Tobacco Documents Online

ADDITIONAL MATERIAL FOR THE LASKER PRESENTATION. Notes: 1. This does not include all the documented materials. They were not available at the time. 2. These are mostly "parenthetical" thoughts -- comments about the listed materials. PRE-PRESENTATION INTRODUCTION: A. Why we're here today 1. We're here today because we are concerned about an unfortunate climate that has been created out of the cigarette controversy. 2. And we think you will be equally concerned about it. 3. Because, in our view, it endangers your fundamental objectives, and ours. 4. I know that may sound strange, but I take it for granted that, as your work over many years has demonstraJted, you are fundamentally concerned with finding the causes of, and cures for, diseases. And that you are not narrowly or solely concerned with the tobacco controversy. You were, after all, concerned with health before there was a cigarette controversy, and'if the cigarette controversy were somehow miraculously to end tomorrow, you would still be concerned with health. 5. We are equally concerned with that fundamental objective of finding the causes and cures. 6. We think we've reached a point where those who pursue the narrow objective of attacking smoking now endanger that fundamental goal. 7. And that's why we're here today.

2 B. A comment on the scientific advisors present Now let me add a few words -- by way of explanation and, I hope, of courtesy -- to the distinguished scientific advisors here, including Drs. Gardner and Hockett. This presentation was prepared before I knew you would~be present. It was never conceived of as a scientific presentation, but simply as adiscussion between friends of some areas which I deeply believe are of mutual concern, and which are above and beyond any of the specifics of this controversy. It was, in fact, a personal notion of mine that a quiet and thoughtful, and non-confrontation, discussion of this with Mary might be fruitful in some way. I say this because I think otherwise you might think it discourteous of me not to be addressing you, and instead to be talking solely to Mary. The simple fact is that this is how this presentation was con- ceived -- as a conversation with Mary. To tell you the whole truth, I think that even if I had known in time of your presence, and had time to change this presentation, I would not have. I think probably we've had enough of confrontation. I am certain that confrontation on specifics cannot help resolve the broader concerns we bring to this meeting. I do welcome your presence here as observers. I think it can only be to the good that you know something more about us. And with~ that word of explanation about what might otherwise seem a discourtesy -- not addressing myself to you -- I'll proceed. PRESENTATION CARDS Card 1. King James Counterblast (I've met people who are thoroug,h~ly convinced that cigarettes are harmful -- and they find~it astounding when they discover how thoroughly we are convinced that they are not. Part of the reason, of course, is this (the Counterblast). The tobacco industry, like nearly

3 every major industry, has lived through many attacks, and tends to have a somewhat longer perspective on them than most individuals. Our industry has, of course, one of the longest perspectives and I think this tends to buttress our confidence -- and it is a total and complete confidence -- in the ultimate scientific vindication of our product. This is not to say, let me quickly add, that we are not concerned about many things that have happened along the way that I hope to get into in a minute. We are, and that's why we're here. It also is not to say that we're sitting back serenely and waiting for science to vindicate us -- in this controversy, as it has in other controversies. We are, again as I hope to show, actively and positively dedicated to doing everything we honestly can to find the "causes and cures.") Card 2. 2&years of the current controversy. (This is also by way of perspective on the current controversy. You are familiar with all of the terms listed here. In fact, everyone is familiar with all of them. The most incredible figure in the entire controversy is this one -- "98% of public aware of charges." Someone has said that 98% of the people don't know who the president is. It is also a figure which I think must give us concern~because when nothing more can be done in the way of public information, the people who promote a cause are often driven to public prohibition -- to repressive measures that endanger the society as a whole. I think, in fact, that is already happening. Many worthwhile causes have already been hurt. Causes within the health field itself. Promising scientific i-nvestigations are getting short shrift because of this single-minded concentration ontobacco as the sole cause of all our ills. It seems to me that there is a Nader report that says this explicitly -- that investigations of pollution and industrial threats to health are now being ignored. These worthwhile causes, of which all society would be the beneficiary, have fallen victim to the tobacco controversy. As a totally personal aside on~this, I think some damage has been done which is difficult to assess, and difficult N to repair, but which is very real -- some damage to our ~ basic ideals, not the least of which is a sense of fairness in controversy. I think, too, that some damage C1 has been done in setting people against people, some Q specifics of which we'll get into in a moment, and which }, is barely hinted at in "segregation andsocial pressures."M M N N

4 It is incredible to me, as I'm sure it is to you, having fought hard against segregation based on color and creed, that we are now talking about -- or at least some people are talking about -- segregation based on personal habits. In my view, it cannot fail to hurt us as a society.) Card 3. Industry response. (I think now we're at a subject that'you may not be totally familiar with, and which I hope will be interesting to you. I would say that on this subject, 98'$ of the people are totally unaware, and most of them that I've had any opportunity to expose this to have found it. fascinating because it presents a picture of us so completely different from what they've been led to believe we are -- an industry with its head stuck in the sand'. We clearly aren't. CTR. AMA. Harvard. Washington U.) Card 4. Industry is responsive and responsible. and 5. (Over and above this purely scientific response, the industry has taken a number of practical and positive steps. I think the sum of this list must be read by any observer as, at a minimum, a very restrained response in the face of what we view as a wholly unfair attack, and which is now viewed by an increasing number of people as an unfair attack based on insufficient evidence. I quote from~a government-sponsored study by Professor Gellhorn~of the University of Virginia of the original Surgeon General's report. It calls that report a "deliberate attempt to oversell a n-2trrow product," and says that it was "released to the public in a misleading manner." No one, I think, was willing to say that at time of the original Surgeon General's report, but now, with ten~years hindsight, people are coming to that conclusion.) Card 6. Product changes. Card 7. Climate created: Despite this -- again what we believe to be -- positive and responsible actions, and most certainly restrained ones, on the part of an industry subjected to unfair attacks, an unfortunate climate has been created which we believe seriously endangers the real objective -- ours and yours -- of finding the causes and~ cures of diseases.

5 It is a climate in~which --almost any excess seems permissible. To take but a single example of the kind of "horror stories" under this head, there was, within the past month, a story of a doctor --.Dr. Joseph Kristan of Connecticut being honored at some anti-smoking meeting (a meeting of the interagency Councill on Smoking at Washington, D.C. Jan. 14, 1974) for going around spraying smokers' cigarettes with an aerosol spray. Now, aside from this being a little nutty,,the fact that this sort of aberrant behavior is applauded by anti-smoking groups seems to me -- and I give it as a lay opinion, a non- medical opinion ~-- a kind'of incipient hysteria among such groups in which, indeed, any excess seems per- missible. Certainly no rational discourse can be had' with such a man, or with those who applaud him. It is a climate in which --many people have been persuaded that if they smoke, their lungs turn black. I regret to say that the source of this is the American Cancer Society itself which in a pamphlet dated December 1968 stated "smoker's lungs characteristically show a brownish,black color." Now, since most pathologists seem to agree that this is simply not true, I pose the question whether inithe minds of people who have been sold this idea, this does not come perilously close to being a hoax. And I ask if this is not the sort of hoax that ultimately turns people completely against not only the perpetrators, but against the scientific establishment generally. I fear it does. It is a climate in which J --a study of "smoking dogs" canigenerate worldwide front-page publicity on the basis of flat assertions that 12 dogs out of 86 had developed cancer when in point of fact, the authors themselves later reduced the number to 2 which, in the published version, were held to show only "microscopic" signs of cancer (and which, even as to these 2 dogs there is considerable doubt.) At least I have seen the statement of one pathologist who stated that the evidence -- even for these two dogs -- was "inconclusive as to the existence of any cancer." N Now again~, I pose the question: Does not this -- in the 0 minds of ordinary people -- come perilously close to ~ being a hoax? And does not this do irreparable harm to Q credibility of science generally? I think it does. I ~A think it already has in the minds of many people. And C!1 I think it would do far greater harm if were more Q~ generally known. ~~+~

6 It is a climate in which --great concerns have been trivialized with such~ suggestions as that smoking can cause wrinkles. I personally find this nearly beneath~ the level of intelligent discussion. --on the rest of this list, nothing special occurs to me, except perhaps under the heading of "personal attacks," the point made by Bill Shinn that these attacks are counter-productive. The example he gives (p.6, second from last paragraph) is that the ACS was quoted by AP as saying that the "tar" reducing trend is "clear evidence that the tobacco industry, despite its public disclaimers, accepts the evidence on the health hazards of smoking." And the point he makes is the simple question: Since the ACS knows very well "that it is the position of the industry that no hazard has been established -- would the ACS want the tobacco industry to completely ignore the entire area of""tar" and nicotine content?" Card 9. This climate leads t suppression of evidence cutting off research (However, anyone may view the list we've just been through on the previous card, I think we could expect solid agreement on the part of everyone in the country that these two -- the suppression of evidence and the cutting off of research -- are unmitigated evils. 1 Let me give some quick examples of what I mean by "suppression of evidence." My simple test of whether or not evidence has been suppressed is the ordinary test that would be applied by "the man in the street" or the legendary "prudent man". Wouldn't such a man say that evidence has been suppressed if he could hear this colloquy about "black lung"': (from 1969 hearings of Interstate and Foreign~Commerce Committee, p. 1101.) Mr. Preyer. "You say flatly that you can't distinguish between the lung of a smoker and a nonsmoker?" Dr. Sommers. "That is correct. I cannot tell the difference." Mr. Preyer. "Is that the general feeling of most pathologists? Dr. Sommers. "Sir, it is my belief that the knowledge of what the black pigmentation represents, namely, carbon particles or coal dust, is known to every well-

7 trained second-year medical stud'ent, and that it is not possible to equate blackening of the lung to exposure to tobacco products." I think it's clear that the ordinary person would not only feel that.evidence has been suppressed, but I think he'd be pretty mad about it, and~pretty mad at the people who had deceived him. - We've already mentioned the smoking dogs. Isn't that, whatever else it may be, an excellent example of the suppression of evidence from the point of view of the ordinary man? Now I'm~not suggesting in either of these that there was, initially, a deliberate attempt at deception. I don't know. (I know that if the tobacco industry had been responsible for this sort of thing, we would be accused of deliberate deception.) What I do suggest is that anyone who is responsible for giving people a seriously misleading belief about health, has an affirmative duty to correct that impression. And if he fails in that duty to the public, he is guilty, then, of a deliberate suppression of evidence. Let me mention a third~example. Is there not a suppres- sion of evidence about the Swedish Twins study, a study that shows that in identical twins, where one smokes and the other doesn't, there is no difference in health. Now I recognize that it is possible to say here that you~have no affirmative duty to promote scientific information which directly and flatly contradicts your thesis -- as against the affirmative duty you have in the cases of "black lung"' and "smoking dogs." I will agree that, so long as you are purely partisan, and not concerned with fundamental truth, that may be a support- able position. But I ask you, doesn't the ordinary person really expect you to give him the whole truth? Wouldn't he think that this is a suppression~of evidence? I realize, too, that it is possible to say that this is a fault of the media. I don't think so. I don't find much usefulness in "finding fault` anyway -- it always turns out to be "someone else's" fault. It is jV a result of a pervasive "climate" which leads inevitably O to the suppression of evidence such~as this. And it is, F'h I deeply believe, to everyone's interest to correct Cn that climate, and eliminate the suppression of evidence. ~ Was it not suppression of evidence to omit from ~ discussion in the 1973 Surgeon General's report (the ~ Horn report), and instead bury in a footnote, the FAA ~ study that showed that cigarette smoking does not harm nonsmokers, as pointed out by Senator Cook? (Cook speech, Congressional Record, Feb. 7, 1973.)

8 Was it not suppression of evidence to omit entirely, even from citation, 2,00&scientific articles on smoking and health in these reports over a ten-year period? I'm sure Dr. Horn has a defense for these omissions. But would it satisfy the ordinary person whom I suggest is the only true test of suppression of evidence. I know, as we all d'o, that Dr. Horn is charged with the positive duty of being a partisan,•by law. But he is also charged with the conflicting duty of giving full and fair reports. I agree with Dr. Steinfeld, our last Surgeon General, that these conflicting obligations are an intolerable burden, and one must ultimately choose one duty or the other. The law setting up these con- flicting obligations almost mandates that there must be some suppression of evidence, so long as the man who administers it is human. I could go on with a long list of examples of the suppression of evidence -- and you might agree or dis- agree with individual examples. But I find it hard to believe that anyone would disagree that not only has there been considerable suppression of evidence, but, far more important, that, given the present climate there must be suppression of evidence. I think I can state that case in two sentences. The first sentence is from Emerson Foote, and~I don't know who authored the second, but I find it wise and I'm sure you will. "There is a war," said Emerson Foote. And, "in war," said someone else, "the first casualty is truth. " ' If we can all agree, as I hope we all can, that the suppression of truth is, at least in the long run, an unmitigated evil, I think we can also agree that so, too, is the cutting off of research. And I think the case for this fact -- that there has been, and will continue to be, less research than needed -- can be stated in a single sentence: So long as people think they know the answer, they will not look for it. N O N ~ Let me quote a small section from Congressional hearings:~& CA Dr. Furst: "...there is a certain limitation on funds 01 (for research), but I think the problem I have is N that most of the cancer scientists do not feel this is a fruitful area because I think they hear too often -1

9 that it is already a fait accompli." Mr. Adams: In other words, you have had a number of cancer scientists say to you that they believe it has already been causally connected -- between smoking and lung cancer -- and they don't want to bother spending more time researching it. Is that it?" Dr. Furst: That is the gist of some attitudes, yes sir." And that is the gist of the problem -- the most serious problem facing anyone who is dedicated'to finding the cause and cure of cancer. (I want to add, as a parenthesis within a parenthesis, a personal notion. I believe that the "felt necessity" of maintaining the "war on cigarettes" is now cutting deeply into the research funds available through the ACS, the AHA and the American~Lung Association. All three have decreased -- I assume because they had to -- the percentage of their income that goes to research from '68 to '72. From 35% to 31.5% for ACS. From 35.6% down to 32.3% for the American Heart Asso- ciation. From 4.6% to 3.5% for the American Lung Association. I assume, although I don't know, that this decrease of the percent of funds for research is a function!of the added costs of raising funds, and' the necessity they feel for maintaining a"public education" war on cigarettes. These figures are from Lyn's brief on "The Voluntary Health Associations, A Brief Financial Review, which I will ask to be included in the documentation.) That's everything I can think of. I know you have a lot more to-add on this topic about AHH and antigens, but my little knowledge would be of no help. I hope some of the rest of this has.