Jump to:

RJ Reynolds

Current Digest of Scientific Papers Relating to Tobacco Use.

Date: Nov 1964
Length: 54 pages
501536861-501536914
Jump To Images
snapshot_rjr 501536861-501536914

Fields

Type
PUBLISHED DOC
Date Loaded
07 Jan 1999
Referenced Document
List of Abstracts.
Recipient
Ctr
Request
Blanchard
1rfp1
1rfp6
1rfp88
4rfp9
Minnesota
1rfp71
Texas
Initial
Disclosure
Castano
Cordova
1rfp29
Burton
2rfp16
Ohioironworkers
by
Agreement
2rfp20
Author
Current Digest
Box
Rjr1130
Site
R&D
R&D Tech Svcs-R&D Library
Characteristic
Marginalia
UCSF Legacy ID
cls39d00

Document Images

Text Control

Highlight Text:

OCR Text Alignment:

Image Control

Image Rotation:

Image Size:

Page 1: cls39d00
CURRENT DIGEST of Scientific Papers Relating to Tobacco Use (Compiled and Described for Informational Purposes Only for The Council for Tobacco Research-U.S.A. The Summaries Are Not Intended to ¢e Complete Scientific Abstracts.) Vol. IX, No. 11 November 1964 Contents 1. Smoking and the Lungs Statistical (. 3. Animal Experiments A` 4. Tobacco Chemistry ~. . 5. Heart and Circulation 6. Other Systemic Conditions 7. Medical Opinions - ~~.., ~.:.. 8. Smoking Habits and Deterrents ,.;---. - . 9. Psychology and Physiology 10. Air Pollution 11. Society Activities - o 0 o - Attached to this issue of the Current Digest are authors' papers and abstracts from the following scientific meetings: 1. American Public Health Association (October 5-9, 196+) 2. American Heart Association Council on Arteriosclerosis and American Society for the Study of Arteriosclerosis (October 23-25, 1964) 3. American Heart Association (October 23-25, 1964) 4. Conference on Biological Effects of Asbestos (October 19-21, 1964) - o 0 o - 1. SMOKING AND THE LUNGS j CHERNIAK, Dr. L., Associate Professor of Medicine, University of Manitoba, i Canada "Smoking and chronic respiratory disease." (Journal of the College of General Practice of Canada 11/1:31-32 & 34, July 1964) It has been shown:,that cigarette smoke produces an increase in airway resistance in all types of individuals, whether they are smokers or non-smokers and whether or not they are suffering from cardiopulmonary disease, the author says. The systemic effects of tobacco smoke are entirely due to the physiologic effects of the absorbed nicotine. Houever, as far as the respiratory system is concerned, the only adverse effect that nicotine could produce would be that of a possible slight slowir.g of the ciliary activity. . •
Page 2: cls39d00
2.- There is a close correlation between the incidence and the severity of,chronic bronchitis and the number of cigarettes that have been smoked, he says. The disease seldom occurs in individuals who have never smoked. '~It .e;,~must be emphasized, however, that not all cigarette smokers develop chronic bronchitis or even a'cigarette cough,' so there must be an individual and a familial susceptibility which probably play an important role in the patho- genesis of this disorder." Evidence that cigarette smoking plays a decisive role in the production of chronic obstructive emphysema is shown by the high incidence of smoking in patients suffering from this disease, as weil as the demonstration among smokers of functional changes which are comparable to those of chronic obstructive emphysema. There is general acceptance of the fact that cigarette smoking increases the risk of the development of lung cancer, and that the larger the number of cigarettes that have been smoked, the greater the risk will be, he says. "There are certain features, however, which would tend to minimize the role which is played by the carcinogens in the development of =°'lung cancer." An urban dweller will inhale 200 mg of 3,4-benzpyrene in a year, an amount equivalent to the smoke of 40 cigarettes daily for a year. Yet urban dwellers will have only twice the risk of dying from lung cancer as compared to the country dweller. "If lung cancer was caused by the carcinogenic action of the tobacco smoke, one would expect that a heavy smoker would develop lung cancer considerably earlier in his life than a lighter'smoker," he says. "But this is not the case." Studies have shown that there is no relationship between the number of cigarettes that were smoked daily and the age at which the lung cancer develops. But in every individual case studied, there was a preceding history of over 15 years' duration of symptoms suggestive of chronic bronchitis of varying severity. "This would suggest that there is some other agent, rather than the carcinogens, which produces the malignancy, and the most likely one is probably the altered conditions in the respiratory epithelium, in conjunction with the hypersecretion of mucus.... Since the majority of patients suffering from lung cancer give a long history of preceding cough and expectoration, this would suggest that cigarette smokers who do not cough are unlikely to develop lung cancer." ~ LINDE!1AN, Robert D., MD, SHAW, Russell F., MD, and BLOSS, Claude M. Jr., MD, "\ Department of Preventive Medicine and Public Health, University of Oklahoma Medical Center, and Oklahoma State Health Department, Oklahoma City "Pulmonary symptoms and function in 4922 southeastern Oklahomans." (Journal of the Oklahoma State Medical Association 57:331-335, July 1964) A survey of pulmonary symptoms and functions utilizing the indirect maximum breathing capacity (MBC), was conducted on 4922 per`sons in rural southeastern Oklahoma. Cigarette smoking habits including duration and amount were recorded. There was a marked increase in the incidence of cough and wheezing in the smoker groups, the authors say. The incidence of shortness of breath and of previous history of lung diseases were similar in the smokers and non-smokers when the age differences between the two groups-were taken into cons:deration. About 60% of all males smoked cigarettes whereas only 24 of the females smoked. Smoking rates decreased as age• incren.sed in both sexes. Although the over-all incidence of symptoms was lower in women, correction for smoking habits left the incidence of symptoms similar in the two sexes, they say. SmoY,ers also tencied to have lower indirect hiBC's than 0 .:
Page 3: cls39d00
3 ~ypMBARD, Herbert L., Cancer Research Institute of the New England Deaconess Bospital, Boston, Mass. "Some:problems of lung cancer." (Letter: Lancet 2:691, September 26, 1964) Commenting on Passey's 1962 paper (Current Digest, August 1962, page 8), the,author duplicated a few of Passey's tables, but using his own material, and found that his figures for the general distribution by age at onset of lung cancer were similar to Passey's although for most age-groups his average number of cigarettes smoked was greater. Cigarettes are not smoked as completely in the U.S. as in England, and this difference in tobacco consumption may be responsible for the higher average in our data, he says. Figures for the duration of smoking habit related to age at onset of lung cancer (male) were also reasonably close to Passey's, he says. The data showed that those who began to smoke early developed lung cancer earlier than those who started late. "I have always-believed that neither the age at which smoking began nor the average number of cigarettes was the most satisfactory measure of .~.r:._.. . ._ cigarette consumption," he says. Estimation of the number of packs of cigarettes smoked in a lifetime in two samples of 400 smokers each, separated by about ten years in time (1950-54, 1960-63) at bnset bf the disease, showed that in both periods the non-smokers of cigarettes(including smokers of cigars and pipes) bad the highest average age at onset of lung cancer. The moderate smokers had the lowest ages, while the heavy*and very heavy smokers had ages 5 to 8 years higher, although they remained less than the ages of the non-smokers. "In my opinion, this does not support Passey's hypothesis, but it is not inconsistent with the view that cancer of the lung is caused by varying degrees of host susceptibility, usually activated by cigarette smoking," he says. In the 1960-63 groups, the ages are higher than in 1950-54 for all categories of amount smoked: Average Age at Onset of Lung Cancer by Definite Amount of Cigarettes Smoked (400 Males) 1950-54 1960-63 No cigaretted 66.5 66.8 . Slight (under 5475 packets) 56.8 63.1 ~ Moderate (5476-12,774 packets) .52.3 54•4 ~ Beavy (12,775=18,249 packets) 57.8 59.2 Very heavy (18,205+ packets) 60.6 62.8 The average age at death in Massachusetts also showed an upward trend from 1940 to 1960 for lung cancers in males, greater than the rise in ages for deaths from all causes, he says. In females, however t- the upward trend in ages at death from lung cancer was less than that for all causes, he says. "Tne use of the average age at onset of lung cancer as a'variable is confusing. Persons born at different times and living in different environments are grouped together, and eausation variables may be hidaen. I prefer to use a control population matched for age with the cancers. Although I cannot agree with Passey that respiratory disease is the prime cause of the disease, I believe his suggestions are worthy of consideration." ( ,
Page 4: cls39d00
4. \ smoke." ,- .,c.. RISK,- Harvey S., NID, Pueblo, Colorado "' ~-'4 "Respiratory cancer. A new approach." (Rocky Mountain Medical Journal 61/10:47-48,-','.r October 1964) The author describes "a new concept in etiology of cancer of the respiratory tract" developed over 42 years of practice in otolaryngology, to zrit, that dryness leads to changes in mucous membranes, which are thus exposed directly to the chemical irritative actions of smoke. Certain drugs and nose drops as well as nicotine are vasoconstrictors which reduce normal moisture of the respiratory tract, he says. "Exchange of oxygen and carbon monoxide in the periphery of -the lung is dependent upon moisture of alveolar membranes. Many patients lose their stuffy noses, sore throats, and cough when they stop smoking and when they stop decongestive remedies." ~ ROBERTSON, Dr. Lewis S., President, National Cancer Association of South Africa, , Johannesburg "Carcinogens in cigarette smoke." (South African Medical Journal 38/28:617, .~ ~ . August 15, 1964) ! ~1 XKOUI~iS, Achilles,. NID, WILLIAMS, Norman, MD, DPH, DIE, and MERRIMAN, John E., 1rID, FRCP(C), University of Saskatchewan and Saskatchewan Department of Public Health, Regina, Canada . "Exposure to grain dust. II. A clinical study of the effects." (Journal of Occupational Medicine (Chicago) 6/9:359-372, September 1964) The average consumption of cigarettes was studied in 51 men (40 smokers) with respiratory tract symptoms (Group A) and in 22 men (15 smokers) without or with minimal symptoms (Group B), both groups with an average exposure to grain dust in elevators of 22 years; also studied were 11 retired men (6 smokers) (Group C) with an average exposure to elevator dust of 31 years. Productive coughs, wheezing, shortness of breath on exertion and irritation of eyes and nose were among the symptoms chiefly found in Group A; allergic sensitivity to grain dust was suggested by differences in the personal and family histories, the authors say. 1 V 0 1 • oN ao ~ OP 0 The Association "is privileged to announce a promising development '':~- in the research into the connection between cigarette smoke and lung cancer," the author says. "A Pretoria scientist, Dr. W. J. Serfontein, and Mr. P. HuY.ter, : a senior student... (at) Pretoria University, have just discovered that the Y: smoke of a brand of South African cigarette contains a highly active cancer- producing agent, or rather group of agents, known as 'nitrosamines.I The results obtained by Dr. Serfontein not only provide additional evidence of a possible causal relationship between lung cancer and smoking, but, perhaps more significantly8 r,. open up the possibility of selectively removing some of the carcinogens from tobacco.N :
Page 5: cls39d00
L 5. ,~ SKRABLE, Kenneth W., HAU3HEY, Francis J. and ALEXANDER, Edward L., Radiation ' Science Center, Rutgers University, New Brunswick, N.J. vs. RADFORD, Edward P. Jr., BUNT, Vilma R., and LITFLE, John B., Harvard School of Public Health, _Boston, Mass. ~--~--.- - "P-Y olonium-210 in cigarette smokers." (Letters: Science 146:86-87, October 2, 1964) The Rutgers scientists note that the Radford study (Current Digest, February 1964, page 7) said the dose of polonium-210 for an individual smoking two packages of cigarettes a day for 25 years -- about 36 rem -- was "calculated on the basis of retention of 3.3 X 10`+ pc of Po210 in 25 years, a volume of the bronchial epithelium of 3 ml, and a mean transit time of the mucus sheet of 36 hours." "This statement is confusing," Skrable and associates say. "Personal communication with Radford reveals that 'retention' refers to the total quantity of Po210 deposited in the lung and not to the total quantity present at steady state." It is based on 75 per cent deposition, "with no correction for decay or biological elimination," they say. It considers the bronchial epithelium as a single uniform sheet over which all the Po210 deposited in the alveoli passes with a mean residence time of 36 hours. However, portions' of the bronchial epithelium would in fact receive only that Po210 originating from alveoli connected to them. Mean exposure times and total quantity of Po210 passing over different segments of bronchial epithelium will be quite different and difficultj if not impossible, to calculate." Recommendations of the International Council•for Radiation Protection (Health Physics 3:1) 1960) on relative distributions of insoluble particles in the lung are quite different, and indicate "that Radford and Hunt's dose estimate to bronchial epithelium might be too high by a factor of 8," the Rutgers group says. "The facts that a considerable quantity of smoke is exhaled and that many particles deposited in the alveoli remain there for a long period of time... indicate that R adford and Hunt's assumptions tend to overestimate the total quantity of Po210 passing over the bronchial epithelium, and hence to overestimate the dose." In reply, the Harvard scientists say, in part; "In our opinion the International Committee on Radiation Protection has not given adequate attention.. (to the fact that the bronchial epithelium is the critical organ for inhaled insoluble aerosols containing alpha-emitters) in setting the maximum permissible concentration of the relatively long term alpha-emitting elements. "h'e are now in the process of measuring concentration of Po210 in bronchial epithelium of smokers in order to permit better estimates of doses in 'hot spots' with a minimum of assumptions.... We do not think that the ICRP model applies to cigarette smoke because cigarette smoke particles are nearly all smaller than 0.4 micron. For particles of this size the principal mechanisms`of deposition in pulmonary tissue are diffusion and, to a lesser extent, gravitational settling.... For particles deposited by diffusion the critical datum is the surface area of pulmonary ti::sue exposed to smoke. Since the surface area of the alveoli of a normal adult is more than 100 times greater than the surface area of the ciliated bronchi, our assumption that all of the smoke deposited... is initially on the alveolar surface seems reasonable."
Page 6: cls39d00
6. After further discussion of the deposition matter, Radford and associates add that "The subject of possible biological effects of cigarette smoking is one on which most scientists now have a bias... (which) often r~ depends on whether one is a smoker or has some connection with the tobacco industry. From correspondence with Alexander, it is apparent that he is ~skeptical of the role of polonium in production of bronchial cancer. Skepticism is a proper scientific approach, and in this case, it is ahared by us. Our skepticism is not dependent so much on uncertainty of the radiation dose to smokers as it is on the question of whether these doses can contribute to cancer production." ~ THURLBECK, W. M. and ANGUS, G. E., Pathological Institute, McGill University, -\ Montreal, Canada "A distribution curve for chronic bronchitis." (Thorax 19/5:436-442, September 1964) ;~.,r......: ._ Bronchial mucous gland bypertrophy was assessed by measuring the ;}- gland to wall rate (Reid index) and the thickness of tbe bronchial mucous glands in 101 random necropsies, the authors say. The same measurements were also available for 157 further necropsies. "At low values of the Reid index and bronchial mucous gland thickness, patients were generally non- bronchitic, non-smokers, and usually did not have emphysema," they say. "At high levels the reverse was true." The Reid index is affected by smoking:* The mean Reid index level was 0.44 in non-smokers, 0.49 in smokers, and 0.52 in heavy smokers. 2. STATISTICAL 1 HAMMOND, E. Cuyler, ScD, MURPHY, Robert, AM, and E4KER, Sol, MD, California Division, American Cancer Society, and Statistical Research Section of the Medical Affairs Department, American Cancer Society, New York City "Smoking, air pollution and health in California." (Presented at 18th Annual Meeting, California Division, American Cancer Society, San Mateo, October 15, 1964) The authors analyzed the four-year case histories of 115,174 California men and women who are participating in the Society's six-year investigation of the possible relationship of human living habits to cancer. The findings on air pollution were based upon the records of 65,576 non-smokers in the group. Physical complaints and death records of residents of Los Angeles, Riverside and Orange counties, which lie in a relatively heavy smog belt, were matcbed with those of residents in forty other counties of the state. Cough, loss of appetite, and nausea or vomiting were reported slightly more frequently by men and women in the three counties, but these differences were small, they say. The death rate of male non-smokers and cigar and pipe smokers was about the same in the three counties as in other counties. Complaints of cough, shortness of breath, pain or discomfort in the chest, loss of appetite, nausea or vomiting, indigestion, and a tendency to fatigue easily were reported more frequently in men with occupational exposure to gases,'dustsand fumes of various types than in men without such exposure, Vney say. .. 0 : I
Page 7: cls39d00
7 "These findings give no support to the hypothesis that general air pollution at levels now existing in Los Angeles, Riverside and Orange counties has a very serious effect upon the health of the population, although it may have some effect," they say. But they warned against quick conclusions that general air pollution is of no consequence as a ::public health problem. "It may be that general air pollution at levels now existing in the three counties will result in serious effects upon health after perhaps twenty or thirty more years of exposure." A preliminary four-year analysis of cigarette smokers versus non-smokers showed that complaints of cough, shortness of breath, loss of appetite, pain or chest discomfort, and a tendency to fatigue easily were reported far more frequently by smokers than non-smokers, they say. This was found in both men and women. The percentage risk of hospitalization increased with amount of smoking. Male smokers also reported more nausea, vomiting, and indigestion than those who did not smoke. Findings on smoking habits in relation to the death rates of men were essentially the same as have been reported in previous studies on this subject, they say. "The mortality ratio increased substantially with the number of cigarettes : smbked per day and was substantially higher among cigarette smokers who '.'said that they inhaled the smoke deeply than among those who said that they did not inhale the smoke or inhaled slightly." ~~EAMMOND, E. Cuyler, ScD, Statistical Research Section, and STOCKS, Arthur, BA, Executive Vice President, Iowa Division, American Cancer Society, Mason City "Smoking habits and health in Iowa and neighboring states." (Journal of the Iowa Medical Society 54/10:563-567, October 1964) This study of physical complaints in 23 rural Iowa counties is identical to the preceding report on California, in many instances using the same language. Cough, shortness of breath, pain or discomfort in the chest and several other complaints were all reported far more frequently by cigarette smokers,than by non-smokers among Iowa men, but the percentages of the first two are notably greater than the comparable California figures for male smokers (The Iowa study did not include females): Iowa California % male c'ette smokers ~ male % female c'ette smokers Cough (slight, moderate,severe) 61.4 56.3 49•3 Shortness of breath (slight, mod- erate, or severe) 37.7 32.0 28.9 a,- Because a statistically meaningful analysis of death rates in relation to smoking habits requires a large number of subjects, the authors combined the Iowa se onent of the study with data from Minnesota, Missouri and Illinois. "The mortality ratio increased substantially with the number of cigarettes smoked per day, and was substantially higher among cigarette smokers who said they inhaled the smoke deeply than among those who said that they did not inhale the smoke," they say. , . .
Page 8: cls39d00
4:-.. • r 8. ~. `JSANMOND, E. Cuyler, ScD, Statistical Research Section, American Cancer Soeiety~ N AALLORAN, John J., Executive Vice President, Pennsylvania Division of ACS, and NICODEMUS, E. C., BS, Executive Director, Philadelphia Division of AtS "Smoking habits and disease in Pennsylvania." (Pennsylvania Medical Journal 67/10:19-23, October 1964) This study of 40,432 Pennsylvania men aged 40 to 89 for 34•5 months is also of the same type, and the findings are in agreement with the findings reported above. Cigarette smokers report physical complaints more frequently than non-smokers, are hospitalized more frequently than non-smokers, and have far higher death rates than non-smokers, they say. The frequency of complaints, and hospitalization, and the death rate increase with degree of inhalation of•the smoke, and are higher among cigarette smokers who started to smoke early in life than among those who started to smoke late in life. "The relation of age to the incidence of cancer of Qertain sites." yT (Proceedings of the National Academy of Sciences 52/4:865-869, October 15, 1964) 0 I \LITrLE, C. C., Ellsworth, Maine The data on which this communication is based are derived from reports on the incidence of cancer from Connecticut and New York. Morbidity records give a more accurate picture of the relative frequency of a disease than do mortality records, the author says. The relationship between the rate of increase or of decrease in cancer incidence at various sites, in successive age periods, may be used to give suggestive information concerning the nature of the host response to tumorigenic pressures of different types and derivation. One of the ways in which the rate of increase or of decrease can be estimated is by determination of serial ratios, he says. As an illustration, he uses the incidence rates per 100,000 from cancer of all sites in white females in Connecticut; three different periods are averaged to cover the years 1935-1951. Ta obtain a serial ratio the incidence rate for each 10-year age-groiup is divided by the preceding decennial age-group incidence rate. The serial ratios between the data from Connecticut and New York, which were averaged and combined, are then compared for each of five cancer sites: rectum; lung and bronchus; skin; prostate; and breast. The rate of incidence of cancer per 100,000 at any given site in any one age group is a measure of the risk of malignant change in the tissue or organ, he says. When the rate of increase or decrease is calculated for total cancers of all sites for New York and Connecticut combined, there is an increased rate of actual incidence with increasing age, with the exception of the ratio between age-groups 0-19 and 20-29 in males, he says. The rate of this increase -- the degree of pressure toward carcinogenesis in successive age groups -- is, however, quite different for the two sexes. Three sites in which both sexes have cancer have been selected for consideration: rectum, lung and bronchus, and skin. One site in which cancer is entirely or almost entirely confined to one sex was chosen i'or each sex: prostate, and breast. .
Page 9: cls39d00
a 9. Table 3: Serial Ratios of Rate of Cancer Incidence by Site & N.Y. combined) (Averages of Conn. -Age group 20-29 30-39 40-49 50-59 60-69 70-79 80+ +'111!t_. - Male Rectum 3.96 6.67 3.98 3.65 2.34 1.57 1.14 Lung and bronchus 3.00 7.53 6.04 3.51 1.61 0.98 0.51 S kin 3.59 3.68 2.63 2.52 2.00 2.10 1.75 Prostate 2.00 9.54 18.04 6.05 3.32 1.89 Female Rectum 1.26 5.11 3.62 2.64 1.76 1.67 1.50 Lung and bronchus 2.20 3.70 5.58 2.02 1.94 1.79 1.18 Skin 3.33 2.88 2.12 2.13 1.94 1.79 1.82 Breast 16.70 8.64 3.10 1.49 1.40 1.32 1.29 . 3 reveals an interesting difference in the "Examination of Table ' degree of pressure toward tumorigenesis at comparable age periods," the author says. "This pressure varies closely with hormonal activity in prostatic cancer," and this contrasts with the relatively steady pressures of the skin cancer data. "There is a still different distribution of the rectal and of the lung cancer serial ratios," he-says. "In both of these sites, the greatest pressure toward increased incidence occurs between the 20-29 and 30-39 age groups.... "If the relatively stable ratios of skin cancer reflect in a considerable degree a relatively steady reaction to continuing external stimuli, then the ratios of lung cancer or of rectal cancer indicate that factors other than extrinsic agents to which individuals are exposed throughout adult life are the major influence in tumorigenesis of those sites. "Whether or not this will prove to be the correct interpretation, the fact remains that the pressure toward lung cancer incidence does not follow the type of course with increasing age that a cumulative continuing incidence on tumorigenesis would be expected to produce." ,~ MYDDELTON, G. C., MAt.MB, idRCS, LRCP, Henley-on-Thames, England "Deaths from smoking." (Letter: British Medical Journal 2:758, September 19, 1964) "The suggestion by Dr. Betty Wallace (Current Digest, September 1964, page 27) that Irish country practitioners shrink from using the word 'cancer' and put down 'pneumonia' as the cause of death when patients die.from cancer of the lung, thus completely falsifying the published statistics, cannot be reconciled with the relevant figures," the author says. The figures for cancer of the stomach for various areas of the British Isles show no indication of any reluctance to put the word "cancer" on death certificates in rurgl practices in Ireland, nor does the recorded death rate from pneumonia show the signs of inflation,which would occur if it concealed numerous undiagnosed cases of lung cancer. •
Page 10: cls39d00
;~. 10. ~ ~ Male death rate/million in 1960 Pneumonia Stomach cancer Lung cancer London 640 323 1,214 _.England and Wales 536 356 856 Republic of Ireland 370 322 322 ;f'-.'-'="Rural Counties of Ireland 359 313 195* *Estimated from published figures of deaths from respiratory cancer "The r tl; o .~,.on+ra_ ~°+~.°°.n l.' t _i • , _- - . -sta n6 uvs..~t v..v..~~aa lung cancer LLaath~ an L'vnavn anCi the rural counties of Ireland is obviously unconnected with cigarette smoking,^ he says. "Its comparatively low lung cancer mortality is only one example of world-wide linkage between the incidence of the disease and urbanization." The figures for cigarette consumption, lung cancer mortality, and population density for six different countries show that Canada, with the second highest cigarette consumption, has the lowest lung cancer death rate; while Austria combines the second highest mortality from the disease with the lowest cigarette usage. _;~...;..-. ! i 3. ANIMAL EXPERIMENTS V ANDERSON, Dr. Mary R., Algernon Firth Institute of Pathology, School of Medicine, Leeds, England "Variations in the rate of induction of chemical carcinogenesis according to differing psychological states in rats." (Nature 204:55-56, October 3) 1964) If chemical carcinogenesis is the result of an antibody induced by a carcinogen-protein complex, different forms of stress, activating different aspects of the immune mechanism, may vary the rate of chemical induction of, cancer, the author says. Four groups of 12 rats each: contented, stressed, alerted, and controls, received 20-methylcholanthrene (subcutaneously) to the anterior abdominal wall. At 40 weeks, 4 out of 12 alerted rats (kept in tension cages) were without tumors, whereas only 2 of the stressed group (adrenaline- treated) out of 36 other rats were without tumors, she says. "It is believed that environmental factors play a part in controlling the degree of tolerance or immunity that is achieved, and modifying the environment, and hence the psychological state, can vary the rate of induction of chemical carcinogenesis in rats." ' IKUTi4, F., MD, and ZIMNIERMAN, H. M., MD, Montefiore Hospital, New York City "Intramuscular precancerous lesions from hydrocarbons." (Archives of Pathology 78/4:377-389, October 1964) 4- The carcinogenic hydrocarbons methylcholanthrene and benzpyrene, in purified crystalline powder form, were implanted into the muscles of mice, inducing reactive responses and one neoplasm, the authors say. Ten animals were studied at intervals up to four months after implantation with the aid of an electron microscope. With one exception, all lesions in the precancerous stage contained cylindrical filamentous rods in the reactive cells. which were identical with those previously noted in intracerebral carcinogen-induced lesions. • (T 0 6. .f
Page 11: cls39d00
These rods were neither tissue- nor carcinogen-specific. They had many morphologic similarities to several known viruses but were not identical / with any of them. They probably originated from certain reactive cell components under the stimulus of the carcinogen, they say. .. . ~ KONTOS, H. A., ALMOND, H. R., MAUCK, H. P. Jr., and PATTERSON, J. L. Jr., Department of Medicine, Medical College of Virginia, Richmond "Effects of intra-arterial injections of large doses of nicotine on reactive hyperemia in the hind limb of anesthetized dogs." (Clinical Science 27/1:155-162, August 1964) Large doses of nicotine injected into the femoral artery of anesthetized dogs abolished or markedly diminished the hyperemia in response to short periods of ischemia in 13 of 21 experiments, the authors say. This effect of nicotine was accompanied by a decrease•in resting oxygen uptake and carbon dioxide release by the tissues of the hind limb. During reactive hyperemia there was an increase in femoral venous pC02 which correlated well with the changes in blood flow. '._'T2iis rise was absent or diminished in experiments in which nicotine inhibited ~ reactive hyperemia. They suggest that the effect of nicotine upon the reactive hyperemia is related to a decrease in the accumulation of carbon dioxide in the iscbemic tissues. An important similarity between post-contraction hyperemia and reactive hyperemia is suggested by the fact that nicotine is capable of inhibiting both, they say. The present findings suggest strongly that the release of carbon dioxide by contracting muscle is an important factor in the production of the accompanying hyperemia. I ORIIdURA, Yoshiyuki, Department of Pathology, Osaka University, Japan; KOTIN, Paul, and FALK, Hans L., National Cancer Institute, Bethesda, Maryland "Photodynamic toxicity of polycyclic aromatic hydrocarbons in tissue culture." . (Cancer Research 24/7:1249-1259, August 1964) Cells grown in culture were exposed to benzo(a)pyrene and related polycyclic aromatic hydrocarbons dissolved in serum, following which procedure they were irradiated with long-wave ultraviolet light. The sequence of biological responses resulting from this photodynamic effect on the cells was dependent upon the total energy absorbed by the hydrocarbons incorporated in the cells. The most sensitive response was that of temporary interference with mitotic processes in cells in mitosis or in interphase at the time of irradiation, the authors say. A moderate grade of the response produced gradual cell damage characterized by membrane retraction, blebbing and vacuolization•of the cytoplasm, pyknosis of the nucleus, and ultimate cell death within a day or two. I .4
Page 12: cls39d00
12. An extreme degree of the response resulted in an instant death of the cell with a swelling and reticulation of the cytoplasm. Irradiation with conventional light and fluorescent lamps for a short time was also capable of inducing responses, provided sufficient benzo(a)pyrene was `incorporated into the cells. No significant quantitative or qualitative difference in the photodynamic activities of several carcinogenic and non-carcinogenic polycyclic hydrocarbons could be observed when the effect was compared on the basis of assumed energy absorptionp they say. ~ MOSIER, H. David, and ARmz-TRONG, Marjorie K., Department of Pediatrics, University of California Medical Center, Los Angeles, and Pacific State Hospital, Pomona, Calif. i I "Effects of maternal intake of nicotine on fetal and newborn rats." (Proceedings of the Society for Experimental Biology and Medicine 116/4:956-958, August-September 1964) A nicotine solution in place of water was given to rats throughout ,'7 pregnancy and up to the time of weaning in order to determine its effect on fetal and neonatal growth and mortality. The experiments showed that exposure to nicotine causes a significant reduction in weight in the newborn and weanling rat, the authors say. The mean values of the various lipid ratios in the brains of nicotine and control rats and also those of the livers in the two groups do not differ significantly. There is, however, a significant difference in variability of the lipid ratios in the case of the liver, they say. No differences in mortality were observed between nicotine and control groups either at birth or at weaning. SATO, Tokuro, SUZUKI, Taeko, TA KAYANAGI, Junko, and OKABE, Tetsuo, Department \ of Nutrition and Biochemistry, Institute of Public Health, Tokyo "Several observations on cigarette smoke." (Bulletin of the Institute of Public Health (Tokyo) 13/1:53-55, March 1964) The authors studied freshly prepared tar from cigarette smoke for the presence of free radicals and tested by skin painting to the mouse. Side stream smoke from dried cigarettes were found responsible for irritation to the eyes of laboratory workers, they say. This phenomenon was not encountered by using ordinary cigarettes. Skin painting of 60 mice did not produce any tumors until 2.5 years. The failure to produce cancer by skin painting of rather freshly prepared tar to the mouse might mean that the activity of the tar is weakened markedly shortly after the preparation, they say. Others claim that fresh smoke is necessary for the study of the carcinogenesis by the tar of cigarette smoke, however. ~ In ordinary cigarettes, high temperatured smoke will be cooled down by the adjacent part to about 100oC by the evaporation of water, and the vzapor will also be cooled dc7an by passing through the cigarette leaves, they say. The smoke condensing action of the cigarette itself is remarkable, and some of the radicals and compounds generated at the burning point are adsorbed or precipitated and some of them will react with water to be stabilized, they say. ' :K ~If ., ~11
Page 13: cls39d00
13. L'SZEPSENWOL, J., Department of Anatomy, University of Puerto Rico School ~ of Medicine, San Juan _"Carcinogenic effect of ether extract o'f whole egg, alcohol extract of ~,,,.egg yolk and powdered egg free of the ether extractable part in mice." (Proceedings of the Society for Experimental Biology and Medicine 116/4:1136-1142, August-September 1964) The question whether there is more than one carcinogenic substance in eggs, or whether a single substance in different concentrations causes the development of different types of malignancies is being studied. Mice of the T. M. strain were maintained from the age of 4 weeks on the Rockland rat diet (Group 1), supplemented with ether extract of whole powdered egg (Group 2), alcohol extract of egg yolk (Group 3), or with whole powdered egg from which the ether extractable part was removed (Group 4). In the later 2 groups the incidence of mammary cancer was considerably higher and that of the other types of malignancies (lung adenocarcinoma, lymphosarcoma, etc.) was lower than in Group 2. :.~.-_ . " This difference in incidence of the above two groups of malignancies is probably due to a difference in composition of the extracts used, since it is known that some lipids are more soluble in alcohol and others more in he says. In the case of Group 4 it is believed that the ether carcinogenicity , , 1 is not due to the egg proteins, but to the unextracted lipids. These and other results indicate that there is more than one carcinogenic lipid in eggs. ~ I 1 i THAYER, Philip S., and KENSLER, C. J., Life Sciences Division, Arthur D. `~ Little, Inc., Cambridge, Mass. "Cigarette smoke: charcoal filters reduce components that inhibit growth of cultured human cells." (Seience 146:642-644, October 30, 1964) This investigation shows that the water-soluble components of cigarette smoke condensate inhibit the growth of mammalian cells in culture, the authors say. The cytotoxic components were in both the gas phase and the particulate phase of smoke. Conventional filters of cellulose acetate reduced cytotoxicity of the particulate phase in proportion to the weight of particles trapped, that is, they did not alter the specific activity of the particulate phase, they say. Appropriately designed filters containing activated charcoal granules selectively reduced cytotoxic components in cigarette smoke which would have appeared in both phases, although the reduction occurred to a greater extent in the gas phase (60F~ when compared with unfiltered and non-filtered cigarettes). Since the gas phase of cigarette smoke.contains a large number of materials, many of unknown biological activity, and since many of them are adsorbed by activated charcoal, it is not obvious what the growth inhibitor ziould be, they say. "As with all laboratory studies of the effects of tobacco products on non-human or biological systems in vitro, the significance of the aforesaid results for the h;,urian smoker cannot be estirr.=ted with any degree of certainty," they say. "fi o•.:ever, the basic biochemical similarity of animal cells of diverse origin gives some ground for comparison." . :a
Page 14: cls39d00
' ~ 14 ~ WEISS, William,MD, and WEISS, Winifred A., Pulmonary Disease Service, Department of Medicine, Philadelphia General Hospital, Pa. 'Effect of tobacco smoke solution on paramecium." (Archives of Environmental ''. ` Realth 9/4:500-504 October 1964) , Tobacco smoke dissolved in water by continuous smoking had a toxie effect on P aurelia, causing slowing and eventual cessation of motility, and ;, death, the authors say. This effect varied directly with the concentration ' of smoke. Cigar smoke derived from a brand the size of cigarettes was ; significantly more toxic than cigarette smoke. Two charcoal filter brands of cigarettes produced smoke solutions that were almost as toxic as the smoke solution from a non-filter brand. The effect of smoke solutions was ~' apparently irreversible, they say. High concentrations of nicotine (3 mg/ml) '.~ and phenol (2 mg/ml) were required to reproduce the effect of cigarette smoke ~' solutions. It is unlikely that either of these substances in tobacco smoke ~` can singly account for its toxicity for Paramecium, the authors say. "There is certainly general agreement that, regardless of method - ;t or material, smoke is toxic for ciliated cells," they say. Differences ': arise over the mechanism considered responsible, but differences in experimental design are such as to warrant considerable caution in attempting to reconcile conflicting opinions. "It is conceivable that the relative importance of the particulate and gaseous phases of tobacco smoke may.vary with the method. It • is also conceivable that the toxicity of smoke is not attributable to any " one substance but rather to the additive effect of several substances. 4. TOBACCO CHENISTRY BR9.aN, John R., bB, PhD, and JARVIS, Anita A., School of Hygiene, University of Toronto, Canada "The strontium-90 content of Canadian tobacco sa=les." (Medical ServicesJournal of Canada 20/7:613-615, July-August 1964) The carcinogenic material in tobacco smoke has not been isolated with any certainty and it is most unlikely that fission products in the tobacco plant are responsible for the relationship between smoking and lung cancer, the authors say. In view of the contamination of tobacco with radionuclides, however, it is of interest to determine the amounts present in various parts of the plant, they say. Samples of processed tobacco leaves of Canadian origin from the 1960 and 1961 crops were obtained from the Imperial Tobacco Company of Canada, Limited. The results indicate that there is approximately twice as much strontium•~Oin the blade of the leaf (the lamina) as in the skeleton of the leaves (midrib) of the tobacco plant in the samples analyzed, they say. The average values of strontium-90/gram of calcium for the midrib, however, were sotnewhat higher than that for the lamina. "Although strontium-90 is present in tobacco in measurable amounts, it is unlikely that it will present any radiation hazard to the lungs," they say. "It has been estimated that the temperature of the burning core of a cigarette is in the range of 850-920°, which is bclow the temperature of vaporization of strontium und this will considerably reduce the amount leaving the ash anc.entering the smoke. I
Page 15: cls39d00
15. "In recent years the habit of taking snuff has reassumed a certain amount of social importance and it is interesting to speculate upon the radiation hazards of placing varying amounts of raw tobacco within the anterior nares." ~..r .^-_,.. ~iLOHMANN, W., Departments of Physiology and Radiology, University of Arkansas Medical Center, and VA Southern Research Support Centero Little Rock, Ark. "The presence of sulfur in cigarettes as determined by EPR (electron paramagnetic resonance) studies." (Journal of the Arkansas Medical Society 61/4:99-101, September 1964) None of the investigations concerning the carcinogenic effect of some "cbemical factors" in cigarettes and their smoke have been conclusive, the author says. The results show that sulfur is present in cigarettes and their smoke; EPR spectra of tobacco ash, smoke and contaminated filters gave a sulfur signal at about g=2, he says. "It might be an important factor :for the genesis of bronchial cancer. This would be in conformity with our cently proposed model for energy-charge transfer in biological systems, ``wbich is based on a metal-water-sulfur complex. There, we would show that any deviation from the right amount of sulfur, giving an optimal biological function, causes considerable changes in the biological activity of the system. Sulfur might, therefore, act as an important initiator in the production of bronchogenic carcinoma. Bronchial tests, however, have to prove this hypothesis." The charcoal f ilters normally used are ineffective in the adsorption of sulfur, he says. Activated charcoal absorbed the volatile sulfur, but it was tremendously difficult to draw through and the smoke was almost tasteless. 5. HEART AND CIRCUIATION ,;BIORCK, Prof. G., Karolinska Institutet, Stockholm, Sweden .) "Factors contributing to the etiology of cardiovascular disease." (Cor et Vasa (Czechoslovakia) 6/3:169-177, 1964) In a paper prepared for a WHO Conference on Public Health measures in the prevention and control of cardiovascular diseases, the author says that one has to take into account predisposing and precipitating factors in considering multifactorial etiology. In coronary disease and hypertension, "host" factors are of greater importance than environmental "agents," but the latter obviously exert an additional influence, he says. "It is well known that factors such as high serum cholesterol levels,-elevated blood pressure and excessive cigarette smoking add to the risk of developing coronary heart disease." I i i U ~+ o 'f w v t • ~ ! ++ 1! + 1~ 1 °
Page 16: cls39d00
A GORDON, Tavia, Division of,Health Examination Statistics, U.S. Public Health Service, Washington, D.C. "Heart disease in adults. United States -- 1960-1962." (Public Health Service _.__.-Publication No. 1000, series 11, No.6) t.d..•- The initial enterprise of the Health Examination Survey was the examination of a nationwide probability sample of 7710 persons aged 18-79 years, the author says. In the cardiovascular evaluation, 6672 persons were examined by 52 physicians, and the following findings resulted: "Of the 111.1 million adults in the United States, some 14.6 million had definite heart disease and nearly the same number had suspect heart disease. "Among the specific forms of the disease, the one most commonly encountered was hypertensive heart disease ... D.5% definite, 4.3% suspect). Numerically, coronary heart disease was next in importance.... L'2.8% definite, 2.2% suspecKj. Definite heart disease was more frequent among women, and suspect heart disease was more frequent among men. Hypertensive heart disease was more common in Negro than in white adults. The prevalence of : heart disease rose steeply with age...." ~ ==. . .. , . . ~ I~INCET, London, England -\"Coronary-artery disease in the young." (Leading articles: 2:628-629, September 19, 1964) Referring to a study by Gertler et al. (Current Digest, March 1964, page 9) of young patients with coronary-artery disease, the journal notes that although they were "a little uncertain" about tobacco, "there is no doubt about the significant relation between the use of cigarettes and the development of coronary-artery disease, though pipes and cigars are exempt.... From the viewpoint of prevention, we have little evidence that attention to any of the factors we have mentioned (diet, exercise, drugs) will really delay or prevent the onset of coronary disease," it says. "A ray of hope is provided, however, by the recent finding of Doll and Bradford Hill (Current Digest, June 1964, page 3; July 1964, page 5) that among doctors who gave up smoking there was a slow but definite fall in mortality from coronary-artery disease." ~ ~ .,. ~ . ~ ~ i ~ ~ ~ I . 4 r RUPNIEk'SKA, Z. M., Lublin, Poland !"L-ascorbic acid in smokers and non-smokers." (Polski Tygodnik Lekarski 19/33:1259-1263, August 1964) The author studied the effect of tobacco smoking ogvitamin C in the blood and urine in 40 healthy soldiers aged 20-23, 18 of them non-smokers and 22 smokers. Among the smokers there were 6 "moderate smokers," smoking up cn 0 to 6 cigarettes daily and 16 "smoking addicts," smoking 10-30 cigarettes every day. Ascorbic acid was determined in plasma and urine while fasting and after the "Vitamin C saturation" test. w P ~1 J P
Page 17: cls39d00
17. The mean value plasma ascorbic acid while fasting was 0.224 mg I per 100 cc in non-smokers and 0.159 mg per 100 cc in smokers, the difference being significant, he says. The difference was not significant in the mean plasma level of vitamin C four hours after the vitamin C saturation test. =,The mean vitamin C contents in 4 hours urine sample after the vitamin C ,Zsaturation test in non-smokers and smokers was 35•393 mg and 14.54 mg respectively, the difference being highly significant, he says. The difference was not significant while fasting. The author says that chronic vitamin C deficiency in smokers may explain at least partially one of the causes of early appearance of atheromatosis in smoking addicts. .~ TODAY'S HEALTH, Published by the American Medical Association "Pain from smoking." (That's a Good Question: 42/10:18, October 1964) A smoker writes that he gets a dull, boring pain under the breastbone on lighting up a cigarette. The journal replies that it sounds like "tobacco angina", but says that true tobacco angina is considered rather ;-:rare. In the few patients described in medical literature, pain was produced 7% ~ as soon as they began smoking a cigar or cigarette. It disappeared when they stopped smoking. "An unusual aspect of the study was the conclusion that nicotine does not cause the coronary vessels of the heart to contract, as is generally believed, but instead makes them relax," it says. It was claimed that earlier experimental studies were not reliable because excessive 4 f amounts of nicotine were given. "But even though more blood may flow through the coronaries, increased cardiac work as expressed by faster pulse and rise in blood pressure leads to a blood lack that causes angina pain. We can only suggest vhat your doctor has undoubtedly told you: You had better stop smoking." ;;. . f i E AL D ld Di i WENZEL, Duane G., ~ Pharmacology, Un s on o ona , v DR , WATPANAPONGSIRI, Artorntip, and V iversity of Kansas Pharmacy School, Lawrence, Kansas ~ "Nicotine and renal hypertension in the rat." (Journal of Pharmacology and Experimental Therapeutics 145/3:315-316, September 1964) Chronic treatment of rats with nicotine for 55 weeks first elevated and then depressed the systolic pressure, the authors say. Pressures of untreated renal hypertensive rats remained elevated, while the concomitant administration of nicotine to renal hypertensive animals reduced systolic pressures below the original level. These observations demonstrate that not only does the chronic administration of nicotine produce a depressor effect in rats, but that it can effectively reduce experimental hypertension induced by renal artery constriction, they say. "While the human response to smoking may not entirely resemble that of the rat to nicotine, the data could explain the lack of a significant relationship between smoking and hypertension," they say. "It could also explain the paradoxical elevation in blood pressure following discontinuation of the smoking habit and may have some bearing on the recent observation of Hammond (1963) that the death rate of men who discontinue smoking is higher within a year after stopping than among men who continued to smoke:" .
Page 18: cls39d00
6. OTHER SYSTEMIC CONDITIONS ATKINSON, Leicester, FRCS, FRACS, Dt4iT, CHESTER, Ian C., BDSc, FDSRCS, ; :_ SMYTH Frank G. MB MS FRACS and TEN SELDAM Rolf E. J. MD MCPA '` > > > o > > > > FCPat _ , h , °. s Department of Radiotherapy and Tumor Clinics, St. Vincent's Aospital, Sy~ey~ ~ ~s=NSW, Australia; Department of Dentistry of the Department of Public Aealth, Territory of Papua and New Guinea, Port Moresby; and Department of Pathology, University of Western Australia, Perth "Oral cancer in New Guinea. A study of demography and etiology." (Cancer 17/10:1289-1298, October 1964) The authors analyzed 209 cases of buccal cancer in the mainly still extremely primitive peoples of the Territory of Papua and New Guinea that were registered in the years 1958-1963. This form of cancer comprised 23.0% of all types of cancer reported for males and 10.8% for females, but these figures are not considered the real incidence rate. A close etiological relationship seems to exist between the habit of betel-nut chewing and this :•'form of cancer, they say. Although smoking is nearly-universal throughout the _'!territory, the betel-nut quid is never mixed with tobacco: This finds further support in the low reported rate of buccal cancer in the highland people, who only rarely chew betel nut, if at all. From this area, the reported rate is 4.8% for males and 5.4% for females. ~(DEGKWITZ, Rudolf, Universitats-Nervenklinik Frankfurt a.M., Germany •\ n n "Uber den.Einfluss des Rauchens auf die Ausscheiflung der 5-hydroxyindolessigsaure im Urin beim Menschen." (Klinische Wochenschrift 42/17:848-850, September 1, 1964) "Our invesbigations did not confirm the observations of Schievelbein... Elet al., Klin. Wschr. 40:52, 1960 to the effect that the urinary excretion of 5-HIAA LTj-hydroxyindoleactic acig of smokers is higher than that of non-smokers and that the smoking of 6.to 10 cigarettes during the day by non-smokers led to an increase of their 5-HIAA excretion," the English summary says. • 0 ~ GILLESPIE, Luke, MD, Harvard Medical School, Boston, Mass. "Smoking and low birth weight." (Clinical Obstetrics and Gynecology 7/3:658-665, September 1964) Reviewing the literature bearing on his subject, the author concludes that there is an association between smoking during pregnancy qnd low birth weight of infants, which appears to be in direct proportion to amount of smoking, occurs in all races, socio-economic classes, and is independent of age and parity of mother. "Smoking seems to be associated with a slight increase in the number of spontaneous abortions," he says. "Smoking is unquestionably associated with a decrease in fetal length." I
Page 19: cls39d00
19. ., His three criticisms are that all but one of the studies was retrospective, that there were no real controls in any of the series, and that no one studied infants of low birth weight to determine if they truly _.-were prematures and subject to the morbidity and mortality risks of 4`- / prematures. Also, there was no follow-up: "No one can say that any of ~:;: these infants suffered any harm because he was of low birth weight because his mother smoked. "The Collaborative Study of Cerebral Palsy., Mental Retardation, and other allied Neurological and Sensory Diseases of Infancy and Childhood is well on its way to the documenting, in a prospective fashion, of fifty thousand pregnancies with follow-up of the infants until they are 7 years of age. Questions on the smoking habits are in the basic protocol of this study. On the basis of the prenatal interviews, all the patients will be divided into 5 groups: 1. Those who have never smoked. 2. Those who smoked before pregnancy, but stopped before the pregnancy. 3. Those who stopped smoking during the pregnancy. 4. Those who started smoking during the pregnancy. 5. Those who smoked before the pregnancy and who smoked throughout the_pregnancy. "Each of these classes can.be studied and controlled for literally hundreds of variables.... When this study is over, I am confident that its reports will prove conclusively whether or not there is a causal relationship between smoking and loW birth weight of infants. It will show whether or not such lcnr birth weight is dangerous or not to each of these questionably premature infants. Until then, 'No Smoking' for pregnant women." rQSKIEWICZ, H., Warsaw, Poland "Tobacco smoking and the excretion of uropepsin, with particular interest for the subjects with peptic ulcer." (English summary: Poiskie Archiwum Medycyny WewnetrzneJ 34/8:l00l-1008, 1964) The author studied 157 smoking and non-smoking subjects with peptic ulcer of the stomach or duodenum, or without gastrointestinal disease, before and after having smoked four cigarettes. There was a statistically significant rise in uropepsiin excretion following tobacco smoking in all the groups studied. The increase in uTapepsin excretion occurred 'in 54 to 54 of the subjects of each group. The group of non-smokers showed a greater rise in uropepsin excretion than did the group of smokers without gastrointestinal disease, he says. }l ~ MOORE, Condict, MD, Department.of Surgery, University of Louisville School "r of Medicine. Kentuckv I- "Smoking and mouth-throat cancer." (American Journal of Surgery lOB/4:565-569, October 1964) v 0 .. A group of 78 patients seen over a 12-year period, all of whom had v. ~ used tobacco moderately to heavily and who had been "cured" of mouth-throat cancer, was divided into two subgroups after their first cancer: 1) those w : 0 . who quit smoking: 29 patients; 2) those who continued to smoke: 49 patients. oD i J %O
Page 20: cls39d00
In a mean follow-up time of 6.7 years, and at least three years after their first cancer, 17 of those who continued to smoke developed a second mouth-throat cancer, while only one cancer appeared among the subgroup that had quit tobacco, the author says. The difference in ~ distribution of second cancers between the two subgroups is highly significant V,-_if--one accepts that the subgroups are reasonably homogeneous and comparable in other respects, he says. "Are we justified in concluding that tobacco causes mouth-throat cancer?" he asks. "The numbers of the subgroups are quite small and the number of uncontrolled variables in any human groupings necessarily numerous; therefore, few will consider the causal connection as proved. Furthermore, any serious concept of cancer causation must include a multitude of factors acting together, of which an external chemical agent can only be one. However, the figures strongly suggest that tobacco is a determining factor in mouth-throat cancer, without which relatively few such cancers would develop." ---- QUIGLEY, Lawrence F. Jr., DMD, MS, Harvard School of Dental Medicine, Boston; ~ COBB, Carolus M., PhD, American Science and Engineering, Inc., Cambridge, Mass.; SCHOENFELD, Stanley, BS, Lago Hospital, Aruba, the Netherlands West Indies; HUNT, Edward E. Sr., PhD, and WILLIAMS, Philip, DMD, Tufts School of Dental Medicine, Boston, Mass. "Reverse smoking and its oral consequences in Caribbean and South American peoples." (Journal of the American Dental Society 69/4:427-442, October 1964) ! In a preliminary study of the reverse smoking habit in the Netherlands Antilles and its effect on oral health, 21 subjects (19 women, 2 men) were examined thoroughly. Generally, the oral cavity had heavy tar deposits on the buccal and lingual surfaces of the teeth; tough, hard, leathery palate; and reduced flow of saliva and.leukoplakia on the palate and lips, the authors say. Biopsy and cytology did not reveal dysplasia. The health of the gingiva was average'and sometimes excellent. "A lthough this custom of reverse smoking is peculiar.and remote, it is of interest since it is accused of causing palatal cancer," they say. "If this assumption is true, the custom offers an exceptional opportunity to study the onset and early cytology as well as the gross manifestations of carcinogenic dysplasia in several ethnic groups. If this assumption is not true, the role of tobacco tar and intense radiant heat as carcinogenic factors must be reappraised." The low incidence of epidermoid cancer of the hard palate in this region, despite the prevalence of reverse smoking, may result from a factor of ethnic background (70% Negroid), they say. 0- 4
Page 21: cls39d00
k\'iG-C'-- . -_ W- WE 21. ~ RULON, J. Thomas, MD, Henry Ford Hospital, Detroit, Mich., and SIMONTON,, K. M., '~ MD, Mayo Clinic and Mayo Foundation, Rochester., Minn. "Clinico-histological study of chronic pharyngeal symptoms." (Annals of Otology, Rhinology and Laryngology 73/2:501-527, June 1964) ~. In a study of pharyngeal symptoms in several groups of patients with or without soreness, dryness, post-nasal dischargej, and a combination of conditions, the authors found that persons with a chronic dry, sore throat believed their symptoms to be intensified by exposure to dust, certain animal danders and diesel fuel vapors, excessive voice use, eating chocolate, moving to a different section of the country, and smoking. None of the patients who smoked was aware of an aggravation of post-nasal discharge with this habit. Only one patient who smoked believed his chronic dry throat symptoms were made worse by his habit. Smoking histories of the controls are not given by the authors. TAUBENHAUS, Leon J., NID, MPH, MALOOF, Edward C., DNID, MPH, and SCANIANj `' John W., AB, Brookline Department of Public Health, Mass. "Smoking and oral pathology; an epid'emiologic study." (Journal of the American Geriatric Society 1.2/9:871-876, September 1964) In a study of 1108 adults in the Brookline Health Department's oral cancer detection clinic, the authors say that statistically significant relationships were found between smoking and oral lesions in general, and with malignant or pre-malignant lesions in particular. The importance of cigarette smoking is further indicated by the fact that 25% of the patients with abnormal oral findings smoked more than a package of cigarettes a day whereas only 12% of patients with normal oral findings smoked this much, they say. 7. MEDICAL OPINIObTS ~~ `CHALKE, H. D., OBE, TD, MA, MRCP, DPH, FRSH, Medical Officer of Health, I CamberWell, England "Smoking." (Royal Society of Health Journal 84/5:271-276, September-October 1964) "Although the exact manner in which cigarette smoke acts has not yet been determined, all available evidence leaves no room for doubt that it constitutes a grave danger to health of the community," the author says. "There is a long battle ahead against this well-entrenched enemy of health; this will be won in time, but the longer the delay, the beavi'er will the casualty lists become." I t , I
Page 22: cls39d00
.-~ ---~= ~ - - Rd.... -~-. - 22. ,YDUBOIS, Dr. Arthur B., University of Pennsylvania Graduate School of Medicine,. Philadelphia ''Tbe lungs and respiratory problems." (News and Notes: *'-'`-'-236a & 240a, October 1964) Medical Times 92/10: Recent population surveys suggest that perhaps ten per cent of all Americans have some degree of respiratory impairment, the author says; "Smoker's back" is frequently ignored but usually represents an early case of bronchitis. ~ GAy, Leslie N., MD, Associate Professor of Medicine Emeritus, Johns Hopkins V\ University School of Medicine, Baltimore, Maryland "Chronic bronchitis." (West Virginia Medical Journal 60/10:282-285, October 1964) . . .V:I! _ . . . . - . =-. - The exact cause of bronchitis and emphysema is unknown, but epidemiologiC. ~ studies carried out in Great Britain have cast considerable light on the origin of the diseases, the author says. "The greatest contribution to the control of chronic bronchitis is elimination of atmospheric pollution and institution of . effective measures against cigarette smoking," be says. Bacterial infection aggravated by urban crowding and overheating also play an important role in the cause and progression of the disease. 1,GEIGER, Frank L., NID, South Carolina State Board of Health, Columbia "Do you love your neighbor:" (Medical Times 92/10:1051-1052, October 1964) Commenting on the irritations caused by his cigarette smoking to his wife, children, and guests, the author notes that as tensions and frustrations have increased, his cigarette smoking has reached a higher level. "My cigarette smoking that for many years was a pleasure has now become a 'bad habit, " he says. "Incidentally, it took me about an hour and a half and four cigarettes to write this article." ~~ GLASS, M., Cape Town, vs. MEDICAL PROCEEDINGS, Johannesburg, South Africa "Lung cancer and atmospheric pollution." (Letters: Medical Proceedings 10/19:420, September 19, 1964) Criticizing a recent editorial in the journal (Currq.nt Digest, August 1964, page 33) that said in part that smokers who inhale get fewer lung cancers than smokers who do not, Dr. Glass quoted from the Surgeon General's report, (p.159) which declared that inhalation was a significant factor in lung cancer in cigarette smokers. "Is it not time that special pleading should be replaced by a truly objective and scientific attack on what is, after all, universally admitted to be an unquestionably serious state of affairs?" he asks. 0 • N
Page 23: cls39d00
r ~.-^ -, - 23. In rebuttal, the journal says that the S.G. report "Overlooks the fact that, despite the American investigations, in the earlier study by Doll.and Hill in the U.K. a smaller percentage of the lung cancer cases inhaled cigarette smoke than did the control cases.... The fact that, in the study, inhaling protected against lung cancer, remains one of those awkward facts fatal to the hypothesis that cigarette smoking is the cause of lung cance r . " ^ JOURNAL OF THE I()WA MEDICAL SOCIETY "Method for the anti-smoking crusade." (Editoria1:54/10:602) October 1964) Despite all the articles that have been written on cigarette-smoking and health and the reports of the-Royal College of Physicians and the USPHS Surgeon General, there still is a group of diehards who refuse to accept the evidence incriminating the cigarette, the Journal says. "They won't be convinced•until some scientist determines which H radical attached to which apecifie-carbon in the structural formula of nicotine or smoke or tar is '^c.arcinogenic for human tissue. Meanwhile, cancer of the lung will continue 1 to be lethal for thousands and thousande-of men and women-each year." ~ I,/LITTLE, H. V., National Society of Non-smokers, Dorset, England 1 "Smoking and Health -- choice for the electors." (Letter: Medical Officer -112/15:213, October 9, 1964) !1 "Electors who are concerned about the above issue will be interested t. to compare the following three declarations on the subject which our Society has received from the Party leaders: i -"Conservative -- Sir Alec Douglas-Home states: 'The fact that smoking, especially the smoking of cigarettes is a cause of many serious illnesses is established beyond all reasonable doubt.' But, it is contended, any restriction must come from local authorities. "Labor -- Mr. Harold Wilson writes: 'I have clearly stated that measures should be taken to stop cigarette advertisements in the Press and on television.' "Liberal -- 'Mr. Jo Grimond would wish to be associated with our Society's aims.'" I-V MASSACHUSETTS PHYSICIAN, Boston, Mass. "Not chicken," and "The ostrich farm." 1964) ~ (Editorials: 32/10:201 & 204, June-July Referring to a study by Salber et al. (Current Digest, April 1964, page 36), the journal says that teenagers rationalized their unwillingness to give up smoking with the stock answer: "I'm not chicken." In an effort to change the Madison Avenue image and to discourage young people.from smoking, the American Cancer Society initiated an advertising campaign called "Athletes Against Smoking," designed to build the image of the non-smoker.
Page 24: cls39d00
The second editorial says: "No one seriously believes that we will soon become a nation of non-smokers, and many will strongly defend the rigbt of the individual to smoke or not as he sees fit. But youngsters have a right to be given scientific evidence on which to base their decisions, and those Wbo want to stop are entitled to whatever help they can get." ~MEDICAL JOURNAL OF AUSTRALIA "Smoking and mortality." (2:423-424, September 12, 1964) "Doll and Hill have painstakingly built up such a mass of evidence that it cannot be ignored," the Journal says. "It may not be so convincing to the pragmatist as the unequivocal demonstration of cause and effect in the laboratory. But, particularly when it is taken together with corresponding statistical findings of other investigators and with such evidence of other kinds as has been forthcoming (this has been brought together in a most efficient ~ fashion by the Surgeon General's Committee in the U.S.), they must be said gt least to:bave established a strong case." ; ~ MODERN MEDICINE, Minneapolis, Minn. "Smoking and youth." (News: 32/2;:12, October 12, 1964) The Public Health Service has almost given up hope of convincing any large proportion of adults to stop cigarette smoking, the Journal reports. Instead, it will emphasize education of elementary and high school students on the health hazards of developing the smoking habit. Dr. James M. Hundley, Assistant Surgeon General, testified before a House subcommittee that a crash program would not be justified by results. "You are going to get effectiveness over generations, not over months or years. You have to change some values and attitudes and practices that are just about as deeply ingrained as any habits that people have," he said. ,~ SCHNAHL, D., Bonn, Germany "Krebserzeugung durch naturstoffe." (Cancer induction by natural products.) (Deutsche Medizinische Wochenschrift 89/12:575-576, March 20, 1964: Carcinogenesis Abstracts 2/3:80, July 1964) The author points out that carcinogenicity is not confined to by-products of our technological age, but is also inherent in many natural products. As an example, he mentions the betel nut, which appears to be responsible for the high incidence of cancer of the.oral cavity in certain Asiatic countries; the carcinogenic principle is believed to become active only Fhen the nut is chewed together with tobacco lcaves, he says. Among other examples are the nitrosamine-like constituents of the cycad nut and certain constituents of peanut meal, he says. m a D ., SC "I I
Page 25: cls39d00
SCHREUS, H. Th., Dusseldorf, Germany "Klinische bemerkungen zum raucherkrebs." (Clinical remarks on cancer of : smokers.) (Zentralblatt fur Haut-und Geschlechtskrankheiten 36/11:371) June 1, 1964: Translated by Excerpta Medica, Amsterdam, The Netherlands) Carcinoma in smokers provides evidence in favor of Virchow's irritation theory, which, subject to certain modifications, is still the basis of modern etiological teaching, the author says. Clinical experience has shown that there are three main sites for such cancer. Carcinoma of the lip is the typical localization for pipe smokers, as a combined effect of the pipe itself and the tar and carcinogens accumulating in the saliva. People who smoke cigars tend to develop carcinoma of the tongue, palatine arch or tonsils, while cigarette smokers mostly develop pulmonary cancer, he says. These localizations are probably linked with the type of smoking adopted, the greatest effect occurring at those sites where the direction of the smoke flow is reversed, and where it consequently remains in contact w ith the'mucosa for the longest period. ;SPRAGUE, Howard B., MD, Massachusetts General Hospital; Past President, ~~ American Heart Association "What I tell my patients about smoking." (Modern Concepts of Cardiovascular Disease 33/10:881-884, October 1964) "Since tobacco was discovered in the New World in the 15th century, there have been repeated attempts to legislate., coerce, promulgate, and terrorize smoking out of existence," the author says. "Despite the opposition of human nature, it is our duty to try." ~~ WATERMAN, David B., DOMM, Sheldon E., and ROGERS, William K., Knoxville, '~J Tenn. 'Ban on smoking held mandatory in chronic bronchitis." (Medical Tribune 5/100:20, September 21, 1964) "Chronic bronchitis produced by cigarette smoking is a far greater problem than the more dramatic problems of bronchogenic carcinoma and heart disease," the authors said at a recent joint meeting of the American Medical Association sections on diseases of the chest and general practice in San Francisco. WILBAR, C. L. Jr., MD, Secretary of Health of Pennsylvania, Harrisburg a- "Smoke gets in your health." (Pennsylvania's Health 25/3:1-5, Fall 1964) In an address giv; n at the Annual Meeting of the Vational Tuberculosis Association in t~eu York City, the author says: "It is a safe assumption to say that nearly everyone in this room is convinced that excessive cigarette smoking is a major health hazard.... I .1 i 1 ;
Page 26: cls39d00
"The fight against smoking will be one of the most difficult and hard fought health battles of the century. Yet medical and scientific facts have now been substantiated to the point that all of us in the health »" and education professions, if we are honest to our callings, cannot help 4,:-..but enlist ourselves in the army fighting this long-term battle to conquer the health hazards of smoking." 8. SMOKING HABITS AND DETERRENTS , ! 1 1ANDRlS, Len Hughes, NID, HYDE, Duane F., NID, and FISCHER, Edward, Southern _\. Monterey Medical Group, King City, Calif. "Smoking by high school students. Failure of a campaign to persuade adolescents not to smoke." (California Medicine l01/4:2i+6-2i+7, October 1964) An educational campaign aimed at dissuading students from smoking was conducted by two volunteer physicians at King City Joint Union High School in a five-year period ended December 31, 1964. At the end of the period the proportion of smokers was greater than at the beginning, the authors say: "There was a constant increase in the proportion of smokers over the last three years which led to the conclusion that our present program of discussion is inadequate." Answers to a qutstioninaire showed that 27.6% smoked in 1960, 35 • 5% in 1962, and 40. 3% in 1963. "Certainly there is a complexity of recognized factors (and perhaps ~ many unrecognized) in our failure to change the smoking habits amongst King City High School students," they say. "One is that, in the period covered by our campaign, the tobacco industry had an intensive advertising campaign aimed at young people. Another is that children probably are influenced by teachers, clergymen, physicians and a large portion of the adult population who smoke." ~/ SACHMAN, David S., MD, A llentown, Pa. "~~„Anti-smoking follow-up." (Letter: Medical Tribune 5/111:4 October 17-18) 1964) Results of one-year follow-up studies done on the first 47 patients who went through an anti-smoking clinic were fairly good, the author says; 27 stopped smoking and 17 were still not smoking one year later. Of the 20 people who did not stop smoking 17 are still smoking. v HAWKINS, Charles H., PhD, MPH, Central Washington State College, Ellensburg I- statutes which forbid the gift or sale of cigarettes to persons under a certain age; in Louisiana and W isconsin, however, earlier laws against furnishing cigarettes to minors have been repealed. "In view of the widely applicable restrictions in criminal law upon furnishing cigarettes to minors, one can conclude, we feel, that smoking among mifbors is disapproved in American morals. Therefore, in the case of this health problem, those in public health already have one cultural asset to heln in their Uork." "Legal restrictions on minors' smoking." (American Journal of Public Health 54/10:171+1-17i+4, October 1964) The author says that 48 states and the District of Columbia have
Page 27: cls39d00
~/ IANCET, London, England "~ "Smoking." (Article: 2:$13, October 10, 1964) 27. ~ ~ According to a recent survey of 6000 electors carried out by ;,,.,National Opinion Polls, 50% of those aged 21 or over in Great Britain are smokers, the journal reports. Compared with previous surveys, this represents a slight decline in the proportion of adults who smoke. As many as 60% of the smokers think that there is no association between smoking and lung cancer, it adds. In addition to the 50% who now smoke, a further 34 gave up a year or more ago and have not started again since, and 4% have give4 up within the past year without so far starting to smoke again. )'MACARA, Dr. A. W., School Medical Officer, Bristol, England "Smoking and school children." (Medical Officer 112/15:215, October 9, 1964) The extent to which the example of teachers and others with whom children come into contact in schools influences their smoking habits, is a matter of dispute, the author says. The force of personal example is the strongest single argument but a discussion with some 13-14 year old children found them surprised at the suggestion that their teachers' example might influence them, a typical comment being "we see our parents smoke, so what of it?" he says. Every discussion of this subject leads to the unavoidable conclusion that success will depend largely upon the habits and attitudes of the parents. ,~ tdACIAINE, Alan G., MA, BEd, PhD, MACF, University of Sydney; Public Education `~ Officer, Australian Cancer Society "Smoking and young people: an analysis of research and recommendations for remedial educative action." (Medical Journal of Australia 2:388-390, September 5, 1964) Anti-smoking measures among young people should be given a high priority in any cancer education campaign, the author says. Based on investigations made in the field of juvenile smoking, there is need for a more intensive approach in anti-smoking campaigns which will take into account the multiplicity and complexity of the associated factors. "If adolescents can be convinced that smoking is an anti-sex-appealing habit -- for example, being dirty and smelly and causing bad breath -- the impression is very likely to make a distinct impact," he says. The present incessant and alluring television advertisements are aimed strongly at young people. • w : I
Page 28: cls39d00
28. LMcFARLAND,-D. J. Wayne, New England Sanatarium and Hospital, Stoneham, •~ Mass. .."A wet way to quit smoking." (Proceedings, American Congress of Physical ,;e,.i;,~,,: Medicine and Rehabilitation, Boston: Modern Medicine 32/20:38 & 44, September 28, 1964) Hydrotherapeutic measures and other simple physical techniques may be beneficial in reducing the nervous tension that accompanies the breaking of the smoking habit, the author said. He suggested that the smoker avoid alcoholic beverages for the first five days. Other measures include deep breathing exercises, a ten to fifteen minute.walk after meals, and adequate rest. Using these techniques in five-day programs with more than 2000 subjects, the author observed that craving, headaches, nervousness, and inability to concentrate begin to decrease after three days in about half the subjects and by the end of the five days in another 25 to 30%. PEEPLES, William J., MD, Chief, Bureau of Chronic Disease, State Department of r Public Health; Member, State Interagency Council on Cigarette Smoking and Health, Berkeley, Calif. "Smoking practices among state health employees surveyed." (California's Health 22/6:41-44, September 15, 1964) The Bureau of Chronic Disease distributed 1576 questionnaires to department employees, of which 1326 were completed and returned. The returns show that currently 47% of the employees smoke; 39% smoke cigarettes and 8p smoke only pipes or cigars. The proportion of employees who smoke cigarettes appears to be less than in the general population, and the amount smoked also appears to be less. The most sizable segment of present cigarette smokers, 32%, smoke less than one pack per day, and of the male respondents, the most sizable segment, 34p, smoke more than one but less than two packs per day. YPYGOTT, F., Radiologist, Central Middlesex Hospital, London, England 1 "Changes in smoking habits,1>-)59-1963." (British Journal of Preventive and Social Medicine 18:163-165, 1964) Analysis of two inquiries in 1959 and 1963 into the smoking habits of 10,000 consecutive persons X-rayed at the hospital shows that there has been generally a slight decline in the proportion of smokers among men, taking cigarette and pipe smokers together, the author says. The drop did not amount to more than 4% in any of the decennial age groups under 65.` Over that age there was a*sharp rise in the rate of pipe smoking, which is no-4 more than twice as popular as it was in 1959. Among the men who smoke cigarettes, consumption increased at all ages nespite the decline in percentages. Thus 97 out of a total of 2689 men smokers betc.+een the ages of 25 and 64 in 1959 smoked thirty or more daily while 139 out of 2398 did so in 1963. ,. l sI 0 v w -t
Page 29: cls39d00
29. Among women there was a decline from 1959 to 1963 in the percentage of smokers, amounting to 3 to 8% in the age groups up to 45 years, but there was an increase of 6% in the 45 to 64 age group, he says. There was a clear increase in the average number of cigarettes smoked at, all ages, however. The investigation suggests that the campaign to reduce smoking has so far had a very small but definite effect in reducing the proportion of smokers in age groups of both sexes, except among the women between 45 and 65, he says. It is obvious that, if the connection between smoking and lung cancer is accepted, the present effort to discourage smoking has had very little effect and that much more needs to be done if this disease is tobe brought under control. 9. PSYCHOLOGY AND PHYSIOLOGY BORN, G. V. R., MA, DPhil, MB, ChB, Vandervell Professor of Pharmacology, rcr • Royal College of Surgeons of England and University .of 'London "Addictions and their effects on communit7 health." (Royal Society of Health Journal 84/5:264-267, September-October 1964) The usual reasons that are given by smokers to explain their habit are psychological ones, the author says. They like the fragrance and the flavor of the smoke; smoking calms, diminishes nervousness, hides excitement, or looks good. "As far as we know, these reasons are not related directly to the pharmacological effects of nicotine. But these effects may... indeed provide one explanation for addiction to nicotine," he says. HOCHBAUNS, Godfrey, PhD, Chief, lT PHS BehaviorF.l Sciences Section, Washington, D.C. ~ "Smoking causes still not known despite research." (Medical Tribune 5/116:8, October 28, 1964) A major gap in research on smoking is the lack of understanding of why people smoke, the author said. The journal notes that he wrote the chapter on psychosocial aspects of smoking in the Surgeon General's Report. Since its publication, he has elaborated on his views on several occasions. In an interview, he told Medical Tribune: "There may exist several psychological meanings of the act of smoking. It may have phallic significance for some; it may serve as a culturally determined symbol of adulthood or manhood for others; it may be a means of diverting surplus nervous energy for still others. A ll this suggests the strong probability that we are dealing with a variety of psychologically different behaviors among the smoking population even though we lump them together under the term 'smoking."' . . . i I ; :
Page 30: cls39d00
~--. ' pwyv~ 30. ~KISSEN, David M., Directoro Psychosomatic Research Unit, Department of Psychological Medicine, University of Glasgow, Scotland "Relationship between lung cancer, cigarette smoking, inhalation and r:: , ~ .i .~t.• personality." (British Journal of Medical Psychology 37/3:203-216, 1964 ~=. ) The author gives an account of cigarette smoking and inhaling habits of male lung cancer patients and non-cancer controls in relation to a number of personality features. The lung cancer group contained more smokers and smoked more cigarettes per head than the non-cancer group, he says. i Lung cancer patients typically have a poor outlet for emotional discharge; this feature is present irre,spective of quantity smoked but is more marked among non-inhalers, he says. Lung cancer mortality rates of those with a poor outlet for emotional discharge may be five tithes greater than those with a good outlet, he says. Extraversion and concealment, - two other personality features with which lung cancer may be associated, r~"'showed no suggestive relationship with exposure to cigarette smoke. "The evidence given in this paper suggests that both cigarette smoking and a characteristic personality appear tobe involved in the development of lung cancer," he says. "If one accepts the view that lung cancer is of multiple etiology and that among factors associated with its development are an exogenous one of exposure to cigarette smoke and an endogenous one of personality, it would appear that the poorer the outlet for emotional discharge the less the exposure to cigarette smoke required to induce lung cancer. Such an observation... is consistent with some of the anomalous epidemiological findings regarding inhalation and may explain in part why some light smokers develop lung cancer while others who smoke more do not." 10. AIR POLLUTION L1~aeradio /1 ~ iiC.l._ ~,.:~J "active particle/ and gases." (Science 146:440-444, October 16, I 4ale 1 6), ~ S osium s onsored b the U S Atomic Ener Commission and the 9 'm HANFORD LABORATORIES SYMPOSIUM, May 4-6, 1964, Richland, Washington . J p P Y •• gY Hanford Laboratories of the General Electric Co.) C. N. Davies (London School of Hygiene and Tropical Medicine) presented evidence showing that the deposition of dust in human alveoli has been much overestimated: "Because of the impossibility of making direct measurements, calculations regarding alveolar deposition have been based on respiratory gas exchange. Since aerosol particles possess a coefficient of diffusion negligible compared to gas, the actual aerosol- dead space is significantly greater than gas-determined dead space," he said.
Page 31: cls39d00
~-../a . Rft- WIWI 31. - c.* G. Saccomanno (St. Mary's and Veterans Administration Hospitals, Grand Junction, Colorado) reported on the incidence of lung cancer among miners on the Colorado uranium mining plateau; he emphasized the difference in tumor cell types between miners and non-miners. In uranium miners, 56% of..the lung tumors were of the undifferentiated type, primarily oat cell, •compared with about 15% in non-miners. It was also found that uranium "miners contracted lung cancer at an earlier age than non-miners. E.' L V.. 0. Archer (USPHS, Salt Lake City, Utah) reported that long exposures within uranium mines resulted in decreased pulmonary function; however, other factors such as silica dust, age and cigarette smoking were also implicated, he said. B. 0. Stuart and J. F. Park (Hanford Laboratories) reported that deposition of cerium in dogs resulted in lung damage and death 8 months after exposure. Four dogs that died about 4 years after deposition of plutonium showed bronchiolo-alveolar tumors, they said. " NGMANN, R., Department of Health, Mulheim-Ruhr, Germany "The inJurious climate." (Hippokrates 35/15:588-596, August 15, 1964) "Despite conflicting international evidence that some non-industrial areas report as high a lung cancer mortality as industrial regions and some do not, there is experimental and epidemiological data tending to confirm air pollution as a member of the causal chain, probably associated with urbaniza- tion, if not industrialization," the author says. Lung cancer has increased 30 fold in 2 to 3 generations and has now reached a mortality rate of 247 per 100,000 for men between 65 and 70 years of age in West Germany, he says. Corresponding increases in pharyngeal, laryngeal, or tongue cancer have not occurred, but bronchial cancer is elevated over 1901 figures when industrial toxicity was small, automobiles unimportant, and streets untarred. Chronic bronchitis in the most contaminated districts of a Ruhr city was double that for less polluted districts among patients 60 years of age or more. In particular, a suburb of rural character presented a bronchitic incidence one-quarter that of the most heavily contaminated urban district nearby. He notes the increases in the CO content of hemoglobin -- already 8% among cigarette smokers -- and blood lead levels in urban situations. "Cigarette smoke is said to invite a replication of the industrial smog situation, given current preferences for smoking in closed spaces," he says. }&HIMA, Yoshio, ISHIZAKI, Tatsushi, MIYAMOTO, Terumasa, SHIMIZU, Tamotsu, `f SHIDA, Takao and KABE, Junzaburo, Department of Internal Medicine and Physical Therapy, School of Medicine, University of Tokyo, and the Sapporo City Hospital, Japan "Air pollution and respiratory disease in the Tokyo-Yokohama area." (American Review of Respiratory Diseases 90/4:5?2-581, October 1964) The effects of air pollution on the respiratory tract among Japanese in an area of relatively low air pollution (Nfigata Japan) were compared with a comparable population in a highly polluted area (~okyo-Yokoharr,a). Pulmonary i'unction tests were performed on 2765 persons, who were also interviewed. I
Page 32: cls39d00
iW•4AW,:.\---1- _ ._-_- ~!~~'" . 32. of Niigata, and this was even more marked in those persons working in the most heavily polluted area for the longest time, they say. Among the Tokyo-Yokohama residents, there was an increased number of patients over the age of 45 with airway obstructive changes. "The results of this study indicate that prolonged exposure to heavily polluted air is associated with an increase in respiratory symptoms and airway obstructive changes," they say. During the survey no cases of Tokyo-Yokohama asthma similar to that seen in American military personnel were found. Because of the limited scope of the study, it cannot be stated categorically that this disease does or does not exist in the indigenous population of the Tokyo-Yokohama area, they say. ~~ Yokohama area had a tendency to have a lower mean vital capacity than those h _ t e authors say. Among these, cigarette smokers and persons with a history ~ of allergies had the most respiratory difficulty." Residents of the Tokyo_ t of sputum proauction, chronic cough, and throat irritation compared to " The residents of the Tokyo-Yokohama area had an increased incidence l1 C!nlnTVmv Anmr.rrmrt+o I . I --- ------- ---.. ~- : ~~'c.'-: - -~ ,,.rf-r.._ ~ ADVISORY COi,g•;ITTEE ON CIGARETTE SMOKING AND HEALTH, California "Anti-smoking campaign urged." (AMA News 7/23:11, October 26 1964) and the state legislature will have to provide $2.88 million for the first' year of the recommended program. Another of the committee's key proposals was that the law forbidding the sale of cigarettes to persons under 18 be strengthened and enforced. anti-smoking arive with the emphasis directed toward the state's youth, the ., journal reports. The committee's report must be approved by Gov. Pat Brotim, e ommi ee has recommended that California undertake a concerted:t;:;; ~ AMERICAN PHARMACEUTICAL ASSOCIATION I -;Z*~ 0 , ~ . "APhA resolutions. 1964 annual meeting." (Journal of the American Pharmaceutical~' Association NS4/9:428-429) September 1964) At its 111th annual meeting, the Association the APhA encourage pharmacists to educate young adults implicating cigarette smoking as a causative factor in illnesses. ~ CALIFORNIA MEDICAL ASSOCIATION adopted a resolution that on the medical evidence certain diseases and F_ "Smoking." (California Medicine 101/4:305, October 1964) At the 503rd meeting of the Council in August, Dr. Teall reported that Dr. Lester Breslow of the State Department of Public Health had proposed to the Comr,iission on Public Agencies that a "Committee of 1,000" be formed among physicians who oppose smoking, to create a nucleus for the distribution of anti-smoking pamphlets and other material. The Council referred the request to the Bureau on Corronunications for stuay and report. .1
Page 33: cls39d00
, 33. ~ IA-MARSH, Judy, Minister of National Health and Welfare, Canada "Smoking and health." (Editorial: Medical Services Journal of Canada 20/7:630, July-August 1964) . The author describes the programs that have develbped since the Canadian Conference on Smoking and Health was held in 1963. The Department of National Health and Welfare is endeavoring to provide leadership by assisting in the coordination of the activities of the various government and non-government agencies, by producing basic educational materials for use across the country, and by promoting research into the extent and nature of the smoking habit in Canada and into the motivational aspects of smoking, she says. Technical advisory committees have been established, a reference book and an information kit have been prepared and distributed, and projects on Canadian smoking habits have been approved. c J( MISSISSIPPI STATE MEDICAL ASSOCIATION _~ "Tobacco:and health." (Journal of the Mississippi State Medical Association ,':.. 5~8:338, August 1964) At its 96th annual meeting in May 1964, the Mississippi State Medical Association House of DelegaVs resolved to "go on record as advocating the voluntary giving up of smoking by those already habituated" and that it "urge its own members, all parents, teachers, voluntary health agencies, and other interested persons to do everything possible to influence young people not to start the habit of smoking." The Association also adopted resolutions that it "does publicl'y.. state that it believes smoking is potentially hazardous to health," and that it does "commend and applaud those organizations engaged in the education of the public concerning such hazards." ERRATA: Current Digest, March 1964, page 26: Katz paper was published in 1963 Current Digest, October 1964, page 41: Eysenck paper was dated July 1964. - o 0 0 - ALVAREZ, W. C.,'T'ne effects of cigarette smoking as seen in autopsies," ~, (Geriatrics 19:623-624, Sept. 1964. (Editorial review of Wilens and Plair study =-:.Current •Digest, Jan. 1962:7) ~AN~R. MED. ASS'N., "The AMA smoking cs~ign and 'Facts You Should Know, "' J. Inter. Coll. Surgeons I/42/1:14-15, July 1964. (Review of recent AMA pamphlet) ,J/A1*:R. MED. ASS'N., "A1•'W Education and Research Foundation, JAMA 190/4:362-365, Oct. 26,.1964. (Review of research project on smoking and health) 6 i
Page 34: cls39d00
~..a.___ .: . ~.:_ . 34• ~ AMA -- ERF, "Cigarette study grants go to 11," AMA News 7/23:1 & 8, Oct. 26, ~ 1964. (Announcement of further tobacco research grants) -1/BF.GG, T. B., "Dietary factors in ischemic heart disease," Abstr. of World Med. 36/4:225-241, October 1964. (Review mentions smoking among non-dietary factors: no new data) ~BOWER, H. M., "Old age in western society," Med. J. Australia 2:325-332, Aug. 29, 1964 (Smoking mentioned as a reversible factor which can shorten life span) ,x BRITISH MED. J., "Work after a 'coronary,"' 2:703-704, Sept. 19, 1964. ~ (Editorial says cigarette smoking is convincingly related to coronary disease) ~UECHNER, H. A. et al., "Baldness and emphysema," J. Louisiana Med. Soc. 116/9:329-332, Sept. 1964. (Bald headed men less susceptible to lung , cancer, emphysema. Smoking not a factor) -,~ - _ °~ BW-HOI, N. P., "New developments in chemical carcinogenesis by polycyclic hydrocarbons and related heterocycles: a review," Cancer Res. 24/9:1511-1523, Oct. 1964. (Discussion of methods of assay, chemical structure and activity, experimental evidence, and endogenous biosynthesis) ACALIFORNIA OSTEOPATHIC ASSOCIATION, "The Scientific Board report on smoking" and "Smoking and Health " California Clinician 60/7:140 & 144 July 1964 ; , , . (Reviews Surgeon General report and California Interagency Council on `CALIFORNIA'S HE.ALTH, "California smoking attack," and "Tobacco scare ads deplored by British," 22/6:46, Sept. 15, 1964. (Institute of Personal and Social Relations and the ACS, Calif. Div., received grants totaling $64,817 from USPHS to support smoking and health studies; Health educators will use gentle persuasion and not "scare" advertising) \ APEL, L. H., "The•menace of chronic bronchitis," Health 1/5:135, October 1964. (Chronic bronchitis is probably caused by air pollution and cigarette smoking) ~ CLINICAL PEDIATRICS, "National Conference on Smoking and Youth," 3/9:509, Sept. 1964. (See Current Digest, July 1964:28, Sept. 1964:28) Smoking & Health program) _~ CONNECTICUI' MEDICINE, "Smoking: Facts you should know," pub. 1964 by AMA " ~ Review 28/8:623-624, Aug. 1964. (Ample quotes from AMA pamphlet given) , ! I h CONSUMER REPORTS, "Cigarette smoking... the tough decisions ahead,"'29/10:464-468, J~ Oct. 1964. (The FTC has attempted to champion the publit's health, but tobacco politics has blocked action) , ~\ ,LEN, K. J., & COLLIN, R., Lancet 2:729-730, Oct. 3, "Daily running causing Wenckebach heart-block," 1964. (Two men who lost weight, stopped smoking, and began runs of 3 to 5 miles daily developed partial heart-block, although initial examination revealed no evidence of heart disease) 1
Page 35: cls39d00
35. DE MAEYER, E. & DE MAEYER-PUIGNARD, J., "Effects of polycyclic aromatic `~ carcinogens on viral replication: similarity to actinomycin D," Science , 146:650-651, Oct. 30, 1964. (Carcinogenic hydrocarbons DMBA and BP interact with DNA and impair the expression of information contained in this DNA) „~UNNILL, D. E., "Smoking at the B.M.A.," Brit. Med. J. 2:762, Sept. 19, 1964. ~/ (Letter against anti-smoking rule at annual meeting) ~ EHND{E, H. & NEURATH, G., "Einfluss des Feucbtigkeitsgehaltes von Cigaretten ~ auY die Zusammen-setzung des Rauches II," Beitr. z. Tabaksforschung 2.5:205-208, May 1964. (Phenols in mainstream cigarette smoke reduced up to 27% by added moisture content of tobacco) ~ FAHY, A., "Aspen conferees seek answers: What causes emphysema?" NTA Bull. "~ 50/9:13-14, Oct. 1964. (No specific agent has been identified as the cause of emphysema; smoking and air pollution may be considered indirect factors) I FISHHEIN,'M., "The cilia and tobacco smoke," Postgrad. Med. 36/2:184, Aug. 1964. (Review of Dalhamn & Rylander and Bernfeld et al. -- (Current Digest, March 1964; and Hoffmann & Wynder -- Current Digest, March 1963; lauds research in this area) v~FLURRY, R. L. Jr., "A simple method for predicting the carcinogenic properties ' of polycyclic aromatic molecules," J. Medicinal Chemistry 7/5t668-669, Sept. 1964. I ! FONTANA) R. S., et al., "Recent advances in the diagnosis of bronchogenic carcinoma. M. Clin. North Amer. I+8:911, July 1964: Review: Cancer Bull. 16/5:98, Sept.-Oct. 1964. (Periodic surveys are recorrmended for "high risk" patients-males over !+5 years who are chronic smokers and live in urban areas) ,~/FUNATSU, G. et al., Three "Tobacco mosaic virus" studies, Biochemistry 3/9: '~ 1351-1355; 1356-1362; 1362-1366, Sept. 1964. ,j GENERAL SERVICES ADMINISTRATION, "Exhaust control fitted in governmental cars," Med. Trib. 5/101:8, Sept. 23, 1964. (Federal body rules to commence with 1966 model cars) GIBSON, M. 0. J., "Bow Arrow -- The non-smoking hospital," Bull. Canad. Tub. Assoc. 44/1:7, Sept. 1964. (Physician tells how he stopped smoking in a British hospital) :,,j''GUERRANT, J. L., "Chronic bronchitis," CMD 31/10:962-963, Oct. 1964. (Reprint: ~ see Current Digest, August 1963:3) , , ;~ F'..'`2 1,Q.4AIti`N, K., "Uber die phenolischen Inhaltsstoffe des Tabaks und des Tabakrauches," Beitrage zur Tabaksforschung 2/5:159-179, Tsay 1964. (Comprehensive review and bibliography of phenols in tobacco leaves and smoye) 0 ~ " ~ , "~ IiIL Adress of the President (Ameri DING, A. C., Ann. Oto` Rhin. Lar. 73/2:358-363, June 1964 can Laryngologi . (If respirat cal Association)," ory tract w OP , , physiology was better understood, there woul d be less "corlf usion over the ~ t fact that malignancy from cigarettes occurs in tze root of the lung and in U ~ the vocal cords and not in the nose, mouth, and pharynx") ! i
Page 36: cls39d00
~ : 36. ~ wa o e a ep . . arc nogens suspec e among s w su s nces q•~> 9 n P ~ , r 7 9.1187-u~t~. d b t ) S t 1 ll 64 (C i t d of carcinoma of the eso ha s i Alaskan Eskimo women " Cance 1 ~• '''~ URST, E. E. Jr., "Malignant tumors in Alaskan Eskimos: Unique predominance .h~JANTLEN, G., "Zigaretten und Krebs," Prax. Pneumol. 18/6:404-414, June 1964. -- (Eaucation against smoking should be concern of every•physician, not th i ti • F h bt tadE lihabtatdi s s hil a ~ p n ropic soc e es. renc a s rac n ng r c verge widely; both praise Royal College of Physicians report) ~( J. MISSISSIPPI ST. MED. ASS'N., "Causal relationship," 5/8:305, Aug. 1964. '~. (Anecdote by A lton Ochsner on statistics) Y KATZ, M., "The organic fraction of particulate pollution including polyeyelie "~ hydrocarbons," Occup. Health Review (Canada) 16/1:3-16, 1964. (Smoke, soot from fuel-burning equipment greater source of carcinogens than liquid, gaseous fuels and gasoline and diesel engine exhausts) r\ KbRBLER, J., "Der Spinnerinnenkrebs und seine Auswirkung auf die Krebsforschung pub. 1962: Review: Ind. Med. & Surg. 33/10:747, Oct. 1964. (In addition to flax., author charges cigarette smoke, cigarette PaPere and viruses amo ng cancer causes) ,9WF LANCET, "In England now," 2:642, Sept. 19, 1964. ("P , "In e, ~ ~., ~, Sept. r ! eripatetic correspondent" reports --in,jest -- tobacco company gift of .!.life -saving float to resort, because studies show statistically significant link between inhalation of sea water and death by drowning) `j LANCET, "Coronary artery disease and temperament," 2:681, Sept. 26, 1964. ~~ (Review of Rosenman and Freidman' see Current Digest 'August l964:21) ~t J,LI?dDEN, G., "Cancer data exchanged," Calif. Health 22/7:49-52, Oct. 1, 1964. ~ (Discussion of ope'ration of the California Tumor Registry) ~/ LO~tJENSTEIN, F. W., Epioemiological investigations in relation to diet..., ~ Am. J. Clin. Nutrition 15/3:175-186, Sept. 1964. (Smoking 20 or more cigarettes daily included in table of etiological factors in coronary heart disease, not in text) ' 11 11 LYNCH, H. T., f Cancer infests big family tree, h,ed. Worid News 5/20:108-110, Sept. 26, 1964. Med. News Sept. 11, 1964:4. Med. Tribune 5/98:1 & 24, Sept. 16, 1964. (33 primary malignancies of many sites, some multiple, traced in 130 relatives, all with high lactic acid dehydrogenase levels) % : IX MacKENZIE, V. G., "The new Federal Clean Air Act," J. Air Poll. Control Ass'n. :-; ._: 14/9=385-387, Sept. 1964. (New dimension added to program, but Congress hasn't voted funds so far) ~MARTINEZ, I., "Cancer of esophagus in Puerto Rico... 1950-1961," Cancer 17/10: a 1279-1288, Oct. 1964. (Exceptionally high rate over 12 years induces ~ etiology study, to be made. Tobacco and alcohol among causes mentioned by others) a m /~ 1dEDICAL RIh'S, "Smoking among teenagers, " 104 : 7, Oct. 2, 1964. (More rural (50%) 00 than urban (15%) children aged 10 to 15 addicted to smoking in Uttar Pradesh, India, schools) •
Page 37: cls39d00
37• YMOELLER, Hugh C., Panelist, Symp. on Clin. Msn'g't of Peptic Ulcer -- Nutr. Aspects, June 25, 1964, San Francisco, Am. J. Clin. Nutr. 15/4:240, Oct. 1964. (Patients may smoke) /MOLD, J. D. et al. (Liggett & Myers Tob. Co.) "The paraffin hydrocarbons of wool wax...," Biochemistry 3/9:1293-1298, Sept. 1964. •- MONTGOMERY, R. R., "A doctor advises his own children," Progress Against Cancer 17/3:5-6, Sept.-Oct. 1964. (Letter reprinted from Kiplinger's " anging Times" Sept. 1964, advises children not to smoke) ~~NEW SCIENTIST, "Preventing cancer," No.410:745, Sept. 24, 1964. (WHO '~. expert committee report: see Current Digest, July 1964:25) ,~ OSBORNE, R. H. & DE GEORGE, F. V., "Neoplastic diseases in twins: evidence for -1 pre- or perinatal factors conditioning cancer susceptibility," Cancer 17/9:1149-1154, Sept. 1964. (Cancer experience of twins like that of single born; but stress factors, if not genetic, may affect likelihood of cancer in twin subjects) ~.~' ADMAVATI, S. & JOSHI, B., "Incidence and etiology of chronic cor pulmonale I in Delhi," Diseases of Chest 46/4:457-463, Oct. 1964. (Smoking was definitely not a factor) JPENNSYLVANIA MED. J., "Smoking's not new, nor efforts to stop it," 67/10:49,_ Oct. 1964. (Doctors letters to county medical societies in 1919 show longevity of the subject of anti-tobacco campaigns.) ENNSYLVANIA MED. J., "Clinic for preventing chronic bronchitis," 67/10:56, Oct. 1964. (Review of Wood and bieqdows: see Current Digest, Dec. 1963:5) ~ PICKRELL, K. L., "Smoking in college girls," Plastic & Reconst. Surg. 34/3:312, Sept. 1964. (Fatherly discussion on handling the problem of smoking) - ~ RAFTOPOULOS, J. et al., "Immediate electrocardiographic response to smoking," Helliniki Iatriki 33/8:787-792, Aug. 1964. (Nicotine effect on ECG confirmed: deep'depression of J and ST segment in man aged 63: English summary) . yROY, L. E., "The doctor's example counts," Bu11..Canad. Tub. Ass'n. 44/1:3, i. Sept. 1964. (Talk to students elicits response that physician's advice would be heeded) ,~ SCHIEVELBEIN, H. & SCHIRREN, V., "Abschwa"cbung der Toxizitgt von Nicotin durch 'T Erhohung der Thrombocytenzahl," Experentia 20/8:432-433, Aug. 15, 196~. (Toxicity of i.v. injected nicotine in rabbits decreases when the num er of thrombocytes in the blood is augmented by a.dministration~of platelet suspensions) \SCJIMTITERLGJ ~,C. G. & F•AhSSON, E., "Smoking rets to the brain, animal studies suggest," 1~ed. World News 5/22:23-24, Oct. 23, 1964. (See Current Digest, Sept. Attach.:5) , SCOTT, W. G. (ACS President) & ANDELtdAN, S. L. (Chicago Health Cornmissioner, J. "Smoking ads addressed to young hit," Med. Trib. 5/113:3; Oct. 21, 1964. (Although reformed some, ads still bad) % i
Page 38: cls39d00
-1 SMELLIE, G. D., "How to sell non-smoking," Medical News (London) Sept. 18 1ta (Suggests ads to "sell" healthy non-smoker) ;:._)(SOLEIL, Jean, "Action nocive du tabac sur le paradonte," Revue de Stomatologie .;.i dextran gel chromotography," Am. J. Clin. Path. 42/3:228-236, Sept. 1964. g f ~ , . . ., . r U nickel in ultraeentrifugal supernatants of lung and liver by means of Public Health Reports 79/10:839-89~+, October 1964. (Current Digest) Juee 19,~; page 27) -~:;. ... -'.~`+-'~' enesis Fractionations "Studies of nickel carcino NDERMAN F W J S t6ICER, W. S. Jr. et al., "AMA Congress on environmental health problems," I of swollen gums) june lyiY+. ktsiasea ramoiings iiiutb vvvc~u- wlvn 3 cases 64 A t AN > N f 64 THOMAS, C. B. et al., "Precursors of hypertension and coronary disease... II. ': ~. Using parental history as the criterion," Bull. Johns Hopkins Hosp. 115/3:21~5:. , ~ Sept. 1964. (Cholesterol role in atherosclerosis permits .:ZAV 51/9:579-581 in ings repor e .~•41 , Sept. 19 .(Significant and consistent 2 (Blood pressure rise in cats from nicotine stimulation) I Med. 55/1:12-17, 1963: Excerpta Medica Card. Dis. February 1964:358• TKACHENKO, B. I., "Reflex changes of the cardiovascular system following stimulation of chemoreceptors in the pericarcdium," 'Byull. Eksper. Biol. '(JNGER, P. N., "Coronary proneness. Can it be identified?" J. Florida Med. Ass'n U.S. Navy Med. News Letter 44/7:2-6, Oct. 2, 1964. (Smoking hazardous only during exposure to or treatment of frostbite) XW ISLICKI, L., True vertigo and smoking," J. Laryngol. & Otology 78/9:860-862, Sept. 1964. (Vertigo in male aged 62 ceased when smoking was discontinued) WOLLER, G. & SCHEDY, E., "Gesundheitsschadigungen durch rauchen," Mitt. Ost. ~ .~/WASHBtTRN, B., "Frostbite," Reproduced from the Polar Record, 11/75, Sept. 1963: preventive measures) , • , .;.'~ . Sanit.-Verwalt 64/2:33-38, 1963: Exe. Med. Pub. Health July 1964:2780. a~~.. (Vienna physicians outline need for objective advice; early start in schools needed to combat smoking) `. • -:. +. . v WHO CHRONICLE, "Cancer prevention," 18/9:323-327, Sept. 1964. (Review of WHO Expert Comm. Report: Current Digest, July 1964:25) ~•= Z.AGURY, D., "Cancers humains et virus," Comptes Rendus de 1'Association des ~ Anatomistes (France) 120:1364-1368, 1964. (Virus-like particles observed in electron microscope study of hu.man cancer tissue specimens) • 6- I
Page 39: cls39d00
-~!~CHMi;NT TO CURRENT DIGEST Ia-11-NOVEKBER 1964 1. AMERICAN PUBLIC HEALTH ASSOCIATION Follawing are excerpts from papers or authors' abstracts of papers presented at tW'92nd Annual Meeting of the above Association in New York City on octofier""Tj-9, 1964. BAKER, Sol R., MD, President, California Division, American Cancer Society, San Francisco "Combating the cigarette smoking indoctrination of adolescents." _ _ _ _ _ "We urge a_ strengthen_ing_ of__hea_lth_eau-cation in the schools, which is usually woefully weak, and the integration of the smoking program into the curriculum. Smoking bans in the schools and elsewhere should be enforced as a symbol of determination and smoking clinics for parents and teachers should be considered." ,-.. .. COHEN OF BIRKENIiEAD, Lord, MD, DSc, LID, FRCP, President, Royal Society of Health, London, England "Problems of health education." "Cigarette smoking in Great Britain remains practically unaffected by health education. Reports and recommendations of advisory committees to the Ministry of Health in 1954, and of the Medical Research Council in 1957, were scarcely noticed. The Royal College of Physicians' Report in 1962 on Smoking and Health had an immediate impact, and for a brief period cigarette consumption was reduced by 10%. But within a few months it was back to normal.... It is encouraging to record that recently an Institute of Health Education has been formed in Great Britain which is rapidly growing both in numbers and in influence." DAMON, Albert, ATUTTALL, R. L., SALBER, Eva J., SELTZER, Carl C., and tr.acMAHON, Brian, Harvard School of Public Health and Northeastern University, Boston, Mass. "Tobacco smoke as a possible mutagen affecting the X-chromosome." "To test the possible mutagenic effect of tobacco smoke, the sex ratios and birth weights of children born to smokers and non-smokers were compared. In 5 out of 6 series of men, numbering 14,617 fathers and 30,382 children, smokers showed the expected increase in proportion of sons Ci.e., smoking fathers had more sons than non-smoking father] , though not at 5% significance levels in any single group or in the combined total (p=.075). However, the exaecte6 decrease in proportion of sons born to smoking mothers was not found among ] 1, 334 rnothers and 26, 963 children. The simple genetic hypothesis ELhat exposed fathers should produce a higher and exposed mothers a lower proportion of sons through da,.,age by smoking to the X-chromosomeDs was therefore not confirmed. . i
Page 40: cls39d00
~~...A._~~.. 2. "Infants' birth weight decreased regularly with the amount of _ mothers' smoking during the pregnancy; fathers' smoking had a negligible ~: effect. Women who smoked regularly before pregnancy but gave it up during _,r.,.pregnancy had infants fully as heavy as those born to women who had not smoked before. These and other findings point to an environmental rather than a genetic or constitutional basis for the decreased birth rate." [:The authors say their data concur with Yerushalmy's (Current Digest, April 1964, page 18)-.1 DUNN, John E. Jr., MD, State Department of Public Health, Berkeley, Cal. "Cancer experience of several occupational groups followed prospectively." "The primary objective of this prospective study was to determine ~. the occurrence of lung cancer in men who were engaged in occupations under ~'-suspicion of having an excess risk for this cancer site.... The greatly increased risk of lung cancer among cigarette smokers'requires that the cigarette smoking•pattern of any group being observed for lung cancer experience be known. This is done in order that smoking standardized comparisons can be made with other groups.... "Cigarette smoking lung cancer gradients were determined for person-years before age 55 and for years at age 55 and older. When the lung cancer risk for those that nid not smoke digarettes is expressed as unity, these gradients are as follows: =~W Person-years Non-smokers Less than About tdore than Not stated 1 pack Under age 55 1 3.6 55 years and over, 1 3.4 1 pack 1 pack 7.5 11.0 4.5 7.6 7.9 4.3 "A weighted relative risk was computed for each occupational group for person-years under age 55 and older using age-specific percentage distributions of person-years in the various smoking categories. Correction factors for differences in the smoking habits of each occupation and in the two age groups were calculated. The factor chosen for the control group was unity.... The last column of Table III (shows)... observed number of deaths minus the adjusted expected number divided by the square root of the adjusted expected number." [Only two results were found to be statistically significant: an excess of deaths among asbestos workers, and a deficit of deaths among printersD 0-E~ ` From Table III: V-p,~" (selected occupations): Asbestos workers +3.84; Culinary workers (never cooks) +1.71; Painters and decorators +1.25; Plumbers (asbestos exposed) 4 .63; Cooks -t.53; Boiler rrakers (asbestos exposed) -.65; Public utility employees (controls) -.74; Sheet metal workers -1.58; Plumbers (no asbestos) -1.58; Printers -2.68. ,"Deaths from cancer other than lung cancer, and from a11 causes other than cancer, both show deficits for all th~, occupational groups as compared to all California males. This will require internal comparisons for the study groups by specific causes of death. These analyses are in progress." ~ 0 , 1 s I
Page 41: cls39d00
~.:~i._._:. ; GETTING, V. A., MD, DrPH, DENISTON, 0. L., bPH, NORTHROP, R. M., PhD, ROSENSTOCK, I. M., PhD, and WENTWORTH, F. H., 6m, MPH, University of Michigan School of Public Health, Ann A rbor "Research in evaluation of public health practices." x--: ~"1"`' : The authors describe their multidisciplinary research team, established to evaluate the effectiveness of public health programs, motivations for acceptance of recommendations, and influences toward changes. This includes a project to study students' reactions to the Surgeon General's Report, and changes in opinions at periods 2, 4 and 12 weeks afterwards, now nearing completion. The paper does not record preliminary findings in this study. I HAMMOND, E. Cuyler, ScD, American Cancer Society, New York City "New findings on the health effects of smoking cessation." X Tabulations were presented by the author extending the data presented earlier by Hammond & Percy (Current Digest, November 1958, page 1), which comprised -333 ex-smokers. Table 1 shows that "disease or physical complaint" was the reason for smoking cessation by 396 men sick at present (76.7%) and by 1457 men not sick at present (56.8%). The "smoking-cancer reports" were factors in 15 of the former (2.90%) and in 174 of the latter Table 2 shows that far fewer heavy cigarette smokers (40+ daily) hospitalized between questionnaires at all ages (50-59 and 60-69) had: stopped smoking cigarettes than intermediate and lower categories of smokers: 27.3% of 1-9 a day smokers in the 50s and 32.6% in the 60s, compared to 1_1.4% and 15.0% of the heavy smokers respectively. Table 3 shows that those who had quit smoking for less than a year were likeliest to resume smoking (37.5% for both age groups). Further tables provide data of this and other authors submitted to the Advisory Committee to the Surgeon General, included in their report. No text was furnished with the 16 tables presented. HAMI4OND, E. Cuyler "The multiple hazards of cigarette smoking." Summarizing this review of recent literature on cigarette smoking, including sub-headings: Acute Effects, Physical Complaints, Diseases, Disability, Mortality, Control on Other Variables, Causes of Death, and Pathology, the author said: ~ "Cigarette smokers have far higher total death rates than non-smokers. The death rates of cigarette smokers increase with amount of smoking and with degree of inhalation of the smoke. Death rates are higher among cigarette smokers who took up the habit early in life than among those who took up the habit later in life. .,
Page 42: cls39d00
... •.,~. 4. "For a great many different diseases, (but not all diseases), cigarette smokers have higher death rates than non-smokers. About half of _-_ the excess death rates of cigarette smokers (as compared with non-smokers) attributed to coronary artery disease as the underlying cause of death. . ,,,,.. . . - If judged in terms of mortality ratios, the following diseases show the highest degree of association with cigarette smoking: lung cancer; chronic bronchitis and emphysema; cancer of the larynx, oral cavity and esophagus; and gastric ulcers.... "The histologic evidence•., clearly indicates that the health of cigarette smokers is impaired long before they become seriously ill.... The association between cigarette smoking and these complaints is found among young persons as well as among middle aged and old 'ersons. "Aside from the increase in death rates, the serious impact of -; cigarette smoking on health is most clearly indicated by the following :". findings. 1) A larger per cent of cigarette smokers have been found among 't. ~:-,::hospital patients than among persons in the general population. 2) In a i '~` two year period a larger proportion of cigarette smokers was hospitalized `Y. than non-smokers. 3) In a large population survey, chronic conditions with activity limitation were found in a larger per cent of smokers than non-smokers. '~ In the same survey, the average number of days of disability due to chronic °~ , j. illness was found to be greater among smokers than among non-smokers. These -~+ differences were found in age group 25 to 44 as well as in age group 45 to 64. _ Ealifornia Health Survey 1954-1952 HOCHBAUM, G. M•, PhD, FAPHA, Chief, Behavioral Science Section, U.S. Public Health Service, Washington, D.C. "Psychosocial aspects of smoking with special reference to cessation." The author says nothing about the numbers of persons, questionnaires or other methods and geographical areas in this study. His principal findings are: No program for encouraging cessation of smoking will fit all cigarette smokers, who differ in many ways; procedures must prepare the ex-smoker to resist the urge to revert to smoking; the possibility of gradual discontinuation should be considered with some despite the popular notion that the only way to break the habit is an abrupt and complete one; the fear-of-disease approach should be tempered by use of positive motivations; and the individual must be helped to cope with recurrent temptations in order to prevent reversion to the habit. HORN, Daniel, PhD, U.S. Public Health Service Cancer Control Program "A systematic approach to the control of personal cigarette smoking." 1 , I Discussing the reasons for beginning and continuing to smoke, and "the intensity of the experience of failure reported by many who were unsuccessful in their attempts to quit," the author said that more success might be achieved by setting lower goals for worried people. A test was made with 165 adults who enrolled for seven sessions in Washington, D.C., held over a five-week period, followed by a course of five•sessions for 164 USPHS employees over four weeks. A 3-month follow-up was completed on the first group and a 6-month follow-up is now in` progress. A 3-month follow-up on the second group is now in progress. i : + I ~ 0 v ur P 0 N I
Page 43: cls39d00
5. "There was substantial attrition during the course itself," he said. "About one-half of the original group attended the seventh (and last) session. Although in a few cases people dropped out because they were satisfied that they had already obtained what they wanted from the course, most of the drop- outs found they were not making any progress and stopped coming. "Three-month follow-up information was obtained on 144 or 88 per cent of the group. Of these, only 8, or 5 per cent of the total group were completely off smoking by the end of the course. However, 12 or 7 1/2 per cent, a slightly larger proportion were completely off in the "three-month" follow-up -- roughly two months after the end of the course. Another 67 or 41 per cent reduced their average daily consumption by at least 10 per cent, the average reduction in this group being from 31 cigarettes per day to 19 cigarettes a day, or from over 1 1/2 packs per day to just under a pack a day.... Despite the fact that so few individuals gave up smoking completely, this is still stated as the eventual goal for over 80 per cent of the group.... Since the Public Health Service group has not had its three months follow-up completed, there is little I can say about it." KELLER, A. Z., DMD, MPH, Veterans Administration, k'ashington, D.C., and TERRIS, Milton, MD, MPH, New York Medical College, New York City "The association of alcohol and tobacco with cancer of the mouth and pharynx." "A study of 598 cases of cancer of the mouth and pharynx, and an equal number of age-matched controls, admitted to the three Veterans Administration hospitals in New York City from 1953 to 1963, demonstrates that: the liver. "l. Cancer of the mouth and pharynx is associated with cirrhosis of "2. This cancer is associated independently with heavy alcohol consumption and heavy smoking. "3. A marked deficit in its occurrence is found among Jews. "These f indings are consistent with the conclusion that both heavy alcohol consumption and heavy smoking are independently and significantly related to cancer of the mouth and pharynx." LEVIN, Morton L., MD, and GRAHAM, Saxon, PhD, Roswell Park Memorial Institute, Buffalo, N.Y. "Temporal factors in the cigarette lung cancer relationship." 01- Variations in risk associated with temporal factors in the cigarette lung cancer relationship were studied in more than 700 patients with lung cancer and other diseases at the Institute, the authors said: I ., .
Page 44: cls39d00
:6. "1. Adjusting for age and amount of cigarettes smoked, it was found that earlv aae at startina to smoke, particularly between 15-19 indicated ~ greater risk than starting after age 24. This was reminiscent of findings =~i€vf=the few studies done previously on the problem. '~ "2. Age-specific and age-amount smoked adjustment on variations in the period of years over which smoking took place suggested that smoking ;w for longer durations carries higher risk of lung cancer than smoking for short periods. ~. "3. It was impossible to study each of the above factors fndependently of the other because to do this requires larger numbers of individuals who have 1°~' !tr not smoked continuously since starting than we were able to examine. Regardless~r these findings are congruent with the dose-response relationships previously iC47 found; in addition, thpy have implications for preventive medicine. Starting to smoke early and smoking for long periods both carry high risk of lung cancer.; ,.,'; ,. ~- e v n iv m i n ."~'""'~~Y~ " f 1 if' t e t' e edic'ne is the findi which ~~'; a e g, nc o pr 0 equa s ign ic requires replication, that increases in length of time since the individual has withdrawn from smoking are associated with decreases in his lung cancer risk. In our series risk after not smoking cigarettes for ten years approached that of persons who had never smoked." MONK, Mary, PhD, TAYBACK, Matthew, ScD, and GORDON, Joseph, BS, Baltimore, Md. "Evaluation of an anti-smoking program among high school students." Simultaneous determination was made of the number of regular smokers before and after an anti-smoking program was carried out in 1963-64 in an all-boys school and at a comparable school without the program. In both schools the proportion of smokers increased slightly in the 10th grade and decreased in the llth and 12th; the total change for all students and for students in comparable college-preparatory courses at the two schools was negligible in both schools; 43% of all students were smokers at the experimental school in the Fall and Spring; 32% at the other school; the college prep groups were close to 35.5% and 27% respectively at both times. Students exposed to the program were more likely to believe that smoking is dangerous to health at the end of the year than at the beginning. There was evidence that some parts of the program had not been as effective as others in terms of students remembering the content or receiving the material. Because of the limited duration and intensity of the program, students were at an age when many had begun to smoke; and the program was countered by much pro-smoking material [ot otherwise described in the tex]t , the following recommendations were suggested: I
Page 45: cls39d00
7 ~- a. Programs should be initiated among elementary school and junior high students where smoking is less well established. b. Efforts should be developed to gain the involvement of students in all phases of the program; the cooperation and interest of teachers in the program should be sought. c. Ways should be developed to change adult and community attitudes toward smoking. d. Research not only to evaluate these attempts but also to determine motives for smoking and reasons for resistance to an anti-smoking program of this nature should be included. PEEPL.ES, William J., MD, MPH, FAPHA, California State Department of Public Health) Berke1ey "The:actions of one state in the cigarette smoking problem." Some 38,000 educational kits on smoking and health have been distributed by the California State Interagency Council on Smoking, the author said; more are to be distributed next year. The IJSPHS has made available a full-time Health Educator.to assist the state•Bureau of Chronic Diseases to evaluate and assess the impact of the curriculum; another health educator had been engaged with funds granted through the Council. The Governor's Advisory Committee on Smoking and Health is expected to complete its report in late November. A survey of smoking habits of all employees of the State Health Department was completed recently, with over 84% response, he said; 96% of the respondents had knowledge of the Surgeon General's report; of those who had stopped smoking, 30% had done so within the past year, and 25% of those still smoking were smoking less than a year ago. The California Medical Association and the Department of Health are attempting to organize a "Committee of One Thousand" physicians to assume anti-smoking leadership. The Bureau of Chronic Diseases has distributed a guide for the organization of smoking clinics, and also a review and abstracts of "all significant literature." But "despite vocal interest evidenced,few anti-smoking clinics have been organized in the state." PERKINS, James E., MD, Managing Director, National Tuberculosis Association, New York City "Effective ways to stop smoking needed by respiratory disease patients." 0- "At least 17,00 more Americans a year are dying from cigarette-related respiratory diseases than five years ago.... (These are) chronic bronchitis, emphysema, and cancer of the respiratory system.... Average annual deaths from all these cigarette-related respiratory diseases combined went up h7% (from 38,765 to 56,076 -- an increase of 17,311).... 1
Page 46: cls39d00
8. "That is why the National Tuberculosis Association has been following with such interest the experimental work on smoking-cessation techniques that has been going on all over the world. The recent disappointments -- whether ,~r~t-Roswell Park... or over in Scotland -- do not discourage us.... (We feel) that development of effective smoking-cessation techniques is urgent." ROSENSTOCK, Irwin M., PhD, HAEFNER, Don P., PhD, KEGELES, S. Stephen, PhD, and KIRSCHT, John P., PhD, School of Public Health, University of Michigan, Ann Arbor "A national study of health attitudes and behavior." Among many facets of individual views and actions in matters of health studied by the authors was cancer: of a sample of 1500 persons chosen to represent the total U.S. adult population living in private households, 44% thought nothing could be done to prevent cancer. Of those who thought prevention was possible, 59% mentioned tests and checkups as preventive. Of those who specified particular ways of preventing cancer, 'the most frequently mentioned response was "don't smoke." No numbers of percentage of the latter response appears in the text. SHAPIRO, Sam, Director; WEINBLATT, Eve, Assistant Director; and SAGER, Robert V., MD, Director of Medical Care Studies, Health Insurance Plan (H.I.P.) of Greater New York; and FRANK, Charles W., MD, Associate Professor of Medicine, Albert Einstein College of Medicine, New York City "The H.I.P. study of incidence and prognosis of coronary heart disease: Preliminary findings on incidence of myocardial infarction and angina." As a result of the first 18 months of a scheduled eight-year study being : conducted with support by the National Institutes of Health through mail questionnairesin a sample population of 110,000-120,000 persons aged 25-64 enrolled in 12 of the =~ H,I.P. medical groups in New York City, the authors have arrived at computed results ~ based on multiplication of the 4% sample by 22.5 (factor for sampling ratio and non-response adjusted to an 18-month period), which results in showing 2713 persons at risk for (t+II) myocardial infarction (including "possibles") and 2673 at risk for angina pectoris. The authors assert that, "The association between cigarette smoking and 141 among men reported by the Framingham and Albany investigators was observed in the current study. A similar association was detected for women. The H.I.P. study also found an association between cigarette smoking among men and angina. In the other studies no such association was detected." W The weighing of smoking effect, as in many similar studies, was based on comparison of "observed" and "expected" deaths.
Page 47: cls39d00
-SPIEGELMAN, Mortimer, Associate Company, New York City Statistician, Metropolitan Life Insurance "Cessation of smoking and effect upon health -- Findings of the Smoking and 'Health Advisory Committee." The author analyzed, with some rearrangement of the material, the sections of the Surgeon General's report dealing with ex-smokers, but presents no new data and raises no questions. His conclusions quote from the report, with further notation that Doll & Hill (1964) and Best et al. (1964) also "attest that ex-smokers have a more favorable mortality experience than current smokers, but not as favorable as that for non-smokers." STERLING, Theodor D., PhD, Professor of Biostatistics, University of Cincinnati College of Medicine, Ohio "Effects of the disapplication of statistical reasoning on environmental health problems." - = It is surprising to find "serious errors in official documents which, because of their controversial nature and policy making importance, would be expected to be searched througb closely for statistical flaws," the author said. "A case in point is that of the Surgeon General of the Public Health Service on Smoking and Health, which contains a number of statistical misapplications, errors so serious that they should make the report an easy prey to successful attacks from any quarter. "However, I do emphasize that Smoking and Health was selected as an example because of its current prominence and not because the statistical errors occurring in it are in any way unique. Also, this report somehow has codified many of these practices and may be interpreted wrongly therefore as having the special stamp of approval by government scientists. I shall restrict discussion to two statements contained in this report which are gross misapplications of statistical hypothesis testing. "The report on Smoking and Health maintains that the effect of cigarette smoking is specific as to mortality. Whether or not we accept the use of mortality ratios (and there are workers who have had doubts about the use of these ratios) ff~erkson & Elveback, 1960; Sterling et al., 196Z], it is obvious that smokers in all pertinent studies die at a faster rate than non-smokers from practically all diseases.... There is only one disease, cancer of the intestine, for which smokers die at a lesser rate than non-smokers, and one other disease, cancer of the rectum, for which the rates for both smokers and non-smokers are alike. "The conclusions that have been drawn in the past from these data were that smokers differ from non-smokers in their pattern of mortality. This has given rise to serious question, whether one either must ascribe the effect of smoking to all diseases or whether he should look for some sampling bias that accounts for the consistent increase in deaths of smokers.... Whatever the merits of various arguments... what the Co:rli-nittee has done has been to bypass this particular problem completely."
Page 48: cls39d00
lU. ., The Committee's interpretation of what it has done with the criteri of._"statistical significance," on pages 184 and 185 of Smoking and Health, :which the author quoted, is "not only naive, but downright misleaaing. Ir =uo.•effect due to smoking were to exist, there still would be some diseases for which the incidence of death for a particular cause is greater among smokers than among non-smokers due to sampling error.... No sound ;'`` th investigator would proceed in this fashion. In fact, e Committee used exactly that line of reasoning in pointing out that pipe and cigar smoking have no ill effects on health." Other papers of interest included: among New York City men in the Club to the effects of the Prudent Diet, but tbat•,: "it seems reasonable" to attribute the significantly lower rate of heart attacks •i CftRISTAKIS, George et al., "The anti-coronary club." The authors report that ;X ., the results should not become the basis for a new "food fad." .,. carcinomas, in a female boxer aged 12 and a male springer spaniel aged 14, among'-4 defined population of dogs." There were 2 malignant lung tumors, both bronchoge~ DORN, C. Richard et al., "The prevalence of spontaneous neoplasms in a 1096 dogs examined during one 30-day period at Oakland, Cal. KABLER, Paul W., "Toxicants, viruses, and anniversariles." To further gauge carcinogenicity of polluted air, the geographic distribution of lung cancer according to histological type must be more extensively studied. the inciaence of change in symptoms in minor respira ory iseases, y fami ies. ',F t d' McCARROLL, James R. et al., "Health and the urban environment." Cornell's Air Pollution study in New York City is to follow variations in health, particularly PERKINS, James E., "The role of the voluntary health association in the control o sir pollution." NTA head pledges support in anti-pollution efforts across the country. diseases among U.S. uranium miners." A serious excess of lung cancer in uranium `:r miners has been proved. ~' :.r May other papers were concerned with air pollution and other environmental:; WAGONER, Joseph K. et al.. "Cumulative radiation exposure as related to pulmonary factors. c F 1
Page 49: cls39d00
~`- ~ I i i 2. AMERICAN TMkRT ASSOCIATIOh :`; ARTzRIOSCi.EF.:SIS & AMERICAN SOCIETY FOR THE STUDY ..: *.T_7RIO.SCLERWSIE 11. Fo1loKing are excerpts from authors' abstracts of papers p:-sented at the 18th Annual Meeting of the above organizyt::.^s, Atlantic C_:,y, N.J., October 23-25, 1964, as published in Ci_Tcu;.ation 30/4-III, October 1964, ~ on the pages indicated. J -"4 .-c :."' On HAPS, Curtis G., Claxton, Ga. et al. "Comparative study of the association or ---ce, social class, and blood lipids in a Southern U.S. co=unity." (P.12) To clarify the nature of racial-social class lipid differences previously found, "a random sample of h_gb and low social class white and _ Negro males, age 40 to 71~ years, living in i~~-ans County, was evaluated for -=-z~"-differences in serum lipoproteins, triglycerides, and the derived atherogenic s. index (Gofman). Beta-lipoproteins, triglyceride levels,,and the atherogenic index were all higher among white than Negro males, and higher among high and low social class. When Negroes were compared with whites of equivalent social class, none of the three variables- were s'-gnificantly different.... 'When differences in occupation were controlled, no significant Negro-white differences in any of these lipid values have emerged. Thus, the apparent racial differences in ser= lipids appears entirely explainable by social class differences; and the rLjor social class ec-m-ponent appears to be occupational." KERSHBAUM, Alfred, JIM.IAi~, Jose) gELL~,"T, Samuel & ZANUI'I'INI, Domenico, Philadelphia, Pa. "Modification of nicotine-induced hyperlipidemia by anti-adrenergic agents." (P.18) "In previous studies in man, it vas observed that the rise in serum free fatty acids (FFA) Vnich follows ciga:ette smoking is prevented or inhibited by sympathetic ganglionic blockade and by ac.renalectomy. To further-elucidate the role of catecholamine and sympathetic activity in the lipid response to nicotine, the influence of anti-adrene-g_c drugs was investigated. "In anesthetized dogs, nicot_ne b`_tartrate (0.1 r-g/kg) was given intravenously, and serum FFA levels were determined before and at intervals after nicotine for 1+0 minutes. The same procedure was follQwed after the administration of nethalide (5.0 mg/kg), afl-receptor adrenergic blocking agent.... 1 I : , i I I I .,
Page 50: cls39d00
12. "In 28 control dogs, the mean maximal FFA rise after nicotine was _-,-~_34± 4.1%. After nethalide, in 13 experiments, there was a diminished FFA rise, 18± 3.0% ... in five animals hlDcked with phenoxybenzamine, the FFA rise was 29± 4.olp (P-:::-0.1). Following chlorpromazine, ten dogs showed a rise of 37± 5.3% (P = 0.33). Serum triglycerides after nicotine rose 34± 6.2% in eight dogs. After nethalide, elevation was diminished, 13± 3.80 (P<0.05), "The suppression of nicotine hyperlipidemia by nethalide only suggests that the lipid mobilization following nicotine administration is primarily mediated through aflrenergic,6-receptors of adipose tissue cells." SPAIN, David M. et al., Brooklyn, N.Y. "Overweight and the prevalence of coronary atherosclerotic heart disease." (P.29) (Dr. Spain with A. L. Mestel also presented a paper on "Influence 'of pregnancy on atherogenesis in rabbits -- P.29) "Overweight per se, in the absence of elevated diastolic blood pressure or diabetes mellitus, has been found unassociated with a higher prevalence of coronary atherosclerotic heart disease (CAHD). Because other studies did not agree with this finding, we now report an extension . of the original study based on approximately 10,000 white Jewish males (age 36 to 65) from the metropolitan New York City area. "Of 10,000 males, 832 (8.3%) had CAHD (these will be reported at 5-year age intervals). Of 8,532 without elevated blood pressure or diabetes mellitus, 498 (5.8%) had CAHD. This group was subdivided into 623 individuals below average weight, of whom 25 (4.2p) had CAHD; 5,092 with average weight, of whom 311 (6.3%) had CAHD; and 2,817 overweight individuals, of whom 162 (5.7%) had CAHD. Of 632 average-weight males with elevated blood pressure, (diastolic above 95), 110 (17.4%) had CAHD; of 743 overweight individuals with elevated blood pressure, 136 (18.3%) had CARD. 1= v a.. '{ .. 74 "Preliminary but as yet incompletely controlled incidence data on 3,000 males followed from three to five years confirm these findings as originally concluded: namely, that overweight in the absence of hypertension or diabetes mellitus does not appear to increase the risk of developing CAHD." TAYLOR, Henry L. et al., Minneapolis, Minn. "Withdrawal rates for coronary heart disease among physically active and sedentary railroad occupations." (P.30) ` "Initial studies of death rates attributed to coronary heart disease (CHD) in a cohort of 42,000 railway s.witchmen and 52,000 clerks, age 40 to 64, yielded an in-service, in-occupation mortality ratio for CHD of 0.68 for switchmen/clerks. When deaths in men who had changed occupation and/or had retired over a five-year follow-up were included in the calculations, the ratio bec4ime 0.84. • .1 •
Page 51: cls39d00
13. "Further information about mobility of men in these occupations was sought from Railroad Retirement data on 1,200 clerks and 1,419 switchmen invited for examination in 1958 and 1959 and followed through 1963.. In service age-adjusted mortality ratio attributed to CHD was -~;-0.73 (switchmen/clerks). The comparabie ratio for CN~ disabi_i_ty retirement .i..;~rates.was 2.70 and the combined mortality-morbidity ratio was 1.11. The examined group contained 71% (857 of 1,200) of invited clerks and 59% (840 of 1,419) of switchmen. In this group, the in-service mortality ratio for CHD was 0.41; the mortality ratio for the disability retirements was 2.10, and the combined mortality-morbidity ratio was 0.76. The age-adjusted prevalence rates in 1958-59 were 30.2/1,000 for switchmen and 44.2/1,000 for clerks. "New events ascribed to CHD as in-service deaths or disability retirements were 19.2/1,000 for switchmen, and 19.5/1,000 for clerks. Prevalence rates plus new events discovered among withdrawals was 49.4/1,000 for switchmen, and 63.7/1,000 for clerks.... To determine true CHD rates, occupational withdrawals must be considered." 3. AMERICAN IiEAtT ASSOCIATION Attached are excerpts from authors' abstracts of papers presented at the 37tb Scientific Sessions, AHA, Atlantic City, N.J., October 23-25, 1964, as . on the pages indicated. October 1964 published in Circulation 30/4-III _ , , ABBOUD, Francois M., & ECKSTEIN, John W., Iowa City, Iowa "Cholinergic vasodilation in the forearm of man." (P.38) "These experiments were done to test the hypothesis that reflex vasodilator impulses occur in response to stimuli which ordinarily cause vasoconstriction such as mental stress . We conclude that reflex cholinergic vasodilator and reflex adrenergic vasoconstrictor impulses may occur simultaneously in response to the same stimulus." KERSHBAUM, Alfred, BELLET, Samuel, JIMINEZ, Jose, & KERSHBAUM, Kenneth L., Philadelphia, Pa. "Effect of ethanol on the free fatty acid response to cigarette smoking in normal subjects and patients with coronary heart disease." (Pp.104-105) Eleven fasting and resting normal subjects were given ethanol orally as 100-proof bourbon whisky (2 oz) diluted with water; ten minutes later, they smoked two cigarettes, and serum FFA concentrations were determined at intervals for 50 minutes. The mean maximal FFA rise after smoking was 3.7% above the presmoking level. This compared with a rise of 30.9% (P< 0.001) in 14 normal control subjects (smoking without whisky). "In 13 normal subjects who smoked and drank whisky concurrently, the FFA elevation was 1.1% (P < 0.001). Ten patients with healed myocardial infarctiorl, after smoking and whisky, developed a mean maximal elevation of 2.61%, compared with a rise of 65.6% (P <0.001) after smokirig in 17 infarction patients who received no whisky. Serum triglyce riide and plasma glucose levels were not affected in control or test subjects. I
Page 52: cls39d00
• 14. "The data indicate that whisky ingestion prior to or during cigarette smoking markedly suppresses the usual FFA rise. This effect could be the „.,,~;:x'esult of inhibition of the FFA mobilizing effect of nicotine by ethanol or a g~nented FFA utilization." '~.:~ .. 4. CONFERENCE ON BIOLOGICAL EFFECTS OF ASBESTOS Following are brief resumes of authors' abstracts of papers presented at the above conference, conducted by the New York Academy of Sciences, and held at the Waldorf Astoria October 19-21, 1964. ...~. ..< BUCHANAN, William D., Ministry of Labor, London, England ; V: "Asbestos and bronchial carcinoma." -i "It is believed that in Great Britain, a high proportion of asbestosis ~ .,-.cases are recognized during life and that following death from whatever cause, '~,~this 'condition is then recorded on the death certificate, often after autopsy '' con~~~: . ?`~ firmation. Examination of the death certificates is'considered to be a :.i reasonably accurate means of determining the number of deaths from asbestosis and also any related pathology found at autopsy. Earlier studies of this type were published in the Annual Report of the Chief Inspector of Factories for 1947, 1954 and 1955• These earlier studies indicated an apparent association' between the presence of asbestosis and the finding of a thoracic tumor.... "Up to the end of 1963, 584 death certificates recording the presence of asbestosis have been thus obtained and the annual totals of such certificates are currently increasing. The proportion also recording a thoracic tumor has also in both sexes, continued to increase disproportionately to the total number so that currently over 50 per cent of males dying with asbestosis present have also a neoplasm. Even when viewed against the steadily rising incidence of lung cancer in the population as a whole, there seems little doubt that this increase is a real one." HANMOND, E. C., SELIKOFF, I. J. & CHURG, J., Mount Sinai Hospital, New York City "Neoplasia among insulation workers in the United States with special reference to intra-abdominal neoplasia." "This investigation has been concerned with 1522 members of the New York metropolitan area locals of the Asbestos Workers Union.... Detailed occupational and personal data were obtained from 1117 men (of the 1258 who were alive on January 1, 1963) who were examined. Union records were available for similar analysis for those men who were dead (264) or who failed to appear for examination (141). 43 men have died since the onset of the'study. We have previously demonstrated, using age-specific death rates in a prospective study of 255 consecutive deaths among these group of men 1943-1962, that total deaths were increased (observed 255, expected 204) as were deaths caused by cancer of the lung and pleura (observed 45, expected 7) and stomach and colon (observed 29, expected 10). wY •,
Page 53: cls39d00
- "In addition to the neoplasia among the recorded deaths, there are 3 men alive with known neoplasms (1 lung cancer, 1 pleural and 1 peritoneal mesothelioma) as well as one apparently cured of tongue cancer, one of cancer of the colon, and three following successful resection of localized lung cancer found in this survey." cl.r*: ... (Dr. Hammond also presented a paper on "Multiple factors in relation to neoplasia among asbestos workers. The abstract was not received prior to the conference.) HARINGTON, J. S. & ROE, F. J. C., Royal Cancer Hospital, London, England "Studies of carcinogenesis of asbestos fibers and their natural oils." "At present the following possible mechanisms are under consideration: (a) that carcinogenesis is due to the presence of carcinogenic polycyclic hydrocarbons or other organic materials in the natural or contaminating oils. (b) that it is due to the presence of certain metals and metal-complexes in stos..... (c) that there is... cancer induced by the prolonged residence _an the tissues of chemically-inert material incapable of being removed by phagocytosis. "One of the more intriguing features of asbestos carcinogenesis is the fact that in the case of pleural and peritoneal mesotheliomata the cancers develop at sites remote from those exposed. Special studies are being made, therefore, on the migration of inhaled or injected asbestos fibers in experimental animals." HUEPER, W. C., National Cancer Institute, Bethesda, Md. "Occupational and non-occupational exposures to asbestos." "The enormous rise in the production and industrial use of asbestos during the past 50 years has resulted in markedly widened exposure to asbestos dust for a greatly increased number and variety of workers. Some of them, moveover, sustain such contacts incidentally either when being employed in various capacities in operations where asbestos products are processed, used, or handled or when working in plant areas in which an environmental pollution of the air with asbestos exists. The harmful effects of such growing exposures to asbestos during the past two decades are reflected not only in a growing number of reports on the occurrence of asbestosis and asbestos cancer in a variety of asbestos workers, but also in the fact that such reports originate from a rising number of countries in some of which such observations were made only recently for the first time.... w MILLER, Llonas & SMITH, W. E., Fairleigh Dickinson University, Mac3ison, N.J. ''Tests for effect of asbestos on benzo(a)pyrene carcinogenesis in the respiratory tract." "Experiments now reported were designed to test an hypothesis that asbestos may'increase incidence of pulmonary carcinomas by prbmotion of action of some carcinogen to which man is peculiarly exposea through smoking. .1
Page 54: cls39d00
Inc:. re-" 16. "Benzo(a)pyrene was selected as a type of carcinogen present in cigarett! ke t Th t t ith 0 h t d t di d d i t .... smo es e was s e w ar ams 5 ers e n vi o 5 treatment groupe • • f 10 oanimals each. Nineteen epidermoid carcinomas were found in the larynx, trachea and main bronchi.... In those examined between the 173rd and 214th day~ .r4~`~ ~.~ur ~ .. ( )pYY "fo tumors were found in 3 of 5 hamsters treated with benzo a ene alone. Fifteen tumors were found in 7 of 7 hamsters treated with benzo(a)pyrene plus _ chrysotile. There were no tumors in 6 hamsters treated with chrysotile alone, ~ in 8 treated with the suspending medium (Tween 60) or in 10 untreated controls. : "A second experiment was done with weekly intratracheal injections of benzo(a)pyrene to a total of 8 mg with or without amosite. In 44 hamsters sacrificed 240 days after start of this test, gross examination revealed 11 tumors in 9 of 25 treated with benzo(a)pyrene alone and 6 tumors in 6 of 19 treated with benzo(a)pyrene plus amosite." SELIKOFF, I. J., CHURG, J. & HAMMOND, E. C., Mount Sinai Hospital, New York City -:"Asbestosis among insulation workers in the United States'." "Investigations reported here were concerned with 1522 members of the International Association of Seat & Frost Insulators and Asbestos Workers, V 6 - 4 men were dead on January 1, in the New York-New Jersey Metropolitan area.... 2 1 43 have died since.... 1258 were alive; 1117 were examined (89.9%), including- 133 of 169 no longer working in the trade and 984 of the 1086 working members. Clinical, radiological and pulmonary function examinations were made. ' . 42, Analysis of 307 consecutive deaths among asbestos insulation workers January 1, 1963 :' August 31, 1964. Carcinoma of lung 53 Mesothelioma G. I. Carcinoma 35 Other neoplasms 27 124 Asbestosis 17 All other causes 166 "It is concluded that pulmonary asbestosis is a insulation workers in the United States at this time.'' significant risk of SMITH, W. E. & MILLER, Llonas, Fairleigh Dickinson University, Madison, N.J. "Tests for carcinogenicity of asbestos." "Single intrapleural injection [pf asbestos sample]` was made into the right chest of golden Syrian hamsters (15 animals per sample).... ' Extensive granulomatous and fibrous pleural adhesions resulted in each treatment group. Large intrathoracic tumors were found in 2 hamsters at 244 days and 358 days, respectively, after injection of com;nercial amosite, and in 2 other hamsters at 419 and 527 days after injection of harsh chrysotile. No tumors have yet been found in hamsters given the sample of soft chrysotile.... , "Inother experiments, 180 hamsters and 27Q rats have been given weekly or biweekly intratracheal injections of four types of asbestos.... Pneumonia and fibrosis but no turors have been found in animals thus far examined."

Text Control

Highlight Text:

OCR Text Alignment:

Image Control

Image Rotation:

Image Size: