"?tlca tCd ii:fortilflfli;il 21.'odt re- sCilrc1 M i,ll~mrettC', sL1tUlilno- and lleaith? Tobacco L.sti;llte tllalks it is; 1-71I,: A=.nel;car. Cartccr Society s:p- F3rePt[1, thil]i•:S it is not. Ihc'~abacco ?nstit;+.te llasrccentlyr chal"u"-cd itl(, Ca;lccr So~,,icty o:l r- rrattcr of l l-,por'mncc to the g,l`)?ir- aryrl the f.t.h:,ic hz-alt!1: "1:1f:. Canccr "c- cl°iy li:^.s not .:upi::d this c111lie.1-L. On F:,1?.meln' S- the i'-mrPr Sn- C'Icty Clyllc(i .^. pr:.ss iC 1ili'F;c.` iil' tIl•~ ~'>>a1CC If f4y i0r11 t;ot{;i in i iCl'e YOI'r; Cityto ,'•iscs!ss areseare;°projcct titlc•d, "T!-:c I:f;ccis of Cig-trc.tc Smoking U f,oa 'l;~ro:.;-,!~l itle cfiiurts Of the La acc.r Soci;;ty, th., pu'0lic was led to bcl;eve that this cxoerialcr.t is a landnlark actric;errcny %:i;ich, for the rrs: ,iznc, dCnioliStra}Cs that Il]n;'c,1n- cer, r~1~L3i)1!aS"' l19i1g cancer in lltililnlls, can be Gr.o,~tiLycCd in YF:1'l]'u: ls with clgit- 7CitQ ! IOiC. The Ca!-.cc:r Soc'ctv cl::imc(; tl:at this retUtcs the conital:loil of the tobacco 1r.C:F:str}' that til,'.!•C is f.o 11,^.bo- ra`•C1rj`, proof of a i'oan-MlCn 11tv-'Ct;n ci; arettc sn:o .rn~ and cai:c(~r: TilcSci:"t'y.^.l;o s•i:I 0n:[t'tlFCf:nilii;es sl1o±]Id have all ilnp; ct on cigr1t•ct'c salo'civ.,- w1cl sl:o::I,i rcsia! in a re: s- sC.is;•ilcnt of tili. s:dv c',ItI I?l:i:S :11iu policizs of the tc;Lacco industry. that if the Society sl:o'.l!cI, for goc:l rea- 71hC Tobacco Jns{Itll'e •?oes llot- son, 1ejCCt aliy sC.lentlst we propose, and the PlU,4,liolilci ll^t :(cei)i thC:G we IlOliiiil?te a S?i tytJt;'ttZ. F1- claiilis at fa_e 1•'aIL`e. Tier: are the I+ally, we offered to bear .,0I costs reasons: - needed for this 1fr3cpcnd:.at analysis: I. The present accounts of this The Canccr 0 Scciety has twice re- sill~; _.; ba:ed soicl.y >l; or il;[crn,,a- jccte(1 this prci osal -ill let:crs dated ii•m1 and r,tc!pretry;iol,s provided to Aiarcl] 12 and C:prit 17. the press. The study has not l-•u'u- We con:inue to hJre that the 1'1 i J •'1y sC l•Oi::-;L.: 'I-e Anlerican CC.rCC! SoC:Ct}' 1:1; '1 ~Q:Ililt +'rere not sl.bjccttiel, as such, the e::amin :ticn of t;-.is •,:'ork in the -a~---- --- - -..•---r--r-----.--•.-:...._..~. QltijiC tjcilC SC:CiltifC rc'.'riel'J: is as it3l"Orta1]t as t~le Cance, .~iociCty, 2. This ii_5`Ory, of tovac,;o a n(I has represcntel it to be, the Sa:iety hea,th resear;>1~ contaills many en:arn- should 11:n•e no h~;sita.iion in sabnit- p16S of eY17C>;ii li:iits wI1ic'1 were tin't, it for reviCl:'. t1Cl1yIL121C(:IuS;Cl~m tl?cl_tri•tl~-tl]ro11,ls, • TIC toI'?rco in`IU:'f}' J I)Ct on l:.tor C,S°alUatlon proved to be and acrCf ts IC iCsi cn°:;D!lity to pro- Of j} ifoallnil:(:l j!~ mote the i5lo''reis of ICidc[' (';]f{en.~ sCi- the in;tial and hrerr;at'~re <^.:ln;,,lnce- elltif:,, ,escqr-.1in'tlie. uc'~ of tobacco PIcTnC of tI]CSy3 C.':17Cr1l]iCi.ts P.12~:es and !.C'ii~IL In C:1sCh:ir ^t;'~ il~..^:t r:.siJn- I]Cl5`S, but. the 1'FitCC criiiris n of the °IIJfIU )',, we I_1?~?vt3 that the industry work r:-,rely co::;cs to 1)1:I:1lL St'de!11o']. has siJc?iSt, rll!Ci CrllillnU;'.: tC) Sp e']d, 3. 'L`IC Toi;acco Irnst;ute has .e- more nloney for sl:eli researc;l than Cll':cstCCl'ilie C:lnc?r Soi,::;t}'i 1'1 tiizrlt:a^_, c^.ily Or"arl:i:ai:o;T,la the U'Itr(1 S'ates. to :C1'r1:1t i: tiiCirOIl- glt 1:iCitiO/:]1(1C>ilt GV,-?- If the C.^.i1CCr coC:Qty Co': ';I1'.C's to li :IlOll of the C\i,CrlnlCn.t a.rl(i lt'i re- CIurIV;lCccss to this recent 1`'Cr n, we Le- sP-:I:S. We said we !:'oL:CI proiJUSC as ]li:\'- thlo will as C^1Citlciei.~, C~'i- revii;rYra; Ilit'l1 of olltSt2liCl;n- (lcr~u'C to the public, lCly and $C.ICn`l]f;c, t'nCC lind 11:'Cgrlty, 1•ritlli whit; y2Y.11CT'1- ti]:1t the O<1t1 \'.'ili 11Q+ti S(i19iJUrt the .^,11C- clb-2 :lLia'i.•^s ri.:lC;V6lnt to U.ta, ':;ho, i,ailCll:s 1!1?,(IC at the .COCIii}''$ V1IlillUlf- \'i'.'. l;c1Fcv,CCi, Vloli'Ci be tI-:orc:IShly ac- ~Cstoria conference. cel:,aWie to the S~ciay. We a: vo statcd i,O)vilat Ji'PJc'Q.ced IoSC'i1Cf i r'c'Colil1t!C!i f(':C(()f llllCorrespaide)!cPClt lTtiSR2!l11c1'L't:'l1lY'P16 'lhz CaNcerSccif';Y c,~?td The Tc=hncco l;rst;tti!c to any intc•resletl irrdiridrrrl orgrotrp. ~.i:1~... . ' ... ....', .5 ~~' ~ - --• .. - . . .. • -. , _ ° . - :.~5:: ~.'_tcq~ .. F--44 P-!"-l tt r i C, 4.. ..r>? tinr :.`S. ta '''3St. J 1 ~ ._ -....i • ~ 1I i j 91 ~! p~ ~f,l - • . It.;.~~I.i~.,p~"/.; ; E .. V17'T'r: - n~ ~-'Fi~M""-'r ~f -1t`l~ i~'"'ii=`e~~-~-s:r,~.1-~ «.. ..,.,lr~o a

C_ r 3iaL 2•+`2 ~u ~1 j} -l- 'm t'Tr.E TO:I:LCCOI\srI•rvn: Match 20,1910 "1x1RNka>cs D- Jrcu i; CGairman of the (ioard Yawres ltan Ca:,u r Suckty 719 F.I. Z2ad Sttcct 11cYcek, htw Yotk 70017 ' t>Rw }TrLca:is:. . Z . ] 6are yrosr lsttcc o( 7„_rch 12, 1?7i . 7 anc . tst•atly iisa(q,ainwd tSat tt: Ans,ricas Car.:et So;ic•y has rcfuacJ to P:m:it tSO icn(vrt:al tAic+o t4 Mmco 'lir'nn•Jdvatsi.s. Is-quatcJ in r.tyt tlcr c( [rh:t 5ry 27 Swe tssso.i:rytt. a a,_._d t, oat1!_ c:psretto isdsslcy, tto rcaa::ss is ro:icecs in 6Fht al lielratiis,•S,itisotdYf:;caadpropcsfart`: iackty to pcrmFi on to Aaac ttosc iinain,s -Ls:scd ly;,aJtpcnalcnt exDCrls-anJ -yae~a-•-t/;. _ -.., You t+:1 rccallthat I r:n(aofe to nDminale xccricxcz scrcrat kttl-L :own scicntit:s1:iEhly Lua;ificd ia Co. fi::ds of aspcti.csental tumo6 pa[ha:oCSand tanpdis: sscs. llu:i will allbe suDjccl lo yoa: rtierl tcn for t.wd caux_ )'our tas :ns for dcnyinp r,tv taqw:G as I uod:rsei:sd ther.t from r your Iecter, ar: that lfa fis•oal par e:s wrZl.lbs D+1 ~i iE':d in thc srry srar fumre and t:uc a ss:Lyof tl:em s..i:( satl9ly auy sc;cr.tiEc on otistt qresao.,s re;arvin; the Cnd2ns_ I do r.ot CcA thexaeasons (at dtnyiey m; tcquestat all wncir,tily FirsGPublirst(o: in a s:iroti6e wurral- eitl not oeeue ¢•a?ir,;any a^at6sater Em \'h.l.tori-As:ntie, :ess con:c[cnoe of Fcbcuaq• S. Srco: d. t'seAn:crican Csaccr Soo`rty et .. . that Dress cootartncc nu;:: srfi ws: t:e,atixss . Socir:y,s:il.fu itt Drca [c ~ase tBat TeAuerSach-lla:n.:.o:,d rindia-s "s:'-nu:d t,a:c Al s:Cniftc:at'.m~3ct ct, efro smcli.ir.c „fc(: a:cttcs in u'riscu:ra;ty; and s. i01 P. •tJa:y lr:d tpa r.-ssesutwn: of ci:iins and po eso: tect V r.te ind.. ry:" Ttese 4ndin,stt+ebecn~Ni )-,DvMirscin ^cws>_r1a an! Oct mcd:cal p:ces. Ifow• caa lhc Can: r5oc;et- ra)- tSat scriocs a:ups8s ef 11•_ ~t,:~:nuu b: d:lay:l un,ilTorn:al putd7.at9en'' . - ene pob!is6cd papcrs tas:al seti'Sfy Cr-sfioas atsoc: w:L cu::ers acR:e p:oy:r i'terptelltio:l o: tl:e PJ-t:+:l:•^.icrlarer;ii. the Fl1e;2liUn that C;;arGt:: S:JCae pt,Yuted ca..ws c irc:s it ~t;:_ dO.s,the s'a!i< it•; .:W sdeq•~a7• o.tl:c esyc;i:rt:n:_I da:z r:nd: paoccdo:e, a. d ii -hettwr,as you as3ert- G:c erncri:aa[ ':'ierts trt kfi~a1test trad;Hnes a.d;~retxot of scicnti+ie imr_6 ;ttion•".]l:ne ^ustrJa cat t•n!y be tno:vcd t•Y csaa,i:ntion o; 4•.s pcrtincra Gata ard nxlrrizt; If tt:C:necc S:xfetydoes not actede to eny rrqs-!, we s•1>r tot•se euvp m:ans at out dis; r,al to ecrto it sial t(kme:it3t ond' v,T 1>ya:u'u c rr a as. t cf uuT r Fzcvropaaaio: sn tP s..tt r- aUs t;rr eiattnJ to c.>_..rn r.. 1;, i. css cs,, t...as. yorespora:_eft.`.iscs;:rinenttAi.a,urti:t s:ien[i,I<s<tut.r.:: Lg r,y:su::_ es!r-:la in lttnraarr.er s % , ed• lf,zLt .C +.tcr 5 ' lr cor.t:ra tod~: ns otiecv ,1i.+•Sicse tbis s.Jl s:cre if ta~ -7a,]c•, t•;.'cr cc Lr tLe Tv3!/,faya !sfenliir„tY~:qhr,.\ueri.aaY• ]fa..:.-san,l da7a i1f c: s f_"p.s; t Iho a;IMaiipn,.C ~de alt1r.: l.tidolS- /•san:i\ tondet T re. . ':.Ziars scrr (re5y. - ' r 4Y t 4~~v.~ y N~ •~ s Jo:rrb U. fc•l:.v.t, J:d '.. Chaisr :anct t'.: ~ic vti.s r.o:>:Cal.c.`, 7ic]'oVxc~l-i;ri:utt„Jne, .Y_wi 10055091716, ail\'1:1;'17tiIXC: S11CIi1111 P7:11171tli A.M.1:I(tCIA G~ XCt:2S0.':rl_•i3' ' . ' .tl~rtilq7,1910 hfr. Jescp:t JT. Cutlrnaa, III ChairmanoJ t1w.P.a<cuurc Conuuittce Th ToS crolmlitutt,Jnc.. I't Islt-is,a:rc. 109114r.A ::ua New Ye[i:, New Yerk 10017 TTo lkterans AAiainist:o:.on, the Amesi::n Canct•r Sc~i::Y as:rl f3oar.r: /--rctb,r li and I lar rw7,, cx+ t acc a,n I rqresls S:atrJ i. e y<+ur t_ tlrt of f riisnaq 39 ; nSI-Urctt :d ?oc.:n cs:du:ci.a~, o(As:c tt a;h- Iiamsm:Jstudy-oa•'IntJ"':~:cl. Cstr ttS:uo ~ UDO:I] byapar,tto( ind p.n'cr,ts: r lstt c bsc-a byynu, )outseq-~st tsarlboul p,c_ctentin lhb seienULe ecsneu,ntn•. 7:tc mf.y cndcr qcettiom res 0: t esu(t ~a:Iheec `.rd ah3I( years aLdi;iycr.: acdbrilJi>nt .otl: by, lsco er.nf.:eelty qvali.`:cd scit:nu6ls r-.ho;o f:nd[:srs harc bren raliG:tn! ty,a:t;nju:3::rd' pattwlo~iss oi w:otld..iie repul. tiun..:a aG:7it;o~, o9:'crA:a±3~g [•atho:~^ists, hd hly 7ti+rJrd by ISxsci.r.lif:: rc^rmr~~i!S•, i,a.e sisi:cd W. Aucrbarli s 1_bor: torr, s-::s his sti:s a: d'.::is:d ttrc CYCdo nc:;u:e: d to nsk tr:a th-se two emSnent men su:nif 0.6[ f aJi:+cs to :ny. _ srleneJ ro.>m;ucr chc•szn 4;•i.',: Tnb:cco Jdsticctr, or r,ny Cher :;eep• 1hc:r e: ksvili b:'f71i:rJ in rS'o traGi:ioma! nat: rr o:. A:n.tcaascree-e,.-h-,_firJ:nWsttcrTCrntY c..cas3n!,acce;w cr,r iacd bys_ito.,ts:o:~!:)sicia~s roeo-iy snctiaainu ia::c uut•l. Wttos and 1!arcmon:i c:ae:cd (rcctY=-r:i FiC=t «. ••. r i:h lur.a fu.^.:i- ! by ~:c fi9rt::l (•.o:~crnmr.a and Ihc :.mu`: n a.a:s.c So:i:ty: TE_ r,e:e b;L.>+d:n ~o: l7 :o.ti c saitn:ifm. cca^.omnS:y :t tart:: and a t.':cc •l.•,try:i:yil Jitlsa ToSa.cco dn::itct:, C. "-y s~2xn'if:o ycs:ar:h a~ a:•, , h>z GncS•s :yas ,ti,:o LnJin4s of thl4tta:dy: th. MIY Ita"-•a5 c0.13-,:la\(i orahe artdan9:ls cf nhs t.`.cse isa liz.c-!:aua:ed t'aY to p:J:cCC- IJtIl)-1 n^: n n:.:]CIirST !•cnup of scir:uicts rti=altSt fh ilab [ ur>,lor . l..atSF Jt Cc S P'+,1nU( SJ.:CtIi3. rrd;+.T,>!•r,r..q:r)a.•f.l an.:;,n- <aa;cr. Th: Ac::bach-l:amnnad n,xrletr;bt.iCy iaraa]ilY+rr.:':tiz uqou. A. d l{,m :oa:eRot in til~ C.+nacii for ]'OEacco F:e;nzrch yoa h_re nr.t.:: et uny(•.t naoct+ait.^.t,(nr cnedcr•tin,•. su:t+ a sc,^!y: vuca.ry.xe ycutC::~nto li•_-Jic~l an~ 7:.y D::1•iic, +o•: h_,c nur to La:Ihe~I:lt.!.l.ll'iep=l'::ofef: ilrteedps-CcncerSOCkty. . - • Gnccrclj•, I•~a ~ 4,~,.., iJ f_•_,:( \'-'il( izs n ~II.1 e,.; s PI tU 11 TI t:i TU C:CCCO t\'ST(Ttl-t'1' lsp:il29i I57J i.tc, \Vi::iarm It, 1_cs:i;: . Chai, nua of the Il.vr6~ 9F A rd a CancnSOC-rciy . 219 1' st 4? t trcat l.ctslor::,i~cv: Y'o[Y_]CJ17 • . n:arlsr.Jc ,•s:: : ~ . . •.)'oar Icemr o(,A;r;l 17statn tlsaE t8e Amerie:n Csneet S7cielyii-.0irv; to r rn Yvai•tiD rj. J rc+i .of.t '.u Sr1• 11 r u0ndd nth .,.:ysl cl dcoan t::e N:oscn Ly One Tobacco tnsutu:q at :ny Mhcr 6roup!' Yos sayour rcCC=st•is u irioWt (•[r.cd>nt fa scicnniGc co:mnc:u;Y.;. I r>e:::it ttrla::ae Caacrr5oc ya .p:o-a tosc•(.IVc ~ unaus:ishea~w.or.:fusDu.,.uyDcr,osesit U wy r:ithvut D'rectdtnt in it, ,; i::ni,4:to:nnunily.7hrnui.;, itsus: Cl p:i,i:::il.• te[hniqu•3 tat'ncr s;ud she ut42l ch~annctc, it is tlaoGanc.r Soti:tyrr,a: t.c . icD:.cro industry-xh;3T; rontT.:y toua i trnd~e6,a: of Ar.r,:ticzn s:ienee, ha prci:rt:d:LisXa.dyiato:hea.cr.~of pa:Ec d'.::,:~•POa: Fun7:::-:^:c. it the ic cUnnuwliiy, tti'at• rraitr:• par,eliar: e'tencouccucl w roricw nr„ocnnt qres¢'ra!,v ssh:ch drpcnd n}os titc inur(srrtztias of i rti': rr!t rr34'.!:i- )'ou e:a-.t D>:l:o7o;;3ts S:.e sti;:cd Dr. Ai'ctiuc]'s ISS•otaory, sac~ his sE~!a aci (t scdt!s:+ca YhY.U t. aoy - clv;- tore:mhanL..,_r.walrc+e~ b)Ci-ti.•.:;4r] scicn:nts, t-si '• in s of ' a• c„iew t:n(th:ss.or-uecFrca.s, tol`.e s_r;sk'i::;pn:.lit:udtia:ta._ cu?:,2os:ry7 As you say, I1xW+s Acefcech end J(sn^nsonl .ot1_ wit:i d.:a[s Scr=C;S: db)• t::^- are.fn:CS,i : ..r0 (roat ;,uis:ic tn.: :.iJ c:t:i.tc.l to n 1:11'an1 fzir a:cocmFa:,:,ictaults-)}c detrricanC: nceaSet;ety-eanr• ;rta^n:r to 1': t4es7;:: re;tJ::i.n'.Jdl'ltc[i.cla: of tfe ou s:a:rd4l:at these scrtntists'•_te Lr.`.olG:a or!ycu ti:::c::ifi,: cor.r =un;lyat f`:?e and to li.\::=:V:ry;l !C; :earlrl:' l;cl C_ Ara:r(cr.e Creccr: oNcw; ae e]1 z r4-n SCp?mle.: t) b J^ 1) 1 a:•.ftN.:;..?-.irt.:s an1 to t;:cpeael; at l:r,: to Pru?iC:co:r., Lte idformas:ea.:s:. tS: t.;can9~ c:::ca it slc;nccs. tsS:c:a1i) it -:ic•:rcd tF,: f:ct sl.:t yau ~Las=. rdra:^u ncas of t:ic tV t rc p_Lac r..:dli. \'acn theSocca it Ga~i>::cd ay~ul itt;rr,c~nt•;io:s a:s.ch res: it shnutd i2ti a !c'~oasi:;;i;~ t, fa:ioeet::: d zta, p•:Sich, ,;t alic;cs, s•.; pnrtl ia 1,^.t:rfrLta:;nni. W. ruY^est a:;zl she Y, y In rc3a:4e .::y (0::1'lt ]S oul t!:: 1 tu~y it t0 dC-cra no•ytCr t<:enieh otFa.;i:::ioa scput ti,- •er:- `.thr~ corttro;c1-r:1~ c tt-dar: yts 71 s: s:royn a st; t s'> t^ C ccr5.+:+c:y'.'Sn.a r_. qknr t..c.ab.:at tss>u>uy f,-. - ita'risi.:::so:;i;y',;+>si:: t bn- .inx c t-rs ~rtd •" .cns s. Jt.a._y.tJ fa •-, uu:la .!_:. _.. i l~!i •F': 1<:[ir:! to ~: iCUniC r an:r n t.Mt %f:r Jl.c C:mccr,S^.r:tny nt:e, ls a:e :ra ~>l ::u~ s~... I:r ~ris. nf t'.e J-'r,ret icae, C:.:ar,! ~~i_IS's p•a;il;c.:l, s~0:1'" ; :Cice,:(n;, l•) t•:;r(,.thiis t::a:tCr to t.-,^, alt:.;:l~n C(ly: )ouavery-Auty, l,•stph Costrwrr ~rJ Cliai: -:t rf tl•t I:s.• u:7cc C7:t^,.nt Y, 71ieTc5assa(nmPCteaIne, ~••• ~%r ' a a .. . . ....,

C_ r 3iaL 2•+`2 ~u ~1 j} -l- 'm t'Tr.E TO:I:LCCOI\srI•rvn: Match 20,1910 "1x1RNka>cs D- Jrcu i; CGairman of the (ioard Yawres ltan Ca:,u r Suckty 719 F.I. Z2ad Sttcct 11cYcek, htw Yotk 70017 ' t>Rw }TrLca:is:. . Z . ] 6are yrosr lsttcc o( 7„_rch 12, 1?7i . 7 anc . tst•atly iisa(q,ainwd tSat tt: Ans,ricas Car.:et So;ic•y has rcfuacJ to P:m:it tSO icn(vrt:al tAic+o t4 Mmco 'lir'nn•Jdvatsi.s. Is-quatcJ in r.tyt tlcr c( [rh:t 5ry 27 Swe tssso.i:rytt. a a,_._d t, oat1!_ c:psretto isdsslcy, tto rcaa::ss is ro:icecs in 6Fht al lielratiis,•S,itisotdYf:;caadpropcsfart`: iackty to pcrmFi on to Aaac ttosc iinain,s -Ls:scd ly;,aJtpcnalcnt exDCrls-anJ -yae~a-•-t/;. _ -.., You t+:1 rccallthat I r:n(aofe to nDminale xccricxcz scrcrat kttl-L :own scicntit:s1:iEhly Lua;ificd ia Co. fi::ds of aspcti.csental tumo6 pa[ha:oCSand tanpdis: sscs. llu:i will allbe suDjccl lo yoa: rtierl tcn for t.wd caux_ )'our tas :ns for dcnyinp r,tv taqw:G as I uod:rsei:sd ther.t from r your Iecter, ar: that lfa fis•oal par e:s wrZl.lbs D+1 ~i iE':d in thc srry srar fumre and t:uc a ss:Lyof tl:em s..i:( satl9ly auy sc;cr.tiEc on otistt qresao.,s re;arvin; the Cnd2ns_ I do r.ot CcA thexaeasons (at dtnyiey m; tcquestat all wncir,tily FirsGPublirst(o: in a s:iroti6e wurral- eitl not oeeue ¢•a?ir,;any a^at6sater Em \'h.l.tori-As:ntie, :ess con:c[cnoe of Fcbcuaq• S. Srco: d. t'seAn:crican Csaccr Soo`rty et .. . that Dress cootartncc nu;:: srfi ws: t:e,atixss . Socir:y,s:il.fu itt Drca [c ~ase tBat TeAuerSach-lla:n.:.o:,d rindia-s "s:'-nu:d t,a:c Al s:Cniftc:at'.m~3ct ct, efro smcli.ir.c „fc(: a:cttcs in u'riscu:ra;ty; and s. i01 P. •tJa:y lr:d tpa r.-ssesutwn: of ci:iins and po eso: tect V r.te ind.. ry:" Ttese 4ndin,stt+ebecn~Ni )-,DvMirscin ^cws>_r1a an! Oct mcd:cal p:ces. Ifow• caa lhc Can: r5oc;et- ra)- tSat scriocs a:ups8s ef 11•_ ~t,:~:nuu b: d:lay:l un,ilTorn:al putd7.at9en'' . - ene pob!is6cd papcrs tas:al seti'Sfy Cr-sfioas atsoc: w:L cu::ers acR:e p:oy:r i'terptelltio:l o: tl:e PJ-t:+:l:•^.icrlarer;ii. the Fl1e;2liUn that C;;arGt:: S:JCae pt,Yuted ca..ws c irc:s it ~t;:_ dO.s,the s'a!i< it•; .:W sdeq•~a7• o.tl:c esyc;i:rt:n:_I da:z r:nd: paoccdo:e, a. d ii -hettwr,as you as3ert- G:c erncri:aa[ ':'ierts trt kfi~a1test trad;Hnes a.d;~retxot of scicnti+ie imr_6 ;ttion•".]l:ne ^ustrJa cat t•n!y be tno:vcd t•Y csaa,i:ntion o; 4•.s pcrtincra Gata ard nxlrrizt; If tt:C:necc S:xfetydoes not actede to eny rrqs-!, we s•1>r tot•se euvp m:ans at out dis; r,al to ecrto it sial t(kme:it3t ond' v,T 1>ya:u'u c rr a as. t cf uuT r Fzcvropaaaio: sn tP s..tt r- aUs t;rr eiattnJ to c.>_..rn r.. 1;, i. css cs,, t...as. yorespora:_eft.`.iscs;:rinenttAi.a,urti:t s:ien[i,I<s<tut.r.:: Lg r,y:su::_ es!r-:la in lttnraarr.er s % , ed• lf,zLt .C +.tcr 5 ' lr cor.t:ra tod~: ns otiecv ,1i.+•Sicse tbis s.Jl s:cre if ta~ -7a,]c•, t•;.'cr cc Lr tLe Tv3!/,faya !sfenliir„tY~:qhr,.\ueri.aaY• ]fa..:.-san,l da7a i1f c: s f_"p.s; t Iho a;IMaiipn,.C ~de alt1r.: l.tidolS- /•san:i\ tondet T re. . ':.Ziars scrr (re5y. - ' r 4Y t 4~~v.~ y N~ •~ s Jo:rrb U. fc•l:.v.t, J:d '.. Chaisr :anct t'.: ~ic vti.s r.o:>:Cal.c.`, 7ic]'oVxc~l-i;ri:utt„Jne, .Y_wi 10055091716, ail\'1:1;'17tiIXC: S11CIi1111 P7:11171tli A.M.1:I(tCIA G~ XCt:2S0.':rl_•i3' ' . ' .tl~rtilq7,1910 hfr. Jescp:t JT. Cutlrnaa, III ChairmanoJ t1w.P.a<cuurc Conuuittce Th ToS crolmlitutt,Jnc.. I't Islt-is,a:rc. 109114r.A ::ua New Ye[i:, New Yerk 10017 TTo lkterans AAiainist:o:.on, the Amesi::n Canct•r Sc~i::Y as:rl f3oar.r: /--rctb,r li and I lar rw7,, cx+ t acc a,n I rqresls S:atrJ i. e y<+ur t_ tlrt of f riisnaq 39 ; nSI-Urctt :d ?oc.:n cs:du:ci.a~, o(As:c tt a;h- Iiamsm:Jstudy-oa•'IntJ"':~:cl. Cstr ttS:uo ~ UDO:I] byapar,tto( ind p.n'cr,ts: r lstt c bsc-a byynu, )outseq-~st tsarlboul p,c_ctentin lhb seienULe ecsneu,ntn•. 7:tc mf.y cndcr qcettiom res 0: t esu(t ~a:Iheec `.rd ah3I( years aLdi;iycr.: acdbrilJi>nt .otl: by, lsco er.nf.:eelty qvali.`:cd scit:nu6ls r-.ho;o f:nd[:srs harc bren raliG:tn! ty,a:t;nju:3::rd' pattwlo~iss oi w:otld..iie repul. tiun..:a aG:7it;o~, o9:'crA:a±3~g [•atho:~^ists, hd hly 7ti+rJrd by ISxsci.r.lif:: rc^rmr~~i!S•, i,a.e sisi:cd W. Aucrbarli s 1_bor: torr, s-::s his sti:s a: d'.::is:d ttrc CYCdo nc:;u:e: d to nsk tr:a th-se two emSnent men su:nif 0.6[ f aJi:+cs to :ny. _ srleneJ ro.>m;ucr chc•szn 4;•i.',: Tnb:cco Jdsticctr, or r,ny Cher :;eep• 1hc:r e: ksvili b:'f71i:rJ in rS'o traGi:ioma! nat: rr o:. A:n.tcaascree-e,.-h-,_firJ:nWsttcrTCrntY c..cas3n!,acce;w cr,r iacd bys_ito.,ts:o:~!:)sicia~s roeo-iy snctiaainu ia::c uut•l. Wttos and 1!arcmon:i c:ae:cd (rcctY=-r:i FiC=t «. ••. r i:h lur.a fu.^.:i- ! by ~:c fi9rt::l (•.o:~crnmr.a and Ihc :.mu`: n a.a:s.c So:i:ty: TE_ r,e:e b;L.>+d:n ~o: l7 :o.ti c saitn:ifm. cca^.omnS:y :t tart:: and a t.':cc •l.•,try:i:yil Jitlsa ToSa.cco dn::itct:, C. "-y s~2xn'if:o ycs:ar:h a~ a:•, , h>z GncS•s :yas ,ti,:o LnJin4s of thl4tta:dy: th. MIY Ita"-•a5 c0.13-,:la\(i orahe artdan9:ls cf nhs t.`.cse isa liz.c-!:aua:ed t'aY to p:J:cCC- IJtIl)-1 n^: n n:.:]CIirST !•cnup of scir:uicts rti=altSt fh ilab [ ur>,lor . l..atSF Jt Cc S P'+,1nU( SJ.:CtIi3. rrd;+.T,>!•r,r..q:r)a.•f.l an.:;,n- <aa;cr. Th: Ac::bach-l:amnnad n,xrletr;bt.iCy iaraa]ilY+rr.:':tiz uqou. A. d l{,m :oa:eRot in til~ C.+nacii for ]'OEacco F:e;nzrch yoa h_re nr.t.:: et uny(•.t naoct+ait.^.t,(nr cnedcr•tin,•. su:t+ a sc,^!y: vuca.ry.xe ycutC::~nto li•_-Jic~l an~ 7:.y D::1•iic, +o•: h_,c nur to La:Ihe~I:lt.!.l.ll'iep=l'::ofef: ilrteedps-CcncerSOCkty. . - • Gnccrclj•, I•~a ~ 4,~,.., iJ f_•_,:( \'-'il( izs n ~II.1 e,.; s PI tU 11 TI t:i TU C:CCCO t\'ST(Ttl-t'1' lsp:il29i I57J i.tc, \Vi::iarm It, 1_cs:i;: . Chai, nua of the Il.vr6~ 9F A rd a CancnSOC-rciy . 219 1' st 4? t trcat l.ctslor::,i~cv: Y'o[Y_]CJ17 • . n:arlsr.Jc ,•s:: : ~ . . •.)'oar Icemr o(,A;r;l 17statn tlsaE t8e Amerie:n Csneet S7cielyii-.0irv; to r rn Yvai•tiD rj. J rc+i .of.t '.u Sr1• 11 r u0ndd nth .,.:ysl cl dcoan t::e N:oscn Ly One Tobacco tnsutu:q at :ny Mhcr 6roup!' Yos sayour rcCC=st•is u irioWt (•[r.cd>nt fa scicnniGc co:mnc:u;Y.;. I r>e:::it ttrla::ae Caacrr5oc ya .p:o-a tosc•(.IVc ~ unaus:ishea~w.or.:fusDu.,.uyDcr,osesit U wy r:ithvut D'rectdtnt in it, ,; i::ni,4:to:nnunily.7hrnui.;, itsus: Cl p:i,i:::il.• te[hniqu•3 tat'ncr s;ud she ut42l ch~annctc, it is tlaoGanc.r Soti:tyrr,a: t.c . icD:.cro industry-xh;3T; rontT.:y toua i trnd~e6,a: of Ar.r,:ticzn s:ienee, ha prci:rt:d:LisXa.dyiato:hea.cr.~of pa:Ec d'.::,:~•POa: Fun7:::-:^:c. it the ic cUnnuwliiy, tti'at• rraitr:• par,eliar: e'tencouccucl w roricw nr„ocnnt qres¢'ra!,v ssh:ch drpcnd n}os titc inur(srrtztias of i rti': rr!t rr34'.!:i- )'ou e:a-.t D>:l:o7o;;3ts S:.e sti;:cd Dr. Ai'ctiuc]'s ISS•otaory, sac~ his sE~!a aci (t scdt!s:+ca YhY.U t. aoy - clv;- tore:mhanL..,_r.walrc+e~ b)Ci-ti.•.:;4r] scicn:nts, t-si '• in s of ' a• c„iew t:n(th:ss.or-uecFrca.s, tol`.e s_r;sk'i::;pn:.lit:udtia:ta._ cu?:,2os:ry7 As you say, I1xW+s Acefcech end J(sn^nsonl .ot1_ wit:i d.:a[s Scr=C;S: db)• t::^- are.fn:CS,i : ..r0 (roat ;,uis:ic tn.: :.iJ c:t:i.tc.l to n 1:11'an1 fzir a:cocmFa:,:,ictaults-)}c detrricanC: nceaSet;ety-eanr• ;rta^n:r to 1': t4es7;:: re;tJ::i.n'.Jdl'ltc[i.cla: of tfe ou s:a:rd4l:at these scrtntists'•_te Lr.`.olG:a or!ycu ti:::c::ifi,: cor.r =un;lyat f`:?e and to li.\::=:V:ry;l !C; :earlrl:' l;cl C_ Ara:r(cr.e Creccr: oNcw; ae e]1 z r4-n SCp?mle.: t) b J^ 1) 1 a:•.ftN.:;..?-.irt.:s an1 to t;:cpeael; at l:r,: to Pru?iC:co:r., Lte idformas:ea.:s:. tS: t.;can9~ c:::ca it slc;nccs. tsS:c:a1i) it -:ic•:rcd tF,: f:ct sl.:t yau ~Las=. rdra:^u ncas of t:ic tV t rc p_Lac r..:dli. \'acn theSocca it Ga~i>::cd ay~ul itt;rr,c~nt•;io:s a:s.ch res: it shnutd i2ti a !c'~oasi:;;i;~ t, fa:ioeet::: d zta, p•:Sich, ,;t alic;cs, s•.; pnrtl ia 1,^.t:rfrLta:;nni. W. ruY^est a:;zl she Y, y In rc3a:4e .::y (0::1'lt ]S oul t!:: 1 tu~y it t0 dC-cra no•ytCr t<:enieh otFa.;i:::ioa scput ti,- •er:- `.thr~ corttro;c1-r:1~ c tt-dar: yts 71 s: s:royn a st; t s'> t^ C ccr5.+:+c:y'.'Sn.a r_. qknr t..c.ab.:at tss>u>uy f,-. - ita'risi.:::so:;i;y',;+>si:: t bn- .inx c t-rs ~rtd •" .cns s. Jt.a._y.tJ fa •-, uu:la .!_:. _.. i l~!i •F': 1<:[ir:! to ~: iCUniC r an:r n t.Mt %f:r Jl.c C:mccr,S^.r:tny nt:e, ls a:e :ra ~>l ::u~ s~... I:r ~ris. nf t'.e J-'r,ret icae, C:.:ar,! ~~i_IS's p•a;il;c.:l, s~0:1'" ; :Cice,:(n;, l•) t•:;r(,.thiis t::a:tCr to t.-,^, alt:.;:l~n C(ly: )ouavery-Auty, l,•stph Costrwrr ~rJ Cliai: -:t rf tl•t I:s.• u:7cc C7:t^,.nt Y, 71ieTc5assa(nmPCteaIne, ~••• ~%r ' a a .. . . ....,

C_ r 3iaL 2•+`2 ~u ~1 j} -l- 'm t'Tr.E TO:I:LCCOI\srI•rvn: Match 20,1910 "1x1RNka>cs D- Jrcu i; CGairman of the (ioard Yawres ltan Ca:,u r Suckty 719 F.I. Z2ad Sttcct 11cYcek, htw Yotk 70017 ' t>Rw }TrLca:is:. . Z . ] 6are yrosr lsttcc o( 7„_rch 12, 1?7i . 7 anc . tst•atly iisa(q,ainwd tSat tt: Ans,ricas Car.:et So;ic•y has rcfuacJ to P:m:it tSO icn(vrt:al tAic+o t4 Mmco 'lir'nn•Jdvatsi.s. Is-quatcJ in r.tyt tlcr c( [rh:t 5ry 27 Swe tssso.i:rytt. a a,_._d t, oat1!_ c:psretto isdsslcy, tto rcaa::ss is ro:icecs in 6Fht al lielratiis,•S,itisotdYf:;caadpropcsfart`: iackty to pcrmFi on to Aaac ttosc iinain,s -Ls:scd ly;,aJtpcnalcnt exDCrls-anJ -yae~a-•-t/;. _ -.., You t+:1 rccallthat I r:n(aofe to nDminale xccricxcz scrcrat kttl-L :own scicntit:s1:iEhly Lua;ificd ia Co. fi::ds of aspcti.csental tumo6 pa[ha:oCSand tanpdis: sscs. llu:i will allbe suDjccl lo yoa: rtierl tcn for t.wd caux_ )'our tas :ns for dcnyinp r,tv taqw:G as I uod:rsei:sd ther.t from r your Iecter, ar: that lfa fis•oal par e:s wrZl.lbs D+1 ~i iE':d in thc srry srar fumre and t:uc a ss:Lyof tl:em s..i:( satl9ly auy sc;cr.tiEc on otistt qresao.,s re;arvin; the Cnd2ns_ I do r.ot CcA thexaeasons (at dtnyiey m; tcquestat all wncir,tily FirsGPublirst(o: in a s:iroti6e wurral- eitl not oeeue ¢•a?ir,;any a^at6sater Em \'h.l.tori-As:ntie, :ess con:c[cnoe of Fcbcuaq• S. Srco: d. t'seAn:crican Csaccr Soo`rty et .. . that Dress cootartncc nu;:: srfi ws: t:e,atixss . Socir:y,s:il.fu itt Drca [c ~ase tBat TeAuerSach-lla:n.:.o:,d rindia-s "s:'-nu:d t,a:c Al s:Cniftc:at'.m~3ct ct, efro smcli.ir.c „fc(: a:cttcs in u'riscu:ra;ty; and s. i01 P. •tJa:y lr:d tpa r.-ssesutwn: of ci:iins and po eso: tect V r.te ind.. ry:" Ttese 4ndin,stt+ebecn~Ni )-,DvMirscin ^cws>_r1a an! Oct mcd:cal p:ces. Ifow• caa lhc Can: r5oc;et- ra)- tSat scriocs a:ups8s ef 11•_ ~t,:~:nuu b: d:lay:l un,ilTorn:al putd7.at9en'' . - ene pob!is6cd papcrs tas:al seti'Sfy Cr-sfioas atsoc: w:L cu::ers acR:e p:oy:r i'terptelltio:l o: tl:e PJ-t:+:l:•^.icrlarer;ii. the Fl1e;2liUn that C;;arGt:: S:JCae pt,Yuted ca..ws c irc:s it ~t;:_ dO.s,the s'a!i< it•; .:W sdeq•~a7• o.tl:c esyc;i:rt:n:_I da:z r:nd: paoccdo:e, a. d ii -hettwr,as you as3ert- G:c erncri:aa[ ':'ierts trt kfi~a1test trad;Hnes a.d;~retxot of scicnti+ie imr_6 ;ttion•".]l:ne ^ustrJa cat t•n!y be tno:vcd t•Y csaa,i:ntion o; 4•.s pcrtincra Gata ard nxlrrizt; If tt:C:necc S:xfetydoes not actede to eny rrqs-!, we s•1>r tot•se euvp m:ans at out dis; r,al to ecrto it sial t(kme:it3t ond' v,T 1>ya:u'u c rr a as. t cf uuT r Fzcvropaaaio: sn tP s..tt r- aUs t;rr eiattnJ to c.>_..rn r.. 1;, i. css cs,, t...as. yorespora:_eft.`.iscs;:rinenttAi.a,urti:t s:ien[i,I<s<tut.r.:: Lg r,y:su::_ es!r-:la in lttnraarr.er s % , ed• lf,zLt .C +.tcr 5 ' lr cor.t:ra tod~: ns otiecv ,1i.+•Sicse tbis s.Jl s:cre if ta~ -7a,]c•, t•;.'cr cc Lr tLe Tv3!/,faya !sfenliir„tY~:qhr,.\ueri.aaY• ]fa..:.-san,l da7a i1f c: s f_"p.s; t Iho a;IMaiipn,.C ~de alt1r.: l.tidolS- /•san:i\ tondet T re. . ':.Ziars scrr (re5y. - ' r 4Y t 4~~v.~ y N~ •~ s Jo:rrb U. fc•l:.v.t, J:d '.. Chaisr :anct t'.: ~ic vti.s r.o:>:Cal.c.`, 7ic]'oVxc~l-i;ri:utt„Jne, .Y_wi 10055091716, ail\'1:1;'17tiIXC: S11CIi1111 P7:11171tli A.M.1:I(tCIA G~ XCt:2S0.':rl_•i3' ' . ' .tl~rtilq7,1910 hfr. Jescp:t JT. Cutlrnaa, III ChairmanoJ t1w.P.a<cuurc Conuuittce Th ToS crolmlitutt,Jnc.. I't Islt-is,a:rc. 109114r.A ::ua New Ye[i:, New Yerk 10017 TTo lkterans AAiainist:o:.on, the Amesi::n Canct•r Sc~i::Y as:rl f3oar.r: /--rctb,r li and I lar rw7,, cx+ t acc a,n I rqresls S:atrJ i. e y<+ur t_ tlrt of f riisnaq 39 ; nSI-Urctt :d ?oc.:n cs:du:ci.a~, o(As:c tt a;h- Iiamsm:Jstudy-oa•'IntJ"':~:cl. Cstr ttS:uo ~ UDO:I] byapar,tto( ind p.n'cr,ts: r lstt c bsc-a byynu, )outseq-~st tsarlboul p,c_ctentin lhb seienULe ecsneu,ntn•. 7:tc mf.y cndcr qcettiom res 0: t esu(t ~a:Iheec `.rd ah3I( years aLdi;iycr.: acdbrilJi>nt .otl: by, lsco er.nf.:eelty qvali.`:cd scit:nu6ls r-.ho;o f:nd[:srs harc bren raliG:tn! ty,a:t;nju:3::rd' pattwlo~iss oi w:otld..iie repul. tiun..:a aG:7it;o~, o9:'crA:a±3~g [•atho:~^ists, hd hly 7ti+rJrd by ISxsci.r.lif:: rc^rmr~~i!S•, i,a.e sisi:cd W. Aucrbarli s 1_bor: torr, s-::s his sti:s a: d'.::is:d ttrc CYCdo nc:;u:e: d to nsk tr:a th-se two emSnent men su:nif 0.6[ f aJi:+cs to :ny. _ srleneJ ro.>m;ucr chc•szn 4;•i.',: Tnb:cco Jdsticctr, or r,ny Cher :;eep• 1hc:r e: ksvili b:'f71i:rJ in rS'o traGi:ioma! nat: rr o:. A:n.tcaascree-e,.-h-,_firJ:nWsttcrTCrntY c..cas3n!,acce;w cr,r iacd bys_ito.,ts:o:~!:)sicia~s roeo-iy snctiaainu ia::c uut•l. Wttos and 1!arcmon:i c:ae:cd (rcctY=-r:i FiC=t «. ••. r i:h lur.a fu.^.:i- ! by ~:c fi9rt::l (•.o:~crnmr.a and Ihc :.mu`: n a.a:s.c So:i:ty: TE_ r,e:e b;L.>+d:n ~o: l7 :o.ti c saitn:ifm. cca^.omnS:y :t tart:: and a t.':cc •l.•,try:i:yil Jitlsa ToSa.cco dn::itct:, C. "-y s~2xn'if:o ycs:ar:h a~ a:•, , h>z GncS•s :yas ,ti,:o LnJin4s of thl4tta:dy: th. MIY Ita"-•a5 c0.13-,:la\(i orahe artdan9:ls cf nhs t.`.cse isa liz.c-!:aua:ed t'aY to p:J:cCC- IJtIl)-1 n^: n n:.:]CIirST !•cnup of scir:uicts rti=altSt fh ilab [ ur>,lor . l..atSF Jt Cc S P'+,1nU( SJ.:CtIi3. rrd;+.T,>!•r,r..q:r)a.•f.l an.:;,n- <aa;cr. Th: Ac::bach-l:amnnad n,xrletr;bt.iCy iaraa]ilY+rr.:':tiz uqou. A. d l{,m :oa:eRot in til~ C.+nacii for ]'OEacco F:e;nzrch yoa h_re nr.t.:: et uny(•.t naoct+ait.^.t,(nr cnedcr•tin,•. su:t+ a sc,^!y: vuca.ry.xe ycutC::~nto li•_-Jic~l an~ 7:.y D::1•iic, +o•: h_,c nur to La:Ihe~I:lt.!.l.ll'iep=l'::ofef: ilrteedps-CcncerSOCkty. . - • Gnccrclj•, I•~a ~ 4,~,.., iJ f_•_,:( \'-'il( izs n ~II.1 e,.; s PI tU 11 TI t:i TU C:CCCO t\'ST(Ttl-t'1' lsp:il29i I57J i.tc, \Vi::iarm It, 1_cs:i;: . Chai, nua of the Il.vr6~ 9F A rd a CancnSOC-rciy . 219 1' st 4? t trcat l.ctslor::,i~cv: Y'o[Y_]CJ17 • . n:arlsr.Jc ,•s:: : ~ . . •.)'oar Icemr o(,A;r;l 17statn tlsaE t8e Amerie:n Csneet S7cielyii-.0irv; to r rn Yvai•tiD rj. J rc+i .of.t '.u Sr1• 11 r u0ndd nth .,.:ysl cl dcoan t::e N:oscn Ly One Tobacco tnsutu:q at :ny Mhcr 6roup!' Yos sayour rcCC=st•is u irioWt (•[r.cd>nt fa scicnniGc co:mnc:u;Y.;. I r>e:::it ttrla::ae Caacrr5oc ya .p:o-a tosc•(.IVc ~ unaus:ishea~w.or.:fusDu.,.uyDcr,osesit U wy r:ithvut D'rectdtnt in it, ,; i::ni,4:to:nnunily.7hrnui.;, itsus: Cl p:i,i:::il.• te[hniqu•3 tat'ncr s;ud she ut42l ch~annctc, it is tlaoGanc.r Soti:tyrr,a: t.c . icD:.cro industry-xh;3T; rontT.:y toua i trnd~e6,a: of Ar.r,:ticzn s:ienee, ha prci:rt:d:LisXa.dyiato:hea.cr.~of pa:Ec d'.::,:~•POa: Fun7:::-:^:c. it the ic cUnnuwliiy, tti'at• rraitr:• par,eliar: e'tencouccucl w roricw nr„ocnnt qres¢'ra!,v ssh:ch drpcnd n}os titc inur(srrtztias of i rti': rr!t rr34'.!:i- )'ou e:a-.t D>:l:o7o;;3ts S:.e sti;:cd Dr. Ai'ctiuc]'s ISS•otaory, sac~ his sE~!a aci (t scdt!s:+ca YhY.U t. aoy - clv;- tore:mhanL..,_r.walrc+e~ b)Ci-ti.•.:;4r] scicn:nts, t-si '• in s of ' a• c„iew t:n(th:ss.or-uecFrca.s, tol`.e s_r;sk'i::;pn:.lit:udtia:ta._ cu?:,2os:ry7 As you say, I1xW+s Acefcech end J(sn^nsonl .ot1_ wit:i d.:a[s Scr=C;S: db)• t::^- are.fn:CS,i : ..r0 (roat ;,uis:ic tn.: :.iJ c:t:i.tc.l to n 1:11'an1 fzir a:cocmFa:,:,ictaults-)}c detrricanC: nceaSet;ety-eanr• ;rta^n:r to 1': t4es7;:: re;tJ::i.n'.Jdl'ltc[i.cla: of tfe ou s:a:rd4l:at these scrtntists'•_te Lr.`.olG:a or!ycu ti:::c::ifi,: cor.r =un;lyat f`:?e and to li.\::=:V:ry;l !C; :earlrl:' l;cl C_ Ara:r(cr.e Creccr: oNcw; ae e]1 z r4-n SCp?mle.: t) b J^ 1) 1 a:•.ftN.:;..?-.irt.:s an1 to t;:cpeael; at l:r,: to Pru?iC:co:r., Lte idformas:ea.:s:. tS: t.;can9~ c:::ca it slc;nccs. tsS:c:a1i) it -:ic•:rcd tF,: f:ct sl.:t yau ~Las=. rdra:^u ncas of t:ic tV t rc p_Lac r..:dli. \'acn theSocca it Ga~i>::cd ay~ul itt;rr,c~nt•;io:s a:s.ch res: it shnutd i2ti a !c'~oasi:;;i;~ t, fa:ioeet::: d zta, p•:Sich, ,;t alic;cs, s•.; pnrtl ia 1,^.t:rfrLta:;nni. W. ruY^est a:;zl she Y, y In rc3a:4e .::y (0::1'lt ]S oul t!:: 1 tu~y it t0 dC-cra no•ytCr t<:enieh otFa.;i:::ioa scput ti,- •er:- `.thr~ corttro;c1-r:1~ c tt-dar: yts 71 s: s:royn a st; t s'> t^ C ccr5.+:+c:y'.'Sn.a r_. qknr t..c.ab.:at tss>u>uy f,-. - ita'risi.:::so:;i;y',;+>si:: t bn- .inx c t-rs ~rtd •" .cns s. Jt.a._y.tJ fa •-, uu:la .!_:. _.. i l~!i •F': 1<:[ir:! to ~: iCUniC r an:r n t.Mt %f:r Jl.c C:mccr,S^.r:tny nt:e, ls a:e :ra ~>l ::u~ s~... I:r ~ris. nf t'.e J-'r,ret icae, C:.:ar,! ~~i_IS's p•a;il;c.:l, s~0:1'" ; :Cice,:(n;, l•) t•:;r(,.thiis t::a:tCr to t.-,^, alt:.;:l~n C(ly: )ouavery-Auty, l,•stph Costrwrr ~rJ Cliai: -:t rf tl•t I:s.• u:7cc C7:t^,.nt Y, 71ieTc5assa(nmPCteaIne, ~••• ~%r ' a a .. . . ....,

1\'E i+: Y[)R11 12:lfr:1;S I=ih,Y 9, 1070 -~he ~igare-.te-Cancer Di.spv t~ PAC7L: 24 An over.. hciming volume of evidence suggests that ciUarette smoking is harmful and can lcad to lung cancer, emphysema, and various heart and circulatory problems. in the c'tir-2^t dispiute between The Tobacco Institute and thc':.'y`ric-r,n Cancer Socict;however, ~...._....._....__.r...u the lat4cr'organiz;:ot tn~c!e an errnr c,f ment which it has now cnly partiaHy rectified. -' Last February Dr. E. Cuyler Harnmond and Dr: -~ - Osczr Auerbaclr attracted world attention when they reported that Mche of 86 beaales trained to smoke cigarettes had deve'_-ned luna cancer. The American Cancer So_iz~y, which help2d supr•:rt this work, declared the findings "eFfcctively refutie contientions' by cigarette manufact1uriDg interests that there was = , • no cigarette-cancer link." The Hammond~Auerbach results were path-break and iml?orta tt, but, ]ikc all piancerin, investigations they must be scrutinized with pi'.rt:c:ular care. That „_-.. the tobacco sl-Loll.1d •x?nttn c}lecl: the d~ta isunc?_r~ ncial,a, . and p tc o;o, ists and statisiici zns - W,Orri:no iU _):,. Cul:~y~;i,c~ a,.vuIu 41.,. freedo'n to examine the b le cv d^ l:e. It wa° a mts- takefrr- 1l:c ATTIc•r lc 1 C 1-er Co c n1 v to Tf;i ; e to asii '!~e two sc ent:sts to"sub-nit il:cii f i~ a: 1~$ to any selected committee chosen by the Tobacco lnstitute, or any othcr group." In the face of public complaint by The Tobacco Institute, the An:ericar. Czt,c~•r Societv ha_s had second thoU°hts. lL !l'IS I`U\ 2S' CCI tI1C 5 1 °~O l~~ii~lc~~ gfl ~12° Z.u: Cl ,~a',Cs 7 1b~ c'_ r., i:11 to r ev,r wt}1c data a Peot o} ai Servic e:s =:lrc4dv en rccotuas be,ievia c'?a c;es to n~z is d1,11reou~ to Ircaltn-~~ ~ Q Scicntific iruth is dctertilined ultimately by open examination of datai and fulli discussion by alli com- petent persons in a fic•:d. The Ham:,lond-Aueroach results should be scrutinized intensively by all inter- csted partics. Any other approach thr~~\vs needless doubt on the alreaciy ovcrv:helmint case against ciu<.rette snne-ltin'g. P ,.. •i+.. .. ~~L~ W1M gyi !i" M k ,-• .Y ..,t ~ °*~Jr ~:r k f •..~, i 4 ^-1 1~. C `:'!,"i:Cl /~/ti _ _ --•N .~ .~ : d ,~; '' .~:~~~;; •z-,-~~

New York 'IimEs Study Data on Cancer To the Editor: Recently you published a tu11 pa,^,e ~ycrt ~ x-^a frorn the Tohacco h, utLltc yuesiic n- ing the scientific validity o1 a stud y by Drs. Auerbach and Ifair;nond on ci-2rette snlolcinm in dogs, which was presented by the Anrerican~ Cancer So- ciety. There has been a mass of evidence, statistical, epidemio- togical and biological, that cig- arette smohi= is the major eause of lung cancer in man. = The cuLtninating evidence in = the rccent Auerb:lch-Harnmond j = s.udy demonstrates that c oos = can E^t lung cancer from sn:ok- i..g eih.Uettes- _ The Tobacco Institute states that "present accouats of this study are based solely upon the info: natioz and int'er pretatio.^.s pro-,-i:ied by the press." The facts are that the findings of the study were made public at a scieatific meeting of the ° Arneriwn Cp^.c°r Se :ety. This = .~.~ ar ooen raeetir,o to wI:ch rePresentatives cf resa_rci. and ;educational institut!ions were : invited. -. One of the reaso:is for a - - prompt prese;ltation to scie:l- tists and the pa'a=.c tivas tna -- significant data obta:nedl in supFort of the theory that the less tar and niaotin~e in the mainstream of sn:one, the less May 13 , 1970 PZ ge 41 C the risk of emlahysema and lung cancer. For yca!s se-inents of the cigaret:e ir.dh.'u'ry have attac::ed vrarnin-s of the dangers of cip,aretre s:nc.tinp and prntest- ed that', no one had i>een ab!e to produce lur~ cancer in ani- ma's \':ith c:g1r 2tti'.sinoiit'. This ~ has now been done. The Tobacco Institute attacks the Aittericait Cancer Srciety for "its use of puo;icity techni. = ques." This comes from an in- dustry that. for years has re- lied on pJ`,l;city and adi•ertis- ing to obscure the fact that rette srn -~king is the mlcin quested tha, it be al',ov; ed to appoint a cammittee to-eview- the f:nuiP•gs in the Auerbach- Hamnlond study. This recluest is without precedent in the scientifir couiInu:city, and we refused the reque_t. There has never bc en Gn~r restriction a~~?nst incivid,-;al ;i scien st's v:~•i.i-=; t;•:e cause of lur.;; cancer in tnalt."- The Tob::cCo Institutr_ re' was dc,,ie, and re~:e.zing the rese3: e;l V: i: Drs. .Sll£I: ach OranL o, N. J.,, wi:ere the •~;crh and~ Ha+.n;t:.7)nd. A rru:^ber of . distinouis ;e1 scientists h-ve a!ready revieu,ed the fi nein-s. Because ofthe great I,•,:~~!ic interest in the b=;_vreelt . ci.carette s:it^lang anLli l'Jn° can- cer, and tisin- c - - .. - _ .,~ -. , ' O'1 l^ i5' ••~<_~ ,->.:..-~. VY L, -,:I --- . ~ i,~. j- ~:: „-) < - - ---~-,:.. - rT-y~) C~.il?u U 1n2i 4J.s of. LrC /i' ~~ ~ 3^. 1 Ii1It?T11GPi:' SIlV1V data, it.Cltoriat iaV S.) Wti!LlA,,, B. LEWIS Chairman, B, ar d of I)i. ,~ctors An, r ican Cancer Societ~~ New york, May 7, 1970 l -J

'v%.Z~4'/J r r r~., r L! t~•~. 1 . ) nr f,[-1r~ 1 rT (~ r•lt1j ~~ ` 'tr tl~. t s , + I ` u~ ~t„~t ~] ~t ,hsUJ L u4l~tin T he Tobacm Institute, an industry tradt; orcanization, charges that'thc Anicrican Cancer Society struck a low blow last scintcr tt•lten it relcaserf the rtes:.rlts of unpablished research pur- portcaly proving that cicarettc s no'c induced lun; cancer inbcag!es. The ~doSs didn't suffer front characteristic human lung cancor, says the institute, asd data from the study aren't ss'ail- blc so it can make its own cvaluatian. f Not sa, says ACS. The smoke from the impasse has yeCto clear. Scientific consultants to the insti- ~ tute claim that the results of the hi,hly~ publiciz~d study conducted by, p:thul- ogisl Oscar Auerbach of the East Orang-c (\.J,) V>1 Hospital!and ACS ~ biostatistici:m E- Cuvlcr Hamnmo:,d arc ambiSuous. \furcos'er, say patLol- I ogist Sheldon SonllnerJ of Ncw Yoru_'s Lcnox I:ill IIospitali and biocl:cmist Arthur Irurst of the University of San Francisco, botlt the ACS and Dr. Avcrbach have rejectcd the prci,o>al a .,. . ., Ct.:,. :..-.. .-J..C.. ...._ -'-- blbcl:cd thent from seeing the s.udy's 1unS-pattto'o,~y s'rd s . ` !( Says Dr. Soatmcrs: ~ tr o Ih ].n ots'tedst of IJ t cH-h c-s ^„~ secoad hanJ.fkn:n_r.c•.\sr_;r :c- ~ counts." r. -_Son n crs co-ncnd; t Mt n 12 of the cigar Itc smo{ n_ bm~!' s devrlbp ,d ad~•no:arcinonas, and only two, sq:.nntous cclt carcinon as. adcnocarcinontn of tllc hu- man 1un_ is infrequcnt," says Dr. Sotn- ntcrs, "so I do notseethat this studv showed anythin, about smoking and }wman lung cancer. Funthcrmorc, we have seen larg~: glussy, prints of the squamous typcs [see smaller print bc- lowl and they do not indic,rte clear- cut clnccr either on th surfacc or in- vasr\ely: Presum: bly, th •sc \\crr their bcst pictures; if so, why areu't they convincingl" - Joseph Culliuan 1'lt, chairr.:an of the Tobacco Institute, warns that I: ^_al steps mi;hb be taken to secure the eontcsted data. "This research was supponcd by public funds," Cuilinan says. The beagle cxperintcnts were supported by the ACS and the VA. Replies Dr. Aucrbach: "If Dr. Sontmc.s wants to~sce the slid, ,, Ill show them to~ him. He never ;ked. Representatives frontith: Tobacco In- stitute were at the sF,aial oprn ntctt- ing when this niatcrial vcas first prc- sentcd. E% crybody received a eopy, of the research report." Mr. Cull nnn'clir,r-a ha•.-cnur thr h O; ti. r a.~ unn,l i.-d 13 i:,tc o~ Cr. ~--.- T~:,r,,r, -~-- --- - ~urnuf ;:c:~ cl tk,: r o rt.c~ t titis sciea- ti5c re..soiu b.t b_caude the story ap- pearcd in anoih:r meclical pr,blir,tion: The rescarcl p t~r_s, scLetiulcd to bc gi~'err anew at tha r1`°[A m:eting in `cinc cc•t- Chica,c. on J1,nc "- '(C sidcrcd i.,r_P~~~!icainm b~ 11 tr~ NIc.+~~chi1c, llr. At.tru; ch pDints out that "seme of the b:st pntl,ol- o,ists in the v,or1 7'os~ niacd the slidas and the data„and wocurocd v:ith IL:. conclusions." He adds, "Thc ihstitut~ is doin- to tnc what Gcucrrl \lotors did to I:alph Nader. Andl cvcrybody has asl:cd mc: '\\'hat is the institutc doing but giving me tuorepubGcity', 'I The concurring patl,ulo i;ts in- cluded Dr. Jo}t Rc,,, chief )athol- ogist at the \ation:il C<mccr Institutc: "As far as 1' know," 1Dr. 13ergsa%s, "no one has bccn cla:nicd access to Dr. Aucrbach's datar L'coplc have bcen trackin ; in and out of his laboratory ever since his rcport ca=r: out. And as for Dr. Sommcrs' poin: about the squamous ocll! pictures, I don't find any reason for his unccrtai,ayc, I don't know h-j%e much surcn any o9c. could be that they indicate incasix•e co tcer. "If Dr. Sornnters says thrt lung adcnocarciitoma is rare in humans, he's just~plain wrong. TruL;thcy'rcnot as common assqpamous, bur Pvc just been lool:iiig at som:, fi uros from Connceticut st'herc th^ occuirencc of :dbnocarcinonra is put at 301•~. Fur- thcrrnore, many of thosc: adeno =_r- r.~n... c in. tt~r h.•a..t~c. enc.• ••.n:'!••c' ing scco,,d::ry squamoustcll c~nccrs." At this point, say ACS offioiais, thcy, will rc,qucst that the study data be an: !y«d by Dr: Jesse StCmfcld, the Sur.;oon Gcncral of the PI1S. And the office of hc Su _eon Gencral indicates thau it is receptive to the rc,uc>t. The institute had proposcd to nomiu, ,c i't!cown ro•icw panel subject to the society's veto for good cr,ux." Commcnt ACS o(l.,als: '.fisl ing the institutc to appoint an inrl.artial group is like askin~; the wolf to exan.inc the shecp „d To Dr. Sa:nnners (!r/t)• cridcnnr (crntrr) o/sq:rn,nor,r ccll earCii,oenn irrradih, a s~uokir;~ (,c,:~!r's Lu;~ uuli'is'ru,ron- , y vii,cing: Gru"N'Cl's 13r. GcrS (ri~ fn) is alisoLru'l}' con r-ir7cc^d. =, . • t ~ i ,,i ~ ~ . ~-~

r- f I C I I .1 ~ 0 D ~ e~: ~ f~ Y NrJ rc i e r'~ f/i r f 7 0 t~ I~ At this time an Amerrc-t t D'fedtc l Aescxt ttirm Tr*:,rml -,r ' tcam is analrziit t7 c i c:i :- 777 iiv u t7~r ,r- >:rc t ar.u _ uvir t m t : t t,>. t l l 1,_II~rS ~..r„'.'-. o t:,t ^rutc S t..tnr• L7t t I):~ty (1 rru xco R(porrtr, : uar} p lbc ) nc~T:.larcn p; c,u t, A slo:- c t n res 'cd that there were nnestions r.:i cd in 77 It.,.~r prertues pr",:nt.~ ta ti:e ze :c :a. . -fhcsc pictures on tite Ix ie sawl'.ing eeperimenr, con- t duetcd under public grants to the American &nccr Society, were in many recpeccs different than most, scientific finding presentations is they were more "microscopic" in that thet• showed only four or five ccll; and nothing Of dic sarround- ing arca," a poction needed in true evaluation of the esperi- mcnc - If the AGMA review pane! backs the Auerbnch-H; m- mond'papcr, the report ts•il1 be published in theA:tIA ! Journal sornetinre in July or Augustt If' the pancli rc- jecLs the experiment papers, it is doohrful the Journal will'd'o 2nytliing more dmu notify the ccicn;isn of the refusal. TfcanR•hilt, there R-as mixed reaction in Japan's \ational Cancer Center in Tokyo. One of the top scien[i<-u prai>cd the uug calrun-ut wLtie a cu:i -.dF;Uc• seriously doubtfull abottt the repoeted' co: clust©n that fiiter tipped eigarctres cott(d' prc% rnr the gcowth of lung cancer in such aniinal c-,Teriments- - - And la-ar month, the Jao.tn Monopoly Corp., the statr on•ned' authoriil• fo: rhe manuflieture and s;rib of tobacco, started an experiment to drrermine whcther smuning wia, cause lung eanrer in chimpz:uccs. An industrn' s;okesm~n, s,•+eakingon the V.S. test, s2id!:e doubted such ani^ial ces[ frn:;inSs eoetld show sueh extreme sensitici's', to cigarette smolie. He added that it is the strong belief of T~p1nc•se seienrists that atmospheric o!lu;ion by smo:.c and exhtust sliould be rcSartird, as the Grear,r culprit. The chimp test is expected to t:!i:e nearly 15 1'r:rs to compl~re. "\\rcic Gnd- ing it hard for the animals to ]tarn to inlialc,"thc spokes, man said. 2<fosr of these events rme to lioht «'hen the Tob.xco Institute rceczlc•dcfforts to l;ct the Amcric..nCanccr Socict)• to open its Autrlinch-1'dir.tnt-,)nd results to the puh!ic. l n i:c the ACS rcftiscd the requesr, movtitr, the ins in:re to start an advertising c-!r.l ai~,n on the s.and- Full l l;r ads ap- peared in Ir-tdi::-1 natic,n.tl nra~>;",^.crs as well asla_^.1 p.np:rs in the top 10:1 U.S, rnard-cts. Sat; s.kcn n- 1 pcrs in the Icaf pro-.cinp sretca al<o rc cncd the ads as d.-1 impnrtanr scientific and mcdical pob!:;•.r:ons. In a m^ztcr of Loitrs after the industry's anno•.tncc- luont, the ACS rcqucsaed ther natioa's sur-cnn ;z•ncrr,l to conduct an aaalssis of, the cxpcriments. •1'llc socicty's statemerervv.s consiiivrcd rrmurc nfla hu;+c tlir.[ tltc uthoc- eo indnstry press forss-ard'tcikh cfft rts to find an :.dc- r~5~~vtr^ ' l t ' !~(~ ~ /turJf ~ r S ii' t I di f r''rr it1: O! ~ i t: t CJ "l7~ t qustc ti:ror than the cancer group's usual Contmeno that ci~aret.c: be abolished. "\Vbcrc cflrctivc filters were uscd in the study;' the society st.uem„at said, "no cancers were prc>?. .d m tt.r do,•' 7hc st.trcnr;ntnu signcdlby Dr. loaa:hun fi. Rl:otds, director of ,trrgon• at tlte Uni%crsiiy of Pcnnsyliunia School Of Dtedicinrana presidcntof \CS; CJilliim 11, Lcwis„chair- man of the board of the ACS; and Dr HMcrvm Pollard, professc r of in:ernal medicine at tlte Universitp of bfichipan Schnollof Medicinc who,is presiJbnt-ell".ct of ACS. The societl m:tintains its srr.t:d'i that "scgmcnts of, the tobacco industry have artaclced R-arninf;s of the t.anGcrs of smolin:; and p:otcsted t~ac no one has been ahic to.produce lung ca-icer in anir.uls witlr ci&uette smol:e. This has now been dbne!' • - . This .lucrbach-Hammosd dog research, a continuation of an osprrimcnn rcportcd about two years a;o, -was per- formcd on be:~lcs. The do^i throats were slit and the cigtrerte smnl>e %:•as foreed into the lungs: The smokess'as reported to be t•e:y hot-hettcr than in normal'smo.l-inp- The esp,erin::nt was described by authoritics as a "iather cllnnsy step" in research; mainly hcc2use of the Angs L`reantng rate auu u ..uv . ....... :.1..c_e:: into t.,e anuunl. One rescarcher~dtscn!icdl he Iatcst dog expcriment as being "highly arrificiitll" During the Tobacco Institute press confere: ce IasrmonrS, JosephF. Ccl man 111, chairman of the In tiiace's esc<utice com:nitree _nd' chaiiman of Philip Morris Jr.--, said the Cancer Socioq• is refusing to mal-e public the data essential for a fuir e.t-alc±ticn of the tests and their conclbsions. In an allied move, the Insritute was seeking the data under the Public Inform: tion Act since some of the rescarch utilizcd frderall fimds Cu )rnan said?:, }Ic dianoo question theinte.- iry• of the researchcrs but contended the Insrinne wanrnT to establish telicciirr this tv-as "Good scicnce. The 'I'ubacco Irstitutc does not, a td the pub!;c should not, accepo at firce valuc tlic findin,;s of this study, if the CG.ncer Society were eonfidcnt abuur the t-aliilicy of its claims, it would have a;;recd in the revtCw:' He cl:.vp;edl the dug-smo!liiil; research was done widu fmd3 "fiinri>i,tcd ht the fn'.i::ra! om-ernmcnt and the Amcri- can &ncer Sccicry. Stnco the) arc fhnds dcrivrd from public soarcci, d:c p;a.;ic is cntitlcd in a,full and frir acco.mr of the res.tlis. 'll:r. Amcricart C.in.xx S©ciet)- eNr.rtot presurnc to b, thc sn:c ccstodiJn ~nd,iiacrlircrcr of t tc vnrl. ... °1 sccros in Li,•lit of the 'Cony Curus tnca.'er , thc•.y (the soci rV,) 'sh0:rl,i re•tcscss tlieir, a.1d\Cr1iSiJ1g 1.!i•;)'' Curris; a noted 110yan o,1lactor; [cct ndy was corn'icted of p ts~-iort of m^rijua:a i;t lingland. Ilc• has appe:ued in ::uisnru'.:ina comn:crcial> on U.S. tclcci;ion. ~

- . - •~._ .a - ~ . •-• •~J PUnlac 111:n1.1-H GCriVIc:t_ 1,111t;rcnNolor:.UC. ~c•fci ~ Pr.r~tt ~o: ,1U5~IDJ10 Jailathan E: - kioads, H. D. 1-merican C811cer SOciety, Inc. 219 Er, st 42nd Street New York 10017 ]'orl;s, ncar Dr. F.hoads ; We Ild1•e carefully reviewect your rcquest that I as Su*rneon General establish a cc::::iittee of scientists to co~lc~.uct a formal analysis of the 1-uerbach-t•r.;;;:.ond study. S)z,p<t}ietic a:. we are to f:lie reasons trtiicli have lec to this request, we do not t':elieve st:cii a fol,~al- .=e~,~._._. ~ ..._.-. 1rel=~Cic' ' ilC.ce: G'.r~~ in ordc_I' to C, tc i~:' Si1 t~~ ~\'~t)-j alil_ 4y of the ~; tuCj}'. XC jr, coT2trFi):-y to fact 'tha'lt sc:1'_elltifi::s 11a,Ve b6C;1 prevented f1:o.t ze`=ic~,1-nlg the ~aucrbaca-};r cao~ld etur,y or that r::,y data have been t~itlilieJ_d. Amo:i- the qur_lifiieci Pe_-sont: uirio already n-lrcdc t}~cia- Bes :•i L}i i•!~Uclt.ai<c1~C1 ~':1:~ i2tive. j7~i:c::~)''iC'31 .f17'115h~`f"•••~i(>.• _ ~. . .. . ....~~. to the laborctor;' :...atcrial a:rc Dr. Jo11;1 R. L: r- c pr:;u'holozist irQ`i~ the 1"1i.7_o:?a:l' Cancer T:..: t..'lt.(2te LS'i(i Dr: t1,r•l,' " 7 v.^_. .. : ]:rC'1 inc 19:iGe1";,`tr.I1d t}:a1t a I1Ltz-bCr of .r..ciel'.ti..ts out:iiziC the Cove;::l,teilt have also gone over the study in detail, a.nd, thGt- the opportunity corzt-illues for revica. b). other personc, including scientiit.s 3i-eprecci7ti_iiS the t~:bacco :industr)r. There is no sc3.et1t5.ff c stuciy -,:,hi_cti callnot- benef it by the ;-eview of . other scientists; it is the j.n:3tit-uti.ona3., "jilry„" rev;cu 1:•l:ich we believe ijiineceseai7'. Dr£.:. Auerbac}1 and 11.::;moi'J6 are quc.i.-'fied iilk'estfg`tors l?110 have int:de \'«IuF,ble colltl'i}hlttioi:5 in thej_)' rCSOective fi.elds over ap:aciod of ra,ny }.ears. They h::ve c<.rried' on the present BtuZy uilder the i:'ost emi3ie3zt r,l>onsorshil), that of your Socfety <+nci Of the Veteraais /;dr:a.nistration. The }~roce:lur.c~& tlre.y fo).lcw,el have been full_y deFcri11i.Q in the lit:cr3turc; they )l lye Tf ClI( C~ l9~lc?t" il )`)Ciir~: ~ . ,.~_..,r,..,.,.. .»..~.,.._.,..~.,...vl.,,,,,..,.~ to be en aC1C'C1t1tCt(2 YCpo 7't Of t}lGii' ! tL'"i;', a~1C1 t11C'.~' lial'e oll^I:(_'Cl t-llejr _-°- ~,.,.,.....z~.+.......,.....-..~.....,.._,.,..~»...........-.-.~ Q dat:i to the inspcction of o:.iier sc.LcncJj.' ts. We do not lalolr tYl3azt more Cati be e):~c.cted of ;~to,especirlly tl,oSe ti?i-th the Y-cpL)tZ1ticns for cxcel3.ence and probity enjo)'ed by })ru. /;uei-bt~eli r.nd }'lasm-.oiao3~. _ ~ : . .. . - . . ~ ~ . . ~ - - . . • . .. N

:'c~~c 2-- 3or,Lthr~n I:. I'~1r~r:clU, tS.I1. Dr. Ucr~, har told ur, ihr,t i:cr lir_s no c;ouht bt.t th;:t L}ze rro~;res:;jvc clhan,;cct: _~n the bronchir.' titsc:uca of the cai~rslt, t,t:udicd Were as Dr> l.uerbacl, has dcscri.hcd thcm-, and that a-;usjp, othet: couditions {_c.titid were e.lly invasive squ.~rous ccll c<<G~.Ilot~a in the brouchiPl lung cancer has been discovered in the lungs of dop,s exposed to i.cncs of two of the do~s. If the qucstion at i_scu~e is whether hun,.ni- c%F,~rette then the ansFrer is yes, in the view of a Public Iiculth Sci-v'.cc, pathologict with special cc=pctencc in cancer. 1'h is Is also the view, we uuider.et4nd, of Dr. ferner ~~nd of the other ; przthcLo&ist;. who have reviewed the mutcrial. • that cigarette s-mot.i-ng causes lung cancer in 31umrn beings. There was cnough evidcncc si.. }•er.rs a'-o to causc the Sur-co;t General's Advisory Co=-ittce on Se:okxng'r.nd l.ealth to co,ne to this conclusion, and this It 3_s not neccssary to go to this stc~dy to support tlie conclusion evidence has been str.criStihened in the yctars si~lce. . The Iiucrhach-Ne?„mon:3 $tl1Uy addr; one more E'-]emi`Tlt of cerr~:yn'1'; *:J a concll3-sio:1 Wi11C{l the yozict s r:eaical and tie4lt-11 auzilorites r:lrcady consider 'cextain. :r. - r; ti -• pzot•ide us with new in~>i;ht into ciosc-r.~l'~ ed pul,:ionary char:4es, both -ncopJ asta cand nr~n- neoplr;!; tic ar a. f:Lt?ie ::c=e, it r,: yprovic':e us w{ th = The studa, s ohyi:ous_ szt^•nificcnt on s: :~eral sco:-c?s. It-appears tc k~orld' s sczcirti f ic literature on C. and iic<~l:h r:~ d c1 aluaGcs ~ t~:Ath an iuryp ort4nt now r:esearch tool, an Ui::i;:zal s}.s tcm on Whiclh -r;odifzcatiors the cisc^_rCi:tC can be tef:tGd. c;n.7 e` al.':i-~QU4 ... ... • . • • - . . -- . . .._ _ ...:`. - . ~ -: .:~' • _ . - . - - -..~.. - . -._ The I'u')1S:c 3!ea1t21 Servicc ha s the st.::tutory responsibility of r-eportin~-, to the n;t regular 1i1 CrVF.1S on L:2 112nlii11 cot7seCOuiGnces of c~- - . ~•- ~ • ~ •~ - ••{ rS.n C. ~~,i rf• G1,1 1'CVS t11u [~i:wi~l ~.v• AC: }iL.=~::a.Lla~~ i...~ .- ..-..._ ~- .---` , - .. . .. . the help o~ esAnc_nt scientists, selectc:d :=c:; both those out sidc the = Govern.-neni: as well as those in the Service itself, =,-The next revi e;a of the health consenarences of -sr.:o?:in ;will be reportcld at the en6 of the calendar year. The st"udy' will be g5ven forr:aZ•re:=ietil at this .t:ir.,e •in its- propc:r; contc;:t, as one of non}s resec=cn ntu:Iie:s shcddins•, )aght on -a difficult r~1. i,spcrtr_:.L' hcal th problem: I :fccl certazn frar.i vtr?L' c e alrenc!v l;r,ai= o~`hc! s;t-iarti= tl:i^.t it Vill n_`ot-~-e r.o be an i,a~~o,t~n: coztr~.tiut~io;i to our uiic'exstaizuinS of t}ie sr..o,:inp, n•zcL htialuh. qucstiun.

J`11w.~ ~.to ~ , - t 'I' , Fr ri C - ~T'i~~ -~ i'' 1 1,f,f [_;)i.;3. ~o'~.. ~~:~if. ..~C•.c~~..'/~1..~'~:..r'[.(v:~,a1: •s• A{cr.`iccf lr t'vrrr,c hrport rIzvw 1'oa: Thc Sltrr;c, n iE3:S.Pnhlic 1-1caltn has to Lct tt~ ;~ ccr:uali''.t•:c cs. c_tc:~~ fi: 'n::•~ s'~I:] _~'•' Cf»Ft'..Ir,'. ~'. ^r•. r../~~ ~!.•-' '.("l ~_-.~. •ct~l: y.,s°t t••f~- 4 ~ w r L•~~. ,'.-.~ (J..r.i::J`:,~•lr, ~c-: LK~.,-..l ,. ~. ~.~ ~.xir`r"IGI_ ---- l~u,r:,:n -•-- _.. ~ r : ms;1 ,.i' , il -, .17. in v.;hicii i:.tng cralccr was rcp-crtcdly i::dt',cd in dogs by eigarcitc snlone, bccat*sc we do not bclicvc sltc li: a fora:nl review is ncccs- sar} in ordcr to cstat+iish The vtltaity of Ifilc :.tu;3}." Dr. J: s_sC I- StetnfcIM otltllnc-(1 st- .t iion in a }ctter sent to Dr. Jon a'1 : L. Rho.•ee;s, l+residcn'•- of ti cAnlcr; :n, C;1- ccrSpciet)', :,nd r.lwdc n,It~llcaL tllc o!^an i731i7n`c Iteldquarters h_rc. The cancer ocicly l:cad l:ad Pskct: for ca'fli Ilncnt I e+f tn^ >tc.•ict+• cc+:ntni::c•: by t:)• ,urge4..~n Gcncr2l in the ++-al;c of rec;ucst-, f,+:iclc by the To'.,a cco-lnstit-ac for an irt:icwr.dcnt cwt1ttzAion of tllc rinent zt,di its fintl- - 7na^s (N'lEU:c:1L TF. t~T, May 25). ~ I ~ I I °1t is centrary to f: c.t 111: 2 sciantiats have '--cn nrcvcr:.ca from revic+:•i:rg ~ir:dv or t ta" am, sietz have L•c•c!1 ~:tttl: cli,•, D. Stelnfcld sa i;:_ Dr_ vs_ar Aucroa -^n, of Nc+v YnrE: I12o.1J, Sc:.17.,- of tn~ At: icri=.. C::ac'.'r S:K.'lct\, lia 1 presc:ltcd! :llctr inaGi._s at a 11^.\YSCO:]ferctlcR (: tL':JICALTtaa.l;KE,I'1?il- .rts:--S !y). -Amon, - the scicntists Dr. S'-_i:dclc3 de-' scrihc-t as f3nlilirir tiitin the st:icjv. and as . hw+'ing 11ad opnortalni:y to rct'irv-r ta: l sl~o-' rator r matcri;a, are Dr. John M'. !3: rg, :r Natios-? Cenccr In~a_utc hat-.olutist, and Dr. 3::_y;;;ona 1'csncr, a}.~atlioi-,ist from ttac Vc!crar.s Adnli.l s itio-s Ai 1=ough Dr. Stc.r.`clcl en1C'..aized that "iherc- is no sacntit~c study +°.•+:ic!I c::nnot hcn^i_ by the reviz:v of other scicn'ists," he co: sic?crs an insUl.:?iOn^I "jU::}••.rcVi::w unnccc cCaly bccaas^% in his c:;linion, the intcsti; , tors rcSFoRSi!JIl: for the StuCiv in . ` questic~n foII:>vrcd proccd'urc: full}' dc- scribcil in scial;tit:c litcr au-c, i,,sucd I- "what :!p, ears to be an : clra?,t.ate rcllort of .iheir study;,• Rnd "oi:Lncd ti:e r d:aa° to L%c ifC.flzclioil of ottittr scicntists. }i<tvostig?fors' RcIputafio:z r'r..iscci "1:'c do not know v:hat more c: n be ~• 'l.Xlk~ct_d of illl•cstit_-iors, cs`,;.islty tlulsc -~.ttrith t;.c tcrutati_•: _ for cxcrilencc. and 6_11aig- pro%i!r cr;oycd by Drs. /1,ctEr1liaclt .and Hamr:-or.d," 1)t.S:einfctd ca d ~~~ Itt :t furlhcr cxj lml:ltiol> cl.f I:is posittorc, thcSurrcon Cicncral 1Cl:ttCct th:,t llr. 13crg "has no dutlbt l+ut tllat, 1hc ProfresciVc chanres ijt, the broncllial1 tiR:u;s of the aninl:il. stuciieJ were as Dr. Attcrbn ch has dcscribcd tllcm anditllat nnlon; utlacr con, di:ions fotisld were carly in+•: •,i+•c sc;u:r- nlolt:; cell caricinornit in the hronellial ttlbes of two of the ctvgs." '7f c,,tian; at iss!.i: is «Ilcthcr hu,n,ian 7-l,,:lc;~r,:.:r !_ c::r cLs- ...~-.•.- 1 cmcrc c l ' P I t' Uii 1., ...~~.___------------ ct^.:retc s,1Sn,a t!1':ir is 1'C s ~e._.e.. in in: +~ic+:, rf 1':~'~tic }lc-:ith S,:rv;Qy; ~ -~---- - ----- - - .~,.~,~ wl:il shccl::I ~l-l6j)'e~1i::C in ccsnccr, Dr. St nteki v.rotc. Oac cxr_ctcJ benc; t fro:^.1 the stiloiy, he added, may bc to pro+'id-, r:.icntist;s v; ith, an ani:n. 1 systc.rn on +vi;ir11 :1 oJiti : ti~~n.; in cigarcitc?tl Lir tested :11'.tt C+ `iL'a ttd. The `,..rg_ott G.,:cr.a Roint.t} out that I'I-I'S lt:~:: tiic statutorv rcs;11)^: il)i[av of're- porti:,2 to C'oa~ress 1411 iractv: lx oa the h_A:I1 of The ncxt n:vi: & Nl•i!f'Ite rc, O: t- a': the onc; of the c::1: n:)slr year anci .., t3,c:t tiil,c th,- !;ac.,:'r.=h-1i_at i:~otld sP:d1' `.+'il1 be in- ~:,:~::', th-C Ct1lt::CiC for Toi,ai.:.o ' liC,.,:drC"-1J.S.n. : nnolltlcid 1)Ctnilc :tlon of the 1196S.69trlnual t(-,?ort of :t-,,5 tcn- tific director, C 1:1rcl;cc; Co; l; }.ti'.lc, Sc.D. r.is:.•rsts Extt'errely c~jn:;llex This review of the ct:rrCrlt toI`accn- hc-'til i icture cOVers rckc:+rclh tau!ir,t; in lunc, cari.>cr„ hcart clis :<<c, and chronic Pulnlorw: }°' :lillrnct is. !)cclat ir.s. that the d.,~c•r.scs dideus~e.i are cX. t:1i ly c, n+,^''x, the rcport says that '•1s nt i•::1 c.:ll, frcr„+ the great~ anw)ttnt of resc:,rch rc;:or 1cd so far that avarictv of r,c;nctic and cm•iron- nlcntai f: ctots nr)' Uc invc,lvctl!" -rcic:t0n of cpi~lc:lliolo^ic \,'ost in?erl i studics is built on th: :«< r.l; :ion that cir: tct'c snio,t:crs and tuo:;. io::crs : rc sufl:cictaly tii;aifar in otilor Icshccts "so that it is lc,;itinlrltc to conapare their tnorbidit}• :+.ntl Illa.7: t;rfit}• cxp: ricrtcc. and to .ttrihutc nl,scr+c~l d1t1-crellcc.; to a solc facttar-stno?;in~," the tc;',:'t ttotcs. - "I'llc restticlccl rloni-l:tctn'ial intcr- ,. prctati~ln of snlul.:r.;t as a aana.tl factnr iti totca ir.c+rt.ait)' or in rrl;ttion to ccnt:-in discasc ~.•` it coa+tict:cs, •.i;-ttores the V;,li- dity of :r s•:at r.m,-vtnt of nscarch rclating :+lo~::`lc ilhssible irllltr:nce of n:any otlt,;r ~;. . . _ ~., tin ts t~f f ctars ~~t~~ t~ r``c t . a t.1 ors or com AC

r LI I I i I I I I I L Dear Doctor: The Tobacco Institute has not accepted the statistical association between cigarette smoking and lung cancer as etiologic proof because of the lack of biologic confirmatiom You will recall that in, 1964 the Surgeon General's Report acknowledged that there was no experimental evidence that tobacco smoke coul& produce bronchogenic carcinoma. The subsequent reports of the Public Health Service specifically questioned whether the typical characteristics ofhuman squamous celli lung cancer had ever been experimentally produced by tobacco smoke in animals. In February, 1970, the American Cancer Society presented new experimental evidence to news media claiming: "For the first time, scientists have produced lung cancer in a significantly large experimental animal as a result of heavy cigarette smoking." The Tobacco Institute sought immediately to have this new "evidence" evaluated by independent pathologists and other investigators. The American Cancer Society, however, refused~ to show the slides and supporting data to such an impartial group of experts. Following disclosure of these facts by the Tobacco Institute, The New York Times on May 9 published an editoriali in which it supported the Institute's position that scientific investigators should have complete freedom to examine the basic evidence. The Times characterized as an: "error of judgment" the American Cancer Society's stated refusal to submit these findings toia committee chosen by the Tobacco Institute or any other group. It also viewed'with disapproval the suggestioni made by the Cancer Society; following the Tobacco Institute announcement, that the data be reviewed by the Surgeon General of the United States Public Health Service, since the Public Health Service is already on record as believing that cigarette smoking is dangerous to health, In the belief that the quality of medical research is a matter of concern to physicians, the Tobacco Institute presents to the medical profession, for its consideration, the Tobacco Institute's recent announce- ment on this subject, and the complete correspondence between the American Cancer Society and the Tobacco Institute. The Tobacco Institute 1776 K Street, N'.W. Washington, D.C. 20006

I I r I I t I I i i L I I I L L TheTobacco Institute :,~, 1776 K Street, N.W., Washington, D.C. 20006 TheTlobacco Institute believes theAmerican public is entitled to complete,authenticated information about cigarette smoking and health. TheAmericanCancer Society does not seem to agree. Is the public entitled to com- plete, authenticated information about research on cigarette smoking and health? The Tobacco Institute thinks it is; the American Cancer Society apparently thinks it is not. The Tobacco Institute has re- cently challenged the Cancer Soci- ety on a matter of importance to the public-and the public health. The Cancer Society has not accepted this challenge. On February 5, the Cancer Soci- ety called a press conference in the Waldorf-Astoria Hotel in New York City to discuss a research project titled, "The Effects of Cigarette Smoking Upon Dogs." Through the efforts of the Cancer Society, the public was led to believe that this experiment is a landmark achieve- ment which, for the first time, dem, onstrates that lung cancer, resem- bling lung cancer in humans„can be produced in animals with cigarette smoke. The Cancer Society claimed that this result' refutes the contention of the tobacco industry that'there is~no laboratory, proof of a connection between cigarette smokingand lung cancer. The Society also said that the findings should have an impact oncigarettte smoking and should re- sult in a reassessment of the adver- tising claims and policies of the to- bacco industry. The Tobacco Institute does not -and the public should not-accept these claims at face value. Here are the reasons: 1. The present accounts of this study are based solely upom infor- mation and interpretations provided to the press. The study has not been published~ in any scientific journal. The findings were not'subjected, as such findings normally are, to rigor- ous independent scientific review. 2. This history of t'obacco and health research contains many ex- amples of experiments which were initially hailed~ as scientific break- throughs, but on later evaluation proved to be of little significance. Unfortunately, the initial and pre- mature announcement of these ex- periments makes news, but the later criticism of the work rarely comes to public attention. 3. The Tobacco Institute has requested the Cancer Society, in writing, to permit a thorough inde- pendent evaluation of the experi- ment and its results; We said we would propose as reviewers men of outstand'ing competence and integ- rity, with wide experience in areas relevant to the data, who, we be- lieved, would be t'horoughly accept- able to the Society. We also stated that if the Society should, for good reasons reject any scientist we pro- pose, we would nominate a substi- tute. Finally, we offered to bear all costs needed for this independent analysis. The Cancer Society has twice re- jected this proposal-in letters dated March 12 and April 17. We continue to hope that the American Cancer Society will per- mit the examination of this work in the manner we have proposed. If the study is as important as the Can- cer Society has represented' it to be, the Society should have no hesita- tion in submitting if for review. The tobacco industry recognizes and accepts a responsibility to pro- mote the progress of independent scientific research in the field of to- bacco and health. In discharging that' responsibility, we believe that the industry has spent, and conti- nues to spend, more money for such research than any organization in the United States. If the Cancer Society continues to deny access to this recent work, we believe this will', serve as convinc- ing evidence to the public, lay and scientific, that the data will not sup- port the allegations made at the So- ciety's Waldorf' Astoria conference. 1005091'726 We will be pleased to send thecomplete text of aIlcorrespondenceon this matter between the CancerSociety and The Tobacco Institute to any interested individual or group. .~: °`*0{;'?'

F I PHILIP MORRIS I NC~ORPORATEU 100 PARK AVENUE.NEWYORK. N.Y. 10017 .TO9EPHF. CIILL_XA.7, $RD CHAIRMAN OF THE BOARD February 27, 1970 F I I L I- I- I- L i Mr. William B. Lewis, Chairman of the Board American Cancer Society 219 East 42nd Street New York, New York 10017 Dear Mr. Lewis: On February 5, Drs. Oscar Auerbach and E, Cuyler Hammond presented to the press at a special meeting held in conjunction ~ with the meeting of the American Cancer Society Board of Directors the findings of their study on "The Effects of Cigarette Smoking Upon Dogs." The Society at that time issue&a "Backgrounder" press release interpreting the results of the experiment as a significant achievement representing the first time that scientists have produced lung cancer in a large experimental animal as a: result of heavy smoking. The Society's release further claimed that these findings should have a significant impact on the smoking of cigarettes and williprobably lead to a reassessment of advertising claims and! policies of the cigarette industry. The report and these interpretive comments have been givenwide publicity. As you may know, there have been, previous studies with cigarette smoke in which the initial'report has ctaimed1hat lung cancer-resembling lung cancer in humans-was induced in experimental animals. These were proved either wrong or of little significance after the results were subjected to rigorous scientific examination. Other developments in connectioni with smoking and health have sometimes been announced under impressive auspices-such as a major university-and, after evaluation, have been found to disappoint their sponsors. Since the American Cancer Society asserts that the present study is of considerable import to smokers, I believe that the industry is entitled to have a full understanding of the nature and significance of the findings as quickly as possible. In the interest of accomplishing this aim; I request that the Society permit a thorough evaluation of the experiment and its results by a panel of independent scientists with wide experience in areas relevant to the data. I suggest the following procedure: When the American Cancer Societynotilies me that they and the investigators have agreed to permit access to the relevant materials and data, I will nominate as reviewers several well know scientists highly qualifi& in the fields of experimental work, tumorpathology, and lung diseases. I believe these scientists will be recognized by the Society and by their colleagues as men~of outstanding competence and! integrity. If the Societ'y should, for good reason, reject any of the men whose names I offer, I would appoint a subst'itute. The tobacco industry will, of course, bear all costs in connection with this review. I look forward'to an early favorable response from you so that this work may commence at'the earliest possible date. ~ Joseph F. Cullman, 3rd Chairman of the Executive Committee The Tobacco Institute, Inc. Yours very truly,

F F I F I I I I I i I I- I I AMERICAN CANCER SOCIETY, INC. 219 EAST 42ND STREET • NEW YORK, N.Y. 10017 • (212) 867-3700 WILLIAM B. LEWIS CHAIRMAN. BOARD OF DIRECTORS March 1'2, 1970 RESEARCH EDUCATION SERVICE Mr. Joseph F. Cullman, 3rd Chairman of the Executive Committee The Tobacco Institute, Inc. Philip Morris, Inc. 100 Park Avenue New York, New York 10017 Dear Mr. Cullman: This will acknowledge receipt of your letter expressing interest in the research work of, Doctors Auerbach and Hammond as reported at a special meeting of the American Cancer Society Board on February 5, 1970: Your appraisal an&suggestions are based on a surnmarywhich was prepared for the edification of science writers. It'is expected that the full repoa will be published in the very near future. This will show the meticulous work that~ went into this latest scientific experiment which we believe meets the highest traditions an& protocol of scientific investigation. Over the years and in this latest experiment these scientists have contributed significantly to the knowledge relating to the effects of cigarette smoking on dogs and humans. We suggest, a study of their formal'papers willisatisf'y, any scientific or other questions regarding their findings without further investigatiom Sincerely, ILB. William B. Lewis

I I t I I I I I I I- I- I- PHILIP MORRIS INCO11OM1TE0 100 PARKAV£NUE. NEW YORK. N.Y. 10017 JOSEPH F.COLLmAY,3RD CHAIRMAN'.OF THE BOARD Mr. William B. Lewis, Chairman of the Boar& American Cancer Society 219 East 42nd Street New York, New York 10017 - Dear Mr. Lewis: March 20, 1970 I have your letter of March 12; 1.970. I am greatly, disappointed~ that the American Cancer Society has refused to permit the impartiaD review of the Auerbach-Hammond data which I requested in my letter of February 27. Since the Society hasealled upon the cigarette industry to reassess its policies in, ligTilt of the findings, it is only fair and proper for the Society to permit us to have those findings evaluatedbyindependent experts-and immediately. You will recall t'hatI propose to nominate as reviewers several well-known scientists highly qualified in the fields of experimental work,,tumor pathology and lung diseases. They, will alli be subject to your rejection for good cause. Your reasons for denyingmyrequest, asI understand! them from your letter, are that the formal papers will be publishediin the verynear future and'that a study of them will satisfy any scientific or other questions regarding the findings. I do not find these reasons for denying my request at all con!vincing: Firsts publication ina scientific journal will not occur until many months after the Waldorf-Astoria press conference of February 5. Second, the American Cancer Society at that press conference made serious allegations against this industry and its products. The Society said in~its press release that the Auerbach-Hammond findings "should have asignificant! impact on the smoking of cigarettes in this country, and will probably lead to a reassessment of advertising claims and~policies of the cigarette industry." These findings have been widely publicized in newspapers and the medical press. H'ow can the Cancer Society say that serious analysis of the work must be delayed until formal publication! Finally, the published papers cannot satisfy questions about such matters as the proper interpre- tation~of the pathologic material, the allegation that cigarette smoke produced various effects in the dogs, the validity and adequacy of the experimental design and procedure, and in, general whether, as you assert„the experiment "meets the highest traditions.and protocol of scient'ific investigation." These matters can only be resolved by examination of the pertinenti data. and material. If the Cancer Society does not accede to my request, we plan to use every means at our disposal to see to it that the medical and lay public are made aware of our respective positions in, this matter. Furthermore, we intend to continue to press our reqpest for exposure of this experiment to impartial scientific scrutiny by qualified experts in the manner suggested. If the Cancer Society continues to deny access to the work, I believe this will serve as convincing evidence to the public, lay and'scientific,, that the Auerbach-Hammond data will not support the allegations made at the Society's Waldorf-Astoria conference. Joseph F. Cullman, 3rd Chairman of the Executive Committee The Tobacco Institute, Inc. _ .~. ;

F F AMERICAN CANCER SOCIETY, INC. 219 EAST 42ND STREET • NEW YORK, N.Y. 100U7 • (212) 867-3700 WILLIAM B. LEWIS CHAIRMAN;BOARD OF DIRECTORS I r ( I- F I L i April 17, 1970 RESEARCH EDUCATION SERVICE Mr. Joseph F. Cullman, 3rd Chairman of the Executive Committee The Tobacco Institute, Inc. Philip Morris„Inc. 100 Park Avenue New York„New York 10017 Dear Mr. Cullman: The Veterans Administration„the American Cancer Society and Doctors Auerbach and Hammond cannot accede to the requests stated in your letter of February 27 and March 20 for an evaluation of the Auerbach-Hammond study on "The Effects of Cigarette Smoking Upon Dogs" by a panel of independent scientists chosen by you. Your request is withoubprecedent in the scientific community. The study under question was the result of three and a half years of diligent and brilliant work by two eminently qualified scientists whose findings have been validated by distinguished pathologists of worldwide reputationL In addition, other leadingpathologists„highly regarded by the scientific community, have visited Dr. Auerbach's laboratory, seen his slides and praised the work. We do not intend to ask that these two eminent men submit! their findings to any selected committee chosen by the Tobacco Institute, or any other group. Their work will be judged in the traditional manner of American: science, where findings are presented, discussed, accepted or rejected by scientist's and physicians whose only motiivation is the truth. Doctors Auerbach and Hammond worked flreely, and without restraint with funds furnished by the federal government' and the American Cancer Society. They are beholden only to the scientific community at large and to the integrity it represents. If the Tobacco Institute, or any scientific research, group, has doubts about the findings of this study, the way it was conducted; or the credentials of the investigators, there is a time-honored and scientifically accepted way to proceed. Let your own or another group of scientists repeat the experiments in a laboratory to prove that, smoking dogs will not suffer tissue damage, emphysema and lung cancer. The Auerbach-Hammond methodolbgy is readily available to you. And D presume that in the Council for'P'obacco Research you have or caniset up the mechanism for conducting such a study. If you carry out your plan to publicize "our respective positions" to the medical and lay public, you have ourpermission to use this letter as the position paper of the American, Cancer Society. W Sincerely, LB. WiB. Lewis

r r PHILIP iw10RRIS IM~OO~o.10N'.~.TED~ 190 PA~RK AVENUE.,NEW~YORK.N.Y., 1i0017~ TOSEPH~~ F. C LTLL1fAN, 3RD CHAIRMAN OF THE BOARD Apri129; 1'970 r ~ ~ 1 ~ l I i ~ L ~ ~ i Mr. William B. Lewis; Chairman of the Board American Cancer Society 219 East 42nd Street New York, New York 10017 Dear Mr. Lewis; Your letter of~ April 17'st'at'es that the American Cancer~Society~is~unwilling to permit'~ animpartial review of'~ the Auerbach-Hammond data by "any selected committee chosen by the Tobaceo Institute, or any other group:" You say our request'~ "is without precedent in the scientific community:" I submit that the Cancer Society's exploitation of this unpublished work for publicitypurposes is truly without precedent in~the scientific community. Through its use of publicity techniques rather than the usual scientific channels, it is the Cancer Society-not the tobacco industry-which, contrary to the tradi'tions of American science, has projected'~this study into the arena of public discussion. Furthermore„ in the scientific community, expert review panels are often convened to review important~ questions which depend upon the interpretation of'~ research results: You claim pathologists have visited Dr. Auerbach's laborat'ory,,seen his slldes and praised the work. Why, then, do you refuse to permit an impart'ial review by distinguished scientists, especially in view of your claim that this work is of great significance to the smoking publlc and t'he tobacco~industry? As you say, Doctors Auerbach and Hammond worked wi'th funds~furnished by the federal'govern- ment and'the American Cancer Society. Since these are funds derived from public sources, the public is entitled to a f'ull and fai~ account of the results. The American Cancer Society cannot presume to be the sole custodian and interpreter of the work. You stated that these scientists "are beholden~onlyto the scientific communit'y at large and to the integrity it represents." But the American Cancer Society, an organization supported by public donations, is certainly also "beholden" to its contributors and to the public at' large to provide complete information about the research which it finances, especially in view of the fact that you have released news of the study to thepublic media. When the Society is questioned'about it's interpretatior.s of such~~research, it should'~feelia responsibility to disclose the data which, it alleges, support its interpret'ations. You suggest that the way to resolve any doubts about the study is to have another research organieation repeat the work-which you say, was conducted over a period of three and a~half years. This suggestion overlooks the fact that the American Cancer Society has called 'upon the tobacco industry to reasses its policies~in lightof the~~present findings. If~this~is the~Society's position~ it should not expect or want the cigarette industry to go through three and a half years of research tb determine answers whieh the Cancer Society asserts are available today. In view of the American Cancer Society's position, we are proceeding to bring this matter to the attention of thepublic: Yours very truly; '~P` Joseph F. Cullman, 3rd Chairmanof the Executive Committee The Tobacco Institute, Inc. = ~ ~-

I F t - ( f I We hope that you have found this material to be of interest. Your observations would be most welcome. ~ Sincerely; /°OA-~ ~ Horace Kornegay President I I I L The Tobacco Institute 1776 K Street, IN.W. Washington, D.C. 20006 ~

PI-11LIP I~~~ORRIS a .ceirc% r,ree 100 A/.RK flrNU~r, hEVl\'ORK, R,Y.1J017 . _ ~:. .. . . , Dr. Gera1JD. Dorman, President American`Medical Association 10 Columbus Circle 'New York, New York Dear Dr. D orman; study of the effects of cigarette smoking upon dogs before the June 22, 1970. I am aware that Doctors Oscar Auerbach and E. Cuyler Hammond are scheduled to read their papers regarding the widely publicized annual convention of the Anlerican Medical Association in Chicago on Wednesday, June 24. conference for Doctors Auerbach and Harnsn~ondi on Tuesday, I am writing to you now because the AMLy, has schedu).ed a press data to an independent and impartial scientific panel for evalu- ation. Three times the American Cancer Society has refused to do so. asked the American Cancer Society to st:bmi.t- the underlying American Cancer Society news releases as a scientific brezl<through that should cause the tobacco industry to reassess its policies. Based on this allegation, the Tobs.cco Institute has three times The Auerbach-Har7unond: study has been characterized in the June 23, during your convention. On the b-sis of a news release, it ~vould--apl~ear that the subject of this p:-ess conference is the same Auer bach- Hamrn ond study which was released at a prior press conference held by the American Cancer Society on February 5 at the Waldorf-Astoria Hotel in New York. As of today, the Auerbach-Ha,liaicaond stu:iy is still unpublished reported that the Auerbach-Hammond in~inuscript, which was in any scientific journal'. mioreover, a xecei;a news story ~. , :~,_ ~ ~ ~~+ --~ ~'.'~•, ~:~-~° ~.,.~r *-~.~,~,~ r~ ~; ~~~~~,,"~ stating thatscientitic reviewern assigne.lby the Journalhave - ca31y, a sP A Journal was r. eccntl.y quoted as u;;esm?n for the AMA . . o y, 1 ~ ssoca oa, ia&O i Specifi- icatinn A ' t' I^ t e~ been accented for Publ Z i subinitted s orne time ago to the Jour" o e mea. , c. c a ' 1 1 f th A r2 ~d .

t- r Dr. Gerald D. Dorman June 22, -1g70 Page 2 questioned the "val'idity, of the pictures" submitted with the reviewers found reason the "validity" of the pictures, the dogs' lungs which were offered to substantiate the claim- that certain of the dogs c?eveJ~nlred lunb cancer. Since the manuscript to the Journal's revietiv board. : The'term "pictures" undoubtedly refers to photographs of microscopic sections of -Vhe implicz~.tion is that th1=~•,~~t•ere unable to confirm. Dr. Auerbach's - cla.irn that the dogs develuP'ed lung cancer. = As a resul.., the American Medical Association would-now appea - - ..~~. .,.......-,,,.,,...,..._.......,~ been and is beino seriously ouestio_ied by the scientists who .~~ _ -- - - - ~auspices to providing additional ov.blicit~;~ for a stud~~ which has ..-.x to have bee n pla.ced Ln the } :tion of le- di-nn its facilitie s and are revie-v;inif: the. findnf:; for the AMA's official Journal. The and unsubstantiated in any way -- already ranks as one of the fact is that: the Auexbach--I+Jan-iirxond st'udy-- to date unpublished most widely publicized studies of all time. is ne.cessarv to estab) Gi~thevYiidit~, oft't, sttc'vy, This opinion , ;,....,_- - - ... .~,~....-......~.r... - cozicludeci, without examining the data, that no formal revieV-1 -- - - - -~ ...a.._ -,.,.....~:._..,,...._..._.....~> :-analysis of the Auerbach-Harnrnond study. He appe _ ars to have. ____-,.._...__.._..~.....~... _'request of the American Cancer Society to conduct a formal Health Service, Dr. Jesse L. Steinfeld, in which he declined the -a letter from the Surgeon General of the Ura.ited States Public On Jiuie -1 ;, the American Cancer Socie ty News Service released assigned to review the Auer-bach-I-1amni,ond manuscript by the :editors of the Journal of the Arnerican Medical Association. - seerns to he in con.flict with the opinions of at least s:onze scientists and, la}- publi.c --- vrould, possibly provide more facts against which to j~jdne the additional pubiicityfhat v~-ilJ. undoubtedly _ wouid' reT,€asc the sub tar.ce of the reviews in its noSS(.::sion- ,,,,,..,.,...~_.,.._... .,....., - - _~_.~........._.-.......,,~....-..~ ...<......, -..._...._....._ .-. concer this cticl~'^ inc)i3c?iT-`o ~~nti' nc aii.VC- flndin~s PuD. nir-.,~+ tlai.~.. i_ disclosurc! to theAMA's i-neinb; rship -- as well as the press It seems to rrie that in the interest of scientific truth it mivht be heJ.pful if the Ameri~can Medic~,1. Association at thi:: rjz;,t ._...~....._...__....~....__------- -- result fro.ri the press conference schedUled for June 23. li d h F an 3 C r rn osp u . ,: ~::~ ttec i m m Chairman'of the'-Eaecut~ve Ca y~ ~ ,~~ y^y M L ~..-fu± 4a~:-d4v 1 .C i ~f~~'~~~. -' 7rTj~3

E~.1~ V is IsC0Rf0lAfC4 100 PARK liVENUti kElY YORtt, U.Y. 10J17 Mr. William B. Lewis Chairman of the Board. American Cancer Society 219 East 42nd Street New York, New York 10017 I am at-aching a co;ay of a letter sent today to Dr. Gerald~ D. Dorman, President of the American Medical Association. . It concerns the Auerbach-Hammond study of the effects of cigarette smoking upon dogs, sponsored by the American Cancer Society. My reasons for writing the letter arc simple: CHAIRMAN OF THC B-_ ARD have not chanoed. You continue to refuse our request for an .- First, since my last letter to you, c'.ated April'29, the facts impartial, independent review of the Aucrbach•- ITian-imond data. Second, the full Auerbach-Harnniondirepo~t,v,hichvou said in your letter of ;March 12 \.,ou1d be. l~~lb].ifFhed"i.n the velrv -near_future " re„iZ" I r.s ~:t~ut~b~,shed. Instead of publication' .i ..,,.-.._, . there. are *-ess conferences -- t~ o in the past iou~r months -- _, ~ -.~ ._ . . -•--,-. ~ u .- .._ ~ . .V . .~ .. and pres s release:.: on data which has not Vet hoc n profes si on ^:lly - ~ - -- - - - .~. . . -. ~ ~ have read a published report.to reviewed. In addition, we .-....~..a..~,._.-_.~.-, the effect that the validity of the Aue:rbacl.-Ha:inin.oiad study is being questioned by scientists reviewing it for the Journal of the American Mlc.dical Association. Another news story indicates that at least one j;ournal the 1\Te\v Enl;J.4nc1 Jovirnal of Medicine -- has rejected the article. Third, although, you ai.Lnouilccd on April 30, that the American .. Cahcer Society was asl.ing the SwrgEoni General of the linited' _: States Public lI'ealth Service to analyze the Auerbach--Hammond dat.a, the Surgeon General has decli:ned to do so. The substance Jasrsii F. Cv[.LtfA2.`, $jtD .

Mr. =14ri11iam B. Lewis - Jtuze 22, 1970 Page 2 and rea:,oning of the Surgeon Gcnera'`s reply confirms the editorial position of the, New York Ti,nes of May 9, 1970 that the review should not be undertaken by the Public Health Service, which is already on record as believing that cigarette smoking is dangerous to health. conference concerning the study will, be held, at your request, during the annual meeting, of the AMA in Chicago on Tuesday, June 23. This press conference will undoubtedly result in Finally, it is my'understanding that your second press additional publicity for.a study - - unEpublished and unsubstantiated -- which already ranks as the most widely publicized study of all time. was fa,- fro:n accurzate and, that it is Jit:el.'y that none of t~he ...t,. _.....-_........_....,.~...~..-.a...-..-.... _.....~...~~,._.~s...r.~„- ~_................_.. .~.,.,_...,,, i1nCln~ ~is 11is*'hl s,,1s?ect; Il~car?ti~_34 v.,lien the first announcement of th2!~: work was n1ie1.e-C at a press conference held under the Cancer Society's ausp'ices at the Waldor{ - Astoria H'otel in New York City, the ),,ed'i.aI:e.1)O2teclthat 12 of 96 dogs.e,.posed to cityarettc sli~ol:e haci c~c ~ elor~efl ~: t~ry w. ~,~ ~, r~ _ -... ... ~ . . ~ ...~... ~... ~. a . ~ Cancer. 7There is now good reason !C> s11.;pGc[" that this repn'_• It is our oPinion tociav that ilie validitv of th'e uerlach::monr ,- ~-. _. .._. . ~.. ~ . . ~. ~~ - scientific or other questions about the work. Following a second request from The Tobacco Institute, the ACS said it would refuse to ask the two scientists to "subinit their findinbs to any selected committee chosen by The Tobacco Institute, or any other group. " Finally, on Aprili 30, following, public disclosure of these facts by The Tobacco Institv1'e, the Cancer Society yielded to the degree of annoih-lcing that it was asking the Surgeon General to aiialyze the data. Four months ago, The Tobacco Institute initially requeste6 the American Cancer Society to permit a thorough, independent analysis and evaluation of the experiment and its results by-a panel of impartial scientists. In March, the Society responded stating that tnie sLuQy future" and that the published papers would satisfy any - dogs developed lung cancer. ~i~

I As you will~ see in the attached letter, we have also suggested that it might be helpful if the American Iviedica]. Association -.would: release the substance of its editorial evaluation of the i (03 Mr. =1Villi:amk3. Lewis June 22, 1970 Page'3 The Tolacco Institute again calls upiin the American Cancer Society to agree to the impartial review which we have requested. of the medical and lay public. work immediately so as to prevent further possible deception Yours very truly, Joseph F. Cullman 3rd Chairman of the Executive Committee The Tobacco Znsti.tut:e,_ 'Inc.

T ~~~~~ ~~~ ~ !'~~~~- l i t ` ' H ITE-Q E_ AME L~ 6~ CAN Wk= D. CC/°;, L A.~'s SOCCATi E O!rd 535 North nearborn Strcet, Chicago, ilUnois GOF,tO • e Area Code 312 527-1500 REPORT RELATES CANCER AND SMOKING was made todiy (June 24) in joint paper by Oscar Auerbach, M. D., I L and E. Cuyler Iiam.~nond, Sc. D. at a 3ylnposium on -Dis•eases of the Chest at the 119th Annual American Medical Association Convention., AUERBAC11-1Il&UNLOND ---Smoking Beagles - For P.M. (CDT) Release June 24, 1970 rusrArn_e4 rPlationshi_n between lilne cancer and cicarettes n the first of the two papers, Dr. HaaLmond demonstrated that lung cancer developed in dogs who smoked proportionally as many cigarettes as a habitual human smoker. his:paper, Dr. Auerbach showed that filter tip cigarettes do not damage the lungs as rapidly as t.on-fi.lter cigarettes. Dr. Auer'L,-ich stated, "In dogs whi:h smoked the same number of cigarettes per day, the death rate was lo,:er among those that slnoked! filter-tip cigarettes than among those which smoked non-filiter L

-2- I ( i I I- I- cigarettes. t' - He described the five types of tissue change which occur in pad-like attachments to.alveolar septa; thickening of arteriolar the lungs of dogs exposed to cigareL-te smol:e : fibrosis; emphysema; Dr. Auerba.ch concluded, "Cigarette smoking is accompanied by walls; and thickening of the pleura.. -these histopathologic changes; the changes become progressively more advanced so long as smoking is continued; and they progress more - - _ _- - ~ , rapidly in heaiy smokers than in lighter smokers." five groups. Group C (control) smoked no cigarettes; group F (filter) - In the experiment 94 pedigreed male beagles were_divided into smoked filter-tips; group L(light-) smoked non-filters, but only half as much as the other Qroups; Qroup H(heavy) smoked non-filters. A Teflon tube was inserted into the windpipe of each dog, and the animals were taught to inhale cigarette smoke voluntarily. Groups H and h smoked seven cigarettes a day, equalto 42 for a 150 lb. man; group L smoked 3.5, equa7. to 21 for a 150 Lb. man. The test - per iod was 875 days. 1005091740 - . The filtered cigarettes used' Ln the experiment contained an average of 17.8 mg. of total tar, and 1.1-7 m;. of nicotine. With the filter removed, the smoke contained: an average of 34.8 mg. of tar and 1.85 cr~;. of nicotine. The filt.er reduced the tar by 497., " 1 . . . . . , .. • . B~fore the expcrimenters started to sacrifice ~. --~• ~.~ , . _.. ~` . +.s x `, .- - -. .. '-.i .,~, . ; . . . . , ~ , ,. logs on day P876, the mcrtality rate.s vere t group 4

r 616 2(16. 7%) ; gr-oup L, 2 (16. 7%; group II, 12 (50'%)'; group h, 12 (50%). '_'The death rates of the five groups of dogs," Dr. Hammond notes, 'Wre in alignment with the dosage of tar and nicotine relative to their mean body weight at start of the experiment." In the second section of the-paper Dr. Liuerbach demonstrates that, "Inhalation of cigarette smoke will produce lung cancer in :'dogs." He'reports his findings in respect to the occurrence of non-invasive and invasive.bronchiolo-a1l.7eolar tumors and early invasive bronch'_al carcinoma in the samn group of dogs.

I Convention, VOICE: - I'd li7:e to in:~roduce Dr. Auerbach and he'll take it from Press Conference, Dur ing" American J•iedical Association June 23, 1970, in Chicago; Featuring Dr. E. Cuyler Hammond and 1. Dr. Oscar Auerb ach . -you cannot prove'that cancer is caused in human beings by pro-. --------_-~ ducing cancer in dogs N.7ith •anything. Or in mice, or _any other .. _. ~..•.F'_~~ . . . - . 3n thesc expera~iraents. : estimate of all the relationship of si o:;ing ~•:ith human cancer -comes from studies of man, not from studies of dogs. Our interest in these e5:perii:icnts was si,nply this. ' As long as a greaf- many people want to smc,J;e cigareLtes--and I- thin]: we oug:-i t to find if possible sc>me sort of cigarette that -.- .. .. ~ . _: . - - ~ ....' ~ . • persona?.Jy I like to smo}ce them (inaudi:b]:e) Dr. Aucirbach--t.hen does no more . harm than~ possible. :-mc•ntation that N:,ould take 25-30-40 years, even if people volun-.. .O • hTo•,-r, it is not feasible to do this with hLlman experi- CO . • . . ~ , . ~,.~ . - . - ~ . ~. . . . ~ ,.: . .., . .• . . . teered,- which they wouldn't. There:fore we looked for

ld ttfi ~th t then we coucs one type o cgarettc vcrsu anoero see ~*hethcr one was less hzrr,ful than anotl-«.r. -years ago, emphysema just exper im ent, which was at that point, we =-one-cigarette agail:st _ the exposure, because in an animal that occur when a: -;lan smo]ccs . If we could do that Now; in a pre]•imi-nary' experiment, publ).sh(~d sevcral: could test. one cigarei:.te against anot-her. Now, very briefly, _•- cigur e ttes with a Lilt.er, a white, cel.lulose emphysc ma and pulrroni:ry fibros z s; they developed we found that dogs smo}:ing cigarettes developed as human beings do. Now this was a.preliminary We wE:re then in a position tm 'test cigarettes, one in our preliminary carried only 415 days, none did not hav6 a test for cancer (inaudible) anot-hcr-. In this it keeps not 'i:o prove that an anir-al where we 1©0so9i7 -43: experiment we tested filter-tip acetate f il ter t•:]i i:ch reduced the tar "ahout in half and reduced the nicotine considc:rubly, - although not -s much as the tar. linc~ %,,e found in rcspec t( that although with the filter the dogs developed a slight.amount of .

human beings do; quantitatively, we thiri7t it is reasonably safe -3 ~: to extrapolate this to human beings. ):o~a ~•re a_lso think we have a metho3 for emphysema for where if insight to cigarettes develop, vrhich hopefully they will be, they can be. tested. bronchial carcinomas. very smali invusive two of thc ra. The filter-tip srnokers and the lighter smokers did not. it's possible to develop a something else. At least one n: this experiment the heav'y smo'King dog of iion-fili:er- 67 Now, inasmuch as the dogs respond . in the saa7e .:1ay that .They also developed bronchiolo-alveolar tumors, 12 of vihich were invasi ve. To t??ese we have not "cancer, beci.tise there's a di.ff-cr- ence of opinion as to hctha r a~~ Ithe N•:ord, ...~_...., ... 'this dag should be callec? a tuinor or this should not be called a _ o--.~.. _.~. ..e.._,. tumor. Different pathol.oyists have cii_ffcrci~t im1rressions of it. So we are simply pub1ishiiig -,;,hat we found, describing it w:ifi.l-jout naudible) smol;ers %•rould li}:e other cigarettes, if not for ^or;r?letcly safe cigarette, 'that' s less problem. -;- tip cigarettes two .of them' also developed e

-4- DTZ. AUEP.BACH: `~"?-:~~ invited to prosent our material i the Di.seases of the 'C}3;~st Section, by 'Dr. Iio,,rard Andersen, secretary In this presentation tomorrow morning, we are going to show the series of changes which occurred in the non-- smo};ers, the light smokers and filter szr,okers and also the heavy , . -have found a large number of these'tumors and since' - cigarette smokers. -V: e sectioned all of the ] ung parFnc;-1yma :we have The tumors are dividedinto two types, those that:occur in the region of the small bronchioles, -%•7hich lie * in- the peripYieral . . - . . . ,. aspects of the lung, connected with the sriall bronchial tubes have In the heavy cigarette-smo}.irng dogs there is a progres- ,Oi:ve series of changes, he -cells sho%,:ing evidcnce of neoplasia, (inaudible) und'erly ing the stroma, -and in fDur : instances these tumors invaded the overlying pleura. - -. . .. -- . . _ .. . _ ~.. -.~ . . :......_ Dr. IIam.mond has already pointed out. we aren't usa.ng. the .ti7ord, "cancer," because d1f1"Ert'-2?t pa th7log1sts, vhcre cancer begins, v=ould have d.if Eerent readings. All pathologists would a:r.ee that or w}ien the tumors reuc}i the pleura; invadc the

-5- that, as Dr.Hamu-nond has z: found squamous-ccl)led, early .I`d a_i',;e to say that during the course of our studies we have shown our slides, in c~~~:~ultation, as is the normal As the patholc:~ ~~ sts co;ne to our -].aboratory to qxamine. the slides--we're happy to sho-..~ thGm to them (inaudible). -ren, -a world authority -(Inaudible question from the floor.) ---_VOICE: Could you repeat the question, Inaudible c;uesti.on rrom the floor. ) :-DR: AULBBACH: In the. group of heavy smo':ccrs we cat,r the deve]op- . nient of early invasive cancers juct as we have seen them in (InauUible- question from the floor. ._DR. AU~~P.B:'~C~i: I'd li?~e you to ~:nozr that we are presenting our paper to the Diseases of the Chest tomorrovi morning at the T-merican Mecriczl Association convention. This is the normal course of events (inaud: hJ-c) . to Dr. -Raymond Yesner, Dr. John~ Berg -and also to D VOICE: Hocr many dogs did you have in the e:xpcriraclit and )-,ow loiag.

DR. AUERBn.CH: . Cuylcr, you want to give the specifics of the des-igri, - the whole design? How many dogs were in this study? 7P, : DR. HP01,i1,101NID: It's a little bit complicated and I want to be as brief as possible. We had 97 dogs oraginally. We kept them _urnder observation and we -%•;anted to eliminate "any -who had a disease ~ . , - or died -z :etcetera. .By random num?-~ers we took out eight_- of them, nonsmokers,, to see what wo'.ild happen to them. This left 86, after three of iem had - died, that we put on srn:o},ing filter-tip cigarEttes--on One group oi aogs s!ciof,ed f: for 53 days--prii-,iarily to gei: them habittuated. •- After that we divid'ed, them in to the following, groups : , , ,. . . . . - _.. .. in this group. In the second group, all the dogs smo}>ed~ _non-filter-tip cigarettes, but they smoked one-half as many cigarettes a day. There were 12 dogs in, that grc~ap. T<•:erity-four dogs smohed nun-f'_a.lter--tip cigarettes, but the same nuTrber of cigareutes a day that the filter-tip cigarette smo',:ers were cmokin;. Now we had a separate group that %•:e?-e not co-n-Darab]le, because they t.;ere heavicr doc3s, some of a3iich are still smo1.~:ng. ~.'hi.s was a si 3e separate e:;~?4ril;lent. We reportc:d' oraJ.y the -- prelimina.ry resuli:, of that at the prc'sciit tirne. .. . : • .

At V~he end of 875 days, half of the degs--of the. 24 = dogs--that: were • smoking - non-filter-tip cigarettes died--that And at that point we sacrificed all the dogs eYcept 'the heavier dogs that were. (inaudible) for a later experiment. ;-.: (znaudible question DR. HAYIt;OND:- r?o. f Dogs are ...have a shorter life span than man. They don' t live as long. And you can' i: extrapol'ate directly in" :terms of n1bmber of years or days in a dog_ versus the number of years and days in~ a man. There' s a general rule of thumb more less, and this is very vague--general. P. year" in the. life of ' .a dog is roughly pro7ortional- to se%yen years in the life of a . man.- But this is . just a rule of thu;n'.D and inustn't be taken too se an animal otller than man to try to get' the precise .- anscrer. to the question that you just as):ed.- This information~ on man co;nes from massive stud7.cs car.ric,~i out o11 men, and it is from those studie:5 tlhat. we cfEt the an.sV17c~rs to the type of question you just asked. .' 7C'have never c3rac;,n that type of conclu_..i:on (inauuible numhier of years (inaudible), our studie:: of so many ailimaJ.s oi.h0_r_ . ..._ _ ....~.: .. . -.

E4 VOICL: j.,hat ` s your l-eaction to the critici_srls. of the tobacco :`' industry 'spo?:esm4n? I said, what's your rbaction to the criticisms of the tobacco industry? '` VOICE: The quest-ion is what was your reaction to the driticism ,of the tobacco industry? ~ . . . . : . , _ . _ . . DR. AUEREkC'H: Well, • I. .think I'd like to answer that since most of it is pathology. Let-me say this: That we are presenting our r.laterial torlorrocv morning to our peers., .We have submitted our paper for: review by our peers. Sie have no quarrel with anyorie. 1 course that scientists should foliaw. _: TJ.R. AUERBI~CPi: I don't thinJ:--I don't feel in any way any criticism 1005091749 DR. AU},RrACH: Am I above criticism? 1woti]_dn' t be submitti nc1 the s long as I myself feel that I have follo~-::ed the general,' generally ;..accepted practice that p~-,ysicians do, that scient:~sts do in pap-br to--for publication without accepting it and ]] ~:otz]_d acccpt any criticisM fr.oin any physician who rinaucliblc), glad).y. If _C'm v;ronc, Iwould state that I'm wroncr and if they have a point of ,._o....,_,.. ---~--~- - ..o _. ~., ._....,. _,...F..._._ --- - -_.............e._...,_.., . . correction I'd be more than happy to do it. I'd lil:e'.to say thai~

:during my ce;rc, r I have.w-.<~'r%a num~ber of instanccs (a.nuudible) gladly (inaudible) . (Inaudible convrtent from the floor. ) DR. AUERBACIi: t-;ell, I'd like to emphasize that I don't consider this as a auarrel. * t•le're_.just presenting a scientific paper. ;. . . _ . , , _VOICL: What further• stn.ciies should be conuucted to show your :.theory is either correct or incorrect? . . .t DR.' AUERBACH: That further studies shnuld be done to what?. VOICE: To either support or refute your studies. DR: I3UERBACFi: -j;ell:, further stud'ies--v~e' d be very happy, to have other scientists repeat our studies, as is material .-i-thin a"shoi~-t perioa oi _:time you will find that any one of a nu:-aber of men or groups of men will try, will attempt to repeat it in the sanle. -,-~ay or -:inother way. We welcome it. (Inaudible qUe:;tion from the floor. ) ."DR. AIP.:r.BACII: At this particular_ time i.naudible ) . (Inaudible question from the ftioor. ) - . ~ 'J'1;C C~li.: S i-? On N,: c~s, ]. f I (].nc~.lldl.bl-C.' ) from dog 't"_o man, vhy %;'CUr}: p31.GO~`~' Iiaybe I d1-dn't. Ill'c.}:C 11'lyself. . clear in answering the prevzotls questio'n:.-. There was »robabl.y

-10 - =_extiapolate. . The only e}:trapolation which we are suggesting as beznc , . . . . _ _ ~ , --- ---~ --- - -- ~ we carried out iri this- experiment. I'said in terms of'years oq'.days it is difficult t Now in human studies we have . . „ . . rose-response relatibnship. The more found a relationship---a cigarettes people smoke death rates from lung cancer, to find ~-whether reducing- tar- and nicot ine-, cutting the amount of half, in effect, would be the same as cutting the.number - -- .. •_ . - • . - - . . _ , , ; ._. of ciqarettes in half. And this is just essentially what we ' :ound. As a matter of fact, we found in reducing, tar in half--the- smoking half as A005017*51-= Actu.ally it shoti•rs that the type of cigarette, maiiy cigarettes now on the market, have rceasu-r-ahlq, less tar and n3cotine ; . ~ . _ . c than practicaJ_ly all those on the market some years ago. -Paici it (inaudible) is a littlc bit of a puzzlc to me tltr<<t so:; e c~-sa~'ette corti'Danies don't liho the idca that they' Ze puttine; out a lc ss harmful product than they were some eaYs ugo.- This to me j• :3 a i: lii.tle bit cur_ ious . I don' t see why- (inaudible , ~ . .. .. . . .a :- ... _'- _ ~ . . ~ . ~ ~ ,. . . .. . .. _'. . '

a ~47iite cellulose acetate filter. •• .When I say non-filter - cigarettes, it's the same cigarette with~ the filter removed. S'7e have not said trhat brand it is" beca-use we neither want to advertise one bYand versus another, nor do we vyant to hurt one company compared with We used a popular brand of filter-tip cigarettes with t is not our aim: to take sides with the different -'companies in the.,tobacco industry. (inaudible) the-infurmation. :-comrrton knowledge (inaudible). For this-.reason we didn't (InEudible.") yt'; (inaudible question from, the f loor . pretty -DR. This is a little bit comolicated. The most con:.rnon forms of cancE:•r of the lung- of the human being occur in whzt are called the bronchi or bronchial tubes. In the heavy smoking dogs = kJe found two early invasive carcinomas of the bronchial tubes, sometimes called bronchcgenic or bronchial carcinoma =found a nurnbew of cancers %•.,hich most pathologists call - bronchiolo- a.lveolar tumors, We also some applying the word "cancer" and some not in (inaudible) dogs. Now these tumors arc not so terribly rare. They're .- not as common in men, they're not as common as the bronchial

D-11. AUERBACH: We are hopi r:- that the pathologists andl other _-scientists who reviewec.i thl,s study will maKe results t:nown finaudible). ke will be happy to have them presented. (Inaudible. question from the floo~; . ) DR. AUEn.3ACfi: Let me say this. _autho I thin): the relationship of an our. report to the Journal, and if the Journal expects us to keep -in. confidence we expect the sa-me with them: P.nd 'I don't think it's for us to say more than we have submitted in the snan, we found in reviewing our dogs the same changes in the lungs In the deveJlop~,ent of emphysema ir• of dogs as we saw, in human beings, with the rupture and tearing veolar septum z,T.d develo~;_~r,:ent of emphyseT„a just as we them in the human 'being and related. to the heavy dosage of cigaret~te smo};e which they inhale. The scvex'est dm.physema occur.red in. the heavy smo.dng dogs of the izon-filter cigarettes. VOICE: Thank you very much, laali.es and ge.ltleir.en. Thank you,

. .'-~= . . . : . . !u Chica9o i'u:;WcdnesdaJune 24,~1.970 0 Cancer 6'Gporr Cai S11:1~ u-,Cd, BY GItL•'GG R:1]ISII,114 FtiR'l iIEP.`EVIDL•'NCG that ci~arct smok- ' ii3o causcs cancer and emptiy-scma was pre- sented today at the A,aerican Medical asscciation's scientific exhibition at the In« tcrflational Antghithra(cr. " . In a 21,~-}•ear espcrimental study of dogs smoing, I)r. Oscar AucrUach and Dr. E. Cuylcr IIallltr,one o' New York fo:LA det•el- opment of early in va sive carcinoma [c•aacer]. .inAhe tronchicl tal;c•s of. it:e animals. They found also the same changes in the 1........ .,~ }l.n .7n•rrnr nnrnrc in I,ittY~:aft,Cnloii- - Crs (:Uring tii:.'o•,;o:t of C•Z:NII_r's`'::1a: At'I:R19:1CII IS a senior medical im'esti- g,ltor at the Vete_a.is AdmiListratior, t,os- pital in East Cra: ,c, N. J., and lia:r.mond- 1s ~'iCe pr~eSid^nt for C~iiaeriliolr;c}` : itd sta- Gstics for the !i:ncricau Cancer society. 'J`heir 1)rel:?.l!t:afy ;7:•esentatdon to the llress yesterday alirost! turr;ed into a ec;:frcnia- tion with rep?-csen': tires ^f the tobacco i:a- dustry. _ ic!r, c'-a1n ^Y~:~eSa CO:,~nh~ ISCC,, A`=t ;t.iL1. e;F to 7 t c!l , ~ !. 1{ t.':e -c~c}hiLir 5,~i~ lnc~o N e, c,eL~A, i yv<^::_~, st...-.,; su13 iuKt^~' f r to r,! St~:c1~:~ : ~ianrr,lend , r:io iLc Parr~sc of il,cit• sht:]y r detc.'r>>iine -whctl cr srtcl ia~ ' <<•as ttot to 'c:arsc: discatia bu: to fii:d a ci;faret that is FS 5Jf : 3S 1?msh)iC. I3!]t lie Sii1t1 tiils tS•,?C • ~ Of resk>arCh had to be CiGl:e on .iiYllnal.S, nOi' 1i11P.IiiTiS. He said their finclir,,s chott-ed t}ta5 rclac- ;k,Lng the Or intuL•t by a fi?ter tip ~':.+s 1t.~re :rets i f ~ c gtit:cfficicnt lh:,n cufti::F the nuniUcr o ;.~ smol:ed bv half. s R w -y x.7' .^ J s ~ -~ i . 'v9 ~~~:ly1•~~~s. ri'M ~~~'tiN~s.~ai~'iiSw. 4

« (rff/~ ~~ `i ~f f ' . Two scientists who taught Su .•~~iSogs to smor:e ci-a:ets and re- ported taAt.I? nf t'hr-!r~ rnt cq;_ .,.~......._-,-~:....,~ ~ ,said U'Ed,ncs: ay iney 1:0fie . otner researchers ti=;ill dtipli- : cate the experiment. The findings have been ques- . tioned by the Tobacco Institute - beea;:se- the tuniors that the dogs developed may not be technicall3• cancer. T ;•e tobacco industry has lon~- contended that no one has been We to prove a ceiinite link betWee:t s:no':ina and can- cer and that even if cigarets were liitlr:ed cancer in dou, no "mear,:nc;wl1 parallel" could be d»aati>> to l:un-nans. THE SCIENTISTS who cen- ..~T,....~.,,,...>,... G~U~i+"v 1:~~: 1~_.....,,k_f r,^ ~.._i?S _ ~ ~ .. - ... Y r10. . J. .,.,a,. C'OiI~eC2CC.L' 1:1'.fi_'rt - •!~ °,~ N. • ,. - m'++:::..i..'a' ('Sy'~?1:~~.~ i3W1'?`~iiY.iiw,f•; {.n.:~:n ^~ ' 1 1'~, tit~_' f^ ' I'.3!l, q !lo u„c ciV:>,:e: ta ~. ~.,.y..~.....o..~.~,~... E Q~~~~oa..,.~ ~•~,~.,a~,~..~.;~ The scier tists, Dr. E. Cyler Hammond, an American Can. cer Society epidemiolo4ist, and Dr. Oscar Aacrbacl:, pat.':olo gist at the East Orange (\.J.) Veterans Administration Fbs pital, forrnally presented their r e p o r t- li: ecinesdar to the Arnerican Medical Assn. here. The b?tsic findings were re- leased on Feb. 5 at a press

. . . . . , , ,. . . a ,. ... CHICAGO T:tIBLT\ E,' tiVT.Dti ESDAT, 'JUti'E 24; 1970 ., , ~• l ~ f `~L.a '.~/ 7r'„~'. ~~ v.Ir . • 1f. : It E F 0 r T E it S AT THE in a paper to the A. M. A.' An;crican Associatioti today. coa'cn:ion got < cioeoic ciosc'of th: ci~mrct co^t;o•~ers•, ~~'cs'~'r- UlnY. 1-11T:1c(:latcly :tltc: two p1hysici^ns told the. rress of ;.hc;r study .howi°,; that do~,s that sr-.;c:ce e~ ^ar ets cic> eJ~_;~ cc-ccr, rcl rcscnt1`:vcs of 1't.:^ To:)c.^^.e I? iitrte stao•,":cd i!a to Fres.'1` t tc rebutt?i. The to'baceo j.eopIc argucd that it N "hi-itl a rr' ~~ i;,~r 12 0~1 `` =n ~ l C:'~:~; It i:t`.:'i .tt''!':~!^f• '•~';' Cny; tut c ~r r. 1n~ s1:: ~ s0 1<.s " t h c 1t on of ~ 1: if~ ~ i cr l:um ;rc: socic'ics. wluch. t)c'.icvc that nlti^x^1s shouid not bc tat.tght surh habits. Dr. E. C;,v,:r I:~;n^:c~ of New Yor`.. City, ar,i Dr. Oscar A:x b;:eh of i:.st 0rar-.~c,.j wi:i prescr.t tau, S:r~Ji >•Is

I 4t51~'VLi~ lYr riJ Jj~i lr1C)/~llnUil(:L 1J'/.11 <p?.Lf;c,f;~ci f.r fjcS) The Senate oave final Conores: sinna';::ai ra a^ 'zc'r'.oa bill ann:na'ail ci^cr::i!e cn r•er- cra ; o"f rc: on f t s,~n rs f Janur:r.(, 1971. It P:-scinenry' Ir~'n ~- Presidenl Niiron on a„_- ! 7 . lavr by' hc r arso sirengthens the warn- irg notice required on e/eryciga- . r:ttd pack. The new r-:essage: "Warning: the Surgeon General has determined that cigarette smoking is dangerous to your health:" The - bi0catted for this to take effect six mon,hs after the Presidentiaflsian. ing-on October 1. T-4e coniroversiali question regarding the Federal Trade Com- miccinn's rr:_crt~nsihilitia: nmr~nr!- -fating cioarette advertising was settled by enjoining the FTC from requiring wnrnings on remaining ads until!afterJufy1„1971; with a six months' notice of intention required thereafter. Sen. Frank E. Nioss of Utah warned cigarette manufacturers acainst a: massive -= alift!of adveKisements frorn broad, cast to printmedia; if this hap- pened; he noted, the FTC would -- act as soon as possible to require : health warnings in such ad- vertising: - The blt's provisions represent : a substar•.tial viatory for the anti- smoking forces in the Congress and the r,ation:_ Sen. flioss, who -sponsored the measures, said, "Thanics to thisbill; faarlboro Co: n- try tvitl' fade into tetevis on history as of next Janr..ary." As the revulsion against ciga- retlo smo:-cing mounis na;ionatly, pressurc ncreascs to ban smot<- tg in public pfaces. Pan Ameri- ran 1^.'ortdiAinvays has c slAtblishcd Inc first air born; "No Srno•.cing" section on its 747'.jet8, and Amcr- ican nirtines is conecidc:ring ;t!ch, VUlU1rK: Ui , !w. 1 a move. A petition has been filed with the Federal Aviation Admin- istration by John Banzliaf Illito re- - quire such sections on allpfanes; it was this young lawyer from Washingtbn, D:C:, who success- fully petitioned the Federal Com- rw:nications Commission for the Fairness Doctrine rulinl; on TV cigarette commercials. jhe' FAA is also considering', a petition by lawyer-crusader Ralph Nader that smoking, be forbidden entirely on airplanes; the consumer's rights advocate cited the danger of' tire as v:e.!I as the health hazards and annoyance. Nader also has oetitioned the' Federat Hig'A•: ay Admini;tra;ion to prohibit smoking on interstate buses„ contending that smoking creates a fire hazard, interferes with the dtiver's abi!ity to safely operate a' bus by reduc ng his efficiency, and oenerates a,poten- tiaffy dangerous concentration of e..rbon monoxide. Another peti- tion of his~ to the Interst: te Com- merce Commission for the same ban is based on the contention that smoking,on buses lo :ers the quality of service. Railroad§ are ali;o coming un- der fire from anti-smoking forces. Recent sun•eys shovi' tf iat about 80 per centi of commuters prefer to ride in "No Smoking" cars, against less thani 60 per cent a few years ago; and the railroads have reduced the n+mtber of smof:in,t cars on each It•:in, ac- cordinct!y: The Penn Centrall Rail- roadi ad;uslcd the prop~,rtion of its s,nol~,ing cars after diecovering that riders erou!d c+ :r•„i up in other cs-s rather than sit among the ctouds of! smoke: tti!<ny top liospifals in the coun- try no; lonqrir sclll cig~: ettt:s on their premises, and have re- Fez slrictedsmoking to limited areas. The ban on sales affected 18 municipaf hospitals in Nov., York City on April 15. The American Pharmaceuticaf Association; with the cooperation of the ACS, has produced al sign read:rrg "'Be- causethey are hazardous to your health, we do not se!I cigarettes" -which is often displayod where the cigarette machines were, and~ in the many pharmacies tha'r have eeased selling cigarettes. - Three professional hockey teams, the M'ontreal Canadiens, the Toronto Maple Leafs, and the Deiroil Red 1'4rings, have banned smoking by, spectators durina gaines at their home ri-.ks. Reporters may no longer smoke at presidentizfl press conferences in', the l'Jhite House; Presidcnt Nixon does no, smoke and ap- parently' does not like spending time in a smoke-fified'roo^n:,Tie Executive Board of the World Heafthi Oroanization adocted a resolution ca!iir•.g on all who at- tend its meetincs to refrain from smoking; this United idations agency stated that "no oroaniza- tion devo';ed to the promo:ion of heaf!h, can be neutral" on the qucstion of cigarette smoking. U.S. Agricu;ture Dep2rrnent fig: ures on 1 °G° cigarette ccnsump- tion shov; that the use of ciga- rettes is fattina at a faster rate than it had'predicte:i. In December, the agency calcufaledi that 19u9's consumption to;:aed' 545.G bi!lion cigarettes, a drop of, 2 per cent from a year earlicr. I-iov:erer, the actual figure proved to he only 528:9 billi n, a 3 per cent c:cctine. The deparimcrills esii;r?ter. of 10G9, per capi,a cig.areCe con- sump'iori be,ran last, Se?,emb^r with an' estimated figurc do•rvn 3 per cent from the 1265, tc.•vef of 4',1C-5: In Ducem!icr„ this v:as re- v;; ;d lb a4 per, cent docfine, but the final aver<:ge shor,,s Ihe fig- urr; actuaffy droi.,pod !i pc•r cen: to 3,t:92 ci~a;cllcs per per.cn over, 16. 7

I I l . 1 10U:1Bf-R OF CIGArtETTES S.r101:ED t•IU1.1nE11 OF CL^,hR[TTE S.r.'OKMRS PEAADULT' UhITEDSTATES;1945-19G9 It7 TNE U!tITED SIATES;3;iS-15G6 4 r- 415 1950 19:59964 1965 1969 IATLSBER OP CIGARETTES SrdOl: _0 50.7 - 493... 495, ldX ?G5 11987 19i3151LLrONS OF CIGARETTE Sr;.Oi(ERS yr;a.:~od o.*r ~- fwaee: U.S. Ue~rrmeN ol Aqrrcvlour~ ". --~ Seurca: U.S. Hatiwrel Cenler 1ar Irealth 5atlsltcs The deparimenl analyst said he smokers, but from 19"6 to 19:81he ezpects per capita use this year, pproportion of former sm:)kers to drop by another 6"5 per cent to among ma!es increased'b}° cnty 12 around 3,763 cigzrettes. The cur- per cent compared to 22 per cent rent trend of declining, cigaretle' among fe,nnles:,The proportion of osebeganx:ithaveryslioht1douvnf -young, people who have never MarO tUrilut isvr. itv.: °1'=1l ic incr,-.aCinn lo0_ In clear, the ana'yst saidi that the 1966. 48.3 per, cent of mv!e ; aged conlinuing fall-off is a'tribule5le 17-24 years Itadneversmorred;;in 10 the intensive anti-smoking cam- 1968 it was 50.0 per centt Among pafgn. femates in this 2ge oroup'the per- Behveen August 1957 and Au- cenfages of those who never gust 1968. an estimated 1.4, mil- smoked are 62.2 for 1963 and 63.4 fion - people gave up cigarette for 1968. smeking, according~ to data re- leased by the National Center for Hca:ih Str.tistics: This uf ped~ to 2.5 million the number w'1o join- ed the ranks of, former smokers since June 1966; (A former smoker is d^_fined as one who had smotced at least iC3ici7aret!es in his cntire life.) In 1968, former smo!cers formed 13.2 per cent of the U.S. civitianj, non-instilutional popu!ation 17 years of ago and! older, an overall incrcase of 15 per cent over 19u6. A st :ady in- crease in peopl~, giving jpi ciga- roite smoking chat actcrized I cvcrY age and sex grnuaing, bo:h in numbers ofi people and as a per, cerd~ of each group: Althuugh producers of vagetables and fruits pay the Aoriculttre De- parlrarntl 510.8, million a-:car to have their crops oraded fairly, the "lords of the tobacco industry" get free inspr'ctionand gra.ding by the Deperiment. This was re- ported recently by nstiona!ly syn- dicaled columnist J~!c~;,An;i_-rson, who estini~tedi that the taxpayer paid S2:9 mi!iion in 19G9 so that the Acricul!ur<., ID^; arUncr;tl could inspect tob::cco for qua:ty:, Icaf location and color- "cv.:y,thing but he,.,., many puffs it 1akes for a full-flhc!ced casc, of lunD caU1cer or ernphysenla." Tltcstu:y,r:hichwasconductorl 1^rhy You srrlolie„11".c NIational for the Centcr by tlic U.S: 13iuc,:u Educalionaai Tctevision serics that of :nc Census in thrcc succes,;ive wa: broaclcast on, cc!zwraional ycars; sho'.vs that a lr:rgcr pro, or- 1elcvision, stetions throun'r,~uL the ject of an extensive follotivup sur- vey in 13~ metropolitan areas to determine how effeclive the pro- grams were in helping people- to, quitsmoking„and hovr many ooo- plb were helped by the,scrie:. - The study, which is being son- ductedi for the ACS by Lieberman Research„ Inc,, vrill survey more than 14;000 people; they, will be contacted by, volunteers in their, area bytr3lephoneand asked about their smoking habits and whether or not they saw the series. A se- lection of those who report hav- ing,seen all five programs will becontacted again six weeks later and t`;en again six months after that for further information about; their smoking habits: Some ofthe data, such as %-.fiich aparoach was most helpful in~rcinforcing the de- sire to~ quit smoking, %:rill alsobe useful: in formu!a!ing other pro, grams to assisU cioarette smokers wlro wish to stop. , Cities lncruocaim rm;blu(iy ntoBos!oa; Rochester; \Nilm;ngton, Pittsburgh, Philade!phia, AtlGnta, Tampa,, Chicago, St. Louis„ Cin- cinnati, Cleveland, San Francisco~ and Seattle. For the first time;, scientists re- eently have produced lung cant cer in experimental animals or sigr niticantly Iprge size asa result of cigarette smoking. A group of purc-bred beaates were trained to. srnoke cigarc!!es throu~h Ira- cheostornies, or openings in their throats, through which plastic luhes v:ere inserted. This permit- led them to inha!e smo{:e into th^ir Iun_ts immuch the sama way humans do. This research effec- fivc.ly answers such rcpoat^d ctcin,s by the tobacco indos lly as that which t:ppeared in a full?pai?e advcrlisemcni from the Arm,rican Tobacco Comp::ny in the h'c1:1 Yor'r. Tinmcs on SeiyteTbcr 4, sayin.„ "aftcr years of tt;:- ing;aovody h~a inducc.d lun) canccr in anirna!, with cigarettc

=-~c stc*dy was dsncv~hv; ui. E. ~ Cuyfer-tjzmmond, Viec: rs;~^nt for Eptdemiology and'"STa;rarrual Research of the h=S =:::n~' Dr. Oscar Auerbach. Senir-:lhcdical Investigator, VA Hosf•ital, East Orango. N.J. and Professor of -Pathology, N.Y. Medical College: It was begun in 19~ = the pur pose of finding out -arettes are safer than concluded~ that cigarette smoking, is one of the most important pre- veniabte causes of: disease, dis- ability and death in countries Iilie Canada," reported th_~ Health Committee of Canada's House of Commons in its hvo+yeac study of lobacco and cigarette smol'.ing. Its recommendations, whicFi it accepted wou!d put Canada in the , vanguard on cicLireite-healih leg- jtd -Dnty sccondarily, s^. ~ it _islhGon, included an end' to all •"fong-term smoking vr.1~-i;-.';,nuse-- aigerette prwmotional activities . lung malignancies in '^as. The within four years after laws are -dogs smoked for almorx tv;q and which is equival'ent -- a half years , ; 1n aboUt 18 years of hu S:, The death rate,, the invesriga- = tors found, correspond_.., r:?recily with the amount of tar andnico- ~-tine that the beagles pu'led into -iheir lungs. Only four ot the tilter ° _smol:ing and "lioht"smo}:ingdogs diedlduring the study; but hatf of: the 24 "heavy" smo'r.er:.:r_~x-pited. rnere wcae nvt::;atim 'c.rutr+~µ iiw eight control dogs that didn't smoke. Among the most common causes of death were such respi- - rafory disorders as emphysema :and pulmonary fibrosis. As for A - cancer, ten of the he,,<<-=^':m I ~toos cie•:~t '~ned mr'ir:, =nk b.~;ry ~ - - -- --- tilmors, and in ll':O In;i~rT~~e I tUm?rs t"n- o :erved in ht:m^rc. ~ So-cailodl benign tumors were found in seven of the light-smofiing dogs and in Q! f th fi!t f f our o :crs- e errsmo 4 The AS has warned, as a re- sulrt of this siudy;, that "Filter-tip cigarette sm.,kers shoulct not be fulled into a false feeling of secu- rity by the report of the fil:er-tip smoking portions of the :.'.udy. They should reaGze th-afi"ertip cigarctres, it lhey, cft.:ctiveltj re- duce tar and nico'ine ii +t-^ !>lain- stream snlolte, are at' :. : only -tess danrr-e ing to lung tie:.: than rlorl-fllleri ciy:.:eiies.- "The ovenvhe;rning m;:jority of health auilroritie; and nrg;,rlila- tions llrroualtout' the v.orlti have enacted, beginningn'.'ith advartise- r..ents on broadcast m_dia An- other recommandatian! is for maximums to be set on tar, and nicotine permissible in main+ stream cigarette smoke. 1Vhile stating that' there could be no "safe" level for these substances, the Commitieesa;dithatmoderz.te tevelsi, acceptuti!e to most smol;- ers, would redUce the daily total -N--„ . , a-.. nicotine. The Committee also, asked that all adt'ertising and' all I cigarette containers carry a health warning, and that the lobacco in- dustry concentrate on dw0oping tobacco that woutd rm.NQ ciga- rettes safer. Estimating that the costlof ciga- rette smoking in Canada in 1966 was some S389' millicn, the Com- mittec eoncluded, that "it is clean thatthe!magnitude of the problem is such lhal something more than- health education is des:rable.. - - Perhaps the most compe.tingjea, son: So introduce practice bl:• legis- lation to control the promo:ion of cigarette smoking is to t ring con- sistency and mutual reinforcement into society's actions to deal with the problem. For examplc, young people can hardly be expected to believe -t!iat gl;vernntents reafly eonslderi clgaret?esmQr'f.ir1Q tobe hazardous if they allow unlimited beans, I puf7ed on plastic ciyarePtes„1 tried anfi-smo:;ing fozenmecand gpm; I lettered the pack with ruabe: hanos so I'cocr.'dn't get a ciyaret'e out„and kepl right on smoking t'.,rce pr,cks a day," To provide support for Her If:rst resnluiion to Cuit„ She2rrangcd an ep,:.virSnient for 9 p.m., Decca;be: 31s,' with a psy:chiatrist t:ho csss a kind of,lryp^csis: On Yc_.r s Cay morning she rcpon;ed to vi :ecrs c! the 7cday Shoa; 'l tl.ough? he v.ould put rne in a deep ma;ic and l'd emcrcre r•: th an atudi rg abhorrer,; e of eigarelfes. !L`.3s. it vta5n'd' tilill ePsy. N,cj4rstIoaChesyou toIrcr1 }'v, sellin rt•hat lie calls a'b::oyant re'azatio n.' I'dcl.l1 it a rnilchtrance in •.:;ria~ y-o,r minois recepJive 13 tiicr i;.'ca er pro- lcclinq <'•nd respec'ing the f.ody in t.hich-:':7:^thor, y0u li!<* it ir ...-yeu h.'acc !c, fire. You irao•,rd ; rls on mind~ So' o'1C•n r.. p•dst r;ihly;It40 ulge to prY1!CCt. }nl4 hcClV t. . 'm^. pcrr.;. ::^n;:;: rnpre ierra,t:rnt P:n tt:f` urR.'i to r~ isOn it. r:'c1r, L l h!-C.n hours : nd ; 1 nrinuY-r: rvltc liut't'i• s,`,rnt mos! o,' i: in a f.i.; .' of :r trr,nce." T1r. t v ^s at t; `57 <.rn oa JjnC;:/y 1. On l:n+il l. i.'rs $.-,:,1ine'1-- widov1 (f arcliiti~cf Gcr,') was cl;!'na1'5 mo,;'ii~q. "l7~1 believed as p, sinrra;cl;< .. I do rha; we r„usr stop pc!IWinr r';c cr-rth, tuhich' isa closcclcysnu:n: ~'.hyal so he!l-hcn; c^ Njt!:::ing Pr.:! cr; cd sys4ern IhaCs rnc?" 7h , ul. ~ic :;tr:n- ercd TV p rsan, iil /Cno S;;nrinen so n^,uchth3l salr r, Y(,ar's re:ohr;ron; she g.^.vo bp T.irs r:cs r,or sc I:n !7rii 1;oquit. Sii-:~ the lirs; fir,;r di-' "cvcry'lhGrit Vol crerye:~'• tvlio rlrrcidcs 10rnit do^s• G:;%erer! Of, rn;f on sgni-); bioc1c°ain,zilcrf them: IJtyeci n,!h vu r}''b.rrris, 0 -.r:Ucl up pcr,s and pcrjcit;, !: uei:cd on en'Ice y

.: >•- # E.C. / ~.._.. (Diseases of the Chest) For P.M. (CDT). Release ?une 24, 1970 IN r~ t'~,r F'r

t 3;ffectB of Cigmrette S:aol:ing Upon. Doga `~~:::r .ri nent; Moxtali.ty; 1'indinrgn in Lung Parenchyma. by. E. Cuyler Sircr;nond, Sc.D., Dr. Med. (=scar Auerbach, M. D. David Kirwan, B. S., and Lmixcnce Garfinl;el, M. A. In ntimerous epidemiologic and histologic studies, it has been found . , . , that the ill of cigarette smoking increrse Vith the nursber of ciga-- . 1-6) rettes smoked per" day. 1lia points to a do, e-roopons.e relation5h3p. The dose of tar 2nd nicotine dewive;.ed in the ccncLp fr= a cig3rette can be reduced in any of several ways, one way being the use of a filter. Thus it _pight be suppoae.d that if tar and nicotine are =inly responsible for the i12 effects, then scro~~;ing cigarettes equippcd with an efficient filter may be less harmful than sWoRing the aame nt=ber of identical cigprettes not so equippcd. i~]`v j.Ts:sC:..''. .^.Xj':.Timer,t V'm-. conducted to test- tt1'-F !1'yPuLiico~: _...F .,., .i c i- t• i`t;1 i ii ~. vnether cigarette smoking i=ould evcutually lead: to lung cancer in dogs. ,In a-prelivin,~ experirment, ten beagle dogs smoked ci:garettes .: ..:.=-t_~ ...: . - 7,8) daily by means of a tube in: crted i_n a tracY,eostcmn. Five of the dogs died within the fir:rt 415 daya of vnol:ing, one deQth being duie to br.onchopncu.r:onfa and the other four to pulmonary ~nfa.rction duc to eraboli. In three of thc.^,e cases the enbol3: apparently ca.^e from a thrc :bus in the right auri_cular appen- dage. xhe remaining ff_%,e dogs were sacrifi.ced on dayn 421 to 423 -sftei- having . : . . ' swokeeet 3,700 to 4,100 non-filt:er cigarettes of a br,-.jid x-ehich Was reported to be high in tar and nicotine. At autopsy, all of the cacrifiGed dr,g, were ,. ' 100509i'761

2. fouud to have cmphyser~a togetY~er r~ith heurt cnlFZ~ge3ent; ~^.nd' it is doubtful whether they would have survived for ii:ny more moiiths. They also had raoder- ately sdvanced histologic changes in the bronchial epithcli=; and three of them had lesions (dyskeratosis) resenbling cwrcinc-ma-in-situ. In addition, all five dogs showed hy~.~.^..rpla'sia ualls of the bronchial tubes.. beings. However, at relatively higr, d.aily duFage (up to 12 non-filter cigarettes a day), most of the animals are likely to die too soon for the investigation with distended goblet ce;.ls a glands in the The preliminary experiment indicated that beagle dogs are suitable experimental animals for tsating various t,-pcs of cigarettes in respect to ~ < •. . -. ~.: - - • • . several of the effects Vnich cigarette smol:ing is knout; to produce in htm;an of long-tern effects. Therefore, in the pre; ent experi;mcnt, . we started' with a lov daily dosage and very gradually increased it up'to 9-cigarettes a day. In. the Ili~'heSL exposure group in l:Tli~ C?:p~L1C~~CiL, '1' ve i~ ~ioi pGiii~ wou ...•+ reached until the 858th day of cc,o kinp. atream smoke vhcn.a cigarette is uicchznicull.y ;,Taoked under stundard test Cig:1rctt-eg i ested Our desire was to deterr-aine the biologicul effectivenes,a of a filter which re:soves exactly half of the tar e-nd: half of the nicotine fr= the main conditions. Several brands of filr.cr-typt: cige.rettc:.> were tc:•ted For us by Dr. Jacob Fitelson (a cl3emist with ].ong eYpcrience in this ficeld); but none .of the-,n precisely met the desired spe-cifi~~~a'ti.o:ls. The riearest was a popular brand of American cigarettes cold in crush-rroof pac1:F9'es. Each cigarette was 80 =: long with a 17 =. t:hit•e filtcr:.. - In testi'tig and later t:hcn given to dogs, each cigarette was sVLokc.'d until the first. 49 i; n. of the cig4rcttc

•3. was consumed, (i.e. until the glowing tip reached the 49 n~. mark) . With the filter attached, the t:,mol:e contained an aver4t,;e of 17.8 mg. of total tar (dry wei:&ht) and 1.17 mg. of nicotine. With the filter removed, the smoke contained an_average of 34.8 mg. of tar and 1.85 mg. of nicotine. ';r-us ehe. filter - xeduced the tar by 497. but reduced the nicotine by only 37°io. We purchased 480,000 of these cigaretteswhich ca.me packed in Heil-sealed boxes, each box containing 60 cartons with 10 pacl:ageg of cigarettes per carton. The boxes = were stored_ir a temperature-controlled, humidified room until used. P.xperi*^ental l~nitn~ ?. s -2linety-3even pedigreed male beagles Kere purchased from breeders who stated that the dogs were in good health. They were kept under.observa- tion in our Iaboratory, for several wceks to make sure that they were in good _ health. - TYacheostony was then performed on each dog. The tracheostoma was . - - . ~ . • . .,kept open by a hollo~.~ tube made of Teflon. In smoking, the tube was c!iangea Teflon tube equipped with a. socket -for coupling to tubing leading to a to a z. - . . _ . . cigarett.e holder. - . At the start of the experiment, 'the dogs ranged in age from 1.7 years to 3.3 -;eara, their mean age being 2.7 years. . They ranged in veight from 20 pounds to 39 experiment -they were ?_0' cages. They were poundn, the mean being 28.3 pound3. Tnrou911out l.he housed in five air ctnditio:led wa.rds, each ward 1taving fed each day following the afternoon smol:ing set;rion, the ~e~l consisting of 400 grLms of cc.rr7crci<:l dog food. The ni.nety-aeven dogs were a.ss)Vried to crzF;cs by compater.-bencratcd'

4. kept as controls. There was one or more of these dogs in each of the five randcxn numbers_. Eight of the doga were then sel.ected by rartdom ntic:bera and .I : wards. The ci€,ht control dogs, hereafter r?ferrcd to as. group C, never sr~oi:ed cigarettes; but their tracheostomas were I:ept open or the duration of i.he - experiment. During seven c,onaecutive days the other.89 dogs (i.e. all except -the eight group C control dogs), were given unlit cigarettes in order to let them become £artiLinr with the 'situation, We smoking of lit cigarettes began on May 2, 1967 %4hich we will hereaf ter cal:, "day -4.1". The first 56 conse- .period. On days 1-1411 each~ dog smoked one filter-tip cigarette in the morninfi; cutive days were used to train the doL-,s to smoke and to habituate them to tobacco smoke. Only filter-tip cigarettes were administered during this 5'wvr.ov days 22-35 each smoked lll- in the afternoon; on one in the morning and two in the afternoon; and on days 36-56 each smoked two in the morning and two in the afternoon. 'Plius each dog (except three that were ].ost) smoked a total of 154 cigarettes during the first 56 days. Each dog Wmoked cigarettes in the morning and in the afternoon of each day, seven days av'c.ek, from then on. At the beginning, sraol:e from the cigarettes was delivercd in puffs under forced draft. Gradually, the dogs became used; to smoking cnd "inhaled . the smol:e voluntarily by drrving on the cigarette. In between each five puffs (or more often when necessary to prevent anolia) the smoking tube was clampeci off allo:ring the dog to breathe fresh «ir through its motsth or nostr.i~:s. . ~ ". .

Whenever a ciog -showed signs of`" d~tr,. ..__ ,a longer period of air inhalat ion was:permitted. After a while the dc4,-.:=appeared to enjoy, the experience as indicate& by tail-wagging and jumping into thi. sinoking box voluntarily. Forccd inhalation was discontinued and the dogs smoked voluntarily from t~en 1> ... • • • . . Three of the dogs were lo':"z3'uring the 56 day training period: .Stzortly after smoking was`, 'started, the' eyes of the dogs were ex- . amined by Ur. Ha :old Spalter (Opthalmologist) and he discovered that one of . • ~,.: . them had a brain tumor. This dog tiaa; withdrzwn fror, the study and will not One dog died on the 32nd day of smoking after having smoked 61 filter-tip cigarettes. Autopsy revealed the cause of death to -he pulmonary infarction with multiple emboi i iii Liae iu~L6ZY hrcint-}r,n- pneumonia on the 52nd d'ay after havinig smoked 13'4 filter-tiP cigarettes. On day f57, the rcmaining 86 smoking dogs were divided into four groups (F, L, li and h) . As described below, 12 dogs were put in group F, [2 cigarettes for the duration of the experiment. Group L, H and h dogs were group L, 24 in group It and 38 in group h. Group F dogs smoke& f i l t er-• t i p gradually transferred to non-fiLter cigarettes (i.e. the sz,:ne brand of citi;a- . .A Since tl,cre vas reason to suspect that effective dosage (ir, contrast * to ahso2ute, do:.ai;c) 'in influenced by the site of animals, we attempted to obtain dogs all of close to the 3ane si'.:: Unfortunatel.y, due to shortage of suphly, . _ . - . . _ ~. ... _ . - -~...i.- _.' .w,_._....... . --... ._• . .. -- . -.... _ ._ ~ . ....., • .. ~_ ..__.. ..... . ..w:~9a

c~ 6. ti -the dogs delivcrcd to us va.ried in weiEht from 20 to 39 pounds. For this reason, we net. ut;ide the 38 heaviest dogs vhich will hercafter be referred to as group h. These dogs, which ranged in weight from slightly over 29 pounds to 39 po.unds,- were used in a sapRrr.te experiment, the prcliminary findings of which are reported . . . .. the averar;e being 25.0 pounds. By stratifiecl randoni selection they were . into gt'oups F, L and H(F for filter•-tip, L for ='lighter smol:er." , .. non-filter cigarettes and H for "heavier smo~cer" of each group in remaining 48 dog& ranged in weight from 20 pounds to 29 pounds, each of the five frurds. On any given non-filter cigarettes). t<ou 1 d be some dogs of day., the same technicians hzndled the sr:~oking of all the dogs in a-particular ward. 057 throus,h L140 may be referred to as a transitiom period. Group F dogs were kept on filter-tip cigarettes Vrile group L, 11 and-h dogs were gradually chanSed fro.~, filter-tip to non-filter cigarettes. On days #141- throu8h #210, group F dogs snloi;ed' 6 filter-tip ci8arettes, group L dogs smvl:ed 3 non-filter cigarettes, and group IT and Ii dogs smol.ed 6 non-filter The daily nwnber of cigarettes 'Has gradually increased there- We ai.r~ied to expose the group L dogs to half as much tar and nicotine after up to 9 cigarettes per day for group p,.H and Ii dogs. As the group 11 and h~ dogs during the courpc of the experiment. The'ref-ore, in order to co:spen:sate for the fact t:lrrt all the dogs stnoS:cd the sanie ntm,bet- af cigarettes during the first 56 days, ths group 1. dogs clcre 8iven fe~r,:r ::.than half as many cigarettes as the'H and li dogs during, the remainder of the .

7. e>:peri.ment: The surviving g,roup L dot;s smoked five cigarettes per day :_dura.nS 49 day:5,but smoked less than this nunber on all other days. During ,the last year before being sacrificed, they smoke.d' just four cigarettes a It should be noted that during the course of the experiment three . of the dogs became acutely ill (fever and other symptorrs) . One was of group- H and 'two were of group h. They were taken off of smoking for a, few days, treated with .:ntibiotics and when they recc-vered, put back on smoking. of these three dogs surv'_ved for many mon'_hs after the eFisodes of illness. Table 1 provides some information on each of the four groups of :smoking dogs and the control group. For ease of comparing groups, data are given on the total exposure during 875 days for those dogs that survived for. t'•tliti> lon6 v- iZ~ .. LC 1 ~..r-..7 f~ar anrl rnYal nico:.lne consmried are based upon the assumption that the dogs received the sanie quantity from each cigarette as was found when the cigarettes were smokcd by a smoking machine. -. As previously described, dogs of group.: L, 11 and h smoked filter-tip cigarettes at the start of the exp:.riment but smoked non-filter tip cigarettes during most of the experiment. This was taken into account in computing total tar and nicotine consumed in 875 dayn. . convenient measure of size. For this reason, table 1 shows: the grams of tar The size of the animal should be•consi:dered in estimating effective dosage; and body •eight of the animalt; at the start of the experiment is a and nicotinis consumed in 875 days divided by the mean starting weight of each group of anicials. By this index., group h had lower effective exposure to tar t _-.. , a;._ . .. . . . . .

I .and nicotine than group H. The set of figures Group F had, 1.06 ti.mes as much exposure to :nicotine as group 1~. for-a 150 lb. man" is based,upon the constant,'relative dosage figures are_intendedonly labeled Lhi"s experiment sroked no more in in cigarettes per day on the average than man} - Sacrifice of Dogs - - L ' v .dl7pJ 4./ ring wh ,actical reasons sacxificin; ~*as deferred for 16 days duich' but for pL~ term ef fects) . Half of.the group it dop,s c'ere dead by the end of day V85v, - _ ~ . - ---- The plan was to sacrifice all of the remaining group F, L, H and s had d i,~1 f of the do~;s ini any onc of these four groupied!. -, ': ..... l._ .,.... •.. vFrv ICnZ (Dogs of group h~.~ere to contirue smo~:iub in orU4~ -. ~• - ' soQ5og17s8 ~,e a;icrif icing of all ren~aitii!ng grocp F, L and I~: dogs was started on day PS76* and ccmpletcd on day ~jS4'~• The exposure of Sroup~ L was half that of group H.. "equivalc ,t ntm=ber of ci,;arettes per asstnn'ptio:~ that, holdins absolute dosage is invcrsely proportional to body waight- to show that, in relation to size, the dogs Sacrifi.cinp, was conducted in This length of *time Was requi.:'ed to zr out thoroughr post-rnortc,n cr.~ir.ations. tratifi eu random or.dc:r, - the 4tratif j-caLi.oit being such that the doSs of e<Ic i . s nf the threc group; would be kept alive for appro>timw.tely the same lengttl^. of dog smo~:ed no each L -filter cigz;rettes1 a day and cac11 H' dog, stnoked 9 .time. Until c.:crificed, each, F dof'l smol;ed, 9 fil:tcr-tip ci.garettes a d,ay, Group C dogs were s•.crificed bet%:ecn days ~,~~, - , Y x ~,~,. non-filter cigare... t=>_ tes a day v:~~~ ~' ~:~ ~~~"' ~ ' ',+ . ~ w < e~ r~r~~".. •r~J}+,sF _ w:~~~"r~'~~a.°c:`~-i~ .r r's":. ~~v _ . , r.r" _'a~.eMne..a~.:ei?,~eai:lr`i,..'r9l.t+., r .~ =~.~.r to tar and 1.29 times as much exposure 4

One cf the F dobs c' ed on day V879 which was prior to the day on uhich he otherwise would have been sacrifi_ced. The principal cause of death : in this case was pulmonary- infarction; and thrombi were found in veins of the extremities. For simplic.`-t~I -n presentation, we will hereafter include this dog with those• that werr-sz;crificcd. , tIons of ~the remaining group h dogs . of the-n died b:_ween days #876 a..d 2,,=906. All of them continued to smoke f -non-filter cigarettes. Later findings in this group will be reported after they have all died. smoking doos were divided into four groups) th-rough day i875. Hpne of the 8 control dogs died; two (16.77) of the 12 group F dogs died; two (16.7%) =of the 12 group L dogs died; 12 (50i) of the 24 group 11 dogs died; and 12 (31.67o) of the 38 group It -dogs died. Thus the death rates of the five groups of dogs were in aligrwient with the dosage o; tar and nicotine relative to their rnean body weight at start of the experir_-lent.. (See table 1) . Table 2 shows the principal cause of death . of each dog that died, the day of death, and the nimiber of cigarettes smoked. We will hcreaf:ter. identify each dog by group and day of deatl7. ' For example, dog 11287 dog of group It which died on day P237. ;TAble 3 shovs a stmtnary of the prf:ncipal causes of nicanS the

group of dogs as ascertained at autopsy. Some of the dogs apparently died f a combination of causes; and all had at least slight indications of pneumonia. On this table, each dog is clas;ified according to what appeared to.be the most severe morphologic r:anirestation of cisease. We cannot rule out the possibility that the acute toxic effects of cigarette smoke may have precipitated the death of some of the dog's including some of those with morphologic manifestations of disease-ufiich appeared to be sufficient to account for -de..th., Furtheimore, we cannot ruLe out the possibility that the effects of car'',on monoxide in cigarette smc'cc may have contributed to the death of some of the dogs. Two deaths (H517 and 11563) were due principally to pulmonary fibro- sis and e,.physema, and eight were due to cor pulmonale. - All ten of these -f 14 ..i 1, i'F,n firot nrriirrnfj ?ft-or smoking. In those that died of cor pulmonale, great enlargement of the right -heart was a more pro;iinent feature than was fibrosis and enp5ysema. the degree of pulmonary Nine of the 28 deaths were due to pulmonary ;_:-ifarction. A thrombus was found in tha right auricular appendage of most of these dogs and sc:ve_al also had a thrcmbus in the left auricular appendage. One had a thrombus in -the vena cava and several had thrombi in other veins. Four deaths (11198, 11203, 11259 and H2F37) were due principally to -bronchopncumonia. In one of these pulr:lonnr.y i-nfa.r-ction and in one pul.r;ionary absceas probat ly contributed to dc~ztlti. -AL1 four had moderately advanc :d

11. autopsy, food particles were found in the larynx of one dog andrin both the larynx and trachea of another dog (IF380). The. lutigs ° of dog 7380! were collapsed. One of tliese dogs died sud: en:y while smol:ing a cigarette and the other died shortly after smoking. Asphyxiation resu;:ting from aspiration of food appeared to be the major cause of death; but reduction 4upply or acute toxic effects may have been a contributing cause. The principal cause of death of three of the dogs is.uncertai~.n (H135, h289 and H858). Dog H135 had a sligf,t to modezate r:i£fuse fibrosis -~4rlth emphysema in all lobes of the lungs. Dog h28'9 died shortly after the morning smoking session. lie had pulmonary fibrosis and emphysema in all lobes of the lungs and organized bronchopneumonia in the left diaphragmatic . , ... ~ but these morphologic cha::ges did not appear death. Dog 1I8:i8 to be sufficient to cause died~suddenly after smokiag his fifth cigarette in thc °: :~-- ~nvz n in g s e s s i on . He had pulmonary fibrosis and emphysema in all lobes of the lung of a degree probably insufficient to account for death; and alarge number of granulomata with brown pig:nent and fat with reaction around these areas in to be sufficient to cause death of these three dogs, it may be that death was Jobes of the lungs. Since morphologic -findings at autopsy did nott. appear ;.aiiu*,-:principally to acute toxic- effects. ~40SQ9~:"~`71 : ` alveolar tumor. were found in the lungs of four of them (dogs h626, hG49, As shown in table 2, non-iiivasive. bronchiolo-alveolar tumors were' found in the lungs of 12 of the 28 dogs which died and invasive bronchi:olo- ' H716 and 11753). These tumors will be described in detail in the papers. Therefoie, not ng more will be said.about thesa hcre. .

Food Intake and F!eizht In F;eneral, the appetite of the smoking dogs as well as the ;-on- scrmewhat in ,eight from one weighing to'thz next. A few lost weight and ' The dogs were weighed periodically. Most of the dogs -flucttiated =•regained_it and a few ga'-ned and later Lo.-t weight. ?':owever, the different xhat is to say, they usually ate all of the 400 grams of food provided each day, although occasionally some of the dogs .failed to do so. .&roups of dogs did not vary significantly in_this respect. Two dogs of group F and two group L dogs died before day #876. Their -weigfits shortly before. death were approxiyaately the same as at start. a. r. ~. 11 a' -~r L..a .7....4..T.tr FT..,.n.. avi ic bzvuy ii-uub~ lllGll. U'iCa~ VcAVLa:- ..ca~ .~.1,., . .~ .- . o~- -- --c~ -, --- 10050991772 Findi.n ,s' in T6unR Pai1cncl«^na and Pleura Autopsy was performed and the lungs removed as soon as possible had lost weight and seven were at close to starting weight. Of 12 group h.- - dogs %fnich died, 8 weighed less just before death _ than at start; one had '.gained weight and three had'the same weight as at start. Of 40 dogs WhUc;I were sacrificed after day "875, 21 weighed more than at start, 17 weighed about the same as at start and two (one a group L:and. one a group 11 dog) t•.*ei~:&hed less than at start. into the tr.ac_,ea after which time was allowed for'adequ<<te fixation of the after death. Tte lungs were inflated by instillation of gxavity-fed fornialin tissue. The lungs of beagle dogs have seven lobes, four on the right side

13. ..apical, cardiac, intermediate and diap:hragmatic) and three on the left side (i.e. apical, cardiac and diaphragnatic). Olie specimen of tissue was cut froas-each of the seven lobes extending from the pleurQ irn4ard about two i r re arcd from each of these seven p p centimeters. ~ microscopic sect on as Altogether, there were 490 microscopic sections, seven from each of the-70~dogs th~:t died or were sacrificed (including the two dogs that died before ddy #57). The 490 sli.des were put in random oraer by computer- geherated random numbers, and, while in this order. labeled with consecutive the reader nuuibers, O:h.). had no clue as to.tl-he identity of the dog from which a section was On ex,^iination, the degree of each of the following factors '•as estimated• 1) fibrosis, 2) emp,rysema (rupturing or destruction of alveolar ta) 3) pad-like attachments to a].veolar sept.~a, 4) thickness of kalls of sep , - ,rt.n Has used to c arterioles, and 5) thickness of the pleura. k grading s)s record .the de:;ree of each type of histolog ic ch-1rnge. in each instance ,~tGrade 0 " means "no rhange" or "nor.r:~al" . For example, Grade 0 f ibros i_s cr,eans no

- .-z_ . .. . . . indication • of fibrosis. The walls of arterioles are normally thin and the .."normal" thickr.ess of these structures. G;:ade 0 for pad-like attachment:s Co pleura is normally fairly thin. 'Grades above "0" indicate greater than alveolar septa means that no such attachLnents were'found. 1'anphysenia was classified in four grades, 0 through IiI; but ;;rade III was only found in tbree sections (group H dogs). Pad-like attach-nents. were classified in three grades; thic}oless of walls of arterioles in t:zree grades; and tatckness of pleura in four gra3es. It may be that when One than any so far observed. If so, higher grades will. be utilized in classifying group h-dogs have smoked for many more months, greater changes will be found the changes. ; The various grades of each type of histologic change mentioned In.uany instances,• all seven sections from the same dog were. graded the sz,_,ne in respect to a particular type of finding; and~there were no in- in which the seven sections fro-..c a dog varied •greatly in this respect. stances For example, there was nc. Instarice in which grade 0 c.:,physema was found i some of the aeven sections and~ grade II e-nphysema in other sections f-:om the same dog. Because of this con;iEtency, in table8 4 and 5 the findings are shown in terms of all the sections-fro:n specified groups of dogs rather than 14Q509177-4 Sections fro:a~ the two dog: tThi:ch had c;,ioked only filter-tip cigarette and died befcre day V-1'57 showed a elight cegree of fibrosis, a very slight degree of emphysema, no pad-lil:e attacli*.r:enta to alvcolar &epta, normal being sho:an for each individual dog.

15. thickness of the walls of ^,r.terioles and no greater thickness of pleura than yas found in uaany sections from the non-smoking dogs. . Sections from dogs F380 and F854 were not much different than those from the two.dogs ment:ioned above. Sections from dogs L347 and L812 were again about the same except that pad-like attachments (grade I and a few grade II) were found in all of shows findings in sections from the 5 group 11 and 6 group It dogs which cied between days f 57 and f-499; the 6 gr,,up H and 6 group h'dobs which~ died between days u500 and P875 and the 12 group H dogs which were sacrificed between days i7576 and ;:8'99. In both group. H and group h dogs, -there was a progression in the degree of-each of the five types of histologic change recorded. That is, in both H and h dogs, greater changes were found n sections from dogs dying between days ~:5O0 and x875 than in iihose dying between days V'57 and 0499, and the greatest changes were found in sections from~ group H dogs which were sacrificed betveen days #876 and f899. the 12 group H(non-filter) dogs which were sacrificed after day #875. As pre- Table 5 shows che findings in the 8 group C(non-smoking control . dogs),' the 10 group F (f iltcr-tip) dogs, the 10 group L (non-f ilter) dogs and .. . . ~ (non-fi_1t:er) as the group F(fi.lter-tip) dogs. However, the group F dogs had viously described, the group L doi,s stnoke<:t only about half as many cigarettes about 6% more exposure to tar and about 29% more exposure to nicotine than

/0( . .-'~_ . , . number of cigarettes ac the group F dof;s. Far greater histologic changes were found in sections of lung parenchyma fror the group 11 (non-filter) than in sections fro-•n the group L_ (non-filter) at~d group F(filter-tip) dogs. Except in respect to tile walls' of=arterioles, greater changea 4rere found in sections f::olm group L than in sections from group F. Except as noted below, sections from group C (controls) and_89,3% shoued only a slight degree of fibrosis (grade Z). All of the sections from group F, L and if showed at least grade I fibrosis; and most were of higher-grade. Grade IV or V fibrosis was found in 0% of the sectiona frow , 6LVUt+ v, .. • Of the 56 sections from group C, 10.7% showed no fibrosis (grade 0) S "7 °14~r r.rrs o•-~~~» F. 12.9% from group L and 91.7%" from group ri, - (See A comparison may be made by consi-d!ering individual dogs rather than akl :the sections from each group of dogs.' Of the J.& dogs of group I', 8 had no -sections of grade 'IV ^r higher while two dogs each had just two sections of =grade IV (the other Bect"ions being gxttles Ix or XIZ) . Of the 12 dogs of these dogs all seven ce"ctionc were of grade IV or V. In otiier words, every gr_oup•f[; all had a majority of the sections grade IV or V and for six of one of the 12 group II dogs had a greater degree Of f.ibl:osis than any one of the ten dogs of group F. This di.fferencc-. is s,tatistically significant .1005091776 ' The difference between group L and group It is st.1tiSticall.y highly

'diffcrences notcd above, is statistically significant by both tests (p .( 0.05). significant by- both the t test (p ..-~ 0.0001) and the Wilcoxon rank sum test. =Tie• difference between group F and group L, though smaller than the other None of the 56 sections from group C showed any evidence of emphysema. Grad:e:xl:or III emphysema was found in 070 of the sections froa group C; 12.97. from. Proup F. 24.37. from firoup L and 98.87o from Aroup H.. Considering individual dogs,.the :iifferences between group F and group-1I, and between group L and group H are statistically significant (p<0,0001). 7ti'e=difference between group F and group L is not statistically significant the.sections from group C, but nonc of these were above grade I. Grade II ,padtJ:ike attachments were Found in 0% of sections from group C, 22.97o froin group F, 4E.67; from group i: and 97.6°l from group H. Pad-like attachments to alveolUr septa were found in over half of 17. (See table 5 and figure Considering individual dogs, the 2iifferences between group F and 11 and between group L and 11 arc statistically significant. (p < 0.0001). The difference betvecn group 1:' and 1, is statisti,ca,l1y sign ific,~1t (p G 0.05) . . Thiclcness of the Walls of Arteriol.es walls of arterioles were of rormal thickness in all the sections Thickneas of grade I or 11 was found in 0`l, of sections from 2,97; from group L and 41.77. from group H. :

18. table 5 and figure 8). The differences bctween group F and li and between Group L and H are statisticai ly significant (p lz, 0.0001). There was no difference between group F and L.. Thickness of rleura . The thicl-,ncss~of the pleura was evaluated as grade 0 in 30.4% and -grade I in 64.57, of the sections from group C. 2'liickness of grade II or III was found in J% of sectio-B from group C, 7 0% from group F, 21.4% froagroup L and 90.57o from-gi oup H. (See table 5- and .Ci gure 9). The differences betueen group F and It and between Group L'and It are statisticall-y significant (p ( 0.0001). The difference bet4een group F and L is not statistically ~.ignificant (p > 0.05). : the finding in- epi_demiological atudies that death rates are far higher in cigarette sWokers than in non-smolkers and increase with amount of cigarette 1-4) u~coking. The mortality of the dogs in relation to ci.barette smoking pnra.llels 10Q+.~?Q9177s . J?uUnonaxy c~rl~r~yse~a and fibrosis uad cor puln,onale are rare ca:ises of death in dog.:y but of 62 he'avy smol:crs of non-filter cigarettes (groups It and h), 10 (16%) died of these di.ser:scs within 875 days. This paraliels the finding in epideniiologica1 studies that ci.garette cmoking is accomp;1nicd by a great inc7:Gasn in dcath ri:tes fro-.n theae disezsea. .I1i..tolcgic fi.ndings in the 1Llnf; paXe11chyRlc1 of the smol:ing do,s were , of the srune, typcc as h ia tologic f i:ndings in the lung parench}nna of h"'„n

19. -1 5) beings with a history of ci e smoking. Both in hu:nan beings and in "dogs, emphysema (rupturing :atzuction of alveolar septa), fibrosis, the occurrence. of pad-like attachments to aLvcol.ar septa,. and thickening of the' wal].s of arterioles seldom occur, or occur to only a slight degree, in the lungs of non-smokers (except non,.-smokers with occupational eYposure to certain Cigaret~ t~~oking is acco-npanied by these histopathologic' changes; the changes •becm-;°pi1ogressively more advanced so long as smoking is smokers. this er.perintent, one group of dogs smoked- filter-tip cigarettes -and other groups of dogs smol:ed the same brand of cigarettes but with the fil:ter removed. The smoke from~ the filter-tip cigarettes contained 49% less lctX iut 'R% l:as PLrOLi1iG FY^-'~ rifiarettes Without the filters. G~- . Considering dogs i'nich smoked the same number of cigarettes per day, _ the death rate wds lower among those" that smoked fiZtex-tip cigarettes than among those 'which smoked non-filter cigarettes. Sruoking filter-tip cigarettes produced less extensive da-mage to -: the lung parench}na (i.e. emphysema, fi:b1•oGis, etc.) than smoking thc same ntmrber of non-filter cigarettes for the s,we length of time. Ho;rever, smoking filter-tip cigarettes for a period of £:75 to 899 days prod«ced si&nificant damage to the lung parenclx}..~~a. Since the degree of such dUnage progresEes taith duration of smoking, the evidence indicates that lunE; parench}^x,-cl d'ainage -ndvances 1e.is rapidly tAth the smot.ing, of filter-tip cigarettes thzr. with the

20. filter-tip cigarettes for a longer length of time would have eventually ;,- resulted in severe damage to-the lung parenchyma. . jactors 3_zieluding duration of smoking, the nirmber of cigarettes sraoked per day and the tar and nicotine content ofthe smoke. Now, let us suppose that the sane amount of tar and nicotine is received in the.sam(*-- length of time i.e. yeara-in the case of men or months in the case of dobs) but in two . : - . ~ . . . . - . . , different ways: 1) by smokino N high-tar, i,idh-nicotina cigarettes per day and 2) by smoking twice this ntanber of cigaxettes per day, but each cibarztte delivering just half as much tar and nicotine. In other vords, all exposure factors are the same except for the concentration. of tar and nicotine in the afinka.' Which of these two types of exposure would produce the greater The eegree of exposure to tar and nicotine depends uoon sever<<I In planning this experiment we hypothes{ zed that under these con- ditions greater biological damage would be produced by smoke with a high con- centration of tar and nicotine than by smoke t?itlr half the concentration of tar and nicotine (total dosage being the 3ame over a period of many mcsnt`is or • years). One of our ainls was to test this hypothesis. It was based upon the -centrwtion. 'Tie prinei.pal phy3iological cffects of nicotine depend upon the theory that high concentration would tcnd~ to overpower the, defense mechaniumtt of the body a.nd thereby le~F.d to'cffcct:ivel), higher uosaf;e tha.n a lower con- concentra.tioz of nicotine in the blood at: a moment of tirne. Since nicotine itz . .. ., ' . . , . removed from the blood vcry rapidly, a,. hx~h concentr.3tion in the b)-ocfd can be

21. .Achicved onl~y_ by rapid delivery of nicotine into the- blood. It would seein that nicot-ine would be delivere& into the blood more rapidly from smoke With .~ . . . . a large amount of nicotine than by the same volum, e of smoke with half that amount of nicotine. Most of the tar and nicotine ih cigarette smoke is con- - tained in particles.. Particles are rcmovcd frcr,n the alveoli by alveolar phagocytes and are reraoved from the bronchial tubes and trachea in bronchial secretions propelled by ciliary action. Presumably, there is a Limit to the rapidity with which the removal can take p? ace even if the removal mechanisms are undamaged. Thus it scems likely that a higher concentration of particles occur on lung surfacds if particulate matter is delivered rapidly (concentrated smoke) than if delivered less rapidly (less concentrated smoke). In 'ac'.ditiorn, cigarette smoke retards ciliary acti_on and, in sufficient concentratiorl, can ((`ortnin of the c5.11astaticagents are in the g2sc4-s_:_ In order to test this hypothesis, we attempted to find filter:-tip cigarettes such that the filter produced a 50% reduction in both tar*r:nd nico- than in the particles contained in cigarette smoke). tine. We could not find Cucch cigarettes. The filters in the cigarettes used effected a 491, reduction in tar but only z. 37% reduction in nicotine. During a period of 875 days, group F dogs which smoked filter-tip cigarettes received 67. more tar and 29% more nzcotine than group I. dogs which smoked non-filter 4 cigarettes. (See table 1). Neverthel.ess, histopathologic chUnges in the luns' parencz)^la c~,c;-e sorae:+hat less extensive in group F dogs (tilter-tip) than in group I. du~s (tlon-f ilter) . 'f'ni.s finding ;s 'consistent with the hypotl esis. .,_ . -Findin~s" in relation to the occurrence of tumors will be descri:bed ~:-in the second of this series of papers.

/a7 Xn -the above di.9cussi_on, we have co:5paxed the filter-tip cigarettes used in this experi,ment with the non-filter cigaret-tca used inthis exPeria,ent. Our non-filter test cigarettes dr.livcred 34.8-mg. of tar and 1.85 . ~ . to _the filter-tip if any. Therefore, some co-nparisons are in order. Cigarettes now on the market vary widely both. as to the "tobacco end" and as "-tn8: of nicotine. In 1955, 'about 8170 of the cigaret_tes sold in the United States 10) did .not have a filter. At that datie, all of the non-filter and mosr of the filter-type cigarettes deliv-~rcd more than 34.'8 mg. of tar and more than 1.85 11) . mg. of nicotine.- delivered 45 mg. . . . - _ ~ _ The most popular cigarette on the American market in 1955 11,12) of tar and 3.3 mg. of nicotine; However, as of October 1969, there was no brand of American 'cigarettes sold in the United States khich~ delivered over 32 mg. of tar and there was no brand which deLivered over 2.5 . . - - - -- --~ -1'~l t'v nicotine, we estimate that less than 170 of the ci~_garettes sold in the United States in 1969 delivered over 1.85 mg. of nicotine while about 14% delivered . 14) mg.- of nicotine. Based upon sales data aau iov 13) over 1.7 mg. of nicotir.e. Our fi.lter-tip test cigarettes delivered 17.8 mg. of tar and 1.17 ms;. of.nicot-ine. In 1969, many brands of filtcr-tip cigarettes deli:vere3 18'mv. or-leas tar and also delivered 1.2 mg. or less nicotine; but these brands . 1 . - ' - . coma:anded only aUout. 171 of the total cigarette market and a`bout 22% of the filter•tip cigarette rnzrket in the United States. Several braiids delivered 12 mg. or less tar and alao 0.8 izg. or less nicotine; but in mi-d-1961) they . conznanded only about 17, of the filter-tip c`.garctte market.

23. I i ared w L but not and nicotinc.cccip uxd be conaidered relatl.vely :.o~~ in tar and nicotine, cigarettcs wo . .. . : • , h civzrettes sold but c=pAred, wi th those eo 1909• our filter-tip tes, . ,.our non-filter tcat cig4retteo ~'ould be conaidcre 1969 they c'ould be consi~,ercd high in tar ld in with cigarettea sol:d in the United Stwtcs in 1955, C t,parcd ow in tar and nicotine; d ~ as lotia as sott~e brnnde nc~~ on the rarket.

/O9 I. References Death rates by cause'. JlJ-kA 166:1159-1172; 1294-1.308, 1958. months of fcrllowup of 187,783 men. Part I. Total mortality. Part II. 1) Id=nond, E. C. and FIo:-n, D. Stiol,ing and dcath~ rates ~- report on forty-foui 2) H'aminond, E. C. Smoking in relation to the death rates of one million men and women. hat. Cancer Inst. Monograph 19:127-204, 1966. 3) Y.Rhn,1I. A. The Dorn study of smoking and mortality a.-nong U. S. veterans. 4) Doll, R. and Hill,-A. B. Mortality in relation to sesokind. Ten year's 0 . fibrosis and thickening of walls of smalj.' arteries and arterioles. New Eng. ' and: age in rc-lztion to Falrzonary ch4nges : rupture of alveolar septums, 5) Auerbach, 0. , Stout, A. P., Ha=ond, E. C. and Garfi.il:el, L. Smolcinp habits J. 1fed, 269:1049-1654, 1963. 6) Auerbach, 0., Stout, A. P., IL..ond, E. C. and Glrfinhel, L. Changes in bronchial epitlieliL^n in relation to cigarette smoking and in relation to Monograph 19: 1-'125 ; 1966. Report on eight and one half years of observation. Zat. Cancer Inst. - observation of British doctors. Brit. I`.Ed. J. 1:1399-1410, 1460-1467, 1964. . lung cancer. i~e:r Eng. J. Med. 265:253-267, 1961. ~ ~ - • r. n ~4J ~,.,.,. ~ ( f KuE'.1 U1t:21', v.', ta<wu~tvuv , ". . , -_------- '-F-Histologic changes in bronchial tubes 2055-2066, 1967. r, , r..,,-f;nS nl . T.. and. St-out, A- P. of cigarette-smoking (ioys. Cat,ee1 20: ) Auerbach, 0., Iiarr~,~ond, E. C., Kirc;an:, D:, and Garfinkel, L. Emphysema pro- duccd in dogs by cigarette scaol.ing,. J1sWiA. 199:241-246, 1967. ) W}-i ider, E. L. and Hoffc,U::n, D. Tobacco and Tobacco Smoke. Studies in Ex- perimental Carcinogenesis, pagcs 250-257, Aca:demic 3'ress, New York, 1967. . Situation, TS-1.03, March 1963; TS-127, ~'~arch 1969; and TS-129, September 1969. - 10) Econcnic R.e.car.cla Service, U. S. Departuent of Agriculture. The Tobacco 11) ConsLnmers Union. Cigarette tests for tars and nicotine. Consumer Reports 26: . 203-207, 3.0,61. 12) t+'ooten, 11. Cii;al=ette sales turn up cgairi in Dece:r.ber, 1955. Federal Tra,lc Co-Nrmi: sion: R:epor.t on comparison of tests of tar and nicotine content of -.i_ga:rettcfs. Dacet nbcr 1969. . .A . _ .. . . . . , _ 14) Maxwell, J. C., Jr'.. Cigarettes 169: The cancer ecare erodes sales - but not 13) very much. Jiarkcti.ng/Ccr.mnunications 297:22-38, November 1969.'

F-7 r r r- r r r- r- r- r- r r r r- r- . Tabl'c 1. Data on pedigreed male beaE~c dog.s of groups F, L, 11, h and C. \ No No No Filter Filter Filter Filter Control Group F Group L Croup 1( Group h Group C 0 of DoPS on Day457* 12'- 12 24 38' - 8 Deaths in Da s -157 th g #875 Y rou h 2 2 12 .12 0 7.' Dead . 16.77. 16.7'G 50.0% 31.67. - o,e at Start (Day 11) Mean Age (Years) 2.7 2.7 2.6 2.7 2.8 Youngest Dog (Years) 2.1 2.3 1.8' 1.7 2.4 OLdest Dog (Years)- 3.1 2.9 3.3 3.4 - 3.3 ai^,ht at :.tart (Day 41) Mcan kei 3ht (lbs.) . : 25.0 25.1 25.01 31.9 30.7 LiEhtestDog (lbs.) 22.0 20.0 20.5 29.3 22.0 lleaviest D5g (lbs.) 28.0 28.3 29.0 39.0 36.3 ^rettes ner po£ in 875 Dags 6,143 3,103 6,129 6,129 - None N,ean No. of Cigarettes per Day , 7.02 3.54 7.00 7.00 - Equivalent Na. of Cigarettes 42.1 21.2 42.0 32.9 - per Day for 150 lb. Man NO NO NO c rt ~rro~rk - a---- FILTER FILT'F-B: FILTr.R FILTF,R: - - MZ. of Tar per Cigarette 17.8 mg. 34.8 mg. 34!.8mg. 34.8 mg. -- Me. of Nicotine per Cigarette 1.17 ag. 1.85 mg. 1.85 ag. 1.85 mg. - ota1 Dbs.a~te in, 875 Days Grams iar per Dog . 109.3 g. 103.5 g. 207.8 g. 207.8 g. - Grans Nicotine per Dog 7.19 g. 5.56 g. 11.12 g. 11.12 g. )osage in 875 Days Relative to StartinL_L•'eiht . Grams Tar/lbs. Weight 4.37 4.12 8.31 6.51, - Grams Nicotine/lbs. k'eight 0.29 0.22 0.44 0.35 - The cmol:ing dogs were divided in :o groups F, L, H and h on Day V57. " Do&r of Froups L, H and h cciol:ed of the experiment, but smoked'no ,ote: Certain of the figures above filter-tip cigarettec during a training period at the start n-fi1'ter cigarettes thcreafter. apply only to dol;J that nurvivcd 875 days or longer. sooSosa.7ss `-~

C9:7. F_ IT. c r V- V- r F_ r~ rr Tabic 2. Mortality experience of ciFarette snok4nfi,doga and non-c:nking dbga fro.;i dry G57 • • through 1S75 by day, of death nnd cause of death. Dr.y G11 was the c]ay When the dogs started smoking. Filter Tip Group F No Filter Group L No Filter Group H No Filter Group h Control Group C Non- Invas- lnv, Day of Death No, of ' Cigar- ettes - Deatha (x) Principal cause of death ive T!ucnor (T) iv Tum, (M) 59 160 x Pulmonary infa:ction 86 276 x Pulmonary infarction 135 518 x Uncertain T 198 888 x IIronchopneu*ionin 203 924 X Dronchopneir.nonin 244 1219' x Pulmonary Infarction 259 11343' . x Rronchopneumonia & Pul.Inf. T 271 1440' x Pulmonary Infarction 287 11560 x Eronchopneunonia v/Abscecs 289 1596 x Uncertain 347 11055 x Aopiration of foo& T 380 1 2162 x IAapiration of food' 416 7:340 x Pulmonary infarciiuu 464 :346 x Pulmonary Iafaretion 517 :3062 x Pu1.Emphycema & fibroeis 563 3404 x Pul.Emphysema & fibrosis T 606 3796 x Cor Pulmonale T 626 3928 i x Cor Pulmonaie T H 649 414-1 x ror Pulmonale T M' 716 4689 x . .. Cor Pulmonale & Pu1.Inf. 153 5030 x t ; Cor Pulmonalle T H 760 5083 x Cor Pulrionale, T c-- 762 5110 x {:or Pulhnoncle 767 5148 x Pulmonary Infarct 6 Cor Piil 1794 15400 Cbr Pulmonale •n 8 12 2847 x Puim.onnry Infarction 'r 81514 5950 X Pulmonary Infarction 9'S8 - 5470 x Uncertnin T -_ - ~-- Nb- Dead 2 2 12 112 No. A1ive on Day 875 LO i0 12 26 8 1005091786 • Total . ~ • _ 12 • 12 I I , 24 38 8 . . . , - ~.~-~•~ ....-_ ~.... • 1, . . .:.y* - -• . .. . _ ~:.. __...~.....~.a-.~v....._..- iAJ

Summary of principal'cause of death, days ~57 through fi875 in dogs of groups F, L, 11, h and C. Princi.pal Cause of Death Pu1: Kdiphysema & Fibroeis Cor-P~ilmonale (pu1~. emphysema &:fibrosis with right heart enlargement) Pulmo:iary Infarction Bronchopneumonia aaner,,tion of Food Uncertain Numbcr-of Deaths No. Surviving 875 days Tota;. Dogs Filter , No No I'G iv o Tip 'Filter IF'ilter ,Filter Group IGroup Group roup ,F h Control Group C Total 1 2' 5 3 1 2 2 1 2 12 12 28 10 10 12 26 8 66 12 1!2 2ti 38 8 94 Note:-Some of these dogs apparently died of a combination of causes (e.g. pulmonary emphysema, pulmonary fibrosis, pulmonary infarction and bronchopneunonia).. In this table each death is classified according to what appeared to have been the most severe condition.

Ycrcenta8e distribution of oections by grr.de of e°.eh of ive types o histologic changes in the lung parenchyma. Group It and h dogo which died in diffcrent periods of tin:e. - No No Filter Filter Group It . Group h Crade of Condition Daws- Davs Days Days Davs #57- 4500- Y876- - #57-. #500- 4499 #875 #899 0499 #875 Fibrosis . .x x Z O: - - - - 7x_ • IL= 23.8 - . . 19.1 4.8 tZI 66.7 47.6 8.3 71.4 47.6 IV; Y 9.5 52.4 91.7 9.5 47.6 T6ta1: _ 100.0 100.0 100.0 100.0 100.0 EsDbysema . - . 0_ " - - 2.4 - I= 76.2 7.1 1.2 61.9 14.3 II; ZII=_ 23.8 92.9 98.8 35.7 85,7 100.0 100.0 10100 100.0 100.0 P--ci-1iYe Ati^ehr.rents 0 I: - 52.4 16.7 2.4 50.0 14.3 II= 47.6 83.3 97.6 50.0 86.7 Tbtal 100.0 100.0 100.0 100.0 100.0 Thtcfness of k'A11s of Arterioles 0. 100.0 -64.3 58.3 97.6 85.7 35.7 35.7 2.4 11.9 II= = - - 6.0 - 2.4 Tota1= 100.0 100.0 100.0 100.0 1100.0 Tnickness of Pleura 0 - 2.4 - 4.8 2.4 76.2 26.2 . 9.5 " 64.3 31.0 . 11; ZI 23.8 71.4 90.5 30.9 66.7 Totall - 100.0 - 100.01 100.0 100.0 100.0 2.v :ber of Dogs 6 6 12 6 6 Ntxiuer of Scctiors 42 42 84: . 42 - 42

pcrcentage dirtri.bution of r..ectiona by grc~de of ench of I i the luns parcnchy;ns. five typea of hiatologic chnn, c r- c+cri£icec3 after L t~nd li do$B uhich were a P Group C , , . 875 dnyn of mnokin8. . ' . • Cotatrol Filtcr Grade of Condition .Group Tip Group 0 100. 0 - 87e1 74.3 1.2 I ; - _ 12,~~ 24-.3 98:8 '- • . ~ ~ 100.~ ,lptgl 1.4 21.4 64.3 12.9 ~~•se~rs _ 1.4 ppd-li1:e Att~ctr~enta 0 Fm 1ticYr.e;a of r`r" 0 I Yx., Yl:z Tots1. 44.6 - 55.4 77.1 22.9 100.0 30.4 69.6 97.1 2.9 97.1 2.9 2.4 47.6 100.0 58.3 35.7 6.0 2.9 1.4 87.1 77.2 9.5 10.0 21.4 50.5 l_oo,a 10o.0 100.0 10 10 12 ~,_ .. 84 7(~ .. ,: 70 51.4 48.6 . 100.0 //Y

n n .... ........ ....,,..,...... U~ ('' Gi~OliP L: ;' C;~0~1P CRaUP C• :.. CP4 i • ,. ~ --~, ~ ROL5 FIL.~'E.R -'' lP NO Fl~ °'ER ., NO ~r ILT -:.~ O i f - C 2 AS n-1AFiY (I/ NNW ~ ~1, , `M Ino Yno rrMIF , wirW T~•S),.,.d ..+ mmmI

pE: . R~ I Sv~.~ ~Ir~J~~r~ GRADe:o,~~ '~dr~~~ ~'~'` ' ~3y~,,, ~ 1 ~C~~~~ c• :,. (;smu;~ ~ "OUP L ~KCUP • 1 :~'~P~ i iP NO ~= !! 'E~3 c il ' . , ; G0~ ~R04~~ L.~. ' ~... , ~ ' ~ ~ ~-- ~'r~ ~w ~ ' ~-•~ on. R ~' A '

~ 'PEr.C."ENi OF &E-C1 IO~S W8 i H GiR.~~~E lE PAD - LEK"E G PZ CU P L:, G R OUP F''+• BL© FILTER. NO FIL_~ ER (1/2 AS M111%NY. ""r Cfo* R G'Ebr--j.,

10050917i93 ;. ; A b~. ~ OR -~; T-~IC~~i~'~5;~ PE~:~E~'1T OF Si~CT6Oi~S ~r'~f!''$-~ C4^ C~~ VJALLS ()F AR I r-N4aLC-0

r'~- ; r-- r--.' , r"~ .~r"n. (4~?.Z 1 ~.1~.~ ~ i ~r.; ~ ,'..,; • p,n,,, ;,,,~ ' n„~' ~ _ ~ • ~ S•d 3f1i .~G_~ ~a~nn,~~ .'"3 S'~~; .~.~"~.1,• ~ , yr.~..; ~ Q ~ • ~ ~~ :~ e'~'~~'~ :~3 ~ a~.~~~ ~.~. 1 tYA'ON : U_--3 ~c~41, -~~~:~.~. i -..

. r. ' Eh'wx IT Oscar (Diseases of the Chest ~.-- 020

, , L'FFFt~T ; t1F CIi,/,F i'CY"tr. StNJ~TYf irrcr,r n~:s Auerbach, Pi.D,, E. .t;uylrr h:tysaond, ~ ~ ~ . . _ . .3 DeviC Kimar., B.S. and Ls*"ence Sant Orsnge, Now Jersey and Iaers eqttipped with an efPf.cient ' filter iti any lefa harrful tlegn amoKing nan- filter ct2arettec; and to de3tezaaine 4tr?ther, zfter sufficier.t durAtion of oxp"ure, inhalation of cigerctte t-noke will pro-d2+ce 1rmt; cas;cer in dogo. Y£ndinga in recpect to raortnlity, ccuacs of decth craG tliCtoi- ology of - 1 • - . . Eet. In tkia pcritr ve will report findingc in recj.ect to tit: occurrcrce - - ; -. , . the lune tiartncjtirra have Llrtadv Lern rPnnrrnrl in rt.& Ff rr.F eaf v6.le -of r.on-invFCire and £nvanirc brohchir~Io-e1vevicr te:;or& and early invcaive brai:chiaI c€retncr~s. dtt:er findirigo will ba reported st a lAter df-te. New York, lieer ioi•t;. Supportcd in part by a reeenrch grcnt frc;fa the Arx.rir.an vocfety. the Y}epartc:ent of l:pideaiology and Staticticr. of tha Azerf,ccn Cancer Society, €rcra tho Vctorrr+~ h,=LniEtr.?tfo-n Horpitr.~1, Esct Urr,abe, Now Jersc:y And Profcuror of Pctholo-y, New York 1•TdS.c.cl Co11<:Pw. 2-~'ictt ire.^.ic:,nt for f'cipi~ie<:~iolo,;y c!nd Steatictictt, f,r.:erican Cancer Socicty, Z•Srrnior h:cti¢r.l Envcr;C4~c~ear, V. It. Kc-r?frel, rs:t t1ta:-Zc, New .Iere.cy and Inc., I:cu Yrrk, I:er+ York. StattatLcG, ls:erican Cancer Societ}, Lnc.., tr'rw 1'ot-1:, I:etr I'orl;. 3-Froject DirGcto-, Animal I:ecr.arcl, SecticYa, i.-.F:oretory of the f'eaor t-:cd.ccL Yn'reetii;;.tor, V. A. :rospiral, Grct Orrnge, 1'_tr J: rcey 4-C'nief, iricld cnd Sf-ecirS. P&eearch Prnjects, ~c,~ar*.~n4nt of I:pld~~ic~faC}~ and W N . ._

TYacbto-3tmcy was perfonwad cisz r..nlh bo.Agle 6o,;a; diGht vero btpt so ao=-5r-_kiag cc-atroLg (CrG:tn, C`). All ott:ror do-'-'a ct-'s'xed cit;r;;-etta® daily t#7 =aua of tahing caagccting the trcchao:Jtc;.a to a ciaarottc ho26xir. Aftar a 55-4-ay trntning 1erLod, the =&-,inII Gogc y~ra ~?:.v4dcd into fmr grc;6psi F(12 L (12 dcde), fi (24 deSa) etz& h(S8 de-,,,c) . 1'rc--. day 657 thrccsgii day f€75, Crc~p F daZs rc-_AYad filccr-tip ctZeratito© cmd grc~e Lp 13 ctzd heoMv Fmikrd mas-fi.tcr cigercttca. Cro4--p L dfG cE~.eked t~1t' eo tj._nr_y cf€cr-,ttes ea tLe at!~*r db-;,a. to dog in grc-<? C Gicd; 2 r;tc~ 19, 2 12 Lrcn:2 P. rind 12 :-rc:W h d~~8 Zicd. 11r.e reM, ri~ :riC gro~ c C, P, L cw i 41&a-r. were 6ACr`sfieaa ctertia,- an dcy P876. l2oa-inraoiva brc-mchioLcs-clreolcr tum-or6 u-cre fc-:.xnd in ca-~ 4na of eract; of tho ffre gro;.pa. rr.vcaiL.e tunora %:-ere net fc--jLd iw lungo of any of cIra gro~.? C, F cud L doKgn. Tm.msivc broachfolo-n1voolar tc_atto t~:sge f(,Lt~4 : in 2 of tho 12 grct-,p h clo; a Vaich ltcd, 2 of the 3.2 gro:rp 11 c;c-ge vMch invegfr4a tmc=rc exCenGcd €r-tc tM p1cLre.. F.'t:r1y fuviscivc aqu3::c~~ co11 ct;rtiutc;;, ~~?oU fe---d ia thc treactii of to of ti.r 12 ,r.,r") 1' Lc--e uhiclt Gied, cud fi of tha 12 grct:Q 1; dno viifch w-rf cccrsficcu. I`£vo of to tsei-c: r,&crifLccd.

paper, an abridqed det,rr(ption will sufficc. ..Since tiie deefgn of the cxporiercnt vas dcocribed In detail in the firat from 1,7 to 3.3 yenTa, The trachenstuv.a won krpt open by e holluw tuhe uade Trachcoetony vaa perfo;tred on pedSgrced male bengle dogp ranRing in ago of Teflon. In cmoking biteiona, the doge voluntarily inhaled cigaYetto amoro throvgh tubing connzcting:.t{u Teflon tube to a cigarette holder. Attho ^tart 8 doge were oeleetei by random numbera and retcintd at non-cr`r+kinL cootrol o~-os -2heae doga will be calleu group C. All of the other doga cc~oked filter-tip efgarettea daily for 56 consecu- tive dnye. The firot day of smoking vill be called day 01. On day 657 the mokir.o dooc were divided Into four groups: F, L, H tnd h. The 38 heeviaet wrs nnr inorp,hrnn raFan(..fno dnon (whfch w~rw Ifchror 1nvofrhf) divided by rnndcea ntnbera Into groupo F, L and H. Ytirelve doge were put in group F, 12 in group L and 24 in group H. The group Fdog: csokcd only were grcduclly trancferred from filter-tip to non-filter cigarettes, and frozs fLlter-tip cigarettes throughout the ezperirr_nt. The group L, Hand h dogs Trocedures then on, caolced non,flIter cigarettea in the -eornSna a;-ij af:ernoon of each day, eevFm deya,a ueek. The daily number of cigerettea wac gradually increauad un- day 057 to day [E75 the group L doga amoked covcwhat leac than half no tzany ,'til each of the group F, H and h dogs w~:e anol:ing 9 cigarettea a dny. Froe2 cigrxetteo an the group F, H r:nG h doEa. Sao`ka frc= ecch filter-tip cigarette contr.it ed 17.8 Pg. of tar and 1.17 tsg. I of nicotine. tean-Gil2cr cigarettec crere obtLiined by res:oviug the filter fraa tigarcttoc of tho ecce brand. Y,ithout the filter, the cr.uke contained 34.8 r`g. of tar and 1.C5 ng, of nicotine. The total tcr end nicotine concuredfu 875 daye by each of the tu ni•rfng doLC vac: 109.3 S. of trtr r.nd 7.19 C. of nico- tinefor group F doLr+; 103.5 g, of tcr end 5.56 E. of nicotinc :or group L.

207,8 g. of tar and 11,12 g. of nfcotino for trouip B; nnd 2M7.8 Z. of tor and 11:12 g, of nicotine for group h. Althoudh or rip A snd aroup h CcVa ro- I ceived the same t.ital s.nounF af tar anJ nicotine, 2,roop h doRo recoivod a I ' or dotn`e that group N doar, in relatton to thc(r bod~w~ht. Yvaotq-eitfa of the taookdng dogs died betceen day 457' nud dnq, 6RL'i. Theoe fq~ luA~d: tvn of t!.e 12 group F dogx, two of the 1Z group L dnra, 12 of thr: 24 group H Any,p an4 12 of the 38 group h logs, gone-of the 8 graup C control d-,a died. All of the recaain- ing group F, L and P dogo, and all of the grnup C dngs were nacrificod bottoen day ft75 and dny M06, The group h 3o•ga rere not tact!ficed end ccntinrad to t:S:e non-filter cigarcttes. Findin.-a on group h dogo Yhich died at a later EBte will bo repqrtod in a later L&gcr. Avta?op raa perfcrrn°d at coon no poccible aftOr tho Lseth of each dcd. After ezrrsir.y tiaa of the pleural sxrfaceo, the lur.go~ t:,ore reaac-ed cud infictod by tica f,1e gravity-fed inctillt:ticn of forz4l2n into the trcc.hce, The limCa of the do,Ze have eaven 1ob~en, foar on the rit;'at eide cnG tt•reo on the left nid<.. A epQC£izsn of lung pcxrenchl:,a aac ramcrved frc: each of theee *rseven 1a%.ae end or~ :it sG eier"cc»ically„ The reaaining pertioxe of the lunge vcra cearched for groeely vicible raacea of e•:y kind; ond thocs r.ecnd were aactioaed cao cicroaca;ticclly en- e3aieod, The trache:.breachiel trca nsa then diar.e•:ted out of the lt~ ,n and diviind into 131 portieno, each of u°tich roo ambxdded in purofYin. A hietclo;;ic r-ectic:: 1i^a L,,-:an Frol-.nred frm onch of the 22 Fr~rnffin Llk-ck.a coQtcia:ie8 the epaciL~-nn 4ren the per r.~in btnpche.a cnd frc~m the right cnd left c;eiccl lo•ra bv3nch£, rrMra twra boon rUcroacc;.iealir eecrchad for brcn.crcial tr--orR. In odGitioca, r.ca--plra of m:-la of the re=iran8 lrng tiscti^m uct'e prtpcred for r.fcrc,co;4c ox.c*Srs:tic-n. LL r2* at inctcneoa, abaet 40 cuch SGCtSC.nG l'erc prefar4d in'cGditic:s to the t;ee;.~n ro:tit--) ltm3 p,rcach^L1 roctior.a end tLe 22 brcnchinl cectic_*_n cccntiaaad All or 'haca eGatfc-:o tperc acerched t_lcroecopi:cally fcr- m-a11 tc:rnrc seSich c.iEI~t L^.ca l•.~w°o avorlc..-ly,d by rtQci: em:inAtitr'.. 1".•.w-ccctic*nn fro= ench tr'.~r uad the ourrnTadinL if.lcrz tcero tjicrn-

•seopicalby esenineat to debeM!ne --br_hJ'ctolo;,ic type, utte of orlEir'ond rlndtn~r " . tmaors veet• Iutmd, the nuab.rr at at:f..*-,rLLea -okcd, the age uf the do& at tims :_ vf death, the type*of tuoor and the loce;ion in which the tweor aoo found. For _Tbe maJority of trrnors, both non-lnvcnii•e and iaveaive, tcore found in the Tfndines it, re:poct to ttxors are e.ir+y.rtted In Tn41e 1. It ehouo the vt our, {r~ 9, 1 N or h), the day of de&th of ea.:lt doik ta vhilcii onc or more luos dogo will be referred to by group and day of' death._. DoEo vhich, were aacrificed tao:fng doga, the dAy of death r®e•na the number of -ay,o of aooiCir.g. Individisal after day A)S (includimg one dog which dteA after dep-{•075) are further identi- fled by the letter "a" or For ezawple, '118192o identifieo one gro-up 11 doII vhieh was eacrfficed on day f892; and "H692b'' identiffeo another crovp 11do3 spicel lobe (rJ.), apical lobea, sore being found in the left apical lobe (IA) thcn in the right Treralence of Tumorc = l,2 !la Che-vn in Tab:e 11, cca,e of the dogs with tu~,orc had only non-invccivc . I L L ttraors, oo" hadonly invaaive tumorc and cor;e had both invaeive end non-invasivo ' - tcnors. The relctlvs prevclence of tuaora in different grmtpa of do6s raay b~a coa- -_pared by diartgardinl, prer.ence or rtbccnce of invcaion of the Table 2 Chowa the nunber of dogs In which one or uore tv:.ora -nuaber of lobeo in which one or more tv.nora were found. The cao hf&hect in dogc of group B end loa+eat In doga cf groip C provolenco wae eo.-teehet htLher in group L thsn in group 1'.. underlying otroc~. Here focnd cnd the prevclence of ttnord (contsol dogc). inc 4

rion -Invrsice fironchiolu- Alvonlnr Ttn.arr. l+on-fu-safve tuaRorc vare fout.d in the :.xeurrallv mnltfcentrt~. it ic difficuli to Znvaefve ttmors ware found In the-1 w go of tvr- of the 12 Sroup n non-filter ., eeokerc that died before dAy E87G, and in it of the 12that.uere cocrfficed eftor i 1 It Is of inrereet that such Lunoro were found in tuo of the eight coa-r~moking ttoors. Rorever, in eoce dogs cuch tunore were foaind in tuo or three dificrent - ..•lobee; and it a,av Jr nsstmrJ that nun-f~rvr,c!vr toaora fownd in different lobec are lodependtnt. hcn-invcsive tu:eura vcrr fnun& It. 41 of the 1 x 29 - 203 lobeo of the 29 doga. :doga were very eatall and a3ght va11have been wfteed except for the fact that ve erclly 6cetBed. It ahouid be pointed out*that thocc found in the tw'non-ECwking group C control dogc. T1sis was aurprisfug to ue in the light of thair rarity in 2,3,4 doge sa reported in the literature. Penczpo they aro not as raro e.e in gen- nicro9copically exetcined a great esany oectfone of lung tieeua frc:n er-eh dog. Invaaive Tasora The tera "iovaeion^ as used here, raeana underlying atrasa, or beyond. l~tt:ga of 24 doQe. Sfnco they were ctFte thc nuabcr of truly ind*pendent penetrAtion of the ttror into the : Ifo inviceive ttrmora were found in the langa of any of the S group C control -doga. in none of the 12 Srovp F filter-tip emofxra, nor in any of the 12 group L non-filter =oNcrs. dey {`Fi75. Inveoivo tmore were nlao fo:md in the 1unEo of two of the 12 group it nca-filter mokere tlLt dicd before dap C-F.75. (l:me of tha group 1i dcEe voro eaerificed ancl-noao dicd betucen dny'(97G and dtq Tcble 3 provic'ea a brief deecriptioa of oGch of the invcefve tc-)or(r,) fox.~cl in the luoLe of the 12 group II and h doLC a.:ntionccS_~ tbovc. th= [v.:ot euo found in indicatcd by 1. , LD, LC, etc. i^ne loccticn in Ohicn

r .t SquarAaun ccll -iuvasfve bronchit+l carcinazaa of aicroocopic aizc Hc~o . in two duge (r,37: a a-ld E1E185a). t?aa of thcof cRrvin,mas aKa in s brcnch of the left apical lobe broncbnc. The other we .a tl.e.le.ft r«af.n'h~r~e-cl~~sa. InvQeive brocchiolo-a1vcoIar t-xvorc yerr: found in 12 d8So. Six of the dogc (h626, n644', H7 53 , HS ; 6-k, ~38;re and Ei892i,) itud such rmsora in t%co or nore . end it appeara that these were indej>endent prijzary t%wors rathcr than orie ed the plevra , one cho,--ed eFrlj involvem-,~ant of the pleurr;, and 15 did not . iavolve tw--or with neteatuaeo to other lobes. Mder thia coauzptioci; at leact 20 indepcn- _ - , _ . _ .. c:ent inYcciYe brvc,cblolo-nlveolar tt,"sors were fo-snd. Four of th.ese ttcxora invO'.v- It ahould be noted - that r•~ny vAcroccopic cacticn s caere prcpcred froa each of the pleure, the inrEnive bronc:,iolo-alveolcr t"more and the aurrc,ursdin'" tiooc-t. T°ne hictol,>gic typr of eQllc variell conciderablj frcca one part hf c~ ti~ar to another part or tho acns tmor. Squmoum cell foci vere found in all of tlM1eae tu...rirc. If ject cmnl~ t•oetioa had bocn propared frca each of the tu:yorn, sc~x of then QiE;ht hAres boen elacoified eithcar ac cSufmwH m^trplacin vith cd.rcenced atrpim, or cq,~ ~r,onc cell ccrcinczta. Th e yct~f;oat do; uith an in~~cniCe t~mor (Go~ P 753) tTct: 3.C ycaYEs old cC lic~ roup li and h, vhich diod earlier. of r 7~,2 firat invAaivc tc--*or mte found in a d.og (h626) c.~hich diet~ on C.ny 26 after havinr, rz-;,:6d 3,928 ciCA crettca No iavoaivE tt-3orn sTere fp-snd in the 15 dogr. - of death, - the oldeat (do;, 1,877f~) the 14nCo In des,a are raroly ovccrvRd at rutojsy Leforo the nCe of ccveu yr.&rti. Wnc 5.4 yec.rn old, and the coAn 80Q at dcatl._ of the 12 doZa t:itl. invacivc tiLmora vr.n 4.9 yeart . _' In contrc:r.t, tt7-:.or:: of - CIA ~- dctniled ecr,criptioq; of the tz.m-oro follo=•tt:

hrom.iiiolc-hlveolcr Tt-cora tf2ay aaanea vero foimd in the lunfe of the dogo. Upoo cacroaccYpic exe=to- atlon. aoas of theet vere found to bQ bronchopncusonia in ortnai.oticn z;hi1e otGere were found to cmtain foci of neoplnotic celia. Fnc vord "tvaor° aaad hare arpliee only to thoce aaaecs vhScc contaiuod foci of neopleotic ce11a; but in t3o®t iaoteneeo, ouch aaoaao s]s+c.~~taincG non-neo?lcctie tLosug. to ot= of tTse do3o, up to to twny ea 20 tcrsro t~ero foecnd in th.: e=o loba eafiicScQtly ol.art to n:kc it ap;loar'thati car} usa indapendcnt. Each oxpsroto taoo: aso eu2wi- -centrie in tl;2 aens,t that oo9a roci of uacQlactic cclic rare e=posateG or pr:rti- olly eoparoteb from othcr foci by areas of non-acopleotic tioac2.• 'r" rulaC£eo- " ahip eaoag the vrriona naoplsatic feci vithin tl3 octao tuaor rnaeo to eftca r,a- eertai4. In izanp ir-tcnceo it cp;aorcd that one focca o:i-~t::atod by Circt cs- _c4_~ '-- .--~c-r s., r1..,. tr.nrr:nceo. it np"crod t":e li.'-.oly that tao d:f- foreat faei of nQo?lsotic eollc eco;.o indepcol•_nt_y. The grwoly vicible Lroachiolo-alvoolor tu--oro faznG in tho dwgn vtt:c.'~, a eisa from one eillf~zter to 3 ca.; x 3 c=. x 2 co. (?ig. 1). L;~m aicrcucc=;?:c cr.c'sLns.tiaa, each tuch tt~or uaa feY.:6 to bo ccmpcoe6 of ntnororz fcrf of tGo- ¢laotie cello to~cfl~r with orcc9 of noa-n.r,Lcatic ticcra. €=I1 fcei of r.^o- plabtic ce11u aithS,n a tt':or v,-jro nolvlLr and, to tho rat:od eye, rco=bied uiltrAry tut;rrclo6, T-trrj often tc: Ccd to r_er;;e ir;.¢rcop : iyly with tho ea.rrc ;d- ing li.•-~; pcrThe ooz..-v,iet lar^or foci of no6-, laCtie cello %-•zra Lc•nortll.ry coro LLffa3e, grcy, fir_- and flc.t. The 1.:rf„e0t foci cr,-re Lerercily ;ellce aws f3ceG of tl:s :v vro fcraod fa t'.::a do;;o rcam'Ao@ oit~er lc~nr raa~.nfo 1A t1«) ctc^o of 3ray t~p.~,cSccticr, r.er .irid i icrc~ccr.<_c t.s?ac_ -c~ V_io lriatotc,.ic p£ctc:e ~~Yiuc frt~ o r t1-_3or to clc:o c:....cr. fYC-i c---o Eo-aa to cuoct:.er in cha tcaz r_icrc:rcc?ic f<_cld. S.ne r.ocplc:e::.e fcxi 4ro Sr.e~rir:bl;~ aare<iztcd uith n b:<.ac:;to.c• (i'it. 2). T:w U:c_caiGlc. csf t,2 G ^II

Ksny wsaoovere foauid in the lunrc of the daao. ation, 00-ne of thece --othcro cmro fo-mrd to were found to be bronchepntwic•nia contain focf of ncuploctic coitc. tfpon nitroacopic cxe--ta- ia orthufcatfo;y cl+ilo The vord "tmor" r.sad hore opplieo only to those cssasec chich comtoined foci of aaoplcctic cellc; but in teast iooteneEO, such r.meGOO'sloo coatoinod noa-neo.,~lactie t1o5rf3, in oo= of •:,tF.o dotye, up to no wny as 20 tu~2oro tirro fo%md in tho ea'sa labo onffLcto:=tly ap-rt to nshc it cplirnrthat eaeti c,ce inZey*cc8cnt. Eneh oepsroto tv~Y erse ou2t1- tentric in tba aeoce that amo f,ici of raopteottc collc e.-cre osporatacu or Isa.Ct- " aily sats..a.~reted fr(m othcr foci by areas of aon-«ea~leat.c ifcac2, Fix3 rolat€ca- ahip cta..-~g the vcrt-cz~a r_soplantic fec£ rita£n t-h* no tuaoz csea it oftcn ~s- certai-r;. In usny ir.atEncco it cp?aarcd t?at c.~o facca osi-~faoto6 by Ci:-cc-, os- «,;-; sn othor iGCtcneen. it cpls rod ra.~ o lil;cily thAt iroo ~,if•- - forcnt faci of tt¢o-eleotic collc sro;.o £ndcfc5?_!•nt2y. The grcwnly viAible brr,chiolo-alvoolr,r ttm-orc focs«4' in t'.a dcuo vEr.cC in ett;o frou one mfllis~ater to 3 m, x 3 cm. x 2 c:~. (Vip. 1). L`rp,= o-crcccc:)_c osrainatios. oach ouch tw.er vao far.d to bo ecFaacG of nimoro-oa foci of eoo- Vaotic cellc to~,CthEr with arcna of noa-nzcnlcctic ticcr,, yr~2l foci of r.oo- l+lastic cella suithia a tc:Aor verc aciuler r.nd, to t;o noG.ed cye, reac`'a=ed cailicry t~e..'~,srcle+t. 'M.af oftca teaCcd to ccr ;o i-^,erca~; .ibly nith two r.,srcw~~ ing I^t;, parcnchs:a. 7he oc~ atet lar„er fo=i of ncvploottc ccilo v--~ra „PCacruliy av:b Giffo.e. Erey, fir,: cad flct. -ne Lcr~ at f.c-ci r.\zrc l;ci+_crcllq ,<s.1ou ©c,~ Viotblc t5rc;la the pler,ra. Gm-o of t-,,s ':c:cro fo•ae4 fn t:a doca roer..r3loC citltcr lc?-ar r~~.;afn LR tha etno of Brey taT-:tir.ctLcn noi IZ7,id f; v~cz2G. . tiicraccc-,ic 7ao 1:£ctoLa;,ic ~;.ct.crc v`r.oa fr.-:-~ ors tc_or to ac.ot:•3:. It aloa vcvLao frc . cco ¢c~.~ to c actLcr in t~o cr~a aacreseo; tc: fic1G. 71c naonlcc:ie foci

I r r - eci3pIotelp or uSnoot c=plctoly ourr,o-ac.eCl by the focvs, thoc: fomirg a c~ ~ro. in other tnr.t©ncen the ttnor ertcn6a tomcrG the p1esaLO in A l.near fc3obim acPzet{raaQ abutting it (Fig. 3). ' The plemrA over2yin; the foccuo ic thickeneL. The clooe relctionnhip betWcen the broachio2e r.nd vur rcK,-ndiitg t~.-zoz in seQZ in the n_E>er of opa,ninha In the eozaunicctiona bete+een the bronchiol4r lt--,en cnd . . ~- . ~ •. S tH,2 ourrounding ocini in the tv.ot (L:.rcSert'c cersr:2o). In cscr~o arm8 the naegicsstic ce119 are srrengod on aci,:i tclhiYE in otbcF -epithelial cella of t'':e;o ccini cwd p:; Ellary forndt.i.ccac vc~r, froa c~©iCel iirc:jo (psrtScalerl; in tho porip"sery) thoy c:~~ }~'+~9t.?&T,+ fc~r~cit4c~a. `:ae to colv=ar. Fn t.l-e oore beniCn cr7oear6na for<-~o thc rc its a nir:;;1Q rc"S of ct:~~id ~l cQIIo, ::`10 nuclei cre aYS.'-'htly cu2.rre'cd r;tld the c;tcrpIcrm is "fncrcased cnd paler than unt~a?. AC the eitc of cc^:~Sc~ tten lsctc.~cc~rs the two (y i~,, The ctrG~- in tl:eco ne brracMc,%a. in the ccr.tcr of tS-rs ttmor ofCc3o t%a-w:a the cew'- tyl-a of e-'>it::e i Ln1 ts--cr co' Za co c;po rroQCht in the e.cini, T,,-nrticvlctrTy -amcn to cc-ano epci Sc cc=paeod of vc_•ic!>2e e~~cr.~.to of ccr<::ectie-e tir;E=E:t t:~ic4a rre otrendc of mrse th vnta_~clo bcsr-?Ivo, i'haro t:.sy bo n ciz}l•.cn, or d biuaE trcan£tioa frc-- the tz;:or to tho s~c~xr~l 1u:,t; Y_tenchy~lc (r i"g. 5A, L) . 55;e _tc.:r ccllo often i;rr;c az3t cmt© t2=~n Bc:~;-c~rtin~ o2roa2ar ce,ata. in the te=,.--r ,<.:o-reorcn, ti;ercr to an increcpc in the era'C'Jr of cell:a v4tt3 on cslterotica of their c7to7o-'ic c5nrrctericticc. The luncFic at t~e acin£ in tlfe t-L.!,-or hemma =~,e19, an a rcoe:lt of or. ircrcracQ in tho tF~~'~~r of ceSl gezrt. T`~;s r.c1Za L ro oftcn err.r:ncd ia r,t-, cc tc 131 . The ton,~,<rtcy tc:serda c c:vc+a gr46tcr in the 2:Zt;i11nr} fc-o::~tic~©, ~io r?zeto4 'rrct Iatger cr:4 cc-tcin prc;i.ncllt .VcZcVEi. G:cnci~Zl:l r.Atotic fQ_7,ksrcrp at:u pi-ctk:r:t. r:.tcoatro i:ribrci:chS.olc6 ffbx-a,+ir: to c,ft4~.;+ prccc-at. rca tYso rore aGvtrcad otegan thtira Sc nGroctcu vr.riotic-ri iu the cicte~ cN:p and otaiitfn- c?:orcctcr of t:ie nuclci. rtitclculi nrc c-ore prc.19incr,t encl ; taftotic UM.raa are c.cro froqunut. SqL,aeme ctoQfes with b-e1l l./'

I iutarcof 1falnr bridgen ere =oro cxtec~ai :e€, i,¢ nteclei in tl-,vQ o4n,=cLo 2enzeo I i obcu aoelenr at)-pirn :L~i1ar to that ceen in the scini (Fig, 111, 0. Cincit nucle£ alco bec~-~ tso:a Qro-~,ineat in the ttn-or foci_, Concccitent with the taore florid proccr,e which caac fo.und only ia.tho uot g of rro---? F and h there ia an extcncion of the tuinor cello throvgh the baecc=-tat - tboobrana into tt-* u.-~dcr7.ying otrr_ss.(Fig. Sh). T.zie occurrod in 12 dc;Sc, -CC= of which ;,%zd tw-orc of thic type in t•ao or na:e 1rr~ce, A1tbors':: tha celln ere t_o'-`o bizcrta c.~ith raoro Cir,nt nuciei; more ca;tot..c fLf;crce rresont; st~d e,wr~-.;~ ereco aro aQre ;SrcnLcent. if G-al}' CZti? Goct'.c3 had tioeln teben . :.- . t=ora-nro ch1t.pZe, thcy ore ~cr, raL;~ ccncentrctc: in cne area, To t%=-,&,r frca~7 t%ir^, t'+3 Of tt:'~2oi , G QvCZr-C~:JeO of 13qt='.r--u0 cG U r'r tcp~[ O~A E3L.~ fi&S$C6d' aty-pic~, or cqc:^:o<c3 co11 cprcinc--z mii;.lt hcve toen r4:Lo. CCiGCJ:&ic.l1:.V.1 ti.i Zitc 1. C;. ~ C'~ Ll'ut~-_.~, ~.- t ~:i• 1. .o n ncsat e:r~.(1. t1P>:a ~ C.F] t'i."1 Q ob^crvnZ in a; r,ts~uer of th3 tv=o_-e, slthouph this e•sc tee;: st3 frGe,ti•sntZy 6 c3be:vtd co in h--,zn Iun~3 rcported b7 Licbc~. _Ia five of t?-o cEceo critta L:;.II3ioM of th'::~ underl.yir=a t~ttc ~a tha:o afco en £nrecicz- of tine overlyio;; picur&. In me of tha tfva rccc;9 tire ttnzrz~ r cc1lo v--rQ cntansLc?e in the elLCtic_ fiLb=ra at t" SL:.ctic~a. :- In thc~ otr5r £o;!r cc:La[a the tt:7,or ca1ln frcra the vndcrl}^ir:s tc:~aon ce~, aztene-cd thre^_;'~t tca e1o^tic tsoun%cry Lnd c:-oro prccczt tteyc;lci tt;c plaurc~ulrorary lc::'ctf_ca fFE~. G's t!r~d ~') . A p::st of tc-~or co1Lc in vac of tl:coo ccc4,6 c-a~c i:~~c~o~ct fu h r.;,zeu r~; ich t,Yd thi ccafiEurctf.o:t of 0 Iy::; haeic vGCC:I; but In omQ of tha cot:aa c:rie th~;ro ev%d,w, co of tntnr,tc.cea to tho trac::ec-bcG:~ci?inl

rcnl_r.y ctiRCYwrft; 0? Yf.r tRC++CIICS Itrveota/e oqcmouu- co11 carcino,.a of atcroccopic 6ito was fo..od tn a broocuua of each of tt-c do3e. In both, an area of urcinc*•ia in eito voo fau--d in the hroucktmi epitheliua; and tnvacion into the uud.orlyinII ctrcca occurred fn thke oita. We have uoed the oarte criterie for carcin.n,~n to citn ond~ qarly invaaicn • 7 in tbo®e 4oso co we provicroely aaed inotudying human natortal . in _ eoreineaa in citu thara is a ccllulcr diaorgcairatioa utth loca of the r.e"l Inq- crinS; the enclet chu;;i grect vartation in oico, ohcpa sad chro~ltin ccetent;• nucleQr 6aperchrc.3~etin to frequent; thcreto an LBcreenod n=ber of mitccen t-ad -In eo^- c¢ee (do8 11II77a, eecrificed m Gay l877 after e-moking 6.13n ei0et- otteo) an invauicfl of the vsll of a brmiohuo vcn fata:,d in the area of a carefn.,_-ra in aitu (ri8o. 107.,10y). Tiro ir:vas4c-: eztcntcd throuun tac .~~:.. .... :.` =Lc brmchen into the pErit,rmci:£sl tiocue (Ftg. 10c). In thia ccoe, n/:oto of equ~e.3 opithalial ta:car cellts c~ero fomd in othcr parto of the ecmo 1aS¢. A ointler irzvacive cq~_-,Qwtoua ccll ccrcinc.::c woo fcr,md in the eoctLo,:it frc-a the lofc t~io bronchua of Gon Ii885a; :hich t•co cacrificod a1 ewy G~;SS nftcr hsvLcg ~d 6,210 e£;;erottoo (f'ig. 11). The depth of the ircteic.n eao not ao crcat ctt Lu Cc3 1~377a; ur:vorthelc€c, the eilvor c~.~•tbaruainc ateic of thtc coct.am ohEood the the ir<terrcr:tioa of,,L.ecor4at >xembrcrn at the etto of inrocicn. AISCI~: STOP9 tlrc:ul:;cilo-tarcolcr 1ir~~orc litatlu tl:?j rr.s jc rity of 1mf, eencer.r, to hL=n Uatr.ro 4ro r.4u ~--a:ra cr_11. unC rn- diffcrentictcG ccrcinc-ue, brcachiolc.al.vc,olor cr:vcir--r;•zto ai•c not rnr3. ll:.fficc I.Cy in ectiratinC the propvrtic,r Nf the lctcer ariacc fro,3 th~ fl,ct that rtr.£e^.ln totr.9 arc ct~cd hydifforcnt petholocirtr.. For exr_,p1c, nc-:.^ tt:_.orc of tlaa typc, ray L3 rc:rartel ea "r:(^rocsrcinnrxpo"; rin! tt,tc to not u7reaccal.blC ei.nce in. uc:i+; crcco tlof s+re Ller-fulor It, aypccreace. In n ncriGO cf 7,454 1-ri::ac7 1u;~,~, cnacorc ftt- ---- 9

cludcd In ths 11--rwria1 lYioptcal Canccr R4btatry, 1,759 t.-oro roeorl•od oe er.xcicrcao . s . 'of spacified hiatoleIIic type. Of the lctter, 214 (11.9X) ncro clersificL to "tcr- ~• ninal broncbiolar carc`.nvy--aaw, Art additional 162 (9,)x), L¢ro;claeuifiod On "eEoQO- eerelaocw", and a fenr of thece may heve LEOU bro:+chiolar in origin. ^'.; `• Is a proapcctive spidedtolosicel srudr of lmig cancer, e Gofinito eceoci- ntiua taaa frtcad ltetvcdtt ci&nrett,e &-vokt„g and dec(h ratao frca ~aGCY.OCarCiGG76" of ~ -. - . .. w. .„ ~ n .~ . i i . G h G n t CW IaaL ( alveoler eorcinaaa and brac+chtolar cercic,rruw l~Lofl iQelt..a • $ 10 coto%j;rrp,) R4enezel, Lovelrnd cnd SirLoa toesad a oiAilar coaocictica, the stan&rd- i.eoc' rsortalit7 ratio for "adcr,ocarcino-....a" of the lunt; bainE 26 tima ec loio avj,;.v. ms>a voo omked over a pacti of ciEarettoe a dap cn cs%*na n:o c:no acvvr tzd:.od. In 11 ecot[ror prospaetiae el•udp, over oobsecto rore trccod for c? to eir gecrr, _"Tn a reeent rerica of the rccordc of thot studp, c>o fouad thet 47 of the ewle euS- jocto uero reccrd,sd as dpirg of "r.lveolcr cercii:c.;.g", "c1rreoler cell carcitccas" or. ."bre_c'aieler cereinc,~a", and ercthnr 1S9 nsle cuhSa-tc usrc recorde6 co uTs.nT oi "edenocarcir,c~a" of tho lumge. Stendcrdired for age, the t.octh rato fr= "brm- ehtolar" and "elror,ler" cErcina:a eac czer thr::o tL,sae to h1& a=,mg t•_^_n rdjb ccre ecrront eitarette tmc,kors at the stcrt of the ctudy ca c~g t:-2n tis;+o hcG mmer cssoknd reCulcrly, Yl:e -&-atl, rate from "cc:cnoeercir,sw^ of the '_,,-as vuo az•cr tivo timae ca hirh ner.g ccrrcnt cigcrctto rma*crra co Ez,mg r.a. -r„okera, - tfo can only nprculoto CO to whp,-in r-..okLnS doto, t-^o fc-nrnd cxrp roro isccr=.ro hraaclrio1o-alroolcr tu.-.yoro then leacc+i~n equLr_,Dua coll cnreir:oade of the tvrcncl_cb. Ao cicaretto cz=kc l,cacoa tlrrauth the bronci::, rs~_a of the icrtfcaicto cat;tor in Ce;oefted a:?ca the cpi:cl:eJ.irr_•, i'fiea, tno!~e enterina the bmn::lriolee 1;Lo e reGnced e<SOeeutratYcu 0 r*rtieclr.te r-.ttter, S4aco the 1:YC.xchi of t':o;;ti aro fvt tFa:rtor thcn thebrcvc hi of e:.n, it rsp ti:s cuy:pocscd thst• Ice.n of the s-':rticvlrtt eattcr S.c ciq:.rctto cza':o it q%parited ca the hronclriall oi,itlictiu:w of t.o-~-,o ar._ c:r;reup2 Gic~,iy i~_u to dclrccdtcd ca tlfi apt`h~lktct of tia ttcncliolca. If co, ti-3 rctio of UrcicLiol:o-aFvcolor. tr__'~'rc to o0>.r '.tma ttT.orc L•r. c:.:~Latt~ t6;a r.u cr~ctl^G 003 the retio in ran cce:lC, to c~ l+ac_v? vZI tl; : 1•Lci3 of e C ~e-r rr•~ ~:c9 rrlatLc~ t:ro;,, 10

Efo hevo cg?liod tho ec:w criterjr-1ec brooci:folL-e.Icncler tm-trre no r.c4d by Licbew for ooet: trsorc occcrriag feo hc:-~ea Datann c-.d tCzicl3 ho GLeeoaCOo -- 6 tmEor ttds titlo GroZR-Alveolar C.crcit--s", wa have used t.ha torfl, ure. ehiolo-alveolar t=or" rattnar than "hrocc-h£oto-r,lveclar carcirnw", fcr tl:a 12 ..t r ruaeoD efate y kroaa tad /:I1CA .. • thot thia torsn lo•ru not c=e1-(;u t o o 'arorop to a bcs£Gn or rwelit,r.c,nt,G-aei&oFiivn. of the Icn; that tlvap scsct be tss;aad a Grcaaly roc:~uzicebla brc.etrrz with a 6 . .. •. :... f2-1~ f.tabom'e critcr{o , V%icF: hIIvo taea L,OaoralLy occepted, ero tF=C tiw t~ors aro ~11 dif€omeWtictoC Af,~aoccrcir.cre o:cerrfflg £fl tSzo rorirlearg tocLascy to cp reab ch2efly Littst"t:a con:" cf t!~ ltz-~ by "c+crb~t4s,c" c-r BsMcrtfea ctrczka for tha caopl6stic ccl.ic. G peL2n.-y c"rcc: "tetGo tbo Es~, 17r;hatfc rccatea. Ip edditic^_, the 9--ZIlo of tUo Eictoi cir nptcco oftc:o cct to r= c--- hafore a Zic,-neeis of L rcacklmlo-e2,racier tcicz cco Fs,3 cz;- fa, li2th~b th-z hicto1c; ic c1l2rcctcrs:Gtic4 of tFa bnsacktoto-ALve~l.ci~ Lc~c:c - fc--m-d In tr.9 c..~tir.3 Zefo aro r.ac iPtcticel to tF-r.s Urc:Qcl:lolo-cl.darlsr tm~-sro Ln {=ssa baiu;a cs 4--scri4ed Lq L£et5cra* , the o•rcrcll F:£ctcro Ssa*_ifios- ttx£r in• a css~artic~ ctrutc:ro for tF-.s trara; but tuia f:r. c~t as ctcJeiV: an c sa £n = fato Lf tFa dc-p tad not t~_-c, cscrificcd. Y`"o taLYc of the circclce c-apta Ccra' cZasie-a in thin catugorq, Vlore are ceticrol LLfrcccncoa. In the ttm--,.°a fG.rid in che- dcy;a, "c3rcqgeracc~ rprcaG f.c prorcr.t; E-_t FS-~7317tic apracd to not ca foaturo. Tt cay or r. p not harc c-:..cc;rrad at c tESoc A Htrii:Ln- recc-,'r,lc.lca to ~L_.c {c3 Ln tt;o rCeco of C~rily Fatht£:tcef:c~ cd 1t;rSC ~r~-~ie fa ;`ich ~~br.e£aca c c•~cr r:?ee ~ae~t osrcn fre:, tr-~ c~i.re.c~ £~ G Q.cecxZ£c,q to l,toloaa c:=.tc: tr.cca c.:cr.re to ct i:car: S'i'7~ af t~ = et•c ~. . . E4ra~ rie;ce cv--ra prc,!,_ctic•x to e. c~t~t £u tt3a t:r.~:zLtclc-clv::cic tc_~~o Lc C:^ .. A c~trctt Iieo £r~ tLa ui£f-ere:~co ot 2y;.~. L<.c ~r.d F:^_ tci?caC^~ fftC~:'r.rt:4Lv:~. L'a h,w:, not o'uc.rvcjO t-l:to is, a:rr t;r.•F:iL;~ C: ,Za e.;+ to., tL:d T:rOG-:t ttf:c.

Liebqv alco atetoo that there in a frequant lnvae(aa of tk,o 1?ulcvsaory artorioo area in the we1l-difforentfated tumorc. Diatant involvte*nt euch no the broin, lircr aud other orglt.ro in eom~e of the ho:3cn casee rf bror.chiolo-alvcolar tisore. •hao not been found in any of our doga up to the prunrnt tiae. Extenaiva otudy frcqurnt iind{ng In the tUe»orn of naoking dogy and accura vith groater freqvaocy of theee orgnna will be donc at o lntrr dato. Gqur."oua catcplceia to an extrec+ely to the more r„alfCnont foree. Liebav r.teteo that equououe r.utaplr.oia in broachiolo- =.alveolar taaora in lcu~sa befng;e i6 rare, havinf, bcer preoent in three of hio 20 _ . 6 - .: - .. t _ t88e6. ~ . ~ . . .: ~ - . - ~ .. ' Patho;eneaie of Brosichiols-1:1vcolar ?u_horn The applicetion of cigerctta rnoko to the luaCo over a period of over 075 daye Lavc us the nniSuo oprortunity to observe u ecriee of progreceitic+ petbolr-gic chcegee 1kahich ran frao: a'non-invacive character to that of eztencion i£to the c+wor- 1Fin;, hltwra. Sere:rr.i qu--etiouo bt"lhe, V etoor.-cut ancvar can b~j Cfver.. TheEe aro; 1) Since th.eee tu_--nro ore ceyTabla of cutcndicg Wyond the coflfinxt of tlk lung into the Plouro, thoul:d tfie5 all, be c4F0Ci4ied on canceroY 2) EincE the oboorvedcerieo of proerecLive chac£Oo occurred urdsr tko it my be celled 'S:gli,pnsut"1 Since the civ_•ngcc crc prnratnive to imvncic•a of tha ti:cro a poiEt at w1:ich ono may aap the tu:or in "tsr.i{a", nnd snothRr 1•+oin[ ct v-;mictr - influ02co of Cigart:tto t'_ohe, can all cuch tvzerc be cecigned to one grcrapY 3) Lc plotqif. liffcrEnt obcervccrti may app1y the terti tencer at different nait:ta in thi0 co,tir.raia rtro:coo. The microacopic air t~ntlcno of the bronctiiolo-altool.cr tL:aorr lcu4 tuppfrt to bro~rie iclc6. eertrel bromehpaic fcwnd no froqc•.:!ntly in the fc:i of thcoe tu-oro, nei! tho rra:.cnco of rz"-ath ru.acle tuadicr. conf the ccini cnd p=rilt;cry fon=tiana e-yeclc ctr(Y)f;1y for thi6 arioin, knnth;r patnt itr fovar of thia vit,-cr in the tnparinC off of (;j.1th^Iir,l. tt~ar cc11c in th, pzril.l~ery, Epitl:elial prolifcrntiona in t.+e IininL of the tr.11c of the alvaole:r c',7: ccic t:are not fcu:iG in cbt:encc of l:rolifcrcticn in thc t,d}r.•lcrt - the Lenerelly hold vicv thct thece t...~orn erino in •tho bronchiolcr cpitLclit.~, lha

Elcctxcn nicroccogic etcdtea of thEne tsc-nrta nci Lwina ro.forr.->£! in cor 'latwratorica ooy eaexcr-thQ queati-oa of +e4ct4er olvaolcr 1iAir.U oo.:rco of thcce t~~oro. rvaturT11,}L Oeencrirv~ £uL.r.aarY Tc ore In Dowa 3,4 of thaao tm-zore verfoe frc:i 0,2X to C,61~ at cyto;:y• - lnlao:mry tt=Dra In GGp havc,, Sern dcociihzd' by netiorol t.u[ho7o. 4 12ieloon Eouad the average eGC ct cleath to !+o 9 resro for GoCs toith oacth-trmoro. The ercroCc nao of the dcgo with 1w^:C cczccr in th-2 r•ezfca reForto3 by F~ e~'cy 40z6 Cra,Q - rea- 1J.a ye.err , one, tho yom--sGat eog in the iorioo me e2ron ycara old. Y.c 17 • lettcr authoro atrooo the fcet tt:,at cnrern^n-a of the 1x:a3 fo e dYclaoo ef old Zo,r; End cp;;roro to bo :ttre in thcae anc,~,r oe.c3 ycara of er~3, 'A FCYioif of the litcroturo i.y i.rc::cp c:; C:::C Cicc<ccc~ i)9 ceai" icng trrt,ra, 63 of v'hie5 s:e .C.;nec-areinccxao. Scb~ and t:er.necy e:z the oth.er Eztd, ac;y that 75% of c_imary tczu2ra of *the Cof; are arr.zct;<uao-r;,-..1_- _t=^^- t`;e3ticcrtric tr.-oaro G+.:y occur In cmo or bath 1t~,2-; but tTpicclly it c c:olitcsp rc..'>;:to c1hic5 iris-eo 12 the pari;,hary of the dirFtirc~::tlc lobc. Crcvth of thece timorn c,ccora by S~u.:o o ccll ccrc£sa-a of the hraacF~i, in dcfo hr.o b ca t~rc~ucr.G try the et n4i- 14 cctfca of tamcco MCao condooccte, Sir-iir,r czncc:ro hfrc been yrc'ccod• by dL-,cttiy- f r^.arlnactcl~, :'ro~3ucad T~-~ern in Uo;rn, t+ica AAd iDf (ltrct:on. Mctolo ;iec11y they cro act-ler tz=orn of ret;w: L-oni; n c; , e sx- [°^...ai: f:c;~°GAca vE thoco tr_~ro natecteazgc. s°':.c a; croscnaic a~t,eFprs c of the s=o in thich the nze2lnetSc col_s C;tc•c ralin'•y ea the cra"tio of the ri:vaoli. G:y1y a tt=ro is einilor to the re:ro tc-uoro obcerv:d in our cotioa. I£L~s. ecChrcaa f~~.~) aiid r_c0i7Lc2.o1ncthrcno, 21- CFt.rtie cn~i tGncr_it_tco r,r. £r,ir.teaed '?u 02 c;:rc--?ctn to 43 Gcza. Li,ta of ten lo; 3; nh£ch, ckmircG frcci 2; to 56 oc.:;;;c icvclof,c4' 1.rc-nchfc:.o•~IY^L1.RI car-

_olvooler tworo uith rubanqw:nt r.alfpant r"rectcr, cre in +aeny t"eFo, Bi+ailar to The uicroecopic fiodinsa doceribed hs ,t',].arka e:,d oeeoeictas of bronehioto- the more edvr:nced ttisnc,ra in our aerico. The eeteanf to plccwprphicw of rt,e calln, . the rreaence of giaat nuclei. rsitoeeo, uvcoi4a of thra u-.dc:rlying otro:*A cad •'finallp, imxofon of.the plcurn; cre aAj=~.~:1o in the tuo etc6iFC. Oar atudy ~,- differed in that v® did aot obuoire natestc'r:co to the trnct.cobre~chiol lpr>ph ceoG..o aar did ao find dictcGt wtectneea after 875 dapo at r.~olicg. Cc+r1S Inacr+ivo Lraacl.iel Ccrcinc-..r .. - , . . 71 Inraoiro Eqeamcmc cell carcinano of uicrGeea•;ie aiee usR CaEVd to krsaci:£ = of tro dose rfiich aaoti.c:d aori-filtcr eiLGrcttce, 'n _oe tr-e cnrcinm2pac aro in- dietinEviaheblc fmi thoto a.hick t.-© h.avo obacrved S.si bzo3chi of ht.>.`~`an bair.~a cho rxokrd ci~erettcs,

a1wo16r ts"ora vtth enbseqer:ut ;: -ihe eiccczcs?ic' Eindinga dmccribed by.Clari:o cad Eceociatca of bronchiolo- the roore advancc3 tmnora i-n our nRlit;nsnt c~Aractcv, are in cccq ragc, oi.z.Llr.r to eeriuo. Sjso crtoi:uiro ploe<aorj::tibrca of tbo co11c, L3S8 pr'PaQacO of Ciant nNClni, CitoG@o, £6'vGcica cftm C':aC.Crty'i[2b`6trc.^..nG'£A, f4c:.ISy. iuvoaic+n of tta plcurc, are ec:j.srcblo tu tt:9 tre e:tt>Gioa, Q4e ataGg • difforef ;a tMt vo did c.t oboorro e~tc+otccaa to tha trncS cacarcoct~ial 1y'zTA c6Zas oar eud we tissd diatact t~tr.atacea cfcor 015 Gayo of c=kinC, Y.~r1g Znvaoico rzrca:Mol CcrcLLF::-2 IsraelYa cell cgrcics..-. of eicrs-scctlc also ia+a fEr.sd £t3 brcachl - of tvo do;;e t<'aich r-ked ron,-filtor ciCaretteo, ~'r:recr [to cnrc€ri=a cra ia- diotirCuickcbla frrrs tkoeo ea£ev t`a hc:uo oboorrwd in bresctL of l:cWu l*ieLo C„9 ~c~ cf~rettoc. -Tho euthore cro Cratefr.l: to the follc-: LnC e;io rcuiet~v-d s£erc-,cej,ic c1iG;fl aced in tbis ctudy; tiet£c_.eI Iuctitutca of i:etiitti, 6sthecc<e. :.arp,lcLd To~a 14. %srC. U. D., t`'"ad. Ei.iGc-`sLcaio~fc Pr.thoEory LI-n£t, t'attoaqt Ccccec F.tret€tato Er=Lo Carctt, 31, U„ Ct;fef, LeborctcL-Y t<-ccv£ee, t'cterera f.d_tnictrctfca 1:_L;3ita1 : . . . . . 21 Souad t:. 13LGZLOfl, t*..~portr--nt of Ar-ir.al f)ircococs, UY:£vero£tp of C.ou-n-ecticeF Tbo cett:nro Srctc fuity r.c4::. -r_loL~r c1; vnr4ctr.rc~ of l.z. L. J. t'altcc•r EcL* Fimy-m-2a3 lcr,~3r, t:. 1?., C?sfef of Stt.ff enf: Ci11cf F ~:.raco:y, £ar+f.oo \'ctcronn Gc:::.lrfotrcaiua t'or.t:facl, 11t.tt {sr-cU, C -,tre. Poto Alto, Ccitfc:fmLu Storro, CcnnoctLcut . •- _ Lhic2G2 i~arr::a, N. C., F'aK LY~alcnd ccrr~ar.o,GcLnitol, L~ccr3, i'~ccceNLC~tit3 prcp--irr:eic-a of ol I(; c.c,:rcp.~ic r:4tcr;.al.

Table I.Dala on dogs with Iung,tunora indicating typc of tumor an! luSc iu vt,rur, trl.' `•'-••' was found. I I I I Lobes with Gronchiolo- alveolar Ti~ora Early Squr-oua Croup Day of Dcath N. of Cigar- ettea A,^;e at Death (Yearc) Non- Invasive Invacive Cc1l: Bronchial Carcfnora Group C (Controls) C °04n 5.1 LA C yU4h Group F(Filter-tip)F 878i 6,161, 5.1 1.A F 879: 6,170 4.7 IA F 885, 6,224 5.2 LA F 890a 6,269 5.4 LA Group L(No Filter) L 347 1,055 3.8 LA,I1C L 812 2,847 5.1 FA L 876. 3•103 5.1 1:L,R4 _ L 877a 3,107 5.2 LA,Li , L Pr2a 3,127 5.2 IA,1.D L 896a 3,183 5.3 LA,R9 L 894a 3,195 5.4 LA Group H(l:o Piltcr) H 135 5118 2.5 P.C H 259 1,342 3.3 LA,kA,P;D H 563 3,404; 4.7 LD„FA H 716 4,689 5.0 LA S 753 5,030 3.8 RI 11,,PjrP.D H 760 S,038 4.2 LA .H 858 5,570 5.3 LA H £t76a 6,129 4.9 Lk,LD,RA H 877a 61138 5.4 LA U.i;3 11 87Fa 6,147 5.3 SA LA II E82a 6,183 5.4 LA 11' SF3a 6,192 4.7 tApSRl ].A H FPSa 6,210 5.0 1.A,PA L H 869a 6,246 5.0 LA H 890a 6,755 4-9 i LA :• H 692a 6,273 5.7 LC,r.A IL 1 1: 892b 697,E E97b 6,273 6,31E 6,315 5.3 5.2 4.5 i:A LC LA,RA I11 Group h(Eo Fi-ltcr) h 60t, 3,769' 4.6 L,1 h 3,928, 4.1. ].A,Fa h 649 4,143 S.0 GI 11,,}L'~ 791i 5,1+03 5. L LA,IU, Lt., left rptc;.l 10bc; IJf, lctt rrcndi:.c; 1.D left di':;plr;sLnatic; FJ., ri;;nt apical; :.y, ri,;ht cardizc; 1?I, righl in-cnaed'iatc; RU, rS1Lt dir.phrtU;,aGte;' LA1:6, 1cSt apical tiranci:hrom:hus; L11L, left catn 6ronc;,• s. For swokEng,doTs the of death indicates the nuczbcr of d'4ya sLncc r,Cart of rTO'KiiiG, The ]CCitcrF ' o: `A" Dotloss thc dccntli of to,:: rn-rlficcd aflcr lay .'t75„ . `~

able 2'. Number of dogs in uhich one or more tumors (Non-invasive or ittvasive) were found; and the number of 1rc,Ues in which one or more such tunors 'were found. Controls Filter-tip No 1'ilter No Filter No Filter Croup C Group F Group L Group l! Group h A. Dogs uhiclL died befnre doy fi876 Number of Dogs -. 2 2 12 12 Number aith Tusnor(s) 0 2 7 4 Number of Lobes 14 14 84 84 Number with Tumors - 0 3 13 8 I B; Dogs szcrificed after day i875 12 C. Tota1. All group C;,F, L and11 dogs. hwaber of DoFs, 8 12 12 24 *. Number with Tuaor(a) 2 4 , 7 19 . * 7. with Tumors 25.0 33:3 58.3 79.2 * Number of Lobes 56 84 84 168 * Number wiCh Ticr.or (s) 2 4 12 35 * 7.° vyitli Twaors . ~ 3.6 fff ~ 4.8 14.3 20.8 * Nu.anber of Dogs $ _ " * Number with T tw~or(s) 2 4. 5 12 7. with Tumors 25.0 40.0 50.0 100.0 * Number of Lobes 56 70 70 -84 ~- Number with Tumor(s) 2 b 9 22 * 7. ~:~ith Tumors 3.6 5.7 12.9 26.2 1 * FiEures omitted because no group h dogs were sacrificcd'. .

_--; ---~ - Table 3. 'jypes of,invasive lung tumors in•12 dogs that smoked in Daientheais r:on-filtcr indicate the location(s) in which the tumors yere found. Deacrihtion of Invasive Tumor bop, and Location of Tumor invasive 6ronchiolo-alveolar tjn„~,%1- v{th squamous cell foci iind pleural Involvement Invasive bronchiolo-alveolar tt~ur r•i~l~ ~y_,G....,,.,. _.. . _ - - and early pleural invol!vement Invasive bronchiolo-alveolar tumor with squamous cell foci 11877a (Left Tidin Bronchus) 11885a (Left Apical Branch Bronchus) 11878a (I.A) h626- (LA,BY) h649 .(LA,RA) 1171G (IA) 11753 (1-4,F.D) 1187f a (LA,LD,RQ 1187 *, a (LA) 11885.3 (P.4) 11889a (LA) 118921+ (RA) 11897b (I-A) Hotc: Do~;s H877a and 11885a, each of ~:1iich had, an early sqi~amous also had an invasi.ve brorcchiolo- cell bronchial carcinor.~a, aJveolar tui1or. 171/

0 ~ l ~ ` 2r-~-~ N<`~ Fii .. ER f ~ j ° ~ x9 @ (!/? L.S A r~Y ClGARETYES) 24

o u

-Why sti-~1e:~eb ~~~e on sr~®~:~n~j . . ~ i~ an 1.r EJ'I',ESENTf1T1A'ES of the tobacco in- su'er d o tl , t p r Ir ~ .....«. ~- ~ dustrr who chal?enged a smo:~np and ~orl s for the LrltedSa,t ~, ~"~' ,•' cancer study were throR~n out~ of a press con- the 1 c,f. . ..s ,.........,_.. ... ~---_ ference disrin~ the American itTedical asso- ~1CC ~'f :C~P. C'' t^n . ciation's scientific ezhibitioa here. Regard- less nf~ the mcrits on either si~le that ic -n xno~; ;=e,e. : 2t,e issue was a report by Doctors Oscar - Auerbach and E. Cuyler Jiammond of New . York, who in: a 2?=-3~ear studv found, aniong other t%unos, tnat 12 of £9 cigaret-smokinb dogs d'c-velcped Iun„carcer. • Die:nbers of the Tc';acco institute said the findinos were "hi;hly suspect"and caL'ed on the res~rarchers to submit their rPs','?ts to an independer.t s'udy. They •,sere ej~cted from the nress roon: bv an~A- M. A. staif member. We hzpp en to think ci-aret smoking is ;t}:armful and that the findings are c~uite piausi:,ic. i:ut :acis are ^I-,avs nceaar.u ~ - we ~~~er s~dc. 't ret t!:~e^~i~t' • r ;n * ore . A ~CJt~ Cr rC5e2IC.: ; til~'011'E re Can Le co ;- aPnf " y11^r~Juch S in '.`;'-: ... ~..,~ _`Ll~ C1E[}'. li~ n Cr°ari'aj q:3 r6g rd Gi?3re,S as w,~1 ~=- . ~-- 'inc iobau'Co ir:iiUsil!y may taiie solace from the purTosc of the study, n-::ich was. to..find the sa-`esti kind of cigaret rau cr _- than prove that sr^o=::; g is a mortal risk. One fid:dir.g was that it is safer to s:ritch, to filter cigarets than to cut smokinlff in half. But the industry didn't ask for solace. it asked for a hearing..It, should have one.

266 Tbb<accc>• TnCi.if.ute vs American Cancer Seciet.y, t~r.~.:__ ~~a. _~~:=~3~._ x>•-..._.. .::~,.x_., ... Al citt('Lr('i1N.'Srlf~ t.7( r(',1!'lJ:itr)1"l:?l•<r,i•ili for 1 S i0 are cstiru.,ve_! at 77 1(.lrl• l+rr,l = in this .(iprv lrill' he /i.~,nttlil (1,• tlt(r lirrr; nria G.Gn0 of the l.mru.y: I)t•:ulrc tuv„)t (,•arrc'er or the jtlrl':r.t- !r?Ql' Ill and of the ll 61.700. c.sl'iil rJ(rl'('Fiirt't'l, Lit(' fi;rrr(rs are iJr',trecciiu. 1!'it'r' tlr(!.tr Ill iO,' liNrlLtl llii, (%tl. r'o1'i'!"\i" liUi 1(fOL !k(' ToIl <;):: , .. ~.,~. C.a•:nl~r~ rr'.rri~c, lIYC• Cr!(i ~.'i~,i:';r !°t' v:t F. r~t'~c :. 'i\ flJ.'f~~ U'rfui.. 1,:,.,finr -'f ii,1~ i: .. ::(•Il~~:.'!'. The l;lieSt flhre-ttjl CO I1Cer1U 1 10ief9lj :I11rloUtlCilllellt l1V the :\11!:'rtk:atl (.:tilcer Society of a rcsc:nclr I,rnj^et titll*tll ..T11c Effc.tS of CLl;ttette S:iirtl.fl'^_ l.Ipit!r I)o•^\•• ACCOr(Ilt1^ to the Allttr!4:1a Ca!1JC'T ~'C7ci:t\•„ Clle esheniilaent clclrorl~r:ltril tlhat luute C111Q~1' Qmll lii hCnltl'. ;t! in [?111111;11~ t'.-Itli ci~arettc cnlol;.•. \ce(!9t•s> t~~ t:!v, rl^f~cl'!i~a, is 111,110nlt:!+71 i•! that ii a•l e<l:tl+l, 1 ra'ltlrC•";l`('~1 0rr~~6^!^i.~at:.1"~i \1~t t ette' strti•,lia~ :r+7t! I`~r! rn,~_~~. IlUII~~ 1!i!~ilsl':!~ ..~.~ are trt!c and the Sluilh• is stltl;t:{nticrtc(I- it would inl'Itwnt'c the ttlt+ac.'o itttltlalv, ;l it $110111C1i do the Si!ttle for the pilliiit: in The -Inbi:CCO, lllsultt!te_ llti(1C1-,o:I11tiI11!! Lllt` im`li(':!tii711 of Stlcil, a "'tutl\'. has lot7ttc:tetl fltl'11 the i:111iC'I' «tii•,`l\' f11: 1 the I;l n1 t11' . ma.tcc !te maJc l:n(,\\rr s(7 alut ftutfltr (\:I - uatlion calt he nur(!.^. -IllC :lntcri.:an1 C!nt-er S(Jl'Ii t)' I1:IS Il to :!!tltlC :((L CV;!l!!;tilrJti' of the cttlcll' by an itlt4'1\entl;ltl cmuh c+t s:ielr• iistc sell,~tecl ;lltli stlnl~nr,tctl 1 ti the 1nhac,l, Iwstitlt:c. 1':,. «ur:lii lie aice, t:!'`., (Ct t1!c• r1n1C.tK:1!t C;111ier tic7ciC-t1•. C)il; i\'-tt o«asions tEl. cancer soc•il has tul down Prc,I,osals by the Tub:lrco Itlctitute. I ll GNckt\" C t,t, itlitll in t111< !lli!tler now r9i_o~ Sr`rt!,I!r. (l,ll~c1~~.1 rpii tl!dlf~l~;? s.l',.'.t'.~i~'?r... :111(h~t,l ~'~11.. aTlnA1'.t.'1. The Tl illstitrlte has made }:nown the correspc,lltlint1c tlAclt has taketl lllat•e by insl tli,7 letterc in ftllFtlage. ne\csl,:thor ct?vIl C':aaoful reaClltlt-, uf tite-sc lertcrs h\' the gonc•lal pa'lIl.: nct the nteclica! profession may She" :01^0 1iE711t on tllk ar^l.itlletlt: -f'tle :nstlittt.C p4titltc Out t11:1! the SCle!ltt-tti tt1- tx,ivQtr TC.~:`1\•i.! ~:!1_ll,tl!C: li'l tlttfic.lt?i;li ~(1ltT:iilltr`;ll :!IYai'llt' :\114:L1'.':l11 C:IlS!C1\ ;ltltl, -">iilcc tltc<e til tll firtlttr }~aitli: S(\llrl'e>, tile l,l!bl!i is i11t!tied to :l tllll, :tllll. (i;lli ;11G(`1?11t of the remilr,,.- This plaCt.'~ the 1?!!rlll't'. in +r; ;)t ltlt O!; :\!ilerliatl C:Ili,:r Sqtul2t\•. l lic i1\ tl: \1,1:•rit':tll C:! r Crt;iCi\~ ,. r,• !1;:It o '> lit. Ii t:'I!i• ~~_ ' ' ~ ~ .~ ,•c t {1P e1'Itll.!liCD ~ •• t~~~• in Itl!!lia!lS lCft'.'. s. 1 IIIC;r.il'l,!:.:~. G?lilllll'u Olt.'h11111{:, IiloiltltSCtnd IUr reilli;S il:I l' 111;1~'Ill Oti St(1J\', it tl1iSQSt?e{i17aotltt'.; ~so surt>c:>ial"' If the \•erv htrhost of th.. Anot•ricr:ta C:!lq,er S(Ici;ttt is to tt~ ar::!v \vi,fi cancc, \`:!:\, hrolon« t! (1Ltl:rtc - if tlic\• idaie tllc C \'iilol -I ce t •, !l:llitl'.' Wnt!1(l tll,:N. bel,;lve il! ~ the sanlt !llal;t,cr if a t>urc t~or cancer \trc t(,nncl'.' ~tl~lar\Ilrni7_'l5t'>, ll•Iln Cle;ll Y.ttrl, il'•C lu,r!tt!s n~ i:rncer in tlleir. Jinly hrn' .<.i.1{l;t( C1l1tICs, ari Cthltl-ttf to I:flt? tlletr h;;d!eliti c\ait!;ltc mnnars 7s hetv:een the ,Cllcni~a,t CIIAt•'<1S~tc1Ct1" and tl1i~Ttnb:lCiUll'ti!1;llii'. i\ I'Ct1 one itt!Y.I(1Jr, the atlttll rl 1110"X\', :1110 11J1': 1~LIt l;ll" t,Ct'!T, ~S~C!lt ttll ::IS C"'. A11't! . . ...~..o.. 1C'l,ttlttl~t' 11~:+';11PIt'•;<tt't~' ~:~t:l{t,. t'ilt~.i7 t ~ ,n~ -r....+..~. PlL Iltll`t i,tUi he \0I;'! t..."`tll•.. - t ~: Irt. .a Ilt!!t i'tt ~t!'ii' 'turr~tit'y?~I? i7.'.ltt Irit: ~~--- t(~l.t ir t~. ~;tll:~,: i! Ik) 11~. >aA 111C t I1~'~ " 1`t`(tl,le Il ott ::IAII'Ci tIt:!!i lk: itoil; Ii. ~.~........ The I ye. t ar, \ox:•:(nctTticteut .`•It-nt:+'t'

~H'u1r1i,';,•r' *<Irr M. •ro;,:,. ,•,Q3welarr/hiA(rJicr F.nc P. Stcalcc , t':illia;;l N. Top;tz r':Idtrcn \lactn lYra4i:rienc tisrr.a•rC!:(iv O:i,•;r Ll~crnor I:ii~!~crc GlzWiart .`'i..:l;, ....rirt P:r1r~~•..r -_ k.• . ~,.. .. . r~~ ..nf' Cv<vsrr.~,y 1,-e::•1 r. Parb:!r:u 1',',. C'ollirti 1YoJi•"i~~rrJ!' S. rri:ea Adcrrrui•:r fr,r.rrrvn.ri,rs, ,bt;r,c . Snl. !'i,ccbr•1 1, ~..n:•irr 6N\:. 11:./•~;r.n..l..~~ (~r:e ~e.,.rft ll..;L Sr, t: l.vl. .., lrror;.r•,:M~, .'l::r~.'r_ r,. 4 co \•T1 \TS Co \'T1.\•r 7 f) - c»- . .. __ ...r_- .~ . -.~_. ., . ...._._~_.-.r--ce«~•.ra.-suv 292 C(lNCl;NlTAL h=.A1 N1iSS AND I:I:1lNiTlS I'lM1ENTnfi:\ P cl',tr,. .v..c, n. r.. n. !j: !:. s'vrt. us. .Srlul: liulLi 297 AD1WS1\T (-Yn rIS \Ml:\ :\N ,\l'rrto:\cn TO I ST1:1:.\l"G l i'~T II' ,', Str!(;:Irn l:ir!! ll::• .U:7;r.r DI:I';\RT\1F`:TS ?GS rnlr.;.; '.._. 71r~.• I',1. $inr::ri.~r: ~ ~7rk: rn,:p•,t+lt rr.•. .1 m. i irc^r, Car:n:~a•~C.7c rlt.l.r.:r.R~,,•..r•(''•'~~rnr,~cf'.(:rc::..n•r . (r,.Tn:ircit~e (~s,~uri'-sti•nr. - ('rtr:: i r. nin,•1 iJ:rr.:: inm i,r (J1': ; f::: G.p ~b~~. r. Grl:fi.vtrrrtt(Nnl^rnrr.!rl.r,•r ~ ?7'rIU('('.-1TI)S1\ 0I'I1-IILV.~:~L(1G}} ~ :(:uiJ,•ln,rhi.h'i±mrrlu,ri:vfr:l.Jrrrc,ll•,plirts/r..sl'ifc1:nl 1I 111 !trY [ rnDef:.1 ir .C<r,:Jili.lr:nec S~'.tim .lG: v (it: ( I'idJer llrr. b%r /1JC::rJ ~p, CM\t('(11'1111- 110K1ll..1lrnfircrs° - :1 rt:1 r:fn!v,ryvvl>ltr:p(, NI tl'ti,[I1~ t IIiClctl. PR(ita(l!.Ifi ;tlry• C(11)!; I:fA'111lS ±11' 1)lll'S„AXI11VI N1~ J I . ' ti! Uti \0l1I,C AND r t ) A I 1 ' I N I S ~ l lno f,•: I:,r. \.,.r:,r..l I lie.d tL-;t ~.A 4L~ LJ

Mr. 7oseph F. Cullman 3rd Chairman of the Executive Committee -The Tobacco Institute, Inc. 100 Park Avenue. - New Yo._k, New York 10017 I have read with care your most recent letters including the one to me and the extraordinary communication 1954 when the first American Cancer Society report on the by distinguished patholooists. Your recent views are much the same as those the ci ;arette industry has e.%1 ressed since Hammond findinos which have been reviewed and accepted : :..~ .:'uacco i-,1uustry conlinue to qaestion the liuerbach- to Dr. Dorman. I note that you as a spoicesma.n. for apait risks of cigarette smol:inS was made. As you knowy in response to your newspaper advertising CampaiEn, we wrote the Surgeon General asking that he appoint a committee of scientists to review the Aucrbach-13amm.ond:work. you have not had a chance to read' it carefully. His answer is enclosed - while this was sent to you at the time we lnade it publi'c. I am inclined to believe from your statements that Sincerely yours, \`Tilliam B.

OF.PI. :ZTNf Ef17 OF NEAt~_TI ;, EDUCATf` N AND IYELFARE f U'nLiC IiCl.LT~1-i S=F2\'1CL" LYA£Hl1dGTOM.0.C. 2R101 - Jonatizan E. Rhoads, M. D. Aruarican Cancer Society, Inc. "219 East 42nd Street • Vcw Yorks New York 100,17 Dear Dr. Rhoads : - tar.P, vo- Ide have czrefully `reviewed your request that I as Surgeon General review is necessary in order to establish the validity of the study. which have led to this request, we do not believe such a formal the Auerbach-han:mond study. Sym,pathetic as we are to the reasons - _-establish a cc.,:,nittee of scientists to conduct a formal analysis of : from- the Nattional Cancer Institute, and Dr. Ra},mond Yesner, a rvit'hheld. Anong the qualif{ ed persons who havt•:r already made thecr- - _seives facailiar with the data and who have been Yive.n opportunity !l YOtiflo•.• n j~ . .. W. iJ:.uO ~-' t'c:tavai~bi~1. to il: bn` ntnw. =:at ~r . .J~-." .., ~ +, • " ` / It is contrary to fact that scientists have been prevented from reviewing the Auerbach-N.~....,o:~d study. or that- -any data have been other persons, including scientists representing the tobacco industry. pathologist from the Veterans Ad:mi:.istraticn. Ule tmdezstand that a number of scientists outside the Gove:rnr,ent have also gone over the study in detail, and that the opportunity continues for review by investigators who have nade valuable contributions in their respective fields over a period of many years. They have carricd on the present study under the most enir.ent sponsorship, that of your Society and of the Veterans Administration. The proceduaEs they have followed have been fully descrih?c: in the literature; they have i:ssncd what appears to be an Edequate report of their study; and they hrzve- opened their data to the inhpectiou of other scientistr~~ Is'r: do not know w:iat more can be expected of inve:;tigators, especially ttlose with the reputations for excellence and probity enjoyed by Dr.s, Auerbach and li1.vzond. There is no scientif-:tc study which c<_nnot benefit by the review of other scientists; it is the institutional, "jury" review which we believe unneccssary. Drs. Auerbac;n and }it:--iond' are qualified

. . /412.- Page 2-.Ioar,than E. P,hordc' 2i.Do . - • . -':• t • . . . "°".-•--Dip= Rerg L_:s toa.d us that he has no doubt -but that the progressive cigarette Emoke, then the answer is yes, in the view of a Public Health Service pathologist with special co--metence in cancer. This is also the view, we understand, -of Dr. Yesner and of the other pathologists who have reviewed the r-aterial. t'ubcs of two of the do,a. 'If the question at issue is t?hettier human- t5-pe lung cancer has been discovered in the lungs of dogs exposed to r~i_LnSesj~:'L.e bronchial tis ,ue4 of the nuiy.als etudied were as =Dr. liUe1L.'•::I has described the:.1, and that among other cor.ditions found werz :arly invasive squru<:oua cell crzzcino,:a in the bronchial -It is not w=-ecescary to go to this study to support the conclusion that ciSarette smoking causes lung cancer in human beings. There was enough evidence six years ago to czuse the. Surgeon General`-s Advisory Co=ittee on Smoking and Health to come to this conclusion, and this evidence has been strergthened in the years since. The Auerbach-Havciond atudy adds one more elerent of certainty to a concl1Lsioa which the -wor2djs t•eaical azd. t:ealth authorities already consi.der certain. 'ihe study is obviously sibnificant'on several scores. It appears to provide us with new insight into dose-zelated pulmonary changes, both t-eopl astic and non-neop :lastic and futtiermore, it may provide us with an important new research tiool, an u-niral system on which r-odifications i e t n the cigarette can be t s ed and evalu&ted. :.. `1'h ,-~} espon_,imi.iity of repoi ting .The 1'ublie f?e41th Service has the ; ~t~ ~at,,to, r ~ to the Congress at regular intervals on the health consequences of Government as well as those in the Service itself. smoking. In preparir.b for- t.he_se. revie4•s, the Service surveys the taorld1s scientific literature on smoking a-nd health and~ evaluates it with the help of ezm.inent scientists, selected from~ both those outside the -. . feel certain from vhat we already know of the study tiiat it will p.ove to The next review of the health consequences of smoking will be reported at the end of the calendar year. The r'.ue--bach--ua::~ond study will be given formal rev~Cew at this time in its prop(~r conte:~t, as dne of many r:.scarch utudies shedding, light on a difficult and i-,:portant health problem~. I . be an import ant- contribution to our^Understanding of the smoL:ing and health question.

-The surgeon general safdin a9cttcr tobr. Aucrhachthat "ib the question at issue I* whcthorhuman-typc lungcanecr has been d::- coreredinthelur lundogsespo cd to c:7art;smoLe, then the tnse:er Is yes.1 1t.s (ar.c^. he said',v:as thosietvof, botluDr.John W. Eet-e apatho!ogist %tittithe National Cancer I::,tr• tule,andDn RaymondYcsner, associcte oro- fessor of patho§opy at Yale University Schoo' ofMedicine.. I`r. Auorbach saidttiat tte ntedicaljour;a' rericxcersdtdit.t daputo thect~_iml;at the tG mar~ found in the dogs •.rc reof num atr tvpe: 1 In pact Was F'orccast When the results of the esperhsen: wcr^_ fiat reported~ at amecting of the Art^:rcz~n Cancer Soeicty last February,asoc:ctj• s..-- man said the esF-:riment ". ^ou!d'nave a ieanPimpacV onthesm 6^; ofcion *cts in t..... country and u~ll probablrtlcad to a reass.c%c-- :ae-t cf adecr r..z c!aiais and policies r!.. cigHret:indus~y... ~ r ~ oc s y re tune or rc~ on. rp : UP'hon the r•rt'rlos uill nn-,rar In nrinL tsnm• Afcw weeks later the Tobacco Icstitutc rc• 1~1a7.1 Street :~ournal July 8, 1970 .11 I . t ~~.~ Journal Dcci.des To ~tVi~tli:liold Reports On Dogs -a?iC~ 5777•'O~:LIbQ • • . • : .. Controrersial Tests Silp~?ogedl~~ Gmased Cancer; the llagnzinc S~cs Articles \ eed I3e~'ision ~ . Syc ~au.Srr.r[rJr.r.awtSta~Eyorttr CRIt:_'_GO - T~._^ Jo:^r.sl o• Ih !~,erii-ar T+ rriii•at }_aoYia{ . c c., c W - to 1i:4: c . . :. ~ -i:t -' ... c '! I3at t~ mao~ ne uYich is prababty the most trid~y rcad nc..:cz1 L,urn_I in the U.S., .i[uisia t1xt the arlieteshax-en'~tbeen rejected Dr. Psu .GC cod tnej t rr. 1 t tlt re- t" eL ut chahcr m~ inc C.areer beicl ance osr' ~+ *Isy., n~ ..*.c obaco `.,... utc ;' cc der the r tcle tf the}• ate r~~ub t rd lea the uapa5l s.cd data on 1un c r, iGreindL•-"~strcdeaarociaUo tnnr,osr.ced t[I t.ith th.erev . onr. Or, he sa u, t, dor- for fur,her .crutiny by "n:en of eustar.,,- ~-es rn~tinc a majoraltaet. aoains: the ealid- 1 mac ecc+c to ^ ta . , ~ ~-. ino contpctence and mrs y" . . _ • _I ityof the: rescarchcr.; fi:acir s. tio•r The zr.fcles desen-be the results o a 2! - jhe tuo rescarc:iers said they havent' de- 1car experiment on 51 pedtgreed beagle dogs I c,dd tch:eh course they w011 tal e. -' - ~ lhat W as earried out by two eminent cien tsls.I Dr. }Iussey rejected .ny su ecstion o pres- ThcAmcr3eanCa ~rSocichtSsclatm dtha: sure on thc m,.vez:rc either Loat~,thc tcbacco the expex=,ment was significant in at least ttvo y.tditstryor the Arnertcaalfcuwcal Association >>'ysc I: nroduccd luap cancer as a resul: o:nottopnb'4ish litcreports.'•Thcrcc-asnopres- ht L t i : t t t i dt : cigarcts-__zl;ingin a significantly large eaperi-mcntxlzrimal, and it marked the first time that eancrr had been induced in laboratory-ani- r.tals by Qusia; t!t^_rnto inhale tobacco smoke. Iicjcclion Is Denled Dr.lkz;gb~ll;}Iua.e,v, editor oftlie mcdical 3wbticatsc_-j, dcnicd in an interview that the ar- ticles had 3,een,rejcetcd forpublicat.'on. •'Ilhcy r.rc not z~+ccp:ab!cfor pwbticationin ihcirpr¢s- attform; hes::id. The articles have been rc- tscnedto i*.eirauthors to said, for "cxtc^sit•c rccHon.- 7?,c tl=a scicntists •r.-ho carried out the cs-pcrimer.t zaro Dr. I7: CLydcr Nrmmord aticc presidcnt of the Amesiean C~ncer Se ctety;andi L Page ].5 Dr. Oscar Aucrhach, scnior mc<' ca1 investiga- fortnal rertew of the capcrimcnt "to cs(ablislr tor for the Veterans Adininistr tion }iospital, 1 vagBily;^ East Orange, \1J... , - In telephone intetvictics yesterdag; both Dr. Hsmmond and D:'.Aucrbarhdcthned totriti- cisa themcdical journatfor 7elurnir•othcir ar- ticles. "We :the articles to thcm In -ood faith, and w.- L_elicoc the Amcriean >Iedical As. sociationc0,-:: acts fn~ good faith," said Dtt Aucrbach._: Neither Dr. Hussev nor the two researchers would disclose details of the suggested changes. But Dr. Hammoad said son:c o'tho objec`i,)as centered on photo r;hs accompa- nx-iae the le-%t: "There were co ipDaints that tFcp`=tareswcrc outof focus. F;btttat's to be expected since the slides otiginallyvrerein cetor but had to be printed in b!e.ck and tehtte (oecause) the mal~azine considers color p!c- tttrestoo c.epensirc;',"hosaid. IteciaxcrsCalledFair. Comntented Dr. tu bach TtiercN5cwers were as fair as they thoughttneycoul6 bo.I r.:-.p not agree with tnem;but tt'sall part of the give and takc;'" sure whatsoever," he said.. Lspen;Consulicd ' Thr~'r~ -:rp-~•.~_•.b~ nn!,!!s!t thc=~.Sln~;. Dr. Husseysali t- by aliotit ' - :anu•rori::.- 'ir.?so in- ch:aed an^ espert o:v s'e:ci:ua:.v ntediEir,e I•.a t}:ol sy; r:n cs!-wrt inlwlino::a:y cilcaseand screral~.path'olo~;ists. The s:umber of reciotrers, sr.id„tt•as.nn.ch greater itanisuvant for anjar:iolh sub:nittcd for pub'.icelion~ia the :naga•:.ico"t~cau=c of the ercat::n:ousa oD.pui::icity tnti oh cd.' Theeap 'inmcnt alroadyhas wonihoalri l ov 1 ofthoU.S.Si::-gee:t (cnrtt•~1ie+ rc~ ccnt!V.atd ttwa~n't nccosssn •ocarry cu0a An institu o spol:esnt nl said the '•To••,tcc~ Insldute dccs no:,and he public In !-J uc: acceptat4acevalue th..findlngsof t':Ludy'." _G

DhZ11:1'-1 ; fOR\ ] 1G HE.R':•lLh ' Durhan, N. C. July 6, 1970 ~ ~.._ f L~ ~ . .~ ~ . ~ p'D ,~~~~,'r5 - ~ -. ~` f~ i i ' . .... ~ ~. .. O . • .• r O ~r a. al \ Y?j t`7 ~ t J ~ V~ !~~,P c± of te~ Tna «•arncd that im f,osition- r iu lur of 3 ~'RIGIITSI'ILLE I3 E A C H sn n a s s i r m I ' . o ; (AP) - A f o b 2 e c o indus- findi',os w. ere madc pu~blic sev- tile. imltort quotas by the liniC try s~}:esr t~r~ssid Tuesday era! ks ago at a news con- • ed' States cruld r^an that "the there is i:r.rer.sing evidence , fcrcnce by the Anlerican Can- pronress made in a th•ud of a that' th,, hi^: ~ na 1> Jci~ ' ccr Society. century of enll;nteacd trade __._.. =~'Sil~':!11 r~ C I iS na CO 11d o0 ] V the bD.d."' honl_ a<< s2:d ne N,., as told ~ ' tobacrc could A_~I:1 Journai rcvicticcr- covI .d He added 1ha cniiiic~a.-...-s not detrrJnine from the micro- be one of the first rictiins c: :.-; _,r .. _ . ~)l:c_ phoio,raphs submi;ted %vit'1 the retaliation" by countt:es that c n t lc_;. paper that any of t e sn:Dkina s•zlI textl!e goods to the Lnlted scl°JJtiflc or}: Loes had develbt ed 1;]aligJla*1 -.Stci£s. - -. Is Cles. ' 1f1B l':orld 15•2ntS our flll^_- SCICP' i^ C lv nru 1.a!Il ''I~ ci n1I-ir AnaMr CurCd tUS'?Cc0 fi.'.t can do \ aih- a.a11- ~1R. ffi.S..L' a p:._,cr rcJrtL.gl 11'E(+~ R'•i: out it So I:11ci1 is the m.uls h jest t~e l rejcat- ab'e from oher parts of the ed by t! Jnu: nal of the Arr:eri- glo rc " Pa r r said. can Tleccal Asa.ation," Hor- j'l. c 1: ~ ~• Pal-tler 2ppcaler3 to the to5ac- ace R. Kvrne~ay of :Vnslurr, conists to esert .nur i:^.flucncn. -~.... ~:a....r ,.C fi... Th}tnnnn cn-r.` rf t•3!in~alsfl"?r!1^f.}t- Jnstitt^ IC ^ ti)l il tC°_' c.^.':a1 e: at thCr CD m'C.._iDa CI T re OS t0".\a'~ I''te: i:3`.I0~21 t:`A.'li^- contit*tion of the Ertht Bclt than Jt'D fiue-cl~ ed tobacro and not the ds- cat doo ap- Warc;o>.JSC f1Fs0ei3tien- R-arPliotls°-:nCn ft'or:7 fi1-e stetes. prDaCh of hl7h t2rL`:S.'~ The C.:l?f_'rirII^nt.5, cor•.'~illcted Sess.Qlls co?7tl;.uCth.'oU,,hTit'1rs- PaL-nerar.d G:h_'r S^2?t:CrS by Drs. Oscar h;cthach and E. day. urged f ' u u ti c v r e d €rawers to sun } N : Culcr 1Iamn:ond; rc,-.-;rtediy .-John D. Palmer of 1Cash:ng- port p•roduction q'.:ota and mar- ahowed fhat in5alatuon of cilffa• ton and N~ i!son, presidn_nt of To+ I:et deveion^ie: t programs in ---?cite s r D}:e over a period af 13 baceo Associates, a.p?o:notioa... two referendums to be held July • Inontlls grodLced 111aligcant tu- _ organization for f'ne-cured 1hFf, J~ r, SnD•3g-as,s of. ti~ash- ir,gton, cice Fresidcnt ofi the Rurley and Dark Leaf Ttliacc., Export Assrciaticn, s:arned that price su, lt ,rb andi other pr c-; gr,lrns for -obacco "continue to ,conte under increasinb fire v:ith- •in the halls of Ccngness." I:OIt\EGAY - Snod.rass adde<}: "1'.-hile it is not expected that propcsals to terminate these prorra:2, be enactc-d this year. Fressure willconti,lue to mour,t I:) elim- inatc the exfle: diture of govern- mcnt funds for tobacco:'

u ~( ! Q ,~ ~ (' ~ fl C,, ~ ! '~'tl /r ~ c~~~~1 ~_...~ ~ ~ fl L'SO I k~`"~,'~derce r~~' C ~i c e ~~ ~31'~1lri;~~~~~~~ a ~7(~J~~';~ , IjI Also, it is to be presurr•.ed that Dr. ' Such an effort to gain, maximum jj!Aucrbach and Dr. Hammond would publicity in the lay press for one inter- l have tal:cn care to submit in substan- pretation of a medical rescarcfi study tiation of their controversial ct tint w•ithout~ the study's prior publication in photographs which were the best ;,os- ' a reputable scientific journal-which siblc reproductions of the slidcs •chich prc'sumcs a review of its dcsig t and r•ra ~+ 1I1~°t! r~ ~r the)• have announced prove the de- ~~~~ ~1~j1.4C.itL:;ti; velopmcnt of lung cancer in the c.v- perirncntal dogs cxposed'~ to cigarette r f .k.-t 7 ,R' • _ .''' amokc. $ut:. a spokesman for the AMA CI3ICAGO, ILI_ -'I1te Journal ~ Journal said that while the Auerbaeh- tion i l' ic A ssoc a , r a of the American Tlcd idav became.the sccond qtcdical on F journal known to have -rejectr.r for,. puhlicati„n an American Cancer So- ciety3ponzored research study.•. hich the- ACS has bi~hly publicized as baving induced lung, cancer in beagle dogs with cigarette smoke. HbK-ever, the Journal extended to the two authors of the. paper, Dr. O;car Auerbach of the Veterans Ad- ministration Hospital in East Orange, t\. J., ana tJr. L E.n)•ter nar,uuuu of Inc T.6S statr, an opporwniry rV revise their work for resubmissmn to -. I the publication. - Although the AMA Journal would l - not divulge the reasons for its initial' releciion of the beagle study, one of the main objections to its publication ~ at this time, this newspaper lcarnod; was the .`,rlina of the AMA's scientific rev iex-en. that pictures of micro- i. photooraphic slides submitt_d as proof of the putative cancers claimed to have been eauscd,by cigarette smoke tt were actually not oonclusive of malio (. nancy. An AMA spokesman pointed out than the slides thcntselvcs, and that judgementon photor.raphs of the slides tahcn of the bcagiei lung tissuc rathcr ~ than the slides themselves, and thaa poor photbgraphic quality ma • have contributcd to what they felt v•::s the indctern,inabilit)• of the evidcnce. ~ However, Dr. Gerald D: Dorman, outro,r,F president of the ~iRIA, told this ncwspapcY that such plioto;;raphs "tvilt' ~onerally show wliat is there on ~ [tie. stidr:;' that~ asreproductiac~u they are Fer••taHy considorcd compi,te and faithful enottF;h to be ttse•d for cvalu- ~ ative purftoses. Hammond study was "not acceptable for..pub!ioation at this time," it mii~ht eventually be accepte& if the resr.:,rch- en were able to satisfy the rcaoire- ments submitted to them by the Jourr nal's scientific rcvicwcrs with hcst implemcrttation, the data produced and its interlr,et:uion by a pancl of the researchers' professional peers - is considcrcd a gross violation of profs sional ethics within the scientific com munity. Since shortly aftcr the initial Cancer Society press conferenco. the Tubaceo Institute has been urging the Society to submit the Auerbach-lfammord' re- seazch~ materirl for evaluation by a panel of indepeadent experts. The In- stitutc has offered to bear all costs of weekend's rejection notiee. We included al lar." volume of sug.-estions for rcvisir.g the manuscript to put iti inI acecptable formt"' the AMA official said. .I-o ._-ct-tts ., the *ze.. E....'_nd Journal of ivfcdicinc. one of the most prestipious medical journals in the world, also rejected the Auerbach- Hammond study for pablication, re- portedly because the study had been previously publicized by the research- ers and their sponsor, the Ameriea;t Cancer Society, in the Npular pt ess. In Fu;.i-uary•, the ACS convened a press cuuference in New, York and sent news rel_ases to all the mrdla to publicizc its interprotation of tbt work as a landmark aehievcment„ demon, .:, for the first time that lung stratinc cancer of the kind most; con„monly found in humans can be produ_cdiin animals with cigarctte smoke„ so:uc- tlting which innumcrable researchcrs, despite extensive efforts during, the -ast several years, have been uuable to da In the context of this intcrpr,l:rtion, the Society proclaimcd pt:blicl~ that these putativc findians "cffcctiVclj: re- fute oo:ttcntions by cittarettc m::nufac- turin, intcrests that tf:erc was no cica- rcnc-eaneer link" (s st:,tcmcnt vrl,ich itself w:s a misrcpresentation of the tobacco industry's po.:ition) and dr mauds '•a rcasscss:nont of the a!t.rtis. ing e1: inu and pulicics of tlrc eir .rettc . indusuy° such a review. - . • The ACS has continued to reject the suggestion, saying that the studj vrould be published~in an indepandent and reputable journal '-in the very near . future `tosattsiy peuuino x.io eo.. v y.. :: - •- --- .a~p

I . I I ~ I f ~. [_ ej, 's 0 rf~cG~~~'J or~. Cllulluuim' 1 We Thffl77 Scvcral days aftct Ihc cfosc o0 thc AT`f'.'v convention, the cditor of the ~!~~r (' ~„ 0~~~~ association's jnurnnl, Dr. Ilui:, 33irssey, J~`U mt'caltxi that the papcr an the dog s(ucf;, luthorcdf hy Dr Nammond, v C-,) D,~,1 s and his ccllc.+guc in the cxllcrimcnti lJC Dr, Jsc.r, Aucrbaeh, had been rejµctcd for publication. JJbu•crcr, iit tans c+u- ~~ phasizcdl that the tcorktcoutldi, be rc- considcrcd fur publication at an} time t t .i ~ r~ the auihirs c(,;sc to rceu;mit it ss'ith u.,h-nli•,I,nn of th^lr: claims. Dr. llantnton+l's notaNlk nor cau- A eice prrsidcnt of the rlmcrican liaats ci:+im in Ch,c~!co con(rastcd Canccr Socien' who, is one of the re- sharply with the l ulial rublicity rc- scarciiers who eontiuctcu its c.+niru,er- lCasedlon Ihe scnrk at aicrmvtled press sia( "smokiniz dbo" study hs greatly conference eallcd by the, American toned down carlicr etaims of the Cancer Society, last l'ebruara• 5 at the slud)'s findingi,,roducing to two from \1'altior[-Astoria tfotcl in New Yorl: 13 the number of bca;le dogs out of City, a Will of 86 cxroscd to cicarcttc At that time, the ACS announcc.(1 smo(?e which the ACS hae` said de- that of SG dogs forced, to i thalc eiga- vcloped iirn,~ eanccr. rcttc smol:c of vaiying eor,ccntratinns The rescarchcr and ACt> official; through sorgical inci.ions in their Dr. E. Cuyicr J3ammond, madd; the Iracheas„ 12 hud, derclopin, lungr more modcst~ claim at a press con- canc~r. That numbcr t•ras carried in ferencc arran!!cd for him by tlta all the press reports on thc announce- Cancer Soziet}• during the American mcnt; the New }"ork Timcs rchortin_ Afcdical' Association eonrcntiom in in the h`ad parar,;:,ph of its l+a,c 1 Cllic;;go last ntonth; whrrc Dr. llant- stor}': "Ttoclrc ofI S5 hcaphs:thnt v:crc mrn ti recounted to it convention mc:t- traincd 10<_ntokc ttovc•Lihcd 1ung ean- iitg v:hat he said v;crc Ilic findin^s of ccr, two scienlisls rcporlecl Yostctdav," his Iv:o and a,hal[-}car stu lp. Sincc the Pcbru;ny 5;rnnnmct-mcnl, S}tho tintc tic spoke t•r the Press Ihc Amcric;rn Cancer Si+L cw has rc- - a day luior to hisfernrd prescnta- pcatcdl}• rcf-cri to rnafic paGlic (Jrc llim to A\rA n;cmhcrs -Word h;,dl tJhla it says su;+p.*rl its cthims, And It•ro alrcacli^Ic ):ed)cd 12 c~,Zcrts as. ,ttotllill jitllrn;tlc lia%C Il'Jc'cliL the rc- cy,cri- signcd to retii:n•, the bcanl:: study for `carclrcn p,P.r d+,nril•in the pt,Ulic;aion in the lowtn:,l of the tncnt. Slup,cism as to;'rts taJi<,tty hns Anrcrican hfcJicai n~sot i,ttion h: d riscn aacordin~as, anrL' sevcr;wl iit• d thadi~?traPlic i cpcud+nt chs ncr:, iucludui the agrccd un:mirnously th:+t ; ,. stt6tuil(ctl in suppuut of 1't+ hCS rc- -iitt'c; which t olpta„cd: to ci~arrllc sc•troliers'crtclusions did not cornfitm adrerl+sin., tintc stq pr,it`.I Ili;: to- the dotrJe,,tnnnt of caucor, in amy of baect, in,lmtr}'s rcyuc;t t!,al Ihc Ltcis t Ilra ,36 dors. of t'r° Auirb;+c'h l f.,nn;iot~,' auu}' h, - , - dtsclnscd~. In a statcmcnt to the prc5s filmed by 1413fi.N1.TV of Chicago oIJunc 23 during the A>f:1 comcnti in, Dr. ffamotond said: "!n this c•a crimcn:,, thc hraey-smokiuy dogs of n>n-fi(ter- tipped cigarettes - two oU tj cm also dct clopcd rei} small invadce (iron- ciiial carcinonta (canccrL Just two of them. The filtcr-lipTec( smol.crs an& tlrc lichtcr smol;crs did not. Thc), also dcs•clopodl sonic bron- chtal ;dtcolar tuntors, 12 of w!iirlttccrc im:+snc. to tnesc we have mn :rp- plicd the Word 'cancu bccausc tlrcre?s a difference of oninrnn as to whcthcr this sort of trnnor should or should not, be calltd cancer. - '•Diffcrtnt patholbgists have dif- fcrcnt conceptions of it, and we're sintjily pub!itlrin^ what tt•c found. dc--nUing it tvithout applying that torm;' Dr. 1 lamntond said. Apparentl}- none of tIc press in' attcn•r:iacc rnalizcd iltc sie.ti'icancc of- Dr. tiamniond's ncw tcrctinoloe}• ar thouc(di it inyie+rtant to poinl out that, contr;u}• to thc doclor's statcmcnt Ih:tt "ac L:n•o not app1icd, the nrnH 'cancrr' " to the 1?' putati,c trtmors, the Amcrican Cancer So: icn• liad' in- dccd idcntified thcm as canccrs in thcir pnNlleih• cffo:t for the sludv. Ui1,:!7'IiiD STATE; TU1)7cC_Cf) 1C9UI.NA1- (cariiicd of~ Dr• iPa;nmoWl rc fr nmuf,tion of the AC~ eh +nr I cl acO \+ r..n it ciot+cd cc (ilm of Il:n' \\ IiL\1 C'\' nct~;c:nt, on th:: Cht +^o rrr~.cenfPrt•ncc, • . Dr. It,+n`mond also said in Cht •ro t,+:rt "iit out' opinioit, }o i c:nu ot pa~cc lri:rt t-.tnPCr is c+usccl, t t lu :n,rn I c+itqs by l+rudu: n, ctneor tn c,, s in 3•ty' catic, or ruicc, or any utl!cr :r.tiaral, andl this tcu not aur u lµ•sc in Ihcsu It

J / ~`~ "` / V rThe eti•ic)cr>te on thc rrlationship of ~ ^_ snroking to ltuman canccr,° Dr. liant- , s mond s.aid, -comcs from studi,•s of for the unpubltshcd swdy at the tc t ecn cnuscs hm cxnccr in bc•tglcs is as rn A1f,~ comenttott has drawn sonr, ~ ntan, rxrl frcxn shwlics in do^.' ennc(usise now as it was before the criticis . m, from momNcr s of the assocra, Hccausc cryrrristcnts tsr h huroans I capcrimcnt ~cas curir d out." (ion, this nc~cspapcr has Icarned; are nc.t fcasiid~ Dr. Hammond said, Dt \'ictor IIu.rlcr, a past president animal modcis could Irgitimatcly bc of the Amcrican Co1hPo o' Pathol- Had his app arancc laecn brou ht _ usc<I to arri»c at indications of the up bcforchand it tti•ould harc raiscd ous rclati4z strspr-tcd harmfulncss if s•ari- o'tat5' criticizecU the rescarch rcporb some controversy, since somc ntcm- ~ on r.umcrnus points. Dr. 13 thlcr as- her frlt it, tv,s imProp' ,.r for us to r,arcitci scrtcd it,tl} tli:,t' the study rannot be "i'cnortat;ti, I hl:c to sntol.c them; pro:idc a fentm for an rnpuhlis!ird l considcrec[ scicnti(1• c roo( f a lin l ~ .p . st.otf •' a hi~bll•=placed sotrcc uithin afDr_ Aucrbach," the Can, bct*v_cn c carctto smohing xnd, humnn, the AMA confidcd. ccr and- Snmcicty does nr that • ressi st ~l sa id li _ , . (~f caursc," hc cor.tim.ca, " i d in the to a: ssa s ntc m0 his l.rimar)' i thcse f ofa at as rcpnr1cc 1 :y thc ACS, as tnadc- a1rpc•vanccs - arc not ah:;-ers cleared dc~•elcqm~ent cicarettc th '°does qttatc and incoatplcic in scccral all the way ulr and Dr: Hammond's no more hW7n than possibEc." respcc(s. didt hacc the appro\a 1 a l of our c!ircctor, l - n c tt• T r t o l) ' fe t f S l : i L C h f ~_ . I eanccr and satd 1, rcgard,^ d hc ssork nh pro ss anguagc uc r ca.c ona tnaried a b•~ c)cparture from the Can- ccr C~cirt~-s dramaue Fcbruary that the "findings of Drs. Auerbach and I-Inmmond'. cffcctivaty rafutc con.entions by ci arctte ntanu- f ciUrin~ int~mts that thcre s~•as, no v cigarcttc - ean:er link ...,° itself a mi5rcproscntation of the tobacco in= dustry-s {rc+sition. The dccisiim by The AMA Journal = noi to publish the Aucrbach-Ham- mo-td rescarch, Dr. Ilussc: saidi was made on the basis of re~•i,\:•s of the prrenlyd uv*k by 12 indcpcndcnt ~ ., atvihoritiCs ~~-hoso profcssional opinions I /~hSA Jr~rrnal to look at the ~cotli was Qauch Srrattr than csuil '-bccausc of SPxc grcat amount of l ubliciy^ in, vaA•cd," Dr. 1'lusscy told the press. Poliowing the launchin- of the Arnrrir_n Cancer Ss+cict„s publicit}• ~rmparir for the unrublishcd sutdy l:at r a L= Lincofit Pr r~onItro~~~ cbrttacv •~rsc solicitcd by the ,11+1.~. These in- cl+rdcd an ccpcrt on ~•c.crinary mc~ii- eiac palh-o:oc,"~•, an cspert in,pulmonary. disea5c and scF•cral patholo~ists. The r-umbcr of reviewers assicrtcd by the ~ , i,ioiogr ptnfcssnr at /~mherst Col p.c;, V:rotc to th` \csv I'orL -Gimcs to criti- eizc the stn.11• as harin.^, hccn based nn ~ " ccicnt;fcally unsotrnd pnxcdurc•" The conclusinns prrs, ntcd for the capcrirncnt by the ACS, the biulnrist 4+•rotr, "can not he takcn scrinuslp." Dr. Hammond and th L' c ancrr S o- "All this experiment prorc ;" he as- cirh~'s atrcmpt to ain fu th g r c: puhEieit y scrlbd "is oaicthcr or not snloPin ~ t _ ,> m cc ar r o of, scicntitic acticitios (Dr. 11'i;liam Kcnluct:r, a mcmbcr of the U. S. );zrcJa~). • ••~r«c o~ . .c_. P. n;ita" "As it t:•ZS,,' he said, "thcrc u•as said. quite a stir v:hcn woed ort Out that. "As you I:now; a scicntist usu 11y in. the (:1Nf ,) Journal's rceicWcrs had .,,t..r, ; -- ~ei• „= iiuuion 1l~c (tbh Irtrot:'Icdge of his o;l,crimcnta sror3: byrtrcr c-Hammnnd) ptrpcr.° tl lt f hi ` -- - bli i l i :e resu s cxpcr ptt s t s o - a!; mcnt in a rcputahlc scicnuftc journaL The resnlts of the l3tcst Aucrb.ich cm,crimcnt have not bccn so pub- li;l:cd. fil}• first knotslcdgc of thcsc cs, crimcnts came from . front-pac articlc in our local ncwspcficr." Dr. 13uhlcr wcnt on to notc that, "Mcdical 'brcaktiuour,h+,' usually an- nounced in ncsrspapcn cca,lUh^s, often turn out to be ctis:tpi nintmcnl5 when subjcctcd to carrful scicnlifio scrtr• tinh.... Dr. Rnh!cr also cri;irizcd the rc- scarcli for cn,Plo, ing unsrn:nd nuthods whieh unu}d alt:,} call in.o scrious qucsticn .ny cou lu>iaa a?lcmrxd from thoTC-sn;tiii; data. I :•:«s in fact the firsr to norc that only two of thc reported Ivmors aPpc:ireeL to be of the t)'Pc asso. i:tlcd with lwunan Ivnc cancor and that u n thi, much w:sun cr4;tin, itc sais, t,,.usL of the rc~ca r, ~ts' u>c of a rnnfiuing lcrminol~g~' and 1Gcir failurc to pro~+ici: cnrro: acaivc lllioto- graphs. u"~•~~bt~,C~~ ~~r:~;~, 3u~,c.~ IC:, ! qtG ~• ~

[ L U..~, -T"© a On~F'ehrnary 5, officers of the American Cancer Society, deeply committed i;.o t'lie hypothesis that sn~cl'.i: o causes lung c-uiccr, calPHO press conference in \ ew 1 or1: City at which,,in effect, they shouted, "rairel-a!" At la--,t, *hey said, two nc searchers worlYing-under an ACS grant ('one an ACS vice presidenty had succeeded in producing lunmcancer. of the human variety in laboratory ailimals (beagle clob 3)' thr.ough cigm•eae smoke inhalatiun. That, necdless to say; was very big-news and was tI'eated as such by the press, incluciinz; the \Tew York Times, , . ,. ----~ =- -~_.... ,... •_..k_ , . r Of primar.y significance in the question of cigarette smoking's relationship to lung cancer - a question that hasunderstand.,bly eng;rged the inicrest of the tobacco in- dtlstr5; the »>edical profession and the general public since it was rai: cd 30 yean, a;m - has been the continuous in- ahiliVof iinluni:, rable researchers Nrorhin, steadily during~ this period to, 'produce lung cancer in laboratory animals through the forced inlialation of ci;;arette sn:ol:e. 5 0" ~ Q a ncn1111C Ul LIIL UWI.. U 1L \laa 1UlUlne) - LaeC at the time of all the fanfare that tiie scientific proof was readily a~~ailable: - J~o` one docs not announce tl•r, discove.r~• of gold - which was the ACS' approach in the matter -~~•ithout I~,:_ , . r 1 ~ „,.,~.. 1,.. ... .. .- - -- 1n•ess for ON hitml)reUation of t14c regarch MiDo;lt fiu•,a having srn'Snlittc(l the work for revicv,' by a p;mel of their pi ofc ; :;tn 11 F.ee>>s. 1): T,iy re"ci icm two ircTl s ago by the Jt;wur<d of the A.., .. ,. _l3rulin:ll_-~t .r^1FlfiI1D -(1f_ll ~ ~(~. _foll.olW1).`.r - Neenly six months have gone by, the proof has not been fonthcom,inn and daily it becomes more difficult to resist the suspicion that the, e is more than a hit of uneesninty here, a susoiciolr encouraged by more than just the time lapse. Eiicoui,a;cel, specifin,L'h•, by: A. The publiclh< expressed opinion of ind'epenclent and reeogiaieed authorities in the fields ofmedic•:a1 pathology and biolegy that the ACS-sponsoreci stucly; as repWed to date, does' not prove~vhat the ACS says it proves (that smoking causes lung czncer), that in point of fact it provcs nothing at all, except pe.rhaps the tendentiousness of the ACS wldert ;king. B. The persistent refusal of the Cancer Society to acecd: foa tobacco industryreqIi st tiltat the d61ta an;lmetha,,lokay of ihsbc .gle exl,erinu nt, UemaGleIpuhlic- f or - ex<:mir.ation byi»depen:3ent experts. C:'The reycUionini,Ian- Ly tlieprestit;ious New ]?ng- )hnd Jknarlnal of .llediriile of a papet?on the licagle e.Nl?tTi- ment subinitted for publicati'o1r 1,~- the-AE.;S researchers, ^;on, of their failn;•e to eo:1form: with for the understood p~ ofcs:ia~r l! st..n~la~ u_~ in rcel int; tUblicitn•in tiPoepopul:n• TU l_u t g7 o

an unanimous decisicn of the Journal's 12 scientific re0ewers that photographs sub- mittecl to stlb,taaltiate the clailn of cancer development Wthe beagiw.s in fact were not conclusive of ma.li;nancy. " E. The most recent statement by one of the researchers, Dv. & Cuyler H'ammond; a vice president of ' he American Cancer Society, that, contral y to the Soc:ety's ol•ip iral claim that lung cancer had been pro- duced in 12 of SG "snlohing" dogs, cancer coul(li be proved to have developecl in "just twro" of those dogs„ a concession Dr. Ham- mond apparently made after learning that the AMA reviewers had concluded, on the pvidPnre nne,ented; that cancer had been .l •.- ltl7~'!1\?L~ of tl,y n ..=y.,. nrrc 1Jf~VM1I'll 1~ V.lu v.- u . The editor of the Ab'IA. Journal has talcen pains to point out that his publica- tion's rejection of the ACS study is in a sense tentative sialce the possihilitv remains, despite the inadequacy of the, evidence sub- mitted, that the authors did in fact prove what their sponsors say they' nroved; an& that the AMA. Journal remains wiSling to p-abli-sh thcir putat ve findings at any time the researchers are able to sat.isl- its re- bewers as to tlicir validity. . There are, of course, delicate 1•elatic,n- shins involved here and the WA; much to its credit, has e:+el•cised its judgsnent Wn- pai•tiolly unc't honesty while oxphessint;. it, unclet•stanclably, with a great deal of dis- cretion, which in this use a.hpeai•s to hasc been a spcci0cfAl•'.t . to avoid the apllear- ance of fii;<rlity in it'ol•cjeation of the haagle paper so as to'sparc the influcatial hmeri- can Canecl• Sociay and i.t's- researcliers embr.l•rassment mid to discoul'ar;c the to- baaca irldklstl•Ys opport:ani;:ing on that Teject4o11. It is rcasonablt to assun:ethat. the A?tiI'A. Journal wolllilMlin,~;l~,~ 1•econsiclen~fol• l~unb+ lication any l csea~~ch of such m;(jol sigAfi- cance on the "_' 1l_!ance of the anMors th(1f. Irorc collvincinr• evicliince coulct be pre- senter. On the other hand, that the evalua- t'ion of the cvidence submittcd! in tHs case should be consiclel•edkparticulal•ly teataUive i.s-mot so sclf-evidcnt. The 12' revWel•s e::- ^minecll the photographs of slides talYcn of the beagles' lllng tassue and agreed unani= mollsly that conclusive evidence of cancer was lacltinS•. Such photogralths,, it. must be understood, are routinclh, accepted W medi- cal reseat~~chias capable, Nrhen prepared con- 1'ectl;.•, of acl'e7tla~e]y repl•ocblleing criginal slicie material. And, there is no reason to believe that these reseal•chers, see:•c'.rrp in- uependent validation of a suspect claim, Wct subinit less than the most persuasive evidence available. At t.hislloint in, a less important dhbate, one wculd simply say to the c.lEiiiu-n;alcet•s, At up or shut up:" But that l~:incl of talk ~ ~ f11o lc_~11P 1'P- is 7 1' - t`^c::".:,_ . tF,1liivtv~~a~c.~c ~ w.: .... jectsa partlan ahproach, and the men woi•hinc!• toward its sct.tlementJ, inel11(lihf, those ioi, the ACS, are to be presumed sin- cere, honest and compet.ent„ thoirgh not in- fallibic, that kind of mutual respect being essent ia1 to a cooheraUke search for the answers we are all hoping for, thol?gh not, we hop ; to the 1;:)int of contriving• them. F egl•ettahy, those hrofQssional9~r engage,l! in suphort of As smohine,-cau;es-cancer hypothesis have not been a1tle questiionin ;'~ the integrity of scicntists who cha]lent;e their position. And now the ACS,, by its mys+.'iQint; beag]-itr-tl'ac-hatn trick (Nowynu sec 1?, count 'em; foL<s, 12 be.agles .:ncl now - Presto - now you see only two. IN sonny, you can't esanline the hat.); and its genera l slei'ght- of - hl•css-release pci•for- rnr n..e, im; ites, unfortuuntc, questio;ams to its im-n >>eliability as a voice in this vitat cdiscussiom It isas much to prevent this 1:incl of \'Q Ti'Lat.i(1!7 of the (IISC11s-,loll as to ShM lnaxirclutll li,^l,t on th;~ sub,j~-et th,it. the Aanericau Cancc:• Sbciety mu:,tsU(1p' coyan(1 icvcai in (1ctailto all illinc~~trd hrrlic::i Mat it has actltally foln:cl out, autci 100. it llusn't found out, uhout ~o :;criotls a 1necLc ~l q11est.ioil. _~~.._.........~.__....,...~..r...y.~...~.~....,..-_,.-........_...,..__.. _.._....~.,..:...~...~...... .

AkE'ICAH /.tEDICAI NFWS6 JULY20, 1970 L THE PAPERS, written by Oscar Aver- Ysis.° '_ manuscripts were not rejected," Dr. not mean "automatic acceotance."stnrP iwssey oeciarea- "•c i inrerpreta;;on of revision and ours may differ in the final anal- t~_ym. n~ ~n<nrp n ~ srm ty een rP+urn^c~ Iw~c ~r revisin5 sug- r geste'y~ more t.un a o'ozen consuitants me rrliowinpl, he sa;dl, who reviewed the papers for JAMA. Dr. Hussey noted that revision oflthe "I'd like to make it clear that the manuscripts by the authors still would Dr. HUssey said thr, mam; r zh;~ them for reoonsideration, ar subit 7- Association, according to editor Hugh The authors have the option of revis- -H. Hussey, MD. . ing the manuscripts and resubmitting byThe Jou:nal of'the American A4edicaf inendations for revision." 1, with lung c mcer have not been rejectcd authors al' of the opinions and reeom- Two ref+orts on experiments with be acceptt ble without revision;' the ed- dogs suppoaedly linking cig:.ret smoki2g itor repor,ed. "Therefore, we sent the f_ R ~ • j..` ~ c, • r s~11~~~~~ ~o nov ~-e~~~6-e~, r • t' t• • - F~ ~poL r"'~ •ia 6`~w ~. bach, MD; senior medical investigator for Veterans Administration Hospital! East Orangc; N.J., and E. Cuyler Ham- mond; ScD, a vice president of the American Cancer,Society, were received unsolicited in March, according to Dr. Hussey. "As is the case with most unsolicited _. manuscripts, these Were seat out to consultants fbr review," the JAAfA ed- itor explained! Because ofthe "enormous amount of publicity' the manuscripts reccive&at a news conference sponsore&by the Can- cer Society earlier this year, a larger number of consuttants than usual was asked to review them, Dr, Hussey said. The consultants included a veterinary medical patholbgist. '15RHEN1d L TIfE opinions of'the con- sultants ha& been recoii•ed; it becarne evident That rhe manuscripts would not "ONCE AGAIN;' the editor emph'a- sized„"I'd like to maN.e it clear that the manuscripts were not rejectedl" Dr. Hussey said Jl,1-fA rules do not permit~ disclosure-other than to the authors-of the comment; received from the cwisultants. The dog,smolcing experiments have been the centen ofi controversy since earljn,MJsy, •.vhcn th'eTobacco Ihstitutc announced it was mounting a major at- tack ag:.inst the validity of tl.;e research- ers' findings. . Dr. Hussey said there was no pres- sure on the medical journal from the tobacco industry. Dr. Auer!rach and Dr. Hammond re- ported oni lheiP, experiments in a joint paper presented at a Syrnposibm on Disea,es of ih° Chest durin',;t•ne Scien- tifia Assernult at lhc,• Ah1A's Annuall Convontion in :.hicago in June: .

T1~L r3L~•r Lr1c~L~r:U "ui:I~riL U1 ri1.i)I clr;t~ ~-L~-/u NOLTAIl:; r1IN Tttt: ;tds•ertisin_ section of the Junc 11, 1970, is-. sue of t11c Jourr:el c•ont.2ins two ;~:} rs purchnscd by t12e Antcrican Tobc2cc•o Iustitnte. The advcrtiscmcnt, whic•h had previously appeared i-.- the la), press, cltall!cn;;cd the conclhtsions of ss•itlely pul)licized .rese:irch on the ch;2rr,,cs prodttcc d in canittc re- spitatory pass.tgcs by hrolon,cd e.v)ostre to snlol;e. As is cx•idertt in this wcc;."s Corrc:spo)}dcncc col- u~22n, dccisi:),t to 1)2lulish this aclvcttisctncnt in the Jourttul has itnt)tcsscil some rcaccrs as • irnpropcr : and even venal. The Jotrr,taI's pos:tion conccrnin, sn2()'.:ing and its harmfcl cffccts sltrntld he ahuncluntly clear. Lditori- i.ls i;2 the issues of Angttst 1, 19uO',' and of July 24, , ~.196cJ' 1 ~ th fo~rtnl's con\iclion` s t tnc } c,111c- s . , re pcc that sn2ol:i2r, is a forul of SeIF clcstntction, that the =•~ cpidatnioloric cv.clcnce- sttp})ortit ~• that >•ic\v -s most perstta.i~~e; that atictnlots to ut2clcrnlt:2c this es•rdence are sttst)cO, and t17:2t ar-pnments that ezon- et,tte sn2okin~ are si)ccinns_ The hc}rd position taken object. There is no doubt 2hottt it: the Jourral was { and is co:)virrcccl that hcavy snol:in,, c•attscs f:2tat lum; disc:rse: . 'The Journ«',,ho\re\'cr, has other co,)victions jltst - as. if not evcn tnore, fhta2clan~cnt~l and imt)o:tant. It - , , ~ , , •, r .a. }. .1.• " at)tcuts i. ..}~, r.~r_......~... C . .11 . -..! . ,1, n l :ll: (• } 1.( C.i.u.u at1C :2 1):2rt1:'n.:1':\~....-....\.ln.c~, ..~. --+a.,.-~.............+.. '~ 15 t1SC sly");1~es:}~of C't')ll}!(7}ls t,`CCaU~c v ll~~n:11~7L\' ..,...~~•.~ ..~,,,a t17C\;?1^ 1!1 ~r1~1r C C'(l;}1r.i1\• to c}ic s U\t-n. _ _ ...,..~ The lourrlal has not : ccct;ictll ac!VcrttSer}aents for 3 cig:2rc•ttcs since 19.54, for such :2•:1VCItlsclncn!s t)ro- i's)iofe a product and a habit t,'l:lt the Journr.l 1)clio\•cs • to be injurious to Itcaltll. '1 Lc ad+'ertiscn2ent (:,f the t ~l An-,crican Tobacco Listitutc t.t:;: the Jotrrrial di p2tl»I'isly does not sell a proch}ct; it ext)resses :,n opinion s12a1Z)l}• at vari:2ncc witl •t12e Jourr,a!'s 1'c- liefs c'on. croin, t!l.c cletrilncntill ,(fccts of s1:2o1 in;~. To mft:s'c it sr; rc for tl}: t \\-r}uld seonl to he a-Icer.~,.n,. ri;l 0, lilL. ~.larn(rf's chcr- r I If li'~~ ,.:\ isl,:clltr:2clttlun c}: cltt.l, c.c1 0 ,.C ! a>e IS t .~.~..~•~..~-- -- ---- - ,~._~.~..r-.......~ 1. Ft::u~z1: 5m%,);in_, Cu c'cslruaion of s:tf. New Lr,- J\Icd 219: 2. t{~ao i~l: 'll+c peo; !c. Ihein c~:~Ith, a~J t!cir Ce::_.tcss. 1~oa- [n~z J 1cr-.t ~11:.1:t_~n4.

y... ; ~ ( IT L 1,ul 25, 1970 O b I ~+.~_! _~ ....~~ 1.t: \'ol. 8 No. l'fi ten Tl'ion oellar grant the tobacco industry had made to the Amerrcan P,redicallAssociaUonito investigate whethar publication by the Journal of llic.imejicarr;i;cdical ffssoria;iou. Uniquely, that fact was first announced by the. Prs+•ntzfthe Tobacco Institute, Inc., Horace R. KorneJey, to a group of tobacco warehousemen on July 7; if lrtus3uV his announcement, Kornegay statedthat "This so-called scientific work is simplyunacceptablis to the -;. -scientific community." ;- By July 8 it began to seem that Kor~neoay might have been injudicious. Medical writers began asking one aiiv hur Y,ilen ,hepresroerriof tiieTob-acco ins*.itute had become a sporesman,for tnescfentnlc communltyand h~~ iiow he happenedlto have this information that had in no way been rc!eascd to the press. A press conference was a,uicklycalled by Dr. Hugh Hl Hussey, editor of theAd7A Journa!, •.vho elaimed th.;t he did not know wiere the. Tobacco institute had gotten its information and that he had not rejected the manuscript in question, but simply returned itwith swggestions for revision. Prepared by Dr. Oscar Auerbach, senior medica!linvesrigator at the Veteran's Administration Ho -pita! in East Orange, New Jersey, and profeasor of pathology ati New York Medical College, and by Dr. E. Cuyl r Hammond, vice president ofThe Ame.•r,can Cancer Society, the study had been presented origma!!+; tothe Ch„st Physician section of the AMA Convention in June. It describedlhow beEgles had been taught to smo!ie cigarettes through ~%- t„ho ;nc..rted in the throat, and as a result had experiencednunerous changes inithe lungs includiny cancer, ernphysema onu iirici.errirry u ii:ear ie, re~. Althpoeh i; was denied th, the AJ1i1 Jnrn,aI nrd^ rti_^., _D2 z ~i ~on rn t7 ~~, urn ! v ~e v ~n <!im n d h=~ +„ld the n ets that~h nlcrn~~dtc fettttiat his chtin c cs ~t c ic lS (Cp7rt toar C herI'V rn~ll ~~~~ , n^ ~ - , f~onc of the press vzere impo ite cno io attempt to link the r..j..,,t cn to a recent A research stUdy showino that dogs taught to smoke had deve!oped lung cancer as a result has been refused `.Boi;ert Rodale EdNSr J. I. Rodale Publisher Hera!d J. Taub Managing Editor Contributors: Don Bingharn, Joan Jennings, Jane Kinderlehrier, Sigmund S. Miller, Ray 11'olfl LUNG CANCER MAKES STRANGE BEDFELLOI1JS there is actuallrf a relationship betweemcigarette smoking and lung cancer. i1- , CHILD,°,E[i! ARE SUCCUI0311ldG TO FOU AIR 1 - Children are contracting more asthma and eczemaiin areas of high air pollution,according to astudy of 15 years of hosplte3l recore5 madle in CrIG l,oFlrtty,NewYorK. The younger tllachtld the ufeater thdl iar:itWo3 s+ow~n in the investig3tion conducted by a team ofresearchers from the State University ofi \ew York at Buftalo and other institutions. Their tabulated results brought out that "The incidence rate fer hospitalized cases under 5 years of age is more than 3 tirnes higher than the rate for children,5 to 16 years of age." fiesu!ts of the Erie County study were released by researchers Harry A. Sultz and Joseph G. Feldman and their associates iniJUne. Hbspital records ofchi!dren under 15 years of<ge from 1946 through 19611 revealed'th3t the avaraga annual incidence rate of childhood asthma jurnped from 32.4 to 50.7 per 100';003 populz.tion at risk bet\vearrthe lov.est and highest air pollution arras. Statis:ics on boys under Giehowel~?n increase from 69:2 to 117.5 in rates per ' also found that boysere more sus- 100,000'pnpulction at risk in lowest air po!iution areas. Previou.s <tudic•s had L ceptible to asthma. During,the period spanred by the study, which is one of the fihst to investictatc the long-term effects of air poflution expo9ure on the heallh of children„617 Ei ie County chilJrcn hadibeenl?ospitalized for: asthma, and 165 had been reated for e_zema: The long te m(.ff:ct ofair pJ!IL ion on children upports th^ contention of some d(](aor ':h~,t most, allergies h3ve D3L`Jr(1L eSti.b:l1 hcl! by the /Ih year of Ilf Since both diFe<.~i:.sare knovan to be allergrc p!1enomena, thc child rnay de,~e;op asthma as well as eczerna front air poliution. In fact, say tl c investigators; "r+bout 5J p^r ccnt of tl rnfint cczemeic s s have some fur m of rt,,^.ira o y allE.;cy in 1r ;rte." 1 hcir rcportsupFut L. th.. gro:ving conviction that c,vronrrI"nt polllnio;t is a nrajor contricutor to chronic disease.

E7750 CONGRESSIONAL RECOhD-Ex•:ensions of Remar]:s 8-14-7'U n,2 _R ,x!,.T CxTflTfznfs ut- ,rournwnrrr:e.tmerican The nrtleles drscrlbethe resttlL•of a?.r'.- . e u,c e \\'hetr I~n*:ecdrd the macttr,gof the!Vrtcr- tlo:ts: The An:cr-,can pwple stf nd to ]r,;e pn>sur r. a- .,t., .at v.--_. . f:.an b•cdlcsl A s..^cistion 1nvCL•Scagoo:r Jrme much more than t1:e tiCnt to~ s:ud:e ca- isrtrzrs eoNsm.rtn -~ 71, 11e~rr.c7 :^a: the Prrsfiieatof the A"4„ aretteslf tcicnttfir.~ Jr,tlgments are~~.madc on~ The dl•cVsion not to pu5ash t'ae artlclcs, Or. Gere:d~~Dor:~n, had tctcrmlhrd frunl a, such n cap:iclous Lacls. Dr. llussc'ysaldl F^stucdo on the b+sfs of rc- eo»er a fo:rvi with theEditcr ofthe Jo¢r~trcC' I rcould be mo.;t pltc.sed to hlce yotU detc; by about 12 !r^,:ncndeu. r.•tt*.orlues. of 11e_i~, .e~^:c,.:. ~fcr;u•at A^sociafion thzt'the cor.tn:ent.s on the observations I have n:eSe Theso includedr.u c. :vontete-rcary 1Lrd,-,,endent rcetr:crs had unaaltnously rcc- In this letter. f 1 folne pnViulogy-, in c;:, crt In pu:m~-ne.ry d.i- omr etlcd rej2 -ori of thenrtlcle I u ' -llere Sincerely yoUrs, aCpG` rnd s~~ e 1 P tto t s a T ic nu:•ber int llr Dcrtran Fnu!t] co•t ::u that lntor- 9Yrr Lis~. Q+szvr: or I r, ] c c 1 t ns ~r. ~ tc r p. ~ ter~. thnn Sna fo7 If you t.Erc.o ~Inau t' Is u va. for n 1 e 1 tt it.C..~.~ pti' ;ca- Amor.,, the t tr.,ms tnat 1,&rtlcul.lv d15- From the WXIl Street JOUblal, J141y H. I97O] tinn Inthc ,. n._ eau.eeo: the nreat turb cte„rs s pi.;ifrtan, r:LOutyour lcltcr tn AMA Jouezren Ixctnrs To \':'Irnr:oto itrrocrs amovnt of publl tS =`+rn:i~cJ;' theAkne::cnn Cr-rscr ~cietplsyour lnst<k- o;r D~SCs esn. 8;.corac-Co::L.otrrsrs The c.lrcttu:rnt.[.tic<,dy he: t:on~tt:eap- eace tnnt nofmn•>trertew is r.cere:.-p to rh~srs Csusn C r+cra.; rurr. proer,l of t1:ea Stu~.<o• on C u r..l ~l rc- esn I'hlTes;tic:r:voftost•tdylut~ tr'e: ;!.tat.-rheS»sArrcrtJP:rr:+P.e•IStox . . crttir dd)t ncr art c vtr- (n) 1 c trccr.::;,oi~or.f i•t: (b) the.cp tt^- 6nre~co. ::e. J ur r1 of t]',r A r.trIuin r'tte'.: of t-tc C~P rl-n.:tt'tu e..tal„i...t tloa cr tnef ec tl_akcrsc .t.(c) tt. f-cl. ttlat~.t a•CiCnti'1511 C7'C n Y-nt5 C41 C.1 :d' TlC•Jt~?l ( 'J 1.l en r S 4 f(: -d I O C7. pU ' -~ t"rl d1t,' the rnp,,.tuu.cc~tu~tctlc tLC d:,tn r fr,~- ll•L ttto cU } rn cu . c I t. . rLS o t r. ,. x9 c~svr^,c.o•t~C,r r at sr C In r lct~.u to Dr'. perrllti: f.:-rtC:I t:.:lt1t ._. teil'l.i(•t. coZtr,rcrs l.t._I,c: n. 'tx:l~.ft d c tl.:., 1:: }.thcb.clt tli t e ctc ~. c~ e 1-~uels A tn •ne pn-u, vmnt 1 you l~+c au'?osc•,l id link or>Jt6ts:nol,in~ lsl.h lung tvh t ur ?.nn ~. .. 1•m ~ c •cr r-ircti La.: r:n,t Cad ndc,cc: AtL.ctrmc ynu c,racn.~ccr: )~ d1S otcr d lu 1 e I u f.T o uP + C pc S. 1 LC c; ~-t4 sr li ' 1 - ^la t She nt l-r of. reclerrers e_s'gned~ 10 t4e to~makcp.:bliopoi!Cy mthe 1actof the p:o- ' t ° ' Aucrir.rh-S.;ruzond~dstaw^asmuchlreaxt Ilferatton beslth controt~c:r.es r,9il:h aro sureonthem r„rl e_eitier maL~et 43ccoLnn usamltti~esse of tbe'controrersnr.lue- eunfronttnqthe American lrop!C: \\'rmust l¢dvstr er tho4s .c?^~ ed-c..11s.x1st:on iure ofthe .rner_= nt. bnse oliJpctdre scicntists to Cufde cue es- not to pub:dso the rrnoas. Tner.. t'.a 5 no ~ d ~h • •- "t -~ ' • m- v.Sw~ele:tK 1 fo.~srazd taco:t•YOU '" - uCCPCfd,dlDr 1[u ,cys_d t1c jo}.rn 1 cilU ~svb ro;rhace e.e.n ihe rnc:osed nrt,icle casu scrlo s dout,t t.qvn the thtcrricy and recons7der t!tea tldes Lec e_ercscb- Stn.•n thr F.•aa. Strre: Jolrrtcr of JWy fi:T;'e authoatbo.. f.t•o:ctztion 1s_uf-tg, trans the PubIiC:II-n!th Se:rdceln re~sr:: to the ¢c~lth ndtted,with tl,e re °isto_s, Of. hesuld, t5o sa:cle:eTruths:theJour.:olof2heAn:cri- eonseque,ncesofsmca~ir.g, and'~thnt mycol. authoa maad:ctdt tosubmit titen: toan- eaa 1ed'ccl-ASSCC:arron bas dectred notto otherpublrcation. b.i the At~e=bxh-P>_-r,raond Pnr.s on leaeces and the American pcop]eshoulEibe w 4'hew'httioresca chersso dthep hsren't de- 15e bs~>s •+" reaz-s n tw-eelnde•xtdcnt /~adcis^di I, I ettted tch co,u cthcy will L ~e: au:?,orit_ ~_ T'.e ertic'.e -,M.ntcd ou that TheCc°~ressls lnereastngly catled upon D r6 Ii .ssey reJqte i L:, 6U cs! ba of p-es- , r *ernt to ho?strs the.r po~f_ion r«.1. or:st n r If . rt_eofpour~_;tt. u=ot ~ d et.r.;t _d•• nu sc. r. c , . I ]ottrnai, is z clear rrfection c{ tcea>•.-F l.i~ v.e e as str as un~v th,,u_nt:haqco hi M }s I o d!ro t a sr let r of sr 1 ¢rt us may not c. ree v th t e~ but ft's el psa of and bfased trs nen iu r.htorcti,tl-e In tJnt on rues 1 ns ¢^o.rt ~e ra dityo, this stuur the p and ta c which(•o s ir W t.oscreptsfs c e vuea I ~ad b:zn r^-std by sC,..n~ri Lzd\,lic.t thca.t.c.hs11! nppcs: tn p.tct 3s ahobeitcrc tha•cour actfoa in th 'ctna'te - 1 . r as ne . • seaachers: In ir.-t, their e:ciion caused the •y.es 1xtor for t1 eVeterans Adininisttat,on, Zll_ Jissel.. authoritetRe7CC•c•I.r•qlac;d Joru.«i of licdi- - S8e S:ugeon Gcnoal, LLS. Pubite Hedth tine to re]c-t the res :.rch cre outr„ht 1 llos italiEast Orange. N.J. Sr+rcc, Dnrtsae•rt of IleaitA Educa-. p"p" In tcdephouelhtcr.ic-rspesterc.a•, both , think you mlht hatecous.de td theSe leets 'Dr Ifn.^.t:nond and Dr. Auerbvcnd. hntd'to [on, and Te:rcre, tt'ashrny:o*rDC . In ess~sfn.thc'reputatton;' olti:e or a- TixEJrSSr,IbavereeeitedcourJu.Y70tti1 nt-ationadpen:,lo1 rolced. g~cri c1 ethe meuic,l Jour al for re.urnt~g zep V t0 my'9Ct.Cr LO y-oU of ..-j19 can.erU•' '~InV1CW oft'.Se~ J ; nt tc t hac pro- ihe thetr nrt"ies. l~e s nt the a_Le:rs I ^ tCcm>tg A_t:`xcch-Iia^tmen ' s_:o (, co. 1¢ good faithrnd aebc~Ileve the I aencaa -_na;r; As y~n c_n Iss,~!-5ae, I at .In pot shoctl.elar:d nou::ced~ the 1r^.ctrt r ot you. o ert .,u es pledresl Assoc1 rion a:-o acts 1irg;'roc :anh,» sa~In'sd to 2u a th t te: you tom 6e etery eort to d etn ,..ie rahats_IdDr:Auerbtch Pt' cr1L•a-tns the Journal the hcftce: Dr•Hu.:~cy nor t5etwroies archers Y Junc 12tot1'e As:iericon Cs^cer Ifcdreal A,soc.ctianrr'iew'ers mr'e Cl the wotdd disclasr• details of the t, es<zd nn ~ve an r-nr,t.a:lf:eel rndo-en:'c .L tothes:tud and to nntend the cor.?ntentsw'h1chS» p oh^.r.ges: But D:. Hemn,ond snld soro or ti e ~1lditpof thestudr,bssedot.r.ae't11 tuorvyou mnUc to the Amer!can Czuc.^r S~~ctet s l:on hea_ -}' e•,or4 o the L nnt bn S oD ectionscen e ed on pho a .ls n cc' ~ r,e t r- rr~aoout nSIn your Ic tcr of June 12 mrdto c~-rcet panrrn.^. the x'•Thcre r erc coct y-rd fec tns a-rs e.a r:rs to h - theerroncn ts 1r^~r :sian Tourle:tcr has leftthat the pitturrs w~tze out of wus Ii•'ut ~ d y e~.+h i z s sc-: atc :°en an 1rre -jwnstb:e z.ot on e-~ur pzrt ar• m.t Irec?- ~th~the Arnori •rr_ pub!ic: thnts to he ext e-.ted slacc the s:lt. s o.i -- As you pe n[ ubut7n yourlct er rottr De- lc aerc 1. tt but had to L ori -ed r- g G':th tne s~e341he oS e.: r.Ch 1 paY.atea 1 qs t s uto-y rc uc 1 f Of in b k nnd wHtc bcr_'u~e thc v:cc ~,u1d your hs!L cce Astnu ( 1 ~±s3 h a t T z aut o ed, the n w b a eau repo-tl tbth COn re p ce. ca vcn the cot dera Co:o f I urJS too e:pFas re ' Inc .+ e-,nr ,o;,lew ~ o p1g state of satcnY cre ch c uce n~ et ss d. .+ n n1, r t rta vour ut-te.tra:scsur_'a r.us -~ --eyez eA snnv lr t to the p:essyn B x nc- _ 1 ~ e C e ted,D All -bh c ' - ^1'ne T^LVewe s ZltSofi a snrnlc]r_s do^Kttdp in an S-. i' tonsWerallovas the :"e!ninent -,ronsorshlp" thcuu to4¢naie tob:cco smo•:e. -t~ tb 511JG' the relatlonship behf22n ` ofthcstudy and the"reput uomt ' It thei. ssrtcno:r is at~]rn Investlgn orsarelrotproper cri crfa for]udo- Iyt Hu;~h If. Hu__a edt or of the redlcal i70r_lll„31:d he31[h_ Ing vNi hLg TI e ure Ican Cano.r 5ocir~tg, as tra:ion, denled~ln an Lrterrlh- t.~et tire TJlc :cicnt.; c to'tCthodS used in this you pro_abil Y..:o:. has s; onao cd antinnok- nrtlcl^s had been [clccted'' for pu eaticn. C]:dy h,'_t'C b en Gt:CS[ ouled The Anteri- Ing comn:c~cfals.fcntt rlngan a,tc stnr who ly-ncy'arenot ar. c{ :atile for pub'Int:on In in Medical: AsSOtihtunn and theIlett•rrasrecentl; eomicecd o:flle t pascsslon thelf present form ' 1:es:+ld. The srdcles S•1 Sund' burna7of Ated ci: 2 rCjecled'~ afmarl]unna. hate bceurcturne,l tothcir autbors,'ae said. Ttoreoter, the Into InrestIgators lnst Febru- ' ~ rC~c31'Ch p:Ylx'f5 Olr1'_.hL. ar telens-ed the:r findin,^,~ to tite fo: "cstcnstverrrlsfnn ^I encle'~e Cong of s 1CttCr to Dr:Je55ey" P<'Pmrr r The two sdrntistc :che arrded cutthees- pro-sti¢forc pr s•.nttn .. them tb thc: .,c1- StCillfCld fa[ cw[~ pC['iLS31S prrimentn:e Dt I. Cuy~ICr, lltm-r : d trce entiGC cv lei ue :a pr -r•dure ubiclr eeo•t-rr c2t of the A t er:can C nc "~r ~c•I ty„ Hasss orRS?gis[szern•isj9.70 : sldcrcdD7 hly fmproper atnol cfcr.dfiero-h nnd Dr. Oscar Purrbach.enlor tned'ealiin- " •cn DCAngnbt 11 „ . Os'sc=Ts,'nCttT - -I toun.oftbelnr.tU mtIDrYe, :lsemployod redalmrdthat4hccxpc:introtvnee:,u:fJcant by theVt rranaAPtlnistrr,tlrn a Ich vresa in at len.stt•~,o rc'r -iIt m.luced li~. e: nr , F71778 7IOUSE OF RITRES£]TATIYE.S eo-spottsor ef the Xt c t•ac11.71 neond _•t •:y, ' e^r as a resuV ocl -arct. ho -1ngIn •t 7n1f- FrieTay, e4uSUSt 74, 1970 In vretv Cf thz.o fncts I thf ul, y ou wlll n• ee thnt' your rellaneeon Dr. Ycsnar WAS proll- Jantelp largce<1 crimcnlnl anlmnl], end It "7.ir• CAR,TF.F- Mr. Spenl:er,recently, ablyln-edrl5cd;. __ rn~lcrx~ ute nrs tlmc that cancer h,dbeen J~_ AuerUnCh sadHfnnlnond Yeported-• I th1:U: You ml(•htalso ncrca that tuch Inducedfn la,ioato:y anlmal5 bycausing ,,,~~,yu,ui ,,.. ~~~_-,_.._..~ ~ ............... .Jcr:rcal /' -cs•1, D FCin t r'r u. pub- year :mrrim94 P vrecd t<. le ~t liclycontra I-etcd:Dr. S e:;:cr'S 1! te 1. e atlon that w.rsenrrfed~ a.lt by twoe n.n. t e..,.n- HO: of ttir.t drtr,. 1ou mtsntelso tr.,ct.:..cnsc+ tls•s. ri:.. Am(rIcnrc C..ncer Soc. tr l:ss :. TIM LEE Cf1:TE~ .. To r 1 t.r, o r oi'.. t:ic ~ttol ^te :'r c 13 tt tl r m.. <tnc nht 1 p b-.bly tro- .c e;•I '. rt e e re ud on. Dl1 r w, td ~ e. rr fto . wld ~r t--. t,::: ic .I!J :- .f t. ti:e L., Lu'± 1 e C r I. 1 in Dr. o: t.C'\ccre.:ss It dc Itl Ic. ]' t.c U-.l rejrC.id.. J'-'r 11, I: .I• *r 1.: s1 .t t I r , cN bccc•^.:r 11reetntcr o!co ..urc:ssfu ec.i.rec- outr:;,htl.,rt inrl;yr_,ur.r.:; for rcr'?:cn, C:.L..Cr L.stit . r , r - . 1 , 7 t!rr•:.Athnnca!:crrr.r:.rcht.udyrrlWr;,lb. TllCtc;~rLl.!.cr,Lcrucrr.,•lu^cnr:!rorcr:.g. c:sois.tcp-f. nuoipa:;to`o_x.atyr:cli;.fc c: r:c•a~.orin;•. P. rec:,ns tl.ct at nr.cutcrd s!nre oor tt'r;, t I tile'iat,.::n I~titltutc, ter It}:;ctiool o'.l Huc, r:r ]! r, I)r. Ye:ucr to,:: ihc 11Lrriy t I Ldr-r- tho 1ndU .trvs irnde r1 rrl'.lton; eb r,unccd I1r. Auertr', r_s1.i thrt ti o n dhCtC y::et'a; eerta:l riata f:o!m an u:rprtL;i>ltrd, It was nr<an,liuil. n mlJcr n'i:•ri. a,-Wti:o ~ rrvlet.cra C]d 1 o!spt::c the ctn.i.: t.:.rttire :tl:;ys ^'•ciuuT c:!-lnntev] ti- br. Llcr:n Fc1i:^'r4not talldltyofthc torcarChcrol hnulu5r. 11:mvn ftmd in L;e i.'cre o; auaia'r tyi . _ ~ a::. As you aii cee lrurn tlio enelos^_a l.ctter ~ ~

0~ ( Mracr vrAS rphrc.tisr When the re_r,:l*.s of the cxprl:nrnt were 111st reporz.rd at a meeting of the Amrrlcan Cancer Sotsietq la.t Febrt:ary, a s:,clet.y epol:esman said the ezperiment "should have a sl!~nfic3at lrnpact on the sr nol:tnr of ctra_ rets In this country and will probab;y lead to a rease~ment of adrert:sing claims and . polices of the cigaret industry: A few ev.,cls later the Tobacco Institute replied by ehalleu,,;ng the C1-tcer Society to release the unpublished data >n lun, cancer in. dogs for further scrutiny b,• "men of out- staindlnd competence and Into grtty:' An lnstitvtie spol_csmuu said the "Tobacco 7n5tttute etoes not, and the public should not, aocept at a face value the findinZs of this • study." - {: - S~loL27cc a\n CANcES 11IOEP2iO:.OCY - .,ditor. IiPving initlated the ; udyt; To the F of ciraretie smoklha and htsto:ooic ntor pholr = ogy in pn'.ients with lung cancer that was It • «reporte;d- in TraE Jot,-sKA[. ( 11:2CC1, 1970). J', ; I regret Its premature publicstion In your bieorcw A'EVa sec.ion. i• Your rmport was based on rtt tterla?'nresent- cd at the recent lnecting of the 4ser:can Atcvxiatiam of Pathoiogtsts [ ad I3acteriolo- • etsts by 3r. Pa= ni•-,rid 1 esne who co'.i:+.bo- rated In this prorect and recordad ma^y o,'- the his'1v:_xtcGndinas. The results presented at that nnien-eting were bxsed on a preL'uuna.ry analysis of the d:~',a, and they ccnl_a!n only D:. Tesn4's L.tr:pretatio.zs of thc- da,.a. The fnaI report may s`:ow dLfferenccs In the percF~;t:,rs because new statistical tab- ulat",ons h±:e been necessitated by a recent chaaZ;e M the crite./a used for cons-2 idat:on of h1st..oloa:c G.tegor5es. Even If the l.crcent- l.ges rer,-'=n uncha.:.ged, however. I d!<ugrce with the i:tter-pretr.tion that hearier satoi:- ;. rIl~j. - CSLL~hi ~Ia;.s;,cl . v• •......b.........~ . in 1ung Cslicer, •i•ce •oase nopu!at:on" :n this c.ud: co:s!s'cd not of - general g:oup of su~a s~~ and norsrzokers, but of people who al-rc_2y hs-± lu:tg c.,L-ncer. Gar~euently, no cstLSU` i-tforeuces can be drawn nbout the I role of c;o4-.ing and creat!-,:g either lung cancer oz different ccll tcres of csncer in a general popula_ion of s:none:s ar-d nonsrmok- ers. FurL:earmce, rltlioug'h isicrc~-_sed rates .. of smo ocinted with Ihcrersed yr - were rs: . . . rates of 1--ndiHz: entiated srn.:ll cell caneers, j: such carccrs were not found to be the most I!I atients nl srl " a i aut" tumors in LLC ~ gu p c m t. e stLd:izd. 11y ot:n inlerpre t:.tion of hc prclitnina.ry 1 data is L,: t they contr:td3ct i long-s'anri-ino belief thz pa*ho-cncas of ].i^g cancer. Al- though cpiders:c!d cnrcinomE It geiierally re- garded rz, e: c ts;. elv s"c:aereL:a sntol:er'c I cancer, ~~our of the 42 people currently cins- = ci[ied in our c:Lrcy as thls ttr_ of 1 ' cancer i~~tl not s:noEd c!r-arettrc, and the rr.tu of ep!derr.inid Ulrnino. t: did: not EhOt;, an Sncrzase In a~rxlltion with inc.-cased _ alnoilnts oi i:'Bo)dL- g In the 447' p3tle:ll5 we • studied- readers who E~sun7ed I bad Fp~:o;ed the oontcnts of your re-port

~~%~~f~~' ~' ~~ ~.• ; . A vyy~ ~ V I LI I I l I ~ I L I I - IAN( E S J. K I L P,4 T R 1 C K ~~ PaI Becacif 3~ar~---,vi Teb. 5, it may be ._.-zacalled, the American Cancer Society staged a remarkable puess conference at the 1Va1- dorf Astoria in New York. With all the trappings of pub- licity men at Kork, a land- mark stud_v was unveiled: For the first time, it was an- ' nounced, lung cancer had been induced in dogs subjected to intensive cigarette smoking. Whatever became of that landmark? Almost unnoticed by the general press - al- though the story is arousing much tali; in trade journals and in scientific circles - a sho:kin_g contretemps has de- veloped. It is t;wginnir:g to ap- pear that the landmark may not be such a landmark after • all. By way of background, it should be said that this study was the greatest single study ever made to establish a caus- al relationship, in a laborato- ,ry, behreen cigarette smoking and luu:g cancer. The investi- gation was conducted jointly by Dr. Oscar Aucrbach„ a pathologist • at the Veterans Admini.s`iration Hospital in East Orange; N.J., and Dr. E. Ct+yler Hammond, a Cancer Society vice president for sta- tistical research. Their investigation, condu6. ed over.a period of three and a half years, was financed joint- ly by the Cancer Society and by U.S. taxpayers through a federal grant. Ninety-seven male beagle dogs provided the source material. Twelve dogs died during the study. Two of them, it was announced, were found to:have lung cancer. At the end of875 days, all the surviving animals were k-illed and eaamined. Ten additional cases of lu1;g cancer reportediy were discoveredi Now, in the norn:aUcourse of events, a scientific study of this importance would have been published by formal pres- entation before a: scientific body, followed by publication, with full statistical evidence and photographs of slides, in a major medical journal. This is how such things are done; and when the Cancer Society by- passed such established proce- dures, in order to plunge into front-page headlines by the press conference route, a num- ber of eyebrows were raisedl Nevertheless, the societv an- -nounced that; the complete. study, with all supporting evi- dence, would indeed: be pub- lished "in the very near fu- ture." Such publicat'ion, said Board Chairman 11'illiam P. Lewis,R°ould show "the metic- ulous work that went into this latest scier.tific experiment which we believe meets the highest traditions and protocol of scientific invest igation ." The tobacco industry under- standably was eacrer to get, its hands on the data. On Feb, 27, Joseph F. Cullrnan 111, chair- man of the executive commit- tee of the Tobacco lnstitute, proposed tiiat the relcva.nt ma- terial be submitted at once to a pane] of distinguished scien- tists. On March13; Lewis refused such: a professional review. In a follow-up letter onlDlarch 20,, Cullman persisted. On April 17, Lewis again re= fused. "We do not intend' to ask that these two~ eminent men submit their findin,s to any selected committee . Their wor;c will be judaed in the traditional manner of American science . . ." That'is to say, the stl:dy r:ouldibe judged upon its formal publi- cation. 1't:ith this exclianLie of correspondence, the s t o r y dnopp-lJ out of the news. . What is not generally known,, outside the immediate community of interest, is that the society submitted the Auerbach-llammond s t u d y first to the prestigious New England' Journal of Medicine - which rejecte& it out of hand, reportedly because its editors were offended by the society's publicity-seeking con- ference in February. The man- uscript then was offered to the Jburnal of~ the American h.fedi- cal 1`issociation,, whose editors, recognizing, the importance of the study, turned it over to a special reviewing panel of 13 authorities in-ihe field. And this is the shocking fact: The panel unanimoasly recommended that the manu- script be rejected. One of the objections, it is said, was that the photographie slides sub- mitted •as pr.oofof the canccrs were of such poor quali'.y that malignancy could not be deter- mined. All this happened in July. Weeks and u•eehs have passed, but thc study still has not bceni submitted' to the judgment of the scientif'ic community. It is not unreasonable to ask, again, whatever became of that landmark? 0 •

WsbN-.SnLEJuj,L F I I F I I I I- F F , Society for the way it handled the report of the dog experi- ment and its failure to permit an impartial review. Dr. Hugh H. Hussey of Chicago, editor of the American 1lfedicat Association's Journall told! the Winston-Salem Journal by telephone yesterday that his publication had given Auerbach and Hammond an opportunity to "resubmit their manuscripts" to the A:%f A Journal. Auerhach and Ham- mond decidecl uot to send their manuscrii?ts back, There had been claims by the ,Tobacco Institute that t h e Amer6can Medical Association had rejected the papers pre- pared by Auerbach a n d Hanimond. This was not exactly the case, Hussey said. The .papers submitted: to t h e American Medical Association Journal were submitted to the Consultants who made critical xuogestions for revisions. Hussey said the papers of Auerbach and Hammond could ' have been published by the : AMA Journal with corrections and revisions as suggested by the consu tan . ~~ rc~~ 70 ~ ~~g ~~gles, Smoking Ar~ide ta ~ Tri~~~ed A controversial experiment the study decided to submit a press conference in New York, a letter in April that said, "The that used beagle dogs in their papers to her f o r'City. . American Cancer S o c i e t y ' s evaluating the relationship of, publication. - The gist of the finding was exploitation of this unpublished cigarette smoking to cancer will that cancer of the human t e worf: for publicity purposes is be published by a scientific "Smoking o is a major public yp truly tir-ithout precedent in the journaL health problem of our time and~ had' been produced in beagle scientific community. And in these findinns deserve to be dogs from cigarette smoke June, the Tobacco Institute Dr. Iiatharine Boucot o f( published:" she said. She added inhalation. ynnewood, Pa., editor of the ' suggested in a letter to the -ZV that she welcomes all types of' Since that announcement the president of the A in e r i c a n Archives o f Environmental manuscripts and that many of tobacco industry has sought the Medical Association that "it Hpalth; told the 1Vinston-Salpm them are rejected. full data on the Cancer Society might be helpfull if the AIIA at JournaI by telephone yesterday experiment "for evaluation by a this point. would release the she pians to pub:ish the study in Her publica~ion, one of 10 panel of independent experts. to substance of the reviews in its a winter issue, possibly in specialized publications of the be desionated by the Tobacco possession concerning t h i s December. She said she could I American :liedical Association lnstitute and subject to the study„ including any negative not say just when. has about 9,000 circulation and approval of the A m e r i c a n~ findings." The studS, she said, has been is distributed throughout the ,ICancer Society." The institute ~ emphasis of Also in June the Tobacco returned by reviewers s h e world. The main o otfcred to bear the costs of such her monthl3 magazine, she Inslitute called on the Cancer selected "to tear it apart" and a review: reportback to her. The findings said, is preventive medicine and,, Society by letter "to a;ree to are now being prepared for problems of environment such I The American Cancer So- the impartial review which we publication. as polltUtion: _ dety's reply to the tobacco have requested" and stated, The study done by Dr. Oscar industry v, as that it wouU not "there is now good reason to Her policy,, she said, is not to querbach, a research arantee of''as'•; these scientists to submit lisuspect that this report was far disclose the names of revie~~•ers the American Cancer Soclet},,Itheir findings "to any selected, frcm accurate and that it is of such papers. No editor does committee chosen by the~ likeiy that none of the dogs de• and Dr. E. Cuyler Hammond, a I this, she said. I Tobacco Institute or any other veloped lung cancer." vice president of the American i Q Dr. Boucot said she did not Cancer Society, was announced group'" The tobacco industry throu.gh know just why the autnors of I by the Cancer Society Feb. 5 atl The Tobacco InstitutP issued~ its institute has continued to I criticize the American Cancer • ~~ __ _- i ,

I l.- TRACI{EOSIOS1f-l,EDBE4GLE inhales cigarette smol:e puntpcd hv niach'ine Ucft) tliroughtuhe attached to trachealstonta. Cibarette-smol.ing canines answer the demand who havecontinued io quesuon the proto- eol of the experiment and the interpretation for laboratory confirmation of the statistical cancer link by developing invasive lung tumors ROCHE MEDICAL IMAGE & COMMENTARY SEPTEb1BER 1970 OR MnAETHANA DECADE,everymajor report linking eisarette smoking and 164 ° J1s9 SliT1©kii19 ~ lung cancer has evoked a standard rebuttal from apologists for the tobacco habit: When watistics indicare a close association between two factors, one faetor must be shon~n to cause the otbcrin an experimental mrinral befttre a causal, relationship be- heeen the t oo can be establishedheyond donbt- To date- no one has producedcan- eer of the haeg in au e-epcriu antaf nnimid bJ'eApasln,Q 11 to tobacco LAokeor treating it with cnudCnsates from lobacco smoke. Thus; lrrbnruron• cor{frination of ihe statis- tical asso; iarrionus stilllaokinp, In v°iecv oflthe severe technical difficultics \ entailed i n making any laboratory animal 'smoke:' the shadow of dbubt cast by this areument on the growing bodyof epidemi- olocie evidence seemed ineradicable until last February: when the experimental stale- mate was suddenly and dramatically bro- ken. At a meeting of the American Cancer Society> new findings were reported that appeared to pro\ide the long sought bio- locie proof: _?invasive pulmonary tumors hadbcen, produccd'in 12 bcacles among a large colony that were plaecd on a cigarette smoking regimcn for pcriods lacting from 20 to 30 months. This achievement was promptly chat- Itnced by tobacco indu..trn invcstigators of its findings. As the results of the studl come tinder fulll:r review, viewpoints among oncologists may differ on funda• mental questions, such as the applicability of the experimental tumors to lung cancer in man. But regardless of its ultimate as- sessment, there can be littledoubtthacthis development is a majpr ad4ancc toward laboratory confirmation of a carcinogenic mechanism in cigarette smoking. The tcchnicalfeat of inducing a large ca nine popul:ction, totaling 86 beagles. to in hale the combustion products of 4''15:00 cigarettes was directed by two scientist who are pioneers in the epidcmioliicic in vestigation oEsmoking butivirtual nocccom ers to animallcxpcrimcntation in the ficld. Dr. Oscar Auerbach, is wcdl-knmsn p: thologi'st and senior medical im•cstiFat at the Vcterans Administration Ho.pitaG East Orancc, N. J., aokno\cicdFcs.'•1•m I

I I I IhumH, when it cE?mc, to me.h!nie;d,4- -Thc,ocJr+fthchE,i,lcnriijcct+ta,plhntcd tail; and nr:rn:rcin_ ;tnimtd.." I:. ( iirlcr late in 1`162 hya chancc ccmmmcnt of [)i. Il:rntnt,+nd. Sc.D:. the Antcrican (:mcrr hucrhach to a sureical cullcawuc;trtho Fast Sitciett-. aico-prc,idi•nt for c[,i,kmin6+_t" Orangc'\':\ ho.pital.'1lbuldifL it he pali- aqd tatiqio%. h;rullundorta{emonc anim;d f%ing. he rcm:nf.cJ, if a mcthod could he audr many year. acatini,ctrich he e%pa,vdi found +,herehy the prn_rc"itc pullnumare cagcJ mice to an inthT+,,ofci,_arcttc,ntoko: chancc, hohaJ nftcn nutcci inrthc lunt! lis- Thc c\parimentl conducted at l':ide. „a. .uoc of human smeikcr,=lo« of cpiih,liid ah:mJirpetl +chen the rodentti Icarned to cili:u h:r,:d cell ht[rrq,l.r ia. nn.l::rr :nyp- hlockthc smokc inlct",tvith'ithrinh„Jioti. i,m: ITnrcn,~lrvm:,l lihm.i,-r,nu,l he in- Dc,(`itc its drantalic redillc. the hc.i_lo' )Iutcd.in~ILhur:u ,oc nniitt;il .w:ii ;ndn stu<I) was undcrta! cn «ith'owt an) special 1 hc ,urcrnn: Di. .l;nnc, 1\iil,sonhr,linc. rc- scmc of urgcncy or dedication. Dr. :\ucr- ,,l, I 1 1, Will I) S. h. .h~ t to t n, n u l ` rn ~ 8 .,yl ~2.~',~~.. r2.. . j~, 24., ... 71' Inm,, ri:n;t hachoci,lrmt+ Uihc. 1\hcn tho lcant nirJ to carn out thi,:)Fproach: hu+1= c>cr, it +rac atnfruntud' hy, it IisrntiJ:rhle ,crie.' if pruhh•m,:, One ol the ma„t serioul prsThicrna %c:rs the Jh+cinpntcnt of Fer,i,tint irrilatiun and tfi,aiun in ihc tiachcal qnm,t, - oonditiiute th:)t intcrfcred +,ith, tlie P;dcnc)' r0quircd for :r ,ucce~~fid c?pcrinrcnL rKnnthcr +ka, the Itndenc)nf Iohacco tan lu cib= the prntott',pc m tchinc, built to ptumis ,tm,{dr intnthc:mim;tl, lung,:Dc+iningFloccduic, for rntra ining acticc dbg, and rnn,liliunin_ c + i t r them 1,? tolerate < no{ a mh:rl.mnn pre,rnlc ! r h-uh iec:dlc Ha+ine _atheredlmuch of Iho. t ~ulumimnt~ cl,ui,lic:d!,md Fathol i• cct uCllaat ,nd hcll? Ir,+nrlli. ti imual L'r II , k. . a: a third majot ch dlenc to th: imo tt n, n. J\":\sctcrinari rn Ix h:•_ m.linlatn~ Jenoc aeamst smol.inv- ncither imE h_;nnrt I criments ,ciih it ,miill eroup ul tl ,,,,. I Dctcrmin e d ti+circum+cnttlre,c 0..hnte,d hcl)ored thati ;rnintal dcmunstrutions' tccre ' ddhcultic,. +chich had htoucht th ~i,acct Shortlc ihcrc:dlcr: this m J et cnlCtpn •-__- nccc~xary to inniminate the of7cnJine +%,r, joiitsd is Di. N"illi:im C Cahan: i\i+r' tn't stimdctill. Drc. Aucrhaclr;mJi\1'olacn- a,_ent. •'But at mcctingc rce were ,n nRcn y,th s)icon rrho ,c;r, c'unJlictinc;t Ji(fer, hoimc carh' in 1964 cnli,tal the fLdl?tim; cr+nliunteJ bs'thc qnection of n h) lun_ can- I, cnl hul rcJateJ di+, wiJs aml rcantrJ kcnnel cern'i cs, of Dar id I:irm;m, a\" i ho,Fil:d eercr+ulil not he Fro+IUCCd inianim:d,." the ~F)rcc for hi. anim;cli. Dr. Cahnn also research a~sictant and .hemifit'++hi+ had '~c++' Jer,c), patholoci,t rcl:ucv- that the x i,hcd [)r. Aucrh.ich', a„inlancv in c+;du- ,lcorkcJ +cilh animall, at the Roa,cfeller necdlfnr esperiment;d proof +,:1capU:rrcnt. ;rtin~ ihoicwIthuf his pm(,e?.edilechniquc. Imlilulc and gained it reptnation for me- ifonlt to alhrt' penple': JEwhtx: For inJueiir_ tcrchcal cancrr: The Fracetlui-r chanic:d incentireness. 1 he first steps in Ele+clupin_ an c\pcri- c,ntJilcJ uruicaily rc%cr,ins a segment of \uacking the problem of nrnintaining mental approach +ccrc c,irric tr+ul hc a„o- the iruchca ,,, Ih:n the cilia unuLJ hcati patency in the trachcall,tom:rs a, his fir,t oiint. of Di. .-\uerhnchahilc lie and Di. , a_.)m,t each othcr :nithc cuture linc- tra ,- ot iscU'+r- \lr Hammund were still Jcoll4y' cn,_tn"cd in ~ . I~irman su,poa ~ that thc tFm_ c)_,notlo t,rr that had bcc~nunuuJuevJl hrch fnilitre ralt had resulted from tlie use hum:m smokin_ ~tuJicc-the Faih„h,'Li'( into thc nnim:)I: lune,, of convrmionaJ metal tr,rolieo,tomt• tulic.. in dh.crihinF the interrelirtion>hil+ ,?G r:ui- R+nlinL ihcii oh,cr"T ian,, tltc Fsrt-tiinc They can he hiehh"irnlnting anJ pave the ou~ histologic chanr•cs in bronchi ;utdlunc c„ILthnr:tt,u, ,oam c:muc tt+ the iml+,+rtnnt tca,t for infection. especialh in acti,c and p.tmnchyma. Ihi uaumician in an;rhzinc tcchnrcal doci,irm th;rt human ,mt,kin_ uncooFerati+c animal,. ,A'flOr rieoroatac death rates from +ariou~ c:m,e, nrnon_ mi_lit6e.'clucolt~ apFru\im;itea ht'mcchJn- screening a broad range of z)nthetic m:r L(101h0011 men and women ++iih 4.nonn ieallt ~umhine ci ~aretti•~ ,mnl.c into roniitc teri:dc, hefinalh sclcctcd' felli?irJ, the idlcal smokinc histot=ies. i- -- T~----- -- --- - A'W-1,Z.rJ...~... ~ ....... _ . ~ .,_ .-- -.. ..r t -~ . -Zv .. - . 4,5~~_~ ~5- -:-~FR00 T10^1,OLS AND FINDi'vGS OF THE BEAGLE SC.IOKIM1G S T UDY 6! ER50 IIGXT '1JiER5 Y ~W, VQKERS , IiE1 540KER50 CHl ER ,!JtlAJIr~LGRO'J SyC`_J~ ~T~~. f LTE' , CFIJ Fi^TER C ©,n ER DIOA.i'TE E[T-'D€C F~PEPIVZNT E y. Cfr ETT 5 CGE,TEG C WERE$ OWTMELIP.GES 035),.. c 1 3Ci7 250° j7'25.1 - p 7~ rx,.~s~~s s ~:.>. -n~ ... . cro .d -71 ,>~ c 3 t .s 3t03 J of 6T5d: ' , 0~4 ~~ c.43 o ` re rum ~ ua Exv U~~ L •;v"os,. ::,~- . +T ~ . rkritr'r BnnC_ - ~ r .. sacr rcnq -•i ~P.:_A~,.. ' - 0 in 7.0 n Cfi =sErn. 1-c mgp 1?9.; 1! 213' 99 3V. tr . t - 7 51 , j~ 3`.e 583: 797' o 1 e o u_.I ~) n. 1 2 - - - -at --^ ~_- -- 3-'- --' ---- ~~ - - ~250,~ ncme ' 6729 ;~- 6.129 354 . 70 ~.. , L (--~ -j r •. ~F ~..7"3.~ '035 (~' 207~e 4~ ~ 209 - 0 1 i dF< ,;,a .:~ c .T: r _ ~ s~-ams ~ ~--- -12' C • '~f2 ~ •12 yl r ~ .:,. .,.~. . . ..

au:.,tancc-nnnirrit;uint, i.ltnahle. ;md4n,- FinallYtftcr nc;u11 a ctar nf\ci+rl:. \lr. • . l c ~ n c.med-Itum uhichio t.t,ln++n trr he-: c .}-~ .• ' . Kiiman was He to (ci! IJr. :luerbaclt th,n i c*sibmy tuhcc. Ry cmfloying thc,e tuh ,. the technical diffiiulues had been sur Ihc inteNtigatnr, hatc been ah!e to m:nn-I mou tain healthy paten o nf the tr,ichad ,toma, nted: Eager to firc thc procedure a thorough trial as an es crm ntal' dil • p tc mo . amonL the ynoktng ditgcfor pcnod, as lone Dr. AuerHach turned to his lons-lime eol- - as three ycars. l b D a orator• r. HammonJ. cchose talentsas a study designer had proccd irtvaluahlb to A MORE t1jxu'air. technical chal.leni the qathok,gistlm earninqout hisclinicall : >c:1s to dcvelbt• a rcliahle machinc ttt nu; invcstigations. The stau,ti:ian, welcoming r;,; wil,uld collect the smokc of a burning ct_n-~ the oppurtunityfarcxtcrimcntal!augmcr,tA rctte and then cither pump if into a ttoc•s lion of thc cpidcntiolo r_ c.rce atainst smok l:um,s,•ia the stoma or pcrmitrolunt;uy in-I ing;sct to wt>rk drawineup protocols. halation by this route~ In an effort to ac- By the end of 1964. the leami consisting emnpli,h this. Mr. Kirman built seceni of Dr. Auerbach, Ain Kirmam. Drs Ham- mnciek: all of rchi.h he was comfelled to mondiandthehttter'sstatistioianassocinte. •,'`-7 T` on their scori.ine parts. Starlin crith so- that croulddetetminc uhethenagroupof 10 z •r ~\ c pAistieated comttoncnts he dt3cortred that pedtf,rredlNeacles cnulJ he ntade to sm+r}e ......-r,.,..t: ,.,,..-,r., the sticky deposits oftar thatiaccumul:ucd feasible plan for an estcnded pilot sludy P. -,A=:: . t •` diuard beeau,e they could nnt ccith,tand Lawrence Garfinkcl. helicved they had a~:'~ ~ -' became eoatcd: diaphragm vahes became to appear. Staitmg tuth thiz cm t'f test r t 3~~~ '.,.} ;~ hq+ellcsly, mired after only two ci~!arcttcs., group ccas considered adltsahle in ctcwot r -~ f• •• v mcrizod by the chemical ac[ion of the tnn reqmrcd to carry out the smo! in~ .tchtcch /'! f7~ S f~ s',i On the eiehth trp. he decided to dicf nsc / s ;Ic,. tcrn ,cnh it r~- t (/ with delicate modern { arts. By usincchirahle myuc. (7on atflcn ccr t t rtal',alves and sim fe com e,ncnts that ostomres.weremvnlwncda,con!ictl>.) IaIIiULUf:ISI O,carautrbech,carchcd m ~ p7o delcrnune thete,t dog,' tolCr:rnce ta manythaumdso slid.s,of thebeales can he cacilj'rleaned. he rcas ahlC to dc,i_n varviirg numbcrs of uvarctlcs. Dc H;rm ! D'tln}mr tn ticcui to hnd ima,ne lunturs. a"smokinc ma hine.. that~ ~orform, do- °-`- prrrdahlcJecpitecantimtauceApocttrctot;u. I mondJicidedthenrintoltr•ogrcutp,accord- HE cRa~t 'tecltmuizetion period The tast major ch,dltn~e-ro dcvclop it ing to wcight. Oncc the docs were Tcncn.mtese,cr.ilundcstrthlcrcacuons. sr aem for makin, dogs accept frequent accustamcd to smol:ing. his phtn c.dlcd for Many of Iho docs at first tricd to hold their sesmkin^ se,cir+nx-reyitired a scrie, of;td giving one group-eompeued of thc h rvt breaths:atticfc rceti puffsofsmol ecntcreJ delional innovatiim, on tlr. l~irman c p;trt. est anim:ds andi some of ar cr r cr crgl•t ; their tv u'hc~ac, buti [hov soom rcalizcd re- Siner d.rilc anesthe.,ia or sedati,,n enwild~d -two more ciparettcsa tlaythcm were gn en sistnnve was futile and coop ratetl!hy in, ri.ks of harming the ditgs and im.Jidiuing to the other groutt: whiehicompnmdth haling the smake rvithout a stru•e. The the result. of the ,tudt: a t Hycical method lightest as cti•ell as some a+•crrze-ccci,,ht beaclos initially alvo.dcvclopcd sy Jmptom, remarkably similar to those noted' oit restr.rint that ccoudd he welll tnlerated dogs. Cigarette concumpUnn scas to he that were was needed. B% tryinc heavy cioth._i tcl;et.; 1;^tluall~~ increased iit each Froup until in beginning human smnkers-salii•atinn. an first~. he I~•arned that severe re,iriction,`signs of acutc toztcity afl.earcd• then tem- dilation ofl the pupil+,;, redness and tearinz of a tic a", movement, tendcd to encourace • Porairily cut haek to aid'suroival. of the (i dii!zii n:niseai and occa rather than discourage rc,istance. Theolu- hir: hirman„tclro directed lahorattiry cv- sional vomitinc. On the siow sciedtdr. ticw to this pn,hle.m_ he deeide.d.,ca, to de- ecution of the siudy. introducedithe dogs these responses suhsided rapidly. After it siem controls that ccould allou theanim:ilc to'moking in casy stagct hcginning ccith cr'cckorur•o.snmedo,_scvcnunanifcstedan rrhtti1r freedbm uithin aJimitcd ,pace: A"sham smoking;' Iror four diq's after their aplnarent likinc for ciearettes hy^ wagcinc siiii hos juct I:uee enouch forth'e do_1oit trachcatl slomas had healcd. the he.t!_Ics their tails and juntpin, coluntarily into the in +va, mounted on a table behind the ,mok- were lakcn out of thut cages twice ii smoking bos nc hen their turn arrived. ine machine. A lieht leather harnc.ss uith andiattached to dtc smoi,inc qiparatus. ' Dr. Hammond?s plan catl ed fbr,addin^_a chain, at the sidcs permitted thedoc tirbe without aJicdned ciy,arcttc. On the firsfday cigarette every four on five days. The in- tethered to the sides ofih'e hox su tnu n of real smnking, they ,ccrc exposed in the creases scented to he going well through faced the machine hut tva, ,till able to shift morning to one lighted fdlcr-ttp cr,arene the 23rd day, it rr htch time the do_snccrc itcM+stuon ccith'inthecnclo,ure. with a lowlar.mcotine content and. in the . smoking six or eight cig:ucttcc tiaih• ac- The methodlthat \1r.iCirmatt chose for afternoon,,cr'ere Fivcn another rcassurmi cording to their gicrup,. On the 24th dny. lir$inL the tr.rcheal'stom:r to the smoking session of sham smoF:ing. The,econd diro however, one of thelightcr smol.tr, sud- nuchine was de,i[ned:to minimiicdi,tress folloccrd the samc pattcrn. Then, for the denl)• devcloped com ulsions that procrd anrl gainthedo s"cunfidl•ncc:Smoke was next seven days, the afiernoon shamvses- falld-sugcc.Itngthat tnaiclevci,srere al- pumped into the trachc;i throuch a rubbor sion was rcplaeed hy a, sccund' filter.tip rcady hunC rcach di prrh ip, hccauce thc tutk° that could he qutct;l4"clamped crdtem cigarette. After a week of groNun, accu, smoking quuta, htd been mcrca,ed toir e%tir the animalshocccd siQns oCansictvor tomod tolucc -tan smoke, the doe,were rupiJly. To ovcrcome thesoh:1zards. Dr. dbeomfotlt AIr. Kirman found'ihat imiri sw'itched to nonGllcr ci;,uc!tcs for the du_ _..-w•.__-_-----_„ ~_-_ ately atlon•ing a dog tobreathefre.h air at ratton of thc esperiment~ sarh times not only provides reassuring re- --- -_ -- - "` Gcf that the do^_ learns to count on htn also a%-oid.s the dangers of progressive :moxia. and ruhFice valces were quickly depolY the catenecc daily handling th•rt,rautdhe f ~ ~

Hnmmond ordered;m immcdiat0 cnhack in Fivc •such dr::nt,nic results," thc p;r.lia+ht. 875 day o.cpcrimc•nt were esuccd by such the dailv numhcr of ci;-:v.tlcs anda,nutch F'ist dcclares: "tlicy slrA,ncly suFnracdlL~i:.nrn:ry, di.ardcrs as cmplry>cma. fhra- morc er:fu:d schcdulo of incrcmcnt,. The that a larFer:mdlongcr study ruuld pro+luce sis„ eor pulmon:dc, puhnauor.ury iitfarction, . beagle __roups were put back on a conRCrva- hmg cancer.'• Nevetthelcss, ca+rcinoma iiti and bronchopaeumamia. t ti+e reamen ofithrer andl 0ve cig;unne, situ was he most advanced cytologic An:lyzin_ the dcath rates in thedili-erenl daily. Ihon slowly rtiscdi to six ;tnd cighr ehange th;tt Drs. Aucrb:tch and lianunondl smokinF Frnups, Dr. Hammoad found that over ai Ikriod of three months hefore .till thought would be produecd when a full- tllcy cJrariy rctlccted the dosage of tarand % hiFheriquotas were cautiout,ly instituti•d. scale.expe•rimcnt with SG smol,inF beagles nicotine the dogs received in rclatitm to { and eight controls was undi:rtakcn in the tlicirhodywci@;ht.ThrproupofbeaFlcslhat c; I I I I L I I springof 1967: smokcd a mavinmm of ninc flter-tinNd r1pIIE STRATEGY succecded. No more A major ohjective of this cnlarged studi•„ cig:trcltes a day had prccisely the same dcstlis occurred for the next 't]t d:r; s, along with dctermmin; the tumor-pro++uc- death ratc-16.7 per cent-as the Fmup On csammmFth'e lunFsof the fir.t c t,u:dty ittF property of crFarettcs: was to demon- Civen a maximum of four nonfiltcr d_a- thetvafter. Dr. Auerbach madr tt+o srFnili- stratc whether smohhnG ergaicttcs with an rcttcs., These results paralteled the total cant findings: padlike attachmcnts on the efficient fdtcr would be less harmful toahe zmount of tar in the cigarettes consumed alveolar septniin all lobes and focal diLd:r- doFs than smolcing the same brandlwithoty by the hvo groups: since the filters reduced { lion of thc alveolar scpttu l le was hiFhly en- a filtcr. With these goals in mind, Dr. Hant- tar production by 49 per eer•.ti In the two dlby the appearance ofithcse early mond designed a new set of protocols. He other groups oCbeaFlcs, vhich pathotocic chanFs, which were similar t+ recci~ed the cour t^c incrcasedlhedailyquotaofciFarcttosmuch highest dosage-a maxtmum of nine non those he had observed inihuman smo{;en. more gradually than in the pilut study and filter cigarettes a day-50 per cent of the h1r. kirman also madc a welcomc di: placodsomc beagles onhalf quotas, hoping li hli.vciFht (logs died as against 31.6 per - covery. After a few months lie fbuml',thcuiE F by such mcasures to dehy cmpfiyscmntous cent of the hcavy dogs. the docs no IonFer requited the pumpin, damage, which had hastened the deaths in SeatchinF for even the sliFhtesl cvidcitce acliomof the machinc to ke,ep th'eni smok- the earlier scrics, so that the beaclcs in of malignant change, Dr. Auerbach pcr- ing: but hadiItarncd to inh:Je voluntiuily. the new program might live IonF enough to, formcd it thorough microscopic eianuna- ~ much lil,e their human countcrparts: develop malignant Iung eJtanFas. 1 As the ++rcks went t;y„no new dcvclu,p. To study the relative effects of filter and se enf pulmo nn yoloN s of sthe trdaceascd ~ mcnts greeted Dr. Auerbach +vh'cn he madc nonfiltcr cigarette smoking• Dr:,H; mmond animals: lie also studied some 40 randam his daily rounds amon-, the do;s- Suspense ~ divided the beagles into four test groups, sections of parenchyma and 22 sectiatts builtup concerning vvhat was hnppenin_ in ~ which,varicd according to ty,pe and dcFree taken from the nppcr main-stem bronchi the hcaeles' lungs as both croups were of ea osurc at related to body wcicl t(,ec radually advanced to a p y and branch bronchi in tfie apical lobes. S peak qtmta of 12 table). The formidabfe logistics of carryinF, cigarettes daily-a consumption com-1 out the massive testwcre again managed - parablc with cxtremely hcavy sntohine in by hlcKirman; who required the assistanec ~Ftc t tttsr tt aT of tumor fivmanon apr man. Finally. on the 229ih da}, a sccondl, of 21'technici:ms to ma4,o five l:cnnrl-ronms ', peared in a dng thathad died afteron.y dog suddenly suceumlied, this time to brou- Of deaols smoke thein cigarette allotmenl; 135 daysof cmo4:inF the high dosaee of non, chopneumnnia. Iniits lungs. Dr. Auerbaehilevery morning and afternoon on a scen- ftter cibarcttcs. in the parenchyma ofthe wa, escited to find rttore advanced paren-' days-q-tveck schedule. Keeping the project beasie's right Iunq: Dr. AuerNach discerrtid' 1 ehymal changes-fibrous thickenin_gs ofthe stitffed with patient"and dedte: ted animal a tiny neoplasm ar ising in an area made up alveolar sepmnvith arcasofrupturc Similar handlem was a eruciat factor in its succcss. of tcrminal bronchioles and thein alvcolii sicnsofdamaeewerealsodetectediinadiiid Perhaps the biFgesu technical proHlent Allhough the tumon did not invade the j doe. ++hia•h died'of pulmonary thrombi on conGonting Atr. Kirman was to prevcnt the undcrlying stronta„thepathotocistfoundits the^_7tah day' l'volumihous smoke released by 10 dogs mere existcnce provocative. He wasauare The seven remaihinF beagles tolerated smoking simultaneously from becoming a that althougli~ carcinomas of the larger this heavy smoking regimen for four adai- health'ihazard to the workers, contaminat- bronchi',are the most common form uf hu- tion:rl months.after nhich two of the dogs Inc the rn„r-k a„ri r;~~i- man lung eancer, bronchioloatteolar carei- their nomas are not rare in man. With time. suddenly dicdi witHin, nnc week of each s rc to the other dogs between u othc.r. -'Tficsc dcaths were caused by m:a- smoking pcriods. To eliminate Ihisthrcat, perhaps this inconspicuous tumor might sivc pulmonary infarctions that destroycd he had powerfullcshaust systems installedl have bccome im•asiwe. The ansvver6 Dr. most of the dogs' lung tissue." Dr: Aurr- beside each smoking machine to carry off Aucrbachrcahzed,ifindeedtherc+vcresuch, bach recalls. "Now we were ptdlai in t++n the smoke as soon as it was released. w'ould have to await further pathologic find- directions. We would have likcd to kceprthc - ings from4he colony of smokinp,bcaFles. lasti fice survivors smokinct but fcll cnm- - ' As the months slowly passed, he found pellcd to sacrifice thcm before more died 5 eta'mtn, each beaglo was graditally, othmrbroncliioloahcolartumors -threeina ,a- heavy smoker that died on the 259th dar; of cau,cs Ih,tt might ruin Ihcir lunu for ~j raised from a quota of ono flicr cig _ dctailed'study," rette a day to whatever level of filtered or two in a liFlrt smoker of nonfilter cigarettes The IunF tiscue oflthe sacrificed'doec tnld nonfdtered sntohing had been set for its tfiati died on the 341-ith duy, two in a heavy a consistcnt story: 420 days of heavy cmok- panicular, group: "Thc crpcrintcnt went smoker that succumbed on Ihe 563rd day. ing had in each case causcd dilation of the remarkably smoothly," says Mr. Nirman, ar•,dbne in another heavy smoker that died animal'c air sacs to a state rescmh4ing with a touch of wonder. "1Yc had none of on the 60Gth day. This merely increased the cmphysema in human bcincc. 1loicover. it the epidemics of respiratory infection that suspcnsc, however, since all but the la,t maiority of the dous' lunF, sections con- run through kennels in winte.r, even though tumor were unquestionahlj• noninvasne. taincd cpiihcli:tl Icsions in which 50 to 69 oundogs wcre vulncr:uhlc to lung diiorders. andl the fnallone discovered was jost on percont~oftticccllxsho+cc•dnuclcarch:mFes Itwasasiffatrlnokedlafterus." thetantaliY,ingborderline. that Dr. Aucrhach bclicves arc part! of a As had'becn hoped, fatirllties occurred at Three weeks latcr, ho++rvt:r. the patholo- dynamic process that may Had to thrdcvcl- a slower rate ehan in the pilot study: and the giht ftnally found a growth that had pru opmenrof c:trcinonra in situ. protective effect of, fliers was confirmcd. gncsscd furlller. A dog that diedon the "I ncc•cr dreamodthr pilul study woulif htost' of the 28 spa+ntancous dcaths, ih thc 620th day exhibitcd a hroncliii+loalreolar. _4

tumor that had irI the stionia. The iml,licatiun, of this di.co,cy ,vcre so i important that Dr. Auerhuch dccid,l•d to -«'' ., ~•-_~t 3 ~ ~~ ~r' seek furthrn confirmartion. Ilc tou.k hi. ~1~'A F~~~~ lid lt d h d • s os to o>Iuni;m s onc .. thrm to Dr C~ n 6 Shields Narren, f:mcri(us Profcssor of r Z I [ [ I [_ 1- ,•. t • . ,._ .. -. - -.... . _ 'e.r~ . ~ ''I •w J ' , PaDholhgy at Harvard and a leading .' . . ? . ~ j ` . ; . authari(y on cancer morphuln r. n '•I'II nucr fur et that momcnt ° cteclares p ° NLEURft' ' " Dr Auerhrch Dr 11 arrcn t{eed that the .... tumor:,as iitvasive and said thc experiment isecmed well on its ,eay to ptuducing hmg 1.`r mimalc ~'tkancerin .~ . ~, ., .. "1~ K-...tr.1 ~- •'s'_ ." f3ROXCIt1OLOAL\'GOLAIt TL\IOR'(nna:,1, in lung section uf a du;; that swnl.cd for IM da)s,originalcd in al,colar tissur ttlarl:crhot(om la,cr)and iu,adcd thaplrurn. search reach:d a new niilestone. \Ihdc # 1~ l' ~•~ \,L o oaamimng the lun, sections of a heavily •• r~l~ t ~~`i k, t :•• A 11 v.•'t` 1N, , t-Ct r t_: t L s •-/ -1 .. 1 -,... .'~; c, ~) t• ~,{ ,t ~~ .~\ J r fIt \ r, , smoking hcaglc that died on the 753rd day. \ +~~ \ ~~ ~ ~t ~'~ ,~t' ~fts~ e!~ ~•„-,` ~ ~~ ~ he came upon a bronchiolirdvcolar tumor << t r, ^t ) t , t)i J t tl !'r C d i ~{~ t i/ f "~ that had cotnrlctely pcnotrntcd the stroma • f ,t ~ r ` ..,` 0 ~ . ~. .r/~ ~ ..lr }' , ! )! .•~= r, I .m `} Yr~ and :vas bccinnin_ to tadh the pleura. ;n - i r , J t s~\ -~ \Ny~ I Signifieantl the nenplasm cont :inodlsqua- ~ than the undcrlving stroma. Examining ad- ditional lung tissucs, he discovered two more invasirc bronchioloalveolar tumorn in a dog tha[ dird on the 049th d.p•„ but thc,r Z rw< J t"i + ar also were confinedito tlw strnma. In i\3•,: 1969, aflrr thrstu(y had passcd ~, ~ 1 ' ` ,< <j~ f\ l~•" ~` .: ~ t` ~ -: ^> its second anniversary. Aucrhnch's , o +mous-ccll foci resemhhnd those of squa- 1 "6 6 • i~ •t . t 3 _~ - , ~ ~ ` L1•E \ t •t r S ti^, mous-cell carcinoma, the most common ! : t •~~°` , ~ - r' ~t I t. ;~ l• s? Fy ~ t}pc of IunS canccr that dcvclors in the C,t ~i / ~~ bronchi nthrrthan in the bron:hiolcs. No,u ' i ' 1 ! i rr` o` at last Dr. Aucrbaeh fclt eonfident'that d + t `~+ 1 f ^ ~~ _I 1 ( ~Ir r) \ a ~ smokinshad induced a luns tun:ur shou•ing sufficicnt cvidence of mnhgnar.cy to s:nisf}' \)~ 1~r~ the criteria of any patholo,tct. I - L3 3~ \4'i[h this achic,'ement behind them; the SQllA1SOGS-CELL C:1KC1!\OV A(arr(i„ )j found in the same don, as the nunor at tnp, inrestigators «ere 6challbnged by it last. shmrs earlr inrasion from lhc bronclrial cpithelium (uplrerla}cr) du,rn into the stroma. !pro:'ocati,-e question: Would any of the ous ccll branchial a l d • do op a squ m ~s eti e • .~, ~ r,-,s-t, ~-- -. - A f r~#' icarcinoma like those found in man? The •~1 ~~ t ~~ ti„~..' ` ~f k s of most of the am, ivors were da smokin y g dra:ving to ;rclose, bccause Dit Hlammond 4r~,; F, ~` . 1r 1 ti ~!. -` ,~f, n, ly haddecided that, v:hen half the dogs in any d_ 411, , •, /~ one group had dicd. the rest ,could be oe • `-' + rr sacrificed, except for the group eontatninc ~ • {' . o l "4. the h it, 1!: t<~/ (Suruvors in the lancr ( a:tcst do °~ w ~ •1' ~V r, ~! f, l? ~ t.," f f ~ kf ~.', • l t~'~{~ Itr t.u;.c sctut.s that „rrc prepared ` a q, f),trl ;rer~ t 1'1 )r ^,~ft r,~~ t;it ~framthc3?sacnhccdsmol;~ttsF»•eDr. ( •y, . y b---- 1 • Averbnch cvtcmi,c rc carch mvuiaL' but A`..+ y he questioned n hcther the smol.tm, capcri- ~ .c' 't sy ra '~• '.r" rw r••j ~ `c``~~•t~ r ('° t ence had la.trd long enough to induce s :. } 9 t`,\ ~ ~O r r h ` 0' • °°~, ~.~.1 greater malignant chaugc Ih m he had al- FrJ, .. ) , . t,. . . P .B .-., r . n . ! rcady s,cn; .As lie begnn ,roi I iit' urrrtimr d~ s~~~ f , g ~ c \ ti eateAor} are being nlln„cd to smoke until F J they die spomancously.) I on the othcr. k r.-i- 4 • .-0 1:a. •1 ~n•y r/ :~.~1 "~. ~~ V~ r i . . four -beaclc groups. the end point finally was reached on the 975th day of the ex-. perimcnt in Scptcmhcn 1969. (71t +'_ C y g J 0. ~ ~ ! ~ , ` r ,t,~rn 1 Lr ! ~ t \i "•. . . ~ f •G 1~ •:J ~"a ~ J ~,_„~ ~ r -- , a a, 1 LAK(.IrR 11R(J\C11I \I. C:1'\CI.L,dia- vrcr in an -smn u, appt .v .. di% idcd nntss of ima:ik c sqlumtou+ ti,Nuc (nnrousC tilit; in tumnr ma} bc artrf.irtt. tvith :vhicli tn an ,crr a full-pagc tnhaccn ._.._ _ ._ _.. _ .__._. _. _ _-_- -•--~-- :_, s C. at his microsecyre the p<nhr h gt,t ,,,tti >aue that he alrcad}' had one indts{,ul,tblc ca.r •r culi F77 ~ .. 6' ~ , .L{ ti <r -...=,v-+~=•--t;l Despite such reassurancc, ho„rover, Dr. ==/q• Auerbach knc:v that some con,crratikc ? ~ pathologt~ts ,cmtld notconsidoran irI j • 4 t `' ` - i1t+ronchiolnalrcolar tumor to he unquestion- ably malicnant unlcss it had spread further

, .[ • r , - Despite such rcass urancc, hntcevcr,Dr. tf i~:z,~'J~ ~ tvM+~ - =~~ S 5{'r4ucrbach kncsv that sonic consen•atice patholoFicts ttioalil not considerian inva,i~•e ~ ~1i,• ~' ., 1 `~~iy_ ~~ ~ hronchioloalicolarlummvtohcunq(testion- -~• if P C abli>' malignant unlcss itihadisprcad further IiR(9\CII[ClLOAI \'IOL~11( TL'\1(ll' (n r(n) it I[m •• i , n t c r a - . , . ...,,na.. i „.t , m [( or SSS days [xi; inalM] iu a1~cuL[r lissucq[11v1 cr bnttnmi:ncr]'.. ,..? :,sadi•d (h[• plJru a, than the ttnderl inc stroma. [samining ad- ditional lung tissucs . he discovered hto i more mvastcc bronchmlo:dvcolart[tmors[n •ri=' r y?:' a doG that diedion the 649th day. hutithesr .,•~ ~,^ ` .. r . i ~-~ l ~ ( .'' \ (~ L ~ . k ~~;,1~• ~ r~ ~c~; `1l. += r ~ salso ~s'ere confined to the stroma. ~ In Atat•. 1969. after the s!udy had passed ,,its second annicersary• Dr. Auerbach's Isearch reached a now milestone. Nhilc i ._ ,,` t c~amiitiir the lun_ sections of a heavily , ~4 : ~ IN, t34 ' t.f 1 Ij t t t` '\~ )!~ti 1 7J . s-nol;ing hc:, Ir that dicd'on the 7S3rd d;ty. ~t °f< he eame upon a hronchiolo dseolar tumor f that had comrlctch' pcnotrttcd the strom-r as bcfinnin^ to invade the plrura. t • F ~ , t~~"~ `/ 1 tl ) f ~ 1 ~ ~~' I:•~ ~c Z: ;and a• t •s• _~:~ - Q L I I 1 t ~: ~1 r <..: -, . Sr ~ i !•_ 'Stcnificantly', inc neoplasm cont:ancd squa- .~.. -~.~`' . ,E f• t i. 1~. ;~. t ~ ~~`.~,. ~ L't . ~~r ~ ! ',`i` ~~~•~'-. mous-cell crrcinoma the most cummor. ~~ .~c' ~:`; ~ t ~•; `~ ;~ ~" y>~ f_. ~ n' , mous-cell foci resembling those of squa- r~~ C~'C!<.tc-pc of lunc cancer thatidcvclops in the ~ E.~{ t~ c 1+ M* ?[ 1' c C ?, ~•t'~ j~ * ~ t, ~`j (~.~' o ' L~ t bronchi rdhct th tn in the bronchnlcs. N[n: ~y~s1 +~'* or t<r ~ 10 ;+, ` ~~n t~ t1 't J^ 1at last Dr: Aucrb+ch fclt connal nt 'thar ~ [[; ~. t e l v j t r7~.r ,_ V r,•t /3 ~) smoking h+d mduced a lung tumor showing r, sulhcient cs idencc of m:dicnancp to sabsf! -~.~f th\Yith this uaclric rm otnbehind them,the SQUA\IQL'_CCELL CaRCI\O\1.1 (an-a„). found in the same do~ as the htmnr at'(u;t: nces4igators ttere challenged by a~ last. shnr,s oarh- incasion from tlic broncliial epithcliunt (uppcr9aicr) do,rnii7tbdhe stroma:. ros'ocati~~c qucclion:' \;'btdJ anyaf the + r ~dogs develop a squamuus-ccll bronchial ,~ :• t p ~ f J r ~ I tt t ~ ~f icarctnoma like those found in ma[n° The ; '~~ k~ •datsofmost oftt~ l . surnnon were smom 1 ' - ~~ t r ~h'\' I i they die spontancoatsly,l I-or the othor J , c'k O t ~•~ . r~, caACCory are bcin; allotced to smoGc until [ ~ ~> ~ t ~ [ 1s{ ~ • ~ ` i }F '~ because t)r Flantmund \ drawing to a clbce ~ C ~ w1'~' r `t '~ ~ ~ . - rv f Ca ,~ ~ P• t t p ,! Q 11 had Idecided that. nhen,half the dogs in anr group had dicJ. the rest t,oulJ he ~ - one , sacrificed, except Cor t, the group cuntaininc . . , tt t 7 ! the heaviest doc..c. (Surcivors in the latter ~ ' ~ r ? ~ c : ~ ,P j . `.~ ~•f o ~;1 _f ~ •~~' f,:' - 1 £ n~ I j :~ ~` ~ J A ~? 0 c ali four beacle groups. the end point ftnall% .~ 4~_` ~ t , r . > , • r ? s q `~~~ was rcached on the 875th day of the cz- i tI s~wy- pcnmcmm3cptcmicr,tyoy. '~. A ~ , P% I I . . ~ - ,, [ ~^ ~ ~~l-p •(~'r0 r' ;~ ~ 1~~`i t ! ti~~ p.~s .• !; t jAt; i i 1 _~ ` lp 1 ~~~ r, ~(~ ~~ t r j f t~ •;1 ~ j I1 t~l~ ~ ne nu~o st.roes that were prch:[red . ~ N•~ 'nl~ •~ 1''>~ ~1 D lr ~ 1 f •, csacrcc~smo[t+:tvo r romt r-,". t 1 { t t'` ~ f/ .~<! f•~., !~ { f~ ~1Aucrhach estcnsi e research mvrri:d. but htquestioncdahcthcrlhcsmokin, capcri- ~~ tY~ ~ t, ~S ~~ ry ti encc had I r,tcd long cnoufh to in.lucc. e f~~ Z E.R t~ t] f' Jr`t Creatcr mdlisnant chan,,t th m he had :,l- i e•+ ~ i• ~ r ~i e r iR ~' rcady scen, As hc began a utLtn, ovrrtime 3 .~ r' tt;, r{ I't . t~ ' I e \~ n 1 f:, L. .)e_ 1~ x~ •.~ ~ t +k l j _ ~!`~ ~ 3C t..`..~ `. ~~ r~r'.y. ,at his nticroseopc, the p;uhnl[ rist ,,:t, sure LAKCIiR l:i2O\'CII1:1L CASCIiI.,tliccnrcrcd in an 877-d:,c sntuhcr, appt•arc asa sulY- 4th'at he nlrcady had one inditipulable ca,c toh f a c acrn a ll- hieh t h ~ o :ms\cor u p \r r t~ diri[Icd ma~s of in,asi,csyuanmus ti+wc farrnosl:.tili(~in Hunnr. ma± 6c artifarts+it s t p,[a ti [ tco,cry ,t[rt so al~~ important that Dr. Attcrbach deeid,d to scck ftnllicr confrm:diort- lic tonk hi: t'r srides to ltnctnn :mdlshmt°cd Ihcm to Dr. t.? Shiclds \V:trrena Fnicritus 1'rofcssor of *r + I'atholosy atWarvard and it Icadin;, .. ~ authority on canccr morphology. "I'Illnet^cr forgct that montent;dtclares ~ t( URA Dr. Aucrh:+ch. "Dr: \\;irrcn agreedlthat the ~utmor was inrasivc and said thc c im xper ent „- FFF -- sccmed well nniits srav to nroducine lane ancrr i amimal c n s. : _ j ~ 't ~ /U~ lumor tnatnau tm•auca tne stroma. (~hi m I it , is if Ih' It, 4 e*-

I I I I I I I I_ L compan}• atlrertiscmenl Ih;tl Icid aphcarcdl in (he ,Yric 1'nrf, Tirucs ju.tla fbto rcceka, e:u9icr. cLsirning lh;d "aftcr Gliccnye;irs of trying. nl has induccd Iimg cancer in anim:dswilh ciprctte smokc.-" A more spectacular robutlnl turned'up almost l immc.diatcly. however. L.ouLint at a section of the left main hionchus of the second sacrificed boaCle; Dr. Aucrbaehidis- covcred an caily inraei%c squamousccll carcinoma that appearui to be idemical in its slruclnro wilHithose occurrim,;iniman. The mountain of remaining slides }icldodl additional tumurs to suhsumtiirte crcrv majpr finding; includinganath'cr sqir,tmou+ cell bronchial carcinoma. HIn Ihs•y alko --brought the investigators one une-, pcoted obserration. A'monc the eight non.nto4,inp control beatIes, which were sacrificed along with the othcrs, two proved to have small mmninvasivc lrtonchiuloal •cohrr htmors. To Dn Auerbach and his collea,ucs, this5nd- ing suggestis that bcniFn bronchiolb- ah<colar tumors may be more common in dbgs than~had pres•iousl'ybeen tl:nu_htl The paramount discovery of this tmique project, the invcstiFaiors heli n, is that both ofiIhe squamous cell bronchial earci- nomas and all '0 of thc in~~asia'e bronchiolo- alvcolar lumors thatwere uftimatrlvf iund. including,5we that had invadtdAhe pleura. occuiTed ir•, the croupnf bear.lcs Ih~l smoked the maximum ncmherofnonGlterciLareues. STA"IISTICIA\ E.C. Itntnmond set tirad- uaihincrs+asin;, cipreHb quutasIhaJ enalllat dogsto tulera(o icarsofs:un6'ing. • o

I_A HORACE R.KORNEGAY PRESiDENT 6 EXECVT1vE DIRECTOR 296-8434 This letter is being sent to you to reveal the facts: about what may be one of the great scientific hoaxes of our time. Eight months ago--just as House and Senate conferees were about to meet and resolve different versions of the 1970 cigarette bill--the American Cancer Society called a news conference at the Waldorf-Astoria Hotel in New Yorl: City. It announced that two researchers had "for the .first time" produced lung cancer in dogs as a result of heavy cigarette smoking. It was, in the Cancer Society's view, a "significant achievement, It which, should have a "significant impact"' on cigarette smoking, lead to "a reassessment" of cigarette advertising, and "effectively refute"'the ciga- rette industry's contention that previous charges were "'only statistical. " The mass media accepted the unevalnzated andunverified findings at face value, duly displayed the story on front pages, and exposed it on prime- time television. The Cancer Society did not reveal that the experiment was as yet unpublished in any professional journal and had not been evaluated by any independent scientific reviewers. Walter Cronkite broadcast the Society's claim that "this is the first such direct cause-effect link between cigarettes and higher animals made to inhale. " A Reader's Digest article stated: "h''ever again can the tobacco industry hide behind its most used defense--that no one had induced cancer in laboratory animals with cigarette smoke. " One of the researchers who conducted the experiment was quoted in newspapers as declaring: ". .. We have snapped the last link in the chain .. There is no question that there is a cancer causing agent in cigarette smoke. ..yr.+^r~~Sr i-~~z.j J:`._: l['t t ~`•- ~'~C_ '--.~~~ ...s- ::.. TH E TOBACCO I N ST ITUT E„ I N C. 1776 K STREET, NORTHWEST WA'S H I NGTON, D. C. 20006 t~~~'"~~.~ ~= , •~.~s ~t~'}'*~ e. .2..A~~.

F I I producing cancer in dogs with anything, or mice, or any other animal, and this was not our purpose in these ex-perirnents." The Tobacco Institute believes that "the case of the smoking dogs" is a misuse of science. It has misled the public and, if left unchallenged, it could help influence Congress to impose even more restrictive laws against cigarette advertising, tobacco agriculture and even smoking behavxor. In- deed, on the very day eight months ago that the Cancer Society heM its the strong Senate bill on advertising when House-Senate conferees meet later "smoking dog" press conference, a Senator issued a press release praising the research and stating: "This only confirms my determination to fight for this month." This is not the first time that tobacco products have been unfairly ac- cusecd, and the public misled by such misuse of science. For over 15 years, the Congress and the Nation have been targets of unprecedented anti-cigarette lobbying consisting of dire warnings, televised "fear" commercials, statistical distortions--instead of solid scientific evi- dence. The smoking and health controversy must be resolved, in the only way possible--by the facts, by objecti~ve scientific research. Conducting a crusade against a scapegoat is so much easier. But it is an unworthy substitute. The American people deserve better. . That is why the tobacco industry is funding more independent scientific research in the field of smoking and health than any other organization, govern- mental or private. And that is why the tobacco industry stands ready to commit additional funds to support additional scientific research that offers to shed light on any facet of this'important question. most dubious beagle experiment. I am enclosing, for your information, a copy of a letter which Represent- ative Tim Lee Carter of Kentucky sent to the Surgeon General of the U. S. Public Health Service. Rep. Carter, who is also a physician, raises some grave questions about the Surgeon General's endorsement, sight unseeny of this With kindest regards and best wishes, I am 1OOS~91,847 : .- Sincerely yours,

IIflifed States 01 Americit Vol. 116 .e......~.,,.......... ,e,,, . 1 PROCEEDINGS tiND DEBl:TES OP THE 9 I-st COtiTGI.'ESS, SECOND SfiSSIOI4' WASHINGTON, FRIDAY, AUGUST 14, 197'& • ~orl'se STUDY ON DOGS AND SMOKINGtndependentrevlewers hadunanimously rec- ommended rejection of the article. I bellereHQN. TI11 LEE CAPTER that Dr, Dorman would conHrm that Infor- t matlon if you were to Inquire. pz. gyrrzvcr.T Among the things thatpartlGulariy dis- IN 7FS HOUSE OF REPRESEnTATIVES turb me; as a physlalen, about your lelteu to the American Cencer Socletylsyour Inslst- Fritlay, AugtrsC1l, 1970 eneethtno fornmlreclewIs necessary, toMr. CARTER. Mr. Speaker, recently, establislr the ralidtttrof this studyherie•^of (a) its emmentaponsooshlp, (b)tht:tcputa- T1rs.AOCrbaCh and Hammond reported tion of the investlgators cnd (c) tliem¢t Iesuts of a smoking dog study inaneS- thattwosctentistslnPovernmentservi:.ehad tort to shJw there18t1onslLpbetween theopportunity to revitw, the dataand ap- smoking parentlyagreed with the reportcdfinmi,gs. The scientific methods used in this to the past point. 1tseems3ou ]iaves ... aWdl have been questioned:Thc nmeri- had some bad advlec At the time You wrote your lettcr, one of the patholo sts Lvhosetal1E:CdIC31 rLSOClatiOa and the new opinlonyou rellcd on Dr. I:aymond Yesner England :oultlttl of Medicine rejected of the YeteransAdmfnlstratton had .Iready the re3earLh~papers outrioht. become the center ofcontrover v in co.*.ncc- R^^ I enclose copy of a letter to Dr. Jesse tion with another rc.Farch study relating to ( L. Steiltfeld for your perusal: cigarette smoltng. It seems that at a nccdtcal HO meeting Dr. Yesner toolc the libertyofincer. i.~ . 14.. L'~CO: RR:fEYNTATICLS, ng certeln data from an v publ i s hed Wvhinptbn, D.C., Avywt lt„7970. pret{studyorlgfnatedbyDr. Alvan Feinstcn of Dr. Jsssc 1~ STearua, Yale. As you will seefrom ,t?ie enclosed I.c.ter The Surqeon Genoal, U.S. Public Hectth toihe Editorof the Journai of ihe A>ncricas Seivice D~ ~ e-'t cJ Aealth Educa- IfedicalASSOciaffon Dr. Fcinstein haspub- fion, and Te]/are, Wnafiinoton D.C. llaly contradicted Dr. 1'esner's lnterpretbtien ~1 - Dsu Jrssc I have received your July 10th nply to my letter toyou of alay 19 concern - of that date. 1'ou mlght e150.11II9e takenec- 7ng the Arxrbacri,Hammond smokingdog counLofthefectth:.tDr.Yesnenlsemployed study. As you Can imgine, I was stiocked andtiy the Ycterans Admihi3tratlonwhlch was a dlxtppotnted to learn that in yourlet:er eo-sponsor of theAUerbach-Hammond study. ofJune13 to the American Cancer Soclety th tyour rellanee on ' DrhYsner was p obp l ~ you gave an unquallfied endorsement to the ebly fll-advlsed. valldityof thestudy,based~~ou oothing more tangtblrtha>y hesrsay reportsaf the findings I~ think you might also agree that such and your orn strng feelings about smoking conslderations as the "'eminenocponsoushtp' and healtb. This seems to havebeenan irre- of the study and the "reputattons"' of the aponslble act on your part and not in keep- inrestlgetorsarenot proper criterlafor Judv- Ing eltbthe seieatific obJeetivltqwhlch: ingveJlditT:TheAmericanCancecSocietyins should atcompany your high office. As you youprobablyknow,hassoonsoredantistnok- must have anticipated- the news bureau Ing commercials fee.turiug a nroviestar who of the AmeritanCancer Society promptly was recentlyconsioted of {llegal possession -1 Teleased your ]etter to the press in an at- of mariJuana: tempt to bof>:cr the4rposltloawith the Lforeover, thetwro lnvestlgatorslastFebru- prestigeof your office. ary , released their findings to the popular Asl lold you In myJetter of May 19, serious press before presenting them to their sct= questfonsaboutLhe validity of this study eutlfiecolleagucs.aprocedurev:htehlston- hadbcen raisedby a distinguished pathoi- elHered highlytmproper among rclentiGare- ogiit whose letter I forvarded to you. You aearchers: In fact. their actlon caused the may bynor haveseen the enclosedarttcle authoritatfveNCtn Eng7an3 Jourvat oJMedi- front thel7atiStr<et JournatofJuly8.The cine to reject the rraearch,papers outright.I artlclereportsthat1heJovrnaloj,IheAracri- think ynmighthaveconsideredthesefacts can d:er:ica!'Aasociationhas deGdcd'noV to In assessingthe"reputations"'ofttie orga- publisb the Averbach-Hammond paperson m Atlon aud people involvedi the bssts of revlews by tvrelve Independent In vicwof theJudgnrent you have pro- author7tten. The article pointedout that nounecd, the InteFrity of your otl7ee requires the numberot reviewers a-s{gned to tile you to makeevery etPbrt to dcterminewhat' Aucrb.xh-Y.amm.oad data w-asmuch greater crtttclsm.s theJournl oJ' the Ar.leriean than sssual because of the eontroverslal na- Sfcdical Associatian revlewers made of the C * ttue of the esperiment: study and to amend thecomments which Wben I attended the meeting of the Amer- you audeto the AmcrlcanCanccr Society Scan aledleal Assxiatlorrln Chlcngoon June in your letter of June 12 andto correct 22. 1 Iclrnedthat thePresldent of the A>fA, the erroneouslmpreszlon your letter has left Dr. Gerald DormanIhad determined from a w7ththeAntericaupublic. Conves,satbn witli,lhe Editor of the Journai Aa3oupolnted outln your lettrii yqurDe- oJihe AwerieanAfcdical Assooiatioa that the partment has the atatutoryresponslblllty of No. 141 reporting to the Congresa periodically on thestate of elentl5creaearch concern:ngetg- arete amoking and bealth:I Icar that yourqncritieal acceptance of, this research, which Is to this date vnpublished In any scientific jovrnal, Is a clear refieetton ~c1 the super8cialand hiAsed manner I. which the Snlo-mattonwhich f:ocs Into those reports Is evaluated. I alsoblieve ttiatcour actlon, In thismatter casts serious doubts upon the lnttgrity and authority oU lttf0 mation, issulng,.lrom thePub5toHealth Srrvtce. In regard to the nealth eonsequenees eZypoking, and t!:atlmyeol- leaguesnndithc.,merleanpeople strould be so ad1'lsed. TheCongress Is IncreaslhFly czlled upon to nlake puh:ic policy In the fx t of the pro- liferation lleaitit CDntrol'CC ICS Vhtcni areconfronttnp the Amarican people. We must have obJectii'e ac-tists to guide our, ac- tions. The American people atRr-d to losemuch, more than the right to C.no'1e cig- arettes ifscientific JUdgments are made on such a capacious basis. I c:ou:d' be mostpleased to have your comments on the observatlons I have made 1n 6hls letter. Sincerely yours. Tnu Lee Caarr.a, lFrom thetCa1lStrect Journal. July 8„19701 AMA Jovarrrnc Dectnr.s To Wrxnaotn REroars OND9cs ANDSTIOS-a--C0\ia0\•LP.ssALTLSTS SOPPOSFDLT CAtiSEDC1CCP,'; j11LL1AaaZINL SAl"s ALTICLGS Ivr.r:D N.LVISIONCtrrcACO.-Tlie Journal of the American Medical Association has decided not to pub- ltshtwo prcviously, announced r^portson a oontroversial ezperiment with dogs that Is supposed to link tigaret smoklub with lung cancer. But the magaalne: which Is probatsly, the most uldely read medlcal journal ln theU.S., Insists that thrarticdeshaven't been reJected outright but simply returned forrevision. The reports have been caustngeontroversy since early May, when the Tobacco Institute, the Industry"strade assDClatlbn, announced Itwas mounting a maJor attack-lust the vadldlty of the researehers' hndliigs: The artlcies describe the results of, it 2112. o,gs year ezperiment on 99 pcdigrced bea.^,le d that wlttcarried out by tFo crNncut sCien- tists. The Arnc¢ican Canecr Sxlcty has ctalmed that thecxperlmentwas rignltleant in atlcast twovrays:It producedilungcan- cer as a result of ciparet smoklhg In asignlf• lcantly Iarge esperimentaL anlmxll and It marked tne fr.sttin:e that can¢cr had been Induccd to inboaotory, animals byoausing them to Inhale tobacco rmoke. al:J£CS]DN is DENrrD Dr.Hugh If. Huss.•y„editor of the medical pubilcatlbn, dcnledIn euihterticwthat the artieVes hnd been reJeeted 1er pulillcatlon. "Ttseyara not acceptable for publlcutlonln

their present fonn;' he cald: The articles have been returned to their authors, he said, for "extensive revision:" The twoscientists who carried out the cx- periment are Dr. E. Cuyler Hammond, a vice president of the American Cancer Soc]etf, and Dr. Oscar Auerbach, senior tnedlcel ih- vestigator for the Veterans AdminLstrat9on Iiospitial, East Orange, N.J. in telephone- interviews yesterday, both Dr. Ilammond and Dr. Auerbach dcclined to cr(ticize the mcdicaL journal for returning their articies. "We sent the articles to them in good faith, and we believe the American Medical Association also acts in good faith," saldDr. . Auerbach. Neither Dr. Hussey nor the two researchers would disclose details of the suggested ehanges. But Dr. Hammond said some of the objections eentered on photographs accom- pnnylhg the te=t. "There wem compla!nts that the pictures were out of focus. But that's to be expected since the slides orig- inally, were In color but had to be printed In black and white (because) the magazine considers color pictures too expensive;" he said, EEYrEN'EES CALLED FAIH Commented Dr. Auerbach: "The reviewers were as fafr as they thought they could be. I may not agree with them, but' !t's all part of the gtve and take." When the artlcles will appear in print Is undecided. Dr. Lussey said the journal will roeonsider the articles if they are resub- mitt'ed with the revisions. Or, he said, the authors may decide to submit them to an. other publication. The two researchers said they haven't de- elded which course they will take. Dr. Hussey rejeet.cd any suggestion of pres- sure on the nragazine either from the tobacco Industry or the Amcrican N:edicaliAssocintion not to publish the reports. "There was no pressurc whatsoever," he said. EIPFT.TS CONSIILTED The dccision not to publish the articics, Dr. Hussey said, was made on the basis of re- views by about 72 indepondent authcrities. These included an expert onv-etcrinary mad- Ic1ne pathologs, an expert in pulmonary di- sease and several pathologists. The number . of reviewers, he said, wna much £rer.ter than is usual for anarticle s.ILnllttcd for pnbl:ca- tion in the tnasazine "because of the great amounG of publicity involved:" The e>:perimcnt alre•rdy has won the ap- proval of the U.S; Cencral, who re- cently said it vrasi :" s:'.:::ssary to carry out a formal rerlew of the <-_pcrilnellt' "to estahlish validity." The surgeon general said In a letter to Dr. Auberbach that "if the que.tlon at Issue is whether huu;an-type lung cancer has been discovered In the lunl;s of do-,s exlzo::cd to clgaret smake, then the answer is ycs" Tl:ii; finding he said, was the vicw• of both Dr. John W. Berg a patholo ;ist vritll the 1:ntlonal Cancer Institute; and Dr. Fsymo:;zl Ycs:u-r, associate professor of pathology at Yale Uali. versity Sohoollof Medicine. Dr. Auerbach said that the mcdical journal reviewers didn't the claim that the tumors fund in th,; were of human type. IMPACT WAS FORECAST When the results, of the expriment were first reported at a meeting of the American Cancer Society last February, a society spokesman said the experiment "should have a signficant impact on the srnoking of: ciga- rets In this country and will probably lead to a reaseessment of advertising claims and polices of the c!g aret lndustry:" A few weeks later the Tobacco Institute replied by challenging the Cancer Society to release the unpublished data on lung cancer In dogs for further scrutiny by "men of out- standiilg competence and SntegrSty." An lnstitutc spokesman said the "TObacco Institute does not, and the public should not,aeeept at a face value the findings of this study." (iFhrom JAMA, July 6, 18701 ShtORI\C AND CANCEP. MORPHOLOGY To the Edi*or: IHaving ihitiated the >tudy of cigarette sinol;ing arifl histologic morphol~ ogy in patients with lung cancer that was "reported" in THE JoLeN+L (2111:1061, 1970),. I regret its premature publication In your MEDICAL NtWs se¢tion. Your report K'as based on material present- ed at the recent meeting of the American /7_3 Associat'lon of Dathologlste and Bnctcriolo- gi:,ts by Dr. Raymond Ye>r:er who collobo- rat.cd In this projhct and recorded rnDn}• of the hLstologie finclin{;s. The result5 preser.tcd at that nieeting were b:+.sed ona prclint!liary analysts of the data, and they conta in only Dr. Yr.-.ncr's interpretntioas of those data. The final report may show dificrences in the percentages because new statistical tab- ulations have bcen necessitated by a recent change in the crirerSa used for con.w!idr.tlbn of histologic categories. Even If the percent- cges rcmatn tichaugecl, however, I dis9greo with the interpreGation that heavier st,;ok- 1ng "eausedr' greater degrees of mtilignnncy in lung cancer. The "base populaS.!on1' in this study consist'ed not of a general group of smokers and nonsmokers, but' of peoplc who already had lung cancer. Con"uently, no causal Inferences can be drawn aboltt the role of stnokiiig and creating either lung cancer Or dlfleront cell types of cancer in a general population of smokers and nonsmok- ers: Furthermore, although increased rates of smoking were assoclated with increased rates of undif:erentiated small cell cancers, such canc-rs were not found to be the most clinically "nmalignant'" tumors in the patients we studied. My owiv interpretation of the preliminary dLta is that they contradict a long-stauding belief the pathooenesit of lung cancer. Al- thouoh epldermoid carcinoma 15 generally re- gardr,d as exelusively, a"cigarettc smoker's cruncer," four of the 42 people currentiy clas- sified In our survey as having this type of cancer had not smoked cigarettes, and the rate of epldermold c3rcinoma did not rhow an increase in association with increased amounts of smol:ing In the 449 paticnts we studied. I apolo-oize to any readers who assumed I had approvcd the eontents of your report because they saw my name thcre„ and I urge them to awaet fo:mal pub:!c~ition~ of the cnmplete results before drwwir s any cOlaeiu;.:ons. ALt'AN R. FEINSTLIN, M.D. NEW IIAVrN, Co::N. 4

I I I I IT I IL Ii i Oct. 13, 1970 Page 11-A 1 T11E : COUR:IER•JOURATAL, LOUIS17ILLE,-. IiY. ---TUESDA-~ -MORn?ING, Society's Tekst on 'Do os L ilie a Hoax, Tobacco Industry -Say-. 1': WASHINGTON (AP) = The tobacco haled smoke as humans do. ``. ' authors, Dr. E.- Cuyler Hammond, an of.' industry yesterday said' the American Kornegay said that eight months later, ficial of the American Cancer Society, Cancer Society may have perpetrated a however, the research still has not been has since "publicly reduced the number hoax by reporting earlier this year that published in any professional medicaL of dogs claimed to have developed! lung cigarettapuff'inb, laboratory dogs devel- journal. He said at least'two medical pub- cancer from 12 to 2." There was no reply oped lung cancers. lications, the Journal' of. the Arnerican yesterday from the Cancer Society. Horace R. Kornegay, president of the Medical Association and the New Eng- The tobacco industry spokesman also Tobacco Institute, Inc., said! in a letter land JournaI of Medicine, had refused said that the Cancer Society has ignored to Congress that the Cancer Society's re- to publish the study because it had first four Tobacco Institute requests for exam- port released 1i eb:, 5"may be one of the been released to news media and because ination of research methods and data great scientific hoaxes of our time." of "unfavorable reviews by a dazen in- used in the beagle study. Cancer researchers reported that 12 dependent authorities." ~ Kornegay said the smoking-doms study healthy beagle dogs, trained to inhale un- In Chicaoo, a spokesman for the Ameri~ "is a misuse of science" which has "nus- filtered cigarette smoke twice a day,, de• can MedicaLAssociation said the journal's led the public:" • velopedi lun; cancer after 2 1/2 yearsi editors had not rejected the stndy but re- Two cf' the cancers were described as turned it to the authors with suggestions similar to the type in humans. _, for revisions. :•The Cancer.Society said at-the time the The spckesman said revisions had been research '!effeotively refutes" claims that made and two reports on the study would there is nolink between~ smoking cigar-. be published in the December issue of ettes and lung cancer. The research was -the "The Archives of Environmental described as the first to produce lung can. H'ealth," a specialty journal of the A11A. cer in an experimental animal which in- Kornegay said one of the principal

CHICAGO, ILL. TRIBUNE D. 805,924 - S. 1,131,752 CHICAGO METRO?OLITAN AREA WASHI?\'GT0N, Oct. 12 (A1-- The tobacco industry said to- day the American Cancer So- ciety may have perpetrated a fioax by reporting earlier ,this year that rigaretpuffing' labora- tory dogs developed lung can- cers. Horace R. Kornegay, presi= dent of the Tobacco Institute, Inc., said in a letter to Congress that the cancer society's report released Feb. 5 "may be one of ) the great scientific hoaxes of our time." Cancer researchers reported 12 healthy beagle dogs, trained to inhale unfiltered cigaret smoke twice a day for two and months later, however, the re- search still has not been pub- Iished in any professional medi- cal journal. A. M. A. Denies Rejection He said at least two mcdical publications, the Journal of the American Medical Association and the New );ngland Jo::rn:il of Medicine, had refused to pub- lish the study because it had first been released to news me= dia- and because of "unfavor- a half years, developed lung: eancers. Two of the cancers were described as similar to the type humans ineur. Not Published in Journals The cancer society said at the time the research "effectively refutes" claims that there's no link between smoking cigarets and lung cancer. The research was described as the first to d u i ' uce l ng ca ncer n an ex- Aw. pro 1?orimontal animal which in• hated smolic as numanS a0, Kornegay said that eight able reviews by a dozen inde- pendent authorities." In Chicago, a spokesman foithe A. M. A. .,n id the Journal's cditors had not rejected the study but returned it to the authors with suggestions for revisions. He said revisions had been made and two reports on the study would he published in the December issue of "The Archives of Environmental Health," a specialty journal of the A. M. A. Another A. M. A. official said it is not unusual for _articles submitted to the'Journal to be returned with suggestions for revision and added "it had nothing to do with prior publi- cation of the study" in the news media. Data Requests Iporcd Kornegay said one of the principal authors, Dr. E. Cuy- ler Hammond, an official of the American Cancer Society, has since "publicly reduced the number of dogs claimed to have developed lung cancer from 12 to 2." The tobacco industry spokes- man also said that the cancer society has ignored four Tobac- co Institute requests for exam- ination of research methods and data used in the beagle study. Kornebay said the smoking- dogs study"is a misuse of science" which has "misled the publie." He said the tobacco industry "is funding more independent scientific research in the field of Smoking and health than any other organization, governmen- tal or private," and is prepared to put more funds into such research. J~.M.k,~IrY t .;t,ur<,HJ~r/:YAvI',~.,,~.7,n:n+~,,•'4J~77,,,;~,y~~h 'y:a~i~ i:`7rorwnp~..~WI:~..:;u.it:•y~r,j.r•AN.i,`..;.•. .,~<-•.•;trCtt~.~:,ly'i~{?Qt',• ' '~'~~.

lecr,~I, / N. C. A J f~lEt~S 4-obSegL ~~ ep-. 21, U70 r ~...r+ -~ , ..r.......r. ..~--.. -.~ .. . .. ~ . , . .. . . ~' . . . `r. ~.. :. ~ ~ . . . , (`c • rCrr Tt7r L L L . an~er. 3ac~et-y. %-v as w rong Some eight m:ar;ths ago, just as House and Senate conferees •.i were about to meet to resolve --'11 differences on the 1970 anti- : cigarette bih', the. American Cancer Society called a news conference to clinch public opi- nion in the matter and to en- counage acceptance of the bitl's tougher verison. Society of- ficials, speaking foil, two researchers, announced that - "for the first time" lung cancer had been induced in dogs as a result of heavy cigarette smoking. The press conference was an apparently successfuZ strokti then. .It has put the socic:ty on the spot now. H o r a c e Kornegay, former Nnrth Caro!una congt•essmar, who now heads the Tob,-,cco Institute, has repeatedly called' for release of the "smoking dogs" study for independent. -ev•aluation by other medical researchers. Properly, he has turned to the Congress to point up the -society.'s four separate rejections of his request. In a letter to congressmen earlier this montn, Kornegay restated key phrases of the society's original press an- nouncement: Results of the smol:ing dogs study were term- ed "a significant achit~vcment" 'that should have a "significant impact" on cigarette promotion ~.: . . . and ef'fectivclv refute conten- tions that lung cancer charges are "only statistical." -The research on which these assertions were made still has not been published. In fact it has been rejected by the New EncJland Journal of Medicine and The Journal of the Aroacricarz Medical Association. One of the researchers has changed his position from the original announcement. He rrow, says that lung cancer was pro- duced in two dogs instead of twelve. And still the American Cancer Society, has not publish- ed' the. study and will not release it for independent analysis by other researchers. I:orncbay, in his letter to con, gressme;i,, fairly charges the society v.,ith, hr.vino misused! science to influence anti-smok- ing legislation, And just as fair- lry• it can be assumed that the society admits its guilt with its continuing• silence on the issue. Not even the Tobacco Institute argu°s that smoking is heathful. But it proEaerl,y, defends smokinU from the kind of passionate exaggeration and apparent deception practice3' by the cancer society on tiois notable occasion. The society should admit its mistake and retract its announcement. It hasn't been careful and. truthful, and it should say so. ,_ '.

SUr1MARY -. 1 _ . Over several years, an employee of the American Cancer Society (Hammond) and an employee of the Veterans Administration (Auerbach) conducted an experiment in which beagle dogs were "taught" to smoke cigarettes through surgical incisions in their throats. Last February 5, in a format without precedent, the society staged a news cdnference resulting in head'lines proclaiming that 12 animals -- the first in history after numerous smoke inhalation experiments -- contracted lung cancer from cigarette smoke. Apparently, the researchers made no effort to give a prior report of their findings to the medical profession. .The timing was significant. Legislation to further regulate cigarette advertising was under final consideration in Congress. The society had~testified as a principal supporter of it. And:the annual "Cancer Crusade" -- the society's drive for public donations -- was about to begin. The cigarette industry promptly sought the complete experimental data for review by an independent panel of scientific experts whose O nominations would be subject to the society's veto. The society O Ca rejected the proposal outright. Z Later, when the industry took the facts of the dispute-:?to ~,~j the public, the society shifted its position and said it would ask the

U.S. Surgeon General to conduct the review. The New York Times called this an "error in judgment".in view of the Surgeon Genr eral's known bias about cigarettes. Sure enough, the Surgeon General responded to the society in effect saying he did not need to review the data -- he was satisfied with the news conference announcement. ! In light of later developments -- two leading medical journals found the experimental reports unsuitable for publi- the Surgeon General to rebuke him for his hasty judgment. cation -- a U.S, Congressman who is also a physician wrote to To date, despite society assurance months ago that the it was not acceptable to the major journals published-by the American Medical Association, apparently some version of it will appear nearly a year after the original press conference in another journal published by the AMA with a much more re- stricted circulation. But there is no longer any reason to believe that the experiment succeeded, that the society's report of its findings was correct, or that it has any impli- cations for cigarette advertising. work would be published promptly, it has,not been. Although The episode contains a lesson-not only for the tobacco industry,, which has for too long failed to dig deeply into the ;accusations about its products and expose their £allacies, but for any industry caught up in the ~about its performance Y ` { fad of irresponsible charges ~-e

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