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Congressional Hearing Transcript: Public Health Cigarette Amendments of 1971 Hearings Before the Consumer Subcommittee of the Committee on Commerce United States Senate Ninety-Second Congress Second Session on S.1454 to Amend the Federal Cigarette Labeling and Advertising Act to Require the Federal Trade Commission to Establish Acceptable Levels of Tar and Nicotine Content of Cigarettes - February 1, 3, and 10, 1972 [Congressional Hearing Transcript: Public Health Cigarette Amendments of 1971 Hearings Before the Consumer Subcommittee of the Committee on Commerce United States Senate Ninety-Second Congress Second Session on S.1454 to Amend the Federal Cigarette Labeling and Advertising Act to Require the Federal Trade Commission to Establish Acceptable Levels of Tar and Nicotine Content of Cigarettes]

Date: 01 Feb 1972
Length: 1001 pages
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CO4IDSITTEE ON COMMERCE WARREN G. MAGNUSON, Wushihston, Ckairman JOHN O. PASTORE, Rhode Islnnd SORILIS COTTON. New Humpshlre VANCE HARTIS'L, LrNvm JAMES B. PEARSON, Kane2x PHILIP A. HART, Michlgian ROBERT I'. GRIFFIN, MHcl)iginn HOWARD W. CANNON, Nevada IIOWARD IT. KAKER,.Tn.,'Pennesscc RUSSETd, B. LONG, Louisiana MARLOSV \V. COOK, Km'tacky FRANK E. ]iOSS, ilah TED STEVENS, Alaska NitNRST P. HOLLINGS, South Carolina J. GLENN BEALL, JR., ]Laryland DANIEL K. INOOYR, Hawnii LOWELL P. {VliICKllIt, JR., Cumiecticnt WILLIAM B. SPONG, JR., Virginla PRROHXLC%.T. LDRDAN, dlplj DlrfeSOf WCrtainL PeuxacHUa, Chiel Couneeb 9. LvNrv SurC...ers, Can.vurner Cnvm.eeL F.oWAUD ]feat.is, ProleseionnZ etaJJ Member AaPN IIK P.1 a Kll VN,.iR., ,141.>IOritv Nt6}I DtreetOr .TOns A. Faussrxe.3tinorizp Stng Omuixei COnTSUwr.n SllsaoalnnxmsE InIlANK P. MOSS, IItah, Chairmun PHILIP A. HART, Michigan, Pice Chairm.nn .IOHN O, PASTORE, Rhode Island MARLOW W. COOK, Kentucky VASC& HAICTKIR, Indlaxm JAMES R. PEAKFON, Kansas llANIN.I. K. INOUYE, Hawaii TED STEVENS, Alaska WII.LIATI B. SPONG, Jn., Virgiuia S. GLENN BEALL, Jn., Marylaud LOWELL F'. WEICKER, .Lc, CuuuecLlcuL T158461120
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3 921e CQNpRES' leT smlox S. 1454 IN THR SENATE OF THEUVITF,D STATES aexm 1. 1971 Nr. Mns intmdncod the fullmc7ng bll.: which 'as read twice nnd re.fened t the Ommnittce on C.ommerce A BILL 7b nmenul the Pedeml l)irarette 7.rbr,ling anrvd Adrr_rtising Act ' to reqairee the Fivleral Tradr Commission to ostebiiq'h ac- ceptahle levels, of lar and nicot.ine content of oigare.ttes. 1 . j3e.i.t, enaclrrl 0, the SenaGa, antl House of JZepresettta- 7, tinwc of 1he (•l-rzikad Statta of America in Conqreas nssesnbtrd. g Thut i:ecfiiun 3 of the h'utleral Cilmrette Labeling tmd el,dver- ¢4 tking Aet is muended bS' adding atthe end timrad' thr 5, follpWinguewpa,rarrraph: .. 6,; The term 'ineiintinnted agent' tneans any cnnstit- ` 7, uent element of cigarettr nutinstream smoke wlhic,his present " g in qnantitic, sufficient to be ahealth hazard." . 9. .: S19p,,.2. Seption i,of the Federal Cigarette Lattekng and i0 Ar3vertising Act is amended by redesi{;nnrting an6seetiuns. (h 1 II T158461126
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P11CC Infant Weight and Parental Smoking Habits, article 297 izloepfer, William, Jr.. letter of Jannary 31, 1AS2-_ li~ll Kornegay, Horace R., president and executive director, the Tobacco lu- s8kntc, Inc., letters of : February $ 1972 633 March 8. 1D72---------------------------------------------------- 649 Long, Iion. Rus,sell B., U.S. Senator from Louisitma, letter of Play 17, 1972 ____.-------------------------------------------------- ______. 844 ]Iorria, Jnhn 11., article in the Ne, Yorl< Timeu------------------------ 695 Moss, Hon. Frank F., U.S. Senator from Utah, statement---------------- 283 l'erkin., Hon. Oarl ll., 1:.8. Representative from Iierttucky, stntement---- 170 Report of "Tar" and Nicotine Content of the Smoke of 121 Yarietiea of Cigarettes: Angnsr, 1fl71------------------- _.--------- ____.----- ..------------ .. 313 October 21, 1470 326 Response to Senator Moss concerning Article by J. Coritlield, Ai'. Ilaenszel, N1 C. Hammond, A. 31. Lilienfeld, NI. B. cnimkin nnrl E. I, Wynder-- 461 Snyrler, Hon_ RI_ f7vne, P_S RePresentatire frurn Kentucd<y, stalenent 168 Sonnners, Dr. Sheldon C., research t7ireetor, tbe Couneil for Tohacce lie- xen.rch-U-EA., Inr., letter of March 30, 1072------------ -__ _ 72u f7temarf, Ilr., R%illiam II.. ehanuetlor, Luuisiaua atn[e University 1ledieal Center. IeUer------------------------------------------ _ _____._ _ __ lf4 The 1;pidemiomgy of Lung Cancer, arttcle__ -- -__ 289 Whiteside, Thomas, article in the Nen- ReHublic----------------- _.. 247 T158461123
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CONTENTS PnqP opening statement bc Benainr bioss_ OPening ntatrntett b~ Seuator Cook------------------- ___ _ _ _ 5 Text of 8.1}oJ______-_.__.._ 3 CHROSOT.OG1C.11. L15T OP NITN1:S~aliS FFRxUSRr 1, 1972 DuVal, Dr. yterlin It., Assistunt Secretary for Health und 8rirutific AP- tairs, I)eparlmeut of Health, P:dueation, imrl Welfare: ac•companied bSDt Sobu Zapp. DePntc Aasistaut Necretarp fur l.egislation (17ealth) ; Dr. Uauiel Horn, Director, Natioann f'learinghonse for tiinolring and lCealth, C.S. Public Health Serciac; and Dr. Gio Cori, Ansoclate Sci- entific Director for I'rogthm, Sa6ooal C'ancer Institnte 20 (jne:ittnnv nf Senator LTarti;e nn~l Dr. SfNnfeltl'n auan'ef~ iherefn___- 46 Clnesfinna of the r»nnnittc.e and 1)r. I7n1'al'n au:;sers thel"to__ 47 Lrrin, Tlon. Sam 3-, L.S. Semttor front _Snrth Cnrolina J 7orA:m. Ilun. li. i;verett II.S_ Semitnr from Norfh Cairulina----------- - 1 i Tzoroegay, Hmiwe, Da'ealflaut 'robncrn Tnstittte, ACar:hington, D.C..._ . 71 Letter.c ]larrit 3. 7D71. 165 1'itofvicy, HoberLLireeton 13nrenn of t'nnsunier T'rotectian,Fe(lera] Tradc Commisslon; luromPauled hy Oe:'sld J. 'Pbaln, a+istanl dirertur Por 5atlonnl A13rerlisine: uud Allea F. Brauuningrr, artorneT, Di1-ision of NalYOmil dtvertiulg_- - - _ 49 PrePared xtatement of- lii F6nRl:ARS a, 1912 Opening rtafenrent by lonatnr cponr------------------ ---- - - - __- 86 Garbn. Paul lC., srientifir rnn=nlt:mtand difeetm'. beveral Cigar Cn., Inr.; :)ecomDauiedhr .ror;;e13. TOriehnrt, vlceprrsident, m.,rkrtiue rliri..inn- lla Ilind. 7amen F'., proJuet manager, 12-.L R«ynulds Toki,• , I.. N"iniai- Salrm, N.1'-: nccomWUtic(l b)' lfox H, 1'rohn..M1r., a., iv, . m, ,.1- _ Yla 1lRricrtt, Itnheal (`.. Ph. D., acting scieutitlc diroct,r.1hefor To- baccn RrsenrrL- 1'.S.A.. Nc1r York, N.L___-_- _- -_- ---- 117,1-10 Artlrk• ---------- -- --- ----- -------.-- -_-_.------------- 10N P.ellqr, Pl. lV., ehnirnlim of Ihe hoard, fimsolidnted Cigar ('orp. Sr1c Yorlc, liccon9:wied by laclc 1Coga!c.en, senior r'ive preairlent; nuA l'url fl. Carlson, vice pre9iqent fnr special Pro7cct----- -- -- . -- 132 Sommers, Dr. 9helflun C-, chainmm, Celeotific Adcisory- I3oar(l tu the Coun- cil for Tobacco RcEeareh-C,H.~~.. Sen' ]ork, N.Y- _.-- ---- --- 88,1&0 $tephano. ConsCmiiue~ prrsident RNCAP (1orp_, Waahinwtuu. T1.(:- ___...- 787 'LiFgclhcak. 1)onald, munafier, metrkat dcvdopntenf, Yitt..bnrrh Acticatod Carbmi Dirision, Cnlzron Corp.. Pittsbnr/rh, Pn- - - . _ _ - _- ___ - - 149 przl TI58461121
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L 21 22 9-3 25 4 2 and (c) thetrnt os suhseetiuns (e) nnd ((I), rcapectivels, and irwerting iimnediately after snbsection (a) the following new aulrsection: "(b) Aot later than six months after the date of the enactmcut of the Publie IIea.1Lh Cigarette ,imc.ndments of 1`.171, the Tedecal 9'radc ('ommi4xion ,chall prmmullpte Ktnnd- ard~ rsfahlishiug slich musimum acceptable lecels of tor. nientine, oud olhcr iue.rimimited a~'en(h as the. Conunis+iuu tleternlines mag bo present in cigarettes in rtna,ntiLieg which will not pose nn umta.nnahlc health hazard. 5ncb maxitnum Irvela mma he rednred periudiealiv, hnt not more nfteu than onu.e dwinI, :my calendar ycar" whene•er the t_lorrrminsion determiurs tlwt lower lrvola aree neeessarv to tLvniri tutreason- ahle health haznrd=. Standnrd, c"tahli'hed Ly- the Cnmmi'sion nnder thin snbseotion sho nll peruiit cigmrtte~ to oeutain ihn lenat :tnount uf tar, nieotine, nuil other inerinrin2teil agents wIiich i, cnu;istcw tcith ( onsnntrr +icccptnbilit}•. So ,ctnnd.u'd eqa bli:hed mider thi.+ nnL~crtiun ahall br enmistont with cuu- ,cuwer arcaplabilitp if ui-o'at'ethr prodneel iu enuformit}tcilh =ueL rlandard would be w nuaccepinble, to n,ctibstantinl nnm- her of cil,arette ~auukers aa tu create antnrket fnr the illicit sale and pnrehase of ~ilpifieatrt qnantiticu oP cignrettee Which fail to wrel >nch alatrdnrd.° Sxo. 3. '1'hi. aet mac be e.iled xc the "Pnblic $eolth t'i1,orctrr-Anicudrncnt,. uf 1971 ". . . - T158461127
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PUBLIC HEALTH CTGA1tETTE Ab1ENDM].nTS OF 1971 TUESDAY, FEBRUARY 1, 1972 t'.S. Sn.V'A9'}:, Cn1urrr1x:u: ON Co.urr:ncr:. SPn('OliiLrfTFY POH CoANi]Cr.RF, 1Prrahir~.p(o~r.; I).C. The subcourmittae met at 10 a.m, iu room n110, Sen- Senate Oll'ire Building, iion. Frank E. Moss (chairuran of the stth(onumittee) presi di ng. Nreseut : Senators lioss. Pea rson, and Cook. OPENING STATEMENT BY SENATOR MOSS Senator Moss. The subcommittee will come to order. . jYe offer our apologies to vou who havc bemi wrritiag. This morn- int; happened to be the Prrside.nt's Pray'er }ireakfaet at which many Dlembcrs of tlre Congress were in attendance and it went on longer than we expected. so Arc rccrcv dclaicd in getbine here wrd I a.polo- gize.. Scnator Pearson appeared on time at f1::S0 and then he had to go to the Senate floor aud asked to ba esrused lor thru earh- part of the hc.arint;. Senator Cook is here and others of the, snbconnnittee we hope Icil I be along soon. The Constmror ,S'nLcoinmittee is rneetiug todayand on Pebrttary 3rd and 1llth to discnss ler.islation whieh I lhace introduced io amend the. Public Ilealth Cigarette Snwkin,r.,• Act to ruluire the Ped- eral Trade Commission to estahlish masimnm levels of ta.r and nico- tiue content of cirareltes. :ldditionallv, durint the course of the hearings cve zcill discuss svicersl nt.he.r aspects of smolcing and health which hacc% come to light in recent mmrths. These inclnde: 1. The marketinv of littlc cigars. 3. Thee statns of Federal Trade Commission efforts to require con- spieuous lrealth .carnings in cigarette adcertiein;;. The news last niaht had something to sar on that. 3. The irnplication in tre recent report on the 1lealth Conse- qnences of Snokino, that enufirin tho legitimacy of complaints bc xuani people of thee effects of obher people's smokinr,r. Also, we may discttss durin-,, ; the course of thesee hearvnhs antismokinr commercials in thee hroadcttsn rnedia, smolcnri; edttcational prot;rnms and other related msrlters tlrat may come to litht. Rnek in 19Be the chairrniur of the Senate Corruucrce Committee. Senator ZV'arrrn G. -lfarrimson, asked tLe Secrot:u,c of the Depart- meut of Ilealth. h:dncation. aud 11'clfare to review the evidence on the hazardons ini_,rcdicnts in cigarette smoke. That recicw, w-hich wasmadepnblic iu Juuiuu.41067. statedthat: St®ff memLrr a,<si~marl to ttirse Ireriringe : Ed«'ard Vtr,r1is. (1) T158461124
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2 1. The prepoidernncc of acienti8e evidence strongly snFRests that.the lower the tar and nlcutlue content of cigqrette smoke the less harmfn] would be the effect, and, 2. We recommend to the Surgeon General that action be encouragefl which rvill result in the progressive reduction of the tar and nicotine content of ciga- rette smoke. Subseqneutly, this Cousnrner Snbcotnmittee held 3 days of hear- ings dnring the snmmer of 1967 to revielv prohress made toreard thc development and the markcting of a less hazardous cig'arettn. As an ontgroicth of those heariugs, ('hairmlui ]brguuson requested that the FTC periodicallv test and report the tar and nicotine. content. of the various cirarettes sold in the United States. Thc first of the.se reports was made public in Vovember 1087. Se:vcrat cirarette mruket- ers as rvell as the Public iTealth Service have made sinnificant efforts to promote low tar and nicotine content. That activity is to be commended siucee much of it: has been done in a fairly responsible mamlcr. The next chapler of this sao,a consists of a request from ('hair- man Magnuson to the Puhlie Tlealth Service to prepare an atrthori- tative report ou other hazrudous ingredients in cigarette smoke, ptu'- ticularlr' thosee that ruight be, present in the gas phase. Prior tu the issuance of that rcport. I appeared in .Tatuiary- 1971 on the CBS program "'I'hc Advocntes". to discuss whether or not the Federal Govenrment should establish mandatorv limits on tar and nicothle content. AIthons:h the most traditional .ray for the Govern- ment to deal with product hezrnrds is to ha,ii the hazafd, this is impractical and undesirable in the cnsu of cigarettes. The alternative remaius, howcver, to set standards to elilninate the most haziu'dotts aspects of thee product. Followint the broadcast of that program I revierae.d the literxture w}hich had come to my atteutitvl and decided that it rvas au appropriate time to introduee legislation to establish just such limits. (?hairman Alagnuson has authorized me to state that lie joins in callinh for such legishi.tion. Z~'e uma move to .Iauuar~' 19l9. and the release of this 3eo-n's report on the health consequcnces of smoking. Chapter 9 which con- stihltes the Secretlu.r's response to the chairlmun's re(lnest fmr an anthoritative review of the lalowledge concer•ninr the significance of hxzardous inrredients in cil,)arettc srnoke uneqnivically coidirms m}' conviction thnit Ihee next logical ste.p is the settin~; of maximum limits for tar and nicntiue rund other hazmdrnls ingredients. At the present time carbou moau.idc is one of those other hazarclmis ingrt•dients. 'I'hus. we meet today to discuss with several representatives of Government a~,encies iuvojvcd as we11 as with the Tobacco Institute both the legislation at hand uid other matters whicli may arisee in the cmn•se of our discussions. (The bill follows:) T158461125
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` rv Fsaarr4nr 10, 1972 Psge Opening statement by Senator \foss___________________________________ 163 Banzhaf, John F., III, ezeeutive director, Artiun on Smoking aod IIealth, Washington, D.C---------- ___________ ______ ______________________ 253 Cooper, Hon. John Sherman, U.S. Senator from KenluckS 198 F,di+~ards, Dr. Charles C„ Commissioner, Food and Drug Administration; accompanied by Peter B. Hutr, Aesistant General counsel for Food- Drugs, and Product Safety Division------------------------- ______ 239 Letter _______ ____ ________ ____________________________________ 245 Furat. Dr. Arthnr. director, Institute of Chemical Biology, University of San Francisco, San Francisco, Calf- -_- -.----- _____ ________ -_ 203 Biographical sketch------------ ___ ____ _ ____ _________________ 207 Slouhtouris, Charles J„ secretary-treasurer, Little Cigur Conneil--------- 278 Okun. Dr. Ronald, director of nlinical pharmacology, C'edars-Siuai 9tedi- cal Center, Los Augeles, Ctalif--------------------------------------- 229 Biographical sketch---- _----------------------------------------- 236 Thurmond, Hon. Strom, U.%. Srnator from South (`arolina- ___.._- ------ 217 R71son, Bruce B., Leputy Assistnnt At.torney General, Antitrust Division, Department of Jnstice------------------------------------ _ ___ ____ 219 1'repared =tateoieut----- _---------------------------------------- 226 Wpnder, Dr. Ernest L., president, American Health Foundation. New york, S.Y _________________ ___________________________ _____________ _ 174 ADDITIONAL ARTICLES, 1.}yFTk7R:?, AND STATEMLNTS Atnet9cau Ilenlth Fotmdation, division of epidenriologp, IIealth Research Institute, 5en' Snrk, N.Y., reporL 845 Auerbaeh, eUranL article in the Washington Post---------------------- 594 Baker, Hon. iWlvard II., ti.8. Representative from Tennesnce ---------- 173 Batzhaf, aohn I'., 111. esecntire director, Action nn Snwking and Health, letters of: .Iaurunry 25, 197-' 604 Jnniuur.v'?11,1972---- _ _______________.___ __ 614 Beffinger, Ih•. Ing..7an, Tobaeco Smoking Research, letter of February 21, ________________- 1972 _----- _----- ________________________________ 623 Berger, Carl G., R G. Dm, Cigar Corp., letter of Febrnary 23. 1972- -_ 639 Brombcrg, Lonin, letter nf April 10.1972---------------------- __ __ __ 600 Cartert Ileu. Tim Lee. U.S. Repreaentative from Kentucky, statement -_ 601 Cigarette tinraking riho", r;.ha¢P ltrup Af1er Br7Hsh Ntndy, article------ fi94 Cook, Ilon. llnrlnw R'., C.B. Senator frum Kentneky, statement-------- 28-I l'ooln•r, f)r. Philip, and Dr. Jnmes B. Kniglrt, Jr., nrticle in the Sea• Eng- lmtd Journal uf IlMiclue___ ______ ____ _____ _____ _____ ____- __ 784 ('rolw. Nnz H., .Jr., secrelary, R. .I. Reymdds '1'oLnceu Co., letter uf March ?9, 1972 - --- -- __ ----- __.----- .---- _._- _.._- ____-__- 715 (hdlm:m. .Inseph F.. HI, PhiliP \4nrris. Inc.. letter uP April 13, 1971- 3p6 Curlin, Ron. 1V'illiam 1'., Jr., U.F. Representativc from Kentucky, state- mrnt _______________..____ ___________ iR9 Davin, Rez D., Direc-tor, Alcohol. Tohacco, and FirearmF Division, In- Cxrrml Revenur Service, Drparzment of the'Preaanry, letter of January 26, 197_----------------------- .------ .._______.--- .__- __-_-____-- 604 Dcpartment of Hralth, Edncation, and Welfa re : Letter if lleceniber 1,1972 849 (7onferrner Report on Harniful Substances in Cigarelte Smuke- _--_ S:i7 L'valnntion oP the 10R9 Supplemenll to nce 1907 Public lleallh Service Rerirl'Phe Health Conseiluences of Smoidng 652 Federal 'Crade Conuuissian, Report to Congress, Pur;umrt to the Public Health Cigarette ~'mokinK Act. December 31. 1971---------------- _ _ 336 Graham, Jamns A.. Commissimrer of lgricnltnre, Stute of Sorth Carolinn, statement - -_-- - - - _.._- - _- - - - - __ ------ __ __ - -- - 6(A3 Herink, Reinhard. P. 11, doetoral studien program, Fairleigh Dickinson University. ]rtter of Mebrttary 7, 1972----- 600 Horkett, Robert c.. Ph. I/., acting scientific dirp•tor, 'Phe Council for Tobaeea Reurarch-P.B.A., Inc., lettere of r AIarch 9, 1972---------------- ------- ---- . ___ -- ----- - _ \Lrrrh 31. 1972_-.------------------------------------------------ 716 777 Hollings, llon. Erneet F., 1LS. Senator from South Carolina, statement- 86 TI58461122
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5 Senator Dfoss. The ranlcin", niinoritv mernber of this s-nbcommittee, rS'enator 1larlow Cook, has an opnin;!stalemrnt, o-tad I will ask Senator Cook i f hc wonld g ive that now. OPENING STATEMENT BY SENATOR COOK Senator Coor.. Thanlc aon. Afr. Chairtnan. l4ay I say before 1 bel~in, Mr. C hairman, that my statement will be rather harsh and it is int•nded to be. I noticed that the Chairrnan said ihtd lie felt that ptnhibition wmtld not he what Ite wanted and that therefore hc saw fit to introdnce the, bill that is preseutly before ns- If I thongldt this Ncould be the last step, I would feel better. Hioweer. lhe chairmau then proceeded to say t.hatt after this was considered. then one n-ould cmtsider the next loeical step. So, as I]ook down thi• list of witnesses. Iecpect that. we wi11 be hearinn, much testiuimt.\ of a technicnl and scientific nature, frmn experts of competence and interrity. II also expect that they wi71 now, as t.he;v have in the, past, eoruc to diametricallv opposite cottcln- sions. And to me. thatt mcans thnt we mi this committee will be. con- frotrted by a1,rennine and perplecinr,~ scientifit• controversy. I do itot believe that auc pmpose will be served in disparaging the a-itnesses who disseut froui the official line by- calling them mem- bers of "the flat etutlr society` or-tools of llre special interosts. The plaiu truth is that after ce:us and ~-exrs of scientific ro- scxrch the questimt of smokiu~r twd health is still a rynestion. Thr phrin truth is that after ectensive scientific and medical testimonv iu the House Cbnuruerec Committee in 1969 thee conclnsiou Was reached Uwt nothiu,',, new had beon detorntined reg:ndiur rh(, rclottiouship bt•nmrn smolciun and health, and thut it )ras .ut area ma.rked hv ,ape in ]cnoNcled,t.. The plain tral It is that this conclnsion ~cas accepted in the Senate where su~uifieantlc no seientific and medical esperts testified in 1969. And the plain trulh is Ihnt C'ou'ress itself made no detecnlinatiml ichen it passed the I'ublie IlealtL C'i;;arefle Smokin~.r Act of 1d17(1- mid I hate tlm rcport befm-e me-be, vond the flndinh that smokinh m ati- be-n ot i s. btd . m a v bc-h az.>u•dons. Iu other words, thrcase is not closed: the question is still open: rtnd the jm•V is still oul. If there is any doubt that a scientific ver- dict still temains to bee rendored, let mc quote frmn the recent record of the Hoose heai iuRs on lhe l: atioual etutcer Attack-Act of 19i1. ly'hen asked to nanre the nrent in cif!aretles that ca.uees Ctotcer. tut oninent phvsieiarn said: "I think we can sta,te now that we do not know thee precise cnuse of malinniwt chewtl;es within tlre cell." Nhcn asked ahain to name the in,redientin cirarettes that is the cause of cancer, Itc said: "We do not have full and precise l.ltowl- edre of just etiactlti vvhat cans•s the cancer.°0 R"as tLis tlie vie.v of u member of tlie "flat earth societv°0! Was this the cottclusiou of someone io the Itac of flio toLatra iidrrest3 IIardht It ~uas the sledeal testimonv of im immediate past president' of the American Cauce.r Society, I)r..Jonathan Ithodes. It is not my purpose to embeurass auvone by repetttinr conflicting statemeuts. liut it does hirbli;,rht the double standard that applies in the eigtuntte rontron•rsY. T fcel that T rnost protest lhr•, ilmcctive T158461128
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6 that is so ea.silti heaped upon one side and not the other. For too long thc citarette. controversp has been characterized by an ample ryuota ol' mnfairuess .nid a callous dis-regard for its victims--scie.n- tists .vho daire to dottbt and dissent in their quest for troth, and thousands upon thousands of tobacco growers whose honest and pro- ductive labor woulcl be taken from them and replaced with welfare pavmcnds and job retraininR. Wlt}, for esample, does antistnokinr zeal justifp denouncing any dcl;ree of donbt as "indnstrv propaganda" or "trivisted denials'° and 'cbalderdash°' 4 Whv. for esampla does antismoking zeal give someone the right to call an entire industry that includes faimers, factor}° workers, and bnainessmeu. "mcrchauts of deait}2" and °`nnconscimiable hncks- teis" «-ho "bomburd the Ame.rican peohle with iranton irvirations to ravish their health°f? Whv, if not to ,:ar, free discussion and full debata? Why, if not to la~- the t*ronndwork for the decline, and fall of-I might sav nmphaticall.v--America's first industry? Why, if not to impose on one arriccdtmal cornmoditv, mid one productt the entiree burden of guilt for ills that may wcll~bel inherent in our stressful. and polluted soeietv. or indecd rooted by now in the mind, and body of industria.l man ? I do not snggest that those who have dedicated themselves to the autismoking crnsade have ecil intentions. On the contrarc, they have good intentiona A-nd these are the paving blocks of the road to rnin- ation on occasion. Snrelc onlv fools would re,fnse to follow them in their crusade a-,ainst cigarette smoking the Nation's number one public health problem to which dru', addiction, automoliile acci- dents, .urd alenholism are all secondarv, aeeording to Surgeon Gen- eral Steinfeld. are con concerned about exposure of indnstrial workers to d>m- gerous snbs(unoes on the job? Do noh bothcr to struggle for improeed occupational health. just put up a nu smokinr sign. Are. ' you emicerued about inercaso,d infantt rnortality, prnmataire birth and denths of nen-born babies in our urban ghettos? Do not wrestle with the difficnlties of improving medical care delivery in the slums. just put up a no smoking sir;n. .Arc rou cuucerue.d ttbout cleauintr up tlm envirunmentA Do not campaicni to rvduce air polhition, lnst put np a no smoking sirn becanso 10persmial pollntinn" accm•ding to the Surgeon Cleneral is more serions. The Surgeon General's theory is about like blaming thc Iolwstmvn flood ou a leaky faucet in Altoona, Pa. In effect, this Satimt has been covcred with no smoking signs for several years iu the form of posters, publicity and propaganda tele- vision spots. And in effect, 50 million people have rejected their appeal. So wtatt happened? Did the proteetors of the public accept this rcferendum hascd on freedom of choi<r? No. TheZ embarked on a policp of prohibition in ecerythin,Rt bnt the name itsel f. For tobacco farmers, tmdistingmished chairman, Senator Moss. proposed eliminatimi of the price snpport tmd prodnrtion crontrol prol±ram. He acknowledged that it would rreate chaotic conditions but hc said. `7 think cve ought to do it." \ow. Senator _lloss is an TI58461129
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honorable man and t lrrend of miuc. Ilavint,, propn:.ed the uupov- orishment of tobacco growers, lie comes to their aid mth a program of Job retraining turd tivc.lfare bauidottts. This is ,tbont like cutting a warrs throat :urd then handinn him a bo-mdaid. The plan is shockin,r in its exllous disre~r~ard of tobacco farmers-- despite, the Senator's protestatinns thathc does not want to harm the "haudworking farmers who are strurrling to mal.-e a decent living." But it is eren mmv shocki::;; in its shortsightedncss. The Senator should rralize that his plan wonld not discomfit the tobacco compu- tucs, Itlvoald simpl. retrun dre countrT to an era of overprodne_.tion of the tobacm. T:umers would grow as much as they pleased and ma.rlcet it ovhere thev could. The snwll and less efficientfarnrers would quicklY rro wr<1er. :tird thee big grolcers who could afford to invest lwavih° in ltuu] and mech,urical harresters would take. over. There would be more tobacco. not less. MI- coustituents reject snch logic. And so do I. And so. I suspect, aould mN mlleagne fronr illah--if hc stopped to think about it. I sincerel' V tvish he would stop and think about his bclpful plan for tobacco farmers. And I sinccrclv wish that zcbilc we are at it. he would stop and think about his plan to help r•onsmncrs h.N limitiug, tar and uicotine in the cigarettes thec choose to bup. To jog hia thinking, us he menl ioned a mirurte aro, T tvould recite a passuge from :m cduvationnl tcle.ieion prol,*rtun called "The Adi-o- eates." Sen.rtor .1loss vca~ cross-examined by Willia.m Rnsher. The eschaure was verv educ:rtionul. ]Ir. Huslrer askerl hinr. "And in 1989. von }-ourself said, 'If krmc-ing the cmrseqnences they'-mean- iurr the consruucrs =coutiuuo-choose to continue to smolce, thev're entitled to do so. Is that rirht2" _lnd Senator J1oss said, "Yes. I have uot adh-acatod that there Ix, :urc total proliibition." and thcn DIr. Rusher asked him, "You just want to stop them from smokim,r cig;uettes .vith tur above a certain Iel,crl4°f And 8ena- tor Aloss sarid, "I rvamt to protect thenr as fur as po~siblo in that rcrard, and to edwate thcrn"aud n[r. Rnshcr askcd him, "I+rom themsehrs?" _iud Senator _lloss said, "From themselves, and to edn- cate them as to wbat-rvhat will be the results if thev do smok-e.r" VIr lirrsher asked. "And if Ihoso r-ons:mrcr= cou protcrt chousv . to consume somr?hine vnu don't .rnnt Ihem to crnnsume. vmr"11 make a law .rnainsr it, is Hnrt ripht?'' Senator Moss said. "Vo. I don't believe in total prohihitiou, but I bclicvc in f;iving the maxirnum degree of proteetirnt rts n-c do in labeling. tnnnv substances that we requirc lahrlin;;~cnrniu„.+ pcople xfaiust rhe routeuts of that bottle." Then :1Lr. Rnsher said. "I icas about to ask you rtbout precisclp that. It is widet ' ~ kna«-n I Irnt alcuhol is a serious druh and cirates a serious social problenr: have vou. or icill \rou introduce a bill to reduce the alcoholie contont of sa}-. beer to 3.2 perccut ?" And Sena- tor \Ioss said, "I Innc no plan to do that: in scvne places it is done b}- state law"-1Ir. Ruslrer aske(, "Iiow about prohibitinr= wines nver 8 or 9 pcrr-cnrt alcohol?" And Senator 117_oss said. "In sonre States Ihrrt's doue, but thrro's no Federal la.w" \ir. Itusher: 'Whis- koY ti0 proof?'' ticnator Moss: `°I'hao is no 1'ederal law"- :md Afr. Rusher asl:ed. "1}'rll. )ch}- isn't thcrc'd \j'hv dorrt vou pass a bill and ma;e a Federal hn~~R" 5euator Jtoss said.~`'If. if ~l thought it mould T158461130
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9 Sen,rtor D'Ios,s. You did not oHcr me a bulletproof vest, though. 11'e hace oco of oweoll~~a;*nos 1cho are lcnmclodreablo mt this sttL- .Iect rcho harc rome 1o feslifi- Iodrn. Pirst. tlre Honmatble B. Fvrrett .Iordtm, 1'.S. Senotor from Vorth (':volinn. We will ask 1-on. Senar tor .Jortlnu. attd Seuator hiraiu-all rit~ht. Rc agrerment, thcn, we n-il1 nslr Senator Erziul of tVnrth C.uolinn, tlte scuior Senutor, iF he wil I come fotlvarrl. At:icbr• ron van both sit at the table. STATEMENT OF HON. SAM J. ERVIN, JR.. U.S. SENATOR FROM NORTH CAROLINA Setr,ttah:r.cr.-'19r:uilc cou. D] r. (`h:ri rmnn. 1, nufortunatelyl sehednled a. heariii", of a subc-otnmittce of mg oleu this muiving :Hud t lLacr n lot of %rilnesse, and ne-wspnper rncn then•, so that is thW . renson Senutor lordxn is permittin" me to tes- lify-lirst. - Senator V[oss. }V'r :ur, certaiulv glad enoup;h to (1o thst, Senator. 1'Vc rcnliza )ou :uc rwuriu;; Ittte, ns NIa mere a little iate gettinr~r started hcrec bec,uusoof thc pravcr brcakfnst this morning. Seiudor I?m-rv. Alr. ('luiirrnmr und rrnllernen of thecommitfiee: 1 (nnio I)ofoto Ihic couuiiillrr ;rs n t'ltner+ %'ith two crrv restcd in(erests: The ~relfare of the Slatee of Vorth i`.rtrolina and the wel- faro, of the. T;nited titxtes of .Unericor. Th~i,• is no c.ortflict of inter- esl, for the d:ur"ler n-hivh ILrcufeus the I~-qpl'~ . of n,v Statn also thrcatans the firr•dom of the vten aud wonicn -'( tl us 1\`nfion. R~[ur tomit, sonue 3o-odd anlitohucco bilis 111m, been iutroduccd in tlir present Cou~reSF. Of most conceru wr. Lltose tltat munifest a desire to improce and perfert hmuau atl'aius a'ith respectt to cirarerte smokin;!. '1'hese 1Lills ;ur calrulated to '`protcet" 5o million Ameri- cuus bv forhiddiur them to bvt--hee:uise of mt outriP,ht 6an or surnphr;u;r t:uation-rcrtain types of c_i~fnrettes of whose alleged dmurors Nrcv xro xlrc:rdN -fullN :tNvarr. 1 refrr to proposnls to forhid matmhxctrre of ci;'nrettes based on so-called truand nir-otim' r°outert or to tax thetn differentiallc on the sarne brisfa. i:ilso rePer to measun-s thut ~could rnonipnlute smol:int; brhacicnhr restrictingarer•ess to adcrrl isiug rnedin.. er hg sl.rildnl; at fnr'7uers tlnonr,+lr thc climinntion of Iheirprice support Irrogram. tiurh lo.. 'islatinu is m;mrl hieonsrtmer tuhrocates who intn-ittinglT belir,ce thry-:tre actin'. : in the public iuterest. Trouicully, tho-includr- manN- tcho iconld Iro mosl .slceplicnl nf ;trwemment interveidion into otlLer areae of ]nunau br6nrior, surlt as preventiro dcfention or no- knork la~cs. 13nt incen a simil:ulc rcpressive proposal donls with to- 6ucco. Ihnsr 1010 should lm tho lust to snpposrp that -"o1-crument t'e- stticlion ttill wml< as inlendcd, or is eccu tle::irable, :un :unonr' the first to snpport it. To he eleorl,N - aud roust>ieuonsh fi:orlo what zve are, dealin-~, zcith is Jerii,lnlion. uci uul or potcutial. that is in spirit desi~'ued to impose npon :lrncrira :in P:lezenth Cottrmtuid~ucut: "Thon shalt not smolce.,; l1'e :u'r• seeiu:in rr.iniple of ~chttt Grorrr 5an(antuia ntrttut ~Ohen lte said thttt `Hmse who for,1-et the past are condemned to repent it." Surh nroprohibitionist lr~-i;lation-to r•nll it L)- its ri~hr uomc - rmJd, of rausr, iutlirt ;,•rcxt vcurromic hardship on t}m people of V-orll, ('nrolinu. AIt~sta(o prnrlm-os marc• flnc-cnrrtl toLaeco nud morr T158461132
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12 Sotiee plense thll11Lr I)erlamation reads "mae be" haznrdmts. not "is" hazardous. Solive, too.-Nlnt it calls onl~for a warnin; ml the parkage, und that throurh loluutal,v ar>recment that Ai-arning is now to appear in ach-ertisin;r as ~l-rll, plus tnr and nicotinc fi-nures. ThrP conotressiunal polidy- --oes ou to stato that a seeond purposc of the comprohensive Federal prn~raur is tlurt : Cmmnerec and Ihr nalioonl economy rnuy be (A) protected to the alaximum extent rnnpi,teor Icirh thic rleclared poliel' :uld (Bl nnt impeded Dp Aiversa, mmnuniform and eonfusiuC ci>;arette hiLelinfi and xdcerfisini; regulnlim;s v°ith respect to nnc rc1ntionvhip behveen smolaug rurd 7ienlti:_ Itt spirit. this polirN could hee considered- ;uid I ihink certainh- shmdd Le cousidored-to applv to the arricultural aspect of tobacco as Isell as the udvertising ;nvf lahclin". It should also apphtn the ahnilahilitv of n legul prodnct to the pcople so thec cnn exercise. thrir freedom to lnnit or not. (trmcink, loburro and sellin~ the finishcd product are e1°erc bit as mucl; a1 pnrt and parc(l of eonmrcrce xud thc national wonom.) as a!tvertisin". That is thr•w end of mY .,tatement. Senntor Rfoes- '1'hanl: cml, Seualor F.rviu. 1W apprcciale- thak rl~rtmurh. You tt-ere indiralin;t that tho warning is simply that i6 mtty he hazardous to hcalY6. Z"ou nm-t mmelnhr~r that tce lLavr~ nun=ndrd ILat xnd the m:nniu-~ uow sn.; "The Surgeon General has detei?nined t hab cil"nrette smold n,'_* is ~ I: I i ~-,-rons to rour health.°0 Senator Een l.. ZPell. T put the tllinl- thntT thonnht Conl,ress stated. tiemuur AlusS.'1'his is r"n"rssioual actiml. Scnator I:rnls. I am avc:irn of that, brd I aun not xwnre of the fact that Ihc :Amerienn people have to make obeisance to the opin- ions of n political doctor. Senator Cuoic. A(;n- I sv. ]fi. ('hairman. that in the aet of 1970. item one caid ".•hho piiblir m2N hr aderyualelN infornied tllst cil"arette snokinr maN ho. 1L:uardons to lu•arltll." Tllis ivus the position of Cmr gress. not flLr povilion of the 14uw;tteml (3vucral of thc [hiited States. ;5enator Erlcu. Yes. Thal is the point T N.-as trYinl,* to make_ 5rnator ]tuss. Well. thn ri~~~aretle or thee tobacco eompanies hs~-e nolN- n;,~reed to put the wnrnin-: not mrhY on the packet but on the ad. sacin_ it is tian„rrroos to hcaltll. Souator 1?r.vl.N. Thadis oue of Ihh I ruuhles- 4on:rtor :bTuss. iNcould like to read jn,t our• pu•a;[raph from the 19(iii (bnmieree (bnmiittee repomt fhnt hls to do ieith the oririnal findiugs of I he titngeou Geueral's :1dvisorv (lommitte:, composed of 10 ol;tstonrlinIg privxte phvsirinns and =eientists selected bs the Sur- rxeou (ieucralof the PnLlic Health ~I•r~-ice. ~~°ith the mncnrrence of the ril"*arethv iutlustrc: }Fhile ihere r2u:niu n snb.<I:inti;;; u:waber of iudiriduuJ ¢iysicia.ns ;urd seien- tiet" the C'omut2ro• C'ommitter ivvrivrd testimony froni 39 of thein i~ho dn nnf helieve lhnl ii L::s beeu dauanstr.rled icientifie;fll.l' that Fmoking cunses enncer or othrr dtsarvos. A'o Drominrnt mrrneal or seiantitic borlp imdertnkin(; a sy~- I:ernatie. recie~r of Ihc. v,idenue bns rcaeLCd c(mclnsious uPPoscd tu thoae of the SurR, on (7enrrnl:<Adrisory pmnmittee. Aud sinee thrn, Ice huve hall fur, morr r<ports cler.c oue coniill;; I o I hc sanic cmtrlusion. T158461135
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I6 So. I nti,mlrt add. luis ovct.e S'orth Carolininn aaid cvcrv limeric:tn 1010 beliece, ill bttsin~_dorisions oii fucls ralher tL;in sssuuiplionsanrl Ticaut to stress ::nssnmptions";md who cheri~h, -: tl, rilght to make iudepvudent jud_ments on tlic producl s hc ch.", < to i i-~. .. If I eorrecllt- interprct the -'roas ontlineti for , Vour snbeommittee, I.un impolled to s;rr Ilicv rchro.ont it fiutLer ccetu'sion into t}s rexlm of Fedetal C-ontrol .vhielt hns alrend~- esceered the bomtds of jnstifil ationantluw'essil~. ~ Ib secros that what coo mar bc h.cingt-o ennct is :t sort of mini- prohibit iou latr for tobneco nnd irs users. T dmrt thiul: rrni wr roim!to bec able to t•e( it, lllr. Chairman. Let rw a=snn° lou thnt I sham miir iidcresl, ill thcv climination of nn~clcuioute of tnl;urro tlwt cmt be shown to constitttte tt health Ihnzard. I huvov consisteutlc supportcd, and will rontimte to press for, sci- outific resettrrh hm, the Omernmonr und tlic tob:ueo inrhistrc to oeLiet~em thnt Inn'pose. Atteraltts of tluv timlm•ou (',rncral aud (1tc Deparlracu6 of I1TW to mnkc a casc on the basis of tencrnlities. nnsnpported nssertion,, and nssmuplious. hacc ill mc judi-nmrnt scrccd onl}- to clourl thoe issne :md to del;n- the search for true aiid ~ crifiablc facts. G•rlainl~' tlu•N - I;rovidc no foundation fur tho tind of lr-islatimt it nhpears thnt ~-ou lmcc in miud und ill the form proposxl iu ouc I>ill ~~on nh-oad~-I;acc Lefur~• ~on. ~ I sp•nl., of roimsv. of S. 1 1.5 1, ,cliiA would proposoe ii tuuiinuum lin;it on (hr rar aud nirotiiic rontcnt of vi_mrttes. TLnt hill piu'Irnrt'l tirsl of ull, lo iilenlifc un "inrrimin:ded apycul'' eoid proposes to set stnndards for Arhieb no precise srientifin bnsis lw5 been rl"t~mined- Tt ~conld h;mc those standards preseribul, instcetd- In tltr F'l'(' tclii( l; is totillr lackin- ill inedir-al or scie;difin cxpoi9isc.. . . Let me tonrh brieflc mt t~co of the otlter aoxls t-on hetre ootliued fmtlacso Ix•ariuo's. . . , Ono Avonld rlcal with tlto progress of FT(' clTorl, to rcquirc. con- spicuous ~caruiu~s in Inrinlod modia cir:nette advertisin-'r . As I;tui swr can Icnol~, a tentati~ c x_rorntcnt bct~ccn thnt ;trcnry- and tlio toLsoo iudnstrp ou this subject mis mwoimocrl ccstorrlur. Tho.n tliero iz Ilic matler of frcim: to bring, little eigurs, sneh us the ACiuohcstcr nmunfarhired be R..L Rc.tnolds Tobacco Co., undcr the proeisious ol tlic ('iLn rel lc timakiuoAt•t of 1969. ]loth the .Iusticc Ucpt:rhuriil :wd the Intcruat Rctcwc Sert~icc huce rttlerl that 1CinrL(strrs arr. ill faet, cirr2rs. pnd I put this testi- niouc ill l60 ('ou;irossionul Ro(ord~-csterda)-. _An}- c$brt to briu;t thcm into thr scopc-of tktc c.istin'r lcrislation crul uulc bc dcs, rl6cd ns nn-nsution irithout fonncLition. In tlosin-. lot mc soiuiri :i ~tord of watnin}r against adoption of Itastc, ill-con( ciccd mensinrs thot rnnltl irrrpniilblY dnmagc a ma.jor iudust r' x zoid its pcoltlc. 7ustcad. I t6inlc it is imporxticc to prres fmtbo fi-urW facts xbont swol:iiit,;utd Lcaltl;. Lot tlie chips thou foill wLrrc rLwt- may. Imt let thent be dropped fmrthe cnrcful Lantl of science rul her I llaui snpposition. T158461139
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17 Mr. Chairman, one of onr ex-colleagues was buried lttst week. 110. emol:ed euoa"h eiaarettes mxl ch,ars to fill this Capitol plttmb full. He was dd N -ears old schen lie died. This ~rmiuds me-in light of some of the sttppos-itions coming before this camtnittce-of the story about annan .cho got eiek and exlled the dot4ur. T1te doctor did not shoNc rq) al quickly as the man thonr6t lie onrht to, so lie called another one. And, yrnt know, doc- tors do noh like to be bronl,ht in togetller at the same time_ Bo one ~,~~ot ou oneside ol' dte bed and onc got on t,he other side, .md eaelt pnt his hond under tlte cover to feel the pacieuEs pulse. One dorlor said. "hueumouia,." and the other said~ °drtn>-k." 1'Lat's a6nttt nce 1.-ay =oltte of thesa hearings are bciug conducted, nnd is tNTittil ol' flte kind oL e,idence that is being preseaited. I stand rrady to fi,liluuctllinr tlmt c-mms out of this committee along these lines. Senatoc lllnsS. tienator, yon will be pleased to know that ow' Sur- Ceon (,eneral and mtr doclors arce not the onh- ones that are cotr fused aud tvronr; ;Jtont tltin. II attcndcd the 1Vorld Conference on Smokin;!~ a:ld Ilealth, :utd Britain, .Tapan, lsruel, Sweden, Poland, Itail}°. Ucrnlauy, and tnanp other countries were all mpresented there bc their pnblic health representati\-es, and they are all making tRe Sallle erl'or VCe :Ll'e. The,} ltnce all conclnded that it is an impairment of the health of fhrir pcoltlc nnd, therrPore, t}hev tnr. takiuo, stups to do some of the Alinrs th;il Nce :uc. tall:inL abont ]tere. T1te5- are trying to reduce t,ar anld nico(ine. Tltey hon-e. tutken cirarette advertisin,n oll' o:f their tele- risiou. Thec- :ne restrictin;; ci"'arette adrertisiug ou billboards and tbiug= o-1' llmt sort. tio it il~ nol lhe. I'ititod States that is the sole conntry in error; it is the Arholr. ilarou morld. ])o yoo nnde.rstand? ,`enntor .louueu. I niirld :tdd thut I think the aigarette indnetry, the tobacco iudnstr}- in grne.ral, has become a favorite whipping bop. I f you xcant lo adt-ocatee sometltinn~, lttsb jmnp on cigarette5. Srnntar ('owc.'I'lie)' pid ttp a'°no smoking" siro,n. Senator.lono.Ax. Tolt ha~r a lot of advocates right, off the bat. Scnatmr llnss. That is what t'oe nttunnf;lefilrers of T)DT said bcfarc its. 1Pv. :uree not after thnse iNho make I)D'1'. It is jnst thntt smne of thc results of usiu,, it are procin),=to be harmfnl. '1'hut is u11 Are ale talking about hcse ilit]t tobacco: thatt smne of the u.~e uf tobacco Las some Garntful results. tiennlor .(nttu.ts. Korcntlc thcrc bas bcrn a trreat deal of etidence- nnd it is not jnst rccentlv Iliat oLes_ity has ;tot a nrcrt dezd to (lo AciHl the s)or( life of people. ;;citatur Aloss. I think it has. ~'cuatnr .Io¢n.tN. I thiuk tlle State of litnb is about number two in thc. trowin, of vuw:ubcctsl so tahc tlo we not tell thein to ent domn on su;;ar ould people will not get fall so quick and tbey will maybe liree a lot lonrerd Let u,s fnlce the Adhalc rauiul, 'Clwre tue a{;reat many thin,~+,s that cmltribute to health probletus. No one has all the snswer5. .Imt lael pcar a piece of legislatiou tcas signed into law providinr for resr.trch on cancci-a crnslt pro-"ram 10 find the ca.nae of cancer tmd tl-icrc. tras *L.GOO million flnthnrizrtl for that prol-raui. ll' lLr.x . T158461140
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14 Senator Fta-tx. 1-rs, wlric6 ilhretrates thee faet that we appoint factfiuders. and those nre factfinders that would not be eligible be- rause rrf their bi:rs to serve on a jm~ if a jinp wem noin~~~ to pass mi an isoe of fact. Senatmr ('uon. As a Inattrr of far•t. it is interestinir to uote, when I)r. Stcinfvld tcsti/ird I:rsl. year beforc thc Honse ho was :lsked this rfnestion b~(`ouqgrassman IIull. of _lLissouri, «-]sther he thought this did not eonstitute a conflir9 of iutervsl, Ihe. doctmsaid he thought it did and thom_]rt rbnnges would be tmrdc. - It is nVerrsting to note thre new mport c.ame oat through the very salwv ci::un:cls it c,une out before and no effbrt was made~to find tun~ me>ws bv which a trport could be sirbmitted to the C-ml-'ress of the ibfited States that did not come froui the t-m.v clearingliouse whose job and responsibilitv it is ttnder the jurisdictiol: of the Surgeon General to coio iuce people they should not smoke. So I must snv. in all fairness. Senator, I believe it is a biased re- porl to berin witli, and I thinl: ymt do. Senator F.r.c:N. 1:Inr convincrtl bet'oud a:n- donbt. Se.nxtor Coolc. A(a)-be this is the beginning of Nd1at cot:ld be called a nelc type of soothern st rtttew. Scnator Fr.vlN. Yes, sir. Senatm(bor,. Let me ask yon another question. because Senator _lio~s' bill rcqniros that the FTC promnlr„tde staudards eseablisl:inr nmxi:nunr aceoptobilihIevcls. lakinr it away from the Surgeon (ienoral, :rnd they ha"to set np all the machinery. Tbey can chantr it cA-crv ye,n. 7 asanrue what thev want to do is, say, one year it is at :ti certain lecel. :nnl the next }v'.<2r a lolrer ]c.vel. and the next year a lower lev el, anci so fmlh, and then "r• wil l have prohibitian. Vow, holv would }'on terro sncb a tnrovision, Senator? TS'ottld you call ita`'miui'r or possiblv-areeping'' ]nrohibition? Senntmr ISu~tn-. We have alnttdc llad the first nmendment, stis- pended bc this attxek oil tobacco. ~ I'on take the FCC-the first xmeodment was snpposed to nive people the rig]]t to entertain dit}'r•rent opiulons 1hrom 6hosee prescribed by Government and xllow them to .speak on the subject, even on ad- rertisiu,_ medio. The F('C now sa}-s. "We xrem in tlre eorr:ple.te posses- sion of all the truth iu respect to tobacco and those who disa„:ree with us have no trntL whntsafrlrr on their side." So thec bar t6e air- m.vs to truth. or nt Icast ]cLlxt noure heuplr conorlve to be flre trirth- tieuatnr Corrlct I lotc (10 i on iit this i nto Nour enrrrent Irearings" Senator F:an i c. It is tolxllr repuLmutt to individual libertr. and I Ihiuk um-limitatirn: on tbo right of advertising is aa violatioif of the firstt amendmclit, if it is alrplied to am- ptnduct which it. is legal to sell to thr reneral pnLlic. 3cuator Coor,. ()n<, yroiision of thro bi 11 states, I think: Vo stmrdnrd ervhiLlirhed nudrr thi, bill ~hnll lie iucnrn:istent with eansnmer ac- cePt:rbility. IC rigurrrtvK Drndncod in rvonformitc cvit]r ~nrh snndnr& wuuld be vo nnacceplnbte ro a dnb.fintinl nnmber of cignrr•tle snrokers as to ercite a umrlcet far tlu• illielt wlc nnrl eurrhuse nf siguifir'mrt quantitiec of cigarettes wLieL fuil to mcct .vnch n.vtnnrlnrd x.. x. S'oIcN app:uruth, if enough people nre ~cillinn to break tlme law for their ci:~:rrcttes. Ihc slrroi,vnrs nf this bill ale willinr: to let them havethem. TI58461137
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15 lti ntv cxperiencr., this is a rarther nnique way of polling the pnb- lic. Sotic, tivhat is vomeicNtou this? ,9cuntor 1+Ltrtc. I thiuk this illnsttn.tes a conviction that American cnnsamers shnuld not huve freedom to decide thiugs for themeelvca, that Ihev rnr incxpable of Inakinr correct decisions and, therefore, thev ongJd1 to Ite undcr ir buwr:urcratic. "'uardianshiy. Senutor ('uorc. IAvill not lakn .uty rnore of t'onr time. I know sou hace '_'ob to ret to cow• hearint's. Senator Ertrl~. Thank vou. Senatm- Dfoss. Thmtk vou. 5enator. 1V'c. Nvil1 nmc honr front conr collearrte. SenatmJordan. Senator Yv:vtdrt.. Mr. (7tairrnan, would Yon ,}ield, and would the 5enatnr.cait jnst a mmnent t 1, loo, mnst ~o to Forci~n Relations, and I w:ntt to crtmpliment Sena'tor P:rrin aud eN prrss rnp re,, tmts to Seatator .lordan that I tmrst Ieavc. I wanl tn sa~I arn inlerested iu 16e har.rings and I aut pssrticu- laritiinte.rested in how the urtc al,,re.etucut rclates to the hcariurs mr .ri. 1=1 iiT. T will be Lack xnd forth :is ni.v schedule herntits. I1y apologies to 1 on, sir. ~ I t}innlc thr Ch:rir. Senator -lloss. '1'hank vou. 1\'c do kuow that vou have other oorn- tnitwcnt.. _~s I explained carlior. ' Non had becn ,hcrc to bcgin with and had to ]canr_ and vcc knotr }=ou ttiill be in and out. But we ap- pr-eciate it vers mnch, tienator Pe.n.rsont tiru:rtor .lordau? . STATEMENT OF HON. B. EVERETT JORDAN. U.S. SENATOR FROM NORTH CAROLINA 5enator Jwtu.is. "Phwilc Vou. Ptr. Chuirman, and nmembet:s of the coinmittor_ Titst, I o^tnt to snc in the aerc barinniut,r that I anree with e.centhinr Senador Rrtin has said. ~IIe said it vet_v effectively. And IVc luave bocu occr thia !nonnd marn-. mtuty limos torcthc:r, so Ave arc in pt•rlbct arrernicnt on thr statemrnt hr ha,, rnadc. As c.re.rv memhrr ol' this subcommittee knotvs. 1\orth Carolinai leads tlic nution in to6acco prodttction aud ruauufacturing. Scii:dor t'uux_ lie ctu•c ful nokr-. 5cnatnr. Seuatnr .Iot;nVs. ITcutuekv does rrm.- somc mi,hh, rood bnrley. It is the nmubor onc State 'for hrmleti- prodnction. l:vrn so. some of vrm mag uotbe tnllp aware of tho part that t,o- baeeo Irl:tt'n in Ihe ~tatc's total ulgricultm•al aud indnstrial cconotn.N-. Lrl me stre=-, iLcu. Ilml iu :ypicruinri here 16iy moruin;t I atu apealcinr Ibr an rslimaled •dILl.0o0'C:m Hrrl familiea tVho depend on this crolt for a licin;y. mnd for aI tnnltimillion dollar indnstry that rmploos thonsands of other tv;oc onruers :ts well as influcruciur em- ploN-mcutt iu nwnc othcreuicrprisos. 'Clu.v havr a r ilal aixlir in lhcsn cvnrin;rs :ulcl !ni the proposuls for fnrthcr rrstrictimis ou the Ictl' indostt.~which it appe:urs vou arr, prrpn riu,, to considcr. TI58461138
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zo I welcome yron gentlemen to the hearings today. TNcould like to make the ob_servation tkia.h this is the first time this committee hns held hearinp., on cir-arett.es rFithout having the benefit of the Snrgeon General prese.ntinrr th(, statement.. In the past ])r. l.utlier'Ceri,c has trstificd beforee tlre conmtittee, 1)r. I4'illiam Srem- art has restifird hefmr rhi=_ eommittee; and we were eapectiut to hievr Dr. dcssc Steinfcld, the ~nr; eon Gaierssl. r..ive the testimrniy hefore Ilie cmmmit(ec lortae, along %N,it6 J)r. Gori of the National Cunocr Ltstitule, who was stqqposcd to tesfiify about the, Less FTttz- ardons Orvrette 1Fork Crrmih, :uzd Dr. Dnnirl Irorn of the National 0earinr•house for Smokin-, ;utd Henlth who was snpposed to talk to ns todav ahou(Ihc curren( state of smokino edncatimt prorrams. 'fhree of bLese rentlemen a.re lirre, but l)n DnVal will presentt the tcstiuionv for all. So herhaps pou cau cxplain %chp itt is consolidated this Nrap, so onr record .cill 1)e clear on that, and then we will nsk you to speak, llr. llnVa.l. STATEMENT OF DR. MERLIN K. DuVAL, ASSISTANT SECRETARY FOR HEALTH AND SCIENTIFIC AFFAIRS. DEPARTMENT OF HEALTH, EDUCATION. AND WELFARE: ACCOMPANIED BY DR. JOHN ZAPP, DEPUTY ASSISTANT SECRETARY FOR LEGISLATION (HEALTH) ; DR. DANIEL HORN, DIRECTOR, NATIONAL CLEARINGHOUSE FOR SMOKING AND HEALTH, U.S. PUBLIC HEALTH SERVICE; AND DR. GIO GORI, ASSOCIATE SCIENTIFIC DIRECTOR FOR PROGRAM. NATIONAL CANCER INSTITUTE I)r. I)r-Vu,.'I9iunlr cou.:llr. Chairmun. Twonld like to ecpress, oil bchalf of the Snr,,eon (xeneral, ])is regrc.lnt not heinr nble to 'oe here. He is at. 1Loine. with the fhu. I am vonlidenltlwt he wonlil waut to respoud to au in)-ihdion to retnrn ed-i cour earliest convenieuce. In Ilie iideriui, 1I wonld likv to say mp associates and I are pre- paurd to do 0111- bect to handhe . miy- qui•stions that yon ma}- othermise n-ill laile direeted to Ihe Hur4mnu [ieuerxl. And itt is poasiblo (ha( wel be nble to defend his position fairly. tieuntor ]luec. 'I'hauilc yon verv mnr.h, 1)r. lluVal, a.nd we ttrc ve_rr. \-erv plrvsrd to hax r you tetify. 11ud Icce appreciate havint,'- all of y~ou ~rent.lenien hcree because cnn rnpre~ent thc ~arions areas~of expertisee in the field that is tlie snb- .Ic.ct of inquit_v here todn-. Ur. 1)iVm.. AIr Chairw.ui :nid nmmbers of this coniniittre: I wish to thank .-on for tLe opporhmity of- appearin1p before yon aud prcs•nl inl" the views of the Departmeut of TTT7W mt the bi11 befrnre )-ou, S. 14n-t, and rnl othcr matters haciur,to do tirith smol:ing, and hoallli. Thrp contiunin," iutereet of this committee in this yroble.m is rm enerniro'-rmont to ;ill ni ihis, cotnrtrc who are worl:inf,~ to help rcrlnre Ihrw dedlh and disnbilitv 1rlhir7i re"nlt from c.iaxrettev smul:in;;. Pour .cceks -reretarr i:ichardson sent to the President of the firnnte oim 107 ~2 P,eliort nu the Health C'onscqneners of ~mnhinri_ 11'ith ponr permission, T.cmild like to reriew Liriefly the highlights T158461143
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L s be effective"]Ir. liusher: °thesc are saioua problems" Fenatm- DTt>,es: If 1 thouulit it would be elTectl"e. I tt-onld be ;!'htd to proreed in that aroa.n .tod Atr. Rnshcr asked. "}'1'In' wonldn`l if he effectiecR" And ,`,"cn- ator ltoss saiil. "Rocutse. if 80 pronf whlskey well, sold. I asr;mne that two thriuks in pla<•o of one wonld get the persuu the samc resnlt.°" 1Yel1. that was sli~,?.ltth' mnre than it ~r:na«o. Yrrhxps Ihu state- nieuts and Ilte qnestioning that tokes pL'tce here in thr nest fetv da Fs tcill he vtpualh' wluoutional. I nieaii to do all I run to ntal:e it so. And I tnnst e"-. lfr. C$nirrnsn. that I atn iealhy rather sorrv that llr. Stcinfeld is not at61c to be 1-iere today and Iwonder whMher :uvcote frotn his ~tiff nr ancoue Pron the conunittee staff Cu)) tell me when 1)r. -;tcinfcld will be able to appear before the committee. Senator llocv. 1Ce hzuc not had :wti n'ord about tnt alternate time. but 1)c Slcinfeld cuidtl he in-ilccl to oum of thc eubeerynent hearinns if ihn1~euutnrtcoulillilcc. 9enator C'ooic. Vino. ticualur :1[01 ~. We :nr !_10ins: to h;tt-c stdtFrqueul hesnim-'s mt this s:tme tocneral suLjcat. Scuator Cnotc. Pint•. Aenalnr 1tos. I ant ylad to huvc be stacmcnt of ticnatmr Cook. llhcitnsk-. he and 1 hxre it diffrronve of opinion that has lonr.i per_ sisled. '1V chairtnun mnderstand, his point of aiea-. I do not tltiidc that I haco erer cnueealod the I'at,l that I Ihinlc f6e yublir h"mlth of uur pcople ttanld lbe betler olF if we had u cessatinn of ci_arette smolcinr. '1'Ite tptesliou is: Flottdo tce procced to reduce the hazards as untch as yossiblc: and one thing Ncc an, talkinff about todal' is thc protluetinn of it eiaiurtte that is Icss hnztudou~uot comhlctel}- tcithout haz:nd, hntless 6:uarduny. 1~1 lotrcring the t:m acd nicotine conteut. The Senator feels that the jmc is still ottt, and 1 think tho jnry has emno iu. That is ubout tlir dilPereuce Iltere is :md, of conr~e. we will luttr tlie t•ridenee ltrt•sonted todttc and in wthsequcnt hearings hofore. the subcoroviittec. There is not uuttlouht Ihat tce ure dealing with a ret.c diifie.nlt probleut. '1'obacco has been pau•I of otu• rcouoluic ltcritagc from the rirnc that rco ttrre scll Ictt as a rnlonc. and to tliarultt that. to Iraycn t6c ltnulnt9iun rnl luharro, cau4cs nuinr crononiir rlivrnptimi. :1nA - Iliii~tt thc elutirmalt has proposed is to tn- to allotiate that disrnP- tion ill tho ocunoiniv serne tcliile tce br~in to tnm r. if Ice ean. tonard impruromeut of fhe ltealth of our people. We xrc lalhin': nltont Ihe houlf 6 consequcnccs of smokinr and that is Ihe piurposo o1 tltese hearin,(s tcLtre that oill iGscuss thclOWerini~ of the t:nanid uicotine eontent. As I said ill nnopcuin,~- satement. somo cig:u'etto rnnttv,tniea 6u~o xlrveltdr dono this oo a, colunt.nrt' hnsis and I tlo rrnmnrud thrnt for it. It is a;.rootl step in the ri;rht clitrrlion. li'haI tm :ur lullciug altout nom 9 tivltether there shonld he t~ertaiu mnsiunint lercls sel that all ci<.arette niauuParhrs. shonld be requircd to nirct ~ tienaror (tour.. As rho tienator Icno.vs.7 har-eiln•itodhiai on manc oc,usionn lo Lc t6e jtrincipul speaker at the atnttutl tnectin;' of the Kenhickc Ferm liin•eaa to ezplain that. TI58461131
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21 of this repmt iu view of its rclc~~ance to the lc~ishrtion y~ou are cuneiderin~. First of all, this 1972 report confirms and stren~.rthens the concht- sions of each of fire preNiorns reports whicdr the Public Health Serv- ice lni5 i,sued on smolring .urd healt.h, begimrine with the 1964 report. of tlie Surlpron ('xcucrat's ldvisory Committee. Ci.~r,wettc smokin, is indeed a harnrd to herrlth aud on this point we can state there is no lon;*er any substautial disagreement amon;; medical scientists. Consider coronat~y hcart disease. In 1961, a higher death rate was noted for male smol.ers as compared to nonsmolcers, hnt at that time it ~ti-as not clear whether the association had causal~sif;nificance. Our wrde.rsisurdinr of the mu;hanisns of 61iis relationship has been I hrc:rtle eslmnded; air;•arctte smol:ing bas now been clea.rlv identified as :r majm- risk fnrtor in the decdopment of coronary lreart disease ( for both nreu ard women. Studios in various countries have con- , firmed this fact. I A ne«• note in our 1972 report is the demonstration that grcater 1 mvocardial arteriole a-all lhiclaiess can be, fmmd in smokers conr ~ pared to nonsmol r i; sng'ntstint that cukarette smoking contribute.s ~ toalnou.sswhereb5 coronary rrtercdrsersedevelops. ~ T6c role of carbou mono~ide in the -moking nnd disease relation- 'p ship is be.comin-,,- mnch inore clearly identified. One of the hi_hlithts iu thc chaplcr ou Iretut disease is the findiu;{ that the eleration of c.arlrozyhemo;~rloLin lerels in smokers can be a contributor to the . decelopment of curonary heart disease and arterioscderotic periph- 'eral vascular disease. The implicatioru of these findings for preventice rnedicinn atn '. obvions. Corrnrary heart disease is tbe Nation's leading ]ciller. Each Ycar, n million people espe.rience e.ither a myoc,ardixl iufarcUion or sadden dealh frau coroiary heart disease anii about 165,000 of tlre deathe orrnr in persons nnder 65 ycnrs of lge. Some important nenfrndings on hmti cancer aree reported in this year's repor-r. A major epidemiological study in .Japan has yielded prcliniinarc results which de.rnonstrate overall effects, and dose rela- tionships similrn• to those ob5erred in previons statdie~ in other conu- trics. The importanre of this study ]ies in the faet that it is the first lar~r*_e-sealr smolcing studv to be urnducted iii a popnlation .dhose diet, and cnlhmal, nnd -"enetic inflttences are distinetly different from those in preciously~ esaunined Western populations. Thc one ammimn factor in all population grouhs studied, of conrse, is eiga- rclle. nmokiu-'. '1'he Jarpanese are, findin,- that the iuore a person srnol.es Ihev rrentrr is tLc rrisk of incwrrin,-, lunr enncer. This pro- rides still :mother confirmation of the smoh-ing-hm', emrser relation- ship 1 hat hus he.eu re+•og'uize.d for °30 years in thelVestern world. Another sirnificant factor brourht ont in the canrent review c.o1r firnis thut es-snrokers hare .r si1,,nificantlv lower deo.tlL rate for long cancel Ihau coirtinuing suioke[5. The slurrpest redoction in risk oconrs a fter the flr<I " vears o f cessation. '1'he 1944 report cites nrn- er'ideuce which establishes a signific•ant rclatinnship bcNcen ci,arrtte smnlcinrand cancer of the ttrinary bladder for both men and nolne.u. The digestive systenr is also I affected by ritiarette smolcin;;. Tarlier reports indicated that smolcers ~ 1 .~_ T158461144
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i i 19 And, by the way, that not only includes price supports for the tobacco industry but price supports for the sugar beet industry. And besides obesity, Senator, they sell millions and millions of pounds of sugar in the operation and production of distilled spirits. So we hav-e got two problems on onr hands. Bnt let me say smnethinr to vou. Besides the fact that it cost the Federal Government 559.8 million from 1933 tto date, it has pro- duced for the Federal and State and local governments 4i0 billion iu reveuur. 'I'hat is a prett' v good investment, is it not? Over a thon- sand dollars return in taxes for every dollar invested by the Ameri- can taspavers. I think they would like to malre that investment everv day, do you not think so'? 5enator .lo¢n.w. Am I correct that the largest payment into the Federal treasui.c, and to the States and cities, as you pointed out,, is from uliiskey. tuid the ne.ct is tobacco F Arn I currect iu that statement? Senator ('onx. 1 do not know. It: may be true. But itt is a matter of the choice of the American people, is itt not? Senator Jonn_as. I think it, is correct. Tbere is about S5 billion a year in taxes paid into State, local, and Federal Governments from tobacco products and tobacco itself. Senatur Coor. I might say that last year the average tobacco farmer grossed $1,400 an acre for the tobacco that he produced and cnred..lud do you know what it prodnced in taxes? The same acre of grorurd produced $i,G00 in taxes. So if you t.hinlr this is not nn industry that has been pretty mucdr bludgeoned to death for a long, long_ time, I think it speaks for itself, do you not? tienator JouneN. I certairilc do. Senator Coorc. Tharilc you,~Senator. Senator Moss. Thank you, Senator Jordan. I suspectt the high taxes may indicate that we suspected all along tobacco was verv Scuator Coo... It has just, been easy, Senator, that. is all. It has just been easy. Senator Aloss. And I,U.atltered from the cnlloquv thals maybe we will wantt to look into the raisinh of corn becausr it goes into the makin;,• of distilled spirits, Pcutncky sour mtush spirits. ,~urator Cooic. Therc ie nofhinc T woold like better than for yott to take ou the entire fnrm commimitv. Senaror Dlons. I thought you suggested that along with the sugar beets. [Laughter.] Ceuator lCos. We will now hea.r the witnesses from the I>e.part- ineat of Healt.h, l:dnc,diou, and Welfare. The testimonv will be deliecrcd by I)r. Merlin DuVal, Assistant Secretary for I3ealtb and Scirntific Aliairs, who I irnrleratand is accompanierl by Dr. John Zapp, Deputy Assistant Secretary for Legislation (FIealth); Dr. Paniel Horn, Dire•lor, hational Clearin,_,honse for Smoking and Ileallh, [-.S. I'ulilic Ilealth Cerrice; and Dr. Gio Gori, A-ssociate Scientifie Director for Prorram, National CaucV•r Institate. II.S. Public Health Scrvicc. Pr. Jr ve titeinfeld, the Snrgeon.('ieneral of the Public He._tilth 5err icc, h rd been invited, but lie is ill today and cannot be with us, I understand. T158461142
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26 this mac affect driving pe.rformance in a poorl,v ventilated. srnoko- filled c•ar. T am proud of the leadership a-hich Scceetary Richardson has given to this problem vrithin the Department of FIF.W. As you mav lniow, we are setting tip proeednres so that supervisors mar establish separate work areas for nonsmolcers where this is possible; ive havee estahlished im-smokinz; nrras in onr errfeteriaa; xnd we are noiv asking ernplovecs und t•isitors alikc not to smokeo in our conference rnoms find auditoriutnc. It is mc hope that these steps taken by m}' Department ntay serve as an example to other branches and levcls of government and to private indnstrY. lu euminarc, it is oor opinion that ;rll eigarettc smok-ing is dam- gerons and poses au unreason.rble health hazarrd to both smokeis and nonsmokets. \Tevertlrcless, the Department endurses the approach taken in this bill and subject to the rjnaliflei.timns we have sttggested. we believe S. 1454 to le, s rcalisticc effort to minimize the health risk of smol:ing in a manner acc,eptable to thc, cnnsnrrring pnblic, whic}r avoids the pit- falls of ontright prohibition. Thank you. 37r. Chairman. Senator l'[oss. Thank vou r-erv much, Dr. DuVal, for that very fine statement. ~ ~ ~~ Yom- summary paragraph expressed what I was trling to stress in the first place. bnt reallp (he best vvav to irnprove the public health is to huvc no smol:ing .rb all. Aut since that is not practical, then we ought to move to the next higher lecel of protection of the public health, mhich is looking toward (hc control of the tar and nicotine cont,ent, and other hazard- otts substvnces in cil-nmttes. Throughout your testimonv you haee made rofercmces to new eeidence, aad one of ihe critivisms in the past has been that, theree is nothing new sinee 11164. Are tiou sa,vimg that there is new evidenco? :1nd is this clinical. or is it statistical? T)r. T)rN'.vr.. There is ncw cvidence. of cotu•se. bein'+ recorded each vea,r. Mr. Chairmmn. One of the, first purposes of the moiual report we publish is to bring the Aluericrur pnblic. np to date on the evidencc that exists. This evidence is both clinical and csperimcntal tuld, as I said, it is ccnnpilcd aud monitored and reported duly once a Year throngh our report. A complete compilation is now in that, report. J3tttt it is new evidence. Senator _l4oss. As part of this c.ollection of new evidence, do you also mmritor the. rvm-k that is beinrr done in ather count.ries? I madc reference to the fact that many other countries, Britain and others, are making similarl:inds of studies. ~ Dr. DcV.nr,. AIr. Cdtairman. Ice not oul.• monitm- the reports from otJrer coturtrie.a. Lut we do ilthrough tco separate devices so they r,an be collated to make 'rnrr'that we. get it all. Senator Moss. Tfris bill procides for a de.finition of tar and nico- tine levels in cigarettes, and whether nr not you believe that we can define that now, one, is there sufficient evidence to select, acceptable levels of tar and nic.ohine and other lrazardous iugredients? And, tw0, 1 thelt' n„ i -A TI58461149
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13 Sonator Rnn.. If T rnav iulerjectniysclf. I saw on TV the ~entle- meu who made the first report mndopted the Grst re.port, und vir- hialll- ('r'crt one of Hiem was smoking. Thcp were in a stnoke-filled roorn which was m:nmfactuirdby themselves. Senator JAIusn. Well, ther will lie snrrc for it hecansr- ,`enator l?xvrs-. L'm'thermore, I would sa.Y-- Sonator I1[uss. Thec :nr pollntin" their own lungs. Senator I:evic hnrtherrnore. A[r. Chairmmi, when I was practic- in-, hi\c, if I had been prrurilted to selert the jmry- that was rehtrn- ing a ve.rdict in rm- cases T tiroultl have been far more suceessful than I ~ca_s. T havee becn arouud Washinwtou for 17 tiears and T have nu1 icrd fiurt ichen the Snr,ron Gencral or anv other hinh oHieial walds tuc advisom committc.e to ronder n certain reporthe a]matis picka oufC as menihers of the advisorv committrs thos'c he knows will ruake the rcport he wturtc made and lu• also ~miatmDluss. IIow do von exlilain. tlren. that 6hn Tobacco Insti- faih• a;,vreed to these expcrts. The.v approved than and the selection in the firstplacc, Senator h:r,vcN-. I rncss they had to. ~ Lnughtcr.] Senator han r.. 'Phec seree jnst like the Senator and I and other \lcrnbers of the Senatr arr kchen the Preside.mt, appoiots a Snpremc. C'otn't .lostice -)i-c either lurve to talre him mr reject him. and we cannot nppnint hini onrsrlvcs. Scuator AInss. Swn. I do not tbink T mn roinl, to corivcrh 1-ou, so I zcill thanl: vou fnr your testmrmy. lloyoo hncr anc questionsF 4enator ("oor,. ]mt mc ash you somethin-, alorw, thatt same line, be- cause 1 thinl: it is important. Senntm• Ek Furlhcrmore. I would like to sav that I have read those reports. '1'hev contain a nmss of tiij-:rues, bu6 na cliuic'(d ovi- dourr. R'hen pcople talk ahoitt fiFvres.. it a11ca}°s reminds mo of this store thot I havv often told abord. Ihe old momuuincer iu mti ruuuf,v. Hr had been haVin" his rocrries on credit at the local I-rocerv store. and ho r.-ent nn to pa.i - the rrocerY hill, and the storcl.ecper told him the tuuuiwL It was mnch more than the old monntaineer thonrrlrt wns jnstl~' rlue. so he stalird comUlainint.'Che stor~~}cr~eper rot out t 6c account bill and opened it snd laid it on the counter and said. °`Here are thr fimurs; con ]cnow fimu•es don't lie." 'I'hc momrlniucer said, "I knotic fi,mres don't lie, but lituns sme do fil"n tr." R~en honeslmrn do a lot of fi,urinr, too, when thev have biased opiuinns. Senutor ('omc. Almi~rr, the snmc line, T think it is very interestinx that thc Aational ('Ienriu;,•honsr for Smoldn~ and Henlth. Ichich is the aerucr- mndrr the jmisdictimi of the Surr,~eotr General which dis- tribntes iutormalion crn whc von should not smoke and the reasons zchc ~'oii should not smolce. aiid if 1-ou do smoke, how ~~ou cazi cnt downt1LC iucidcuec of it hat thoc ir}~ is daunerous-it is the verc or- „{anizatiou that rloms tlm n•port thrd,nhrnits it to the Stu'gcon Gen- eral ol' the lTuilcd States. I)o ~-on uot tlrink it is rather unique, that .ce have rt biased or-,;aniratirnt Nvhich is the orgaauzation that is proinp± to submll Ihi' report ou smokine, and hrnlth to the Con~,rress of IheT nilrri8tatesevcrrvearY T158461136
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18 alrendv know the answer, why did they not jnst say, "cigarettes," and save $1,600 million. Rnt, tlrey do not laroiv. If thcy did, we would not have to have that program. I arn for the progratn. I coshonsored that legislation. I belie-e in it. Since the c:mse of eaneer is still in doubt I think those bltmiinc citnrettes arc picldnh an imahinarv and a popnlar subject to jump on to whip np pr,nple. It is a{;ood camlrainn issue-except I do not ridc that campaign issae. - Senatm• ]ioss. It srenis to rne ~se har~e some campaioninr bein" done here today. I wonder if the primaries are inmunent in North Caroluia and Fentnckp? Senator Jor.nns. A[y tobacco people are zdl hehind me, anyway. Senator :bloss- Sentdor C'ook? Senator Cnox. Before von lcace, let ns discnss this. Let us say, for instmrce, that some comrtrics bhrourhout the world lnnhibited adver- tising on their radios and telcrisions. And a lot of those conntries, the bruadcasting, indnstry does not belong to the people and private enterprise; it bclonrs to thc government. Wonld vou sae that you arr, in favor of the governruent, every timc it de,cides that somefliing, is particnlarly not rood for its peoplc, that it onghtt to issne an edict and say, d°Henecforth and for- er-ermore, thou shalt not"? Or are yon delighted to be under the cnn- sHtutional furrn of roxcrnment rather than thc fortn of goNcrmnent that exists in those conntrics? - Senator Jonnvs. You arr quite right. In Pngland television is nperated by the British (3mernrnent. You pay aa tax on a television svt il' con rece.ice it. So whate.rer the ,ruvernnncnt dreides to broad- cast, that is what you hear. ~ Senator Coorc. Those governments contrul what goes oes on the radio and television in regard to advertisinh_ . Senator .Iormeti. Totallv. Senator Coox. Is that what you want in this country ? Senator .Ionnns. Absolutely not. Senator Comc. That is what we, are moving toward, is it not? Senator.iownex.'I'hnt is.vhcrc wc are hcadrd right now. Senator Caox. It secros to me, as the father of five children, they should iucrease my insnrance plan beesuise everythiug is going 111) and np, and I sccm to have a dirge of hills at the end of the month. I think one's life now belon;;s to Ihc Iulernal Rerenue Sercice emd the American D[edical tiocietv. Let mc. hrinr ont a point, Senator, and get a few facts on the record ns to the cold, hard facts and I think these are, cold, hard facts-hecanse Senator iM1[oss wanted to abolish the support pro'gram for tobacco lost year. There was a Jnree and crv throughout thc coun- tr.~, and I am sure that rt lot of people in t}~is room may feel the same .cay='Al'hy shoidd uty tax dollars snpport some.thing I don't likc?" «'ell, the cost to the Federal C',overnment in operating tho tobacco price suppurt inrol,ram froni 191D2 to date has been million, or one-fourth of I perceut of the cost of all farm commodity price sup- port operatimrs. T158461141
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23 It is against this background tha.t the current report states: A prngresvive and siaoultnueons rednction of all rnb5trtnces considered likely to be involveQ in the health hazards of emokiug should he encouraged as tile must promising step available at the hresent fime towards the development of a less bazardoue cigarelte. Primarc emphasis should be given to the rerluction of the tbree snbstances (carbom mnnoxide, "tar," tmrl nirotine) named in the first tnble. and as a sec- ond priority to the reduction of these snbstances or claaees of rsuLslttnces in the eecond table . . . S. 14Ci1-, the bill now before yonr committee, wrnild reqnire the. FTC to promalvate standards establishin~, the maximuln acceptable levels of tar, nicotine, tuld other incriminated agents that ma,y bee present in oirrarettes. Thesc mazinnuu lerels mnst be snch as not to pose, au mcrczrsonnble health liaz.ud, and rnay be rednced (not more th:m once each vear) whenever the commission determines that lower leccls are necessarv to avoid unreasonable health hazards- Nevertheless, the bill places nn important ]imitation on the. settina of these levels. Standards established hc the commission may not lower the contcnt of tar, nicotiue, or other incritninated agents in ci; arettes below tlic level of consimer acceptxbilih~. 8peciGc:ully, the standards may not reqnire a lecell of these agents that is so low as to give rise to ail il licit ularket ill noncomplying cigarettes. \j"e. do not question t]ICe practical need for this limitation. If maxi- nnno lecels nrlr to lm establislhed ou the basis of hralth hazard alone, we wonld find ourselces bannin, ciparettes entirely because there is no snch thin,, as safe levels of these agents. Althollglr ..c reco,nize that thn banninIg of cigarettes would not nleet crith public acreptance, 1 here. is good esidealce that the public is willinl- to accept lorler levels of tar, nicotine, arld other incriminated agents. The key, perhaps, is io do this gradually. A.el;y considerable reduction has alretu3c taken place in this cocultrv; the publictoday acce.pts a produck that itt minht not havc fomx7 acccptalile a p?enendion ago. T4e believe that fun•ther rednc- tion; cnn and shonld be nlade in protection of the smoker's health, and IL«t ti. 1454 will help achieve this. Nerertheless, we wonld recommend that the bill be amended in secoral respects. We haie pointcd ont that there are no safe levels of tar, nirotinc, or other incriminated arents. Therefore. snccessiree rednctions in the pmnissiblc levels of these agrnts. under this bill, shonld not be made solely dependent upon the acoid:ulce of °°lmrrasonab]e" health hazards. Necessarilv, anv tiven reduction of these levels lmist emerge from a balancing of con- smna• accepL•cbilitv of a redueed level al,ainst the relative. reduction tlrat tbe lecel would etTect in the hazard to the publichcalth. Or, to east thce point some.what differently, if a level is to he reduced, as Ibo bill non- procides, bncanse it presents an 0°mlrcusona- bld' health haaard. Iho bill should Imike elcar that a health hazard ma1- be considered "mlreasonable" if the public will accept a lower .le.ti-el. aoid thnt Ioirer loce1. althmlg6 adnuttedlr• not safc, crill me.as- nrablv dirninish the danlgcrs of smol:inr. In tLis reOr,rrd, we .could also recvmmmend that the bill providn that, prior to establishing a,n,ic-on leeeL the FTC consldt with the Hecretor.- of HEW with reapect to the health implications of the new level. T158461146
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10 cignarcttes than rwv cornparabin area in the world. The initial impact .roeld be to imporerish morc than 200,001) f,nrrrt ftuuilics and thorn- sands of nal~re esuuers emploced in sellina. processinr, transporting, andruannfactnrinr the product. vationall,q, the cconomic fallont would be more damaging. Tn all, about :3 tnillion memhcrs of f.om firmilios depend mr tobacco for thcir principal iucome. They live iu 2? States and would lose asnb- stantin.l portion of thce s',1.4 billion a vea.r that their crop brings in. More than 100,000 workers would be deprived of paychecks totalling ruoree thmr a half billion dollars a cear. And Ferlenrl aid State tax collcclors would haro to do rrmre than scratc•h their heads to cwtjru•c ttp ner~taXes to make ttp for los of cirarette, revmnm tvhich uow amouuts to morc. than half thc pnrchasc price. IIotverer, these are econoanicc arguments. '1'hey may be potverfuli thrr rmn- "ive us pause; but tbcc areV not in themselves the most se- based on efHcienr.v. eqnitY, and-most importautlu-on pcrsmral froodoni. 7;lforts such as those that are cnntemplated are inelilcient. 'Phey simply do not tr-ork as the}- wer-e intended to work. Indeed, they often seem to n-ork in the opposite a•a.-. For example, the baat on tolerision advertisinL-~ apparcntl' I did not, as some of its advocates expected. depress rinarette sales. althougb it. rnost certairdv de- presscd broadcasters. The}- lost ~cell over $200 million income; cina- rotte compmrirs nre spending less on all srdvertising rmtv than they did for broadoastinr alone And despirr. th is. sales havr, ~mne up. Prohibitinrw cillarettes aborr a fixed lercl of tsn- aud nicotine would also lm nnn-mkable and pe.rhaps even comttm~productive to the intentions oP its ;rdvocalcs. To urrdcrstand whr, sinrplv imaginc the efTcct of a law lomcrinr the alcohol eontent oL bevera,o,s fronr 86 proof to 4(1 proof. li'Len asked what iaonld happen in that ease, the distin-fnisbnd chairman of Ihis subcormuitlcc admittcd thalt pcoplc would drink tn-o eoclrtails tt-herr thev formwrlv had consnmed onh' one. Witli tar and nicotine or alcohol or cholesterol content, it may not be so mttclt a question of how nnir•h is in the prodtmt as how rnach is taken into the bodv. _1nd let rne rernind 1-nn that anv serions r~.ffort to enfmree the amnmrt that a person cats or drinks oc smokes nordd reqnire a police state far bevond the ni-lumaree of Germanp nnder Hitler or gnssia mrder Stalin. ~ 'I-hese iuocuiiltin;; ;urtitobacco measures arc also inequitable. Bc that, I mean the rernlator} polic,y does not apply equall~i tro all sides of tlue coutrot-e.rar, rwr is its basis ]niownin advancr. Rnsinessmen as a nlnnp are being treated more mrfairlc by thesc rertdatmy forces than almost aur1- other se,m,ment of sorietv. Tree speeclr has nemr-total protection bnb comntercial speech has near-zero protection. :1n ach°ortiser must substantiate his rdaims, bnt a counter advertiser nred not. 'I'hr. Rederal ('onunmtications Corrtrrrission ap- plicd its fainress doctrine to the antismokino, side of the emitro- versv; bnt it denies the other side the ri; ht of reph-. lntismokin, m•oups could wgc broadcasters and otlrer mrtss media to bar 1111 cit,r_ arette advertisiiip;; lrut tobacco compauies could not thc.rusc.lves vol- rnrtarilv tt-ithdrtnc their adcertisinr for $.nof possildr antitrusl Niolations. T158461133
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24 This is partivul:n9r dt•sirnLh• 1_mranae sc- ie•ntific informtttinn eon- ccrniuy; Ilie iuerimin:ded ugcnts in cigurctlc srnolcr is mnstanth- inc'eosing as thc rrsult of ne.c rescarclt anrt stnde :A cnse ill poiut is otu• iuereased concern wiHi cwrhon tnonoside, mhie6 I hnw touclLCd ttponcuilirr ill thisr+tntrutenl. Frnm a n'hnlly terhmical stnudpoiut, tm find thee bill ttncloar ns to the cmtsequcnce that icould flow irom nu F'I'C rletcnniusttion thut a cig<un'tte wtts bein'• mnrl:otod ill ~ iolaYimt of its standards. 'lltc bill does not oxpressl}rtutend thc penalt}- prokisious of tho Fedcral Cigarcttc Labeling smd Adirrtisinr Act to apph- ill such C'.liPS. I tun tulrisrd bc otu' ;muc'al couns4 that his staff will Lc ;ttail- nble to Ihe eninmifte"r to rrndor terhnic'xl asr'ivtauce to eltn•ifc tlir bill nn this point. and to aid in aniendiu;,r the bill to accord with om' other snggt_stious. In endosing thie bill, we (10 not ill anv wac retrent ftnnt onr position that the' oul}- ccrtxin fc;(Y to pro(cct both (he indieidual and :ro(icty is bc ruruiira~_in_ prownt sniolccts to quit ttnd )ouitg. penon~ ueror to take nls thev hnbit. In f lie pae.t fenc N=ems, millious of Ameri- oults haet• qnit smolring ;ind ill thr warss to come ~cr ,ire crnifident thatmim~-millionstuorc icill do so. Thc present score scems to be 36 percent teho ru•c cig;trette snok- w's, '31 pctrcut t~-ho are forntcr ri,,'arette pmnl:crs. ;uul -}fl perreut who haNr ueecr lxcu rig:nctto stuokets. It is qnitc trnr ILut ill thc ptst pear or s_o, cigarette con:-tunptiou has lerrlcd; por capita. cousnnption for thc csthmd:ur y-eru' 167T, ns estitnated he Ilie I'.~. llepxrtment of Agricnlture, n-as 3,!16.-, ciga- rettc,s (for c.-et'y'one 1s ccars of age aud oeer) as cmnpatrd to ,.9HS3 ill calrnd.ur rcar 1970. This is still a lowcr figurc f'or tuiY cctrin thc 1f16Qs-it I,K4iI in 11163-htd icc wish it vrerc lower ti-et. The Illost prohahle ro;uou for the leveling out of eigarette con- sumption i" the Public llcatlt6 Cigarettc Smoking Act of l!lti7-a lon'. -ternt victorr for ihe pnblic ltcalth. bntone whose imnmdintee conseyuenrt~s has heru lcss forlnuate. Rc reuzoving cig,atrtteo ttdvt~r- tisiug iTom telet°ision, it ]uts also seccrely reduced the pttblie's expo- 5ure to tmticigarrtte udcerlising. ~ The Governmont :tud tltc iohmtarv ageucies are contiutting their ednratimial cfforts ou radio autd trlr.t'isiou and are devotin;,~ ncw eflorts to edneation ill thc priut mcdiat. We hopee thttt radio aud tele- vision u-il1 uon° iuereaso thoir broadcasts of ttntisutoking stnnonuce- rncnts; T know of uot6ing tlirr van dn tchielt wottld bc a morc effec- ti.>e contribntiou to Ihe pnblic-}tenlth, whicli would saee more lives and prucuit inore diseose. thir recmrd tcilh romtg peoplo htts uot Lreu ate good as .cith adults; if there has lieeu un siguifictutt increase ill smolcing among youth, there has be.en no decrettsec either. T9e tu•c currently snrvi.cing the cntoking habtts of mnnz; people and shonld hnve up-to-datee iuformation soon Whatcvet .re niati futd. n-e qte certain that further empLasis must br placod on tliscmn'aging more younh people from tnldng up smokiug. titudies of r6arttc(rrisiics ~rhi<h distingiiisli sutolcrrs fivm non- emolaers uruoug te.enagers have revealed somee that appear quite cmtsistently. T158461147
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2,5 First, couformitv to famil5- smol:ing pntte.nis is notable. Children 1chose parents nnd older hrot6ers nud sisters suroke arc most likel.i to fikr up smoleing. l.ow nchieermad ecrms to be another characteristic snoking is couunouv.r urnmrE ah ildreu n-ho wc. not doing wcll in school. jj'e know that fe.ar of futwm discase is of limited e-ffectiveness as a deterrent. Yonth arr more reaponsn=eo to positivee u.pproaches-a sound hcalth edncation program ill the schools, colnbincd with a family and commmnitp cnrironment ~ihich doe=not promote smokin-, . At the prescnt time. we believe 1ce have developed a iuodcl for tho health cducntion of Americnn children superior ill rnnnl~ wem% to anything Nce ha~~c achic~°~•.d hefore. This has been developc:d ill thc llanville-1Valnnt Creek. Cnlif- school system for elementnry and jnnior high school ,tndrnts. is now being tested and further ~devel- ohed ill a lirnitcd number of othrr :1-stcros, iuid ns re.=.onrr.es permit, will bo extcnded fiurther. 19ris approach is devoted to do.veloping in children the capacit' v to midcr,tand how their bodv fmictions. how itt is influenced bv various exposnrrs inchidinh hvr5oual-clwic_ce bckravior, and how to develop the capacitv to make choicrs thnh are based on this kind of mlder- standinr. We believe, edncatimi of this Icinl will snhstantiallv redttce the incidenei• of =rnuking as well ns of olhcr bch.u6or thali is contra.r,v to tlre, best intm'est of the child ill venrs to rome. Reforv" rnircludiug, this presenlxNiou. I would lil:e to commeut on annther import.ud chndre in the 19i1-~ report.'Phis is one devoted to a review of what Nco knon- af nir pollntion bront.•ht nbottt bY tobuceo smoke. You are perhaps ;nware of our comorn Yur thee ri;,•hts of the nousmoker; this stndy suppm-ts xdhat 1 arrd rnema 16ons:urds uf othr•r nousmokcrsLarebcon saI -iun-forso Iong.. Experiments are citrci ill this Year's report in whirli measurements huvc beon made of contamiunnt~ ~in smoke-filled rooms. Tn these stndies, levels of cnrhon mwroxidc havcc hcen shown to eqnnl anrl at timos to exceed thc lear;d limits for maxinnnn air polhr- tiou f>ermittod ill n nnmber of Iocnlitics. T;nder certaiu cmiditions thrse levcls carn cccecd the occupational threshold limit vahie for a nmmxl work period hresentlp ill cfCect for lhe Vnited Statcs as a Wh ol r. The carbon muno.ide le-els ill these smolce-filled rootus. ~Ohich ranged from 20 to 50 parls pcr million, m:LV be associated with advcrse. lrcfrlth effects as mrrsured l>,p impa.ired pcrformaucce on ccr- tain psTdiomotor tcsts. Tnaestigalor; have noted thot esposurv to carbmi Iercle of 50 parts pe.r million aud np Las resnlted in altered auditoc.v discriminntiat. visnal ncnitvt aud the nbilitv to distinguish relatn~c brightness. The avera;;r~~ inrliridual nra~ probuhlv not often be exposed to such 6i;,vlt rnucr•nlratious of tniukc for lon;; p"riods of time 1cithout relief, bnt tho factl thxt such d.mgrrous conditions can develop should sonnd a nnrning to n,. We cnnnot orerlook the factt tlrntexpoaire to such conceutnEtions Illay be especiallY hur,nndous for tho5c who are, snffe.riug fi•om heart disease omelnoiic broncliohriltnomuY discase. and ice nnrs6 a-rtainlv ti~c =crluus thottnht to thc question of ho~ T158461148
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11 The tobacco indnstr}• hai nn une(Inaled record of accommodation to rcnndatot.Y Pl'r'ssnres. Ithas utudc major adjustnlent to accomplish these objeo.tives throu;;h voluutary meastnrs. Cigarette advertising is off the air)rtives and its exposure to yonng, people is consequently sharply rednced. Tar and nicotine content is disclosed in a]I adver- tisinh. rt.nd 1,jnst smv ill the petper this morning that the cigarette people hace agreed ivilh Lhe PTC ro put the healflt warning in adeertising. As a re;nlt, the American people are informed up to the mttsi- rntnu capacil,v of the se.nsor,y organs abont the allered hvards of suokiutx. Itavinrr coupe.rvtte.d in this mlprocedented effort to insure that people have the facts and aru not misled or deceived, one minht exprct a period of respitc so Ihat fanmers eould sorc and reap their crops oud Ihat busiucssmcu could brn- the lcaf tuld sell Ihe fini'}hed product, secnre ill the belief that t7hey- were abidintr bc tdle ru7es and could reasonablv plan ahead. Tnstcad, tllc rule_c are chmlged-not becanse of anvthing they are doiu", - but sintplv becanse GO million kLnericuns, who are iilllt= fncare. aud infonned ahontt possible dauger. continue to malce their indil-idual frec choice to smoke cil,arettes. .lalues Q. Wilsun, professor of rmvernmcnt at Harvard, offered a vivid analogy of the uncertainty created in the regulatorvfield: ln a ba:seliall I;mue the iuupire has voaer becauqe 1Le can call rne out after tlvee strikes; but Lis poirer over nre would Le much greater if every time I rorur tu Ihe Platn he lolri mc thuf ho,c many strikes dePendetl mr how tr•elt I smuug tdre bnt, or maSbe holc clcan mc nniform wns. TTn cmrtinnerl this analogy by pointinn out t.hat: It I~ asif the bxseb¢Il uaupiro de.sired not just to see that the game waq . plnped fairly, hnt edsn fh:rt a vertain number of runs lcere vcored tso that tlre ' f.ms Would be haPPB), ti eertain mumer of pitchc; thrown (So that the pitcher ' would get a good workout), lurd a rertuin price eLttrged by rhe owners (eo ' thw tconld bc rither hapgv orunlmppv, deDending an h9c intentions.j ~ The tallroot of the approachin;~* tvrtmny~ is fear. No one ];nows the ~ cause or ctu<el and ow it;nmance of the origins of this dread dis- / tse inspnrs fc2r in thte stnn est hearts Ihe hee to removinp_; this te`tr. hont%r.trs sin.rce-honr t, objectlre, unbiagt.d scicnce It is ~ not omotion t it is uofi c•rusudes; ih is not propa,ganda; it is certainlY nots prohibitiou of freedom of chuice. 13nt c.vactly this cuin•se is being, seriouslp sn;+~~ested att the rronnds that it is necessn1 -. Le1ns re,lcell tlfis sngrvstion as 14illiant Pitt, the }-otmn+er. did in the iTonse of Commons in 173): /ONecesaity is the plea for every infrintierncut of human iieedom. Tt is the argiunent of tvrantsg it is the creed of slaecs." Ivreedom abdicated is freedom rarely reo-ained. T rn'og upon this romnfittr.c .r e.dnl review of the sense of Congress mhvn it euacted tho Pulrlir Ilcaltll ('i_r,urtte ~makiutr Act ill IMi9. Tlic la.te brran n-ith a"Declarnlion of Polieti" which statcd: IL in the PoncY of the Conqress, and tLe purpose of this Act, to esfabllsh a ~ comprehen izr lednral trrgr.tm to deil orth cr nrette labehnf, tnd advertising wrth respe.t to >rnv rrlitronship behvetn .wnlrrg and ht`tlth wherebp (I) lht Prrhtie m iy I e;¢le Rrtlelc iofrn ed fhnt elga~ettr vmol, n n ap be hqe3rd u' ill htrLth !t incLnrrn of .r «.rrmn to thdt effect on each lulcl..rge of ugr~rtle~. 1 7, .,, , <. .E #, TI58461134
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2s on other persons. What do vou think can and ,~hould be done about the problems of air pollution trom other people's smoking? Should general regulatiau be issued on this? Or should it be left volmdar- ilti as pou describe. it as is being done b,~ the tiecretar,vof HealtL, Tducation, andlYdfare'; I)r. T)trZ'.v. T A%mrld aulirnit that at this time this is an area of individual rights .vhere we ;u•e not comfortabla in cominl* down with a tirm conclusion. I have spoken publicly in the past about the right of onn pcrson to smoke and the right of another pcrson to breathe clean nir and observed that tdmre is. in fact lr contradictimi between tho=e two rights tchen they are excrted simultuncousl ~~. It woitld scem to me thn.t there is no zrav in mhieh there conld ba apropcr gmornmcntal intrusion into that particnlar cmttront:ition. _hnd I would do overythiuff I could !mtil snch tinte as ~ee r"arh thtrt point (if indec(I Wo cio), to encomaga pricate and Local etForc to nndertnkc progr.uns to creu.te nware.ness af tha prohlem locally and cont rol it ccon in=ide indi cidnal bnildiu;,~s and rooms. Senator Jlosd. Well, I can Iccl1 remember v0hcn all pubiic trus- portatioa used to baveau ubsotute bar ,oeainst smolrin;,~ in the vehi- cle, trhiclt vveis the steetear. mostly, tivhen I was a bmy. And that ims now bcen ichrccd or nlmost forgotten. I)o con think N~ -e onhht to movc back to thut? Ih•.IhrVv.. If Wewere able to go back to the days iu ahiclL we nscd to ride ou the "smolmr" railroad car, we might find that the ]e~rels of carbon mm!oiide in those cara was past the point of good judhm!ent to Lavo taken place, hud we b!rn able to preveut it. I a-ould prefer that vcc try to find a wav to use our etipcrtis!, our tlroughtftthtass our teclmology, to change tie rate at wlrirh air is tnrned over in a room; to change the allocation of seat positions in airpla.nes, or whatever is neressar} to try to find some better way to :rccommodate to wluil. is clcarly an insoluble prohicur. Seuator Moss. The tlriug lliat strikcs me is a sort of clusnge in attitude. It seems to me that, wcll. 30 }ears ago it mas ge,nerallc thought that the 1molcer was intrndine somewhat ou the uonsmoker and, in fact, it was custonnu•y to ask permission to smol:e in a par- ticuhar place. Now it seems to mo it is just the other way it is pre- snmed that anybody can snoko ;w}where ha waaits, whether it is a movie theater, or anvplace else; and thee nonsmoker re:illv has no protection anymore. That has conie about in the last 20 or 30 yoars; has it r!ot? Dr. 1)cVea Yes I think it has come about in 30 years or less. 13ut I think we have rexrched a point in our own growth and developmenb when, in point of factf we are bccominv more eensitive to the individual rights of all people, aud we are a little less certain as to how they should be exerted. It is possible also that the t.ypo of material smoked 30 yeurs ago as an average is different than it is today. There are many people, for example, who do fiud Wbacc,o, such a.s perhaps cigar smoke, some- what more ofPensive than ci°arette smoke. Under thos,e circimi- stances, it mialrt be more noa'mal to ask permission to light ct cigar than a cigarette. I think t]te explanation of the observation rou have recorded may be a very complex one. TI58461151
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22 havo higher rafies for peptic iilcers than nonsmokers, and, in addi- tion, that their continued smokinn appenred to redttcr the effeative- ness of standard nlcer treatrneot and to slow the rafie of healing. New experimental studicq sn~.~;,~est me.chanisms through which ciga- rette smokin;{ mac prodnce th is adcerse effect. A tiLird cm.ptcr of the 1072 report deals with chronic obstructive broncbopnlrnonarry disease, primsn-ily ohrmiic bronchitis and pnhno- nary emphysema. Cigarette smokin;,r is the most important known cxnsee of this „rrrnip of diseases, havinr a^reater o.rrsill effect than either air pollution or ocenpational exposm•e. lllcn and womeu ciga- rette smokers have an increased prevalence of respiratory symptoms and dirninislred pnlmonary function compared to nonsmokers. Other inve_stirations, a.nd especially those involving high school students, havn demonstrated that abnornial pnlmonar,y fimction and pnlmo- mu;ts}lnptoms are nwir conmon ill yomtrr smokers than iii nou- smokers of comparablc ame. The chapter in the. 1972 report that is most pertinent to this hear- ing deals with t.he harmfnl constituents found in cigarette, snoke. Srr arrav of cornpommds is listeri and an estimation of their hazard is made. 'llie furst c,tmiltonnds listed are those jndged most likely to contrib- ute to thc hoalth hazards of snrokint;; they are carbon monoaide, nicotine, and tar, the last narned beinn the particnlrrte matter col- lected front snokc after nicotinc, and moisture han-e been removed. The second series comprise a total of six sobstances judged as proba- ble cmntributors to the health hazards of smoking : these are acrolein. creaol, h}•drorv.mie acid, nitric oxide, nitroreu dioxide, and phenol. A fnml, Ihird scrics, c+nnprises a larger nnrnber of componnds ,jndred as sisper•.ted eorntri butmrs to the healtdi hazards of smokin,-. 'I'his c6upter ou htrrmfnl ingrcdients is more. than a'`statc of the art" review. Ttt bears directly on thco public health chnllenlge of pro- tectin-~, ripr:uctte( sninkers from at least some of the hnrmfnl efl'ects of their suwkin{±. This is, of conrse, the pnrpose of S. 11.'"i•4. In 191316, the Puhlic Health Cercice prepared a technical report ml tar and nicotine. 'fhis statecl oclml. bas beconic the Public IIettlth Semce's positirnr that "the preponder;i,nce of scientificc evidence strongly sn., .rrests that thee lower the 'tar' and nicotinee content of cig- arette smoke, tlrc Ics's harcnfnl would be the effcTt." Amoug the studies cited in this technical repm•tt were sereral whieh showed that tar caused skio c.utc.er in micc: mid that the tnaror-prodtteinl., cap:rcity- of cil,rarette smoke cordd bc rednced by reducing,, the tar uud nicotimO . conteatt. tiince that timc, additional stndies har-e been made which give fttr- ther eridence that redacing tar and nicotine in cigarette smoke reduces its hat•inful effects. Onc of these is the Hammond-Anerhach dog stndv, which demonstrated that cigarettes with filter tips eapa- ble . of jnalcin-,~ substantial reductions in inhaled tnr and nicotine werelesshrutnfid tlian non(iltercit•arettes. Ctudies of Imt~.* cancer uatients showed there was a lower risk of lmig canrer for thosc patients wlm had smoked filter cigeuretteq for 10 Years al'ter switchin;,• from nrnnfilter cignrettes than those who continned to srnolce rmfiltered eigarettes. This suggests that this lorrer risk mac be dnee to the lower tar cmitentt in Prlter ei;_;anrettes smolced by flmse paticnts. T158461145
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:31 Thoy are also rzsnd rtmost by t:he. avcrare smoker; that is, the ono who smukes about a pack a dny; and least by the lir,ht smoke.r, under l:i ciraret.tes a. day. '1'he hcaey smoker. the ouee smol:ing 25 or more cigarettes a. day', or ovcr 2., a da}', charucteristictilly a pack and a half or two packs, is somewhat intermediate. Low tar cit,rarettes arc usrd morc bv men over 4G, and also are used mnch more b}° the eet.v light smokers. thosu who consume under 15 a dav. Amont, ticomen the puL(ern of usc of high and low tar oit;rurttes h}- al,c aud level oP suiokiur is cery similar to that of mr+n, al- thomih, of conrse, fewer women tluur rnen use high tar cigrurottes <urd more ivomen than men use low tar cigarettes. lgain, hilh tar citaretles a.rc used most bp women between the ahrs of 45 and 64. and least bp women under 85. Thcy again ure usod both hv the avcragc smoker and least by the light unoker. with thee heavy smoker being intermediate. 'I'hc low tnr ciharettes are olearly used most by the light smokers who smoke nndcr 15 cigarettes a day. tlttd in the case of women, also bc the older smoker, women over the age of 55. Senator Alons. 1 havc heard of a number of volantarv efforts ~~~oiup; on in other comrtries to limit tar and nicotine.. ('an vou tell us about cll'o~rts iu Co.nada and Germany, and wirerever else this is ;roiul,r on? I)r. lloas. Approximately a year ago, the Canadian Government submitted a bill to its Parliament that would have provided for the settin, of a mavimnm Ievel of tar and nicoflne in cigterettes. for ihv.ir nuunrl'aoturc, and it is my understanding that this bill, al- thmir*h it had its first reading. it never went through the necessary sceond lmd third rexdings and do.hatr, hut is being reintrodnced in this vear's sessimt. 1pparcntly in ree;ponse to this-and I am simply qnot.iu,the to- bacco publicatious as au important source of information-the to- barm indnstrv of C.uuada has voluntarilv agreed to set a ma.inmm tar .uid nicotine leveL .chich was to go in effect it may be in effGet now; I am just not su•e of that point. But this was sot at 'l3 milli- r{rams of tar. It is also mv mtdcrstauding~ that there has been n volnntary set- tino, of a mn.vinumn level of tar and nicotine for filtered cigarettes irn jvesteru (7ermaIlv. Senator IFlocs. By reduciuq the tar and nicotine, might weo he in- crratsino, xuI• of the other hazardous substances in c.igarettes, such as carbon rrwnoside2 1)r. HoaN. 'Chie is onee of thc thorny problems of trvim_> to deai Ncith the harntful inLrcxlicnts in cirurette smoking. The chapter in the `°Iicalth Cmiseqnencne of Smolrinn1° that deals with this issnc uas lar"n1y the result of at 1-day conference involcing a substantial niunbcrof people acticely en~a,o,rd in research on the question of the in_nxlieuts of ci~urctbe smoke and its effect on the lntman bc,dy. '1'liis is onc of the ntost thoruv problems at issue. '1'hc ronscusus tha.t is rnpresented in this chaptcr is that although it is theore_tically possible to raiuce ecrtain ingredients, and at the samo . tirne incteaseo other inriredisnts, or increase the intake because T158461154
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r 30 Now you are going to have another study that may th.row more light? 1)r.lloltx. Y es. And this wonld give us additional information. Of course, it is quite possible that some people reduced their tar intalce and inereased their cigare.tte cunsnmption. Some pcoplek tit thc same time may reduce their tar inta.kee and reduco their cigarette consamption, whetlter it is because of lowered satisfactiou front thtt indicidnn,l c.iga,rette, or bcrause they are chsrnging their cigarettc, in order to protect bhemeelves. 1nt1 at the same time that they chaneed tllc tar content, they feel they are doing other things to protect themselvts by reducing their intake. Senator D4oss, I)r. IIorn, if by regulation we set a masinnun level of tar and ruco6ne in cigarettes at, let's say, 20 tnilligrams of tar and 1 milliKram of nicotine, could you give us a profile of how peo- ple would be affected by this change, and what this might do for thein cculth? Dr. Horzs. Our mnstt reeent national snrvey, in whieh we have col- lected substantial information on a representative sample of the U.S. popolabion, was done in the spring of 1970, and we have fr;;ures showing the percentage of people who use cigarettes of various tar levels. Tn the first place, what you say about bhe tar level of a cig;m- rette is practic.al]}- identimil with wlurt one saNs about the nicotia:. levei because there is such a high correlation between the level of tar and the ]evel of nicotine in cigarettes as they are actually marketsd todaY. So that when T say high tar, orle can makc the sarue statement for high nicotine. And when I say low tar, olte cair make tim srine state- ment for low I11cot111C_ rlpprosimately one-fifth of all cigarette smolters--that is, adult cina.rette smokers-use cidaretbes that produce 25 or more millierarns of tar; 27 percent of the nten ant115 porcent of the women. Then below 2u millirrams we have a group of about 6 percent who slnoke cigarettes berin-een ?t and 91 milli;;ra.ms of tar. And then the bnik of the cigarette smoke.rs, two-thirds of them, nso cigalrttes with t~ar levcls of 15 to 20 millignnus, with, of course. the n1o5t popular cig'arettes rnnning around 19 and 20 milligz,Zms of tar, and representing 41 percent of a,11 the people who smoke. Olilr 5 percont of adult snokerss use low tar cigarettes, deCrned :ts ratdcr~1:i milligmms of tar. This represents 9 pe-rcent of worucn lvho smol.c und 3 percent of men who smoke. Thesc figtn-es :Lre somewhat diffcrentfrom the ones you would tet if con ~1-e.rc to aualyze saks ftrrures, becausc sales figures give you thr• proportion oC cigarettes ia the varioas am t:tPc- ing nbont th:=w propomtiou ni sinokels who srnohe ril.aies :rt th^sr lovrls. And tke distinc,tinn come.s out rzIther clearlo in sotne of tLe further commcnts tlrat I hcn-e to ntake, becausc dlc 1, .,c i,ir ci^arcltts tendtcbcc•ansmncdhyp"oplc.l-hoeonsnme.fet rc'__~. . ~ Tlie low ttu uarcttes colr.prlsr r sninller ]r.t:lio~r ,' tlte marlcet thrh is aold tl:..n .•,onld be .rarranted bc rhe pcrr j a-re of pestplc wbo use ttlenl. Amonyt lu:et, high tar ci~;arettes-and I am using `9iig11' as 2:, milligrams aud a.bol-e-n.re naed most liy men who arn ia the a.ge. hruup I:i to 8#, and least by ymulg men who are under the. age of T158461153
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34 Senator Moss. Is any research being done on drugs that might be used to assist people who are smoking, and want to quit? Dr. Goxi. The current pharmacological knowledge in this area is very primitive, and dnrgs that are currently used do not have a demonstrated pharnracological activity. The National Cancer Institarte is sponsoring in the next 2 or 3 months a conference on this particular subject, and we hope to pirr point avenues of research in this area. Senator Moss. On what basis are you now developing a less haz- ardous cigarette? Dr. Gortr. The clues come from two ways. One, the epidemiological studies showing a dose/response relatioruship in the development of smoking related diseases, narnely, if one smokes more, there is a higher risk of developing disease. The other is the large, experimen- tanl~evidence that we have in laboratory animals to support the same conclusion. Therefore, we are trying to develop a cigarette that, while main- taining aa degree of consumer acceptability, would deliver tar and nic- otine that would be less objectionable from a health point of view. The approaches used so far have been mostly formulated with the cooperation of the tobaceo industry, and by studying the parallel re- search that is being conducted in other oountries, particularly Fng- land and Germany. 14e have been~~testing several modifications of cigarettes, several parameters that could be changed, with t.he aim of reducing the haz- ard connected. We La.ve tested the paper porosity, the additives to the paper, the size of the tobacco shredding, the possibility of adding nitrates to the cigarette to improve its combustibility, modifications of the blend. the use of reconstituted tobacco sheets, and other methods of processing tobacco, such as dr,y-freeziug, artifical tobacco substitutes, low-nicotine tobacco, tobaccos that are dewaxed, and, of course, the nse of selective filtrrat.ion. This is the general technical approach we are exploring att this particular moment. Semitor Moss. IIow can yon tell that a cigarette is less hazardous? In what way do you detcrmine that? Dr. Gonr. The assessments of tbese experimental cigarettes would be based, eventually on epidemiological evaluations in man. The premise on which we are working is that less tar, less nico- tine, will result in less hazard for the smoker. On studies by `'4yn- der, and Bross, it is clearly indicated that people smoking filtered cigarettes have au appreciahle degree of risk, but it is as much as 40 percent less than those who smoke nonfiltered cigarettes. This would imply considerable benefits to pnblic health if we would introduce widespread use of filtered cigarettes at tbis time. For the immediate evaluation of the cigarette, we are using a bat- tery of tests in animals which have been recommended by the to- bacco working group, and represent the joint understanding of sei- entists in the. D'ede.rsl Government., the academic world, and the tobacco industrv. Senator i•Zoss. Well, what cigarette do _von recommend right now as the least hazardous? What type? Is it the low tar and nicotine T158461157
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29 Sentttor Dfoss. Dr. Horn, I tcotdd like to ask u question or two of yon. Dr. Horn, a smokcr ch.uiges front, say. a 20 milligrarn tar cyn- rette to a 10 iuillimom tar cigarette, is there anc indicntion that hu «ill bco smokin;,• rrwre uccansee of that chante? Dr. Ilon~'. 1Vc dn not. Itnve any precicee informntion on the ,ues- tiun as von po=ed it. 7'he best informstinn we have camr from mt 2ntrlv,is ot' data rollcrted ou appracimntclv 1.i0o ci_!nrttc smol:c'rs in 19611 who tean; tLen rcqnestioned in l0ii(i. The coml>arison 1catS rn:rde of tho, ntunher ot ci;'tuOtes smol:ed in both perioile of time, and rooparnd for tltose wlto had rednced the tar intrtkt, and the nieotiuc intokr, of tLcir e.il.rxrette- during tJtat iuterval. 1Flutt we fonnd wa,; thatfor those n-ho stived ot the same level of tar anrt uicotinc intuke in 196fi as they had hr~cn in 1dfi-F.46.~, perccnt, suivod at the sune levcl of cmu7wnption. 4ipot[uit decreased theinr loecl nf uun=nuilrt iun, a.n<L `G(i ltcrcent n'cnt tih. I httve got thotir" ra.vcrsod. It is `3G peWrnt who went down and 47 pcrrcut who .vent np. . . _Omonhr those. who cha.ngcrl to a, lo•,cer tar and nicotinc cigarette, Nw. O:,+mns rccre xlmos!: idenural, 46.;i petcont stnced t!ie sautc; °7.3 p crcv u twe.n t up : an d°_7. SS percutt tvc ut. doec u. The nnly eoncln;sion I can draw front that i,=, that blre factors that mt:kv fnr ch;uir:.inc; ILe mul Of cigaretus tlnrt are cons;nmeAl uppetnto he indrpendcut of r-hebltcr orrot Ton donge the tar and tticof.itte lece.l of tLe cigare!.le. Senatnr Plovc so from thr rnther limited sainple that i'ou havr, it would indicar(c thxlt ltropJc do nut snokcc more ciRarettes ,jnst bee.m<e thev hu ve lo,s t.u• iu tlu=m ? _ I)r. 1-Ioxv. Ycs, si r. ,~enntor (7ooi,. (lan }-ou sav thrtt from tLe concluaions aud pereent- rigcs Vou j ust gave us? I)r. NursN. 1<eh me :unend it a little bit. 11'e have sontc naw d,et:e which are not pet analyzed. and we ssrc in the proce.ss oP anzdyaing thetu. Nclrich represent a morr rrrenl, poriod nf tiinc. That is. ch,urges that :m.vc taken pla<•.c. betacan 1966 and 1D7(I. }Fe are in the process of andlp•r.ing these t,he sante way. And since n-e have more cases-we h.rvc altproaimately 4.000 reinherviews in the ea.se-we should be in a, position to look more eurefully at people aaid quitr, precise cxtedo- ries of tmr and nicotine cmdent. So I wonld likc to withhold at final judgment on this tmbil those data are available. But on the basis of what lit.tle datn we do have, I would satv wr hace no evidence thatt a reduction in tar and nicotine pfays a signifi- cant role in the ntm6er of cignrebtc_ one cnnsmnes. Senator (hxuc. On the contrary, yon do tmt havc any evidenee that it does not ; or that it does ^ You s:>.yyou have no evidencc, hut you cannot say ah hhis timc, a(. this stage of the game, that it is to tho contrary? 1nd it is because von hacr not, even Legun to rnake an analysis of your now reports? I)r. IIoxv. That is rihht. Senator (Joorc. All right. Senator bloss. A'ly question, of course, vcas on the old limited sample you had. It does not eee.m to rnake auy difference in that. TI58461152
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35 cigarette, or any other type of cigarette that you have experimented with? Ilr. Goat. Our programs started about 3 years ago, and this type of research, takes lots of time. We are just now in the process of fin- ishing our first experiments. I do not think that we are ready to in- dieate any particular solution for a less hazardous cigarette beyond stating that it would have to have the least tar and the least nicotine compatible with consumer acceptability at this moment. Senator Moss. Thank you. One final question, perhaps. In approaching the smoking and health problem, why do you put so much emphasis on cancer, and not so much on cardiovascular and respiratory diseases? Dr. Goar. We are considering both aspects at this particular time. Our research is coordinated with the Ileart and Lung Institute. With cooperation between the Cancer Institute and the Heart and Lung Institute, we should be able to provido a comprehensive a~- proach or understanding the problems posed by cigarette smoking m lwth cancer problem, and the cardiovascular, and respiratory fields. Senator Moss. Thank you. i)r. DuVal. over the past 20 years, the average tar and nicot,ine luis decreased substantially in cigarettes. When may we expect to find a decline in morbidity and mortality, if the cigarette is indeed less haza.rdnus with lower tar and iucotine? Dr. DUVAL. It is very difficult from a purely scientific viewpoint to give you a date. I would suspect that the lag period in terms of catching up on the statistics on consumption from milder cigarettea wonld probably be between 10 and 20 years. It might be less. But the statistical analysis itself is awkward, because people change their habit,s, obviously, enroute. So it would require very large numbers to make the case. Senator -Moss, Putting that somewhat in reverse, for a long time- be.cause women seemed to be less afflicted with lung cancer and these other diseases-it was said it was because they had not taken up smoking until the last 20 years, in any appreciable degree-and is there a similar lag there that you can see? Dr. lluVAi. Yes, sir, there is a similar lag. And as a matter of fact, the full impact of that change on the national scene has proba- blv orot vet become evident. ~Senator Moss. '1'hank you very much, gentlemen. -My colleague, Senator Cook, will have some questions, I'm sure. Dr. DuVAL. Mr. Chairman, could I intrude for one moment? Senator D'Ioss. All right. Dr. IIUVAn. Yon asked in my judgment a singularly important question which should have further documentation in the record, and it relates to a question Senator Cook has also touched upon, and that is the evidence that shows, so to speak, that there is a de.finable dose illness, as it were, curve or relationship. '1'hat word, while it can be found in many different points in the medical literature, is very nicely summarized in the J-AAZA, Volume 213, Issue No. 13, September 28, 1970, in an article entitled. "The Epidemiology of Lung Cancer," and I would be pleased to submit a copy of this for appropriate inclusion in the record. 6 T158461158
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L 32 people smoke more to compensate for the loss of some of the wnstit, neaits of tobacco smoke, tlurt we do not have anv ovidence at hand to show that this actually takes place. Nevertheless, Lhc recommendation of that ¢ronp which is quotcd in the "Ilealth Cmisequences of Smokin,n," is for the sirnidtaneous re.- duction of as rnauy Larmfnl ingredients as possible that are identi- fcd in cigarette snaoke, with a sct of priorities. That is, carbon mmr oside, tar and nicotine bcin;,~ set as the top priorities, and another set of substances as the srcond priorities, and then another set as the third priorities. Now, one of the concerns that omj might have would be particu- larly on this matter of carbon monoside-ahain. although it is theo- retically possible to reduce tar and nic,otine and not reduce carbon monoxide, the fact is tLat in popular cilgarettes, the analysis of which I have seen,lhere is a very close correspondence between the level of tar, the level of nicotine,, and the. level of carbon monoxide, so that I would assumc that it is possible to bring all three of them down by changing the combustion characteristics torvard more eom- plete combustion. I feel aai expert in the field of chemistry involved here is the per- son who should really speak to this issue. Senator Moss. Thank vou. Do people generally inhale cigars, little ci_ars? I)r•. IlocN- . We do not liave any specific infm•mation abont inhala- tion pattcllis in ciga.rs; at least, Avo have not collected ow• own inforniation on that. And the little cihar is a rclatively recent inno- vation a.nd one that has not, been widely adopte.d. I simply camiot ansiver the questioi, other Uu, mi that most cigar smokers say thec do not inhalo. And I ca,n believe it, being a some- time c.i-'tw• smnke.r nn yse.l'f. Senator Moss. I was goin;,* to ask you about tlie Winehe.ster prod- uct that is sold as a little ci;,rar. To me, at least, it has all the ap- pearauce of acigarette, and I wonder if this is generally the snbject of inhalat.ion or not. or if you have any data on it? Dr. IIona: T do nott havc any iiiformation on that subject. Senator Cooi:. llr. Horn, in this regard-if I may, Mr. Chairman ? Senator Moss. All ril-ht. Senator CooK. Is it not true that small cigars of this caliber have been prodacerl and packed by the industry for mmny, man-y, man,y Scars? Dr. Honx. They look socnewhat different to me. anain. T am no ci,R,ar manufacturer, but I understand that the ci2mrs are made with a cliffer- ent, typo of tobacco. That is, the tobacco is handled differently. Thc:-and I have, seen this; in fact, I tried to smoke one-it seems to use shredded tobacco, very similar to the way tobacco is shredded foaL the cigarett,os. It certanily is more like a cigarette than any of the other ci,gars I nan familiar with. Senator Coorc. Yon are aware that t.here are many cigars on the market which have had shredded tobacco for years, have they not? Senator Moss. Would it be possible for you to do a study on the T158461155
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27 two, is there adequatc. tcclmology for the nianufactm-crs to design their prndne.ts so Chc;v can mont tltc>'.n lcvcls 3 Dr. DUVAL. It is tdie position Of rnrr Department-and 1lhope it i~ ahprnprintelt re(Icctod iu our testimony-that the settinl, of a level of tar anrl nirotine and other ineriminated agents is properly thee procince Of thc FTC and not IIF.W, since to tal.e att.)~ othc.r poeition wmild bee to arknorvledre that therc is suc6 rt thing as a safe ciga- rette. Tt-e believe that the Ti'1'C, with zppropriate advice and counsel, can find levels that wonld be aceeptable to those growinn as well as consnmin,q tobacco. Tlris is coniunied by the fact that in less than 10 Years the concentrations of nicotine and tar has been brought doN+'n ertbstantially in ci-arette aud, at the eame time, vice apparently have e.vidence, strong evidence, t6at thero is good co~tsnmer acceptability of the, milder v.iearettes ammig tlto?e who are afllicted with the habit. lve know, for example, att this titne amonn females, 70 percent of wll females sruokinl, are smokinl; tobacco that has less than 1.2 milli- ytams Of nicotine and less than 20 milli-rams of tar. Tn this cate- goe}' S6 per cent would be true for males. This is quite difereut thaar the profilc 10 ycars ago and indicates to me that a level of public aceeptabilitr can be achieved. 8enator A1oss. 11-'onld there be an appreciable time 1111 for the tobacco nuutnfactarers to nmett a new level of tar uml uicotine vou- tcnt? What timu dors it ttlce them to do that$ Th•. IltrV.+r. I thinlcc that answer woiQd havee to comee from those in Ihe industry, Nnd as I recall, the lano'lmoe Of the' bill dors not spell out s.uc.h ¢ time lag. It wonld br, the position of the Pepartment that any- time lag that n-as necr ~s'ary to aclriove tlie nhjective would be accepbuble, siuce in principle this would iu elfect be a type of importantt legislation wotth achievin-. and the penal.tg, so to sprdc. Of the tirue_ lag see.ms to ns to bc minnr. ScMator Moss. Von- that there is going to bee a health warning in all ciharotte advertiseuieuts, what addi6ional irifurmation be pru- vided to tho pnblic! I ain thinlcinL aboidpoint of pttrrhaso displtn-s fcaturin;; ttr :nrd nicotine information artd things of that, sort. Do you visuwdize that.? 1)r. lltV.u. I do nmt bclicxe tliat. I could tunplity furtLcr on the imprSmuf.im oP Cou;_;ress_ whic_h lots already tal:en its owu positimt ort tl;is materr. li'e )cotdd go witlt t.6e viercpoint, i.hn.t cou alroad.v luu-c c.:prc=sed apropos thc display of appropri:rtc vvaenlnna. lcnutcr lloe~;. lu lour epiuion, do tLc adec.rtiscmc.nEa J'ur AVir.- :1u..ter 1i tho cir<trs ~hirlt si<. vstrcmely similsir to ( Og.rtette n.dver- t:.nxnt.. li-rd" tnr.ne.the I'nbl.^,I10,11 tlr ( -,,aretto S t tokiu;; ~tct E I h.k;°a l pack <, W iiicLo_Irts liero. 1' t:5 ie lim indk idmtl fV'in- i 6o:aeI ~oh the iiltor tip o;r it. _\-, f.n, a:: I can tctl it is p_ ". s.lytnc-.amc ve! ,,;„cl,a retto -, i.ditlms~h.cd'lcu tvu:roin:illc. t)r. llv~_~.. S[r- Chs~irm::u; T n;a tnnpted to totsa.vr :.ses' Lut it sao.nts fo me that t.u- bclongs somewimrt tuore in tL(, 7urisdicliotl Of Ihc FTC. :1n,11. hope y ou will ,tddro.e,thaul quection Lo Ian:nr. 5ensitnr AIoss. I,JI.ill. Lt vour 1D72 Peport on the Hculth Conseqncnces of Sniolcing Act, therois nn t•.utirr, section devoted to the e$'eat of cigarctte smoking 7'-Ul_4 -7! T158461150
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33 smoking patterns of people who smoke little cigars? Could we have the Clearmkhonse do that? I am particularly interested in knowing whether jltinchPsters are inlraled and how inhalation patterns compare with other little cin_ ars ctrrentl}- on thee market. Dr. Ilnx~-. }I'ell, mre of the difficulties would be in finding people who ha.r-e gone to thc purchase of a new small cigar of that kind. Yon see, the experimental conditions of a study wmild be quite different if von were to hand somebody a new product that lie has ne~rr tried ~beforc tutd tried t» find out how Ite feels aboutt it, be- cause one deals with a new product somewhat differently than one daals with one that one is used to. A proper study would probablv require that you ident,ify poople who ha+o Started to smoke the small ciears oftheir own volition, and then to study their smoking pattcrn. And preferably, one would have to identifv~ such measwes of intalce of smoke as the level of carbon monoxidc in the blood auil so on to see whether or not they doe in fuct inhale the cigarette smoko. It would be possiblc to do such a stndy. It would be somewhat complex, and it would he diffrcttlt to iind people who have becomc habituated to Winchester ci},•arettes, since they have been on the rmurk-et. in mrly two cities, I believe, np until the last week or so. Senator Moss. One fiuad question. Has the Clearinghouse coin- puted the cost of smolcing to onr ecoirorny? How much does t]le ill- ncss and disabilitv cost cotnpared with the tax contribution of ciga- rette revenues? Dr. lIot.N-. This compntation has been mzide for the United States by a tobacco economist and published in HS111HA Reporl.s, and in this report the total cost to the U.S. economy of the danratr, that rc- sults frrnn cigarette smoke, the medical espenses, the loss of life, the loss of earninrs, and the results of fires, cotnes to apprnaimatc.ly $5.5 billion a vcar, in contrast to tho '$5 billion calue of the product it- self. So tlrat the conclusion in that analysis was that there is ap- proXimatcly a. 10 perceut loss to tlre totaal ecornoniy. SenatorJlo ,. Th:urlcvou. Ih•. Gori, perhaps I could ask two or three questions of ,you. In April of LIE19, the Secretary of HEW put out a statement abrnrt a joint Atnericui \Icviictt111ssociation-Pnblir Ileatilth Service- tobacco industrv comrnittce workin; on the gaps in laiowled1ge ou the srnokinr and health problerns. Is that committee the Tobacco Tl'm•kin111 Grrnap? Anti if not, can you etplain tlre nenesis and the makeup of the tobacco workin, group? Dr. Goac. The Tobacco Worlcing Group, is an offshoot of the l.rute Cancer Task Force originally set up by President Jolmson. Senator Dloss. 1Vhat is the role of tlte tobacco industry in this To- bacco A1"orkinr Group? Dr. Gost. ll'e have technical represartatives, from the tobacco in- dustry, and thcy serve as advisors to the National Cancer Institute in tlte conduct of research and activities in this field. They have been giving, us the greatest eooperation, and as far as te.clnricalities of developing a cigarette, the engineering of a ciga- rette, thn chemistiy, tbe- v have been vcry helpful, and, I would say, indispensable to onr pro~ram at this time. T158461156
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36 Senator Moss. Tlmnh yon. We would be glad to reccive it, and it wil l be placed in t:he record.' SenatorMoss. Senator Cook? Hanator Conic. Dr. I1nVa1, I mnst say T was rather snrprised at thr romarlcs that Ar~re mnda after Yonr prrsentn,timi. Aeeanse z-ou said th.~t the report =howed new evidencc and the report brought up new findings. I tmist say to yon, in ;tll fairness, that I did not. see it :utd I did not rrad it, and T do not know lvhcrc the tmw evidence is in this so-called ucw repurt. Also, yon are still rcferrinr to the totally discredited jFrndrr tuicc rcport and the;lncrl~ach-Hammmirl dog s6ady n*hich v:ere so completely and fhormtghly discredited that the Journal of _Americm -lfedicat Assoc.iation wonld not print it, that the JaMA refuscd again to print it later. Yet in eorn- remarlc=s on page 5. one of the, thinga that con referred to is skn cancer in mica rmd the Aucrbach,Hamtnonrl dog studr. Now let us lret to the Wyndcr report, bcc.utsc when 1re did it, li(, came. tq) with the astmtndinh* fignrae that ontt of 81 mice, 41-;+ percent presentccl ~kin earcinomata, suggesting that cigarette smoke coudcn- sate is highlF ca,rcinogo.uic. Everv shrd,j since then. as hard as anc- bodv has lried-iu Gre.at Britain, in the i;nited 5tates.1s a matter of fact, the last, one Itv T)r. Day, who toolc 7,975 mice and camc np `t•ith 3 riercent. Now, admittedlv, we have had a decrense in tar and nimtine in cign,rettes, bu( do~}'on thitilc we have come down 41 percent. '1'he poutt I am trying to rn.iee again. Dr. DnVal, is I thonp'ht that n•e nright have a new, $esh cimc of this )r-ith vmtr trstimmiv. Rut rvce have not got a fresh view at all. tiVo n.re still with the tuice Surd the dogs and still with the same things that this srrme bronp has lrern talki ng, about for ti cars. AIa- Y-be tvhnt wee should havc done is have ttte. Surgeon General appear and he could hatc tepeal.c.d his speech about the seven presi- deal:; who smoked martjnrna. That is ccacththc wap I feel. I am reall, v disappoint.ed. I)r. DoVAL. Cenator. the issue. T would submit at thce moment is not whether or not. the findings of the induetion of cmeer in the sk;n of a, monse froin cigareth; Ixrs is, in fact, confirntatible at one level ;tr opposed to anothcr. 7'he issue, I would submit, is whether or not it oecm•s at al l. And t.ho,re see.ms not to be any question. hnt that it, does indeed occnr. And if i1 mal- take tttip from Congress: Congress has spoken to our Department on this matter alrcadv through the llelanoy Clame of the Food ruul ])tug 3ct. We are not permitted to use ane food addinivt: if we can show, at any lime, ittespective of incidence, thu,t it provol:es the appearancee of caneer. Senator Coor.. 1)o pou think Vou can makec u direct association betwcen 3 percent urtcter normal~ c_ircnmstances, and nonnat condi- tions, and tha fact that cou malre an absolute and emnplvte finding that yott lvould give to lLo Axnericart pcoylr. as n resnlt thereof? Ilc DaVen. I would submit, Senatm, that whito that seems to be tr, fair way of lookin;r at it, that there is another lcay erruall.V lair. If I can produce tYre cancer at all, using the products of cigarette smoke, the issue is madc. ~ 6ee p. 289. TI58461159
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L 38 there may be a multitude of situations that could put carbon dioxide or carbon monoxide into that room. The fact that an air conditioner could pick np air from the outside, the fact that there are automo- bih,s and trucks on the streets outside that building, tha fact that thee very air at sea level-the best laboratnrv to test what ie in % cig- arette was exactly what the FAA did, it seems to me. If you really wanted to find out if tobacco was the sole and escln- sive crilprit of evervthing that yon and your depart.ment blame it for, then a confined~laboratory ought to be the best place to find mxt. For instance, when von state. withont equivocation, that in t.hese looms, as you eall them. "smoke-filled rooms,°° 20 to 80 parts per million may be associated with adverse health effects-did you makei any detcrminat.ion at the same time what the availability of parts per million of mouoxido were right outside the. door, so they cnnld be assessed in relation to what is in the air as a whole@ Or was it cmiel usi ce to blame it all on cigarettes 4 Dr. lluj7.u.. I am going to ask Dr. Horn to speak to that, because I think von have raised a very important guestion, to which we worild 1 ike to have the answer on the record. Dr. IToxr;. The studies that were quoted are studies that arc pub- lished in the lit,eratru•e, and the methodology is dcscribed in thesc studies and also smnmarized in the reports. They are not studies tlmt we ourselves conduct.. The problem here is what happens in a room in which a good dcal of smoking takes place, compared to what happens in a room, simi- lar rooms under similar eircumstanees, when there is not a good deal of smoking that takes place. and Lhese are the comparisons that are drawn in the studies. Obviouslv, if there are other outside sources of carbon monoxide emanating ~in the room, then that would maintain whether or not smoking was taking plaee in the room. Senator Coor.. I still contend-Dr. Ilorn, I am nott quite, sure you havermswered my question. Unfortunately, within the bureaucracy. it is too bad the public has to be advised by Jack Auderson instcad of the people responsiblc. Rut. Jack Anderson reported the FAA study back in 1970. Was it held for your convenience until December of 1971, so it need not be made part of a 1972 report? Itt has been available since 1J70. Dr. HorN. Certainly not. When that report was made, available to its, itt was after the final report was completed and on its way to clearance. I sce nothing in that report that for any reason should be withheld. What it indicates is that the air exchange s,ystem in airplanes is so complete and so comprchmrsive that there is no buildup in the ambient air of the aireraft on long Rights as a result of cigarette smoking that takes place there. Senator Coori_ 1Ftay I say, Dr. Horn, it was just a few minutes ago Dr. Duva1 said there ought to be sonse method evolved by which this very thing could be accomplished. And yet you have just finished saying that the rr.port shows the cireulation in aircraft is so good that it really causes no problem. T158461161
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W` 42 Page 69, "Cigarette smoking has been reported to be a possible precipitating factor." Page 93, "ildditional studies conducted in Germany havc dernon- stratcd a strone association between cigarette snoking and lang cancer." On palec 136, "°There, is increasing evidemee to suppm•t the .-ien- " Page 147, "rl possible liir]c bet.ween cigarette smokin; and peptie ulcer has bcen demonstratcd in dogs,"-and I certaitzly hope tlr.ot does not go hac.lc to the Aucrbach-Ilammnnd studr `°hence it is dif- ficult to evaluate the magnitude of the problem.°1 Page 18L, "The research so far reported on the nature arid eH'ect of exposure to srnoke pollutants in the atmospherc has not bec.n as extensive and wcll-controlled as that done on the health effects of smoking on the smoker himsclf.p0 Page 184, "Actual volume measurements were not reported." Page 214, "The consensus is-" Now, is that the best that we who are supposed to legislate can get out of the Department of HFW in relation to an unbiased report? Dr. Hoxx. Senator, it sounds to me as though that does represent an unbiased report. Nobody ever said in this document or any other document that there was not disagreement about the mechanisms, about the theories as to how these effects take place. The issue on which there is no substantial disagreement is the issue of whether or not cigarette smoking represents a serious hcalth hazard, and this is accepted generally by the scientific fraternity and by the hcalth professions throughout t]ie world. Senator Coomc. But, doctor, unless a reporter who writes about the study reads the whole report, the first thing lie sees is that the Sur- geon Gencral of the United States says there is no longer an houest disagreement. Maybe a few of them might go to pages 40 arid 45 and 57 and 183 and 153, but I doubt it, very seriously, don't you? Dr. Hoax. It seems to ma we have always emphasized the fact that there is still a gre,at deal to be learned about how tdre efl'ec.ts take place. And if we are to cope with the effects, we have to learn how they take place. 'Phe docuxnent as the aarnual summary of the Surgeon General in this field has been one of the instruments that has been used to encourage the proliferation of research that has in fact taken place since the first, Surgcqn Generaps report in 1964. And during that period of time we have learned a great deal more on a great many diseases arid how cigarette smoking is related to them. Senator Cnob. Are Tou ready to make a firm recommondation to this committce as to whnt the tar and nicotime limitations on a ciga- rette for the Arnerican consuming public ought to be? Dr. IIonr. I would certainly say that the general position of the department, which has been for tlm promotion of progressivee reduc- tions in tar arid nicotine, is a very practiaal way to improve the health of the American Nation. As far as a safe level is concerned, on the basis of the information wee have now, it would still be a zero consumption of cigarettes. Senator Coox. Then if yon say a zero consumption of cigarettes, then how ca.n you be for a bill that is to set a limitation and give that anthority to the Federal Trade Commission, which has no TI58461165
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37 Sonntor Coor.. Yon sav 1vithout eqnit-ocntiou. in rGt_;atrd to carbon moitocide. there_ are certain pLxces n•here it ;rocs to sQ parts per ntil- lioi. Aud miay 1 ask-mid I nslr Imrr colleatnv:-if il: is tltis high at thi7 level, whait was the rcasmt for fnilin~,~ to include in the 19,•2 report, the FAA report that was done iu connection witL your orna- uirutiou. that shon-ed that this was not the effect in st confined ttiir- crai't on rcpctttcd trips? As a matter of fact. it showcd thnt tliocrtrbon monosidc levels wcrcV sn low in somc instances, thop con!d uot et~en read them. - . . I re.illv wonld 1'ho to knoc- andd anrborlc c•onicl anstver it at tlte h.hk: wh}- lltis report n-us not made liert o'f the 1972 rcport. Is it becanse tlto report really s'how ed it did not have the effect on luaman bciug,s. that it tu&}' ]mtt boen :rlittle dis;wl,inz to theni, lint as f.n• na their Iloalt6 mis ooncrlsted. it Imr no ef£ect? llr. llcY.a.. So. sir; and I tcould enenrna~(Ye vou to include unv part of tlntt repmrt as part of the record. ~ ~ Senator Cooic. lt is not my duty and responsibilitc to repo•tt it. It is v'ours. It, tcies douc in 100. aaclc :lnilcrson repoelcd iL to lhe Antorican people in 16)70, but yon didn't inalnde it in your 1972 rreport. Dr. TTorn's responsibilitv, as a part of his joli. H that Nms donc, is to make iC part of the 1971 rchort. It was not made. It is 3tiII not nutide. Tou can ;ett it iY t'on want to cetlll otror there and htn'e, a rope scnt to cnn, but it luts not bccn rnatle pait of gnnerz~l pnblic kno.cled:;~o. ~ Senator \los,c. If the report is in, T.cill ask for its production, and we tvill put it in thc record. Sanator Comc. _lltty I sav. .llr. Chuirntan. it is one tbing• to nmke a report and it is anothei• tliing to ha.ve hnd it since 1970. Rul bcruu,aee it did not say tt-hat the 1)cpnuiinr•ldd ts^uted, fltey hsve refnsed to make it pnbLc. llr. I)eA':v.. ienal:m, tcc ob;~ioaslv srill cl:rrifv thu point for you. The report first bect,me ,tvaihtble to ns iu nrid-Dcnmber. And as far ;rs I Icnott" it is still intended, after uppropriattc clcxrmtce, that it, tcill bc relea.ccd to the pnLlic. In auy, evmrt. the point }-on raiscd about the uoneenl.ra,f.ion of carbon morolide, particttlarl}- in nirplmtc c:ibins, I think ducs dc5Pr1'D COlnntetll. The nirBnes. it srem's to mr, hu.t-c done a mostt creditable joh of attempting to move oir tluougc enhins in a manncr that woold Iwrn it over at a. rnhid iatc. I would ndd inrthm• tha.t we 1-iave vet;y snrong evidenuc fhat the mrasnrciucuC,t iu sniol:c-tilled roonrs. that is in clo,ed spnoca are t-orv clonely related to thrt mnomtt of ntoisturr in the air. '17te incoming sir nt an airplane is esce.pMially clrv artd colcl. and nnL ruluerable to thc smnc-- - ~.Senator Coor,. .ls a matter of faua. is tLal not a nureh, itmeh botfer labo2tmy to t,est ciE"ettes in, pnret and eimhly because y0u have ta confined area o•itlt lti,qlt a.ltitude air, eren though it is dry, to deternnine jnst exactly n°]tnl: the cll'ctt of cirarettes is, tuut onlti_ eigo.- rettcs, antdnot the.reat of t6n pollutants in the air at sctt lovcl4 73eca,nse, von sec, islicn cou rcport in cotn• studv tltnt it 1.oes from 50 to 80 pa.rts per million, yrott arr not talcing into cousidcraLtun i.hat TI58461160
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3J Dr. Honx. I said there was no problem in the buildup u[ carbon monoxide. In the same report, yon will find t,hatt over 40 percent of the, passengers eapressed peraonal discomfort cuid amioyance- Eeurator Cooic. Over 40 percent of nonsnokers? Ilr. Hoiev. No, 43 percent of all the, people. and then }-ou go to the uonsmolmrs, partictdarly those mdro have respiratotiy problems, you lind this expres,ed by over 7(I percent of them. Senator Coorc. Whon did you read tlris report, l)oetor? Dr. lIonx. About 2.veeks ago. Senator Coox. T ixness burea.neraey is a lott slon-er downtown thnu I thouoht it nas. Ne have always heard that things more slow on the Hi~l. But if this report was available to a columnistt in a news- paper in 1970, and yon just read it 2 weeks ago, then yorcreiu Nrorsc shape than I thought was possible. Dr. Hoax. I am sure there was no final report available at the time that it was quoted in the colmnn. I suspect that this is like mostt cohmms, somo iuforrnation that was obtained over the trle- phone from somebody. Senator Ci>nx. Will this report be filed in your next annual report? Dr. Ilonv. Yes, of conrse. 5enat~or Cooii. Let's get to the Clearinghonse for a minnte. Because.. Dr. DuVal made it very clear that he wants the Federal Trade Commission to hundle this, because in no way does he want IH?W or your departmcrct to condone the smulcing of any cigarettes at all. Now ]ie madc3 t.hat very oleqr, and I think the record will indic,ate, that in his remarks, Ire said they vvished the FTC to do this because IIE'vV did not want to say in any way, shape, or fornr thn.tt there was snc$t a thing as at scYe cig4rette. Now, if this is tnm, and if the Congress. by its a,ct, asked that the N ational Clearinghouse for Smoking and Health render to Conrress an rmbiased and objeatice review of the scientifie ]itera,hre. how can you even consider making areport to Congress at all, or being the agency to make sne]) a report? Dr. Iloux. We are respousible for the pieparation of the rcport, bnt we are not responsible for the co¢terd that goes into it. -We have a procedurc sot up which requires-and by contract, .ce have a complete review of the worldwide Iiteraturc, with tramsla- tions of the foreign articlcs. Senator Coox. ll.eview hy people of your choice. I)r. Hou~-. No. Senator Cooic. Ilo.v do thev come about? Dr- llonx. Initially, they siuiply were sought and found by people who are basically Iilrrary technicitms and who look for a complete hibiiography and provide us with a copy of just abont e.verytLing that appears in the scientif{c literature on the subject of smoking. 'ihe attempt is to be comprehensive. The evaluation of these hasbeen done both in oar own stafk and also through the use of some 80cmrsnlta.nts who represmrt a Who's Who of American Scientists, all of whom reviewed for us these articles and try to either prepare ini- tial drafts or review drafts that are written which smmnarize all the mat,erial that has been published dtuing the, preceding year. TI58461162
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51 tively low ammmts of tar and nicotine but that these cigarcttes com- prise only a small fraction of all cigarettes sold iu the IInited States. The Bureau belie.ves that if S. 1454 were enactsd the promulgation of standards in accordance with its provisions would pose a nnmber of dificult but not insutznountable problems. Chief among these would be that of determining what quantities of tar and nicotine in c•igare.tte snoldng would not pose "an unreasonable health hazard." The Commission does not, at this time, have tho necessary research facilities, medical and scientific staff, or allotted funds to develop the bases for the medical and scientific judgments contemplated by this bill. As an alternative, the llureau wonld suggest that a certifi- cation program by the Fublic IIealth Service be adopted. With its facilities and expertise that, agency would he better suited for deter- mining masimnm le%,els of tar, nicotine, and other incriminated agents in cigarettes. Still another problem presented by the languag'e of this bill is tha.t if levels of tar, nicotine, and other incrinnnated agents consist- ent with the avoidance of unreasonable risk to hnman health could be established, S. 1454 would prohibit the Commission from setting maximum tolerances at those levels if cigarettes produced in aecord- ance with such a standard would create a niarket for "significant quantities of cigarettes which fail to meet such standard." This language poses two problems. First, it would be difficult to anticipa.te just what maximum levels of tar and nicotine would e ve rise to an illegal market for cigarettes exceeding the maximum lecels. Second, I am concerned about the reqnirement that we slzhor- dinate public health considerations to °`consumer acceptability" in promulgating standards for tar and nicotine levels. I beliece that this problem could be avoided if the langaage of section 2 of the bill were changed to direct the. Commission to estab- lish maximwn levels of tar, nicotine, and other incriminated agents in cigarette smoke, by balancinr• t,he possible risks to human health posed by the presenc.e of those agents in varying amounts aga.inst consumer prefereuce, as measured by sales data, for the many ciga- retke varieties now availablre and for which the levels of tar, nico- tine, and other incriminated a,ments have been established. The Bureau observes that nowhere in this bill is the mawfactur- ing, importation, distribution, or sale of cigarettes containing levels of tar, nicotine, and other incrirninated a~ents in e3ccss of the standards which might, be promulgated by the Commission specifi- cally forbidden. It is suggested that ciolation of this law might be declared an unfair trade praetice in violation of section 5 of the Federal Trade Commission Act. The Bureau supports the purpose of this legislation and, with the changes suggested in these comments, feels that itt would be a sirnif- icant lol,>islative program for minimizing the ill efTects from some cigarette smoking. Turning to a different, matter now, as this committee noted this morning, the Commission yesterday provisionally accepted consentt orders from tlie six major domestic cigarette manufacturers. They account, as T recall, for JO percentt of all cigarette sales in the T?nited States, and I believe close to 100 percent of all cigarette a dvertising. T158461174
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` 54 I think it is more useful to think of these as a balancing test rather than two separate findings on two separate questions. Senator Moss. Wcll, the figures you quoted wonld indicate that the acceptability of the very low tar aaul nicotine cigarettes is small now. Is that correct B Mr. PrroFst;v. That, is right, sir. Senator .llos.s. And therefore it would seem at the present time that the level should be somewhat higher than these lowest brands that yon mention, the ones with ver,y low content. D1r. Pra•orsrr. Oh. I would certainly think that a program like ehis would start at the very high range and try to slowly and grad- ually in a very cautious way, try to bring the average tar and nico- tine content down. I would think that would be the way in which the staff would propose the problem ought to be approached. Senator Moss. You heard the testimony this morning and the rep- resentatives frorn HEW generally said they would prefer zero level because thatt would eliminate thc health hazards that we are tniking about. But tha legislation tries to find the area where you can get it down wit.hont driving into the bootleg business many of the ciga- rette maxmfacturers. Do von have difficulty with this sort of novel idea of trying to find a~level that is lower in the substances and yet can be acceptable enough that you can hold off the bootlegging? Mr. Yrrorsxr. I would have to say that it would be a very difficult xnatter to regulate in order to satisfy those two partially conflicting goals. But I do not think it is impossible. It could be done. And I say again I think the way to do it is to take very cautious first steps, analyze the data and then move on from there. I do not believe--I say again-I do not believe it is impractical or not feasible for the Commission or some other agency of g_ overninent to manage that balancing act. Seuatoc Moss. I was, of course, pleased to hear of t.he steps taken bv t.he FTC in the consent orders on the display of the warning in advert.ising. What are your thoughts about displaying tar and nico- tine contents prominently in advertising, or at the point of sale of cl lrettes B ~Sr. Prroi=siir. R'ell, under voluntary agreements that the Com- mission is aware of, the industry is presently disclosing a good deal of tar and nicotine information in their advertisiizr; and in some point of sale materials. Not all are covered by the voluntary agree- nrcnt. I would think that to tha extent that voluntary activities by t.he ei,aarette rnanufact.urers emphasizes, clarifics mnd rnakes more con- spicuous tar and nicotine information, that is all to the good in terms of health hazards to consumers. Senator Moss. Have yon given aiir thought to whether there should be any limitation on the amomrt of print advertising for cig- arettes, again, not barring it entirely, but having some kind of luni- tation on it? T158461177
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45 arailable published information and submit it as a report and draw such conclusions from it as seems warrantod, and that is precisely what the report is. Senator Comc I nuist tcll vou, Doctor, You have not been aboard that lon,l, and I think that I would hace to honestly disagree with ron and say that is not, what the report has been ~ Tlie repmt has been a biased report. The reportwill continue to be a biased report. Dr. Horn is thc gentlnman who oversees that report IIe has stated emphatically how lie feels on the issucs. Hr, has stated emphatically thnt the figures should be no consumption at all. For instanee, it was said by Dr. Horn in re~ard to carbon monos- idc, that You had a 1-day seminar. Now, were any doctors in that seminar tltat I mentioned 11) von that have testifiod before commit- tces, that have put into the annals of medical science that they disa- ;,=rec, iii one form or another@ Were any of those in that room? Or was this again that group that avere under some obligation and under contrac•.t to your Department that sat in the room and decided to cornc+ out with a report nnd said: Well, this is a little bit nebu- lous, hut we w-i11 pu0 our finger on it and at, least try to say it is ocron,1? The only point I'm til~in,n, to make to 'ott is iu this bnreaucratie stisfem, wheai one mulccs up his mind, as'Dr. Ilorn has, that ever}'- body in the Cnited Statei should stop snol.img cigar(Atc~s, I eamtot stol) hiia from feelin,- that «~ay if he .vmit.s to, and I do not dcny hint that, but I:c -ant to Icnotr how hc can w-rite an nnbiased report. Dr. Dt-V.v,. I thinlc von liave made yonr point cxceptionally strrm" , In at lenst ninc otlcr conntries- Senntor Coot.. I am not concerned about nine other aountrias, but T sun conceined ahont foiu• or fiye other Sur~~~uon Ge~icrals in the past e-ho 1-•r;e ta.Lcn aniore objecNze view of tho report tban Ih•. lte~.ufeld has. i)r. Du`v''ar..'I'hat m,it• also be a yery 1alid point but in the past 3ears thu amonnt of dati tlmt hare increased is dery substantial. Senator Coor.. I nm:t ~ax- rrholcheartedly yuu iree not coxrae.tt on tl~at one. In }our titrnuuG You still refer, to the mice studies and the _Lucrho.ch-IIamnuond sh;dz-. Beoa.nsro if arnthina, has been totally di~~o:redite<ld sc.ieutificr iniormaLion in this ficld, it is those two. And you saw fit to use thoac as the basis that says, this is the basis by .rh ich we in the dep:utment aa'~ these are--- Dr. DrV:v.. Lf I had liad tlte benefit of conr eounsel, I would have left out the too paragraphs. But I do noC thin]: the thrust of mc tcsl i monv would h are been clangerl. ~Scna.tor Coor.. I do not really disa,o,~ree o~itlt you, Doctor. Let me say this, I think rve can come up Acath aa report. Also I think the indnsti-t- is tiyin.m to do its bcst and I cite the arecment to list the so-cn.lled wnrrun_~ on all adveitisiny. ~ I think it w-a.s the chnirmau w-ho said the.v had decided to put this out, entd this is nice, bnt let me tell you, a lot of peoplo decide to do thi n~s w-hen they mro hit oi•er thc head hard enou~h. IY-heu vou uo to lhe 1-1 RIl' Secreta.ry, .vith your bndeet and lie sits thcre and .x}s, "I mn told by the Office of Mana„emont and Budget to het tlus down," then ron get hit over the head and you walk out T158461168
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1 43 ospe.rtise and no scientific knowlodge as to how they should state it, how they should come by it, what they should recommend9 Anc] yet cou aro here saying that a bill should be passed that should set limits, but that ichat you really believe is that nobody should smokc. Where are v.e going to get t7ie scientific expertise to accomplish this in the F TC ? They have no expertise on it at all. And if we follow this logic, then what we have done is hacc a iood advertising ciunpaigsi from your department from 7961 until this date, and yct no rewnnnendation can be made by your depart- ment whatsoever as even a guideline to the Federal Trade Comrnis- sion. Yet this act could conceivably become law in 1972 and be signcd by thc President. And what in the world would the industry and the FTC do with your department sitting over there and piously saying, °°We are not going to tell you what it ought to he, because it should be zero consumption"? Dr. DvVeL. I hope the recorded commonts this morning, Senator, will show we did not-say anything about zero consumption of ciga- ret.tes. We are not talking about smoking. Th e are talking about health. Senator Coox. He just said that. Dr. DuVnr.. I understand that, and I am amending that testi- monv. The issue, Senator, if I may be allowed to finish-the issue before us this morning-and again, the record will snstain what I am about to say-the issue before us this morning is that in the interest of the public health of the people, we must seek to rednce those materials in their enviromnent we luiow to be hazardous. There seems not to be any substantial disagreement remaining but that the eonsnmption of tars and nicotines through cigarette smok- ing does constitnte hazard. It necessarily then follows that the depart.ment can only hold the position that the consumption of such material is not desirable. if there is a way of eliminating or even reducing tars and nico- tines from cil,,arettcs, our posture would still be the same. We do not want those materials consumed. But we are not talking abont smok- inr; as such. - In thc mcantime, though, among 200 million Americans-tce do have, let's say, 160 million who do not smoke. We also have 45 or 50 million, who, at tLis timc. are still smoking and we 6ave an obliga- tlon to them as wc11. Senator Coorc. Well, doctor, ]et me interrupt you just a minute. To be very candid about it, cce are in a helt of a fix, because the gentleman fromn the FTC, unless he alters his testimony, is going to testifv that thr! FTC cunnot do it. Furthermore, they want to depend on you to give t,hem the information on what those, figures and what those statistics should be. Now if you all rc•_fnse to do it and take the position tLaC you catmot do it and yon (10 not know how you are going to do it, jnst of what significance is this bill noing to be? Dr. 1Jtrl%.v,. I thinlc you will find our testimom ehmrlc states that the v ay tile bill is draicn at the moment, it as] s that the lev-els bc set between two diff'erentt positions, one, having to do with tile pos.si- SP-013-4_--J T158461166
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DJ \Lr. Pia•oastcY. We have not in any direct way. I would not, it seems to me, be appropriate to challen,e t.he intensity of advertising under the false and deceptive portions of section 5 of the Federal Trade Commission Act. However. one wulrl look at that question in tet7ns of lho impact of advertising intensity on anticompetitive market structure. Last week tbe Conwrission filed a case against the principal cereal mann- facturers in this countsv, in which it raised questions about anticom- petitive consequences of advertising intensity, brand proliferation, false advertising, and shelf market control. That. it seems to me, is the only way in which one could look at the question of advertising intensity, and at present the Bureau is not doing that with respect to cigarette advertising. Senator iYloss. Getting back to the warning, and how it appears to the public, have you done any market research on the effect of the warning, or for that matter, the effect of remedial advertising in general, since really the warnmg is a form of remedial advertismg? Mr. Prs•oFSxr. Vde have done some and we expect to do more, but we have not done a great, deal. `Ve have, for example, in specific cases faced situations in which there is a controversy over the effec- tiveness of afirmative disclosures, remedial advertising, that sort of thing, and those issues are being ccplored. Also, the Commission in its hearin~s on modern advertising prac- tices this Fall got into those questions, as a major theme m its exploration of these advertising practices. Those arc the only instances 1 can think of in the past. The Uonr mission yesterday, when it published its provisional acceptance of these consent orders, noted that it intends to monitor cigarette advertising more closely, assuming these orders actually go into effect-, and to take into account, or devise methods of taking into account, the effect of that warning on ennsttmers-pa,rtictilarly whet.her they continne to perceive and appreciate the health warning that will appear. Senator Moss. jCell, I would be interested in that sort of a study ix+cause we started ont with a warning just on the pack itself, and rathcr soon it seetnect to me it was pretty well overlooked. Now Iwould like to know what is the effect the warning in the advertismnents themselves, what impact, it would have on the c.on- sumer and the markcting of cigarettes. Sn I.think thatwill be a vcry intoresting study to complete and brin„ us a report. 'i'hew brands that do carrv tar and nic.otine cvosig,ratiou mr tlimu uo1l. il is IIquo fid Ic tolimt.uilv. is thar ri;_~;ht? .ltr. Prmorrr,r. Yes, that is rh=1d. So~rator Aloss. 11'r.IL fhanh y<~u, 11Ic Pitofsl.-y. I,.;~I~r.',ciata vour Lest.imoty~mrl your ~~,ponses to m,4 rilestions. ; iri ~ator Coolc m.+.V have sotne questions now. Sr.nntrnr Cooic. Mr. Pitofskv, whyt do you personally knoW about nicotine ~ndtar in ci;{are.ttes? -lir. Prrorsxr. I rake it pon mean tha comtectiorn between tar and nicntine in ci;;arebtes, and the health hazard? 5euator Conr.. Yes, sir. T158461178
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44 ble stinnilation of the appearance of an illicit market, and the other hsn-inc to do with the public safety. I have aaked speeifically in nry testimony this morning tlmt the HEII' make a detcrrnination of the appropriate level, based on public acceptability and not on health, and that, they should onlv sen-e as a consultant. And I hope that clears the record on this matter. Senator Coorc. This clears the record, but it still puts us in a pnai- tion that the FTC is l;oing to tell yon, me, and t1je general public they do not have the expertise and do not have the knowledge to do it, and the,y intend to rely on You for such information. Now you tell me, that you are not going to give that to them, so we are at an impasse, are we not? Dr. D~VAi.. I would not have put it that w ay, Senator, but if you s.w ive are ah an iuipasse, then we are. ~I have suggested that thc bill be amended to eliminate the rr.fer- ence to findin;,* a level of tar and nicotine which will not pose an imrc-asoiable health hazarcL tiVe would submit that the level can ouly be zero. And tho issne then remaining becomes the matter only of public acceptabilitv. Innsnnch as both the tobacco indnstry and the consuxninR publie does have a taste and an issue here of concern. we would like verv much to acknowledlge the importance of that issue. ~Ve would alsn like to ael:nowledge the importance of smoking to 45 million Ameri- caos u-llo, for their own rcasons, are not abandoning the habit. They are our concern. and we are attempting to bring them into oiur sphere ot concern and show tha.t we are responsible and are attempti!.i,r to inodify, by degrees if ncr_essary, the enviromnent with which thev finrl tbemse.lves surrounded. 1nd 1 would submit that an amcndrnent to tlle bill, as sa~;~~ested- which attuel:s the sam( points yon have made, incidentallv-does da tlmt. E+enutor lL-~ss. Tf:uI iule.rrnl)l. aud svc ii' I r:ui rtsi;ite it 9 The position of IIPSV n-onld he that it on--ht to be pnshed down as far :is possiblee rnl tar and nicotino contentnntil it meets this line of publle acceplabiLty that the FTC is cir.;r to have to find-is that not really what yon are siying? 7t on,ht to ~o down as far as it possihly can unLil it crossesthisline of notbeingacceptable0 Dr. Dr-7.~i,. Yes. I3ut I would add the proviso only, that whatecer constitnte, thnt line, that line he determine.d first by public accepta- bilitv rnther than in terms of health. `lcnator (7ooic. Doctor, I do not disagree with that as such, buC let me, ask von this. If you fcel thart the factor ought to he zero, and if you feel that some~othe.r method, by amendino~ this bill, will talce away anv coor- dinated elTort bet.veen the F1'C and your Department to find what level of acceptability thatit may be-because you insistthat the fignre should be zero-then I reitsrate again, do You feel that: You arc the, right Deparhnmit to make an unbiaeed rep_ort to Conl-ress on smok- inn and health? Dr. DrrVAr.. I would submit that our charge by the Congress with regard to such reports is to develop, monitor, a-nd collate all of the T158461167
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41 -\o1)' there was a report by~ .I. YernshalmN, I'b. 1). thxt a doctor concladed that tile lir~,-hter birth weight. is the result of the type of Nrornan Ncho smo]ces, and that the weight ia c1ue to the stnolcer, not to the smolciug. I)r. IIor.v. That report Ayns we11 corered- Senntor (_:oos. iludyon rejectedit. Dr. Hor.x. tiVe ditl not rejoc,t it. We nl,o pointed out tiyhat tho criticisnns IVere ot tluit study, cribicicius that hwve aleo been pub- lislied in thr literaturc. 8enator Oorn:. Do cou hare reports that are critical of this statds? Dr. Ilorv. Oh, yes. Sonator Coor.. tii'otild Non put them into the record, please? I .could unprc+iaf.e it.' Dr. Ifoar. All right. Senator Coou. Agwt, Dr. IIorn, you do not, feel that tlmre is any con(licf at alt in yonr issuing, as the 1aw requires, an unbiased report on emolciua to the Conl;ress and the fact that the Sationetl Clearin,' - honse for ~,molcing and liatlth, the.ir mtuin tt.nd principal job is to cmrvineepeople i» tile Alnecican publicno6 to 111101e? I)r. Hotc.v_ Oh, tLnt is not our nizLin job_ sir. 4t:naior C?ooic. What is yonr main job? Dr. IIot:~N'. Our tuniu job is to re_duce the death and diSItbilitr tfmfi resiilt front cig~arcttc ~moking. Seturtor Cooc. A.ud us a result o[ ttal., yott cssu iesnc all unbiased raport to C'onrress crer~1ear 7 Dr. Ila;s. As part of thaM1, that i.~ oae of tlm assianmenta that ma ltavec had. ticnator C oor,. Do k mt fec] that tts5innment is misp?;tcr.d ? Dr. Ilor.~. I e.mnos find anybody else ticho wants it. (Lnn_hrcr.) Senator (`nor.. ~`i 'oc thn! is Ndw Pr.~.teinf^ld did not( follow tbi•ourb ~citit a'hat hc told (~t -tess lasb year, that he thonl'ht thc)re was et c.odiicimud thour,d-i if-Ir:Idd be clialiged, b))t he did not do it becanro lie contd not lind ~ ~I , -dN, th.tt wanted to do it. I)r. Iior,s. lt ii a rrtr joh to do. It tala^s a;ncat d.e.il of worl.. And I asaui i. vou t'aat we Lave to lenu oeer b cl.wards to give fiill :uu] ttdta{uute rncerstg~. to all cliss'entinl,r opininns ns ihe.y- oeciu• in t~:e scici uilic irorld. ~ Senator Coo<. Yo~~t lrere aNcrc inlugtral parL of that rcport, and tLat npott s;}'s 1-7mfi thrae is n. lons_*c.r :ui Ilonest r65t;tret•mca)t. YoucbosS sn.i d tha t did h e n ot ? Dr. Horzx. Yes_, sir. tionatoCoos. If thcre is no ionger all ]totest d''uagroement. let me quote soinr, of the -.to.temrnts the 1973 tVport slItd ttsA, yoa if they (to not, bp thcmioh-e=, import an ho)cet disa; re.c~nent. On prze }p, `:The biologica] si},,nifica.uce of rohesn Puidiiibs retnains to be drkermined.:' '-retnuins lo be dci onuinE~l." Page 43, `Ciharutte smokieg has not clc:u•ly beeu demonstrated to be a ftu;kor, neverthelese the posaibilit~ " Page tti7, "Cigarette smoking does not appear to be rela,ted to denth from bronchial asthmal" T158461164
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50 The early part of my written statement constitutes a resume of the provisions of 5. 1454. In summary, the Bureau believes that a limit on tar and nicotine is a desirable objective and that this bill is a sound effort to achieve that objective. As we view the problem, it is that despite the diselosurc of health hazards on the side of the pack of cigarettes, despite the voluntaty efforts by the industry to disclose the Surgeon General's warning in advertising, and the vol- untary eR"orts of the industry to disclose tar and nicotine informa- tion, r.onsutners simply are not switching in significant numbers from high tar and nicotine to low tar and nicotine cigarettes on the basis of this infoilnation. In tests of 120 varieties of domestic cigarettes completed on Octo- ber 21, 1970, tar cmrtent rangod from 2 to 31 milligrams per ci~a- rette, and nicotine content ranged from 0.1 to 2.2 milligrams per etg- arette. Ten of the varieties tested vield 10 milligrams or less of tar per cigarette. Sales data snbtnitted'by the nine major domestic ciga- rette marmfactnrm•s indicated that combined sales of those 10 varie- ties amounted to less than 1 percent of all domestic cigarettes sold durinh 1970. T.renty of the varieties tested yielded 15 milligrams or loss of tar pcr cigarette. Combined sales of those 20 varieties accounted for less than 4 percent of all cigarettes sold by domestic mannfacturcrs in 1970. I)uriog 1970 cigarette manufacturers devoted 10.5 percent of their total a.dvertiaing espeni9itures to promote those 20 varie.ties yielding 1S niillimatns or less of tar per cigarette. Senator Cooa. Mr: Pitofsky said he wanted to summarize his statetnent and asked his statemeirt be pnt in the record in full, and now we are quoting from the statement at great len,;th. I wonder if it might be better for all concerned, in regard to questions, if Mr. Pitofsky .vonld just go ahead and read the cntire statement or whether he wishes to rcfer to it again and read at length. Mr. PrroFSxr. I could eertainly read the sta.tement, sir. Senator Moss. I think it is for the benefit of the committee that we have a selective reading. We are not only into the afternoon already, we have two scheduled votes Ikiow we are. going to have, in .clnch we will have to recess to go and complete those votes. So I thonO.,ht it would be to our advanta,qe to have Mr. Pitofsky selert those areas that lie thought he should emphasize orally before the committee. Senator Cootc. I do not really mean to prolong this, Rlr. Chair- puan. Obviously we are wasting time. If you wish to do it that way, fine, I have no objection. And obviously I do not have any desire to hold np the committee proceedings this afternoon. I merely raise the hoint that he wanted to summarize it and now it seems we are going into great. length to refer to it. Bid lie may certainly, subject to your rtilin;,=, continue. ,,enator Moss. Thank cott. You mny proceed. Mr. Prroesicr. With your permission, I will read two more. pages and summarize the remainder. Senator Moss. All right. Mr. PrroFsxv. This statistical information indicates that cigarette mannfuctnrcrs aro capable of pr)ducing cigarettes which yield rela- TI58461173
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56 Mr. PiroMsxr. I do not claim to know more than I have read in the surgeon gene.ral's reports and elsewhere. I do not claim to have firsthand scientific knowledge on that question. Senator Coou. Well, you don't have firsthand scientific larowledge and you rcally don't speak for the Federal Trade Coimnission, but for thc Bureau of Consumer Protection. You he.ard the testimany this morning that the De.partment of HEII', takes the position that zero consumpt.ion is what they want. '1'hey also do not want to cnop- erate with the FTC on this matter. Therefore how are you or any- body in your agency l;oing to come up with an answer to the prob- lems elicited bv S. 1454, if it were to become law? Mr. PiTOrsxr. Let me say again, it will be a. very difficult matter to manage. I had not been aware that llru te_stimony would ba that zero tar and nicotine was desirable. :issurning that that is the position that HH7W would take, it sce.ras to me that then the BurearPs policy would have to be to aim at a tar and nicotine level that is as low as possible. on the assuurption that the lowest possible would be zero. We conld, for e\arople, institute rcgulations which would recluire that, c:ip;arettes over a certain level of tar or over a certain level of nicotine., not be sold undcr pcuaLty of violating =ection 5 of the fed- cral'1'rade Commission Act. Senator Coorc. Al I right. Lct us look ut scct.ior~ 5 of the Federal Trade Cornmission Act. Are you saying that every sale over a standard thatt you set is going to be iu violation of the ach? A(r. PiTOFsx,'. If Congress enacts a statute which nrakes those, sales illegal, and gives the Commission power to enforce that under sec.tiou 5. Senator Coorc. 1j"ordd you ask for it? If we take your advice, would you ask for it? I ou are asking it be included rmder section 5. Now, are you sayitv, that under section 5 that you would sa,c- thatt every sale constituted a separate offense? Mr. Prrorsr,r. N o, sir. Senator Coox. How would you put it? Mr. PrTOrsxy. Let me take an example. Assuming Congress gives the commission this power, I could well imagine the Bureau proposing a regulation that cigarettes with in excess of 25 milligrams of tar- Senator Coox. Where did you get the figure 25 ? Mr. Prmovsxr. IC would be a prospective judgment, Senator. Senator Coox. Do you have anything to base that prospective judgmenton? You have picked a figure of 25. It seems to me there was sonie dis- cussion 1 ast yea r of 20.'_~ ow you are up to 25. Now, is there any reason you would pick 25 ? blr. Prror•srzY. Let me be clear about this. I have no reason to pick 25 with respect to the scientific associa- tion between cigarette smoking and health. Senator Coox. Other than to usc a figure for the purpose of answering the question? 111r. PrToasxr. No, other than knowing that the scientific advice we would have is that zero is the best fi=ure for tar and nicotine. T158461179
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k 40 Now, that most of them hare arrived at the emrctlus-im2 that almost the mrtire scicvttific li-ateruitr throuL,,hout the world have arrived at, and that is that smoking is harnnful, docs not indicate that they are binsed. They are draw-int,, certain conclusions from the evidance. The primary focus of the report is not in the area of whether or not ci; s.rette arnokig is safe. Titere is hardly anpbody in this world who now nays cil;arette ~mol;in,v, has been proven safe. The, ianeis primarilc lLe sciudific one of what is itthat prorlures the effect and is responsible for the fact that eiga.rette entokers have hig glur death rates than uouoigarette smokers, who are comparable iu other respecta. Senator OooW, T haYe gonc over the list in the front of the report of those who lraae. oither contracts or grants with ,your agency. I assamod they were selected be you. You say thcy were not. I noticed in re*ard to the, hearino,~s fltat have ;+one on for a numbor of years that there tv~ere certain exceptions ~of people that were not in there. For inshanoe, Dr. l$"illiam Ober, director of lahorat.ories of TZnirk- erbocker IIospital. New York City, also associate professor of paLlt- olotiy at New York-Medical College. He wasnot on yottrlist. I)r. iionald Olam. director of clinical pharmacology at Cedars- Sinai DLedieal Center in Los.lnIgeles, assistant professor of ine,dicin:e and pharrnacology at the Unicersitv of California at Los Angeles. 1)r. 'L'homas 16rern. profe=sor and chairmon of th(' De.partmmtt of 1ledicine at the Luico-rsitc of Sou.*bern Cttlifoxnia School of lfedirirta ~ Dr. lluane Carr, profcssor of sur~-err at the Ilniversity of 1'ennes- see Ctrllege of Afediciue and formtlcr of the Sontheru Thoraeic S!tr- gical ~?.soc.iatiuii. I)t. it I-I. liil,,don, lvroi'essor or p;itholog)', L,niversite of TeN-as meQirn.l brauich. ?lotv, is it your opinioi, when these particular doctm•s di=n,qree with }'ou, that ther do not constitute lmn >t opposit ion E Ur. IIor:n. AVhntt itose gentlernrn ]mrto say is well recorded in tostimony that they havo given b-fore r,, uress rr in articles- Senator C7onrc !la, v I sav, one uther ~ I,~r,q? ltilrat tl.ey have had to say is not well rerorded in the 1 '1T' 1~,lrb tliut wus roade to tLo Americun people tclwn yon wree ~upp -d to malce a, rrpm,t to the Co11~1110sa that Ir.is Uui'uiased. Dr. 7ior~-. I know of no articles thcti published during the pr(- redi n; y ear that should ha\e been in cluded, becauso - tictr.iior i"omc. 1)id rotr as'~ tlrem to make it vonlribntion? Dr. Ilaev. We do no'r. ask people to make cmrtributions to this report. lA'hat vcc do is report on the publislzed litemtuye. Senator Tfoss. If they hace publishe.cl their report or a stardy in the precedis,g cear; wotild it hat°e been reviewed and been made part of v-our report ,? Dr. IIo:N. Yac. We derote apood deal of time to reporting troae aetiales, especially thoso articles wbioh in any way bring into qnes- tirnr some of thr, precailinti Lheories abouL Lotv uiga.rvLte snmkine aff ects hc~alth. ~ 9enator Coos. Let its got to that, because vour 11972 report con- cludes that smoking by it pregnalrt worrran will cause the baby to he lighter in weight at Uirth than if site had not snoked. TI58461163
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83 public in learning about possible health hazards in cigarette smok- d and therefore last toar made the, folloArirg two recommenda- tions : (1) '1'o inerease appropriations to the Department, of HRIV for education of the public, especially youug people, about the Irealth hazards of rig;urttev smokhyt; and (2) To cutvnuugc, the sidrst possible ttissemination, through all ;w-dia of mass eommturication, of messages to alert the gen- r.rsl public to the health lairards of cioarette smokiny. I think, Air. f-hairman, I have tonched tdl of the ma.ior subiec.ts cocercd Li nrv stxtemenk. Senator Moss. Titanilc you vcry much for your statement, Mr. Pitofslcv. As I indicated, tls fnll statement will appear in the record together with the suppltments' that you have referred to. Ilow wo!ild you go abont setting tAte limits on 6ar aud nicotine and other hazardous enbstances ns you recomrnend in your state- mzitt ? R'h;rt, procedures would vrni folloR-? \[c lianescr. Well, I think the Bureau zvould start out bv pro- 1l tiiafi some for1n of hc1rin,' be held at which interested parties v.~uld p;u9icipate. I t,aild e.pum., for oanmple, tha.t representntives of the cigarette indnstrV, t.he scientific vomnnotity, aaid coitsumer interests, could appetur at those hoarings ntind participate in those proceedings. I snpho=e that the c.ploratory hearing or rulemaliing could be as fonnal or informal as Cmtrress determines in setting up a statute like tl_,is. If tdm Conimissinn vrerc airru no directimis whatsocver, T~rnuld eype~? tLnt the staiP ~conld ~propose some kind of infm•mal ridemak- ina[, in ;vhich we could exlrlore-auite franklc, for the firat time, sinse this is a noti-el notinn in tbe req111:~,tion of~ cigarette advertising and sales-cotdd mplmy the practic.rl problems that might ariae in irnplomultin, t)tie statetc. Senaor Dioss. You exltress concer~t about findin,e,' that you would humc to depend on the Public Health Service for eapettise in deter- mining the dy-ree of tocicity--wh:uterer word we nse for the ingre- dients, and also fudiuf; tlie level of public : cceptabilit,y. Would vou procced iivn lindQ the pablic aeceptability level fiat or Avonld yon prorced from tt_cuw to find the mcdieal leve7l of isrrcdients that can be tolccatedB ~Ir. Prrurs<Y. That is aiery difficult qaestion, it seerns to me, undcr this statnte. Rut INcould sugaest that really it is one sinnle balancing test and not two stepS. (lac wotild have to rnake a determination-I would hope with the xssistance of scientific element:s within the Governiient-of what an unreasonable health risk is. I3ut I wonldn't think tbat that is vers- meaningfSrl in isolation, and therefore, in the babrnciug process, ~I would think one would also have to explore these questions of ennsrmter acceptability. , see no. 67 and TI58461176
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J! The figure 25 would be adopted experimentally in the hope that you could get consumer acceptcurcc at 25, and at the saime time miniuiize health risks. Senator Cooic. You just piclced something out of the-aire a figure of 25 ndlligrtuns, and ~ou sav this would be a formula of z.ero to 25 in proportion, and then go to the genera.l public for a degrce of acceptabrhty, this is why I hrve really got to say to you. Mr. Pitof- sky, tha't }on arc2 cr-ht yoiu rdea is so novel there is nn wsr in the world that .1 would be in favomof informal hcacrings to perfect this particular 1it,•ure. 13ce.a.use, if infonnal hearincs are carried on the wav informal he.uriugs havc been carried on in the past arcd you are talking about the establislunent of tar and ninotine, levels in cira- retus, with no hclp or cooparation from the Public Ilcalth Service, and no mrniis bv which yon, withiu the fraruework of Your own department, crnu determine a peracutate of tar and nicotine. I am very- sure that not cvcn the ge,nersl public themselves would like infocrnal hearinqs oil a matter of this magnitudc. You rnadce the remarh, after your extenihorancous reiuarks, when I said thnt thcre would be no help from the Public IIenlth Service, znd von said son were not aware of this, y-ou ~cr_re not an.are that their tigure was zcro consunption. llai1 say by yoru. very testimony that that is what vou want ti-oursclP, :md zero consumlrtion is the sale of no cigarettes to anv- body as a matter of ltcw; because von said slowly xurd graduxlly bring thec tar and nicotine down a.ncl that meaus down to zrro. 1Cov:, are you for prohibition? Mr. PrroasrT. 1$ith all due respect, Senatoc I did not mean to brin'- it dowu to zern, and 1 am not in favor of prohibition of civa- rettc marketing, because I don't think it is practical. ~ So,nntor Coor.. I was delighted to see the industry go off the radio and tr.levision.s beT.nuse I thought they could savc xwhale of a lot of mmiey t.hat advertising a„g,onc~es throu~rhout the country had put the tobacco industry in competition with itself. I am sorry thcy have increased their advertising in newspapers and ma.gazines, because I dmrt thitik iL was necessary. But I sure want to see the FTC try to corninco nowspapm•s and magazines that they have got to give somebody free advertising in their newspapers and magazines to be in competttion with paid ads, because that is one place where yon aro really going to get into trou- ble. The FCC required this of the broadcasters. Now, let's get bacdc to your statement. T cmderstuid correctly, do I not, that your position is not that of the FTC? _lfr. PrrorsrcY. That is absolutely right. Senator Coorc. Now, what exactly is tho authority of the. Bureau of Consnmer Proter:tion? PIr. PizoassY. In terms of its jurisdiction, it is gcncrally to enforce section 5 of the Federal Trade Commission Act in areas that involve consumer int.crests. False advertising, deceptiN~o- parkuging, and truth-in-lending. are three examplcs of areas in which the Biu•cau is involved. In terms of its relationship to the. Commission, its authority, of course, is no more than to recommend action to the Commission, I T158461180
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49 Qtrrstvm" -br. Fm es ^1 '*rfen,' to the SuLCOmmitt-' tAe Johzt C'n„er.~' " on, b'ntut.. ., .u P1> tDrzt E'o. f, ae Ci„~rnrzw, _s! ~...~ presr, P].no_ "'PYig yrrmr ... -s on thi.e .eta6 .~J of tn . i r~,141v,et';, Snswer.-1,r. Gorl Lits ncrer pnt off calliag meetings. At thr 1 r-i me, 4 Hxe Snhcommitb, of the,Toint Cnumiitte on b'inolring and Ho.alth h[ . ~ I m, I 1 i , ir-_- 43, 1970, at l.a Jolla. California Dr. Goriicas asked by the m, -i ..beri , r~et n: Chairman. Ainon?; other resolntiona of thot meeting, as indicatod in Wr oHi,inl minutes+. tLe Cmxliuittcro ra:omrnentled that "The nest mcrtiryg iv yehed~J at the time of the A]1N workshop on Smolcing and flealth appro.iniateiyin e., ~-Ip 1J7_" Dr_ Curi hn5 called tud is presentlP arranginr the nest meeting ol: tio- snbenm- mittee for .Tuue 1(i-77 in couSnncl:ion Nritn t1,c :ninunl ?MA meciiu;' in $;ni Franci5co, California. tienator Moer. '1'ho committee wil,l no1lreeess. Ave hace it i-ote. We wilt rccont'eue at °3 o'clock. IVe have two very important witnesaes yet to hctr. (lV'hereupon, at 19:30 pan., the subcolnlnittec was reccssed, to reconrure at --) p.ln., this same d.i,y.) AFTLI1NOOV sE9.~ZO. Senator Moss. The hearing will come to ordor. ZPe will resnme rece.ivinm the testimoni. _llr. Hobert. 1'itofslry, llirector of t.he Bureau of Consllmer Protec- tion, Federal Trade (,ommission, will be otd, next witness. IVill eou please introduce the gentlemen who have come with y'oll to (lie tabic. STATEMENT OF ROBERT PITOFSKY, DIRECTOR, BUREAU OF CONSUMER PROTECTION, FEDERAL TRADE COMMISSICN; AC- CO:VIPANIED BY GERALD T. THAIN, ASSISTANT DIRECTOR FOR NATIONAL ADVERTISING; AND ALLEN F. BRAUNNINGER, AT- TORNEY, DIVISION OF NATIONAL ADVERTISING \fit PrrorstcY. Yes, sir. Mr. Chairman, members of the, Connlnittce: I aln accompanied on mv right by JIr. Gerald Thain, Assistant Burcau Director, Bnrean of Consulner Protection, and on my left bv L111e.n Braunninger, who is at iuerubcr of the sta(T of the Divmmn of Naaionu,l Advertisinn. I want to thmnlc voa for this opportlmitr to testify before the connnitlcc, With iour permission, Mr. Chairm.ul, I would like to snmmarize rather th>ul read my entire ttdement, submitting the 4acemenb for t.llc rocord, and retldinn only a few pa~_1es .viLere statistics or other data is ittvoh-ed. SI•nator AToss. Thtlt will be ac,-ephtble. The entire seatclnent ~-ill bo placecl in ttle record and yon ma}' hicblight or elltphasize sttch parts as you clloa~, to do _llr. Prrolrsr.r. Thank .-nn. At tho. outcet I~.ollld lilce to cniphnsizc that mv statelnclt rcpre sents the views of the Burean of Consumer Protection and not those of the h'PC itself. c11so, time has not perlnitfid receipt of clenrance of this statement by the Office of &Ianagcinent and Budgct. T158461172
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58 which then nurst be passed upon by the Cannrission. No action ocr.nrs until a majority of the conunissionm•s vote. to do something. Senator Comt. Then we enter into some of thesc voluntary a.gree- rnents. That is like saying I volimteered to take my wife ont, to dirmer the, other night because she volunteered to leave nto if I didn't take her out. Sfr. PrzoFSicr. Are you referring to the agrcements entered into yestcrday d Senator Coos. Yes- 1VIr. Prrol=srv. That was a]ittle difl'erevt there, of conlse. Com- plaints were issued. Senator Cooh. Do you have any knowledge of that? Would you explain how those agreements came about and how the industry volunteered to agrce, they agreed not to be prosecuted. Mr. Ptxorsxs. I mentioned voluntary agreements twice, referring to the tar and nicotine disclosure and the voluntary agreement of the industry to pnt the Surgeon General's health warning on the side of the pack in adt°ortisements. Let me say, incidentally, I thought that was highly responsible ac- tivity by the indnstry. But the problem in respect to the Surgeon General's warning, that it was done in such a way, in the opinion of the Commission-not tro Bureau, although the ]iureau recommended action here-that it was not clear and cunspicuous. We thereforo brought administrative complaints against those six companies charging that, there is a direet, association between ciga- rette smoking and health hazards. After 6 months of negotiations, we worked out an order which these companies were willing to si¢n, though they said in connection with that signing that they denied eirclt and every allep,ntion of the comphiint, but t,hev sigrned the order and that is what I had reference to earlier. It was a consent order. Seinrtor Coos. That is like a plea of no]o contendcre, isn't it 9 Mr. Yrrorsxy. 1Pell, it is roughly like that, that is right. Senator Cooi;. OK. H'hich is done every day for the convenience of the administrative process, so that, you can t,.et thinh done short of bringing a cease and desist order. Alr. 1'rro-tcr. '4cnator, 1.rnuld add thut it is sonirlimes done b~.° conipauies ~w! -o do not think tl ~., ~ » n win if they go to litigation. ~ `~nirtrn• ( ~- r. I cspect ll;is i: true. lint I nr_It sav to yon that. the omis is alwavs there, ec-en thour_h tiic m2v go on for S~eat~s. The .rrt,-.nucnt is really in frti'-or of the FTC, ratlrer than the big badcompirY llydlnndnc„qmr.eflLin sn'titS 31 P[rn=.~c~ S unnol cu{ainoftli2tn linh 1 renllr x~?reo with you that frutnently these consent orders are entered iuto to avoid c.ost1r, protsacted procecdin,~. Sertatnr (`omc. I 7 night adii,_ in all fairness, becaii~r we have been on oppo;lte side,, at least the FTC and t1iis senator, for quite somc tinu, itt is prcth° tonrh to come out of the FTC with a rulinn in your fa eor 'that tho F''C would appeal. R'hen the FTC anthorizes the study, the stal then studies it. The slx.ft then preaents tho case to the FTC. TI58461181
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G3 Senator Coox. That is a pretty broad range for consumers to choose from. Mr. PPPpPBIiY. It is. Senator CooK. You say all cigarette advertisements by the end of 1971 were including tar and nicotine data, is that correct? Mr. PrToFsxY. Yes, they are. Senator Coox. And that is correct? Now, I hetud the byplay; it is not on the pack, but, just a minnte ago, the chairman said that they put it on the pack, the warning, and he wasn't satisfied with that, he now wanted the warning in the ncwspaper to soe how that would make out. So I t,nu•ss now they are going to put the tar and nicotine in the paper, they should prd it on the pack, and we will see how that worl.> out. When we get through with that, we will find something else to put on the pack and something else to put in the advertising and ser how that works out. Finally, when we get. tlu•ough, maybe we will have enough room left on it, so we can still put a Camel or Chesterfield or something else on it,, bxrt it is doubtful. Senator Moss. End of speech. Let's have the questions, please. Senator Coox. Do not these statist.ics on tar and nieotine, and in- formation in advertising, together with the periodic I e.der 1 Trade Commission reports on tar and nicotine content afford an informed freedom of choice to [lie American people? Mr. Prrorsxr. Yes, if that. were the only conaidoration, I would havc to say thore is fnll $•eedorn of choice aaid adeqnato information availableabout tal, and nicotine levels to those who seek it. Senator CooK. What more do you want? Mr. Prronxur. The fact reznnins that despite the dissemination of this information, the statistics indicate that approximate]y the same number of people are smokinn very high tar and high nicotine ciga- rettes today as smoked them .r"i years ago. On the basis of the testi- mony that was heard this morning, to the effect that HEW has fonnd that high tar and high nicotine cigarettes are a more serious danger to health tlran loocer tar and lower nicotine cigarettes, I therefore would favor legislation which would attempt to bring that bar andnicotine level down. A ot necessarily to zero. Senator CooK. Now what basiness is that of the BTC? I can see it is the business of IIF.W. I can see it is the business of public health. T.et me read section 5 to y ott : "IInfair methods of competition in commerce and unfair and de- ceptive acts or practices in conrmerce are hereby declared rmlawfiil_' Now of what concern is it to the r i'C about tar and nicotine in cigarettes as it applies to unfair and deceptive acts or practices in commerce3 Mr. PreorsxY. Well, there ara. many answers to that. Ecnator Coox. Let's have them. Mr. PrroFsxv. First, it would become the concern of the FTC if the pend ing bi l t were enacted. Z'nder those circrmrstancas- Scnatm- Corn:. But this isirtlaw; this is just it Klmun in Senator• Moss' eye. Let's talk about the FTC. We are not, expanding the au- thm~ity of the FTC now. We are talking about the law as it is today on unfair and deceptive acts or pra,ctices in commerce. They are not T158461186
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Fio bfr. PrrorsxY. I am not really familiar with the details of the ad- ministrative arrnnl~ements at 13I;tiV and, therefore, I think it best that I not comment. Senator Coox. If it, was that arrangement, wouldn't it bother 3-on? Mr. Prroesrcr. I think there comes a point at which there could be bias, but I am not uwaro that these Surgeon GenAral reports, going all or the way back to 1364, have been put out by people who have been proeedin any way to be biased by the nature of their responsi- hilities in colernment. Senator Coofi. Doesn't it bother you that Dr. Horn sat here tlus morning and said his attitude toward the entire matter is zero con- smnption, and lie is the overseer of preparing that report and sttb- mittinq it to the Sarareou General for distribution to the general public? Mr. Prrorsrcr. No, sir, it does rmt. It seems to me that one can- Seuator Coou. You are more bnreauaratically inclined than I am. It bothers me very xmrcL. The onlv reason I uiig$t sry to you, 11Ir. Pitofsl<y, that. it bothers tne is because we in the legislative system are criticized tsll of the time for this same thing and somehow or other we cannot get out front underzreath it. But it is standard oper- ating procedure witbin the burcaucrac-v and I do not quite ander- stand it. Airo, ,yon a.mare of the fact that HEW Secretary Elliot Ric.bardson did not includo any such recommendation in his .January 10, I9i2, transmittal of thee report to Congress on ciaarette smokine, that maximum levels be set on any age~nts in cinarettc smoke? Do you disagrce with the absence of srclr a reeommendation in his reports H ltr. Prronsi. ~-_ T was not mcare of snelc absence. Senat~n~ ( .~..'u. Do You a;;'rec that hc should not, based on thc I97~ report? _llr. Pin ~r.Y. I do not wish tc comment. I aun not aw.urc of tlie siglrificance o1 the rcport, what has :;one into it, in the past. I am not preparcd to roumient. Sentdor 111.l ,<. lsIA it a fact Dr. DuVal just spoke for HFl3T here he~orrlLis,~u~,~itl_. thi,rr.ornin~•? Senator ic_ 1s. Dr. 7)nFal spoke abmrt urice and dons and thiu~,, that .~becn discredited lor a lonr, lom tinie. Scnator _lf FIe spoke for IIEjS' and your criticism was m[nbe Mr. R,ir.hsurison lmd not rrcommenrlyd it_ 'f'his mornin? Dr. DnCal spoke for 1! Alib', cieareci by IIl:jV and Qlll3. ~ Smrator Coor,. I nm,t say to yon, Mr. Chsirman, T em not sure that I)r. hnl"ol said in rm.y way that'iLe. remarks he made this mornin' .vere elet.red 1re O`tR, nor am I sure at any time, he said thn.t liis remarlcs ivere clca.red by the Secretary of HE\V. I lunoxc lie said his rcmarlc5 were cJe,urd by the Snr-eon General of tlre United States. If we c:m confine it to that, I mn not sure he said it was cieora~l bv am'hodr rlse. Senator ^Soss. R'e will jnst have to stand on the record. I ttnder- stood it was cleared fr dl y Ihi s mo rni n;; before hc ypolce. Smrator Coon. Now, ,you said you have no comment to make on the fact that Secretarv P.iehardson nradc no comments about the faht that there should he any le_,islation in re~_ard to tar and nicotine. Is that correctB T158461183
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6'L Senator Coox. 1 don't think it was ambiguous. I think it is flat out you are opposed to cigarette smoking and you believe in prohibi- tion. You do not believe that all of the money that has been spent in HEW, all of the money that has been spent with your Department, all of tl.e fmids that have been expended to put the warning on the package all of the work that you and your Department have gone through to get consent agreements and voluntary agreements, to put ads in the newspapers is going to do one bit, of good at all. You think that the Gorernment should take this thing by the reins and prohibit this. Is that correct.? Mr. PTTOFSKY. No, sir, I do not. If I recall correctly, what I said was I thought it was appropriate for Congress to legislate out of ex- istence highly dangerous products to human health. That was arn- biguous. Senator Cooa. Eacuse me. Would the stenographer please read this back if the chairman doe?n't mindB I don't think he said any- thing about health at all. I think he said he felt it was something Grnn-press should prohibit. $enator Moss. I thint-k he repeated exactly the second time what lie said the first time. Senator Coox. I asked tho stenog_ rapher to find it in the record. Could we recess until she finds it@ Senator Moss. We will do that if you want, Senator, but we are nott going through a court proceeding here. SYe are trying to get in- fonmrtion before the conunit,tes. lf we mark up a bill, we will read that record front and back, top and bottom. Senator Coorc. Lett me say this to the chairmo-un-all right, I haee no object.ion to doing this, Mr. Chairman. Except I will say to you that wheu I stated to Mr. Pitofslcy that what he really wanted, be- canse he said it in the record, was that slowly and gradually bring the, tar and nicotine down, he didn't, say to zero. But he said that they would have the authority to slowly and gradually bring the tar and nicotine down. Now, without any level, this means to zero. And if it is brought to zero, this means tlutt this entire industry is de- stroyed. I think that is his attitude. I think that is what ]re said. .Ind I think it ought to be on the record as such. Senator U.oss. 1Vel1, I think he also said he favored the provision iu the bill that has to do with consumer acceptability. And we had some discnssion about how you fuid the line, how low can you take tar and nic.otine and still have consumer acceptability and those two have to be brought together for the standard. I am sure he said he would like to hring tar and nicotine down and that is the general thrust of this whole thing. But down to a point where you can still have consumer acceptability. Senator Coou. That is what lie said. IIe said he now wants to turn the FTC into a market research organization, over and aboN•e all of thce things the,c now do. Now you said in your statement, AIr. Pitofsky, that the range of tar on tests completed in October, 1970, was from 2 to 'I1 milligrmts per ci.gaac.tte. And that the range of nicotine from 0.1 to 22 milli- rnuns per cigtu-ette. Is tha.t c.orrect 2 Mr. ,Prrorsri'. That is right, sir. T158461185
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L 64 advertising that cigarettes are good for you. They are not advertis- ing itt will make yonr life a lot better if you smoke a paok of ciga- .reGtes a day. - Mr. Prrorsxy. That is true, Senator. But I would say two things aboutt that. First, there are solid precedents for the proposition that deception by silence is actually deception under section 5. And where a product is sold that involves an extreme health hazard, the Com- mission has the authority-that was the theory of the complaints I referred to earlier-to require that kind of disclosure. Second, it seems to me that it is true, of course, that the cigarette companies are nott advertising that cigarettes are good for you. Senator Coos. As a matter of fact, starting as of yesterday, they are goin;,+ to tell you in all advertismg that the Surgnon General says they are not good for you. Mr. Przorsrcr. That is true. Senator Coou. What more do you want, other than that? Do you still say you have a problem you ]rave to solve, when they have done exactly what ,you wanted by vohmtary agreement? Mr. PirorssY. 'Ihe problem is that people continue to smoke hirhly hazardous cigarettes. Senator Coox. You want prohibition. And you want the FTC to rule prohibition, don't you Q And, that is not yonr business. Mr. PrTOFSicr. \ot necessarilv. Senator Cooic. Ntnat do vou want? &fr. PtTOrssr. This statirrte calls for the lowering of tar and nico- tine- Senator Coox. Arid a review every 12 months. _1[. Pzmorssr (continuing). Consistent with consumer acceptabil- i tv. YSenator Moss. Would you yield? Senator Coos. 5'es, I will yield. Senator Moss. Senator Cook has eharacteriied this as a gleam in my eye. But the fact is that if this legislation should become law, the duty for arhninistering it would fall with the FTC. Is that right? Jir. Prrorsitr. That is right. Senator Moss. Just as flammable fabrics. I don't suppose the FTC knows very much about flammable fabrics, what damage they do to children, but when we passed the law, we assigned it to the FTC to administer. Therefore, it doean't seem to me inappropriate for you to comment on somethmg that is in the hopper of. Congress. Mr. Prrorssy. IIuless I am mistaken, the Commission indeed has commented on all sorts of congressional legislation dealing with flammable, fabrics of various kinds, in which it offered its views as to the point at which a product is'so Aammable it ought not to be sold. It seems to me that is an analogy to the proceedings that are going oa today. Senator Coox. Let me read you something in the bill, because I want to know how you will do this-"Such maximum levels may ba reduced periodically, but not more often than once in any calendar year whenever the Coinmission determines that lower levels are nec- essarv to avoid unreasonable health hazards." \ ow how are you going to do that? TI58461187
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65 TLr. Prrm*sr.y. You mean how would the judgmcnt be made tLat- Seiiator Coor.. The chairman jttst said uhe Surgeon General. I would like to get into the record just now that you can't use, the Surgeon Genera], beeause IIPW just said todav what they want is going to help you, lxncause thec don't want to help you. They want prohibition and they want you to join them, I suspect. ]1fr. Prrorsny. In respanse to your question, it seems to me there would have to be a fairlp extansive hearing- Senator Coon. Informal? Mr. PtxoFefiy. Not necessarily, Senator. It would not necessarily havo to be informal. They could be as formal as Congress directed- 9n which a ircord is xnac7e withrespect to the scientific sidc of this balancing problem, and I assame that scientists in government, as 77e11 as others who have a concern with this kind of problcm could testify; auid on the other side of the balancing problem, what the likely c,onsumer reaction would be if the sale o£ cigarettes, which currentlv have tar and nicotine ]cvcls above a certain lovel, wcre declared illegal under section 5. Sonic judgment would be made at where the line cocdd be drawn which would lower tar and nicutine levels, and not produce massivo consumer refusal to go along with that law. Senator Coox. Suppose it produces massive consumer rebollion. Whatt do you do? Go back to where you were before and say we lost, we will try again ? Mr. Prror•scr. IIndcr the statute that is what we would have to d o. Senator Coor. So we are really giving you an either/or. If yon can satisfy the customer, fine; if not, you have to go back to where it was. Mr. PrTorsr.r. Tha6 is right. Saiator Coos. It would be tough if you had that with thc soup compruiy in New Jerscy, if you had a law like that on soups, wouldn't it, if the customers still wanted it, you would have to say, well, I am sorty, we have to give in, because they want it. That wouldn't.nnike any sense, would it? This is not ,q_omg to make any tnore sense tban that. \Ir. Pzrorsr.r. We]l, I agree-of course, the u~ial way in which the government deals with ha.zardous substances is to ban their sale.. But I think in this case it is only practical to recognize tloct there is no sense bannutg the sale of cigarettes above a certain tar and nica tine level, if that is going to create a black rnarket for that kind of cigluettc. Senator CooK. And you, if you get down to zero, you will aban- don it anyway; if it goes above that, you are under the FTC Act and you have afining procedure under title 5. _AIr. 1'rrors.r. It secros to me it is rerv mIlikch-. under this law and n ven the criteria that are set out in this stat.utc, that we would ever go down to zero. Senator Coor.. How do you change section 5? Bec.ause the way it is written now. if you arc going to make an exception for this indus- try, sorne dav I expect section 5 will be thre~fourths of the code on t.hcL'TC. If-you say that it is not a separate offense for each sale, TI58461188
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47 Answer. 'Phe Public Iiealth Service efforts to decrease the health hazards of sinoking include, and will continue, on several major frnnts. Encouragement is being given to public information campaigns against smoking, particularly as directed to the younger population segments. At the same time clinical and pharrnaculoglca,l research towards cessatimt is being pursued, as well as studies to identify individuals at higher risks. Finally, maxinlum cooperation is being sought with the tobacco Industry and other experts, for the deGnitiou and conduct of research towards ever improving models of less hazardous cigarettes and their timely promotion to public acceptance. AVSwEns'r'n'r1fE (2IIESTIO]s DIRECTED TO T1R. 11TFRLiff K. I)II{'AL Question, Dr. Srrrarn.erx in Ais testimony on L'ebruary 3, 1972. diecns;,~ a book predicting longevity by 2ose anet Bell, a stxtidy in the Yeteraro~ 9dmini~l,a- tion. GnBoston still poinp on. Or- Sonamers xtated "irhen they e-:'c'l~im7 1rlp death in these cetevnns eatinp the s4m-pte statisNrs, onz to on,e, colrvgu, u; smokers and non-rrr,nkrrs, t7iet/ found as had oti,.vr struLies, theat amokir:a nas the mm~ber mw 7rred:uf r of' "'-M death from. a.ny/ oe-+, ^e, "Thcn vf:Aen ILen aPJ~li: n nr ,-, ' and nbore sopF.ben:"ted cronpa.risona tbay jmmd that cipa.retto s,.o,:ki,u, „olr,:l: hrpl drogr, .? ujJ th: 1•" as a Predictnr of mnrly death. it 9oas aem,,.l,~wc br-rni (A, Idtn ra,yn~ IL.r' ~hey had id.erctLfeed. Co-udd yotd proD{de an !,: u( ~:• o, O f fN i Answec-Dr. Sommers' comments on study of predicYGOn of longevity by Rose and Bcll (Rose, C. L. and Bell, B.. Predrictiveg Lon,qi i3Ey, Heath and Co., Lesing- ton, Mass., 3971). The authors consider in this book tue possibility that smoking is "secular," i.e., that the earlier death of those that smoked more and these that smoked cigarettes was due to tlre fact that they were botll born later and lived at a time when there was nwro smoking, rather than because smoking was lifc- shurtening." The hypothesis appears In be seriously questioned by the author of the foreword of the book. In this foreword, R. L. Nuttal of Roston College writes . . my opinion is that although tile cm'relation of 6.48 between cigareue anoklns rnd age of death might be reduced in a secular free design, it would still 1asub<r.urcial" Y,:: ~or?--Dr. dornrrwrs cited severaZ studics 2nhiein he qemted in the Y96D Aoo- + leea'wogg beginninp at page 1098. To hina these do not stpipord the conohr- sionx ot the I'wLMe I/eadth 6er'z=ice. Wove7d ?lotl provide t7ee Crnnnttittee arith an ana'aa.u oI tlae st+edios wloio7e he citea begis.ninp on paae 1098f An,wen-Hr. Sommcrs mentions a total of 10 research studies in the resti- mony cited by Senator iiartke. 5everal nf these have been corered in successive reports of the Public IIcaith Servirc on the Health Caneequences of Smoking: the rest were not, being considered too peripheral to the question of smoking and health to warrant mention. In our opinion none of the studies brings into qnes- tion the relationsbip between cigarette smoking and die.ease: some of the studies. indeed, support such a relationship, as Dr. Sommers acknowledged in his te8ti- mony. The studies are diseussed brieHy below in the order in which they wcre mentioned at the hearings. (a) Lnndman, T. Smoking in relation to Roronat;y heart disease and lung function in trvins. A co-twin control study. Acta Medica Scandinvica (Stockholm) 180 (Supplement4:i6) :1-75,1966. Landman used twins to study the relationship between heart disease and cigarette smoking. The twin study is a valua.ble tool for the control of genetic factors in population studies, but the prevalence of overt in silent coronary heart disease was, as Lundmun concluded. "too low to permit of definitive conclusions." The reWrt is based on dnta available from 8wedish twin study up until ]9flli. Since then, several reports have appeared based on data from the snnlc registry. 'Ph~we f 13efs. CV (1uS11 37 to 40 aud Re.f, CP (1:)7"1 '3.5 and 36) havc bt-en rnm- meuted on in detall in the 1971 and 1972 Iteports to Congress (1971-pp. 48-52 and 1972-p. 31). (b) Sohnsnn, K. C.. Yano. K., Kato, H. Coronary heart disease in Hiroshima, Japan : A report of a six-year period of surveillance, 19i8-1964. American Journal of Public Flealth and the Nation's Health 58(8) : 135i.-1367, Aisnat 19f8. This is a study of 9,270 tnen and wemen of Hiroshinla to determine the inei- dence of myocardial infaretion and certain risk factors associated with (lie de- velopment of heart disease. The stndy states that people who developed CIII) smoked less than the controls, but nothing Is said about the role smoking played in the development of (7HI). Because of the lark of precise data concerning smoking habits and t,he fact that smoking habits of individuals are considered only a}ter T158461170
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61 Mr. Prror+sKy. That is right. - Senator Coox. Now,.this is also true, is it not, in the cnrrent FTC report to Congress which you are filing here today as an exhibit, there arc no recommendatiuus made? Mr. PrrorssY. Thc Commission in its present report to Congress, at thr, limo it was preparcdL had before it the pendinh complaiuts in thosc cases that I have described against tLe six cigarette cornpzuiics. As T understand it, the Comnris.sion felt it would be inappropriate at that time to make any recornmendat.ions to Congress on Qicse matters. Senator Coos. Is that why yon are making your reoonrmendations in regard to your division and not to tlic Commission as a whole? -lir. Prira'sxr. TVe11, I am representing the Bureau only here. I was invited to testifv. Of course, my statement was not cleared with the- Commission and that is the reason I aiu not attributing it to the Comniission. Senator Cooic. Your statement, then, is the personal position of you and yonr ow*n Bnrean? ht. Mr. PrrorsrY. 'Phat is right. Senator Coor.. aud yon do not have any knowledge wh.dsoeccr whether the FTC is in a};reement .vitb S. 1454, whethcr it is willing to accept it, whether it is not willing to accept it, whether it is will- inn to ma.kee the chrurgcs you recommend? These are all based on yoin• own ideas and thonghts? Mr. PrrorsxY. That, is right. Senator Cooli. Now, aprevions Surgeon General, Surgeon Gencrmrt Stevi~ai•t, said dnrinn the 1'J70 appropriutions hearings that lie would uot likc to see ci.,,nrettes above a certain level of tar and nicotine bau.neii frorn thc markctplaco. He said people should be able to clroose a lower tar and nicotine, assnming they have had all of the information related to cigarette snokin g. Do you beliece people should not have that choice? Mr. 1'rzorISr<r. TVith respect to cigarettes I believe they should not have that choice. Thut i, ritht. . Sen:rtor Cooqc.'I'hev sl_rontd not have tlrat choice'4 Mr. Prroi=srCx. Yes. !I tb.ink it is appropriate for Congress to legis- lai, md. of ~'..,Lrncc ccrtain extrenicip dangcrous products. Se.naror t'rc. And yon concider ci(,arettes one of them? 1Ir. .:cr-. That is riolit. jT'r11, than, if tlris bill were to pass, it would he prt -:.n'l Q ils imhlurneutation to yan, who do not even harc qn ol ,,rive ~~iew toIearil il.. You are totallv and cornpletcly for prohi- biti" ,, w}hi'i ~n h;we jnst said. I would lot the stenographer rcod the words bv,le to you, if yon hlcc really said this, that the Con- gres, of_ the IInitecI Statos sliould empower the FTC to deal with this in t! Lc rcahrr of healtb, not personal choice. Therefore, do you think there is any way you conld act in an tnr biEisal mmmcr io promnlgatins rules and regulations on this? Hr. Prrorsrw. Let me be clear about this. 5enator- Senator Coox. You better hal it read back, what you said, be- causc it is pretty clear to rne. ryfr. Prrorsr.r. It may be what I said was anrbignons. T158461184
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48 they have developed CUD, the etudy has not been cited iu tbe Surgeon Ceneral'= reports. (c) Brnlm, J. G., lColf, i~ . Tgvn, T. A., Bird, 11. li., Chandler, B. Social as- peets of coeonary luurr tll" i .. iu a Pmtnc,rh-aniu Gcrumau comurnuity. Soclal ScieneeandAtediuiuc- -"l-_u.Tni, ]DGii. Thi.s stu(ly was not dcsigu, •I to ~nIablah or ecau,inc I]te role of smolcing as a cvusa of heu't discase. Vo i rurn:utlon is givuu mi the uumber of heolile 'hu sulnl.e:7, Nj7tat they snmLed, hmv nntch CIlec pmutcud, or how long I:Ley suoleerl. (,di Rrown, B. C., Bltznran L. 5ometactora ansoeiate(i n'ith absen=n,rT •~~ruualt;v hcat rliin ]e ,ons aged tla or olderc Jmtrn:it of tho ar..ti' _:u: Geria.tr vs SecieL, 16 ~:~ I: S38 =d9, Alarch lali7. 'rhH smm.yr.patterns of 133 elderly pa.tient~ who did nnt br+rn -mouorr Itrnt di_~, :. uid ia be uot significunlly ditl'creot troln It_.6 ( LLr-+il-u] _r. rl.,l( IUU el~l.rl, pptielta tcitlt CIIlI-t no ynrluti>tng fin1lim ~ iu pet 1 1 1_<-d ~, a,.-.tuttrlt of Ihe efeut of 'i okine in Ihn dmenl l-liL ocr-t , s rn earlier rler,tides ol' I t_ ]Ioreoc,r, such -,d ( t,.nLitalm.ed pntu-n19 eNclnrlr,t anbvtmttini nuntber of Cill) victiuu4 mb1 r.i ;c nndden (bnth am] con- qi: ,tly never reach the ItocpilaL This slnrly a. - i'~' in the supplrmentnty hiblingraph nf the 1'.liq n•pnrt to l'onlrrxs. lel Bes(, E, }t'. K.. Wallker, C. B., et al. Simun;up a Caumdinn nhidy nf s1uokln;; n.ud l:eodth. C:uutdian illeflicrl Asw,clarion dourna] 9G(Yo1 : 110-I-11Ctl. .lpril1:i, 1067. - The ontotanding lindiog of this :;tudy tvas thc rignrette stnotera oompurrd to nmrsmdcers hail c'ce€sit-e auurtulilp'. P::rticula~9v frooi benrt am] circuletmy di5eases, hntS canccr, cuul brmrchitis und r:ubihycema, 7'hc rnornility rntios 8a henrt and circulatory dist~2ses were elet'ated e'en for hRnso ttLO sntohed cignr- ettes lrsp tlmn fkc ye¢rq und ectneined reizttivel,. ennatnnt as tl.c dnr:,lion of aouoking increased. (f) AnLry, F., Collins, J. P-, et n1. Etude de I'Hahitndo de Fnnmr en Heffititat 9vec POccn(la.tion. (~"tudi of d,e S'uokin- lnbit ill relaiion to occapation.l C,tnadian 7ournai of Public Health 67 1 4' 1'.~ -. .42. .Ana :ust 11006. Sottriug is snid ubont sruol:in_ cnd b.~ It iu ;I studp of tLe rtdatian of s'moking hfibite nnd occups(ion. (gl Throne, M. C., Winc. A. L., PaffruL~u,r. R. S., Jr. Chrenir dt,eosr in former cnllege stndnnt'n. VII. Llarlc precn^a'~ of minfstai cormutry hcarc dit;- ease. dmerican Tonrnal of Lpidrniinlogy f~;1 : a`d0o'_'l, May 1f105. In this sttldy of fnrnier wale uulcer:~~y sludeuts under the age of 30, Cce characterietics iu yonllt tcere iournl uz;,.oci:tted ~titii ti.e Inter decoloptnent ot nrmfntxl eoronarg heurt dlsonse. Ci,nrettc r'miilcir, mns found tn be ot:r• of Il:c G,e charactet'istics. 'Ihe etudy in citod iu tLe 19(i`7 ropnrt nn the Rtnlth Con>r- (Inences of Smol:inK. page 1(1- (h} Truett, J., Cornfield. .7., :md Rnnnol. R-. A nmlti.:uriate aualcsin of the risk of coronarc hoatt disense in Frnminghnm. Journal of Chronlc Iliacases Yo: u11-+T_-1, 11JIYI. pfl.arette sntoki:g "us ciled aa mre of thc most intVOrtaut risk factor,s in corenary he:u't disease. This stnQy 1s relerred to in the 1967 und 1fRiS ropurl.e on "Ti+.e ]Iealth ('onlequr-ms. of 3umi.nig;' on Pug(,s otl anfl :?5. rc,upoeilc<7y. (i) ]frnri.q \F. iT_ SL iieurt diseass iu fa rn: v-oi3cera Cnnadian ]IC•dirul Asnvr- ciatiun J onrrm I!1(i : h31~"-l. ]Parch ?3. 1511:7. Tae :IVrail.insterl incidence rates of corouary Leart Oisease fnr non,, 4cars aix 2_7 and 3.4 for tt:c fnreu erout, aud 95 ru,d i.8 fnr the rmnfar,nvr._ Chi.v Would inriicnte tLat altbon,ylt tbe farmer< hnce les CAD, =moker5 hni ~ ,'e (7131) thun nonsmnkors it7irther Lhoy ore iorusra or not. T'o r1aN nrv: '~. i. m vmtilciny,' hmbil:s of tbe entoliers on tiha fa"n or in the e!ty. The sl.udy tc. -1 su n snplilemental referencc in thl ]`iu7 ref4 ot rm rhe Iloalth Conqeqneu of-~rI nl:- im<. - (i) Simnta, S. FlVir:-~~iolo~rieal Andies relntod to mronnry hearl di~..~ , (1hn.n~teriutiee of ud AO-63 in scven countrict. A fltrnuinp; twd u ii~in~ vilPge in Sapan-TUOt>nooaru und C'shibnlc:iI dcta .ilodica 8nantlinuvira (1n(. ploment4601:'131-: "1'~- In this suet'e~ of un u:-~T b° -p, S6 ro Fp percent snoketl mtd c;nre founrl lo l:acc lower bloodd pr' .>.-irIl,nu I Lnsa icho rlid mtt ,molre. The =mvec ~r:,> -i c- sYgned to deterndine the rnle of tnnolcin;_; in Il,e devclupn,ent of he.rt .G,~ ~-- If thn pnpnLatinn Intd beeu follonrd over a period of time, it would havr bi n in- tarr+.l.ing lo ser• ihe diffareuce in rhe dovelaVment of ecmnary Leart di-„.e iu smokors nnd in nonsmnkrrs, . TI58461171
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nething. The staff acts as the prosecuting ssttorney. itary ;,.gt'P The stafC acts as the purveyor of evidence to the jury, which is the vife out ,e n~o i f ommissiony whieh authorized the study in the first placa So it is pretty tough to come out of there with a pretty good rul- itered int ~s, '~~~ .. ,": . Mr. PrzorssY. Without agreeing to all of what you said, Senator, it certainly is true that tbe Commission wins most of its cases. that is fine. That is what I wanted. All ri~,ht. Oli Senator Coox . , rse. C.c,ln_I Now, Mr. 1liles Pirkpatrick, the Chairman of your Commission, January 37, in remarks before the 1972 Con- said last Thursday , sumer sumer Assembly of the Consumer Federation of American: `°Con- hoW thn _..-...,._.. ,.i.....lA L.~ N..,i„ ..m,, nl.nirn .,~fhev th_in hnvinn ..... uJ~ .,.. ~.,~,.. .., s... ~.......,...,. efer u« ,~..,,., ring He remarked that bhis conviction rested on American economic nent of and political theories. I)o you a„rue with him'? on the lqr. Prw)rsxY. In gencral I do. A th re exce tions? t S C re e p ena or ble ooh. 2e- ~ Mr. PiTOZSZ:x. Yes. Senator Coox. All right. ;, that Mr. Prrorsxx. Let me sa.y II listened to your remarks this morning ot the along this same line and I tend to agreo with you that, if at all pos- tV[as sible, govirnment reTulation shonld limit itself to the role of giving pcople relevant information and permitting them to make their own o s'x choice, even where that choice may have adx erse consequences to the :jba Nonsnmer. ~0115, 1 woiild havc, to add, however, that t1Le record in this country ocer Ih~~, the last 10 years, from what the Commission knows about the health tied haaends of cigarettes, permits Congress to make a judgment, and the the Bureau would nrge that judgment be made, that cigarettes are spe- cial and unique, virtually unique in this context. Senator Cumc. Wh}• don't von bring a case before the FTC against American Motors and Chrysler and General _l'Iotors and Ford Motor Co. saying that it is absolutely got to be mandatory as of January 1, 1978, not a speedometer in t1m IInited States should 'e record a speed over 50 miles an hour? Because the statistics on acci- e dents over 50 and between 50 and i5 miles an hour are horrendous in the eountry and c:mses an immuinent and absolote dan;;er 1'o tbe ' American people and therefme somethint= should be done to protect their lives. jlr. Pirur-sr.r. 1 am not familiar with the st:distirs as to tlie association bctrwceu spced, speed alone, and mortality on our hi~,=h- waN s. I would say this: If that association were proved to the extent that the association between cigarette smokinr and serious disease has been proved, I,kmuld lhinlc the Commission should entcrta.in that sort of remedial approach. Seitat.or Comc. Yoir ]miof is the report of t:he Surgeon General? Mr. PrTOrsr.v. Tce, sir. 5enator Cnor. Arn y-ott familiar with the faet that the agence that is responsible within the >urr.eon General's department to dissemi- nate information to the. American people that they should not smoke is the same agency that produces the report? Doesn'tt that bother you? 9]-Vli~ ;- ~ T158461182
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32 These consent orders worild provide that in all print advcatising- and this would rarrge all of the way frozn point of sale materin.ls np through nen-spapers and magnzines to billboards-there would appear the Strgeon General'?.varnirtg. It wonld be blaclk on mPute and enclosed in a reetangtlar form vrith a bordcr in black. Thc warniny itself would vnrc in size depending on the size of thee publication in ivhich the adecrtiso.ment appenrcd. For ccauiplc, ill a nragarine approsiiuateh' the aize of TV Guide, a fnll pal"e aclvertiseluent would reqnire a w,2rving in 10 point tvpe; in an ndh'ertiscrrreut approximately lhe size of a fall page in 1~Teiva- week, it n-ould bc 12 1>oinit type; a full patre ad ill l.ife magazinc wonld irquirc 1-1 point, type and so on. On thc average billboard in this comrtrv. the lettering itself would be not less than two iuches in size. TLcre are also 7novisions in this order wbich vcould require that the « ruring itslf be isol tted Srom other letters or shapes which might detract atlention from it, so that there will be no ennfnsion as to the wtunin~ itself. These consent orders will be placed on the publio record for 30 days and pnblia wmment will be invited. Assuming the Commission decides on the basis of any record made that the consenff onler;s ;ne in the, public interest, a frnal order will lre entered and ren cani cxpcct that hcall]i waaraings in print azedia will bc-in to a.pprrer a,hout 2 or 3 months after the final order is entcred. alNron"'h in some print m?dia, snch as billboards, it maT take lmn_er to briat„+ about this change. '1'he Commission etaff is nmv collecting and tabnlatiug data c•olr ecrnina ciuarette salc_ and adeertisin; cxputdittrres for the 12 rnnidhs of P71 from ull domestic ciunarette manufaetrn-ers. When this is tnbulated a statisticril supplenent to the Comniission°s repoa't Nr-ill be stbmitted. Tt is not necessarv io a~critt the restilts of such a fornnal mctvmrt- im" to iual-;c a f:nw nbservakious about I~hee general direetion of the sLifL in media uaed bY ci-1'su'ette adveitisers. Using data obtained from nnot7icial smnes, fm•the first 6 months of 197o and 1971 the- Commission sta1P obserred thre, germral trends in media select.ion bi ci garette a dvcrti sers. First. there has bee.n a raxlnction ill total ci,rarette advertising espenditrnrs during 1971 as a result of the discontinuarme of advcr- tlsing in the broadcast media. Data used bv the Commission staff iudir.ttes a reduchimr ill total mdvertising espendit.m•es of 30 percent. Recentlt the Tobacco Institute, a trade association of eigareUte mau- ufant.nrors, placed the reduction at 28 percent. Seroatd, etnergencc of ma,r,azines as the printripal advertising rneliimu fur cigarette adtcrtisers during 19TL, zvith cspca.ditures mmrc than doubled over tdrosc for 1970. Third, grcrthT increased espenclitures by ci,,arette advertisers for newspapers and billhoatrds during 1971. with increases in newspaper supplements more tlmn tripled over 1970. and billboard developing into a major cigarette advertising medium dnring, 1971. Let me say a hust word about the mattcr of legislative recommen- dations on the part of the Commission. In general the Commission is concerned about those recommendations which ivould assist the TI58461175
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r 46 of the room. And vou not onlv agree, you conle up here enthusiasti- cally, even thourh'it is tS70 million or $80 million short of what you wonld like to have-is that not true? Dr. DUVAL. Yes, sir. Senator Moss. Thrlnk you very mnch, ffrntlclnen. This has besn a very fruitful session. Zti e have been talking a lot about bias and pre- dilection to some point Of view, alld I think we have got that fairly well behind us. Senator Coolc. I might say, Mr. Chairman, I have some questions I would like to submit to them, and I would appre,cinte it if they would answer thmn and put their answers in the record. Senator .lrfoss. I would ask the witnesses, in the event written questions are propounded-and there may be some-that you supply us with a written answer. . We will keep the record open for 30 days so we can conlplete any points that were left unanswered. We do thank you very much. (The following information was subsequently received for the record : ) AS5WILR6 TO THE QUR9TIOSS DnnuCTEn TO DR. JEssE L. STEINFELD BL .SEEA'1'OR IIARTI{F. Queetiora.-iGe have beem hearing a Zot about tars anfl. 'nlrerurc reduetio9a and we all want sa)er ctigaret tes. i r'rad a statement in. your 1971 y-r,r,! I ynote: "The poltYnueear aromatic ly;r;rocarbosts liab d are oonxe.~1 to pyuy a verg sEgnvficrwat role in pa7ononaay ,rretnovna dtie to tobacco ew .47usnaearestomethntthchuriocarbonsnr- , -, :o~itphnpr- Th.eseareatso part of the tars and srorrld 1., . rrd,rrrd, I u ^Irl t4i,k II ! r: ia p, ~ttr eovnneent orn what has been done to re,Sd!a th.. I.yrLnacarbr< c,,n (, u.t' Answen-Polymtclear aromai 6hydrocarbons (P AH) are :.i;;niBcimt contribu- tora but not the sole, responsible factcr in smokinv related carcinogenesis. The methods to reduce PAII in clgarrre smoke are : (a ) The use Of tobacco leaf stetns and reconstituted tobacco sheets as significant proportions of the cigarette blends. (bl The nse of filters to reduce emivsions of tars from cigarettes. (c) Utilization of tobacco rurieties conlainin,a less PAIi premmsmos such as wazes, terpenes, etc. (d) The use of speeial additives, su9t as nilrates, that may favor more complefe combustion of tobacco. (e) Tlre usc of cigarette enb'inecrina techniques that favor better combustion of tobux=co nnd dilution of the snolce, ench as high pmnsil,y par,r. m.-rse tobacco cut, perforated tips, etc. (f) The nse Of mbnccos from wLicL I'AII piccursrrs have been ectrneted by specific suh'ents such as besane. ti.rsr, h'ron~ rcading Dr. Wytnder's rosea'rch anrt from yovtr tablc on page rnr.rt -qy- s tr> us that benao(a)Pyeun irv thtswst o{ tlrr.re Dr. 16Und':' said in a 6'clence 11ogrzinr' articZe r.j ]'ocenaber 3u, I"G`: ,rnd f nrofr: -rt7.u~45percvnt)inth n~rrmeweciamrox- ta vLrrr,ry U'' ~~ Jvrnnd to relate to a eeqr r]artJon in the 77r 'qf,r, :.lst (/+„l::*vr- f,,.-„.:,reffortxtomrrrd.zvvrhr, '~ngthebenco(rr)- ~. p7Irr r fm" rnmr I r l. ,~ rr,l ren ^y hai•e a safer cigarette /rrmr tRe Gruup r rqzirr~ r r•-- > L, 'f 1 'l,G'r%eeNciththrisF Ar~=,ve'_ Itisverylikelythatreduclinofbenzo(a)pyrene(naP)inciznrett:e smoke n'ill prodnce a redactiun of the total carcinogenic capacity of the smoke. Dr. Tpynl9er in the quoted article refers to RaP as an indicator colnpound, its reduction in crnoLe being usually paralleled by reduction Of other noxious P_AII, as well as of other probable carcinogens present in smoke. In other words the re- dnction Of the carcinqaenie capacity of smoke is likely to be obtuined by the rednetion of entire clusses of potential carcino__nens, and not necessarily by rerluc- tion of BaP alone. Que-ntion. Doos gonr o.lJtce encourage the tobacco irulrzxtrp to prorlu,ee clpw'etles rotith redr[c'ed B7piroc<rrbons in tlee tars as'a elt as reduced tar anrt rnicotiur_? T158461169
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66 which would be a$:i.0o0 fine for every pack of cigarettes that is sold over a particrdar conteirt. of tar and nicotine established by vou, and pon admit you are not prepared to set it now and you don't have the maohinerv to set it, how are you going to change it so that this industry is considered emv different than any other industry? Or is it because you want to pick this industry out 9 ~Zr. PrrorsKy. Senator, I really don't think that this general approach is much different than the approach that Congress has used with respect to flammahle fabrics. The FTC was directed to follow standards established by the Department of Commerce and enforee section 5 so as to prevent the sale of certain fabrics that burn in less than a given nnmber of seconds. That seems to me to be an analogy to this situation here, although there is not in that stat- ute. nor in miy st,atnte t.hat, my attention has been directed to, this factor of what the consurners will go along with. That is the differ- ence. S want to grant irnmediatelv that this will be a difficult statute to enforce, because of that novel factor. But I think not impossible. Senator Coo>t. Mr. Pitofsky, let rne just tell you why I am pursu- ing this course.. Frankly. I don't smoke, but let me make this very clear to you: What I object to, in vour testimony, in Dr. DuVal's, in the approach that is being takett Ircre. is that you really believe it ought to be banned, and that is in the record. I don't think there is mty question about tliat. Tf you want to introduce a bill to prohibit t.he growing arrd sale of tobace.o. let's face it'forthrightly, and don't nibble a.wnv at somehhing little by little by little. Tf you want to do it, let's do it fair and square on the record. Let's Lal.e a bill over to the floor of the U.S. Senate and sav let's prohibit it, let's prohibit its sale. Let's prohibit its growth. Let's fight it out on the merits. Let's not nibble and quibble the way the American peoplc consider they are bein6g nibbled away at on e.verg little thing that comes before them. No are saving we dmi't want prohibition. Don't tell me we don't want prohibition. Se.nator 1loss would really like to have it, but, says he, it is impractical. Rttt that doesn"t rnean lie doesn't waut it. You havo stated it ought to be controlled and banned, so I tirink thisclears the, air on how vmn feel ahont it. So if that is the way you feel, make a reconmrendation to the Con- gress of the United States it ought to bee prohibited. Let's see how far we get with that kind of a bill. Let's not nibble away at the right of the American people to make a choice whether something is good for them or whether it is bad for them. Let's let them malce that choice and let's lett them stand on their own two feet as 60 mi1- lion Americans and make that choice. I think we are beating armmd the bush when we talk about, infor- mal hearings to determine nicotine and tar contents. You said 25 milligrams. You have no knowledge as to whether this is good, bad, or indifferont. Dr. DuVal said zero. Here we have a bill that gives the authority to vou. You make a statement that says the only way you can do it is to have the work and cooperation of the Public Health Service who says they- are not ping to give it to you. So if we are going to facee something in this country, let's face it forthrightly and squarely, instead of beating around the bnsh. T158461189
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67 That is my only point. thank you very much for your time. Senator Moss. Thank you, Mr. Pitofskv, for your testiniony, responding to the invitation of this conunittee to come artd comment on the bill which is before us, which is written out-I recognize you didn't write any part of it, nor recommend it in the first place; we simply asked you to comment and you have done that. Arid I apprc- ciate it very much. f appreciate Mr. Thain and Mr. Bratmninger being with you at the table. Thank you. . Mr. Prrorsxl-. Thank you, Senator. (T7re statement follows:) STATEMENT nF honSWT I'19'UN6KY, Ll6W`CTCn, Bt*IiEAtt OF (;UNSTMEH YADTECT[ON, Fiwn:uar. TuAue Coxmrtssms Mr. Chairman: Thank you for the opportunity to testify before the Con- suuler Subcommittee of the 8enate Committee on Commerce. At the outset, I would like to emphasize that my statement represents the views of the Bureau uf Consumer Protection, not those of the Federal Trade Commission itself. Certain consent orders, involving cigarette companies, have been provisionally accepted by the Commission and I will discuss later both the orders and the procedure for considering them. The Commission has tukeu no position on this bill because it will soon have before it the question of final acceptance of the order and may have to judgc cases which might result if the orders are not flnally accepted, I will comment on 8. 14C>4, a bill to limit tar and nicotine con- tent of cigarettes. Additionally, I will discuss the current status of proposed complaints against six major cigarette advertisers which seek to require a clear and conspicuous disclosure in all cigarette advertisments of the same statement which is now required by law to appear on a1L cigarette packages; the shift of cigareLte advertising from broadcast to print media as a result of the enucttnent of the Public Ilealth Cigarette Smoking Act; and broadcast messages to discourage cigarette smoking. The Bnreau of Consumer I'rotection has given careful consideration to S. 1454, because its provisions would place in the Colmnis:aon tlre responsibility to establish maximum levels of tar, nicotine and other substances in cigarettes. 'fhis bill would amend the Federal Cigarette Labeling and Advertising Act by requiring the Commission to promulgate standards establishing "maximum ac- ceptable levels" of tar, nicotine and "other incriminated agents as the Commis- sion determines may ne present in cigarettes" within six months of the date of enactment of the proposed legislation. The term "incriminated agcnt" is de- Gned in this bill to mean "any constituent element of cigarette mainstream smnke which is present in quanticies suIDcient to be a health hazard." 'llhe bill requiros that stnndal.9a promulgated by the Commission must limit the qnantities of tar, nlctliine and other Incrimillat4:d agents ill t'igarette smoke to "quantities which will not pose an unreasonable health hazard" but which are consistent with "consumer acceptability." By the terms of this bill, cigarettes conforming to such a standard could not be "3o unacceptable to a substautial nulliber of cigarettr• smokers as to create a market for the illicit sale and purchase of significani quantities of cigarettes whirh fail to meet such standard." The bilt further authorizes ihe Commission to reduce periodically the masi- mum levels of tar, nicotine and other incriminated agents in cigarcttes, but not more often than nnce during any calomlar year. For several years the Federal Trade Colnmissiou has been concerned with htr and nieoHne contcut of ci;;arettes. This concern results fronl the relation- ship between hnmau health and exposure to tar and nieotine by inhalation of cigarette smoke. In 19b'7, the surgcon Qencral of the 1'uLlic Health 6ervice re- ported that "the preponderance of scientific evidence strongly snggests that the lower the 'tar' and nicotine content of clgarette smoke, the less harmful are the effects." That satne year the Commission adopted a methodology for test- ing cigarettes for tar and nicotine content, anFl direrted that sPaff to begin testing cigarettes using that methodology. Since then the Commission's labora- tory has conducted nine tests of domestic cigarettes for tar and nicotine con- tent, the most recent of which was completed on August 6, 1971 (Exhibit A). T158461190
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70 keyed to advertising deadlines of the media covered. Full compliance in all media is anticipated within six months of the effective date of the orders. Last month the Commmission sent to the Congress its fifth report on cigarette labeling and advertising pursuant to the Public Health Cigarette Smoking Act and its predecessor, the Federal Cigarette Labeling and Advertising Act. This report includes abservations about the shift of cigarette advertising from broadcast to print media, during 1971, and I would like to make this document a part of the record of this proceeding (Exhibit C). As this report indicates, Section 6 of the Public Health Cigarette Smoking Act has thus far fulfilled its basic purpose in that it has effectively denied the use of broadcast media for the promotion of cigarettes in this country. During the final weeks of 1970, sevcrnl articles appearing in trade journals and general circulation periodicals speculated about a number of schemes which cigarette advertisers might em- ploy to avoid a complete brm on broadcast advertising without violating the letter of ,ycetion 6. '1`he possibilites envisioned by some journalists did not ma- terialize in 1971 into any serious thrcat to the acluevement of complianrp with either the letter or the spirit of Section 6. TLe Comxaission staff is now collecting and tabulating data concerning clga- rette sales and advertising expenditures for the twelve months of 1971 from all domestic cigarette manufacturers. When this tabulation is completed, the Sgnres for 1971 will be published in a Statistical Supplement to the Commis- sietl5 report, as we dllne 1nAt year. However, it is not neceNsary to await the reenlte of such a formal accounting to make a. few observations about the general direction of the shift in media used by cigarette advertisers. Using data obtained from unoiGcial sources for the firstt six months of 1970 and 1971, the Commission staff observed three general trends in media selection by ciga- rette advcrtisers: 1. A reduction in total cigarette advertising expenditures durhtg 1971 as a result of the discontinuation of broadcast advertising. The data used by the Commission staff indieated a reduction in t,oixl advertising expandi- tures of 311 percent Recently, the Tobacco Institute, Ine., a trade associa- Hon of cigarette mmnufaciurers, placed the reduction at 2S percent. 2. Dmergence of magazines as the principal advertising medinno for eiga- rettc advertiscrs during 1971, with expenditures more than doubled over those for 1970. 3. preatly incraaaed expenditnres by cigarette adcertisers for newspn- pers and billboards during 1071, with increases in newspaper supplements more than tripled over 1@70, and billboards developing into a major ciga- rette adve•tising medinm (hnring 1971. In its most recent report to Congress on cigarette labeling and adverticing, the Commission did not include any legislative recommenda6ions-, because at tlre time that report was writteu, the possibility existed that consent order ne- gotations between the Commission staff and representatives of the six cigarette advorlis-rs might fail. Had sucb a possibility materinllzed, the Commissinn did not want to complicate adjudication of the six cases by issues of alleged Com- mission prejndgment. 'fbe Commission may include legislative recommendations in the forthcoming Statistical Snlrplement to it.s report on cigarette labeling and arlvertising. Last year, among the legislative recommendations made by the Commission in the area of cit,'urettelnbeling and advertising (flalubit D) vvere proposale: 1. To increase appropriations to the Departalent of Health. Education and Welfare for education of the public, especially young people, about the health haaards of cigarettc smoking; and 2. To encourage the widest possible dissemination, through all media of mass communication, of inessage to alert the general public to the health hazards of cigarette smoking. As you know, the Commission's basic function Is that of a regulatory agency which is authorived and empo.vered by Section 5 of the Federal Trade Com- missinn Act to prevent unfair methods of competition and unfair or deceptive acts or praclice in commerce. The Commission's activities in tLe area of elqa- rette advertising and labeling for several years have been directed toward the discharge of thie basic statutory mandnte. At the same time, our involvement with issues related to cigarette smoking and public health makc-n ns sympathetic to thoce private groups and govern- ment agencies interested in making the public more aware of the health conse- quences of cigarette smoking. For that reason, I favor the enactment of legis- TI58461193
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71 fation to facilitate the dissemination of information to the general public about the dangers to health acsnciated wilh cigarette amoking. Thank you. Senator lioss. ~L:•. Horace Pornegay, president of the Tobacm Irstitute,lvill be our next witness. Mr. Kornegay, we are glnd to have you befmr, us. AVe look for- ward to hearing your testimony. STATEMENT OF HORACE KORNEGAY. PRESIDENT, TOBACCO INSTITUTE, WASHINGTON, D.C. 11fr. Iiax. ea_tY. Thank } ou very much, Senator. SIv nsulr, is IImrace Iiernega~, aud T am prosident of the Tobacco Institute, an association of various U.S. tobacco product manufac- tnrers. I have held this positimi since .I une 1970. As the spokesman for cigarette makers of America, Senator, I welcome this opportunity to testify before this distinguished suh- cornmitteo of the U.S. Senate and cettainly oxpress uly appreciation to von and other members of the subcamnittee for this opportunity. Let me state at the outset that. the cigarette industrv is as vital7y concerned or more so t.han any other group in determining whether cigarette smoking causes human disease, mhether there is some ingre- dient as found in cigarette smoke that can be shown to be respon.si- ble, and if so, .vhat, it is. That is why the entire tobacco indlrntrc-grorcers, warehouselnen, and mannfactnrers-since 1954 ]las committed a total of 5}0 million for smoking and health research through grants to independent sci- entists and institutions. Thatt is why the tobacco industry is spend- ing more money in this special field of research than ar.y other single source, Govenuneut or private. Despite this effort, the anstivers to the critical queshions about snol:ing and health are still unknown. Let me first brieflv review the conduct of the cigarctte industav in relation to this enntinuing and unresolved coutroversy. Its condnct has been both responsive and responsible to an extent unparalleled in American industry. Here is a brief clronicle of the tobacco industry's record of rceponsible self-regulation a.nd other relevant voluntary action. These are actions taken in an effort to resolve difficult policy ques- tions arising out of what is essentially a perplexing scientific contro- versy. ln 1063. the industry stopped all promotion on college campuses. In 1964, it established au advertising code to limit its message from rcaching yoath audiences. Although the code has been tecluli- cally tmminated, its principles are stil I arlhered to. In 1967, the industry began a continuing program of technical assistance to the FTC, related to the Commission*s tar and nicotine testing. While we have not always agru;d with the results amrorulced and continue to question the significance of tar and nicotine content of cigarettes, I believe the industry's contribution of its expertise in this testing has been helpful to the Commission. LI 1969, the iudnstly eohmteered to stop all advertising on radio and television. Today, eigarette advertising is off the air waves as a TI58461194
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94 I was rather disappointed that a new face within the confines of the Surgeon General's Department would come up with the same line that has already been discredited. Thank you, Mr. Kornegay. Senator Moss. Thank you. Mr. Kornegay. Zi'e appreciate your coming to testify. We will now be in recess until 10 o'clock on Thursday, when we will continue these hearinga. Thank you. . . (`irhereupon, at 4 p.m., the hearing was adjourned, to reconvene .,at 10 a.m., Thursday, February 3, 19i2.) T158461207
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ss In 1970, the Commission initiated a Trade Regulation Rule proceeding to re- quire disclosure of tar and nicotino content of the featured variety or varieties, based on the most recently published Commission test results, in all cigarette advertising. In response to this proposed rulemaking procedure, eight doinestic cigarette mann£aclru•ers agreed to make disclosures of tar and nico- tine content in cigarette adti^ertising on a voluntary basis, and tJie Commission suspended its Trade Regulation Rule proceeding indetinitely to aHord these m[omfncrnrcr, w opportunitv to iamplement their agreemenL Only one domestic cigarette manufactuxer-American Brands, Ine.-was not a signatory to that agreement. Cigarette advertisements which coutained disclosures of tar :md nic- otine conLent in accordance with the terms o£ the industry agreement began to appear in February of 1971, including advertisements for cigarettes manu- factnred by American Brands, Inc. i by the end of the year, all cigarette adveo- tiscments published by domestic cigarette manufacturers which the Commis- sinn staff observed were including tar and nicotine data. The Bureau believes that reductionn of the quantities of tar, nicotine and other bazarduus components whiclr may be present in cigaretre smoke is a de- flirahle objective, The Burean would prefer enacttnent of legiSlatiOn Wltlch fo6- ters within the cigarette indastry competition on the basis of reduced quanti- tics of rar nnd nieotinc. For c~arnple, reqniring label and advertising disclnsnres of tar aud nicotine content would £oater competifion un this basis. However, it conccsles that in the absence of such competitive pressure, legisla- tion regnlating tar and nicotine cmrtent may be necesssay. In tests of 120 variet3esof domestic cigarettes conipleted on October 21, 1970, tar content ranged from 2 to 31 milHgTams per cigarette, aud nicotine content ranged front 0.1 to 2.2 utilligrauis per cigarette (Exhibit B). Ten of tbe varieties tested yielded 10 milligrams or less of tar per cigarette. Sales data submitted by the nine major domestic cigarette manufacturers indicated that comhined sales of thone 10 va.rieties amounted to less than mm percent of all domestic cigarettes sold during 1970. Twenty of the varieties tested yielded lir milligrunus omr IeKs of tar per cipenreLte. Comhined snles of thoae 20 carieties acconnted for less thtui four percent of all cigarettes sold by domestic mnau- facturers in 1970. During 1970, eigarette manufacturer; devoted 10.5 percent of their total adverlisiug expenditures to promote those 20 varieties yielding 1u milligrants mr less af t5ir per cigurelle. This statistical information indicatesthat cigarette manufacturers are capa- bie of prodncing cigareues which yield relatively low amounts of tar and uico- tine but that these cigarettas comprise only a sam11 fraction of all cigarettes sold in the United States- The Bureau believes thnt if S. 1431 were enacted, the promulgation of etand- ards in accorrdance witli its provisions would pose a number of difficult hnt not insurmountable problems. Chief among these would be that of determining what quanfltiea of tar and nicotine in cigarette smokc would nat posc "an un- reasmlable health hsuard." The Commission does not, at this finte, have the nece.?vary research facilities, medical and scicntific staff or allotted funds to develop the bases for the medical and scientific judgments contemplated by this bill. As an nltenative, the I3urrnn wmIld suggost that a certifleation pre- giant by the Public Hcalth Serviec bc :dop;i "1. 11'ifli its facilities and experrise, that agency woutd be bctter sniird for deten li~ing_ m:isiutum levels of tar, nic- otineandotherincrimirmLeda2entsin~i_,n•ei; - Still another problem presented I t LLr Iuu;iage of this bill is that if levels of tar, nicotine, and other ineriminaled i - ~~nsistent with the avoidance of unreasonable risk to human health eoulci I~~ ~-ctblished, S. 1451 would prohibit the Commission from setting maxirmmnt tohnaaces at those levels if cigarettes produced in accordance with such a stanl.ud would create a market for "sig- nificant quantities of nigarettes which fail to meet such standard." This lan- guage Ioses two problems. First, it would be difficult to anticipate just what maximtmi levels of tar and nicotine would give rise lo an illegal market for cigarettes exceeding the maximum levels. Second, 1 am concerned about the re- qnirrment that we subordinate public health considerations to "toustuner ac- ceptability" in promulgating standards for tar and nicntlne levels. I believe that t,his problem cottld be avoided if the language of *2 of the bill vicere ehanged to direct the Commission to establish maximum levels of tar, nieotiue and other incriminated agents in cigarette smoke, by balancing the possible risks to human health posed by the presence of those agenta in varying amounts againstt consumer preference, as measured by sales data for the many TI58461191
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76 Statements made to the Ilouse Committee in 1969 with respect to tar and nicotine showed how little is scientifically established despite much research. The statements pointed out that human beings do not smoke tar-that no relationship between laboratory reports on tar vield and human health has been established-that even if a disease produeing substance were present in the tar it might be present in a very small segment or fraction and the amount of total tar might be completely irrelevant-and that nicotine, not considered an impor- tant health hazard by the Surgeon General's Advisory Committee, has not been scientifically established as any hazard at all to snokers: = Normer Surgeon General Stewart said in 1969 that the tar and nir: otine level "is a crnde index and tdle diffeir.nca between one point, I millirram, probably doesn't make much difference."" During the 1970 IHouse Appropriations hearings Surgeon General Stewart indi- cated, in fact,,l-hat the index was "very crude" (emphasis adde.d ) J' The 1972 Surgeon General's report refers toa"new section" re- riewing ingredients reportedly found in cigarette smoke. This sec- lion is chapter 9 of t,he 1972 report and is described as the "culmination of a 1-day confe-renec held in June 1970.°1a It seems strange that t)lis xneeting, whir,h was deemed to merit the addition of a new seetion in tl]e 1972 report, was not even mentioned in the 1971 report. The 1971 report wa.s issued in January 1fl71-over 6 mollths after the June 1970 meeting. _1 fu11 transcript of that 1-day confcrence and any reports thereof have been requested, but regardless of whatt the tran<cript may show itis clear that although chapter 9 is titled "Hannlfnl Cmistituents of Cigarette Smoke,9° the content of the chapter does not live up to the title t=iven to it.. Tlle following quotal lon from chapter 9, for example, ilhistrates the mucrtaintv wllich cenroinues to exlst as to the sic,uificance of vas- ions compmmds, including tar, nicotine and carbon monoxide: of the Lundred~ ot eompannds indentified in cigarette smoke, some occur in the sanoke in conrentrations wlui4i may pe considered sulficient to present lmz- ards to health. Other componnrts appear in borderiine concentratiuns. Still o8o- ers, although Potent]al]y Larmful, are probably not present in sufilcient concen- trarinus to cnnuibnre to tbe hazard, and some may- be Lanardous ou]y mhen they interact with other substances in the smoki Le Chapter 9 of the 1973 report also aclcnowledgesseveral other im- porrant problems inberent in setting tar and nicotine limits : (1) Lowering tar and nicotine content nlay increase other effect,s clolmed by some to be. harmful:' ~3) The possibility of '°interaction" among various substances makes it "difi'icult to asaess" reduction or eliminction of any constitttent 1s ==nearinpa Before tfie Commkttee on LLLerstnte and Foreign Commerce, Hatse of Rep. veqeptotlves, April 1CYNay 1, 15fiP, p. ] 116. :l rnt~3.. p. 17x. ~• Hearings Before a snbertmuroittee of tIle Committee on Appropriatlons, Honse of Bep- cohitiyCP. FIarch 1969. Vol. 3, p. 57. .~1053 Snrgeon General's Acport ftn. 2, xrzpra, p. SV'. TI58461199
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72 result of statutorj~ implementation of this self-regulatory initiative bt~ the industry. ~ In 1970, cigarette companies voluntarily began to include FTC tar and nieotine rating_ s in advertising. In 1971, all of the member companies of the Tobacco Institute began voluntarily to depict in advertising the side of the package carrying the Surgeon General's warning. In 1972, the industry consented to an order by the, FTC whieh requires a clear and oonspicuous disclosure of t:he Surgeon General's warning in newspapers, magazines, billboards, and other advertising. Now, the tobacco indnstry-growers, sellers, factmy wnrkers, and manufacturers-is concerned about the proposal to legislate arbi- trarv limits on the tar and nicotine content of cigarettes. There is certainly no scientific basis for such limitation and, even at best, putting a governmental starnp of app roval on tar and nico- tine content below fised levels would mislead the public. But in even a larger sense ilt should bo aconcs3rn of other indns- tries and, in the highest sense, a. legitimate concern of all Americans. For the question it raises is thk: IIow far should the Government go isr controlling the behavior and restricting the freedom of choice of informed adults in the ma rketplace ? People are aware-as Cmtg'ress intended them to be--that ciga- rettes may be harmfirl 1 o their health. People are inforued abont tho tar and nicotine content of ciga- rettes in cach advertisement, and by the pnblislred reports of the FTC. People who rcad cir,raretdc advertising or look at the side of any cigarette package ca.n in no way be ruraware of the Surgeon Gener- al"s vicw of ranoking. If the Govcrnment's fmrction with referencn to legal prodncts is to inform the people, to giva them the facts or to see that advertis- ing gives them the facts, and then to leave the eseraise of free choic,e to the individual-there is rm place for governmentai limitation of what type of cigarettes may be made legtillv available. The n.rtging conu,rnr exists that futme policy nray be based on protecting peoplc from themselves, by somc form of creeping prohi- bitirnr sur_h as the pre-;ently proposed controlling and pro~'essrvely redur_ing of tar and nicotine conteut to the place where ugarettes will no longer be pleasm-able or even acceptable to the consrmier. With each passing year, the screws conld be t:ehteaied a turn or trvo by proginesive limitation of tar and nicotine cartcnt until more and more people are prohibited from exercising their rig}rt to suoke cig- arettes of their choice. Or, conceivably, thc intention rnight be to progressively restrict c.igare.tte advortising, as some have predicted, from more mrd moree medl.u. Needless to say, tl.e bnrden wonld fall most heavily on the leasta(fluentnewspapersandpe,riodicalst Now I will turn to a more specifio discussion of tar and nicotine, the background of the controvorsy respecting these ingredients, and the lack of evidence "ineriminating" them in ternrs of human health. Low tar and nicotine cigarettes are availablc to every srnoker. Information concerning tar and nicotine content is available to T158461195
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69 cigarette varieties now available and for which the levels of tar, nicotine and other incriminated agents have been established. The Bureau observes that nowhere in this bill is the malmfaeturing, impor- tation, distribution or sale of cigarettes containing levels of tar, nicotine and other incriminated agents in excess of the standards which might be nrumul- gated by the Commission specifically forbidden. It is suggested that violation of this law should be declared an unfair trade practice in violation of Section 6 of the Federal Trade Commission Act. The Bureau supports the purpose of this legislation and, with the changes suggest,xl in these comments, feels that It would be a significant legislative program for minimizing the il1 effects from some cigarette smoking. At the same time, however, the Bureau notes that the legislation proposed by S. 1454 is a more measured approach than the position that all cigarette smoking is per se dangerous. The Bureau believes there is a possibility that many cigarctte smoGCrs and nonsmokers might connlude that cigarettes pro- ducetl to meet standards promulgated in accordance with the terms of this bill could be consumed without any adverse consequences to human health. Such a result may serve to undermine the effectiveness of the statement now required to apl>ear on all oack: us of cigavettes distributed within the Cnited States by Section 4 of tto Pnii',,Ilenlth Cigarette Smoking Act: "R"arning: The Svrgeon General Has Dct^tuined That Cigarette Smoking Is Dangerous To Youi klealth." As you know, on January 31, 1972, the Commission provisionally accepted consent orders from the six major domestic cigarette manufacturers, by which those firms are obligated to diselose this same statement clearly and eonspicu- ously ilt all cigarette advertisements published by those firms. The six firms which are parties to these consent orders manufacture approximately 99 per- cent of all cigarettes sold in the United Stittes, and are responsible for almost all cigarette advertising published in this counny. The consent orders specify that the warning statement must be printed in two lines of type, parallel to the bottom margin of the advertieement, and en- closed within a binch-hordered reetangle. The warning statement itt its rectangle must be printed in black against a solid white background, and cannot be included as part of a cigarette package. The orders, which are identical in substantive provisions, contain a schedule which increases the size of type to be used for the warning statement as the total area of the advertisement increases. The provisions of the orders apply to all cigarette advertisemente in newspa- pers, magazines and other periodieals; billboards, posters and cards in public tranrit vehiclre; pointof-mnle displny naterials; and handbills, direct-niail leaflets, and theater programs. As you know, Section 6 of the Public. IIealth Cigarette Smokillg Act prohibits eignretto ndvertisements to be broadcast un radio or television. While these consent orders are for settlement Dnrposes only and do not con- stitute admissions by the firlns that they have violated the ]aw, the provisional acceltfance of a eonsenh order and ita snbseqnent issnance by the Comntission does curry tlto force of law ccilh respect to any futuro acftmts not in compli- anee with the order. A violation of such an order issued by the Commision n,ay resnlt in a civil pemilty of up to $.i,tN10 per day heing imposed apon the respondent. The six complaints and consent orders have hcen placed on the puhlic record and comments by nll interested parties will be xeceived for a 30-day period thereaftcr. Conunents from the public will be considered by the Commission when it dceldes whether tn entcr its ]inal order with respect to these siu cases, or to withdraw its aceeptance of the agreements. The Commission will with- hold any ilnal assessment of Ube adeqnacy of these consent orders until nii comments have been received from the public. At the dme the terms of these consent orders were announced, the Commis- sion e.cpres,ely noted its intention to monitor carefully the continued effective- ness of the disflosure required by the te'ms of the orders. The Commi,vsion has noted that it retains the right to reconeider the effectiveness of these or- ders at any time pursuant to the provisions of the Federal Trade Commission Act and the Commission's Rules of Practice. If the Commission does not withdraw its acceptsnce of the orders, cigarette advertisements containing the required disclosure will begin to appear about two monthfl after thn date the Commission enters final orders with respect to these cases. 'Plm orders contain a time schedule for Implenientation which is TI58461192
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of 7e ir e PUBLIC HEALTH CIGARETTE AMEnll)1EnTS OF 1971 THURSDAY, FEBRIIARY3, 1972 U.S. SENATE. COILMrrTF.fl OK CobCMPRCfl, CI;BCOMMPPTEE FOR COSStIV[L]RS. Washington, D.C. The subcommittee, met at 10 a.m. in room u110, New Senate Office Bnildiug, Hon. 1'rank E. 14loss (chairman of the subcorrnnittee) presiding. Proscnt: Senators'-Vloss. Spong, and Cook. Senator nloss. The hearing will come to order. Senator Cook will he here very shortly, and I hadagreed with him that we would not hear the outside witne.cses, anyway, until lie was here. But Senator Spong, who is a member of this subcommittee, and has worked on this problem, has a statement to give this morning. I know Senator Spong hn.s other commitments. He has to be on the floor on some business that will begin there by 11, so he will have to get his other work done ahead of that time. Therefore, we will begin by having a statement from Senator Spong of Virginia. OPENING STATEMENT BY SENATOR.SPONG Senator SroNa. Thank yon, 3Tr. Chairman. Initiall,v, I would like to say that I regret that other commitments prevented my attending the firs^t session of your hearings on tbis bil], a bill to require the FTC to establish maximum acceptable levels of tar and nicotine in elgarettes. I have reviewed the testimony presented Tuesday, and I am famil- iar with the record developed on the cigarette controversy in pre- vious years. IvVith all respect to the motives of those who support the pending bill, the mcasnrc in my view, represents another example of the mistaken attitude that, the Federal Government knows what is best for all citizears, and should be empowered to make all decisions on their behalf. The, bill is a splendid example of big-brotherism. It proposes an intrusion of the (xovernment into an area of decision- making that rightlidl v belongs to the individual. Congress expressly declared in the Pub7ic Heal(1i Cigarette Smok- ing Act of 1369 an intent to establish a uniform labeling policy so the public can be adequately informed of the health aspects of eiga- rdke smoking. Only this week the tobacco industry agreed to include warning messalges in its advertising. It is my understanding that the agrecmcut will be implemented in 2 or 3 nionths. (8:]) T158461208
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who included several participants in Dr. Horn's June 1966 1-day conference, warned members of the Senate Committee on Commerce that : 10 (1) Filtratiolt might inadvertently remove °`carcinogen neutralir- ing substaaces front cigarette gmoke", that is, make cigarettes more carcinogenic. (Dr. Paul Kotin, Director, Division of Environmental Hcalth Sciences, Public Health Scrvice, p. 20.) (2) "(M)ore research is reqnired before it can be concluded with certainty that ehelnicals (or some combination of chemir.als) con- tainod in the tar are mainly or entirely respnnsiblv . "(Dr. E. Covler Halmnond, Vice President, Epidemiology and Statistics, Alnerican Cancer Society, Inc., p. 174) (3) "(FF)o simply do not know just what specific agents are in- volved." (Dr. George E. Moore, Director of Public Health Research, New York State Department of Health, p. 26)• (4) A threshold level at which "no risk occurs cannot be deduced from the data." (Dr. Ernest Wymder, Associate 141ember, b'loan-Ket- tering Institnte for Cancer Research, New York, N.Y., p. ili)) (5) Research is needed to find a "tolerable" level. (Dr. William ptewart, Surgeon General, Public Health Service, p. 153.) (6) Any effect of nicotine on the heart "needs mnch more rese:trch, further running down," (Stewart, p. 1.60.) (7) Nicotine is rapidly elimilrated from the body-there is "no ev- idence" it causes coronary xLherosclcrosie. (Dr. llummond of the Cancer Society, p. 174.) (R) There is no colu•lnsive evidence that harmful effects, as far als cancer is concerned, are caused by "tar" and nicotine. (Hammond, p. 169.) (9) "The big problem is to find out whether having do so you have accomplished anything in reducing thc harlnfitl effects." (IIwr mond, p. 171.) (10) No direct evidence is known that any of today's eigareltes- low tar and nicotine or not-are less harluful than others. (I_Tam- mond, p. 167.) (11) With respect to the content of smoke: We need "further pllr- suit" and "a better understanding." (Dr. Stewart, p. 165.) Congressional hearings in 1969 again failed to support the proposition that "tar" and nicotine content is significant. Neither the 1965 act nor the Public Ilealt.h Cigarette Smoking Act of 1969 im- posed ra,ny reqnirenlents with respect to tar and nicotine content. The 1969 report of the CoTnntittee on Interstate and Foreign Commerce of the IIouse of Representatives (which followed what the chairman of that distinguished committee described as the longest hearings he could recall) commented: On the basis of these heariiTgs the conuuittcc conrindes that nothing new has beet determined with respn:t to the relationship between cigarette smN<ing and human heulth since its hearings tn 19ti1 and 1l/fi6. The arguments pro and con with respect to cigarettes tme the same now as then, though supported by a larger statistical base." "' Revie,ring Prncretiu MaOe Tn.card the Developmcnt and ]lnrkethug of s. T.ess Haznrd- ona CSgaertce. L.S. Senalc, Ang. 2&25, t36i. "Cm mltlee rTi Interstsre Im n Pnrel yn Commeree Report on YuUllc lleulth Qi ymrctte SmoMng Act af 1959, Report So- 91 2,9, Sune 5, 1969, r. 5. 77-016--7-- - TI58461198
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7£ It is obvious that not even a far lesser level of proof, much less "beyond a reasonable doubt," has been met by the mere unsupported opinion expressed in chapter 9. And what could create greater pub- lic expectation and reliance than permitting only the sale of ctga- rettes meeting government "sta.ndards"? Low tar and nicotine cigarettes are abundantly available in the marketplace. Tar and nicotine figures are carried in ciprette adver- tising. Tho FTC puts out a seorecard on tar and nicotme regularly. Thesc actions are in response to the interest and desire of some smokers for lower tar and nicotine content. They do not indicate that snch cigarettes are safer than others, but are only the result of the FTC's annonncing, when it withdrew its long-standing ban on tar and nicotine content advertisino, that the tar and nicotine con- tent of cigarettes °1may be materia~l and desired by the consuming public." It is clearly one thing to advise consumers of tar and nicotine con- tent, hnt quite another to ban cigarettes above a, certain tar and nicotine limit from the marketplaee. The then Surgeon General Stewart, when asked in 1969 if hee would like to see such a ban, replied : No. I would rather have the fact that when people choose a cigarette they can choose a lower tar aud nicotine or a higher tar and nicotine assunllng they have all the information related to cigarette smoking and the hazards to healtL.y In conclusion, the cigarette industry has demonstrated a real and continuing interest and concern in finding answers to the important questions iidierent in the controvcrsy over whether cigarette smoking is hazardous to health. Government shouild do no less. To pass legislation imposing arbitrary standards and limitations wluch could falsel,v reassure and mislead the public withovt benefit of scientific support would truly be a disservice to the public. Such action would undoubtedly deter and delay the search for scientific truth. Itt is the consideretl view of this industry that to enact S. 1454 would accomplish these undesirable and unfortunate ends. Senator Moss. We are glad to have you testify and give us the po- sitiou of the Tobacco Institute on the bill before ns. I wonder if a person did not srnoke and was going to start to smoke, would you advise lie smoke a low tar and nicotine cigarette or a high tar and nicotine cigarette'a JIr. Koxs>:caY. Senator, I cannot recall ever having been asked for that particular information. If he said he wanted to smoke or was going to smoke I tltink I would advise him to maybe try them all and decide which one he likes. I think that would be m,y- advice to him because, as is obvious from my statement, I do not get the signific,ance of the difference in tas and nicotine insofar as health is concerned. Senator \Ioss. So far as you are concerned you do not think yon could advise him one way or the other, you would just tell him to do what lie wanted? 'E AUPropristion He•dnge, foolnote 14, naPra, voL 3, P. 54. T158461201
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74 and nicotine cont.ent lrad less effect (c) no proof of anlr tar and nicotine level below which there was no effect and above which there was, and (d) no evidence on which to base a determination of whether 31ry differenceP in tar and nicotine content between two ciga- rettes was or was not significant. Tlte Chairman of the FTC1 specifically warned that tar and nico- tinc figures could result in rnisleading the public.° This was entirch• consistent with the Conunissimr's long-standing position, dating bach to the 19:i0's, that compauies could not advertise the tar and nicotine levels of their cigarettes. In March 1986, the FTC announced a change in its position and said that corupanies could disclose tar and nicotine content. The onlv renson given for this change in policy was that the information "may be material and desired by the consuming public."' There was no new scientific evidence even claimed to exist. Thereafter, the FTC set up a testing laboratory and eolmnenced to issue its periodic reports on the tar and nicotine eontent of cigarettes. The FTC stated, however, that "no matter how relatively low its tar and nicotine content. no cigarette may truthfully be advertised or represented to the pul?lic expressly or by implication, as `safe' or `safer' .. " s The Commission has also issued an advisory opinion rejecting advertising for a new prodnct, claimed to he a'°revolntiorr ary invention tdiat provides the answer to safer smoking" on the ground that none of the reports submitted in support of the inven- tion showed that reductions in "tar, nicotine and benzopyrene eon- tent" result in a decrease of "diseas<s associated with cigarette smoking." e Dr. Ihuliel Ilorn, on behalf of the Surgeon General, held a 1-dav meeting of a snmll group in -lune 1986. No neiv e.vidence on tar and nicotine t`-as announced either at or following that meeting. The group did not deanonstrate that tar or any specific innredient was harmful, nor did it claim that the Surgeon General's ANvisory Com- mittee was wrong in virtually exonerating nicotine. Instead, the group merely stated that the preponderance of existing evidence strongly suggests that tlIe lower the tar and nicotine content of ciga- rettes,.the less harniful the effects. The group did not, even purport to give tuly definitive answers to these critical quest,ions: Do tar and nicotine have any unfavorable effect on health at all? If so, at what level of tar and nicotine does this effect occur? If so, how nnrc,h lower in tar or nicotine content mustt one ciga- rette be than another to avoid this effect? These qnestious were likewise not answered by hearings held in August 1967 as a result of claims made by the inventor, and promot- ers of the "Strickman filter", who were not associated with the ciga- rette industry. 5uch hearings failed to adduce any testimony for the proposition that tar and mcotiue content is sie tfic,ant in terms of humaJi health. Even the witnesses invited bv the Government to tes- tify at the hearings, who are avowed foes of cigarette smoking, and ^rnr,-- I seuaie I[e,dn~n. ~ FPc Ve,pp RCIrvisC tlul.ea ]L,r. ";i. 1990. +Letier d::1 d Oct 21, 10117. frnm Juseph W. 9hea. ecexetnry D'ederal Trade Commis- plon lo ]!r. nnvnrd IT. Rell. then Aneetne nf thc Ndn Code dnLLmdts. °'ibmre Rr;mb~tiun ReyorrnI'eroarnyh 1fiA59,Ldvieory ONrironDlb+estSO. 377, Oct22, 196J. TI58461197
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£1 Senator Moss. I appreciate. your testimony and I do recognize the many voluntary steps that hace been taken by the Tobacco Institute and tobacco companies at various points and I recognize that you have generally been very cooperative. We are ]ust trying to get as full a record as we can here to make a judgmentt whether there ought to be another area that we should move in legislativelv. Mr. Kousr:caF. Thank>>ou very much, Senator. Tlrose remarlcs are appreciated and certainly I nnderstand the legislative process and know exactly the purpose of the hearin"n Senator A'Iosa. Thank you. Senator Cook? Scnator Cornc. So I can put mv advocacv in propcr terms. D$. Korniegay, and }ou and I can 4art off on the right foot. if my son weree to corne to me and ask rnn whq,t eiga rette lie mrgl'it to smolce. I woiild tell him not to smol:e any. I want that elear. But. I want him to have that choice and I hope the stations are snccessful in the Supreme Court of the United Slates, because then tLFp will have that choice also. I would say to you in all fairnoss. we e rc get.tinl,r back to the same thing that has prevailed in Congress for ve.rrs. thorc is not it thing mr the books, not a statntor,v word anywlrere, that distillcd spirits. over and above wines and beers. catmot be advcrticed oil radio and television. But the threat of Con;,ress is there and thcy do not nePA a vohmtary order. But if QLev want that ri=~ht, they mxght to have it. I would assnme they would not do it, and I would hopee they would not. But let's get down to the bill before us. This would direet the FTC to set maximum acceptable, levels of tar, nicotine, and other incriminated agents as the Conmiission determines may be prescnt in cigarettee in quantities which will not impose an um•easonable health hazard. This poses some serious problems in relation to the testimony you and I heard today, doesn't it. The PIIS of HEW says it does not want to give any help or aid to the FTC. The FTC says there are some insurmountable problems, lmt not totall,y insurmountable, because they would get aid and assistance from ~HE\V, sinee they hare no funds or expertise to do this on their own. So aren't you rather frightened that there is no means, if this bill were enacted, by which a scientific basis could be established? MG. Konxv;aar. I think t,hoso of us who were privileged to be here this morning, Senator Cook, witnessed a most Iuuzauo-rl situation with reference to the Government. It is refreslring in a way. It was obvious tlicy had not gotten together and agreed on any common approach; you could hardly call it a hand-in-glove situation. I con- clttded from what both of them said that it would resolve itself into, frankly, all impossible task. Senator CooK. You are talking about the correction by Dr. DuVal of the remark by Dr. Horn? T158461204
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so The farmers would have difl'iculty because, as I mxlerstand it, tar and nicotine content in the tobacco varies from year to year depend- inh upon the season, the climate or the atmospheric conditions. So therc is a big practical problem over which we have no control. Senator Moss. Jastt as a. matter of curiosity, the tobacco companies agreed to go off of broadcast advertising as soon as they could com- plete their contracts and then later on Congress went ahead and gtatutorily barred that kind of advertising. Now the broadcasters are challenging the constitutionality of this law and should that be overturned and be found unconstitutional in the Supreme Court do you think the tobacco companies would go back to advertising on the media? Mr. gonNEeaY. This is my personal expression: I would hope not. But I am not authorized in any way to speak for them in that re- gard. This is a highly competitive industcy and these are, of course, decisions made by e~ich individual company. As a matter of regula- tion and charter, tie Institute does not become involved in the mar- keting and advertising of cigarettes as it pertains to the indicidual companies. I can only express a personal feeling on that question, sir. Senator Moss. I understand it is very speculative. As I understand it, then, the position of the Institute is there has not been a showing that tar and nicotine hnve any bad effect on the stnokcr of cigarettes and, therefore, you do not think this legislation shonld be passed rather than taking the other view that there is no power to put a limitation on the contents of a product if it is legallp sold. Whic.h of those theories do yon adhere to now? _l'Ir. ICorNFanY. IVa certainly take the former of your two alterna- tives, thatt there is no evidenee to incriminate tar or nicotine as a cause of any disease alleged to be caused by cigarettes. You ean always, I think, perhaps make a good argumenty legal- and whether it would prevail, frankly, I don't know-that this sort of r tvernmental intervention in the marketing of a legal produrt is ttnconstitutional, is an ttndne burden on interstate commerce. Yon could make that argmnent. Our case is predicated on the fact that there is no scientific jnstifi- eation for sich action by the Government. Senator Moss. For example, we do prohibit the sale of milk with above a certain limit of vitamin D added to it and, therefore, there is a ceiling put on that particular ingredient in milk sold. What wc are talkink about is a similar kind of ret,n.llation here, putting a limit on a certain ingredient in cigarettes and, therefore, I would think tdiat there is a precedent for doing that sort of thing. But I understand tion take the, other view that there has been shown to be no deleterious effects from tar and nicotine. Mr. KonNEO-~r. That is right, there has been none demonstrated, as I tried to indicate from quotations by people who have followed this very closely, in the CCovernment and private health organiza- tions. T158461203
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I S2 Mr. I{onxnaar. Well, that is part of it, but I am talking primar- ily about the fact that the FTC says they want the PHS to do it, and the PHS says they want the FTC to do it. It is a ping-pong ganle. Senator Cootc. The only think I got out of the correction of Dr. Horn is Dr. DuVal is not quite as biased as Dr. Horn. That is about all Igmt out of it. Let rne refer to Nour statement berause I think this is very inter- csting. I think this Icind of gets to the heart of it. "The FTC stated, hon-ever, that 'no matter how relatively lotiv ite tar and nicotine content, no cigarette may truthfully be advertised or represented to the public espressly or by implieation as 'safe' or `safer :' Isn't that really what the general public is going to get out of this legislation if it becomes law R That the FTC in the past has said you cannot, do it, and yet now this bill says we want you to pick that tar and nicotine that is acceptable to the general eneral public and tell the gen- eral public it is available to them to smoke? Now, isn't that saying that we have now gone 180° in telling the FTC what it should or should not do 0 :1Ir. I>;onsnr,nr. Yes. sir, aud it could well putt the etamp of approval on all cigarettes that arc lcgally marketable under such arrangemeuts, where this is no evidence to that effect. Senator Cooec. I hope this is not going to be totally and com- pletely misimderstood bv same people at the Surgwn General's department, but I am going to say it frankly. I am impressed with cour restune in your statement, but. I thinlc this is tbc positirm tha,t the leadership under Dr. Stewart-and I have never met him, don't know him, would not know him if I saw him-hut. I think this expresses the attitude of the Department and those who dealt with the Department when Dr. Stewart was in charge of it. Becauso when I came here in 1969 Dr. Stewart, and others felt that a great deal of research and a great deal of scientific effort had to be aecom- plished. But it has not been accomplished yet, isn't that correct e _l(r. KosrEa,vY. 1'es, sir. Senator Coor.. But if we believc Dr. Steinfeld and the report that raine nut a conple of wceks ago, the sun bru shone throngh all of a sudden, and all items from orre through 11 were concluded, and an answer was found for evcry one of them, and there no longer is any room for honest disagreement in the seieutific community. We simply do not know the thteshold level at which no risk occurb, research is needed. Any effect of nicotine on the heartneeds more research. Nicotine is rapidl,y elimiuate.d from the body. But, there is no evidence it causes coronar,v, et cetera. But under the 1972 report everything has been solved. Mr. lionvra_%Y. Aci•ording to the present Surveon General. Seimtor tloooz. Let's get to that, because yon made reference to chapter 9: °°Harrnfnl Constituents in Cigarette Smoke." I wonld like to read into the record two footnotes. I think it is interesting, this 1-day meeting. Because I guess it was a real scien- T158461205
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94 Senator Moss. Ii'ou]d you provide the committee with a list of the scientific papers published in the last 10 years which you think should have been considered in the preparation of the reports that were not considered? Dr. SoxMrns. In the reports of the Surgeon General, I will gladly do so, sir. Senator Dioss. All right. That will be made part of the record.' Senator Moss. I think you stated you are a pathologist, doctor, and therefore you work in the field of examination of bodies rather than prescribing_ for those who are ill. I wonder if one of vour collcagues came to you and aske9 you whether he should recommend to his patients that they smoke, would you suggest to that physician that as far as you were concerned, t.here is no reason that Lhe patient should not smoke, if he felt like it? Dr. So3ivlsne. Sir, I do not prescribe and I do not advise people on most subjects. It is not a part of my personality, and in particular, I do not ad- vise people to smoke. My position is that as people become adults, they drive automobiles, fly airplanes, drink alcohol, smoke tobacco, engage in sexual intercourse, and I don't advise them to do these things, but they do them. Senator Moss. That was not the question. Would you counsel your physician friend who asked you that as far as you were concerned, there is no reason why the physician's patient should not smoke if he felt like it? Dr. Son7alrns. I wonld advise him that in my opinion there is no serious significant health hazard for the average person who smokes in moderation. In this field, moderation is never mentioned. Senator Moss. Well, maybe that is the key word wc arc looking for, moderation. You do think his smoking ought to be done in moderation? Dr. Sonmicus. No sir. ,sI say, I cannot advise people how to behave. I think some, for reasons unknown, feel the need to smoke more than others, and some feel no need to smoke cigarettes at all, like myself. And I don't feel in a position from irry training and experience, to tell these people what to do. Senator Moss. I am not saying we are going to compel anybody to do anything. But I come to a physician and I ask him for advice about my health. And presumably I pay a fee for the advice, and I expect him to advise me. He is not going to compel me. A physician might tell me never to touch another piece of broad and butter, and that would be his ad- vice, although it would not compel me to do so. Dr. SoxlwlEas. Sir, I think that the health problem has been over- emphasized with respect to tobacco smoking, and particularly ciga- rette smoking. ' See pp. 461 flnd 729. TI58461217
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86 No one can argue that theree is inadequate information available to smokers. Thev know the tar and nicotine content through advertise- ments, and through reports published periodicallp ba the FTC. A wide range af brands is arrailable and individuals have the right to exercise a free choice iu sclecting the type of cigarette they wish to buy. Thero are mnn.= brands nvailable now which could be expected to meet or be slperior to an}• tar and nicotine standard set bvtllohl(1. Another point we must consider is the possible adverse economic effect of this legislation. Manufacturers can and have exercised ron- trol over the tar ernd nicoture content of cigarettes. bnt climatic con- ditions over which there are no controls also play a.n important role in tar and nicotine levels. Thonsands of farmers are dependent upon tobacco as their peinci- pal source of income. it is entirely possible that their livelihoods would he adversely affected by a staurdard their crop cannot meet through no fanltof their own. Thosa who amoke und those who contemplate smoking are fullv informed about the hazards which rnav be involved in the use of cir- arettes. They should be given the rigfrt to make their own decisions without unwarranted intrttsion by the (lovernment upon their per- sonal freedom. \Ir. Chairman. I thank yon ver,v mnch for according mc•e an oppmtnnity to make this statement at the begiuning of this second hearing. Senator Moss. Well, we aree verT glad to have your statement, Sonator Spong. and rve hope that vou will be ablc to attend some parts of the hearing. although we know of your other commitments. One of the unfortunate things is n-e have rnunv assignments hcrc in the Senate, and that is one reason we havc been holdint; up a little bit. Senator Cook had anotlter commitment that he had to keep this morring beforc he could get here, aud later in the daF I am going to have to be, ont for a while. 9o, Ave all turderstmvl Ihe circmnstances. 1 understand 'Noun point of view. but, of course, if we accepted that fttllv, I suppose we onght to repeal the fia¢ardous Substances Act, beaxuse we could jnst tell pcople that tlrings had hazardous substances, and then let them make their choices. SenatmSro.rn. I don't necessarily concnr with that, bnt, T know there is going to be ample opportnnity, both in the committee and perhaps on the floor, for ' you and I to discuss our differences. Senator lfoss. All right. We will do that. We will make sure thatt we have that discnssion. Thank you. Bill. In addition to Senator Spong, Senator Hollings of South Caro- lina wished to make a stah.mrmt for the, record and he is unable to be here personally, so he has supplied it. and this will be placed in the record immediatel ' v following thaL of Senator ti9pong. (The statem ent f oll ows :) STATEMENT OV Hon. P7ssrsm h. I4ar.r.ices, II.8. Svssrox Fxo~t tiOC1H tiACOLI56 Jry 5tate, 6outh Carolina, has a tobacco heritage going back to the coloniza- Gon of Amcrica. we are prond nT that heritage arrd of the thonsands of South T158461209
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119 Mr. FionxFanY. Yes, sir. I would tell him to try them all and pick the one, he likes the best. Senator Moes. Well, for that reason, then, do you think it would be undesirable to have any kind of direction as to limitation on tar anrl nicotine in cigarettes generally? ]4r. fionr-ron.. Yes, sir, I do. Senator Moss. I notice you quoted quite estensivelv from some of the earlier reports on this question and one reaching bach I think to 1964. You, of course, are well aware that there has been an updating report approximately once a year on this matter 9 -AIr. KorvsanY. Oh, ye_5' since 196$. 1 think they missed maybe a couple of years in there.. I do not believe there was one in 1965. It took them a while to get geared up for the reportu>bg activity aud then, when the act was amended, rather than reporting in the mid- dle of the year I believe it went to the first of the year and, there- fore, there, was an 18-month gap between the 1960 and 19i1 report, if I remember correctly. Tes, sir: I tried in the statement to go all of the way back and bring it throttgh the whole controversy, and I think most of my qnotes, in fact perhaps all of them, with the exception of a Senator or two, are yuotes f-rom t]te governn.ent, quotes from the Snrgeon t3enera7, quotea from Dr. Horn, who was here this morning, quotes frorn vry-ell-l:nown people who do not look with any favor upon ciga.- rettc smoking. Sevndor :1loss. I am adnised that in some other countries they Pw.re alivady set tar and nicotlne ceiling levels in cigarettes. Do you think the 'lobacco ,lnstitnte tnight be in a position to lead the indus- try with a ti-oluntaz.v agreement of the sort that might be developed herc ia the United State. I11r. Iioxn,•:r,ax. «"itlz rclerence tn setting a limit? Senator Dloss. Yes, \lr. Konstsmx. No, sir. i be]ieve we have led the industry a long way, if I can give the Institnte credit for that, but I do not beticvo we can in this regard because there are other factors, Senator, than those yon have heard this morning that malce it hi;Ulily impractical to get into this surel. No. 1, and fnndameual, of course, is the right of freedom of choice. After the public is duly advised of the alleged hazards of sinoking, as they are there are practical and technical difficulties too in the point of control-I am no expert in this area, but 1 am ad- vised that tho xnamtfacturers have, of eourse. certain controls over tar and nicotine, which is obvious from the fact that vou can find cigarettes that go up and down in tar and nicotine content. But e-hen itr,omes to a variation of one to two points-and there maybe those teoluiicalh• qualified who wozdd say more thatt that--snch tlun_s as humidity. moistnre content, age, packaging. have a bearing. lftion set it at oate level, theu for reasons totally beyond the con- trol of t,he manufackurer, by the time his product geta on the shelf or is sold to the consumer, it might have joinped up a point. That is one of the practical examples. T158461202
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Ss cific meeting,they all got into a romn and.started talking about what was in tobacco smoke and tdtev finally catne to a conclusion and they said evervbod,y- who agrees tiv,ith this raise their blulds. That was the scientific basis for chapter 9. I cite the footnote on page 211: Obvionslc, some people did not raise their hand. On page 216, the footnote rclative to the results produced should be less hazardous to health on the top of the page: An alternative point of view held by some is that smoking behavior Is a re- sponse to the need to reach a certain nicotine level, and that lowering the ammuntt of nicotine available from a eigarette nta9 result in anincrease in the number of cigatrttes smoked, the depth of inhalation or the number of puffs in order to maintain an aecustomed level. Snch incrense in smoking might result in an increased inhalntion of other ha.ardons mbstances in the smoke, thereby potentially negating the effect of reducing the amount available in each cigarette. 'Now, do ~'on think with those two footnotes that there is a wide variance in the opinion on the hasmfitl constitnents of cigarette smoke? blr. Konn r:oAr. Yes, si r. Senator Coox. Yet without those footnotes Dr. I3orn and his Departrrtent recommended to the Surgeon General and to the public at large that there were all tcpes of hazards in cigarette smoke and that this was another nail in the coffin? NIr. I?ioxsromer. Yes, sir, that is the impression one would get from the title of this chapter. Seuttior Coonc. Rq the .car. I)r. 5feinfeld is the s:te gmttlenlan who made t.his report public, and .carncd ladies I think not long ago in a special mcetiug. who told women if they smoked too much thev rvonld get wrinkles in their face. I think he is the same Surgeon Genet;tt irho made a speecii sottinrr frirth ac :1 iu:rtter rrP iact that seven formcr Presidents of the L;nited State<" had smokerl marihuana 9 DSr.Iiouxxo,ar. I saw some press accounts to that effect. Senator Coou. And when asked to reflect on that speech, one geu- tleman within his Department who had helped prepare the specch wunt oil a,n ectendcd lcavc und almU.er gentleman went. on it vaca- tion and nobody in the press could find ancbod.y to comment on the substance of that speech @ \fr. KoureoAr. I do not know about that aspect of it. Senator Cooic. And did he refe.r to the fact that this had been mnde bv a I)r. Bailev or somebody. 1 think, who was a research epecialist for the Smithsonian Llstitntion and thev later found out hheree was no such research specialist for tlte Smithsouian Institution? Jir. Iiousxc.ov. It was not Bailey; it was Dr. Burke. Senator Coolc. Whatever the doctor's name was. 11H•. Koaxsoer. I undetstand there was no such specialist. Senator CoUa. IIonestlv, I do not ntean this facetlously, but I must say to you, I put such a speech irt the same category, with all due respect to Dr. PnVal, as the mice studies and of the dog studies that the medical associations throughoutt the United Statcs have absolutely discounted. - T158461206
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However. I think we will proceed now, and if Scnator Cook does not come in a very few minutes, rvhy we will have to decide what other procedure to t.ake. Our first wittess will lx Dr. Shcldon C. Sommcrs, who is chuir- man of the Scientifie Arlvisorv Tioard of the Cormeil for Tobacco Research, from New York Citv. We are very glad to ]ttn-e yoa, Dr. Sotnmers, and if you would be suated at the table, you may proceed with your presentation. STATEMENT OF DR. SHELDON C. SOMMERS, CHAIRMAN, SCIENTIFIC ADVISORY BOARD TO THE COUNCIL F0R TOBACCO RESEARCH- U.S.A., NEW YORK, N.Y. I)r. Soaxirrns. Thanl: vott, sir. _11y namc is Sltcldon C. Sottnners. I am a physician specializin}; in puthology, dircctor of laboratorics, Lcstox IIill Hospital, New York, N.Y. Alv ac:ldnmic appointments are clinical professor of patlLologt, Colwubia T,"niversitv ColleRC of Yhysiaixn.s and Surgeons, and clin: cal professor of patholo"T, IIniversit,y of Southern California School of D'Iedicinc. _ In April 1969 I appaired as a witness before the L.S. ITonse of Tlepre,entn,tines committec that hold hearings concernuig cigarette labelutr= and advcr6isi ng. My cnrricnlnm vitne and publications are appended in the recmrd of these lrearings, publication se.rial mrmber 91-12, 1960. . pa:;es 10S`a-1093. Ypdated publications now number °33:i, and thore arc new committse, consllt,rtiv_ e_ and editorial responaibilities. For lLc past 5 yrars I 6ave, served on the Scientific :ldvisop~ P,oard, the Council for'Pobarco lirsrarch, of n-hioh T n.m cmrorth~ chairman. For nearl a? r-cars i have bcen research director. ~ The Council for Tobacco lie=earch-U.S.Aa is funded bv tobacco companies with about_ y,2.G uiillimi amrually. 'L'his is expcndcd fmr reEearrh rrants nnd contructs awardcd on the basis of dwisions ot the scicnfific advismc board which c.onsiders the competitive scien- tiGc nteritt and relcvzuiec of Ilte proposals receive.d tosrnolcing uud health problems. The board inchtdes distiugiiislted antLorities in cturciuogcnew>. 1)t:s. Andervont tmd 1Lreb~ter, in heart discuso.. Ur. Riug; in cluonir, rv,spiratorv discasc, Dr. Loosli; and in ol] icc scierific disr,ipl ii im, Out rlCorfa nie direch'd to helping ffitnd ii "li lafr~r~ who mzty discover the causes and tnechnnisms of disun. Ijimeil relaled lo smoking tobaceo, in par(icular cancer, cL-,~ni; ,-IQrar,,ry diecasc~, and coronary he,nt diseusc_ I wish to connnent bi-Ily on proz;n,sS iu und thc pr~~ni stattts of researeh in t]tis- mca. First, hm" , r r, as a citiaen 1 1611 to poiut out souicthing serieus that has haplio -cd iq tlre rt^te mtr government deals with our people. This -~!>>k- of sclctive release to the pross and meilirt, of certtrin technical informatimi lutcL conclusions while withholding the evi- dauce and sources of tbe material. One elamplc is "TLe IIcalth Cmisequences of Smoking 1971," which T received in printed form only after tha pre~s release of thc 1972 report. TI58461211
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91 these men amon', othesthinas stnoke, it is a very difficult problem in mnltifactorial statistics to sort out the contribution of a sitr~le factor. Evidence clo.inmed to show a dose-response relationship of cigarette smoking to heart attacks, based on the earlier cruder statlstical metlmds, is too uncertyin to bn conclusive. Now that both a nutritional and nonnutritional coronary cireula- toty flow pattern are recognizerl, better understanding of rather par- adoxical fiudings of either increased or decreased total coronarv flow after nicotine nlay he possible. Effects of nicotine on tissue metabolism in coronary artorial walls are being studied. The question is as yet unartswered. Tobacco snloke condensate seems of no practical importance in this Ileld. Yitv.lly, to rwmx.eut on carbon monoxide, informaLion availaLle for u to 80 tiears scarcely justifies emphasizing it is deleterious to the smoker. Hea.dache is a simple indicator of increasea blood carlion monoxide. 'Ihee bayie iniormation that a nonsmoker confined 8 hours in at, tutlcntiiated sno!m-lilled room shows increased blood carbon monox- ida is scarcelv sluprisinr. Tr:ifffie tnnnels and ulato exhaluts are more everydxy exPosures to excess carbon nmonoxidc. TraditiorlaLly, those who spend eight hours in unventilated mnukc--11ed rooms are politicians which suggests tlte possibility that pol itics mnv represeut a. health haz>ird. [Lang'hter.] Scalator AIovs. At ]cast I a~zree with your last statemeait, doctor, and tlhrh;lps tha.t is one of tJm n ~sons I am ausions to get the stnolce-1Wed roouts vcntii:tt•d, so c, - o:on't have headachcs. Yonr arl,,luaent, s,s I[tilce it. i~- ia, i-i that there has not been a medical finitina of t6e precise I -~n~l ~'t carcinoma, and therefore we ai-A~ht to rlisre;_iarrl the atatistics that show there is sonie relalionsliip Lhut catrses it; is that right'd Dr. So~r~tr:ns. AVell, sir, I mttke no arbtmtent.. I attempt to review the lield iu myovsn cxperienee and como to the eonc,lusion that the canse of ca.necr iu general and luu_~' cancer in pa.rticnlar is unknown twul, lherefooe, to impute wuv specific cause other than ionizine radintio¢is probably imdesirablc at this time. dcualor .lToas. 1Vell, you do not dispute these rundom statistical fir_ure~ that a.re asseanblcd, do you? Dr. Sonseuaes. AYell, sir, in comnlentiug ou the, statistics I would like to point oltt that there has never bcen inade a study of random huwnan beings with respecb to smokn.2 This would he diffimdt, to achiereg tJso sl.abistica7 stndies quoted in the smol:in;; a,nd health report-: are based upon older techni.ques, many of them on a one-to- one hasis, and tlte tusthematics we Jhave avnilable and what wee have leurned about slatistias in the tneautime render these conclosions I think unrcliable. Senn.tor \toss. How do vou explain that there has noL eccr boe.n any- contrarp set of fr~was published eho~sirn~ that those wiio smoked had an equal de.uth rate, an equal incidence of these c,vious disea~es, I mean the British, Israelis, Japanese, aud all the ofliers? Dr. Stinn[ur.s. Yes, sir, TI58461214
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S7 Carolina tobacco farmers. processors, warehousemen and the hundreds of oth- ers who today earry on the proud tradition of growing, processing and selling the fine leaf that has made American tobacco crops and produets pre-eruiuent throughout the world. I am, therefore, concerned, Mr. Chairman, with any proposals that would en- danger the livelihood of man,c of my constituents by imposing arbitrary limits on ;m,r eegment of tile tobacco economy for results that may be unrealistic und even unattainable. lt is not my purpose to debate the speci&~s of the lea slative proposal this snbcou,mittee is nolv considering. I am confident that witnesses appearing be- fore ymr will have the opportrutity to fully express their expert views on the controvereial scientific issnts involved, and that their honest difference of sei- entiflc opinion will be carefully weighed and given long and thoughtful consid- eration by the subcommittee-and the Senate Commerce Committee as a whole of which I am a member-befote any legislative action will be taken. Bnt l aut concerned, Mr. (lhuirtuan, that those who are opposed to smoking are pushing hard and fast towards prohibition. And I am equally concerned l,y the recent 1'TC and HE{V reports and sonre of the statements endorsing their swecping findings that have been made during these hearingsc From these it ia apparent to me that thoro are those in high positions in some of our govern- ment age:clos wlw wmtld also have the Congress move precipiAtusly to impese further restrictions npon the tobacco industry and upon the rights of those who choose to amoke to cmtinue to freely do so. l am em]eerned, Mr. Chairman, because I believe that those who would pro- hlbtt the tobacco cunsumers' freedom of choicc have not given serious thought to the nitimate consequcners of such action. That is the destruction of a 1egiG- mltte industry employing mmny tlmueundes of hard working people. From the testimony alrearly presented before this Committee, it is cleax that nwen more. rescareh ~.- M1. L, done to determine the relatioushipe, if any, het,ceen varions level. . nl, -~Pilne and tobacco smoke and hnman health. 1 am told that t.herwill hu highly coatpetent witnesses following me tuday whu will irLLruduce additi0nal testirnony on the science of tar and nicotine. I rvill not, therefore, prssnn this puint further, but T would ask this Committee to carefully consider (lie wisdom of recommending legislative or regulatory au- tious based upon hmomplete scientific evidence. Lt c_ummary, Mr. Chairman, I would hope you and the members of your sub- cmnntittce will give just weight to the many laws and regulations that now control the U.S, cigarette market, and to the many voluntary actions that U.S. tnLaceo u•.anufactnrere have taken to assure that the public is _ fully aware of tile possiblebealth hazards of smoking. Like you, I am coneerued with the many proble,os that bear on tile health xnd physical wcll-heing of enr nation. However, 1 believe that many of my col- lengues agree with me ihat for too long tobaceo has been the main Congres- sinnrl target. Yerhaps this is so becanse it is much easier to attack tobacco thiu tu get nt nl,jectlre srNentific truth. It in timr, I belicve, to conccrdrate greater iesearch effort, and find the au- rn-erp to the m:lny nnar,a.vercvl que=tious reluting to thc ol7eped caueraurl-ef- fect, rehatiouship hetweim srnolcing nod hcalth. Much ntore tmbiasal sciattiHc rrse:rch irt this field is moat certainly needed- But equally certain is tile need to couduct in-depth reaenrch in mmny nther fielrLs as well, for lhere is a grow- ing body of evidence implicat-ang many ntorc, products in everyday use with the nuuiy dislaees Wut over tile years have hnruened humanltv. I trust, Mr. Chaimnan, that tho Cbnsnmer Snhrommittec will nddress itself to the muny other suspecC products that may be a cause of human I1lness with the snune vlkur lhaL LLus brsn a.ccorded to tobacco for .<o tnany ytars. ~euator Moss. I am cerv vehictmttI to ffo ahead, bec.s uce T had told 6enator Cook that we tivonld wait Hr_e thought lie eonlrl be here lly- 10 dclock. IIe hns Sncli aW'aatinterrst in thcce healrings thnt I do not like to procted withont hinl. And yet we have a nwuber of witnesars to Liear today, a11 very impcn•tant, and I am relueth.nt to delac lon{er c•alj9n, thein up. T158461210
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77 (S) If smoking behavior is a response to "the need to reach a cer- taul nrcotine level *** lowering the amount of nicotine * * * might result in an increased inhalation of other hazardous substances.19 (4) There is a need for "better bioassay scstems to evaluate ciga- rettes" that may be modified.2° (e) The individual smoker will continue to control "critical fac- tors'0 regardless of variation in the product. These include the nnm- her of cigarettes smokedr how far down the cigarette is smoked and depth and frequency of vntalation?' Most of the references mentioned in chapter 9 are articles merely identifying certain compounds or gases in cigarette sntoke or ciga- rette smoke condensate. But these articles do not demonstrate that these compounds or gases are harmful as found in cigarette smoke. It is wholl y misleadin,n, to label them, as the 19i2 report does, "Ref- erencos on Harnrfid C0nstitnents."22 The only citation discussed in chapter 9 is the `'technieal roport'° on tar artd nicotine prepared by the Public Healflf Service in 1966 following the 1966 1-day meeting previously mentioned. It is and remains true that there is no agent as found in cigarette smoke that can be specifically pointed to as a canse of lung cancer. Stnrreon Cieneral Stewart agreed to this in 7968 and aqain in 19E9" In fact, the failure to identify any ingredient or group of ingredi- ents in ci-arette smoke as responsible for causing any of the human discases with which smoking may be statisticallv associated gives emphasis to the lack of scientific proof for the alleration that smok- iuh c:inses fliscuse. 'Lven if it were to be assumed that smoking is it ha.zard i'or some pcrsons, it does not follow that there is anv tr.lation- sltip betlccen flie tsua.nd nicotine content of cigarettes and health. 7s it not possible that imposing a prohibition on all cigarettes above a. certain level of tar and nicotine content could cause a smoker to conclude that cigarettes being marketed were certified as "sa fe" by thc hederal GovernumnC % Hv:lrim in mind that one millit=ram is only 1/28,000 of an onnce, is it nnt- apparmlt that any level lased ontnilligcams must he a verv irbitr:lrr nnc? Are not ticse questions inlpai•hult for this emnmittee to ccntsicler-ptuticularly sineo present scieutific knowledge does not establi'h (1) that eitllor tur or nicotine is ;izltifican( at all in tcnns ,If ]nnnrtt health. or (3) sui,y waY of knoioiilg lvhnt amount of tar and nicoline miyltt be important if thc.v were siqnificluit at all? After the Strickntan filter hearings, Senator D1an uson, the chair- nnul of the full Senate Colnmerce Committee, made the following obsrrvation: I holw that t1LC lcaeon to bo dmwn from these evcnis Is not that the 9rneeb fnr a.citer jT.~.rrtr, is hopdess, but thntthe senreh must be enrriad mlh so- berly mfd ccientiGc:llyc For [LC value of any deTetnpment in filter tecTmolo@a ?hnuld be esfiLiisheft , ,.nd , reasonnLle donbt beYoeq and not nLter„Rreat public eNheetation hua ,oif geu,fated tllrough Public claims and ballyhooP' no Tbld.. P. -10. ~ IbilL, p. 216. 1bi,1• p. 216'. "-" Ibid. 1, 220. Mearlyiz, S S_f rC A'a I.ommil0re an SpArnprinF H. o n1 IiCpiCarnfnttvC+. ]lA[Cb llf P Fal 1 Fi G nrl n_ " ApPSqtx 1tf H-vl ,r. [tn 14, Ful 3. P 45. " Wal .(. Yf F~~ . CLaemnn Sile C~ „ i o L'ommr.xeC, nnlement to fLe C~I111I2 LOLCCrllInS nl2' r,triCkmUn Til(CC, ' jl. 2. T158461200
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J6 oommittees, and governments. '.lfedicine is a very individual thing and medical re=_esrch and its advance are based upon individuals. I think if you will contact the individuals actively working in the field. lung cancer, emphysema, bronchitis, and coronary dise.ese, you will fiu:dno such nnanimity of opinion. Scustor DZoss. ZVell, there may not be a imanimous opinion but thn vast preponderance of opinion in the medical profession now is tliat thcre is a causal cmuiection and that not only that smoli7ng causes these diseases, but that high tar content in the tobacco smoke increases the incidence, and, of course it is based largely on epide- miol ogi eal data. That is the way to measure it as far as human beings are concerned. I don't suppose we are ,oing to hook any individual up to a oiga- rette-srnoking machine to study him. Dr. Soummns. Sir, statietica.l mathcmid.ics oan never proti°e cause and effect. All they Jhow is a rclationship rcqruring fnrilur s(Udy, usuallv e•-kperiments in nui:uals, to 6nd out thu meanii~gtulaess hio- lovcill~-of this reJsitions6il~. -I really believe that annong the aetkc researc,hers in the=e fic1ds, there is no great preponderance of feeling that oigaretto smoke is carciuuguni.c. Senator ]Ioss. In your sta.ternent, pou quote the Standard lrneri- can'Pestboolc of P:ihhology, sirth edition. is that an extensive book, and how much of it is devoted to lung cancer and eigsarette smoking? Dr. SoMmmrs. It is a tNv~o-volume work. I belicve it runs at least 10 rWO pages. The new chapter by Dr. Millard is an extensive cl.apter. Rfp mmn- ory is that there are at learst five or six paees, double colmmn. that deal with lung cancer. Senator-Moss. Are ymx acquaurte.d with Dr. Jlillard? Dr. SoxarFxs. I have never mct him. Senator 3ioss. I intend to write a letter and ask him to furhher expand this statemeut about eaneer and cigaretke s,nokin,m„ and I will include whatever his answer is in the rccmd, if lm will reapond to m7 inquiry. l3e is instructor in pathology at the University of Miaani, ia that corrcct? Dr. NoMac>;ns. biy memory is, lie is associate professor of pathol- otR'. Senator 11loas. I see. Thank you very much. l1'ell, I regret that Senator Coolc has not come. Since,jenator Cook- should have an opportunity to ask any ques- tions he wants to, I would ask you, Dr. Sommers- if you would re- main and perhaps return to the table if Senator Cook would liL--e to question you. Thank you very much. I appreciate it. Dr. Sonimi•;xs. Thank you. Senator Moss. Our next witness, will be Dr. Robert C. Hoclcett, Associate Scientific Director of the Council for Tobacco Research. Dr. Hockett, will you come forward, please. TI58461219
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95 I leave to the individual physician to decide what advice he gives to thc individual patient. Senator Nloss. T)o you think this matter of moderation that you mentioned might have to do with the extra particulates that the one who is immoderate and goes beyond and rt gets into his system rather than being moderate and not getting as much? Dr. Sonzasmns. Sir, iny belief is that these are different kinds of people, psychologically and neurologically. You can't compare them with each other as if thev were the same kind of person. Senator Moss. Well, I agree. Everybody is different. But I still haven't been able to get you to say what was modm•a- tion. You n•ould not, advise them to snoke beyond moderation? Dr. Soat-uw2s. So, sir. I really would not advise a person with re- gard ta smmking, nnlaas von wished to qualify that and give me an esampic of a sick person who is serionel.y or mildly ill, and in cer- tain circnmstances T would think smoking would be helpful to the patient and in certain other circumstances, I think it would be harmfil. It is impos~ible to answer without more detailed information. Senator 11o>s. Wherr yon testified in 1969, you said that as far as you were concerned, there is nothing new in regard to smoking and careinw„enesis in the 5 years since the original Surgeon General's report. llo I on still agrec zvit.h thut now? l'L'e h a ee este.nded it, sometime n nw. Ur. So.rprare. Sir, there is ahva.ys more new information. I think what Ica, rueu.nt Ncas that there were no new basic findings or revo- lutionarv iindings. 1i'hat I fnd iniere;tiqg in the last °d years, as cited in my sfate- me,t, is the indicat.ion t:bat viral particl.es conceal.ed in cells make these cells more s'qseeptible to transform into neopl:ustic-like- cells, when there is e.posare to quite a variety of substances, and also radiatioi i. I think that is escitint. SetIatmlioss. 1Vell, on tlhe basis of your tcstimony, arc we to con- cludc that the, medical profession in Canada, liritain, Denmaik, and Sn-eden. and Tsrael, JaWan, Poland, and many other countries, are all o!i the wromr tractc hecanse they have c•.mno out with reports con- nec-tinh• cicarctto m1oldng n-ith the diseases wc have talked of, and hxN 'e recoiumondi-d to ttsir go~-crnments various programs for less- eninf smokinw ? Trr Sir. I speak only for myself. TL~=c m„mtzation5 have reviewed the puliliahed evidenee, which is Jartrely sta.tiatical. They hatie accepted it, to mv rnind overenthu- sia>ti(oll~c, at a period where this part of scrence is still developing, and tl.cv hacce conre ont.citlr resoluticns. If there were not a cm,troversial problem, it is doubtful that reso- lntions v:onld be in order. There is no resolutioir that I know of that poliomyelitis is caused by the polio virus. So we have here a resolution of organizations, d TI58461218
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93 Dr. Sommrrs Well, sir, in a question, the answers to which is unkno1rn, and in which an article is submitted, that does not over- throw the whole sitna.tion of inedical thinking. Senator ]foss. I wonder if yon could supply for us, as you did for the Honse Committee, discus;.ion and ansvicer, a detailed answer, to the mrrtcri:tils in thia ~aper that I refer to by Cornfeld ° Dr. Somnrnr'. I will be pleased to. Senator Moss. Thank rou. We vcil] place that in~the record, and that will help us zrith our bnc!u_~ronnd stndi.' Senator ]Ioss. I think, Dr. 5rmmmers, when yon testified before the Hcnso Interstate Roreign Comrnerce Conunittee, you stated that you w~ere one of se~-eral membe~ from non$\t_t a.nd nongov-ernment groups rPpomted to a subcuuunittec, which was to establish priori- tes 1'or r senrch ill those arc i~ .3-ticre there were de6cicncres ill lrnovlledge regardinp, ,Smul.6rh anrl health. 11"ould}-oa sup~l, ts the report ef tlint committce, which you stated in 1lpril ID(41~ aild be ready ill a.bont amonth 4 I )r. Somacrms. Y.-t ecir. 'l~iee conunitn , nized nnder tLe Secretary of I1P,I'ti', Coiren, and thc.a ~i ry Finch. 7t coneise(l nf representati)es of the AML1, l:cveeirch Lto:md:rtion Comnrittce on Tolxuco and llralt.lr, of inenzbcrs from tLc National Lrstitutee ol' ITealth; and membcrs from tl;: icientilif.ldvisory Roiu•d, Conncil for Pobaeeo Ilescuch. We r.ar aslced to de.velop a doc.ument Wat e-onld ecplain the gaps in laro„IrUue in tho ::ur~hing and health Iield and priu:itie, lor fillin;-, ' ilrrse gaps. li-c.hchl several mectinhs a number of draPts were prepared of what was to be a joint staternent. As it tauncd out, rce could not reach at*raeiurnt with the represcnt- atic-es of N I[i on various parts of this document beca.use among other flring,-l, they insisted that n-e accept as proved that lnne cancer is di:o to cigauette stnokinr. SVo then agreed to dclete from the doeument everythin,n, on which memhera of the snhconnnitiee disa~~reed, and onl_v ta b_z,,,a ~ dnru, - -me~it inat wodld -mw'lndc the gapE~in lciio~r-lc.dge and priorities for fillin,* thcar on v<'hich eve.rycne arrced. Bot this v,as uneafiisfirrtory to the V~!..TI representatives, and conse- gue.nttyj no joint docnme.nt has ever a.ppr;nrd. We L:r:e tLe finitl draft of tlie docnment prepared by Dr. Looeli, and nivself. for the Cbnncil of Tobacco Research. lou are welcome to a e.opX - of this dowuner.t. jl'e hace n, I rhith that samc group subseqnently, we have eselian,•ed informotion on granta that are fnnded, and tte w'nv the field is 11, and we hope for more rneetings. But rmfortu- nate Iy, a j "i nt d, ~: •n ment 1 i as never resulted. One uti.; r r-,r-n rvhv it has not is the YIH people always had a bod)ch pagm in their versiou of t7m docnment. It appeared that the other groups in e-;aencc rscre helping tLem to develop a budget pro- gi•am to be anbmit.ted to the Congress to help proe•ranrs within the IN111. . ="a,. Ja9 m, n s~s. TI58461216
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73 every mmoker from a. variety of sources including cigarette advei•tis- ing and periodic reports bp the FTC. This availability of a broad range of products toget.hor with information about the tar and nico- tine content of all cigarettes affords every smoker an opportunity to freely express his perference in the marketplace. Senate. Rill No- 1454, on the other hand, would prohibit a smoker from esereising free choice by bauning all cigarettes above a certain government-prescrik,rd level of tar etnd nicot.ine content. This would be accomplished by directing the FTC to set "masimtun acceptable levels of tar, nicobine, and other incriminated agents as the Commis- sion determines may be present in cigarettes in quantities yvhich will not pose an unre.asonable Ilealth hazard.'° t Lnder this bill tar and nicotine content would be arbitrarilp prescribed by Govcrnment ediet rather than by free. choice in t11e marketplace. There is no tar as such in cigarette srnoke. The tcrm tar, while not defined in the bill, refers to the particulate mattcr collected by laho- ratorv rnethods. Tbe amonntt may differ froln cigarette to cigarettc eveu of the snme brand. The 1912 report bc 5urgeon General .7e=se Steinfeld notes that at present no "°availxLde instrnlrnentation . . thtplicates the precise p}lysiochemieal conditions prevailiug in ciga- rette smolm. as it is inhalc.d."' Despitc mueh repetition of the dlaim that the tar and nicotuie (or an%, otdler agent) in cia~arettes aroe harinftd to smolcers, there is lit.tle seientilic evidence to SnPport snch a proposition. .A"e.itller can it bo sltpported that a re.ductimt in tar and nicotine would decrcase any cl, imed ha.rmfnl eftects of cigarettc smoking. At Utis (loint it is u=eCn1 to revicav brioll~ ,ome of the histor,y- pcr- tinrnt to the l,ressnnt rorttrneersy'. Iu 1964 tLe Stlrgcon Clmlerrtl's Advisory Committee reached no conclnsion that the tar and nieotine contentt of ciga.rette smoke had been proved to havo health significance. The Colmnlttee expressly not-ed. in fact, that nicotine in cigarettes °probabl_v does not repre- selil a slg_ niGe,tnt he,alth problem."' lluring the 13SS Congressional hearin~rs on cigarette labeling hills, the TTt7, the YIIS and the llepartments of Connnerco and Agricnl- ture took the position that tar and nicotine had not been pror°ed to lutre health significance. The 1f365 report of the Senate Cmnmerce Commil.ten took particular cot,nlizance of the vieyrs of the Chairnlan of tl~e FTC'stnd of Smgenn General Terr1-.° The recognized facts mcre that, tllere was (a) no prooi that tar and nicotine had an tutfa- vorable effoct on healtll, (b) uo proof that cigarettes witll lower tar I semve Bln 145 f , I'!`_, ess llmst sess.: r1pr. 1. 1041. p. 3. l 'rha lical6h I ' i. of Smokint, A Report Ln the Snrgeon Gencral; i:.S. nep3rrment uf 11 1111 ~ Ittl1 ~, ulou & yCelfure, 1f]PY, p.211. '$mo6t .v tna ll~'Irn Repurt of The 2,lclaory Cormnittee to the &urgeon GmzcraL of TM1r r G1M1 J M1:.'th ac -cc. 1164, p. 09. 4 1 r~. iP. mhorse iLC 5urgeon 6ener¢t's stxiement to pnu, whi¢h I believe in effect rnLl Le . ~, lt v ozLl bu LeLLCU to ]m.acu thn Situat:mi alann. IL em:Ll rexoir In rn n4 of I ~nn_~.nt.i lon z netlring mislen6ing If one cigareLte en]ne mte uni srd~ S'i it Tn~. 1 a, :. u.,l s m]~ n co6uc hR iL, auil n mLhcr a nue ,m t :d salrl it had 01111 1, I :h.v thls stud' h,ia cmer urnred ib avhat a ent¢ 'tav and nfr_otine cnntent have not 0.rr'ivevl ut what In emukin6' ie Lhe ngeut a+ sneT ilint ta exv'>Ing i Le,, don't know whethur In bL.uue It {cm.eurl au u@otina. tnr, or many ofher' definer] nmI undcnu¢d Ty~lroennbous and chemfcala that ~talce place, ehcmieal reactions LhaL hJCc pl:.nn rqbncee bum.-.' Am] Ruuil Disou, Clmimznn Fetlernl Trmle Cnmmisslnq nc.uin>;. 6efore rize ConuIIm ou Commarx, n.S. senxlq 19fia, ParL 1, pp. 41D, 906. s"yChtle It vcems at L 1 i p1nn. D,lc tLUt cl¢xrxtLCS wlLh law¢r ix[ mnl ztlcutln¢ mq9 pre=ent lesscr henllh ha..:.-I~_ thcce is rresently uo proof Lhst thlx is so." Snegeou INru- erpl Lu[tt¢[ 4'1'erry, 1'~ nute ]leurtnb'u, rczzprq Purt 1, P. 34. TI58461196
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90 in Lancet, t.Le current .Tanuarv ]97•2 issue, is an article by Dr. ('arl Seltzer, Harvard School of Public Health, pointing out critical defects in these comparisons and conclusions. Last year's strongest statistical evidence appears destroyed this vexrr. I salute the editorial board of T.a.noet for this example of Eng- lish fair play. One doubts that Dr. Seltzer would have been allowed to publish this paper in a annparable L'.S. medical journal. The key point is that in a new and uncertain scientific diseipline, still developing its techniques and a bettor understanding of the biases involved, neither reliance nor decisions based on the statistical epidemiology of lung cancer appear warranted. Lnng cancer researeh in animals has progressed little in two years. We still search for a reliable animal model inhaling whole. fresh smoke in a natural way approximating human smoking. The reports of cancer in tracheotomized dogs appear generally discredited. The importance, of genetics and the viral oncogene in lunr* tnmors is increasing, based on findings in mice, harnsters and in tisstue cidPure. (ieneticallV pure cell lines exposed both to an oncogenic virus and a chemical irrrtant transfm•m in tissnecrilture into neoplastic-type cells where neither agent alone produces transformation. The cells are of connective tissues, the tumors are sarcomas and there is no current relei'ance tohwnan earcinomas which are com- po=ed of epithelial cells. Howecer, thc amazint. technica.l advances in viroloLv in the past 3 .-ears provide bope that similar viral genes in epithelial cells may tmrn on and initiate some animal or human carcinomas. I'ntil at least this is achieved it is premature to implicate or to exclnde various chemical substances, including whole tobacco smoke condensate-so-called tar--or its fraetions. Nicotine, of course, is not carc.inogenic. For brevity, other less spectacular advances in eancer research are omitted. Tn respect to chronic pulnruonary diseases, particularly emphysema end brronchitis, a slow advance c.ontinues in the techniques of demon- strating clinical. physiologi(-, and pathologic indicators of thesc con ditions. So lnnt. as pathologic emphysana means something different regurdingits pre.senee, type, and extent microscopically to each of niue difl'n•ent eyp•rts in the field, as reported rocently, a consensus coucerning canses and developrnental stages eannot be cxpected. lu1portant ne.w information has come from sputun cytology. Tis- sue-digestlng ensvmcs a.ffecting the, ]nng are genetically controlled and cxplain eome emphysema. The. cru•ious absenc.e of etnphv-sema in most Negroes, regardless of envirc>nmental :md other factors deserx,es more inquiry. To blame cigarette ;moLe, condensate--so-ealled tars-or nicotine fmr hronclutis-euiphysenma is simplv to aucept a delusion in our enr- rentlv early stage of understtuiding these conditions. Coronar;v heart disease is flm most common and serions disease rlaimed related to smolc9ng and tlurs the most important public health proble_m. lYhen a ctindition atfects to some degrree, based on clinical tests, nearly half of tniddle-aged and oldec men, and when a majority of TI58461213
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nt is 5 e 97 STATEMENT OF ROBERT C. HQCEETT, PH. D., ACTING SCIENTIFIC DIRECTOR, THE COUNCIL FOR TOBACCO RESEARCH-U.S.A., NEW YORK, N.Y. ~ 1)r. Ilocra..;-r. AIv n,rrne ia Robeet Cn.snd Ilor4ret.t I sm Acting Scicntifir, Director for the ('ormcil of Tobacco Pesearch and hxee held this position or that of Assor_iate Scientific Direetor with the ('onncil and its , ~redro,-- ,°. the 'dbbacco Indnstrv I:csearch Commit- t:ee since shnrtlv after _ur~,,s~ tirrrr of the latter in 195 1. Brn- nenrly ;U ~-arrs I i:a~c. Slrtciuiizcal in tlre (iclds of om'y,viic cl.cr .~..try and bioch~ n stry, seiences that r e!*rentl} eo~re.*rned with all life processes both nm-mal end abnm~ml_~T rceei:ed the Tiaehe- lor's. `.faster's, and ?)octor of Philos,)pVay dearees for these subjects from the Ohio State C nieersity rr,:prafivcly in 1925' 11928. and 1929. 1111.cr a vea.r and a half as a nnest scientist at the 11at,ional Insti- tntes of Henlth, under a, Tisdior.il Rc=carch Council Fcllow=hip, I becau:e a member oF 61ic s4~rf there to engage in biochemical re- search re]ated to medical problrms. Betwecn 193# and 1950, I was sucr,es?it-elY assistant professor and aesociater profe~'sor of chemistr,v at the 3Iassachusett= Institute of lccllnolo2p. coudnct nh res-carch. trainin- •radnuic st.udents for hrtrher dcq;rees and ar,ting as a cousultant to pharmacoutieal, cl.emi- cal. and torod intlustries. Proru 194-1 to 19:f3 1 Rms scientiCe direclsor of the Sugar 1:esearch Tonnd2.tio,.. snpervising sprnrsorcu reaearch in nutrition. food tech- nolo;;c, ar:d in related mecliaa'i IIelds, such as diabetes and dental nrio;. I havo ant'lor 'd more tl,a.r 60 rescarch papers pabli.hcd in Q•hemicuf journals p.nd have also wiitten numbers of papers for nred- ical societies aud hesvlth assoc.iation; mr problems of Iundarnmaal ro- seareh related to health. Iu 1961 I had the privilege of presenting to tl-ie Committee on Commerce of tl:e r.S. Sernu.e a review of tobac-+'o and heetilth re- seurch sponsored by this Commil since its inception, in a contest of scientific findings in this field from other sonrco.s. 'Ihis rcvieev "-a,s pnbli=h(d in thc ru;ord (p. 807 ff.) where it can be consulted. In 196% 1 present,ed anot}rcr sCatement to the Committee on Inter- Aate and Foreign Commerce of the Ilortie of Representatives alt its huiring on cr„arctte lakelha and xdvcrhsinq, for the puipe se of np- d Sing the 1r15G revicw bv describing sonre new findn ,,.., expanding certain s-tions and particnlarlv pointing out the implications of the fin h~_-. ~¢, I savw them, with respect to the matter of tobaceo use in relation tn human health. This statemenb was also published in the hearirc , -vrd (pp. 110£i 1YYei) where it can be consulted. In 1=1 0 0 d 1969 I described in considera.ble detail the nature, or- ganizstimi and modus operandi of the Conuc.il, and these desc,riP- tions were included in the xrcords. Mlv oral statement of 1965 was snpplementerl by a complete backgronnd document outlinin~; the Conncil's history, organization, scientific program and pnblications. This also appcnrs in the record and need not be repeated here. My thesis in these previous presentations was ihat neither tobacco and health research in general, nor that of the Council has estab- T158461220
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so Sweeping statements about carbon monoxide in the 1972 report are not substantiated by the. detailed exposition in the basic docir ment which is only obtainable in typescript copies passed hand to hand like the "sunizilat" in Russia. Budketnr.y restrictions, inertia, and inefficiencp cannot eacuse a 1- year delay in receipt of this goiernmental publication supposedly ecnt to all physioiaus. Other esamples may be cited such as a press release coucernin* oral bvporlycomie druhs for diabetics based on an impublished ancl unava.ilable research study ln.ter reportcd as not above valid criticisms. Diabetic specialists havo used potition to the Government as their only available, metuis of redress since various appointed oPieers, com- mittees, cornmissions, bwealus, and so fortli, are apparently exl.rile- gal or snpralegal. - In a tee6nologic. age, to annomcc nmdicail and other nonmililarv discoveries and decisions, keeping restricted or secret the basic d;ua and their soiure, is dan~~m•onsy ncndmnocratic. 14'here are the traclitioual checl.•s and balances? \Vhe.re is t]-ie informed electorate or t,he informed ley;islator? Now to consider problems of smoking and healtb. In respect to lunm cancer, a focus of attmition, the newly published standard Arncrican textbook of pathology, fitli edition, tip. 11 D. Ander=on, edit.or, 11071, Diosby C'o., St. l:onis, inclndes this statement, by Dr. Max \7_illard, page 964: "1'he close relationship between certain types of lnng carcinomas and cin,'arente srnokin~ luxs been made well lmoom, as has hhe ]esser rclationship to c.i{~ar and pipe s,nokint. Whether or not a, canse-and-cllect relationshih has been proved is a blend of lof,ical, statistic.al, nr.d emotional argmnenr." Vote tlie ouiissimi ol' mention ot biolordeaievidence or scientific proof. I leal-e aside td io cn iotional in ~ol vetnent. FresumaLlv by logical arnumcnt is meant the idea that ~rnol:ing ougldt to be harmfnl, whether it is so proved or not, originated by Iiimg James, and a moot question ecer since. Thero remains the Statisticnl erictenc(3 to conider. -lssoc_iation does not mr.ui cattsation nnd, iu 1940, on this basig, the main cause of lttnl,r caneer zvas aone idererl to be I udmrc.nlosie. Stahistical matl~ematies so far developed deal snccessfnllv Nr-elv with random potnil;&ons. Since sm okecs aaidnon,moieis are se.lf-s::- I~.led,no r;andomized trroiil,s exist to compare. '19=e applic<Ition ofinappro1rriede m-,thetnalical formnlas tlnls .~ h k providc a, -,;ilid resanlt tivhen sr.>kers and nonsmukers aro nu~,arad on a one-to-onc bisis. '_I`iio crrors in derth crrtilicutc di~i_,rn-~..i iii most such stndies arr retimated at 25 pcrcriit to ov~_ ._.! ;.-.1_~. Ifins alnd tho missiouar}- zeal of some incesticators who ho,-o reiun^~l to releaxc 116 r~EU! for recirw cadt n pal I uii their eonrl The Royal Colle.co of Pbvsicians' reporC, available in 1971, consiil- ered statistic~al e.vidence nf the increased disease and death ratcs snnong Britisli doctoxs who smoked ci„_,nirettes as the stron,rest indi- cation of their ha.rm_'ulness. - TI58461212
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92 In respect to early dcabb, Iwould lilcc to csite the hook predictin;,- lonpevitc by Rose and Bell, a stndy in the Vetorans' Administration in Roston, still going on, of a group of veterans. When they esamined early death in theso veterans, usiuz the simplo stafiistics, one-to-one comparison of smokers and nonsnolcers,, thea fonnd, as had ot.her studies, that smoking was the number one predictor of early death from any cause. Then when they applied neticer and more soplristicated eompari- sons, tlrev i'otwd tbat ci,q;:retto smoking completely dropped o,P the Gst as a preciictnr of enrl~- doath. J.t ivas some~rlhere beyond the thir- tietlr fac.tor th .t thee had identified. So, I bc.lieve 11rat was nna of a uwnber of stndier, that do not sm?- port tbc idea that ci!!arettc smokiug is a ca,usc of ovarall incrca-cdi eplrlV deail.lt. I ctui ci(e s.rirtiv of slirdi(•s of suiolcers ill rrspect lo <ur..nxrv dis- ease ill whi,-h the cigiur*te smoker~i h,xl eit}mr no iucrenscd coronary disease, or in some eascs had less eoronwv dise.vise. Senator ]Joss. Well, if Tou hare tmy-star.h studie,, I.rould liice to have them to inclnda in tlte record. If it can be sirorvn that smoLers a?•e cqnal to or have less death and di?.caise than nmismokers, wh}, 1 thin'u Nco ou'ht to hare thmt i1i t6c ruc.ord. T ha.°;e sprnt a numbcr of ycaa-s ill this field and Leld a lot of hearinit;y and I have never seeu any in Pormat.ion of tha6 sort. AncL Lwnocier aboirt tlm medica.l profe,,ion itself, after the re.hort of tl e Snt~,eon Gereral, ti-w nse of ri mart,tte~ by ALD.'s droppeci iLra- maticsllt^ andhas reroained doxmt dramaticrlllv. Don't you tbink the medic.a.l profession 'senerally is convinced theree is a causal cormcction? ~ Dr. tioarrvrs. Sir, the ntedicmrl peofes=ion ,R,encralh- ReG thcir informal.ion secondh:rnd like otlter people 9n the comnnmity, and they are srusc,eptible to prop,iganda like other membcrs of thecommrnn:tti. In recpeet to the citzrtions you remrested, they ber!-in on page 1048, when I irrn bein• rpiestioncd by illr. Ik.kbardt, and there are also some incladed at the eard of that seme. volmne of the T.B. Flouse ofRepre,entatices ]toporls, Nihen lhe chairman, Air. ~6agger, asl.ed mee to respond tn a letter from tbe thetr Snr;eon Ueneril. and tliat becins-pardmt mw- l..liat berins on page 1&1I of that same roLrme,, serial rmmber 91-13. Smtator 3loss. Page 141-}2 Dr. Yes, pa~:e 1114, sir. Tt is divided into seaions, sir, and ill rcferenee to cormiurv iirnrt disoa:r, 1.hat part is on page 1-11fi. ` Senator ALote:. Yrs. I see it. Are ,ro',t fmmilia,r,Doct.or, witir a paper entitled Smoking andLutL, Cancer Herent b:vidence, and a Discussion of Some Questions anthored bv Jrrome C1or^ifdd et. al and puhlished in the Joarnal of the National Caucor Institute in 1959. Dr. Soxi,.rt:cn. Yes, sir. Senator Moss. Doesn't it answer virtnallv all the qnestions float, ha.ce been raised by skeptic.s arbontt the health haaarcts of sruohina ~ TI58461215
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ss lislmd thrrttnbacoo use or cigarette smol:ing in particular is a "majon ceallh hazard." ]1v point is that it has not beon shown vchether, horv. to wh:-it e.xtent or in tirhom ciffarette smoking can con- tribute to the ctiology (eans:itinn) of anv disease that is presentlv a ma..jor cnuse of- illnrss or carlv de.eease. 1' do not find any convincing evidenre t1Lat either tar or nicotine or anv othm• agont in ci~~arcttc smoke has been "°incrimillatc.d" in rel:,tion to any hmnan disease. Conseqnenth. IL, re is no scientific bnsis on which to establish'`max- i.mum acrept.nAle I, .~~ of tar, nicotine or other incriminated agerrts' as proposed iu .S'. 1 I 1 i. The basis for t6cse views has bcen preso-nted in mv 1965 twtd 1.9(i9 statements. I aleo be~ le.ai-c to append for thee record without re(ed- ing it here, a palr ~ititled "The Tobacco-liealth Issue: An Over- view of Medical N, -~°.ic-li.° that I nresenbed atA a Univelwitv of Iielr tu?k}° sympo-imn c.r 1971. These materials present my overall vic~ss, and should b, msidered as the foundation for the connnents that follow on the qru+: ions iiow before this committ ee. 5enunor bSoss. 'I'hat paper will be inclnded in the record. Dr. IlocsnrT. I have. it here. SenatorAioss. Very m;cil. \TCO':1VE Dr. lloer.rTZ. Since nicotine is a pharmaeotogically aetize sali- stance many inr(ctigators have apparcntl_v aseumed that if ug,u~ette smokim,~ docs have xny rclation to the developrnent or pincipitation of cardiovascular diseases in particular (for that is where we trsnally find nicotive nnder diswzssion specificall,v) it must be sd.trib- utable to the effects of nicotine. '1'his, of course, is not neces.rarily true, and the misconception is corning to be recognized. The matter is raised here because nicotine is mentioned in S. 1-t31 as "an incrim- inatcd substance." It should be recalled that the 1964 report to the Sllrgeon General of the U.S. Public Health Service did not talce this position but st;4ted:'`The rapiriity of degradation to nontoslo metab- olites, the reswts from chronic stndies on aaliunals, and the low mortality ratios of pipe and cigar smokers when compared with nonsnrohers indicatc that the chronic toxicity of nicotine in qu.ulti- tiesabsorbed from smoking and other methods of tobslcco use is ve,r_v low and probably does not represent a si;*nificant heulth problem". Subsequent sinnuri,l reports by the Surgeon General to Con~h*ress entitled "Tkm Health Conseqnmlces of Srnoking:' have mentioned mxny observations of nicotine effects. While these camiot be re- viowed critically here because of their nnmber anrl divcrsity. I sub- Init thatt while some of thun raisc qucstions or present possiN lit,ies that rall for consideration and further study, rcpetition and exten- simt, t.hey do not at present alnount to anv inerinlinatiou of nic_.otine, but remain almost wholly in the realm of conjecture with respect to hnrnan health signific.n(cc. Alany cardiovascular diseases such as stroke, angina pecetoris pe- ripheral vasc.ular disease and "(heart attacks" (m}-ocardial infare- tion) are believed to have thoir origin in the gradual thickening of the blood vessel walls (atherosclerosis proceeding to arteriosclerosis) which eventually brings about cluonic or sudden restriction of blood supply to the heart itself, the brain, the extremities or other olgans. TI58461221
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101 cigarette smoke in the expectation that they would develop hmg can- cers and that the responsible substances in smoke could then be iso- lated and eliminated. But over the years, these many experiments have all failed to produee human-type lung cancers. Surce I last commented on this subject before a congressional com- mittcc, in 1969, some experimental work with beagle dogs has been reportcd. In my view, IJtat study does not warrant any change in that statement. The experirncntal method that did produce an observab!c result wa- the painting of smoke condensates (ge.nerally but erroneously called tars) on the skins of mice. The multiplication of sueh skin paiuting esperiments hae been chiefly responsible for the widespread and apparculJv cnnfiderrt idea tlmtt the reputed danger, of human cigarctte srnoldng with respect to lung canecr have already been traced to the amour.t of tar in t.he smoke. I feel that this is not bv anv means correct, and that a pause to consider some very snnple and basic facts will show the tenuousness of the case. My skepticism of t.he relevance of the skin painting studies to the hmnau lnng cancer problem is based upon five very fundamental c.onsideraiionst 1. The relatively enermous dosages used in the animal skin esperi- ments, and really reqni,ed to get results. Calculations have been madc, indicatine tled, ~n man would have to smoke from 30,000, to 160,940 ci~rarettes a day and inhale every puff to got such a dosage of tar on au~ eqniralent arc.a ofhis luna. The great diifercnces between mice and the. primates, including msm, in susceptibility to such cancer-indueing chemicals. Vledicinal sal t-es used withont ol?=crvable harm by humans will readily produce skin caneers in rnice. \Tonke--,st in experiments, have been shown to re=ist inilefinitely the same skn trelhnents that will produce skin cancecs in mice in a few weeks. 3. DiP.'erences between skln and 1hmg. Couneil-snpported ecperi- mrnts ba.ce nhowr, the•;e tissucs to be. far morn resistant than tbe skin. Smoke coudensatos introduced dircctlv into the lung have not prodnrrd can.^.ers. On ri,e other hand, somo strong carciuovenic chemieals will do so if 1;iured down so tLat they remain in contact and are not quicl:ly oarried away by the clea.nsin,_~ mecharrisms of the lung (snch as mu- ew!s flow aml the scavenger white cells). -}. tirnol:e eondr.usutm or ta,rv are not eqtticalent to whole, fresh, nornral smol.-c. Condensates nf smol.e collected by passing smoke throush cold traps at verv low temperatnres are not equivalent eithcr in physiealor in chomical properties to whole smoke. Wc know that both chemical and physical changes occur, some rapidlc, following the fm7nation of smoke in the burning zone of a ciraretxe. These continue to take place in the condensate after collec- tion. _vid, of course, the capor and gas components of the whole smoke arc not present in the condensate. Still fiirther, it haa been shown in one of our council studies and others, that condensates from pipe, cigar, and cigarette type tobaceos all eNert a similar, though feeble, activity on the skins of mice. Yet the statistical incidence of lung cancer is very low even among pipe and cigar srnokers who report or believe that they inhale the smoke. TI58461224
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I 102 It seems clear that the effects of chronic, ]ong-term inhalation of 'tvhole, fresh, normal cigarette smoke can never be realistically ap- praised by means of smoke condensate studies. I once summarized tho inadoquacies of the mouse-sl;ux expcruncnts by stating that these involve the wrong material (that is the condensate instead of whole smoke), in thc wrong dose, and in the wrong form, applied tu the wron,n, tissuc of the wrong anilual. \'ow, the fifth point concerning the relevance of mouse-sldn paint- ing exneriments to the human lung cancer problem lies in implica- tions of viral agents in cancer production. A new dimension has rocentlv been added to such stndies thrmx~h application of the viral genome~concept of cancer genesis. The runi- fications of the concept are too complex and extensive to discuss here at any length. Ho~Tever, I should mention that a C-type IiNA virus particle has recently been isolated from tissue of human origin. This hes been under scarch for a]ong time. This may prove to be the human coun- terpart of those previously isolated from several other species and used to prodncc.the rcage,nts neccasary for deternxining the presence of the viral antigens in those species. If this becomes possible for man, a new era of research to detect cancer susceptibility in hur-mns and ncw roads toward the goal of bolstering their defenses against cancer may be opened. Meanwhile, the Council is endeavoruig to use animal strains em- ploying these concepts to elucidate the interpla,y between internal mecltanisms of cancer susceptihility and the role of external infln- ences. R'e endeavor to use only animals that arc controlled with re- specC to the status of the viral genoxne for studies related to this particular problem. Rt present, however, these hopeful developments onlv emphasize the difl'icnlty of extrapolating the~ results of animal evperiments with smoke or smoke condensates to man, since the animal strains used heretofore were not observed or controlled with respect to the status of vira.l genome or its expression. CARBON MONOXIDE Recause the Surgeon GeneraYs 1972 Report to Congres=~ iucludcs carbon monoxide along with nicotine and tar as the `compounds in cigarette smoke judged most likely to contribute to the health haz- ards of smoking,l I will comment briefly upon the state of our knowledge of this subject. lt is well-astablished that carbon monosido is a normal cnnstitu- tent of human blood produced by metabolism, and also tdiat the body can also destroy this substance, though slowly. }+qithout any expo- sure at all to external carbon monoxide in the air, the blood will contain from 0.2 percent to 1.0 percent of carboxyhemoglobin (the combination formed by this gas w.tli the red blood pigment). This level is equivalent to that produced by constant breathing of air con- taining sevon parts per million of the gas. I just mention that to emphasize the fact that it is not a substance that is foreign to the body. Carbon monoxide is formed when almost any carbon-containing fuel is burned with limited access of oxygen, so that cave men hud- _ J TI58461225
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105 Senator Moss. I can understand that. The reason I asked: Some have a feeling that because the Public Health Service has publicly taicen the position that cigarette smoking is harmful, it. cannot possi- bly be an objective reporter of any sort because it already has a con- olusion. It would be the same the other way, to pre,snma that you have a conclusion, and therefore you conld not publish an ef£ective objec- tive. Dr. Hocizn9T. It is not quite the satne, because the investicators who receive our grants are scattered around in medieal schcwls. In most cases, we don't even lrnow what their views are on the, subjcct ol' tobacco. And they are publishing their papers on the basis of their own medical school rescarches. Therefore, we hace- no control over that. tiVhatever I might think, or o-hatever tlto metnbers of the scientiGc advisory board might think, this has no 3nflnence on what grantees publish. Sen+ctor Moss. That is precisely my point, sinc.e the agency simply ¢athe-rs the research that wmes in from all over the conntry, a1l o'-er the world, and assembles it and fits it into a report, it does not necessarily mean that it is not objective and would be biased. I)r. Hocr.nTr. It does not necessaril_y tnean that, but in readinl,, thrse reports, it would seera to me that they are not hiahly objective, and thee reason ior that is that we peruse tho literatnre, we collect tlsse pnblications, and we find many observations missing from the re;:ort of the agency. \ow, we don't do the same thing, jVc don't attempt to present an anal.-sis of all the world literature ourselvcs. The only analsis that is made is through gr:mts. Z~'e have subsidized the preparat,ion of seve:-al monographs on the subiect of the biolo"iv.al ell'ects of to- bacco, but this work is farmed' out to a group at the nniversity. They do it as they see fit, and tlzey have published:ui oricimil ruono- ;rral>h, plus two supplements, so that our judgment is outside of this, and :any possibility of our bias is rnlod out. Senator Moss. Well, I wonder if you could furnish the committce with the studies about nicotine that have not been included in the biblionrraphy used in the prepamtion of the reports on the health consetluences of sr.okingB Dr. HocxL-ca We will endeavor to do that. We will be blad to present a supplecnont, so to speak, or eormnentary, or compilation of material t,hat we mightt feel should have been included and perhaps was not. We jush re.ceicod tliis report. Wo haven't really had time as yet to do a very complete job. Senator ~Soss. I would esclude the 1973 report. Perhaps there isn'tt,imet But tlie 1967, 1f)38, 186J mid 19T1 repor(s would he help- fcd, if you could do that' I)r. Hoc~l:,cr. Yes, sir. Senator liloss. Approximately how many parts per million of car- bon monoxide are yielded by an averalge cigarette whcn it is smoked? Dr. Hooicns-r. Well, I havo not translated it, into those terms. It would be abont '? or 3 percent carbon monoxide by volume. i see p. 716. TI58461228
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11J6 Now, that is not quite the same method of statement as parts per million. There are different ways of stating these things. Senator Moss. Yes. Dr. I3ocsFrr. It might look like a fairly substantial percentage, but the point I want to make, is that a person takes about 3b millili- ter pnffs, perhaps 10 of these from one cigarette. This is so intermit- tent that you can tolerate without any ell'ect a much higher part per mitlion level from that cigarette than you could from the air that you are going to breathe all day long. You breathe in the course of a day, about :i,500 gallons of air. And even if you smoke a couple of packs a day of eigarette,o, you would only aet one-tenth of 1 percent of thatt volume. So, you sec, tltis enters into thc calaulatiou. Senator Moss. You eay because of the breathing that is in be.- twee r- Dr. lrocxerr. The duration of the, period of exposure is a11 impor- ttint in this ,nattm• of carbon monoxide. And as you probably know, the Navy and the Air Force people hace set a series of acceptable levels, depending on the period of ex- posure. They will allow healthy young men to work in an alauos- phere of, say, a thousand parts per million, or 1,500 parts per mil- lion of carbon monoxide, for 10 minutes, and in a somewhat lower level of concentration for an hour, so that all these dosage loce.ls hace to be considere.d in terms of the t.imc of exposure. Senator A'Iosu. I am sure you are acquninted with the tii'ynder re- search pablished in the Journal of the American Medica.l'Associa- tion concerning dose response relationship of cigarette tars to dis- eaSe, and muno1Iraph 28 of the National Cancer Institute on the harm of cigarettes. Don't you think thesc publications are some of many that hace led to the idea that there is a dose response relation- ehip, and not as you state in your statement, just the paintings on mouse skins of tar? Dr. I-)ocict.rr. Well, if I remember those publications, these. Were effort to relate hmuan experience to the kind of cigarette smoked9 Was it something like that? Senator Moss. Yes. Dr. TIocicxi"r. Well. I think those are extremely premature. T,jnst dou't thiiilc there has been nearly enough time and largo euonyhh nnmbers to get aa sound indication. It is going to take much long er. I just dori t have any faith in that work. SenaRor Moss. I3ut there has been other research done other thrui just painting mouse slvns4 Dr. HocKnVr. Well, I would go so far as to saw, if nobode hadever done any monse-skin painting, the rest of it wmildn't havearonsed aatv interest at all. And it has even really been questioned whether most of those little- tnmors thatt de%-elop on mouse skins are really malirnant tnmors_ Most of fihem are papillomas and will renress. It is only oocasionally that they become nali~•naut, a.nd we have done a considerahle amount of such work in this regard, and it just does not seem to me to come into contact with Lhe human problem. There is too great a, gu l i. TI58461229
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104 The possibili.ty of any hazards to nonsmokers in the same room with cigarette s-molcors, attributable to carbon monoxide, is certainly so remote that it can hardly be considered seriously. (The N-cry con- trived situations mentioned in the current Surgeon General's report serve only to reinforce this comment, since even in those cases the concentrations in the air are not alarmingly high.) Recently there have been suggestions that chronic exposure to car- bon monoxide may have an influence on the development of athero- sclerosis. These suggestions, however, are based upon a rather small number of animal experiments. On the basis of my comments on the very re- cent development of animal models suitable for controlled studies of the atherosclerotic process, it will be clear that we arc only just now entering the era when we can hope to make meaningful examination of this possibility. I think it should be noted, however, that severall studies of men chronically exposed (10 to 18 years) in their work to quite high car- bon monoxide levels have not shown anv earlier or more substantial circulatory abnormalities that could be attribntable to atherosclerosis than the general population. While there is much challeng ng research yet to be done. I do not feel that there is presently any scientific basis for legislation relating to carbon monoxide output from cigarettes. In summary, evidence has hceri presented to show that ncither nicotine, tar, nor carbon monoxide from cigarettes have been incrimi- nat.ed as ]mman health hazards by any scientific, evidence that could justify legislative regulation of output levels of these, agents. Senator Moss. Thank you, Dr. Hockett, for your statement and for the references that you have e ven us. You and Dr. Sommers serve on the same Council for Tobacco Research, is that correct? Dr. HocurTm. He is a member of the board, and I am part of the scient.ific staff. That is, I am acting scientific director. I do not sit on the advisorv board nor vote. Senator 1Vloss. I see. You are serving as a scientific director with the council. Dr. Horzmcn-rr. For contact with the investigations that are spon- sored. Senator 54oss. And how long have you served in this position ? Dr. HocscTT. I believe I am in m,y 18th year now in this capacity. Senator Moss. Has this been funded by the Tobacco Institute over all of these 18 years? Dr. Hocxr:rr. Not by the institute, but by the tobacco industry, by manufacturers of tobacco products, cigarettes and so forth. They have funded it during alll this time with the understanding that the pivgram is completely nnder the supervision of this scientific advi- sory board, and they have full freedom in determining what is to be done. The investigators are nearly all in medical schools, universities and hospitals, and they have complete freedom to publish their work. There is no restriction. Now we have some contract researches, but the same rule holds there. These will be published in full and made available to the entire scientific fraternity. TI58461227
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103 dling over their smoky fires must have inhaled the gas and have ex- pe.rienced blood levels of carboxvhemoglohin considerably above those attributable to intcrnal metaholic processes. Occasional forest fires rmic have given thcm „reater exposruMs. Cicili•r,ation, hovNever, has very greatly increased the amounts of carbon monoxide poured into tho attnosphere so that now the con- centratious of the gas along the streets of big eities may sometimes rise to 50 or e.ven r00 parts per million. Imrnediately be.hind a slow nroving trnck, thee concentratiort may rise to 1,000 parts per million. Indeed, nearly (i9 percent of all tim carbon monoxide in the air comes from 2nelc used for transportation, automobiles, trucks, and planes. There are also many other industrial sources. Continnons breathintt of air contnining 100 parts per million of carbon monoside wi7l~eventnally increase the blood carhoxyhemo- globin levet to about 1u.7 pereent. This air level, however, bas been art bv the United States of llnn•rica ~tnndards Institnte as the ceil- im, <wuecutration to which worlcers in indnstrial atmospheres may safely be ex l:osed durim', .ur S-hour .corking day. 1'he lona-known and most obvions elfect of carbon monoxide is its ability to compete w-ith ox}-gen in combininl, temporarily with the red blood pi,q_'ment (bemor~lohin) mhose. ma.in function, of cmtrse, is to transport ox}-mn to the tissurs. 'I'hns, by formatinn of cnrbox}•- hernof'lobin, it tics up smnc fractionul part of the total bemo~lobin and removes it from function. This temporacy tienp, hosocer, does not in,jure the hemoglobin, tivhich roturns to Iraus(rorting oxvgcn jnst as soon as thc carbon monoxide is remored. This Irappens n-hcn air free from or lower in carbon monoxide is breathed aga.in. Ha.lf of mry carboxyhemoglobin then in the blood is diminated every 3 to d-hcnus. The rate of elimi- nation is substantialhy increased by exercise. As loun ag_o ors 1933, it was shown tdrat nonsmokcrs who were also not iu much wntact with autornobiles had nbout 1.5 percent of their homorlobin boaud to carhuu monoxidc. Smnl<ers, aftcr snoldm,_r rurd inhalin;,r from 10 to 15 cir.m-ettes n-ithin u period of `3 hottrs, showed a rise to a percentage setur,v6rm from 3.1 percent to 6.7 percent (av- erage 4.3 percent). Souo of tlsm eslierienced o-urti syniptoms attributable to earbon monoxide, which realle is to be expectod, since these levels are far below those approred for indusbrial exposures. Further, cirarette cxposnre is, of course, generally intermittent as compared to the da.-lon; exposure often encountered inn industries. Dlmeover, it is n-el1-esfablislhed that exposnres to multiple sottrccs of carbon rnouoxi dc are not di recN v n dd i t ive in effect. The classical stndies in the field which go back many years ]tave shown tbat a. 10 pereent. carbotyhemoglobin level is rarely even no- t.iccd in any warr by the smoker. Even a 20 pe.reent level does not produce symptorns, even headache (which is one of the earliest) in most people. Hence the general view for many ycar, has been that smoking was very unlikely to prodnc.c even tiny inconrenient efEects, let cloue present any actnal }re:rlth hazard throrgh carbon monoxide. This view roas fnrther snpported by the fact that tolerance to car- bon monoxide is snbstantiallc iucreased by repeated exposures. TI58461226
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Millions have been spent and mueh time has gone by, and we bavart gotterl the answers. So I think they are hlmgry for an anslvcr. In a11 these countries that you mentioned. there are groups of people who are highlv convinced by the stntistics, and I think if it ivere imesflgnted thoroughl,v, vou would find that these small groups of people have inst.lgated activities, resolutions. and reviews, and that the rest of the medical profes.sioas in those countries, because of their eagerness to find a way out, have really been stumpeded bv these other studies. Senator n'foss. What about the active little group that is con- vinced that it is not and is propagandizing and trying to do it. and they didn't get anti =_tampede9 Dr. IlocfadTi. The reason -Por that is that everybody can sah that it ia se7f-intcrest. The medical people mnst be intereste(i in the pmblic health, therefore tl:oti have a much greater degree of credibil- it._v. Senator lkfoss. Don't you believe the Inedical p_ rofes.sion is intor- ested in public, health'? Dc Pocr,lerr. ph, yes, of eonrse. But I think they cou!d be misle.d. Senator Moss. Don't you think they are trying to find a way to improve public health? Dr. Ilocxsrr. 1 think they hope so. I think the grea.t majorit~, of thern have not had the time, the energr, or the opportunity to look personaIly into the matters of the evidencs, and I think they have been starnpeded. Senator '_Uoss. Well, I am not a medic, but I have more faith in them than that. i don't think they aro really being stampeded. I reall}' think they are makulg as concentrated an efiort as they possi- bl.- can to find out tJre canses of disease and to avert them, and that is nhat has persuaded mo. I have gone to world meetings, as well as sc~Fsions in the IInited States, and the medicAd acceptance of this is just so overwhelming. it is juet almost un iversal. Dr. Hocrnmr. 1 find a great deal of skepticisnl among the people I have talked to. But it is not comfortablc and popular to st.and up and battle unless you have time to really delve into the effects. Some of them don't care to do that, even though they have great personal reservations. Why shmald they? Senator 1lfoss. Thank you, Dr. I3ockett. We are glad to have you testifv. (The article referred to earlier follows :) T88 TOBACCO HEA6TH I95C6; Ax OYYII\4Ew oF AIEUIc3L AEN£9ACn: (By Robert C. IIockett*) xa-raonvcxIOv A few years ago I had the privilege of attending a previous symposium here at the University of Kentucky wLen a.ppropriatious for tobacco and henlth research had been received from the U. S. Department of Agriculture. Among the presentations made at that time were several by members of the TJniver- slty faculty and Experimeut Stution stafP, who prOVided a very considerable •dssocinte Sclentttlc Director, The Counoll for Rbbaeco Research-L.6.A., Inc. TI58461231
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Irp R. l7irt affects the lc1-e1 of sernm lipids (such as heta-lipoprotein) and the derelopment of atlLerosclerosis, bnt the relationships are not simple and t1leo interrdations are complex. Hence the effects of dic- tarv ingrcdieniee are not independent and cannot be assessed by the usunl atatisiical mcthods of mult.ivxriatr, analvsis. The conh'idernticn of these obscrcations shows or suggests mar,y re.a:~ons MhV hnmun stndies with their ralative lack of alntrols ap- pcar so confusinh- inconslstent.. and contradictory. And thep do. On1~; no~i-, or verr recentl}, luis it; become possible to de,igu a pro- gra~tn of scstematic and weli-c,ontrolled nnirnal stadies for attacking the problcu of whether and, if so, how, nicotine (or tobacco smoke eaposlre h-v the inhnlntion route) can exert ^nv significanr, rffee'ts on tbe processes ineolved in Lile rarnple.c etiolo,oy of atherosclerosis. -llran.vhilo. nav effort to Incrimiaate nicntine as a cause of athero- scleroeis in humane rests upoo a hiahly ir,nuous and conjoctural basis. pt)L NCIL HTIn1P 9 OP SIG!.rl]79 r11.1BVIACClOGY A quite extensive progr.um of snch studies on the plnrmacoln~~:al efFecrs both of smcl ma nnd of nicotine, has been c uried out by tho cao:.vil. The<e have c.ml:omed a-~ain lhe verl tlal ;ient nntlre of slch eiTclte, manv of wllich mav be considered benefic.ixl. Zvhile a great deal of infornlation has bcen added to the stockpile of knowl- cdge iIl this icld, none of these studies has established any contriblr timl bv nic.otine to the causation, an._~~racation, or precip$:it:ion of any ca.rdiovascnlar disease that is among t1le important causes of mortcili( ,~ . BLOOD FLOA{' Nicotine has been shown to have effects rather similar to those of li-ht esmcise on the work of the heart. It tonds to increase flow of blood in the ske!eCa.l muscles and in the arteries nf the heart itself unless these are diseased and too hardened or sc=erotic to expand. Flow in the s1;iil may bc reduecd by nicotine in cold c~LCirname;lt3, bnt espanded when estarnal temperal ure5 arc h While nicotine tends to incarase blood flow in the eoronarc arter- ies, it is less clear whether the extraction of nutrith-e substanecs from the blood is increased correspondingly. A11;0'1'LNE 31li1'.1BOL1nM E>tensive council studies ha.-e traced the brcuhdown of nisoti:ie in t.he bod,y, the stnges by wh.ich it is broken down, and shown that it is vcry rapidly canverted into other substances of much lower phur- macologicael activitv. The council is sponsoring development of a rapid, specific, and precise method of ana.lysis for blood lucotisle which, if suc,cessPol, should make furtller stndies possible. ea.rTRn T1Iis is tt term wllich I do not appsone of. I prefer to call it to- baceo smoke condensate. When the statistical reports indicting cigarettes in cancer were first published, many investigators undertook to make aninlals inhale TI58461223
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107 That is one reason why we have continued to do inhalation experi- ments. Ne are particularlv interested in the lumr, and if we ¢re par- ticularly interested in this mgur, we ou0ht to co our studies there. We have been continuing suiilr work alroady for 12 or 14 years. llur- inn the last 4 or 5 vettrs we have been trying very hard to develop better dm°icea, me.ehaniral devices, for the e.xposme of mriuials to the inhalation of a fresh,.vhole, normal cigarette smoke, and in this Kentucky paper tdiat. I am submitting here, there is an appendix whic.h describes the arit;cria that wc have set, up that need to bc met in snch expe.iments if they arc to lie regarded as realistic.. While we haven't fully attained a,lt these objectices, we thinil: we are coser fo tlrem than anvomeel:e we knmv of, aml tive h:eve a larte mnuber of inhxlation shidie.s ~oinn on. Rut so far, we do not have ei~idence in animals that the inhalation reallv of normal c,ic,rrette smoke prodttces lung tumors, anythiug like those that are seen in mau. Senator ?t•Loss. Well, you are somewhat expressing the same opm- ion that Dr. Sommers did, refrring to acceptt the epidemiological base tlrat has been shown the causal relationship between lanp_, can- ccr and cig;trette smoking? Dr. Hocr,ma^r. I am very skeptic.al of that, for the reasons set forth in my paper, but I think he pointed out one of the vety significant ones. If you are going to do an expertrnent with mice, you tEiL<e litter mates, from the same mother, so they will be as nearly alike as pos- sible. ~You put one in the control group and the other in the experi- mental group, and ynn set the conditions exactlv the same so ~ou call c,tnnpare what happens to these and what happens to those. Now, luuna.n populations that are usrd in these studies txre not so seleclTd, becai.use. tiou have to ,m,o out and find out who stnolces and who does not emoke. You don't know anything about how they hap- pened to smoke, whv they need.ed to smokq why they wanted to srnoke, how they difte~• in phy, siology, tcmperament, or ~enetics. So yon have a phony experiment when yon start and no matter how lmuh statistics you do, and how beautiful youtstatistical tech- niques mre, qou onrmot get away from that selectron factor. \Ce have aa lot of evidence, showing that people who do smoke, who, for .vheitever thc reason is, want, like and need to smoke, are quite diiferent from those ~cho don't. Thes differ in matters of per- sonality, in body build, in tc~nper:unent.~l7iere have been a dozen sudt studies. ilnd we may not even be asking the right questions as ~ Rnt this seems to me like real conver„inn evidence. These are not the same kind of people to begin with, Tven the brain waves, the electroeuccphalo[rraphs of these people are different. Senator Moss. Could v-ou spcculate for roe•, as to ahv the vast prc- ponderance of the me.dical and sc.ientific comnmonty in a11 of the de.kvloped coimlaics of the world have bcen misled aud gone down the wrong trn,ck and are off on this? I)r. Ifocr.rrrr. I will be l;lad to oomment on t,hat. I think these diseases, like heart disease and cancer and chronic pulmonary diseases, have been baflling the medical profossion. They are eager to find some way out. 7v-rst4- -rs - -8 ii I T158461230
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a n-n ~n- ry Ig te e. 9 99 'I'herefore, if nicotine is to be"incrimuiated" in relat,imt to these dis- enses. its effects upon initiation or progressimr of atbero:clerosis is a priine quest,ion. 7t is mnverealle u.cognized t}uit rnany factors may be involved in deterrninma ihe ~rn:tc at which atlrr,rosclcro~is deirlops xmd also in influencin'-, _ the prec•ipitation of acnte discase events. In mp 1.9C9 statement I listed tt:entv snch factors tlrat have been reported bv carious investigators, and pointed out that while some are c{erulc of a genetic nature, others are environrncnl.at. Sar,e wonld oppeitr to aet direcLh- while others, if tl eS are valid, must exert their influenc,e indirectlv or onl,}- ~assooioted zeith other factox•s lhat are truly ct:ral_ Tn assc;:;v tt ir trne siRnificanoc b1- epidcrnroingiral methods applied to hununr ~ ~,ulationc is estrmnelv ditl'icult, tirne-ronsunring and cost'., and anil.~l-i of thc data aenenrred in sre7r studies often transcrnI the cn. !, '.itics of cvea thw hest arailable methods of mnitivari.ih iula.:-is. The r:l lsul:lpraeart of beitor aninral models for tbo . st.udt- of atherosclerosis prmnise.s to provide new and probably verv n.srful tools for the ctudl" of these drsco,~es. Certain breods of pioeons and several sl ecica of- monl e;vs appear rueful becxnse ther naturally de- Ae.lop atherosclerosis verV sirnilar to that in mail, and are able, like rnitn, to ecpcrience boart attacks. Many otlhcr .uunral sl+ecies do not, a.nd t}ho.re are r.rnnv ~tndies tlurt hace been carricrl orxt ou anilnals thatlNere mrsnitable for the purpose. Stndies of these snscep6ible anirnt:ls have produc.ed fiudinga that ma' v nelt be found applicnMe to man, and that c.an nud certainlv musti bc cottsiderrd in thr desihn of fnLwe hnman studics. 1. h:ieiations in tlre bloud lecels of clrolcabc-rol iucruase i.he os- tent n.ud scr-eril-l- of atheromat.ous lesions in all anirnals that develop atherosclrrn-i=n,tm•aPv. The sus,rltiblo specics and strairu men- t;.onedrv;'rnrd tu -_(uitc modera„r m r.a- ~s in dletary c:holestr.rol. ?. l:)eu m; ;;t.-ains that il ~clc p lesions tirlron fed snclr a dieC, Urere is a grcat voriation in the individuals .vith resp:~.ct to the extert of arM1v.rinl chn:nges, 3. Genetic faetors- are predominant in rletermining these varia- tions. Breudurg elpe.riments suggest that 90 percent of the variation is genretic, though effects of age aud e,uvironucent can be seen. 4. ~'eparutc factors appear to determine t1le suceptibilitv or re- sistance of various major arterics to aftirroselerosis. 'L'hns in some species, cbanLes in l.h,e aorta occnr, in others, chant;es in the eoro- nar;e (heart)- arteries and in still~others, changes in the cerebral (brain) artrrics. These diitercuces in the location of lesions have been a mc,terv in hurnan stndies, wrd consitule a problem that needs to bc resolvcd. o. Atherosclerntic lesions are capnble of regression_ This fact was not easily dumousLrated in hnmans because obeervations can be made onlv aftcr natnral death, whereas anirnals can be sa.rnpled after con- trclled reeimes of plamred duration. 6. Diabetcs and hypcrtension increase the eeverity of hsions that develon when hlood cholesterol leve}s are constant. 7. T`he same degree of elevation of blood cholesterol has different effects upon devclopment of atherosclerosis depending upon whether there is m accompanying elevation of beta-lipoprotein in the blood. TI58461222
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lIl J'hrir n'i/leninn apidication, veverVheless, has Probably produced a quite Ileti- tians Pielnre of the axlent of actoal incre~nce in imidence of Primury hurg car- cc ^`~ t.`ct' a period ai time- lllJle =b'S sHl~,tion Inay not greatly af[ect the responnttiilitfes of the rnedi- cal prot.- IIt in the rr'ml of treatment, it Dresents a prohtenl to t'he atndcnts of etinl_} ,.. d upon an acemnte picture of chnncin,g inaidence over LLne if 1LeT rc)iahle conelations wifh environmental factors tlrat h:ne Fimilail~ i ~r the smne period. Gthrr proWelus *, 'I.ann ilnrecolved. 'i'he ordinari, death cerfificate does not nlwace, hy ,Iny m.~ ., retlect or inelu'~at1 of the infoemation gWnial post- mortom or e-cn chu'_~xllc, anrl eontinues to be primacily a document required for ir,col pur_-es rnihcr than a 4ien11ibme H^~i report. For eiawplL L.,a Bi' tine5on buhvri, pnii-.cy ]tmg caneer and seoondary metestal.ic aru,cer iu tllung is uct e:°'- '.~ke in many cases, and since it i.s ut r!nfir~lv tit/!e nnporfance to tb, I .c.mn responsible for trexttnlent, is not g •.lll: : ~ , ml', 'I n'ith nry •t. ,duity.'So thc stitdcnt of etinlce,r, how. e'cr, this d'I.v-ii1 is of prinlc imporinrvc. I aut advised l7rat death cet4ih- catr tl0 ta tal nl , ,1 '1r govcrnment stttlsu iu n s~ ns do not provide any firm basis for rlsr.vin_ :ime trands in rhe incidenre of trne primary varcinoma of the lun}:." ltorp~r=r, lilere ace ecidcnt-ov of clirrieO m:crdis.gnosis al:triiontab.n to tlre enrrent - rt-light of atteutimr to ILis disease, ,vhen uarefill Po+t-mortcm confinuation is not made" Many othsr confltving pr, '.tems eould be mentinned, bnt becauve of time lim- itatioe", I wiil mentlnu o~tv three morc. Ove is the matter of snbstant-iat dif- Ferel:ees in the inmdi°.-:I: 'ln- eaieer in variouE geogroPhical areas, yvhich do ntrt en're" I° with t1r il ~"'erl l~vele of ci°arefte 5lnoltin,°, in tlmse nrens. Thrre nrc loI IqT.1, >na where lung cancer is rr_.pnrted to he relnticely pt .'~ . h ct,• i r.relte smokh4g is ulinilual and others wit,h the rerere9 ?iilk I,' d:qnur,9nalytii5 of all the faCtora that may be involved wiil r.inirrc- on a-nie that exn probably be provided oeily by a major -n., . .t'~ I io . inI l.wf,@i a8cuey. A s '. lr',) in i3 tlie perdidting 60bstIlnt]a1 BifPerenCeS between lung canrcr Icu, in £emvles as comPared to rnales, including ovexall incidenee, relative iuclnf the vnrions rell Ivpes, end a different pat:teen of associa- tinn Idth ,gnrette smol:ing" Slill a thirt9 enigma i=s che gradual rlse in the _ f 1'1k invidence of cancer in tlle lung drtring tlm cra mhen pignrctte . Lluc was steadilp increosiuS" One would espect the age of PeaG incidcnce !, dine if an inenra3ingly Irevalert envirmiurental ageAt tvcfe thc major ..i _. ..' ive factor. qlc nea thr r nf RnhL^ il u l- i, A(. /' .1 , , ~.9-r' ~itl L I.~i,~ r I . 2fec ~. .... .. ,. ~ ~ - I ~. ..od At. D. I: ~~ - n- I:nn ~ 1 1 .. .. , I . , ~,..~ . - . .. .. . 1 rt7 tp6T, tun a1tL srmrnr .... I~ Li.i~~T.~i~lf nl~ ~o-,: .,.(~,I~ I i...I~,ilo.ttte- ia '. en. 'L F C,~,.I,~,J ~. i.. I~. I~. I;~i. L. ~•..n Nnf- TI58461234
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109 7,arndc of GllenL I especially remembcr being impressed by the potentinls for mudifping the chemical and physicul properties of tobacco by means of ~enetie manipnlurions, variat.ions in cultm'al coodilionE, and by alterations in llrovesa- ing n;etheds. The repetitive plea of these scientists was, '*If the investigators of health problems cnl tell us how they want tobacco altered to niaGe it "safcr" fur sumking in the form of cigarettes, we are quite confident of being able to accomplish the_ changes deslred." Thlm was, hov'.ever. no answer given to this qucstion. The geneticists, bii, lnv, i~, agrononusts, and processing experts were compelled to retire lvi-6., i . iviic been given any clear health-related geals toward which to tar- get lheir~investigations. 'Che -~I ability of health researchers at that time, to provide such goals, did not, of , -, 1 rae, stop all progrross. lt did howevcr, compel the geueticists and agronomi~ta to conduct their studies largely at a descriptive level; i.n. to record and catalog the changes in the ultimatc composiflon of processed tobucco or its smoke that could be brought nbont by the Icinds of systematic alterntions they could achieve. For e3antple, it has been possible to dotcrmhm hotiv the ldndc_, amounts, and sequence of applicsition of nitroa neons fertilizers affect the'.evels of certaiu uitrogennua consHtoents in the product toiJaceo and the corresponding levels of several nitrogen compounds in the anmke.' Thus, a stoclc-pile of infornulLon is bcing bnllt np which can be drawu ul'on ii' aad when eriteria enn be defined fnr assessing any health consequences of higher or lower levels of such compounds in smoke. LSADIDp,nATE TESTS Obviously, if there were soume simple, reliable system for testing tobacco or its smoke for relative "safety", for hnman use, a mueh Iuore highly aeganized, systema.tio, and ethcient prqgram could be planned and implentmned Ioward the goal ot mxuimum safety. 1'rescnt deseriptive work cannot truly Is targcted toward a health znnL ihongh Pxperimcnt Statiou OcrsonneL and health agen- cies would like to be able to directly attack the ccal problem. llnfortDlnttelr, thosu is Im siwple single test or even battery of tests ade- 17nate to guide snch a program. Existing tests are no better tsan the hyPotheses or conjeetures upon which they are baaed. But the complesity of this prnblen3 h:rs nnt been universally recognizevl, and eagerness for a systent- atic "tiaYety progl;'xnl" hns- apparently Impelled sonle investigators into placing an unjustified degree of reliance upon certain tost sy5tems such as mouse shin painting with cigrnrtte smoke condensates. IIowever, before colmnentlug upon this test mefhod and others rrgarded as better by their proponents, we sbonld lmnse to emnment nnon the origins of the view that cigarette smoking is a 'major hazord to human healtl3." Ontnl V s Or IInALTA I68IIfl lt is not necesvxry to go into any detailed examination of the evidence, since we ire all awaxe that the conjecture hus nrisen largely ont of epidelniological utndies- that rcported statistical associr.tions between cigarette smoking and the rates of incidence or death rates ?rom seve3'a1 disensw. 77tese included cancer in sevcral sitce, varions caudiovascular diseases, and chronic ailntents of the long, as oell as Iwmerons other diseases in such variety and dive,sity, in fact, as to 3traln CTCdllhtf.' . 1'l1oDLRMS 35FOCIA'fnn \9I'1'II TIIL" nlHUnliIOiAGICAL SPPAO.1e8 lt is nntversullT conceded that the cansns of diseases can never he deter- mitwd by snch ePidrmiotugiual stndics alone." These studies may point to areas e tLnt rt: i r nitn rmnrehenpieebiblluurnphv" o3 Healtl J_1 ali,n q I R Ilure S.-/in.y aull Flenltb Kenrf of t I vtv.e to t1._ :.! en G :-f-TliPt 9lulllenlfon 1303, R'nshinGfon. .__._-. _. he I-' Drvlh I trr -,nd Phy_ICnl L'uctora," Buif. de 1'I>latrztnf bufern¢tinn¢3 - - Srsluu. I'aris, 19P1. enrnth Onrl 1i. }]hmi.."rt.,lrvi iclnmgen nber den Nttr¢tachalt des TnhklcF." ~4 ~, /,"n. J' .{ p . 33Phe cfcr n es Lld/d ~,l In thie pap:r are . tl ~a4 i Ibut,_a; In sncvl5c e m, . liefel,mces lu thrree anns r rOlrr .I ~„hn of the prolPem of InterLretndm, of stntbitlenl sM1ldles fn cn,c= of 'J r . .,,lion (.911 bx fouPIl In G.Y. Tlila. °The Flmetinn pf SnrtLstJral 1I - : fl 1 tlylllo " 11, rini Futip H........ h linrrrd Fspart, 28, N su rb Gn"m„] / b a FMA L i 9 D ,. ^.. p., 1924 andepartmcnt h, GCUCatioy, and \YJfarq 5~c.oi'~.. ...~..v~,"itli, op. cit., P--0. TI58461232
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112 COII3CIL STTITIIDF TOWARD THE Cl'NFdIIOLOUICAL .1YPROACII In view of sucn limitations and uncertainty in the interprel:ation of t.hese epidemiological studies, The Council for Tobacco Research has adopted a rather aguostic aititute loward the etiological significance of existing eTddemi- olouical evidence. They have not abandoned epidemiologieal studies, bnt are sponsoring several investi2ations by statisticians who are further analyztng great collections of data already accumulated in major clinics, in the hope of gaining new insigbts. lfenlsahile, they are coneentrating particular attention rlpon experimental and cliaical stndien.~. Their policy is to cmNtaaize study of the etiology of those diseases reputed to be linked stntisticnlly wilh tobaeeo use. 'Phe three discases or dasses oi' di.c- ensea particularly involved are cancer, diseases of tile cardiovasenlnr system, and the dvmlic pulmonary diseases such as emphysetnn, bronclliris. asthma, and others. Thee happen to be the tLscases that have becmne the greatest cur- rent medical problems sinre substantial conquest of the great infectinus dis- eases of the pasG They are all "cons[itutlonal diseases", which means to me that they develop Blowly ovee a long period of time und comc about through relatively gradual failnre or distortion of normal bodily uluchanisms. In Iheir certainly rnultifactoria] oriein, It cno Lardly be donbted tlmt coneenital differ- ences in the efficiency nnd reserve cap-acit,p of enzyme systenls, bor,noasl caFacitics and balanees acd in the operation of hmneostatic conl.rol systrms are involvixl, Of murec, environmeraal iniluances placa constaxrt demands ul'on these systerns and tlmir cupacity to ndjnst to these demsnds effectiveiy must depend to a!arge degree upon genetic endowments. PtfrLar, nllenlC9L nKSP2ncII NF.nns The m2.dicine of the future must certainly be increasingly preventiva as wrlt as palliative. It would sem destined to undertake discovery of notentLzl woa1.- ness+es in the body's internallnechanisms in time to protect thenl aeainst ehal- lenges beyond their cn, ac4ty, or, better, to fortify those adaptive cnpacilies sgainst Permntnre hrcal:down. This goal does not diminish emnhasis upoll the necd for Plseine reasom,Lle controla nPml the chal1enges of thc rnvlronmcnt, bnt it does imP"se the additional tas9: of deceribing titc role of many budlly functions in dealing wi81 the vasi nunmber of inecapable environmentai a;;ents and influcncrs. NO one snpBoses that the vnst research implied by this statement will be accomplished qnickl-r or easily. bIoanwhile, to t.he extent that functlonal deflciencies can Le detected in Ir,dividuals_. thev ean be t.nken into aceount, not onl,v for holstering a mnn's inadeqnate intcrnal mechanisms, but also for giving him selective pTotecli011 against the challeneee he cannot handle arle- qnately. A familiar IDnstrntion is provided by tlre diabetic, whose deficiencies in the metabolie handling of carbohydratas are sometimes managed by rerluc- 3rlg the load h; metabolic machinery is called upon to handle, antt someGmes by bolstering his available insulin snpVly, or by both. Another illust,liou is the conrential glneose-6-phosphnte dehyrlrogenase deficiency responsible for the condition known as ^favism," that develops when persons deficieut in this enzyme con.sume fnva beans. The same beans are eaten with impunity bc Per- sons with a^normrd" enzyme romltonent.'r flbviollsly, if fava bcans l.ere investigated by the health Imthorities of a langdom whcre the enzyrne defieienr-y was tmlver,al, they tvonld he rated as poisonous, whcreas in a hing- dnm of nor'mnl persons they would be ratefl as wholesome and n'mrishing. Thns, Lneretins' dictum of two thousand years ago has beCn verificd: "What is qnite liternliv food to one man may be 8erec poison to others." The significance nr this enrmne deficiency extends beyond the matter of fava beans, since it also influences the effects of certe.in drugs used in areas where fnva heans are nnknown. I am not aware of any method for off-setting deficicncicw in this enzyme, an[i have the impression that in this en,e the otIly reson'.ce is avoilnnce of afients that the de'icient nalSent cannot bandle_ 'xd. G. MatnlaAy nn? J. lf. Cnmphell-T:rnnt "Ponnlatfon r•nrttrs of GlnrocrBPhos- plmro Uelim-m-' , - nr t1Itrd 1, 11 ° ln ProP v nl t1 e t o t.tera_nrr mu Ger,tr P ri rrnl ~s T'o-.a in At,Rivmbnrg, B 9. pdL[nr. Grune m,i Strnltou .. ~S i961 P. In'Jt. 1 TI58461235
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113 THE COU>-CIL APPROACH All the foregoing has been mentioned here to explain tbe philosophical atmosphere in whicb the program of the Council is being pmnned and eacried Ont. It emphasizes etioloa of the diseases thatt have be611 mentioned and it places great attention COlrgl'tlital and COnatitntional factors as e5senfial to the underetanding of etiology. InveStigation of the responses to tobacco smoke is ve15 definitely included in the progam, but the dc_sign of biological test sgs- tems for such investig,xtfon is tremendously influenced by the eoncepts of eon- stitutional disease that have been outlincd. I uae tLe plural ' T4emr" advisedly, since I feel sure that quite a considerable mmuber of systeaie will have to he nsed, hopefully intot9ocking systent5, before thc jigsEw puzrle c.^.n bc flllod out to show whethcr, how, to what estent, and in whom the amoking of cigarettes can contribute to etiolegy of any conscitutional disease. CHE]f1CAL CAR I t00ET-0 Poilowing the epidemlological reports tnit aroueCd the oriSnnal concerne abont tubacco, a mmnber of cherniub: mutl ii- n.. tical work aimed at flnrling onr ahctber any of the s, :, I,I 1 ...., "ubstance5" alrnadf known to chemistry wcre presett in toL =-r -This sear'ch rcouired fraetimmtimt ol ~ , N, ~~ 1 PmcarLff eeparalion techniqne., paxticnlsrly claomatoertphv, end phy- ,l.~uemical tet9miques for idcniifying siJ.-Iu•.:.~~ in very minute quu~ I'tir, 1,, ~re brou=ht to bear. ltany of the weiblcm.tcu chemical cartanogenn' tl, ag to the clnss of polgnuclear hvdna-lrons. Ii ~ i -.1 'ol, that tlio most abundant member of this claes dei.lu I, in nli- -.;e by modern melhods was benzo(a)p9rene Several bi;;nlS >I dl ts orit_',inall,v failed to (lei'a 41my benzo(a)pcrene in s:'. kc ben-o..~of tLe minnte amnmils. ln carlicr tin:os it woutd probably have been rc]'nI as nn .-.'Uthle. 19ut finally it wtts found to be acti, Ily I', -ul. Nevc headi, "- reported tllat a"..t caleinogenic substanee h ,,- b'n idan',.JI~1 in cigarette. emolkc." 1SUt '. his is :t qnantitative nge. It is no loawcr sufficient to aslc "Is ir thete'"I, We ma-r. alsu ask. "Is enough present to lie oi an.v consequence:"' \lenn.vhile, hiological investigatnrs n called Lhe history of coal tar investiga- flon e-hieh led to discovery of sevrlil carcinogenie polynnclenr hydr'or[trbons in thin c,auples ndsl.ure. Coal tnr p:l'-~ 'n ctn the slcine oC rvioc prndued eanrers. an~9 • is test was dteralore ueud de d~ru.ical frsctlonntions nnfil vz,-r-ral of rhns.ptive ingredients such a- isoI.yrenc were Hnally isolntcd- The sm, '~chnL-lue oas applied to c._.F -x oke condensates, perhnps because bi, familiar vcith t-:.,i- .. i^ling tc^_hniqnee. eUthouGh ?eceral 11 in _,~i, r. ~htained negative re tl .n~~1 ia rc;l nrted a marginal aetivity if 5u"I'. I ., qu3I ities oP condens¢te v I'=, i to ens:tive mousf str ains for a lmt:.- c~~.' n~h time. 77:e tautor.r-, so . a.r.amsl7y nonmaligae.nL and tl. 11 to be mali~r.int had httlC ensive [atwer and did not rnctuetasize or "~I° d to other parts of the body. Pn Ihe other hand, mouseslcin painting wl ., .~! tar or benm(a)pprene, qnite ~r_vlnrly induces the common nlveolo- gent ' :iyuora of Inicq in nddition to skin trmors~'" E -~e,xlly notable is the fact that even this faSnt aetlvity camtot be attrib- nted r- t tzo(alID`re <ine, the tt, '¢n he atlded to smnhe cnnden=ares to inerease the contcnt thirty fold without altering the mouse-shin activitS`r This Hnding largcly removed the spot-ligbt of suspicion from benzo(a)pyreue as bhe spceific poicnliul cancer agent in cirarette smolce. Neverthcless, no tdhc-r sub- stance h-ns emerged out of analytical studiea to supersede benzo(a)pyrene as a prime object of snspicion. These findings have not generated any nen-<paper hcnP.linrs- Primates (monheys and ape,) are vcry much tnore res'istant to skin pain5ng with the "carcinogeuiN' polynuclear hydrocarbons t1lzn mice or raUbit,.'" Though it i. not feasihle to condnet such evperiments wilh men, the relative in: r,Isitivity of hnmeil cells to snch snbstanees has been confirmed in tissvr, P 11. Onerto. "Aenvn[n1Pr"rene Cn-~rent ~afe.Rn=uIIF uf 1M1nrt'renn „e,d Cong-9'erm t. 37 : 19HR, p- 69A. Ic l'rotlucc Cnuvnr ln ItheSa= yton6er, with tlrocarbons unr] 19etrI •-,tsl' Cattcer Rescarch 5:1940, p. 6:A. tbld 8: 't. Hermld. "A Crittqnu of F,zporimen+a t.a inJnre Cxrneer arvilh - • -+. +'.rznt(om.d de dtrztie4iyvc. dcfva do Za 3.3• TI58461236
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114 cultures.'0 It hac_ also been pointed out that certain medicinal slaves contain- ing ooal-tar havn heen nsed harndessly by humans for generations in the treat- ment of skin disorders, whereas these same salves readily induce skin canrers in utice. Of course, ]mman smokers upose Iheir shius to cigaretlc eutuhe for years on end and often haze yellow fingers, but no skin tumors have been reported from such exposure.°0 The mouse skin painting test has persielxfl nevertheless, being used In the assnumtion that it mirht, measure overall "eontact carcinogenic potency" of a whole hattery of substances, inchtding perhaps unidentified earcinogens, inhibi- tors, and promoters, arting In concert. The test has been uced, in facl- as a gllide to modifying tohaccl) 1)roducta', on the assumption that a dinlitlntion of mouse skin activity hy the corresponding smoke eondcnsatrss will be an indica- tion of greater "safety" in its nse by man. I regard this as a vet'y naive nssumption. while skin tests of this kind nmy provide some kinds of infnnna- tion that will ultimately he tteeflll in building the total mosiac of knowledge, they certaiuly do not Provide any simple or direct measure of aIq' ]wtnan hav.flrd in cigarette smoking. For one thing, the te5t inclttdos the tacit assumPtion that the only effect of coneeqoence iu r'elntion to lmlg cancer Pathogenesis is the potential activity of toh9CCo smoke a,a a dirPCt contact Carcllingen. TherQ is no reason to assume that mus+ be so and to neglect a dozen other 1>,ypothotical possibilities If ddny in rlenrance of air-borne carcinogens frmn the lung sholUd be a factor in lung cnrcinogom'sis, then tne effects of tohacco smnlar on lung clearanec mecha- ni.ms might be relevant. Tf chronic irritation of the hlng increases its suscepfl- hiiity r~ cnreino,cenic iniiltcnres frnm any sotrcc, then potential irritnnts in tobnrr, ~nmkc micht be relecant. If inadequacies of the immune sysfem permit repetir~e bacterial or virai infections of the htng that pave the way to even- tual ) , iligm:mv, or lower the defenses against "transformed" cells, we may be ir/.red in the effeets of chronic smoke inhalation on the immune scstem. Awl .., nn. T nnee srmmari~.ed some of the inadequacies of the mouse skin painting system in relation to tbe hnman lung cancer problem bv pointing ont that it involves the "wrong material, in the wrong form, and in the wrong dose, aPp-irrl to the wrong tissue of the wrong auimal.^ ° SmNcn eondensates are the "wrong material" in that they do not contain all theingredients of whole smoke that impinge upon the lung surface of 3ntolrnrs. They are stsle, rdntively speaking, nnd may not contain n11 the shorGlived subatances present in fresh smoke: They may contain artifacaual aubvtances formed dnring storage bnt not present in fresh smoke.° Condenaatce ditfer from fresh mnol:c in physicnl form, bcing "blobs of glob" instead of an aerosol of tiny liquid droplets bearin,g electric charges. Skin paiufing, as ordinarily Hrneticed, uses dosagos that concentrute a far greater amount of material on a unit arca of shin than is c+perianeed by anp equiva- levt arce of the enormous internal lung surface during normal human smoking,"' The skin is the wrong tiesue in thnt it differs radically from the lung, b,ing proteeted by fntsoluLlo sebaecous matcrial whtle the lung surfaces are hathed by a hydrophilic mucns. And it differs in a good many other ways as well_ . Dinmond, "Tlm Rffe%` nf Cnninnn-s1r Rrdrnrvrhrrr,c nn Rodnnt and Prlmntu Ce1. In VItrt" d rrnrti l` ~IJ :d Om~p/rota" P)<veoPqL 6a: ]9P., p tA:t ` Jt D Pn.-r ,Aeol1 . i~ I In Tobn c anN Xeaith G. Tnmes an 1 r RoeenUml. 8.llmr,. Thour~.:~~ gprt.....l, .ld IP?. "R C > c6 r1 y i I `: i,ental Alp i.h o- thc ]nnan Lnne Cnn•r Pr - L~ ]vr + fn :i . L. Crverl 1)t q Dlviston of (`n.neer Fe- >ra_rrT. -~N. .T. T.~T_'F- l'IS. „ And D. ,T. P, Ineuno. "I+roe Rnflirnles Prosnrefl 1v Clea- rottn Pmn ' ~rkr~ 111 : [n.4 n. tlle$ AnT f3_ Nrnrnth_ " r C"raCr' des ~'orknmmens vnn ~'.9h- -,rhl"hn1n (n'fabnrrnneh." li^nerii^mtM_ 2.',: ]OGP, p.400. Ic1 ~ the Pn ~onrentrntxl rl25rrtte vmnL ennTpnsxiea an11ei1 h9 wyodrr In ; nall :ns~t nP n mmrse'e bne- to lnt)nce movne rkin r . x m,shnnid hacr. to I nakc ` la:nt t011.n/le ripsrrtrea /9nilv to _et n r onnirslentr exnari re to nis Inn.n. AC11n. n=tng {Vpnrler'9 olsn fijnl2R t11Rt rCdnrLl1¢ the tiOF9 }nP /IAII fnil? to tnYnee nlnn,¢n skin rnncep a mnn rnn1A thrrrrrHr,nliv =mnkr 50 000 A rlnlrettes /1si1.S winnnt rlnn^er nf lnn^_ eanrcr from ,cmokioJ' Parnphrnved from L 3tae/innald, "An AnNvsis of tbe fti_,irrHr anA Lnn, Canrpr Thnnb:° 9tnrement before }t)e Snhrnmmlttee nnr.exnt onrl Mnnrlnn- Affnlra trnuse Committre on Gonernment Operatlonp, U.S. Cnngr^s=, 35th 9esvioaJnh' 25. 1'J[], nP. 2SIi-284. TI58461237
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11S paticnts over a long period of time. The hope is that- numerous biochemical, pat.hological, bactcriological and radiological observations can eventually be correlated with the clinical course to produce better definition as well as improved diagnosis and treatment of chronic lung disease entities. At the same time, new eWolugical insights may develop. A relatively new aspect haa been added to emphysema studies by the diccov- er,v that a lack of the enzyme inhibitors which normally protect the lung from "dia stion" b,c proteolytic enzyrnes from bacterial or from bodily min ns i, a factor in this dieease. This enzcme deficiency, being cleari-v congenitsl, is another example of the kind of defieiency that may predispose to many othcr constitutional dieease5. PAaa-nrac.o7ogicO S(ud4ex.-At the present time, most of the pharmacological studies bcing supported by the Council are concerned with the e0'eets of nico- tine and/or smoking on thc central nervous system, with thc object of learning morc abont wli.y peuple like, need. or want to smoke. It has been sliown that nicotine reaches the brain of mammalian species, presumahly including man. In certain ways it facititatea the leaming processes in rnt.s and there is evi- dence that it ean produce a true tranquilizing effect in man °° FLTrH.\RY ANII COIICLU6IONs in snmmary, T hnve altempted to present an overview of the tobncco and health issne by describing where the Council is placing the empbanis in its program and why, since this involves implicit judgments as to the vnlidity and signiflce.nne of the various observations that have given rise to present wide- spread attitudes of the subject. If I were to look into a cqstal bell anft forecast what future developments in tBe general climatc of ol/inion will be, 1 would have to say that my partico- lar crystal ball may not be infallible. Rut,, the presently prevailing attitndes toward the tobacco-healtlr issue ha~e such momentum, and the progress of sound and nlethotiical 1'eeearch is so slow. though accelerating, that I could expect the situation for tobacco producers and processors to worsen before it improves. Att thc samc timc, I belicve that as Nce gain a better understanding of the origins of the Constitntional diseasev, tbcre should be a progre-asive attenuation of the claims Wat cigarettes are a "major health haaard". ArPCNllI% RzQuirements for any hlechanical Arrangement for Exposure of Animnls to the Intialntion of Cigarette Smoke under Conditions Comparable to those of Human Snmix Esposure. For the past 15 years, the Council for Tobacco Research-II.S.A.t has been conecrnlvl with the proper bioassay methods of tobacco smoke inhalation research. The sriantific sinff rermnmarlds that the following factors be consid- ered when using an animal model. First and forcl:--(. m.nnlugtul daLa can only be obtained if the whole smokc delivered to i I,, . luu^'s of the animal is in the same physiral and chemi- ca1 state as that whirrh n~rlncCs tiie resPiratory tr'nct of t-he human during normal dp,arette smrv_'u;~. ~Ince moet aniulals cannot be made to conform ~' P'.ew York Acnz ,r ' "TLe PPects of Vicniinr nnd 8moklnr on th, n„Itrnl INervn l. 9v~tem." I )f 11 -~ ~r i' n,or. dnna[x of the V'< r.+k 9cnJ ., nf °or.s, 142 Artlde 1. 191:7 , Th. Cuunell P- T I i... I e, in ILC sl •ing .v^enrv nf ,i pmera of reamcb ,inro . .... /~ I P i -..,1 he,lth. It « e~tl - Iv i 19:.1 1 rPpr, i(,ntOti'.' ~- Gl ' Y Iln! a- ".lell. 1 -' ' ~ ~ hns hecn m.h : - Yp e.l by c 1 ..i I senrch w,til Insfit . n A 9dm1bA- AP P uld. ^cnNe(in_ of ten i`.Ftv nna n 1'rr .i y,ho m,tlr inin Jr r I ~ilI rat ntalirieP. hns L,h ^ , policc and prngn inl It doca not directl n -~ Can II r i x fr n ih fn n 4v . in hegin i , tlr, `t 5 h, . onAht i - qivi ,crh widch r wouID hiurttfr nuti n.a e tl f i111 y b I'd I =nllnn of cerbun chmedc 1-- YHe ihnl Y II t-J1. ~YaouaLNd ndLh - i ~~kinr tihar Nct, Phe G~n 1 I .ir0~. thrref Len a=e~ I- neU R'I111 he CLtoi(1/{V , i'Cl:r. P.11i'nLLn(1 Cilrollle fePkil' I~;YeY. Gaurts-inalln for reYenrrh are marV bg -he Bonrd to InftePendent nc'r ~ 'hu arn a.Ynrrd completo scientlllc freedom Lr rn-nlnctlnr ILefr reaeanch. tirnnten.~i snonxible Lur ruYtmliug or puhlirhhl3 -~ r flndlnee In the nsl~-y4•d scicnLluc~nanoer- n thrm,h mrdicn] and ecirntiftc jnnrnals nn„ Yueicticv. Note: Commrnts tn 110, naPCr nre lhose of Dr. IIackett and do not necceearlly reftcet the opinion of the arfent(6e Advisory L'onxd or The Cauncil. TI58461241
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115 SMOKE INHALA'lION 6TUpIlt9 In the seareh for more realistic bio-assay systema, the Council has long sponsored etvdies invulving cigarette smolce iTthalstion by 2nimals. Phe esact- ing specifications for any mechanical systeln aimed at exposing animals to the monitored chronic inhalation of fresh, whole, "normal", cigarette smoke under emidltiona enmptu'mble To tttose enconntered b.i man in ordinary smoking grarl- naily became apparent wilh experience. About six years ago, a complete rede- sign of the egnipment for such experiments was undertaken. A device that mocts many ol' the specifications reasnnahly well is now ncarly ready for pem- ductiou. (,~ce Appendis) it may of course prove to be the Model T of its kind, btlt Is certainly betler than smne of the horscless carriages that have becn in nse. The most difficult problcm, perhaps, as well as , nie of the most important, is to meaa, . re I.w much of the pancculate phase of snloke acttutlly reacl,es the limg rlr-, -= of normally uose-brcathin¢ anim'i'<- R'e hope that this 4lucsfinn is now tPlr^Idng solution so that dor~r„"i, a.-, nlrtionships cau be studied reali=li":~IL, . li.e new decice is deeigmd In such a way that a L1hr cau he Inserted into the line to remove particulate materials lhus permitting concpari- son of tJln nffect5 of whole Gmuke inhalat.ion with thnse of inhaling gas-vapor pLaee ab nl .'- A cemph', -iHOn in such stlidies is the fact that handling and confinenlent irn t.he_ ma.chii.is stressful for animalat Thus. "ma:Jline contrnis" imist he employed R'ithout actual smolve exposure, as well as unbandled cage controls, if tl-c cM , Ivv of smolce inhalation are to be s'epxrated from slre.-,s effects, Unta-w ..i.lt . this device does not allow us to study smoke effects separu*ely fr-al th~-,tress, but it hns oprned the way to some most int,t:res[ing stud- ies ef a. I.i~lu::nical effects of stress. We hope we are now rcady to begin studying the effects of >moke exposure on a emisiderable number of biologicat and bioche~niesl systems such ss those hintetl att in the discussion of constitutional diseasc etioiogy above. At ciiis stage we are far from rrvdy to ralmpace different varieties of tobacco. On the contrary, it is necessary to nse a uniform, fu11y described "reference cigarelte" to minimize variations in the smnke being used in these investigalions. Rre ure indebted to the University of f{entueky for nudertaking to provide such ciga- rettes. Furthermore, we have found it necessary to improve the standardization of altimalc. For must studies, crosarcan-lerived animals substantially frec from pat7to.eu5 are elnDloyed, and their virus profiles nre determincd Its fully as possible. The availability of nimly inbred strains of mice with khown congeni- tal tumor susceptihilitics still recommends the use of mice for mueh cancer rosearch. As inbred strains of hamsters, and infornmtiou on their virus stntus have developed, studies with this specics have been underta&en in cases where the larger lung and greater blood volume are an advantage. In the Council progr'am of exposin.G animals to the inhalation of whole, fresh, normal cigarettc smoke, it is possible to distinguish several catca'orios. First, there are the purely descriptive etudies. Following exposure of various strains and apeciea to detined levels of smoke for various periods, they are snnipled for description of thc ltistopathulogical statc of the Lnngs and nssaycd for selected biochemical and imnluno-clie[cical chsnges. If any disease uti- mately develops, antecedent changes can hopefTilly be assessed as early waxn- ing signs. Ill other cases, the eHects of smoke mhalation on a specific biological sys'tem that, by good evidenee, is thought to be related to disease susceptibility, are being observed. For esample, there can he littie dmtbt of the importance of the pulmonary alveolar macrophages in the defense of the lung against exta'anwus material. Hence, tlte influence of smoke inhalation upon the mobilization, metabolism, and phagocytie capacities of these scavenger cells is being shrdied. In such rtsas. the exposure of the whole animal to smoke inhalation, followed by collection of macrnphnges, is cmisidcren essential in parallel with tesC-tnbe exposure of Hte latter, since all the hemeostatic and feed-hack medlanisms are "• F nAereer .qnA R. S.enrLfrnhercer.'T.R-i- -f (9vnnic R,halstion of wAnl~ FreFh CI¢nrette Smokc ¢nd of /ta Gns Phaee uu T''1~ Tum s rah ln Snell'z Hlre.'- In D/otyLolomi nJ SxprrimrnFni krspirnton, C,~cinu,,, .-, 1'. Glvphalm, AT. G. Axnna, Jr., an,l J. w. Denther.ge, Jr., E,iltnes. U.B. Atomic bluergF f:wnmission 1970, p. 239. TI58461238
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124 Sceond, the tobacco filler used in our Winchester Little Cil,ars is dilfor"nt from the iiller used in Ainerican cigarettes. ln ce>hrmon 4cith othe.r littl^ r~--rrs il, is m.1de up entirely of ei~'ar t.obnccos aud air-enrol t,oSauIn contrast, the 7argcst portion of the lillcr of A-merie.•i ri rvi.,es 1= mnde up of tlne.cnrod tnbnceoa, none of which are found i-n ZPinchestm•s. Tndeerl, the reqnirements of thc Internal Revcnue ,Service are thai in crder for a tobacco proriuc.t to be cLissified as a cigar the filler mtt5t be substaurtiarll,y of tobaccos tmlike those m crgaretles and mua not h¢ee a;iy addrd. favorinr vtiYr~h woald calr.,e tre prrducrl to havc tho trste mt arer i;. _nerall-,i attributed to ciyaretae,. The Winchrater filler cnmyrli,ns fnlle with these requirements. Tlm Winchester filler, aswells as the sinoice f.om TCinchesters, hss a distinetive cigm odor, quite difl'erent from the odor of standcsd Americart cigarYlSes. The color of Ihe . Wuchcstrr filler is strikit _1y darker than tho stnndard rolilen LLUn oP American cigarettes. The taste. too, is di;tinctivo--agnin qnite difRerant frmn ci;a,rettes urii, we thirvI the beFt tasae of snc little eimar. Third, tiCinchesters hace a cellnloso acetate filtcu :~t least ei~~ht of the 111eading little cimars also use cellulose acetate filtor:s, a~ docs a ]r'Lding class r1 small ci~,rru. These eiglrt little cigors constitnte approxrniately 74percent, of the market. The A$inche,ter Illter is rot identical to those found on cigarettes, although cellulose acetate is ge!rert~llv used in ciga.rette filters. Fonrth, with respect to size. Winchesters are 85 mrn. lon~ and have a circnmfermrec of 25 mm. Similarly, t.he 11 little c.igar brands which accounted for over 95 percent of the 1970 llittle cigar sales rahune have a lenvth of 8H or 100 enm. amd a aircumference of 123 mm. The size of Winenesters, as well as other little cigars. is dictabed by the requirement that they must be about this size and shape in ordcr to meet the Internal Pevenne Code definition for tat purposes. The Code provides that to be within the categomy of sma11 oigars (which is the pertinent one for littlo r.iga:s), 1,000 units of fiuished product uiav not weigh more than B lbs. Thus, in order to be cl:rssi(led within this categorv. a product must approximate the size and shape of standard cigaretfies, which have a circumferenc.c of 25 unn., and lengths which vary from 70 to 101 min. Fifth, I wish to discuss the charge that cigarette srnoking pat- terns, ineluding particularly those relating to inhalation, carry over to I~'inchester snmlcing. bb'inchestms' characteristics are those of little eigars and we believe that the patterns of sno.L'ing Winchesters will in general be the same as those of cigar srnokers. Let me avplain this further. A major distinction between cigar smoke and cigarette smoke is that cigars tend to lre alkaline while cigarettes tend to be acid. This in turn is closely related to inhalation practices. The more acid the smoke, the more likely the smoker is to irilrale. The more alkaline the smoker, the less likely the snroker is to inhale. 9rrd, those who inhale smoke of greater alkalinity are less likely to do so in as deep or prolonged a mcunmr as those who inhale smoice of greater acidity. Not surprisingly, therefore, most studies have indicated that a vast majority of cigar smokers do not inhale, while probably a majority of cigarette smokers do inhale. TI58461247
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130 1ir. Hrsn. I'es, sir, at this point in time, the answer is yes, it is nol. Se:mtor tiiosa. lYhat is the difference aetween cigarette tobacco, which yon said were primarilp acid, and ciga.rs, whic.h Irere primar- ilv alkalinetl li'hat is the dilFcrenceR Ts it the hind of toLacco that izrows, or is it the way it is treatTd or what? Air.ILsu. Again, you have to rocotmize I am a tayman in this .:rca and T would just not n-anh to „et into discussion of that partic- ular qncstsion. I jnst arn not capable enough to answer tha qnestion, 3f r. Chairman. I thirilc yoa can appreeiate tl:at. It is tecliuica7. Senator Moss. TI gucss it is a technical qucstion. I am surc3 that if wo rave von smne qnestions in writing, you could write ns hack the answers. Mr. Hrsn. I will take the question to my company and come back with a response, yes, sir. We certainl~want to cooperate in all respects. Senator Jloss. I sppreciate that. !8e mae want to proceed in that manner. Senator C`ook, do yon ]mve any questions? Scnnbor Coocc. Ves,thanlryon,Mr. Chairm:m. )AIr. Hind, I don't really have too many questions to ask vou, except, to sav that there are many of the-e in here that are tho sune size as the Ai'inr]iester packarm. Some of them appear to he the same size or smlch smaller. But itt just happened thatt as a result of sonic research by this commintoe, they happened to name AFinchester, xnd Pon huppeu to be on trial rather thau all the rest of these partirn0ar con:peuiie.s; isn't tluit correde lblr. Hixn. Yes, sir. 5enn.tor Conn.5o prni hme to come np with an eeplanation on Winchestsr, bnt, somebody doesn't have to conie up with an explana- 6ion on Omegas, or on Sano or anythinh else, do they 8 Mr. Hz~o.Unfm•tunatclv. thee don't. Senator Coox. That is right. Mr. HiNn. Fortunatclp for them; tmfortunately for ns. Senator Cooic. Havc~von read the ]an:;ua,,c in the bill that is hefme us? Mr. Hr.n. No. Senator Conlc. "\ot later tha.n fi montl:s after the date of enart- me.at of the Pnblic Hcalth Ci~,:arettc Amendments oF 1971, the FTC shall promulgate standards ectablishin;w such masimunc acceptable levels of tar, nicobine, tmd other incriminated avent;; as the Cmnmis- sion determinas may be present in cigarettes . . . " and theti shall make that determination. Now, the Chairman of bhis Comrnittec is perfectlv willing to let, the FTC malre a determination on its own as to what shall and shall not be various levels of tar and nicotino in cigarettes. I)o you got tl:at front that langua}reB JIr. I-Lrnn. Yes. - . 8enator Com.. Tho rcason I ask you this is under the Act that Yon hasee recoiced cle:lrance from, the Conr•ress of the United States dee.ided to ]ett the iR6 snd Nio Jnstice Departiuent pronmlliate endi rnles and regulations as will establish what is a cigarette and what is a rLryQr. TI58461253
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116 in which laboratory experiments witlh anima:s, integrated wi11I human cliuical observations, a.re nceded to rxplain and interpret the rcal mcaning of statisti- cal relationships gleaned from hmnan populaiion si.udiea. Experts in the field havo pointed out many unsolved problems relating to the elddrmioiogieal approach. Perhaps the most disturbiug criticism of existing studiex is that in hnmmt populations, the smol:er and non-smoker groups nre stlf-selected to begin with instead of being assi;vcd at randonl as would be the case in any comp'I/nt animal experiment.' At present, we do not know enough about the con-laus or unconscions moHvations inIolved ir. the Indop- lion or maintelnvtce oC r'1^.Iretle smoking to judge fully the nature and eiteut of the ditYerences betrnr, u the smoking and not-snoking poplilations. Vor can we determine where tl, - : differences are themselvea aaaociated with disease predispositions apart from snloking. Nevertheless, wherever such difl'erences hnve htrn explored at the levels of personality, body build, ulectrocnceph- alography, style of life, vocational interests, or psychological make-up, they have heen found to he re:il." Tt is important to look for still other tlifferences and especially to find out in cach case, whether or not. the differeneces them- selves or any health differences associntcd with tlmm antedated adoption of the practice of snloking. In lung cancer studies, especially, many authorities have pointed out theInadcqnncy of death mrtificntcs aa evidence with Iwspcrt tu nausc of denlh,° and the great probabiliry of Imder-dia2nosis in carlier times on account of gen- eral iuiawnreness of the discase; and the lacl: of clinical dingnostic meth.ods particmlarly of inetbods which could readily differentiatc between this di.iease and others such as "galloping con3umption" or pueumonia. Post-mortem pathol- ogc ma,5 aatnally capable of providing a rcliable diagnosis for nearly a centnry before tha diaease reached any very general nlelical vsnsciousucesa In tho~o few centers where autopsies were conducted frequently, the disease was c,t only recognized but was fvlmd to occur at a rate comparable to tllat rcportt' I today.' The recent development of a virtually universal awareness of the d~nse.. together with increased application of such techniques as lvtproved dt^su ='ic radiolqqy, bronchoscopy, esfoliative cytnlogy. and esploratory thor:i -:.. havc greatly inercased the reporting of the disease. These developments :Ire certainly to be applauded insofar as they bring about more eil'ectne treatm, .,t. .FOr h,rthe-r d/-nv=1nn ": T. 6~r6-a "The S[nH,ctlrnl Ctud,r uf A 'n tween smnking tu,l I ' i - " I' ~-Nlrz;f iftrlv,U+ nf tbe Jfn. ~ R ]A6R. !. _t.. iud .F S< ,thn~~. t /t= I ~ ~/~ tLm.rv au ] rp.lnltion _ Ichlrmla- loAlcal I< ~ I I i~e." l n H /' i, .1 .'- Y td T R._ tthal, FOdtto s Phnnrna, Ilnd Y .. rnp.~ r Aard . • nr ,.. ,. Thlan, ~'-li~.~ - tufYnl 0 ~fv ~ Nmle . f: 1- of Rii~~Iinc. Thornna 'Cb~.i "~ H.~alll~. t un_f,ha - 14 11rt ' F rl ,lurlr RLwtr I deP 9'nbp8tull-[.:. H. , :beio. I'diror. ~ 2: (;. lt smirb. •.1• ~I/.,.1 an1 .n~Sin- il Ic Chattnr Y of tbic ht enrk et. N. `I'on:attc ; ~ 'At'. LLonth. "Uiftct. i.ues 23i-twrvn - l! hfedicinr1 la1 ln'oA. p, gpq- r' tJ TObnrN : nnJd~i'_. ~ I., ,,,a/x OI '. 1'. IL. `.C t i.im i I I I . ~.. v Ilezr~. Iq, M,~iq . . I 1 ~ 61 9 V I ~II~~ I ~and 1 Ct:,(_ I' ~ f i k.ic i d I F ~I-i.r;d ~c , I O'li m ct~cs." ~1: F nlOO r fo, ~ne_ p_ T- Id nnd l. 1]I~_- ~~r .I~Itu.~ rf 9mokinv IIn~~rlc in ..ilvll `.'~ LCJQ.n: q. L. Ili.~•,. n 'JCa1lnC F]th .ntc[pr lf :, 1' fnllr I1I -- ;- r ~..ri t I l,sue: AI 1- KnFmrll tt Thc In - 1+ 1 d: E ~o .F ufnt 1- 111,19 . 1>9 , l .L I'~ I I i i t:N . IT I Iii . 111111,111, ,r If li nf Ttl ;1.~- 9,m;ix ~ - I H L 1.. Lombfd , It I' R . Hnrek ac,l I F , . . S, ~a. n . -.i ni. .r 1,1Ii Itc~x,l," P.cerdtn9a nJ tRe ttl,rzu( 'Ar 1 1 ~Iri~.~. : 1.1 _,. I ~Plli ~~Mr_ [^'pyre96 in LunC Cllvrcr~ HS'Oriul Q .-ciett, 16: 1969 il all 1AL R ,~. L,,.c:. , U. J. h. I.t i i'. u1 t1-tl of Lr.Ib Cn :er Vu tslit L/utn," RuUn, J ~ ..1'n. 1 nf 9fe Jri: 1)fo p olA. ' DI n R obhil - f tu.e in tl.e lath fe tnrc, (tleL[etin ol IfixLOrn or D/efiicine. - :i5:t'.,.p .: , . a It,~: cubl~i1L~id. TI58461233
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12u The smokr, fronr tlte first puff of a stmdard Arnrrican i5 pe'enerallV more acid ihan the. smoleo f_trnn tBc fitst pr,ft' et e ciror. 1 herr„fter, the sn c-a: from rach sncceisive pufF ot a ci_:lret.~hecomes ecen more ic:id, v;hi6 hhe sma'ce frmn each sr,ccr=sicr puf of ty cirar L, ,n.., r.vcn nIorc alkalitte. Tn this re„ar"I. (hc stu"lae frr.nt ti~inelhs a~ v.Il - thett l.orn other 1iWe ai?ars, i-~ i ~e-a more ai.aln.I~ r.-Ilraii, tuid thn= is qurte ds;imi!ar h~ ~._ rcttnsm'' 11 :ititIn~.~~.hni~,te.t'.ntt:.viewottle:.tlk"fii~i~ at the 1, -.~ 1 o,i uiv .'_ait7 the later paiF:,--~.o-, '. in- uotl stunl in,~ vi i. _ h. nc a-ortiil tcnd t.o fraaIv ctytu' iuhsl- ation pai--•rn=. ~1'hese ti,., are `1 r 10 :~snns Winchi sters ore litNv . c,rars snd rtot i -~. The are ci-n1. II„1, m rl-v~mL e. t: grorzotcd as su'h, .!~ 11 ~io basis i'or ~ ..La'r.r that con;nmors .ci31 be con- fn--i. In i', r+- I , 'ct..,o 1~ L~ r~- r to tlte, rtetel;ninatian~ of the Internal li suro 6c.tviut mnti i I ai', n e, ot Joste(~ tnat. uudcr applicablolatc,D:Snnitestt rsnr,lii:!;., '.., _•.,Prior to taarketinn Wineitee'.,.s. liepuolds sought an advance rtrihi, trnnn flte Tntctn.tl iier n`cice t!tst, I tn'. •bt .ild that this tva's on a z,olr,ntarti ba9ic. I I i,a- u~t rerjnircd hv law. I'or tax ptaposes. Ii'inrltc5tcrs u-otdd ittl', within tLe 6tternalRcvenuc Codc category incla[Hng litt.le cigars ns opposed to cigIrrettes. This wfts because, being ncw in tile cigar btwmess, we were nuccrnrin as to wliat spec.ifte criteria the Rever,uc Scrvice would cot4sider in making a classtfication. Accordingly, fteynotds snbmitted to the Scrvice inforrnation pcrtaining to the roa.lceup of the prodn~~t packaning, labeliu;,r, attd sdvertising, n-gain on a vdunt.nry basis. The Servicce indicated that, without chaa;ges in the makeup of the prodrmt rve vvould not receive a litllo ciga.r classification for li'incltesters. Cluat;es wcre, made. The Service did not indicate a need for any clutnges in packaging, labdint,. oe advertising. The Service then clns- sifi_ed Winchestera as little cinot ac cigarettns- T thinlc it is important to point mrt that L. ~ statutory language defining rettes. umder which TLtarqal 5„nue ?rrvice made this def:ermuia- tion, is ide.ntie.al to t.ite Ianr.,... ~c fomu- in tho Cigarctto Smoking Actof 1969.In spite of th(s Internal Revenue Service classifiration, and in spite of the fact that all Winchester packaging and labcling clearly destguated the product as "little cigars,'° question has heen raised as to whether or not our usa of the broadcast medium in connectimt witlr our marketing, prontot.ion and advertising of Winohesters vio- lakr.s the Cigarette Smoking Act of 1'JG9. We at Reyutolds are conh- dent that it does not. We are supported iu this view by the recent announcement of the Jrstice Departrnent of agreemenG between it andItesnolds regarding the marketing of Wincltesters. tiVe had not considered it neccssasy to make any changes in the Winchester paclcahing or promotional mat,erial to advertise on the broadcast medium and bo in compliance wit.h the 1969 act. And, indeed. our agreement with the Justice Department does not require any revisions of broadcast advert.ising. With respect to the broadcast advertising formats, it should Iie noted that Winchesters were designed to appeal primarily to men, which is our target market. Accordingly, the advertising formats we TI58461248
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119 spontaneously to suclt conditimis, the smoke for inhalation by animals must generally be produced by mechanical means and delivered to the animal under the right conditions. In order to accomplish this, it is necessary to use a mechanical device-a smoke inhalation exposure machine-t-hat will produce conditions simulating humsn smoking as closely as possible. It should meet the followiug rcqnire- meuts : 1. It must produce smoke by intermittent puffing of individual ciganNt.es' with aceurate, and reproducible pttfi volumes, puff dututions, aod puff inter- vals, all regulated to fall within the range of human smoking mrrhanics as determined by observation of human smokers, smoking normally. The conven- tions most generally adopted at present are a 35 ml. pull of two second dttra- tion, taken at one-minute intervuls, to a 23 ml. butt length. 'Phe machine should, however, have the c:uptbility £or accurate modification of these puffing conditions in order to extend Ihe range of possible observations. 2. lt should have a port to permit sampling of thc smoke stream for chemi- cal or gas chromatogt:wphic analysis, when dcsired. 3. in order to permit biological comparisons or gas-phase effects with those of whole smoke, the machine should permit insertion of a Cambridge filter to remm•e purliculut.e rnatcrial from the smoke and allow only thc gas-vapor phase to reach the animals. 4. Since ]mmau snlokcrs draw a purf of snoko into the mouth and then Inhale it into 1,110 lung alung with fresh air, the smote must be diluted by air in a ratio determined by human experience. The ratio of dilution by human smokers is determined by the individual's pnff volume (ih ml. to 45 ml.) and Lis tidul rn7runc. 9Riese vary so that the ratio of dihttion may rnnge £rom 1:4 to 1:40 at the extremes. 3leehanical devices need to he adjustable over such a range as this sa that the fatio will be known in any individual experiment and can be.aricd. 51. 'She rilne ef smoke transit from the burning zone of the cigarette to the lung surfn~ ~mirt he elose to that which occurs in hnmau smolcing (oc within the 1 ':1:-, :o :"n:t the smoke Will he or corrrparable age in terms of fractions cf a„, i ~'. '1'Iii, age control isto insure thnt chemical and physical changes such a~ ,.i.uown W occur rapidly In stnoke after its instant of formation will Le ~mpuranle for the animal and man. Such age conhol is usually achicved by regulating the distance from the burning zone of the cigarette to the lung surface off the aniuml, bnt can also be modified by regulatiug the rate of flow. If this cannot be made the same as for man, the dietance musl. at least be constant and be known. These requirements also make it. necessary to expose anlmals in indit-idual containers where they occupy Hxed positions rather than in groups. 6. Since humans inhale smoke-plttsair from the orat cavity without its pas- sa{,e throngh tl : nasal turbmales where particil5tes might be trapped and thus ful to retth the lun it would be an advanttge to iuduce e_rperimental antm ds to itlh:le through the montL This is being attemplcd thcough nose scalm .aith t idents wiW: the disadvantage t.lm.t Ole procedure Is made much more tr.lumallc. ]ionth inhalation is easier to attain with doga but at the cost of other complications. 7. `;Inre s.u:olze inhalatinn by humans is intermittent, and air is inhaled between Puffs, there is a minimal build-up of carboayhemoglobin in the hlood in norm;:l =n:oking'. :nilnnls must be given simllar iutrmittent conditions by pnrginK smoke and gases from any chamber in which they may be housed, or by giving adequatc access to air between smoke inhalattons. If this is not done, blood carboxyhemoglobin builds up to a point where significant physio- log,cal efYects re:ilt. 8. Auin:als mnst lie ezPosed with only the breathing apparatus in the main- stream of smoke. If there is smoke contact with the fur, they will preen them- selves or lick m:e lmother and receive dosages of nicotine and other smoke consLitaentN that are not tnlwn into account. 'J. Since aome of the conditions dcsmribed as necessary are tranmatic to ani.- mn1e, sl.re~,s efYects may complicate (lie results. Hence "machine coatrols" sub- -ieclal to all the same conditions as Ctiperitnental animals except for actual ' Cndrr xt~cclnt, cnrePUlly enntrolled eonditlons, two or t4rer clgarattes may be puRed simoltaeeouslyI TI58461242
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127 we ?qrced to make certnin chau't,_cs in Winchester padcahing nnd point-of-sale tnnterials, which tha 1)cpartmeut felt made the word5 ..1.itUc. C'ioar~" inorn prYmiiuent. (.1s I uoted ^.ihoee, tlre dt>mges (lid not includ,~ .tuv r~.-isions of broadcast arlvertlsing.) >j"e agreed to inrrexise tnc size of tlm °/P.ittie Cirars" lettering eomewlmt on point- of snlo cuid psckaging waterials. We chssnged this ]ctterinl' from ?nld to wLlte on the pache.lro, smd v:c added 16em words "Little Cinars" oil the bottom pnnel of tb.e puckage. We also arnced to usc, our bcst efforts to encom^age retailers to place lVinclrestrrs ou one of the extreme, sides of ca.rt.ou aud packahe fistures and in vendimh maclrines so that the prodnet is not bonnded by cohtmns of ci"arottes- I]hstveI outJioed the facts relatint to the reviews 6ti- t]re Tuteiaral Iteve.nne Service :rnd the Justice Department ill some dotail. T'Lut is liceans_e n•e believe 1Lat tlLcir oct.ious fnl11' snpport our com°iction that our Winchcater prodnct is trulv ai little ci_-ar and, tlicrcforr-. can lm lawfrdlv n.dvertisud on tiiee broadanst mrdinm us ne. Imce been doing. We trust ILnt mv tcstbrtonv will ttssist vort in nnderstaudinl; «diy the elaims to the contrlm arc withontt fouudatirnr. It is our sin- cerchelief that, in marketin"; and promotnrg our yCinchester Little Ci-ars, R. J. Revuol<_ls Tobacco ('o. has scrnpnlously corul:lied with both tLe spirit uud the.lem.er of the law. Senator Dloss. 'Ph:urk yan lor yrnir testimovc, ASr. I[ind. Yon said that }j'hrchesters arc 85 millimeters long, a circumfcrence of 2, mil- tin-.ea,rs. 5iuuilarlc, the Il little cil,ar brande which acemmted for over p.i peccent of the sales eolnme in 1'J70 have a length of 811 or 10'a millhneter~ :uid a circumference of i'S millimetrrs. Is t]rat correCt? Atr. I3nNn. If von rend thc statement correctl-v_, that is correct, DTr. Clrairman. . . ,Senator DCass. Well. I:mi no expert, but I don't Jx-lievc that I have obsertied other little cigars that were just precisely t,hee size of a cil-aretto, and tL.rt is the re.rson Lwas ynestiouiug those fi;;ures. Cun von wune tinti otlrer brands that, would flt iutn t9iat? 1Ic JItNo. S es, sir, 7would bo glad to ito so. You waut t.hc aehurt brrud names? Senator 1Lua,. Yes. Jitst onc on cVo in nrder for me to erv- to re] atC to it. Mr. Hrvn. Ol+tav. Thmc is T:dl N'Slim. whicli is a hundred milli- muters, if I recull right.'Chcre is OrneK:r at 100 nullirneters; Aetion, a lucidrecL Omega, Sii millimetcrs. There is Berivueu The Acts aud Madison. TLerec is little 5ano rigars. There is Wolf Pros., Little iVippers. Tall S'Sliny both in thee filtcr and the menlhol version. Senator Aioss. I see. Well, I uuderstand yon said no flavminp,• could he put in tobacco for a little ei' L"ar. Do vou have mcuhl6ol little cigars? illr. lhm. TLere is a distinction here. It is a technical distinetion. Whe,n we say that tltere aree no fJocorinss ln ci;r:'r tobacco ;le luezn no tl,uurings inherent in thc tobn, :'. ii--~f. 'L,rc are (l.el-orinrs or- -wt flavoriugs, but tLere are `,~,J~ i1+ =.as ILe teclnical blend poople call it, tLat sre put mi at the Int~~sta•es of the products processing. This is :r ta]rnical distinction. Mr. CLnirman, und I cau sec, lahcrcitwould bc confnsiug. T158461250
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128 Senatm14foss. So tLarec are mentjinl little cil~'ars da.t arc markelcd ? Mr. IItxn. Therc are menthol flavorings where t6e menthol is put mt at the last of the process. Senator bioss. What was it about the ori,m,inally submitted SVin- ehester that aauscl the I1:.8 to classify itt as a cigarette or at least to require some chango? Mr. II[Nu. Tlmtr coucern was not with thc advertising, not with ishes paclmo,ing or the labelurg, nor witlr the factt that n•o were pnt- ting it in cendina maehines, nor wihh the fact that, ne wero putting it, oil cignrettc corrton or packaging racks. Thcir concern was with the product itsclf. Senator Moss. You mean the tobacco in the cigar itself, the eon- tent, the tobacco? Dfr. ,ftrso. Tes, sir. Scuacor ]Ioss. You said this wrapper was made of cimLr leaf and other iu:recliants. Is it made in a sheet-like paper and the:n rolled aronnd tlre prodnct? Mr. ITusn. It ia not a sheet-like paper. It is not paper. It is a reconstituted ci,,,ar lcrapper, whioh T nndozstand is made in a sheet form. 8enater lloss. lint it secros to haNe a seaan up here, just like the paper seam, and other than color, looks the sa.me to me as paper looks. 111it IhNzn. It is a rec-.onstitrrted cig,ar wrapher, and it is in a s}heet. I trrn recatli.ng rery memory, but I be,liete that is eorrect, Mr. Clrair- man. Senaror _l'Ioss. And vou Paid that the filtor here was somewhat dilicrr.id~ frcm the filter tlkat yoes on a ciz+arette Is this a cellnloec ftlh•r? llr. IFilter or iillcx? Senator 9loss. F;Itcr. bir. 11[:.u. Yes, sir. lt is a eo,llulose acetate filter. The diil'erence, I mi;ht state for the record- is that it is denior, and by denier, I refer tn the =izs of the strands in the filter itself, is unique. It is nott iden- ticnl to t4ose frlters on ci_=irrettes, in tha.t respoct. 6enEiror 31os~a. Notiv, .vhaU r:as it that lltS Ncanted chan:,.ed, the chnnyr thnt yott did mak1~? ~ Mr. Hrvn. As I mentioned before, DIr. (!herirsnan, it was in the prodact itsolf. ~enaror \lo,ss. In the tobacco? Mr. IIrnt). Yes, sir. Srnator Moss. Did vou have to put iat a dificrcnt kind of tobacco. or ili(f'erenh color or tubacti•.o or n.ho.t? Mr. Hrsu. Sn, sir. Ave went to IES with n prodnch thatt had heen fmmnlated on tlie bnsis of tbe gnidclines, aud one of the gnidolines o-as that flm filler ivonld be suhst.urt.iallv of tobacco unlike those in ordinarv ci;arettos, and vre ;irlf:lled tLat gnideline. By fn,r and away, the majority of tobacco, in onr INinchester, and this wac the initial prodnct n-e snbmitted, was of cihn.r t.obacco. Af-ter they evabr ated their :rarnlv=is, and I might add the.y were verv thoronnh in this area, they felt that we did not haee the smokin~,, characterisbics of a ci,rtu-. And thcy requer,ted that we make ehanors to accommodate thi~. They did not indicate any specific chantn,es whatsoever. TI58461251
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131 Notc, the Cono,n-ess (I id that„ didi'1t t.heti•? ) h'. Ilts nI les, sir. Senator Con>i. And ron have eotnplied *Wth rnlings of both the IP.B .utd the .Tust.ice 1)oparunent. You qualify as a cibat} don't you? 1\Ir. 1-Lsn. Yes, sir. 4cuator Contc. The reuson I nsk you tLese questions is becmUGe now they are not satisfied that they have asked those departtuent.s to pro- mnlr_ntc rufes and regulations. They want to ohange them. Is thYt your underatnlnding' Mr. }Ci~i>. Yrs. Senntor Cnorc. I am wanderinn how long it will take before eomo would he dissidi.fied nith 5-11.A lf it nere to paas hhe. Cnugress4 R'ould they be tutltapp,p u-ith allrncinr the FTC to promnlgitte such rtilrs and ~rcrulations as thcy found logical in their ozsn wiadotn, even thonglt the FTC admitted that they did not have the resouires to inztke a determination on what the levels of tas and nicotine should hc in cigarettes. \Ir. I-fiud you have qnalificd tmder the 1.tiw,ha.vetPt you? Mr. It!ru. Definitelv. In fact, I think our company and myself and thc people tltal, lmre. wnrke_L oxt this brand lvent that. extra mile of rohmtnily initititing coopertttiou. Scnutor Conr.. And Lan-ing received the anthority of CLe Internal Ite\-enne. DeDartrnent amr the Juslic.e Dehartnent to manufactnre, a+lcerfisc aud sell this pr•odnr.t, }rou feel that you have qiudifled? Alr. Ihsn. In all rvspects. tictator Coor.. The issnc here is tha.t you cotne out rcith a softt packsge thah looks lil.e a, cir:trette package, nnd LltercYoree yon are indicted becausr yon are trving to inake cigars l.oolc like cigarettes s-o lhat yon vnn adrertise on televismn? Mr. Ii t r n. Th at scents to be tlre issue, yes, sir. hea,ator Coni.. _lii~ht I sn;~*~est thsd you mirht be >tble to mal:c a oiga~rette lonb: likee it~Granadier. Therefore yon will hare a lonh cina- rette that loola like a ci~,ar which you ean ad~°ertise on tclevision tn srll ci~~mrottea. Isn't that ~clt,tt ~~e nre nitpickin„{ aboat? iAh:~Hixn. That is exactla it. Senator.('.oom. Mo says you can't prodnce sontcthut,R, nnd put it in a ~iackar~e like this'? ~ \tr. Iitxn. Exactly, nnd I miuhM1 ndd, SenaLor, that eqnstutters do not perce.ice a geotnetric:,hape. They perceice a nkno. They pcrccirc oigars on the front of the ftael:age, on the hottom, and on the toy, that is vltat thee cmistmers perceive. Senat.or Comc. 7)id yon ever stimd at a cirarette comtM1er und say cc me a packk of ci~ntrettes~ l[rn lltro. No, sir; I havrtrk. Senator Com;. Neibher have I. People ask for a nationally brand cigarette, don't tlte,yE Slr. lii Yo. Tlie~- ask by nrme. tienator Comc Aes. TTn" 1cu heartl thun latclv wadking up ancl stipmkr rice mo atction IO0L ~11icr mc Omt._as, or give me jI'olf Pto.. Little 11'ip- 1JCrs? Rfr. IL~n. Cf1 do. I trt, to [orget those Hiinas. Senator Comc. Put they ael, for F~'inchester. TI58461254
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129 Senator Afoss. Do t°on hziow the tar ;md nicotine content of the Winchester? - DIr. IIiNU. T do not know the iricotine. I do recall in the IRS dis- cmsion a TPAI number being thrown out, and that is the only refer- ence I recn7•1. Om• researcL peogle made it quite clear to myself and to IRS that the TYl_1 aud tiie nicotine levels were irrelevant, academic, and immaterial, for little cirars. Senator :ILoss. Bnt vou do lIIiow the qwitity of tar i is that correct? Mr. Nivn. Yes, sit, Mr. Chairman, I do. Senator lloss. ALnd how high is it? DIr. [IrNn. I recall that it was 16. Senator Dloss. in your rescarch for marketing this produet, IumI sure, you did studies on consnme.r acceptability. Did your studics find that people did inhale tii'inchesters? 11Ir. tIacn. We harc not done any studies of that type at all, Mr. Chairman, none whatsoever. Senator D.toss. In }-onr adccrtisements of Winchester, do the peoPle on the screen lnhale the product? Mr. IIr:n. No, sir, absohitelv not. In fact, the male principal is a ci1-ar snolcer, I am told. Senator Vloss. Do ~~ou nse air-cured or fermented tobacco in the ~~~ragper 2 ~ Mr. Iltsn. 1 do not know. That was in the technical blending area, and I just do not know exactly. I do know that the tobacco that is in this wrapper is common to that in other little cigars. Sennte3r Dlor.n. Is it thra4hud tobacco or shredded tobacco? Mr. Ilz-:o. I do not lcnow, Mr. Chanman. That is in the technical area. You are hIIkin" abont the wrapper? Senator 3ioss. No. I am ta,ll.-inq about the filler. AIr. Ih-Nn. T?scuse me. I tliouR_ht yon were talking about thc ~: rappcr. Senator 3loss. No. 9[r. Ilc;n. In tbe filler? Senator Moss. Ye.. .lfr. llr.co. It is a manuPactnrin,, term, °ishredded." ']'his applies to a cut. Iiut it is shredded cigar tobacco. Scamtor A[osv. .1re thee stalls included in this filler? The tobacco lcaf stNil:fl'? . . Mr. IIt:cn. I don't imderstand. Jenator 3loss. Stetns maj-be. Mr. ]T.rNn. Stems? 1 cannon answer that qnestion, Mr. Chai»nan. Tn ihr, nuirl:el in~ department, rcee ha~°o kno.cled;e of ;,reneral charac- teristics of the blend. This is very confidentiall:nowledge as to the mal:enp of the blend, and I just don't know. ,~enator D[oss Are ynur sales priniarily in ver.dinar machinesR Do ti cu sell M1heae primaril_v in rending machines? J'Ir. Msn. No, eir. The) are sold in all ti-pes of retailed outlets, aome that have vending' machines, some which do not. L\Iost of which (10 not. Senator 1lloss. You think the preponderxnco are not in vending mccPcnes? TI58461252
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117 'l'H5EEdnllIl'SOSAL dSPECI6 OP'PIIE COUNCIL PPAGGAAr C'nrd[o:n,colHa.r U4ven.ce.-In thematter of cardiocascular diseases, several, cerec;ally corouary artcry disenee, are reputed to be morc fraquentin cigarette srnNcors. In the eal9ier stu_ •- •t the Council program, a great deal of nicotine phurn.,lcnlog,r study was 5i- -~r"d iu the hope of finding some clneS as to vl'hy such an associaiion should esixt. In fact, no substantial elucs were found. BL=.r-ndli:c, bviu studics in °-den have shown the predominant importance of hen::tnry' faclorn ill ILtn ; . : by eomparing identical twins, orle of whom hat 1,-, a cig;trotte -,nl:er l~i.,le tl:e oll,er bas nut. Vu sianiIIcant differenees n, ~.•_ . ~°uLar '.= m- syrm.tmns of disorder, or in of death were ~... ~ I~ss cnl l, :e stud-v of Americnn twius pvli.ted in the same .11 lr, -nt there are flve nutstanding reeds in our cormn:ry disease etudy pr-rr:n. I~irFt, I= a-. I ulethod for the cOnh'oll^d Dl'T1rL.: otl of corol:.ni^y atln-l-.1 -.cis in so.-.1'erimentnl m:inal_ Phe le~~, ns i nnlA he emnpsnnl>1e to tlier.;o ionnd in lnun- :Inatomicallyund histotogically, aud cLould he produced bc met'mds not too '- , "tt_ived" or "unpitpololog'ical'l If the cr.nditlol coutd be prodn^rd at will and . I l Pre;lirtnllle srrerity, i:hon the inflnenre nf Inany eln 11'UInSCnlal .';1CtJ1'N. 1nClUdillg fm1U1iU exposure aat lllrlltine, could lIe Ntndied CYNrCtNp'ir2L11,.. Of ronr>c a.trmnYt, iwcr hel:n made in measure tLo cr:ndition oP inunnn eor- onari arteries post ulnrtem and relate ~everltc of the tesions to envirom-lental £aclorv duriuy life. 1t is very diffienlt lo get. vecurmte retrosneeliccly_, ou hxhitn surh >:a sn:ol;ing, diut, escrei+e, eta., after the dealh of a pnlient. Yet tLe most ro^rlnm post mertelu smnplin;,e af the healthy hnn all noPnlatiou are prob::bly 11 prnriCrQ h.xry.id Ils, ewpeclxlly xuinmobVe aceidenls. Severnl stndies rr 'ut ciclim~ h~9ve rrPorted no relation betweul the degree of ath,a,-sr9~,de , and amount of smokin&-' 19ut the dielculties of snch Lnman slu;li - ..icnd fLC concurreni use of au aninlal uwdel for espediling sy's- temali^ au ;' protlem. .lu ~.Lv~ pnd.l'•m, htill unsulvrd, is that of inea..rrri'aS with acolraey the relalive ral> .,i.d urnuunts of nicotine aDSOrptiou iuto lile body by lur. uf I•ignrettr.- , and a-:u's, re.pectively, nldcr reed-li'e eonlitiurw, ~ .' ns tLe ratc= : dwl~ral and tuetabolic ch:mgc of this alCaloid under thr :nli- limt~. A l:nmvl.. : the'siae;iu PuLteru slmuld s e t.l:e Gee_tiou ufwl:e~lmr dle, :Ir~ , i, - drt ,rences in the d osaecnicotu:e osaec ' stnol<crs 1n t3lese Lhr.e cat< .i,~n an 4inR in the normal fashion. This is most inlportant to le,ovc I' I I . pli,e and 1 gn, sn:nlcers nre roported to develop curonery urha,r di ~-relcr thm nnl smN1e,~Y.'" If it s1mNd turn onh that they 11 ahr, t9as rn,i i, -.. . .,- ciearette smo'_:ers, and attain similar puale lecels in tho LIouP1 f roml~~: . ~'ornrion, it would scom to foltorv that nicothte conld uot he iuaylicated in :~.:vy artery discase. If this Droved to bc the case, there cavld he a rediro ., of effort into nlore promising ch:urnels lt,Pirn!w'y D(se,a,e, the study of chronic rrFpirn.tory diseases, particu- lar9y iu rleterminin;; tLeir I .~-. a hasic l:roblem is tLe lack of generally zlore.pted eliniral di-ttJncth" = the various reepiratorn dittieulties. These inclnde elnPnpsema, bronchitis, ;IyLlna, and even certain heart ailments. inndecnatr deCiailinns, nnd 'lie lack of tlniform rllnical dislinclion of these lo..ditione lu:re cunft"•d a'.~nts att epiderniological studics nf cansation or az,ernvatiorr. It apPearn also ,1 nt diatalostic uncertainties and douGtS, as vvell a8 ohnn,es in the popularihof slch tenn,e as "emphc5ema," may have resultcd in a fictitionn incrrase in repurted incidencc ratos:° Hence, the Conu- cil l,;la l,-eu atq,PUl'tiuq al lonr terrn Study m a*?ultuonarp discaoe Ginic Iv'here Cninllrehcnplye And Pepet-itiCe i'tiel'cations can he carried out o11 IDally chroaiC 'iT, I,111'?rn:,ll. "tinlnlili!-!n n t0 horn"aP}' A^.Ir1111NY~IFP nnll T.nn+r 1*nnrllnn 1n Teim.' .etn Mci"n . t-.1. Cupn. ;,5, t':bN. i.- P herr. Itt ileflerlof- T. 1 n'r.mn. nnl ft. 01;-u~ " , In 9i ltlg il _.-r ant No; -, /, tSC 9nd DI¢y¢otla 45.1.:' pmq- k:,:riron. 6..•)rtr I - `n. rlof. r. Prll i L lir ;rtli1.nlor nnrl li.:'n. :arv S'mPtmng tn Aclattrv. tn Pobaecu 4 1.1 'Cwiie° 1J_ 1 u.vrmt Xarelth, 1c: t46p. . r,5. r. -° 3- A'Irl n¢„n,eq . Ir > - 1t1 e.,lerneiv in Persona Dying Vfo- • P- .~ „ of IiLtt ]: ~ i~.~ , I :r, '~ mn]c>,p ¢nA FfnN4h- Rnpnrt nJ ,ev, LL91'FLS Pplillun[ion No. 1103 N'ash- 1t. Ltnnu,plnl~-, `limDhS=cr.,;1," Jovn:¢i ¢l tTe in.eric¢rn Ua'iutrica $oci¢Fy, 91: i., n. b1S. ! T158461240
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121 Eastcott, D. F., °Epidemiology- of Lrmg Cancer in New Zealand," LenceC 1: 1950. Eysenek, L. J., et al., "Personality and Cigarette Smoking," Lite ficferieca 3: ]9C3. Feinstein, A., "Clinical EPidemi.1I, The IdentlDanlnn of katca of Lts- ease,"Arnao,l5ofhvtPrrwL.N, .,, - , i'.f3:ItJ81. Friberg, L., R., Cederlof, T. Lunuroan, aod II. Olsson, "}lortaLtc in Smolring Discordant Illmrozrg;lic ;pid Dizygotic Twins." drek. bYla+ioron. Heailh _~1: 1970. Heath, C. AV., "Diffrrr- .~ nr!ween Smokers and Sonsmokers," A.11.A. drchlrrcnfIn,ten,,.": , .,I, il:lf, :`. Hockett, Ii C.. "1.~'.I iIn ILe Lil'^rin-ental ApDroach to the Hnnl:ln Lnnb Crmrer Proi,lcru l.r..,r '1 .. ,. . Irr .?.r,tl.q Severi, L., liditor. Uiv-1- si,:n uf C;mcor H, ., : ~' Huebner. P.. .T., ni.d .. J. '...,ir. ~i:. - ur ~u. ~ of RSA Tunor T'iruses as D+irermintnts of Cut 4•~rvdc,ny r.f .SCiarces 0: 10811 6ie:aiofP, TT.. nnd R. H. i('cr of LIte 1'roblem " P'-.rru, rr Laear, 1'.. 1. - CJUIetiL aml I Short Perm :mc aT:7^,0: i-iIlr~ - ez Itatia. A Rev'icv riu, ~.i_I Ai. - .~. '9trnznlalP.`rane ~,a~ette Bmol~, ~~ ~~.'ur7eii :-tc-l,rFrlrv ,if rnab oP Ar J,_. r;..cer instftrete Leo/Tnruhi•~ , , , ..~.id I.. I rm~Sterrb, ~ .:cr, "Effects on ('hronic Tnhalatinn of \it'h,qe E,, _11 , rv~i l.r~ r .~. , ,~~l ~ f it:s Gac Phavc orr '•-rLmonarS Tmnor- t.V ~--I:. in , il- fl~. :1101 ,yPhoPOt! 07 EsDUOwr~':,7 L . fnrchw- ~I ~. . r .. ~. I., `.a. G. Ilat.na, Jr. xnd J. W. Luatl ;,~, Jr., Friitore. LilicnPr ~hi A. ill.. "ICn.otional and OLLer Sulected Chnrnrteristlr~ ~ Snn L, rg xnd 1nnamokera as Rchltrd to IDpidenuoL.l,~ical Si.nll~~ C:nr ....r and otL~r Disevses,.' Inrovru6 of fhe Ardtoat<i Crm,..: r 1U57. Lornbard, H. L., "4,me I'rabinms af Lnng Csmcer," Ltsrroct 2! 1'~,:-. LotnLard, H. L., It. 1'. I:nYCIa, and L. S. ,3uoieircfl', ':1n .Apf,rai.-1 of rile Cancer Death Rerord ' P4o, ~.-: ~rttl•s of the ti¢/,o„al 1c¢J..,'.y oI ..--a,cc 4R: 188 LomLacd, II. L., nnd Pi. P. I?ucclr. "An Elridcmioloaical Sludc of Lung Cnnccr,Amnng Fam;iles-° Orotrlle 3'P.. i: ,;'.. Lnndinan, 'I'., "SxnnkinF in 1:,1:1: l.- i.r Coronary Heart nia and Lnng EluicLinn in Twriis." r 1...,i7nacica.7c0. SuPp. ` . 1"Lr< Lymis, 1`i. J.. J. F. Gibson, an,i D- .L E. ingemn, .'L'rce I;a.i~:aa i'roduccd in Ci.O<Irctte 9mokc;' _Fatearr+Yti . : 1fa.edmurid, E. .I., J. IL .Veitin~h~n. and P. D'. Wolf, "Rerinnal Patterns in Tlor- talit7 frvm Cancer in the Cnil,I ~`-'^r ., -.r 20- 18/1;. D4aedunald, I., 'An Annipsis of Liie I4tea u.d Ltmg Cancer Thenrc:' State- mout bcfure the gabcalnmitt,.. ~n :.~I ar,& \tunetLrrp Atfairs, Ilons: ('om- mir...r on Government OPend u. Irncrv4`th Ses im ,]nlc 25. 1Pdi. DlT. P., H. ]f. }IacParltum , md I. I~ I'orterneld, "The Didtrihntlon of tlIartalityinOlio'.ln^rf=, Pnb~:ol/r.a7t%t:19aib r4clrtbr.r, C., E. Kraldron. and .T "'I'h.• pspeA"logy of Smoknie,' ,7otervanl, of-4baenrma7 a / , , : 7'.aKh.n,.,,.g : ~i~ i].. 11[etnloF.y, A. G., and .7. ,1 Ca 1, 11 G`raul, "Pu/ n r:'na5es of Clacoee-(f- 1'hnsPhate Dehgdrogenaee Ilcii~ i,.ieS of rhe 1{,~I 11',L" i:. Yrocevdirlf.s of @hefbm(<a-n;rce on f7"ncflc Pu2yr d'y,uixn:a o7ad qcr , I~7kc Vuriations in fJisease. Rinmberg, B. S. Editar. Grnne aml Stratton, N. 1. I~Ni1. neorath. G., snd H. N.hnilce, 'Y:ntel:.ilrhngen uber dern A'itratgchlilt drs 9'abnks," Red.trRl7e =vlr Ta oaATnrsrhn,p 2 :7 19(i4. Neve York Aearlem,v or Scienucs. -71he Effeets of \ir_etine and Cmoking an the Cenlrnl Vervou= F~-I!•m." A"eger, Ir„ 1-L, Edilar. dnrxxix of the tiem Fm-7; Acuoe,iqloi> , , :II'!:Article1,19GT. Passep, R_, "Souw ProI'.~ns if Ltmg C2ncei," Lanrtet 2 : 7952. Passe>', R. D.. "Sro;•:,r ~is: t.nngs" in Tnbacro arctl Headtle. t3. Jantes and T. Rusenth;n, Editors,'Phmnev, Springfreld. 1962. PfaiiTer. C. A., xmt E_ All(n. "Attetntrts to Prodnee Cancer in Rhesns Afonkeps wit14 Cnrcinogenic Ilyrirocarbnm and Estro.gens" Cancer Re=rarelt F: 7t) 76. Pilao. 3[. t`„ and E. UoLI, "Age at Onset af Lung Clancer, Siguiflcance in Eela- tion to Effect if E,nolcing;" Lmrcct 1: 1065, I TI58461244
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132 I have come to the conclusion we were talking about what makes a cigaret.te a cigarette, and what makes a ciaar a cigar. Afaybe you are going to qualify for a cigarette when vou offer one to a lady and she takes it. 13nt it seems to me that youYhave been picked out and you have, been indicted as a mannfacturcr of a particular brand of small cigars, when in fact you have every right in the world to make it as :ma1L or as large as you want to, as long as you comply with the laties that this Congress enacted, and as long as you qualify for being a cigar instead of a cigarette. Air. IIrxD. That is reassuring to hear those words, Senator. Senator Cooic. I might add that I don't smoke either one of them, Air. Hind. Thank you. Henator Moss. Thank oou very much. The next witness willf be Air. Kelley, E. W. Kelley, chairman of the board of the Consolidated Cigar Corp. Air. Kelley, you may proceed. You are accompanied by-will you identify tho gentlemen who accompany you? STATEMENT OF E. W. KELLEY, CHAIRMAN OF THE BOARD, CON- SOLIDATED CIGAR CORP., NEW YORK, N.Y,; ACCOMPANIED BY JACK MOGULESCU, SENIOR VICE PRESIDENT; AND CARL J. CARL- SON, VICE PRESIDENT FOR SPECIAL PROJECTS Air. KFnnEr. Chairman ]~Ioss, I am aceompa.nied by .Iack Nlogn- lescn, who is senior vice president for marketing_ of the Consolidated Cigar Corp., arrd by Carl Carlson, who is viae president for special prolects, and who for many years was president of the Cigar 11lami- factnrers' Association. Senator ASoss. tiC'elcome to you, gentlemen. ZVe are glad to have you here. ~ Yon may proceed. sir. Air. Kn;ur,r.r. This statqment that we are mal.inn today is pre- sented on behalf of the Consolidated Cigar Corp. Jlercly for pnr- poses.of fnrUrer identification, because you rnay not recogni~~e onr companti~ naane, our largest nxid leading brands arc Dutch Mustcrs, Iid Prodnetos, and 37nriels. We havemany other brands, but these are our three major brands in the United St.rtes. Pecause we are ono of the, country's largest cigar manr.faaturers, we have an important stake in any discuesion about any product bearinn the name ci~~ars-small or large-and ~rc asc, therefore, mest grateful to this couunittec for• allowing ns to c::prese our views about thee matter of little or small ci:ars tie~hich yoi{ are no.c conaidcring. ~ I might =ay, adlibbin, here, that tlre. term little and small, are kind of misunderstood by n.ost people and most consrnners. _A't the out,et, let me sac Lhat Consolidated Cigar Corp. currently manufactures in tlre United States only the so-called large ci~ars, that is cigars that weigh more than 3 ponnds per thousand. We do import from one of our European affiliates a. small cigar that weichs nnder 3 pounds per thousands. That is the little one that comes from I3olluid. These sales in the United States are mifortnnately qttite sma11. TI58461255
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116 operational in the whole animal. In a test-tnbe, the effnct, of smoke on mobili- zat5on of macmphages cannot be seen, and the iruportant role of this factor in the totai cffects is neglected. in the present stage it may be said that we are senrching for systems that might elmw significznt hiotogical etFeets, either desirab7e or presr.mably unde- sirable, of smu'.ce inhalatiou under condibicuts reasonably comparnble to thuse of tmrmal human esposnre. Only after such systems have been developed and evaluated will it be reasocable to use fixed biological scstems for contnariug difE,,rent tobaccos or diffIrcut smnl:es, or attemplin}; fractiouation to blentify the actice ingredicntc, or delving into the biological mechanivns of the ef:ect with a vicw to oltsetting t11Fm, TIIF VIRAL CE10]II+: CONfFlPT lfecently, still another dimension has been added to cancer sttldica throngh apulicatiun of the viral ge•nome conerpt of cancer.' This concept Postulauw that ienkemia, sareoma, and carcinoma are all espress?ons of it vertieally tran"nittad 'biral genoote" ~,nt in all mammalian eeh`s, which probtlbly perfolTns some lmrmal and nr~°<-ory function in tile embryonic stage and then is normally repre&sed or '. I o1T". '1'his rei,r=,~nn n;ay ultimaIely fall under influenues such as au!, ,I =ore to rnrlia,viral infectlon. chemical agrcnts. or othera' a.till nn:~ i'.", ' llnd(r •t3iu renmstances the 7.nome may give rise to trrm8'ferable it rarely spout<nnously transmissihle) "C-,rype virnF pflrticles" that can produ^!ncer in a sui,` Ilhost, The ramifications of this c,c~epr are enormously complcY. But it appears to be proeiding a rational interpretatioa of tnany entpiricalLv described differ- ences in tLe "auupticility" of various mmtsc strains to cnnccr, as well as teclmique.s for utaaipidatin<° Ihese suw'>^~~ilaliticrv experimentally. In the C... !acil I n."nlm, we hope that the use of models based on these con- cepts will help ell, I!:~rnthe interplay between internal mechaniams of eanuer susreptib!Hty and n.,. .,! ~ on the one band, and the role of esternal agencies oil the other. In thia inetrme'•. it is possible that ]mrsuit of the ramifications of the ciral genome eoncept cnld ead to the discovery of some general method for identi- fyim_ etnccr-sus-ecptible persons and bolstering their defenses to prevent the diseaee. EITTCTINe STSTIi3t5 POR STLTY I feel this there are unportant criteria to be applicd in seleeting systems For stlidy. 'S'he Council is attetnphng to Eelect Pystems that have it hlgh tLL'Obability of benring upon In, diseases in which we are interested. If such crirer;n are not used in selection, a prograrn Can degenerate into the collection of interest- ing bnt presently useless information, rather than pr'oviding answers to clcar qn,sttons. For esample, our Scientifm Advisory Board, is presently dlsinclined to sponsor further sdtdies on the po.sible effects of nicotine or cmocing on binod eloctina meclianisuts bcenuse of snbstanttat donbt whether abnormal clot- ting mechanisms are really casualty related to "coronary occlusion or myncnrdial infarc!ion':9e The Conncil has still nnother objective in the attempt to provide oositive models for the prodnct3on of aquamous careimmna in the Iungs, of animals. If some simple metimd can he devised that docs not depart too redicnlly from the k.inds of experience met by man in daily life, it could In, most usefnl. If lung eancer of the type that is nrevalent in man could be prodnc,ed repetitively at a sharply reprodueihle levcl, say 20 percent, in mice or some other nnimal, the t%ay would be opened for a great maRv mganized spstematic studio= to see how age. sex, horrnones. irritants, stress, diet, infection, and many othcr fac- tors micht in9uenee the level and retc of incidcnce of the tumors. ~ It. J. Yf,bncr, nnq G. J. Te,wro. "nncoxon^a of RM1'A Tu:nor Vlrnhes a*latPrnlnents of Iln ° Prrocrec~. . 0 t 5,+ J t , 61: 19fio. p. 11:- -rd ~tnS to T)rt 'Inebnnr t , t n on.4e, i19<ken anT ~ ~nrrtln the RNA t hnt ~ *allo 1 ^m5ERc3 <tai~ nutr, , of t§e atr,~l ,nony, i,, pa 'n. ,... haRarSxnt defarmimlwr -t 'Thu i I mto - for - In a br- nty prr r. t f free livl g noa lnbrd Imn ~ and b om¢n poP ulatlo must ~Pre3ant n Prcl.iTr leterminent 4 Inueonnrrr.' ".-1. Ti, T. RobbSmlrh. "T1=.e ICnlgmn of Cnroaarc IIecrt Dlpe:rs, " Year Book \fedlcal pubtlshers, Ino., CbIcaS4 10134. TI58461239
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126 ttso contain somn of the emno clements oscel iu rnanv othe.r mnle-ori- ented prodncts, snch cs beer, mnn's toiletries, ulotorcccles, little cii;rn, .uid bif; cig:rrs. A Z-ith rehrn•d to AVinehcsters' tactr and ruildnes:, it should be noted that tire so.r.rrlled thcn-rc of Winclrester= contains certuin deseriptir•c rcorrds ahont taste oftcn nsed in cigir advertising. tiVhile thecc rvords rmFC also havr bcen used in tho promotion oi some cige.rettes, the j$inclicstrr theme is nonetheless fmidamentally different from that of cigarette adaertising. In both broadcast and~print it is repeatedly stnted that 1Vinchcster• is not .r cigarette. Iteyr.olds clearly advises cieiccrs, lisbe.ners and readers that the product is :L litl:le cig:u- w primu olvrmple being the srperimposed cop' Y, "GO Littlc Cignrs," at t1LC cmicltrsion of rr.ll television conrmercizils. 11'inchrstrrs are sold in packages containirg ?0 cigars, as nree the 11 leading little aihar brands on the tnnrhet The packages n.re the same size and sh;tpe xs a concerrtional 8ii-millimeter soft pack. lu like fnshion, 10 of the leadinh 11 litt.le cigar brands, which awcwuited for 82 percent of thecltegory's ID70 sales eoh.rne, are sold in te conrea:tional soft pack (GU percent) or a cigxrette-ty-pc crushproof box (2d percent). 1i'iuchretms arn displayed in retail ontlots oz tnerchtmdiving rucl.s from Mhich cigeuctl.cs Lraditionally have bnen marketed. (hcr the years. cig;r.r products hrivc been sold contignons to aignrettes, often in racks .rttac.lred to cigarette csrton nnd psclaWe merc-handising fit- turos. Aforeover. in a nnmber of storos other little ci"ars are mur- lsted on sur-h listures in the sa.me fashion as 1Vinclresterm. Winrlres- ters, in nddition, are also disnlatrd with other little cigars tvherever n-e har-c been :rllowerl (o do so. lti'herevor j§'inchestcrs :rre marketvd on cii,arrette paclur~.•ce fi~tnr;+s' ltey'nol,t)5 plnces pnint-oF-salr' pieces .vlii eh clcrrly identify and drstint,rnish the product :ra >t 1!ttlz cip,xr. 1)urir,g the comsr of onn. subrnisson to the Intcrlrnl I{eventto Cer~icc, we :Ld-aised that :4roncv of our intention to disli!uti 1S'in- c}restc.rs as I have jnst doscribed. Wc Zsere, t.old thiit this would not pre.sr!rt u problcur arS -lons as t.l:c product continoed to bo cleii.rlY rdentiPwd a5 a lit:tlc ri,mr. A tnumber of ci_"nr,!Ie Nmidors have agreed to place Windrestors iu thcir macrines.-'hLi. is not the flrst, time that ci,_.ars (incL-rding littlce cigars) har" n. sold along with crcxrettes in vniting maclnnns. As in tbr -~_ of nlrs of the prodw.t in rctnil iorc., on.ch ve.nding vohnnn eo'i:.:l!':::~r; IL'inohesters s c.lexrly labeled xnd des!g- mitod "Littlc f, ~*urs," and a liltle cigar noticc has been ptrovidetl to yendors to bc put m-t to caclr coin sl.ot, an cltra mex'm•e on our part. The Internal ltevemic Seri-ice w.rs also told of our plrtns to scelk rending distribution, ai:d 1rc xrccivcd the same assrnance as T mcntionrvl aboee with resl~eTfi to display. A, I h:wco said. in amueclion mith eVin r:~viev by the I)epartment of Jnsoice of otu- methods of tnarketin~ \4inchesters we had not eon- sidered it necessmr}~ to ma.kc ,uty ch:enses ill packaging or protno- tional matcrinls to advcrtise on the broadeast meriitmi andd be in coml.lw.rrve with both the slririt emd the letier of the i'n'+lin IlrrJf~h Cig.untte. Smoking Act of 7969. S~ecer9hclees, in our dnsire to coop- oratc rrs much as possiblc witn tho Govermnent and still retain our rightful martreting indapmxlence in a highly competitive industry, TI58461249
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122 Robb-Smith, A. H. T., "The Fhrignea of Cororrav-y Heart Disease." Year Book 3Ceflicnl Publishers, Inc., Chicago 1967. Rosenblatt, N. B., °Lmtg Cancer ]n the 19th Century," Buddeti.n of History of 3fodie,tne 38: 1964. Rosenblatl_ M. B., I. R. Lisa, and S. Trinidad, "Pitfalls in the Clinical and Histological Diagnosis of Bronchogenic Carcinoma," Disease of the Chest 49: 7 966_ Rosenblatt, M. B., T. R. Lisa, and S. Trinidad. "32etaslatic Lung Cancer 1las- ilncrading as Bronchogenie Carcinoma.' Gertntric,y 21 : 1966. Rosenbintt, M. B., "Sex Distrihntinn, Longevity, 6moking and Lung Cancer," .Tournal of the American r: -rin~ rr,? Sooiety74: 1966. Rosenblatt, ]4. B., and J. It. Lisn., "Diagnostic Progress in Lung Cancer: E:is- torictQ Perspeetive," T-rnal ^ t the Awaerica.n Geviatrics Sncietyt 16 : 1969. Rosenblatt, ]i. B., and J. R. T.1ac, °Bimnlation of Lung Cancer by Rletastases," •Ioternat of the AnzerGaan Gi r1 ~;rdr..s Societ4r 15: 1967. Rosenblatt, ili. B., "The Inexr.ac in lung Cancer: Epidemic or ArtiCact7' 7fed- irat rountc^rpoint 1: I9(9. Rocenblatt, M. B., .T. B. Lisa, P. Teng. and I. Beck, "Talidity of Lung Cancer Mortality Da:ta," Rat7etdn of 3'ew Yorb ACadway of RfetMcine 45: 1990. Rosenhlntt, :MI. 1i., "Emphysema," •Totw-nal of the Arnerioava Geriatrics Society 18: 19 -'0. Rnr-nldntt, M. R, P. Teng, S. Pierpe, and I. Beek, "Prevalence of I:mtg ('.mcer: 1]ispn.rity Between Clinical, and Antopsy Certification," IlTedicol C:,,,irp,.%a.t 3: 1971.. 9elriec C. @., °bloephologieal Constitution and Smoking;' Journal of the Amer- . „ t,,Jield.s.eo<zation1C4:1963. Sel'nr. ~1, "Cmtstitotion and llernditv itt Relation to Tohaceo 9utoking," of ! 0•New York .4 cada.>np o f tleiences 142 : 1967. Smith, G. ]L. "Personality and 5moldng." Iu lTflaatin: t'tu, 'rnakolqfie uotd Tom- -. 9 deB Tab¢d^rauches, Schievelbein, ti., Editor, Gcurge Thieme Ycrlag, 1969. Sterart, H. L., and K. IDI. ITerrnld, "A Critique or E,-, ~"n,ents to Induce Cuul-f •r witlt Tobacco Derivatives." Bealt. de d'Iruv'",.,Oe i" !, .,,rl'..rort de Sta- tisr;,,:.% Aetes dc ta 38 c Jession de BPnst. Pn.t (be Rtat 39- kic' Todd. u. P., and J. I. Mason, "Concordance of Smoking Hahi - in 57onozfgotic and Disygotic Twins," Heredity 131 i9u9. Thomns, C. R., "Chnrae_6eristics of Smokers Compared wi', Ii ~ir.-Rmokers in a I'opulation of Healthy Young Adults," Annals of Internat 3Lediolne 53: 1960. Thomas, 0. B., "On Cigarette Smoking, Coronary Heart Disease and the Ge- netic Aypothr=i=." HopE>ink NudSr,nd.Toe[rna2122:1966. 1'ici. B., 8. Dom- ~- imd D. Saledo, "Coronary Atherosclerosis in I'ersons Dying Yinlently.°.Ir.-7: nofInt-ertaabbletNaime122:1968. ICillis, R.. A., "'Lhe lncidence of Histoingical Types of Pulminary Carcinoma, with Comments on Some Fallacies and Uncertainties," Medical Joverrar.l of duxtra.ida 1: locd. Ycrnshalmy, .T., "8tatistical Considerations and Eva7uation of Epidemiologienl Evidence" In Tobacco and ITeatth. G. .Tames and T. Rosenthal, Editors, SN'ingrield, Illinois, 1962. Ynle. G. V., "The Function of 8tatistical Method in Snientifte I[westigation;' Tndestrial Patigwe Pe.search Bnard Report 2&1 Medical Research Council, H. N.'s Stationery Office. London 1924. Sanator DZoss. I don't know what has happened to Senator Cook. Iam going to ha.ve to determine where he is. and therefore I am going to recess the hestrinn now nntil 12:30. That will give us an hour recess, and then we will resume. (Whereupon, at 11:30 a.m., the hearing was recessed, to reconvene at 12 :30 p.m., this same day.) A1rTBR_\"OOV SESSION Senator Moss. The committee will come to order and we will resnme our hearings. Senahor Cook is available and will sit with us TI58461245
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136 Senator Moss. I guess it is because this wrapper seemed to be a ncw factor to rne.. I am perhaps thinking of t.he large cigars. I recall thatthei-mere simplp wrapped in a tobacco leaf. Air. Fmnr,r:r. Mr. :4logulescu gave me here, and you might want to refer to this in pour further thinking of the subject-the IR,S has a circular, 69-11, iseucd April 3, 1969, which ssys this: "A cigar is dehned as any roll of tobacco wrapped in leaf or any substance con- taining tobacc.o. When rcconstituted"-and that is what this sheet is called, when you take the tobaceo. grind it up, and reconstitute it "is uxd as the wrapper,1° and the IRS set out the following require- mcnts: 0°It nnrst contain a signiflcant portion of natural tobacco.'° The industrv agreed that is 60 percent or inore. "B. The eol.or of the wrapper must bo within the range of colors norrnallv foundin natural leaf tobacco. "C. IIave smnc of the other charanteristics of the tobacco from which produoed," that is Ihe nicotinc content. the tasto, aroma and so fortly and I'm gettinu~ over my head, "and not be so changed in the reconstitution process as l:o lose all," rmd we wonld say most, "of the tobacco characteristics)° Setator Moss. Well, thank you. That. is inforrnative, and I appre- cLate it. As I understand vour testimony, yon distinguish pretty much be- tween cigars, little cigars. and cigaretfes, in that cigars :rermrally aro not inhaled, and cigo-rrettes oenerfllly are inhaled, because of the dif- ferent compositimns of the tobacca If a little cigar were niade in such a waI that it would be inhaled, would that be enough of a crossing of a line to begin to consider it a cigarette? Mr. Kncx.nr. IVe think that is only one of the distinctions, the One that you have made, and obviously many people consider it an important dist.inct.ion, and we feel that t.he satisfactions of smoking that conie from the taste and the other characteristics of cigar tobac- cos is the satisfaction that the smoker gets from the, product. rather than what some people consider dre inhaling that comes from a cigarette. Senator Moss. 1'S`ell, I followed your testimony in which you said that there ought to he cigars--cigaaa ought to be marketed jnst as ci~arettes should, side by side, hoping that people turning to cigars mrght, by taking a noninhalable smoke, be more protected than if they werc continuing to inhale the smoke. 111r. Kr:ra,r.r. Our basis for that is that our research, and there is some public research, sa,qs that for various reasons, some of which we don't underst.2nd. that there is li.ttle or no risk in smoki.ng cigars, and that it does not all come from not inhaling. And I refer you to the Royal College of Physicians' research that was released a few montis ago from London, in which it addresses itself as to what they consider sonie of the possible reasons for this. Now, as I understand it, the research has not been carried on enough to know really the degree of importance of this as yet, but at least it seems to give some insight in that therc may be a differ- ence because of the alkali versus the acid and other characteristics of the tobacco that are completely over and above whether a product is inhaled or not. TI58461259
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12:3 this afternoon. Our next witness will be lUr. James F. IIind, prodart tnan<Iger of ti. .(. Recuolrls Co. IIe is to lre accompanicd_. I mlder- atmtd, by Tt=ac H. Om11n,.Jr. Il"e zvill he plcased to hear from }'on, AIr. Hind. STATEMENT OF JAMES F. HIND, PRODUCT MANAGER, R. J. REYN- OLDS TOBACCO CO., WINSTON-SALEM, N.C.; ACCOMPANIED BY MAX H. CROHN, JR., ASSOCIATE COUNSEL Arr. Ihso. '17tar.k ti-otl. ?Ir. Cllairnlan. All. Cro1m. dr., is the asso- ciate colut<e! for It. J. HeJuolds, tind us ~-ou mentior.ed, he in here mith mc. Senattor _lloss. 1\'e arc ret_t' glad to hate pou, sir, today at the hcnriui. 1Tr. i'r,olu. Thank you, air. Atr. Hlcn. 3[p name is Janes F, Hind. I am employed by R. J. 72epnolds 1bL•awo Co. as a marketin~, supervisor responsiLle for the mo.rlceri!tn :Inrl pronlotiion of 1Vinchoster Lit.tle Ci~gus. For that rcxsot, I am ]tere, rm P.eti-nolds' bellalf to inform vour comutittce of thee facts cor.cerning both the product and its marl~e,ting :end promo- tion. It has llecn charged Ihtit, lVincllester5 are rcetllg cigarettes mas- queradiu_• as cigars mld, therefmn, Hslt Retitulda' ase of the btvad- cast meditaur to Itd,,ertise lhmu constitutes ot-errraclting. I.tm velv glad to ianve this opportunity to delnonstreitc to tllis commillce lhat thrrn is uo ttrtthi to these ch.u•ghs. Littlc ci~a~s Inu=c bcmi sold in Ilte LTniled Statos for over 50 years. In rrcent vears, sales hace been iucreasin_11 mar!mctly. Reynol~ls, in de~~clopulz ',Vinche'tera, had no rnotive ol7mr tl~an the marlceting and saie of a nca,, h_igh-qualitp little citr,ar. R'e began ronsidering rutry into Htis market in 1.PB5. As Willia:n S. s'nlith, p_resident of 1{e}llolds, lmcenth; pointcd out, und I qaote: '17te idea of cutering llte gwwin; ]itllc rigar narket-mm esfimate puls Lhis irar'v silrr- armvl.h ut %o vercent_-„ab one that c:une to us long bef'ore tie radio=PF ban_ Devel,qinsut uf the pra,luct 6ns bcen unaetlvay flince ItIP;d, ro,• w renlized thfltt it t.oultl be guod business for IteniNds, the Nutioi's lwgest tobacco emnD:uLr. to linve an entry in tbe littlr cignt' mn I 'lecl.. And t1,is entry in the little c:ipr marlmtt iS what we are accout- plis 'ing. JJ'indtesters a.re IICI.Ic ugars, 11hir]7 Pocnolds ls utminfnc- tnring. proniotio", and selling in fivill compli,mce wibh tho apirit as tcell as f.te- letter of the. Ynl>Ilc I1caLth t'lrarelte Smoking Act oi 1969. ~ 1&st. there is no Wiltll to tlle charge lhat 1Vinclrestcrs are 1 r tpned n bimcn paper p'ltich npparcntle oonlain5 nt2l1 traces ol lobreco. lilnihrsters do not rt_c n, paper ttr,q>per, t5 clrlu•ottes do. Instead, the wropper is mai!e hntirely of roco~erituted ciltar tobacco tand certain con-titnonts to provide ten5ile stren;-rh. These are the same matcrial sls u_cd in tcrappers on all little cigars preseldlv on the market, anil na mtmbcr of lursc ciaars iwe compete a1.o with varions sizcs of l:u c u,;eu-s). in ndlition. 6he. eolor of the Wiucheater wrap- Ier is l-a'oVl --the tt Ididonal color of cigar m.u•ppci- which clearly cit l.in,uui, s i1'iuchkst rs fru.i .hee co u ultilmal waute tcrapped cigarettes. TI58461246
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137 Senator Moss, Well, thankwu very much. Senator Cook? , .. ~ Senatnr Coor.. 11Ir. Pelley, how old are somo of these brands that we dismis;I'd awbil,~ nffo0 For inrt:mce, T thuilc I}ta.ve seen Between the Acts ever since I was a little kid.'Chev used to be in a little tin box, if I remember correctly, but they were the same size, weren't thev P 1bIr. Knr.rmr.l~6. Biogttlescn can answer that better than I, because he has bem ill the indnstt;v longor than I. Mr. Ttooucrecu. Senator, Between the Acts, and I certainly shouldn't be commentiqIq upon other people's products, but I am sure they won't objecb to iY Sexiator Conr.. Let's put it this wac: If it's bcon done for a lon~• time, you onuht to admit it, because the wholo indnstrv is on trial todnv_ \7r. Afoarr_rsnrr. I do believe that t.he Betwcen the Ac,ts von are holding. a.bont 70 pears arro betran naing what is ealled eec.onstiArtG+d tobacco, bnt the brand anal the fact tdtat it was a little cigar has becn before mr birth. prohably. bnt I mn :mt aire. Senator Coorc. :Gt this size l 31r. ll'Ioctrclsscc AVell, I would asemte it, is somewhat aronnd that slz!`.. Mr. Xrrm;r. If it is sold as a little cigar, by rnles, it, has to be ap- prosimatrly that size. Sow, in the cigar indnstac-- Senator Coot;. AVell, there air, some on the market. are there not, that are titinner thsn tho size of these small cigars, but longer. Mr. D4a;rr,r:sr:r.'I'hirmer and a little bit longer. Senator Coori. 5c,cxns to mc, I have a colleague on the judiciary conmiittee that smokes them. DSr. Itr•.r.r.Fr. The problem is that ~i'th a maclrine, you can't get them too much smaller than that, and have a firm, good product. Senator Coor~. -What we aro really getting down to is the fact that somebod' v savs thatt a cigar is a cigar because it is supposed to look like it ci' -.u. Irt effect ~chat we are sayinF is that we should freezee thc. state. of f.he art; irceze. 010, induatry's in"cuuity to prodore a<lit- ferant prodne.t. A1r. Knr.r.r.r. t1s a marke,tintg man, I would say tmder those rules, you would have little pro,;ress in consumer goods. Senator Coor.. Thatilc you. Senator ]Ioss. Tnank~you, gentlemen. 14'e appreciate your coming. ItSr. Constantine Stephano, president of the I1IICAP Corp. Mr. Steplumo. we are glad to have you, and you may proceed. sir. STATEMENT 0F CONSTANTINE STEPHANO, PRESIDENT, IMCAP CORP., WASHINGTON, D.C. Mr. S-rra•ta ANo. 11tr. C~hairmnn. Crentlemen. my name is Constmitine Stephano, I emi president of TMCAP Corp., management consul- tants. represerttiniz the lirm of Stepha,no Rrothers, a cigare.tte. mann- facturim,, firni cstablished in YS9it in Philadelphia. I am also a dirce- tor of Stephano Brothers. Stephano Brothers are rnannfac,tnrers of bfarvels Filter Cigarettes which have consistently ranked either lowest of second lowest in tar T158461260
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133 Howeler, we mnst frankly tell the committee that we have spent over a period of yeai.is, considerable time, moncy, energy, and ~-crv important.ly, management talenc, to develop an American small, Ametican-styled :rnall cigur, that conforms to the present definitions of a cigar of the Internal Revenue Service-llopefully that such a product lcould bc able to make a. serious clent in the ci<_.arette market- aud confidcnt, based on thc zarious~ studies issued by the Sur,reon General, and other medica.l and scientific authorities, that such a small cigar would onlp he all improvement for the cigarette smoker wl.o switched. ~ I want clearly to state that products we have developed, but not vet rnarketed, conform to the present definition of cigars as stated 6v the IRS, and will, when marketed, be clearly labeled a ci'ar, olearly defined as such in our advertising, and will use only cigar tobacco. The latter point, the, nse of cigar tobacco, is most vit.al to us-and we believe it is to tion-for we believe~ that there arc diflerences of substance betv;een ci;ar tobacco and cigarette tobacco, and that tl.is ditierence may .vcll be one of the reasor.s or seceral of the reasons ndcy cir;ars emergc as a lcsS hazardous form of smoking. T.hese dif{erence.s in tobacco lead to a diffcrent taste between cigars amd cigarettee, including small cigars and cigarettes, with or without filters. Some people might clm.racteriae this different taste as being str•on_er, more lxm.ent; we like to chasactcrirR this diffcrence as bcing richer, more fravorful, more tastefnl, words of that trpe. B$at, 110 ruatl.er hur it is characLerivcd, Lhis taste tenils to inhibrt inhala- tion, or maybr not be a cause for wanting to inhale, )N•hich, of eoru•se, is to the smoker's farther adcantage. Tu this connection, it is import;rnt to note that the various tiSnr- geon General's reports, front the first one issued in 1961, to the ciu•- cent one issucd in 1972, do not reveal any distinction between small cirars and large ci;,urs~nd that these reports have consistently sls.ted that ci;nars are relatively a safer smol.nrg prodnct from a health staaulpoint. In view, tdrerefore, of the positive assertions nmde in thesr reports, we cannot. hclp bnt aslc rvhat contrarv, positive and overridiug eri- deno.e i; there ih,rt ivo"ld call for thel imposition of a.':ealtlr ticarn- in." on packares of small cigars or the imposition of olber restric- tions, siu•h us the ones provided in tlre Public IIeal'dt Ciparettu SmoScing Act. Such a step withont full and complete. scientihc basis mav well harm, nnt, only the cigar industry, but also deter cigarette snokers from making, in the lit;ht of present evidence, a sN6tch that cvonld be snlut:uv rather than har~nfid. Pecnnse we believe fihat 1Im nature of the tobaceo used in a prod- nct is the most detcrminative factor. I would like to describe for the uouunitteT the dit[erenees between cigaratte tobacco and ci<rar tobur.cn. True, the tobucco plant in the field is basically the samo except for parl:icular sec;d strnins that are con=ide.red more suitalrle for onn prodnet or tho other-thcse have been developed over tlhe vcars-bnt a veY_v major differenee in the fillcr tobacco de,relops tlirough I he methods of grmvinr*, harcesting, mrring; and fermurtation. TI58461256
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134 All of the lnbscros ttsed in our cirn.rs are slowly aircured ove.r an extended period of timc, hauirin~.r in toba.cco barns. After retnoval from fihc bxrns aurl roacbinm the warcbouse, cigar tobaccos are piled in bulks in bi;; contalners, and allowed to ~erment under their otivn natnr::l hed, 1citL temperann•es r~>acLin; up to 1-16° F>ihrenheit. Dependiiy; oii the, tnLaccos, t7icsc bullcs a.re turned many Isirnes, the tnbncco, ;mtil tbere is no longer enonnh moisture in the leaf to gen- erate heat Only then 1s•i1L tire tobacco be put into bale.s for storabe and fnrtlhcr a~~inn. B~- c.onta~ast,~urost American cil'arettos are made predominantly of flne-cured tobacaos, that is tobacars artificially heated until dried, and n-hieb do not undergo the prolonged fermentation proass which is accorded to cigar tobacco. Because of the method of treatint, cigar tobacco, the main,tream smoke of a. cirar tends to be of alkaline composition, while the mainstreacn smoke of most cigarettes is of an acld cmnposition. While this is not, intended to be a tec}wical dissertation, and I am not qnrilificd to do that, we vrish to point ont that, in our .-iew, it is of t!reafi importance tdmt air-cured and U-el1-fermentsd tobacco has a nmch better and more complete combustion. lai thc light of these obseactitions reearding differences in the tnethod of grovcint;, harvesting, curing, and fermenting tobaccos, there is c.learl ' ~ u wnuque quality in cigar tobaccos that is nnlike those in ordinary cigarettes. Tbe.refme, bccause of ishat we bclieve to be these basic difterences between oiff¢ret.tes and sma.ll cir;ars, or little cinars, we, in all eqnitv, adc that small cigar products bo judged within the current definr tions of tbe ITi-S: fitat they bc judged by what these products are, not by who makns them. Even thoum6 we recor•nize we may vve11 be invitui~i serious crnnpe.- tition into thee eih~ar business from companies with more resources than 1le do, neierthelese, wo believe that if the product itself meets thee test of thee definitions of the IRS or whatever as a ci°ar, it sliould not be snb.ject to cirarette burdens. If advertisinl,~ is false, it, must be chanGed; if the advertising is in bad taste, the consumer, in his ulbimate ~wisdom, should reject it: if pa.c.lcat ag is deceptiye, it shonld be altered. But tlre natnre of the product itedf should determinc its classification. I say hhis laiowine that v.e mi~,ht have a.n easier I:ime in our coln- panv obtktinin~ important sales of stnalt c.iLnaa products vicere we to call tLem ci-,,a.rettes, even with tile °4rarning" notice. But we have stayod ont of the cigarette bnsiness all of these years becanse of our br~.licf that cio~ars lvere difl'erent from ci~arettes. ~I'e would be seri- onslv injnred ~to now find that ice were legislatect into it because we nnido a sma1L ci;ar. Sinen we have never tried to reap the buha econornic gains aceru- ing to bruic rn tbee cirarette business. we obvionsly do not want to bo suddvnlr saddled irith its disadvantages becattse we enter or mi-6t ute.r, thc L•tlle cigar field. 11 r rc we to onter the cigarette ficld «e .vonld do so openly, oberino' all the rnles, c2rrping the. bnr- dcns utd tenpinn the benehtg and the pi oGt3. \\ c mgc. yon, thcrefmr., nut to jud"e ,r litbic ci„ar product by the fact that, it is paclre.d in a soft pack of 20, because this is the most T158461257
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13R tration, Nationstl C7oaringhouse for Snoltin' r and Ilcalth, ltoclaille, DSd S08`a2. I3ow mints' of ton Uentlcmer., ntcntbes of thc U.S. ~cn- atc lntot~, of thisprocedin~e4 .. . Greater attention shonld bo, Ifiven to the desscmination of tlic pe- riodic cig,rrettc tar and nicotiue talrles to the pres~ to 6e pnblished by them in lhr. publi(' iiriercat. Some iktouglrt should be givrn to a me:enI ungful pror-ranr to mruke the cigarette tztr and nicotine t::bles aca.ilablee at tlie retEril level tcherc eigarrltes are sold. 'Ilte lese lrazardous ci,n,arette Surgcon (xcneral Stcinfeld sugt?c;ts 6e, developerl alreadv exists. The public has just not had proticr av- ces=s to thi,s puLlicc informatimn to know tlrs. Tnr and nicol.ine tests armm beinm done onn a rcgnla.r basis bt° 'the OWtal Goc*ernmeut. 1Ch}° not mn.kn these ciga.rette tar nnd nirotine, tables readilv :n*ailable to the stnoking, pubtic and let thnnt decide lchat brund iL<•y cltoose to smokeF Senator Aloss. R%cll, thank vou. D1r. Stephano, you recommcnd that the tar itud nicotine contcut be. readily displayed at Ihe plnee of sale. Do you also faeor the settine of macimmn levels of tar and nico- tine in cigai•etus? 31r. S'trrrrnNO. Afr. Chaitau.ur, T tun in favor of making acuilrtble tlm total list of cigMrettPs mitlt ti.t• and nicotine conteut us Ihey- tu'e tested on recaitu- basis. I sm not, in favor of a masimnrn one on tar and nicatine in c.ir<uettes. Senator Dfoss.'19utnk ynn. Sen ator Coot,. 1' ou a rc not in faf-or o f S. 1#:i}'? D[r. STr.rtiA-.o. So. I thinh the pnblic ean decide for themselves if they have available io tLclu tLis important informatioat. Thn pur- pose of rny coming to these hcarings is to espress n frnstration tslticlt I have had ocer t,he }•emrs. Ta.r and nicotiue te+ts are doue., the iixta is avaihtblc 'I'im ta.r a.nd nicotuie test reanlls jnst do not gett cirenlaled. Scutrtor Comc. ?fr. ,S"teph:uto, it aceins to me wltal rort sre rcalle saying is that you iv:uit alist ptthlisLteti at ecert- eigmmtte and cirrar emntter sltowing lhe amount of tar and nicothte in the cLgarette. It will show- that yours has the least, and obviously, thereforc, they are goingtohuyynur brand.Isa't Ihis n-hat t+e atmreally lallciq? Jir. S'rrsrHeno. _A`o. Oies doe; not hace thc least. Senator Coor.. Rrell, close to the least. Mr. STscuevo. AVe vnrY be.ht-een one a.nd ttco. Scnal.m- Cool.. 1)o you think thc Govcrmnent should act into tltc tardcrLy again2 \Ir. Srrerc,+so. I think if we can produce a cihare~tte at that qtutin- titT-, so ea,n alqo'e else. Venator Coux. Don't you think you ought to bc utiliziun }•our own kalents in adem~tising r.r,thcr thaat~let, the Fedeistl Gocernmrait do itt ioryouq Mr. 5rrrrrnso. jCc do the bestt we can teit6in t.hat c.ategor}', but rny conl:ertion is that if these fi,qUres tahldt are produced by a Fed- orul abe.nc} zuo at'ailu,ble, why are thev not tnsrde at•aiLrble. to the pxbllc. ~.S'cnator Coor.. It scetns to me that I have .scen it in crcrv rnajor newspaper in tLe l:uited States a nurnher of titnes. .1uso, the P'ederul Trade Conunisaion said a few senrs ago tlmt the5 were pruhibitiug 77 Oli _72 - --YO TI58461262
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120 smol:e inhalation must be used to apprehend such effects. (Very substantiai stress effects have been nbscrvcd in recent studies). Gradual training aud hztbi- tnation may be of eome vahte in redncing sl.ress. 10. 5ome method of nteasnring the nctrml eznosure of lunR surfaees to smoke, both to gas-pha"ae and to particulate material- is necessary if dose-rcla- tionel:iVS are to be determincfl in other than very qruilitntive tenna. Gus phase contact with lum- snrfaces is best iudicated at present by blood carho,yhemoglohin de[erminations since carlion nionoside is nnt upprerdnbly ahsorbed in the oral or nasal cnvitiea bnt is rnPidly taken uP bs the biood tdnronch the pnlmon:u'T metnbranes. Blood analysis for carboxyhemnglolon is snirable for rouline muuitoring uf gas-vapor phusc cxPostre of the litn¢. J1easnrement of lnng contact s-ueciflcally with par(icu:utes is more dif!icnlt since a tag is needed Ihat is prrBent in t]te particnlates bnt absent froru tlte gas-phnse. Vicotinc fulfills Ihis rrqpiirement hut its absmption, trsnsnort, and metaLoiisnt are so rapid lhat rluantitutiun of lnng coninct with pnrrie:dnte ntarter bv n3cotine ensd}-sir+ of htnes remoced and Oced immediah~ly aftrr osposnre is uot vnliefactory. lndicaoous of minimum dosage hare h:en obtained by this mcthod. -1'!, ,, - to mhich dichlornbenzophenane or '"C-dotriacontamLlG, 17 hnve be", -u..~rporttted Prmince smoke containing t1le tag sfl.eiflcally in the ,..rLcro- late nhu=•. A:xperim.nts are nnder way to deterurine ]mtg dosnve of smokc parficnl;U~> by u=e uf lhese Snch rnethodp maty serve to enli6•rnhr the ftmetion of particnlar machinre, Imder deflned conditimrs witL Particular animnl r,I ies, bnt dn nolappear suilable for routinc nroniroringme. il7nsr o~ Jte cvnditions listed uhove have been atrained satl+facb;rily mith notr ecptipment desi;"nod to espose emsll anirnals intlurlin;- mice, ratw gninea pi,gs, and hnmslers. Clther cunditions such as celatively iolv stress and direet irdmlation ef smolcc from tL(, bnrning cigarette (instead of ruechnlucal pnflinq) have been attained wilL doKa un!1 monke>'rs at the sacrifice of vnrion.c adren- ta.es of thc smaller nnimnln-. Aniinu!sused in inhalation studies should be fully descrihed us to agr-, sez, o'eight, nutritioual stale, l,hysical emndition, virus componenta, ertent of surgi- cnl trarumt, anrl the de"ree of stress to which they are subjn:ted. ApirroDriate nnmber= of both sram-smohed, and ca,ge-treld animuls shonld serve as onntrolv. The end points to be sougl.t inclnde more than morl,holo=ical altermtir,es and the presonce or absenee of tumos. They also should inviude aPPronriate hio- chemical measru'emenfs and their arralysis. ]ir4tivnr3aut analysi: ahnNrl be aphlird to the dntrt obtnined frnm the cysicmatic obsLrcations of '6e -.drNled parameters t'ehttive to the smolung mnViine, tLC nnimui mod, 9, and I,.'inlogi- ca] aml bioehrnienl meavnremsnts. By taese means, it u:.l~ be i•,1e 11 interpret sonte of the biologirnl eacets resnlting frmu exposnre of animais to cigarettr smoke. Hopefully thcsc rlata c.:m eventnally be applied tn Iummlix. 1'ast experinumt., mherc the sole object.ive was thc attempt to ind'.i, ~ tuutnrs,, mnst be enreftilly arrd eautiousl.) - interpreted in light of today's knon9odNr. nrnJ3pGF3PnY IIerlcsvi. •J., "ThP ~rintisticnl Shxly of Associntion lietwoen Sutokiug anrl Ltug Canc,t°' Prn:...NEnjJ Pfr.etting.s of d7ae,)fnuo t'dJrrlc, 30: if1:i0. I3erkgr,, .J., I 1'1'.wlty of lnlcrpretutinn of the 'AssociaCon' of Ik:uth Rarrs and i9tTsical L'aetm:C' Bnilctrbe de FTmatitute lvrtc~riizwtiovraL de S.'atislitva, 33rd Se=sion. Pa'.'is, 1961. Brolt~n. B., "I o~m Charanteristic Fllectroencephaloeraphic Differeners entween IIcavy Bmoker nnd Nonsmoker Snhjectel' SeltrrPayrhoio,9lm f: 19('iS. BnecltleP, R., J. E. Lnnn, 7r.. t7. Jdnden, and L. Bresloev, "Hscess l.nng ]]nr-tality Rates Amnng Mexican Caomen in Califarnia." Cmzcer 10 : 1965. Cedurlof. R., L. P7iherg, and Z. Ilruben, °Cardior:rncnlnr unrl Fospirnrr.rr Symptoms in RRlation to Pobaceu bmnl:ing-A Str.dy ent Americeut Ttrina" Arch. FJnrirom. Nerr(Ih., 1a t 1909_ Denn, G., "Lung Gtncer Among White 5onth African?," 6ritie9i 3fcr1£cal .A.ur- +ral. 2: 1!)a9. Dean, (3., "LUn.g Cuncer in Anstralin," DTedicaE ,Jourmrd of 9 nFlraFin, 1: 19B_^. Department of HcNth, Y7ducation, and Welfar'e. :~~,ntinp ruxd Tlralih, Prqm-E of Ihe 9dnisory 6'rmam4ttre En fiae tur'OCon-Gon'aL LSPL38 Pnblicatboi So. 1103, Wtlshin;;tnn, I1.C. 1964. Diamond. 1... "'I7,e Effoct nf Cnrcinnn aic Hyrlrne. -ins nn Rn<lent nml F'ri- m,ite Celis in Pitro," dounna6 oi !'e-IIer7ar narafite Phyxiolnpy C6: L'11:;:. TI58461243
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140 t,he advertisement. of the parts per million of tar and nicotine be- cause thev said stop this tar derby. Now, what vou are saying is that the mannfactnrers ought to get back into that business. hir. STa.rxsso. 10, what I am sarirrg, in terms of the newspapers which yan saw, ,vhich ~•ou probably did see, thev were probably back acound 196'r. Thc recent reports of the f.ar and nicotine con- tents as released from the FTC have not been receiving any public esposnre. R'e have aa clipping service, and it is minimal, I would say limited in the last time to perhaps three or fotuncwspapers mrtion- alle. Senator Cooe ZVell, I can onlv sav. it seenrs to mc that if this is :rn intemral part.of-thc nrornotion of,vonr prodnetit would not take very mueh to L+ave a few hundred thousand printed and ask cigar and rigarette counters all over the IInited States to post them so evercbody can sec it. It. just seems to me that we have enough inter- ferencc s.-ith the Federal Government. IVe have some 30 odd bills be- fore us that in some Nvay restrict this industry. I hope the Federal Gocer-liment doesrrt get into the bueine.ss of telling cnnsttmers what products to brrp. y4r. 1~,rrt:%so. Again, just to correct that. We are not telling them to pick one product over another. But I believe that if this ma- terial has potentiallv. anp implied importance, that the smoking pnblic should have access to it. Senator ConK. bSy only disagreement with you, Dir. Stephano, is that yon took the time to quote high tar content. from the Sttrgeon General Steinfel(1, and high tar from Snrgemt General Stetiva.rt, and then turned around and said that we are way down close to tha bot- tom. So, it seerns to me vou want to utilize the fact that government officialshave said it is~bad to smoke high tar eigarettes and they ought to pnblish this because your product fits into that catefiorp. l-lr. Srrrnrrvo. Anyone could join ns in that category. Senator (7oor.. Thank you, blr. Chairman. Senator 3toss. Thank you. Mr. Stephano. We haec a live quorum and then a vote. Wc will racess until 16 minutes past 3, and at that time T will ask Dr. Sonnners and Dr. Hockett to be available to answer qttestions that Senator Cook hae, and we will proceed, and if I am not back by then, I want Senator Cook to go right:ilrcad with his questions.'1'hankyott. (12ecess. ) Senatnr COOK (presiding). We ask Dr. Sommers and Dr. lIockett, if thev will, please, to come forward and wc will kind of tako it collectively, if you don't mind. FURTHER STATEMENTS OF DR. SHELDON C. SOMMERS AND DR. ROBERT C. HOCKETT Senator CooK. Dr. Somnrcrs, in regard to the testimony I am sorry that I«-as nott here this morning. IIowever, I read your st.atement. There are a numbcr of questions that I would like to ask you, and Dr. Ilockctt. Dr. Sommers, are you in honest disagreement with the Surgeon General of the United States? TI58461263
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1as mld niv.otine amitent of all cigtuettvs Iestcd br+ the Fedr•ral 'I'radc Couunission since the inception of the testinr prorrmn. AIv .tppearance at theso hearings todaV is with the purpose of publiclp posing some iluertions which have nreatly perplc;ed me slncee the nteepton of th,^ cigarettev t,lr and nicotine te.vting program at the Federal 'l'rade Commission. Chl :lnrnst 3:i, 1067. William IT. Slew:ut. 11LD., then Surgcon Gcneral of the Public Heaith Sertiiccs, reported in testimony before the Oonsllmer Srnbcommittec of thc Commlttee on Culucrce of Ihc, I'.S. Sen:de, tllat and ad hoc advisorv cormnitl.eo hud cuncludc+l lhat "trc prcpondcrunce of seicntifin evidrnce strongl.y sngreets the lower t,hr tar and nicotine cnntent, of cigarette smokc, the less harmfill arc the effects." In "The IIealth Conseqncuces of Smoking-a Report of the Stlr- geon General : 19 i 2," the above statement was reafTirmed. it wac concluded that the prepondecnnne of scienfiHe evtrlence strongly nr geets timt the lomer thc tar and nicotinc aonturt of eiFare[te smolcca thc lens harmful vvould hc Lhc effcet. Several etuflies reported since that tinle iiave ndded strong support to this posttion. Sm•,qeon Uerteral Jesse L. Stoinfeld further concluded in the cln- rent 1972 report : lt is reosanahle to tekc the position that unless there is positive informnrtnn tG, the contrarp, rigarrttcc in whieh overnll tar nnd nieot9ne levels have been reducnl present to the smnl:er lotver cancentratinn of the Inlrmfnt suhsLOnce in the Particulate phase. The rouu-ensus is tlmt a Drogrevsive aud si,miltnneonc rednctim~ of nll snh- stanecu concidered l1kelg to be involved in tLe health hmmmrds of smoldng sIlmlld be encour,lgetl as the most promiping step avxliluble at the preaent tilue tomards the development of a less hazxrdons cigarette. hl the FTO hir nnd nicotine tests in Attgnst oF 1ni1 tar contult of a.Jl cirgnrettes testrd rnng'eJ frn;n a high n[ 38 milligrams per citra- rettev to a low of 8 milliizrams per cidwrette. I wonld liL-c to point out 16nt the high tnr brand hnd 11 times, 1.100 pcrccnt, morc tar c.ontent, than the low lar brand. In the sltme tests nicotine levels ran'-rd from a hi--h 2.4 milli- -117•am.v per• cigarr•.tto to a low of 07 millirrarus per eigarette. The higlt uicot.ine brand has 13 times, 1;2C10 percent, lnore nicotule tban the low nicotine brand. The point T am establishing is that there is a vast rang r, in the tar and nicatine content of cigarette brand thev select to smoke. consid- ering the ilnplicd importance of tar and nicotine contcnt, tlte stnok- ing pnblic should have readg access to information of the tar and nicotine conteIlt of a11 cigarettes as deteimined Lc I~lle FTC. 7'hc qnestions tivhich have grcattr pelplezed me and tvhich L atn pnbliclv posing at this time arit the following: Whcree and horv can the average cignrnttc smokcr readilv find ac- cess to a list indicahing thr tur luld nit,rotine content of all cigar•etlrs? Why hasn'ls fihe Federal Govrrnrnent taken meaningfnl measm'es to see that this publio information which appea.l•s to be in the pnblic itlterest, is not made readily available to the smokingrplblic? At this tlne if a smoker wa nts a list of the tur and nicotine cmi- tent of all cia.arettes ha mnst icrite to: U.S. Department of III:R', Public Hesilth Service. Healtkt Servicee and 11Tent.nl Health Adminis- TI58461261
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135 ee.onomica,L way to packsga this product; not to jud!{c a li{Qe cirar product becanse it h.os a. filter, siuee that ia seemiuyli. .vlLxt tite con- sumer desires; noli lo judrre a produet by who makts; it, for certainly tLnt Nivrould b.ti-ritniu,tlorV. 13'e utge c-on not fo rutaiu Por the ci„,~- arotte basiur-- I', .;tlmo-l vlrtu!ul monopoly it, has had on the. super- market 1nut I I r,. Lt our opiuimt. If lil:tle rigats are placeil neIt to cigsretirs o'' i 1v la}+~1~ I as little cig.u•s theu thwY pose tt mmo immediate .urd r ttilteu- r', it f,,r the snoker. 7hero is no loric in in„ by legislation the purity of the cih.atette couttcr 6i tice stutermarhets or other retail stores; and by sintiltu' le"ialutlmy relegating cigars, bu they little or larger to ot bac7: sholf. Quitn the] coutrary, if ei~arettes su~e to be etutllenged 'ul the pubiic ntintl, it is to tho publit~i- nadt•autssge to know that a product that is tnade zvith cliifercnt tobacco, tLat trastes different, that smokes differ- eut, tlrat is, iu Iart, coutplntoly di(Cereut, sltotld bo ailovml to be plxocd before. thc. Anrcrica.n puLllc as sui adcante] <;cous alioauntive. :1_l,rnur, gentlcanen, I tltank yon for the opportuuity of appeari.ng before von, arul in all sineerity I sav thatt it is our belief that eLanhcs in the present rules tchiuL might pena.lize smne, Ncill, in nhe. lour; rnn, bt+ ha.utfnl not afouc to those who make little or =uwa11 ei- gnrs, bnt to t}m dec-clopment of stmolcin;, produets thut seem to be a less h,nmful a.ltcrluaivco to cigaretta_. -. Senntmr ALoss.'lhtutk you. Mr. Pcllcy, for your statemcut. I had aquestioa about tile wrapper here that I was nskvi', the pruvious .vituess. ;mr_l, of cmnr?o, 1 am no expert at, all. I alwayn dtought t.rgars were srrsr.plretl tu 1c:a.P, tts tlro cocrr aeottnd tLe iiller of the cigar, bnt this is a manufactured covcr, the witness said, mado ont af tobacco leaf and other products, to be in asheot, srnuething lin•, a sLnct of ya,per. Is lhat tlte way the little cigstrs that cnu tntutntacture are also wrauped'd ?llr. Iten.r.rn-. Sir. tNeu do not make any little c-il;ars right notv. 11"e. mal,~I:rolucts fhttt are called small cigxrs in the trade, which are. Iar_r thatt threcpotutds pcr t}tonsiud, of wiielc Wo have several br .,. and thcy lui.vc a nrapprr somctdLut aintilur to Ichutt yott are ltoldii.= tlirn. The~tcfinition of tobacco sltect., and Igivo tiou this as a laytu.ut, not :-.ti teehniciau, is that it needs to contain at least 60 perecut to- tmccc., and ot.her vegetable aolids to give it streuI,lth, teusile strengtlt and thosc sorts of t:diiV11e. And a,ll oP ottr products--and I can slhMC you--wo ha.vc sotne lit- tle cigars, tvhiclt are larger dmu tlutit, that are sirnilar-tliis is one here. '1'his is a shent, .ahich luus a ecam. It is n einnle sheet, hut Nce don't feel ndtether it lms two or turee or a dozen shects mnlces any dilSerencc, is lorng as it hae cigar tobaeco itu it, and it luis all cigar tobanco e_.c,ept for vcgetable pmducts that gives it strength and dur- abil itv, none of wltieh Ice consider harmf d. And l this is the rtile that has 6een ttigrcecl to with the IP,6. Ha) o I aus.cered your questiot? Senator \toss. Yes. vou i tasu. Jrr. Ivmr,t:r. 1o.v, we obvionsly shouldn't be speuking i'or what is iti jS'iuchesters. TI58461258
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141 Dr. Sou?iens. In rcgard to smoldng and health, sir; indeed I r1111. In the ptblic press be ia quoted as making stntements which I regardd as immoderate, as going beyond the scientific faetso es xnalcing a kind of a publicity appeal. Achich does not seem to me fitting for de office of Surgeon General. One of his statetnents is that those who disagree with the Gnvernr mcut's position are actually doing harm to people's hcalth. I was tanght that a doctor naver does any harm. I am a physician. I don't believe that a free expression, in my opinion, based on my esperienca, research, and reading, if it is the truth, is going to harm anybody. The truth will set ns free. Sena6or Cooic. Dr. Soimners, did vou hear Senator Spmig's state- ment this morning? Dr. SomiTxns. Yes, I d id. Senator Cnmc. For the record, I would like to read three or four sviitences back into the record sigain, because I think they are so important. Senator Spong said this mornin;7, with all respect to the motives of those who support the pending bill, °Cthe me!isuren in my view represents anoCher examplc of the mi.staken atitude that the Federa,l ta•overnment knows what is best for a11 citizeau and should be enr Iiowere.d to mahe n11 decisions mi their behalf. The 01 is a splendid example of big-brotherisn." It. proposes an introdnrtion of the Gorernment int.o an area of decisimunaking that rightfnlly belongs to the individual. Do yon I~, diece that Dr. Steinfeld.could not ascribe to that basic philosoe,h5-1 Dr. F. +i +i vnG. I really don't know. I am afraid he might not,. Senator G- i:. Do yon think that that could be part.ially sub- stantiated hv l,is remark in delivering the 1972 report, when lie said there is no lkmr•er rui honest disagreement @ Dr. Som[sra.ms. Sir, that is manifestly untrue. Senator Cooi. In yonr staten2ent, doctor, yon use the phrase smokeIs and nonsmol.eas are self-sclectcd, ti9hat do vou mean ieben you say that? ~ Dr. Sonrnn:xs. So far as I know, no one is torced to smoke, and no one is absolutely prevented from smoking. Ordinarily people ded.de for themselves whether they will smoke or not smoke When they elect one or the other, itt tclls ns something about that person, some- thing about this psychology, their physiology, and their anthro- pometrv and so on. Senator Coo2c I)oetor, does thc recontreport by Dr. Yeruslialmy have any relationship here? I asked some FII)jIt tivitnesses about this staidy earlier, and who told that it had been criticized, and therefore there is no rcference to it in the report. Dr. Sosmimns. It, is possible to criticize almost anything. _1 most interesting ftnding in the recent Yerushiilmv report on mothers nho smoke or did not snolti, and the birth weight of their infajcts sas that women .vho did not yet smoke had smaller infants, significantly smaller in titi-eight. than women who did not smoke, although the womon had not s•et taken up smoking. And this indicated another aspect of difference between the, smoker and the nonsmoke.r. TI58461264
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143 Dr. 6o,r.rLns. Yes, sir. I hnre leac~ied of that. I think that, is rather srmprising. ~ Satator Coorc. I would ha1-e a notion that even 1)r. Steinfeld might read Jae,kAnderson's colturut. [L€tughter.I Neunbtr Coac Ih•. Sommers, I was concerned abont erntr comment in ponr prepared sttUemeut that scientific informutiwt or data has het n kept I'rom the scie.ntific comrmmitV. .A'ow, c•sn Von comme,nt further on this, and if possible, giNe ex- amplcs of =ome instances .cluclt Lavc occ.rre.d in the smokin„ twrd )temlth nrc.a? Ir. So.rna-aes. In epidemiolomc stuiiies., in the lastt few years, it has tm-ned ont th:at new tcchtrirlues and reevaluation of old dtttti will show that the original conclusions should be changed, and this has Imen permittrtl by all of the major investigators in England, I tutderstand, and also some in the I;nited Sfiates, bnt sornc investirn- tors have refused to release tlteir data, the mttjor one being I)r. Ilarn- rnond. Now, tltat epidemiolonic stndS plrohably is not balaneed for the whole Ti.S. popnlation. It evideattlp had very few Negroes, so the couc!nsions could not lie applied scientitically to Negroes. R'hnteier else. may be in that data, on reecnlmt,tion, it is iatpossible to ascertain beeause Le has rePnsed to rclease it. One wonders if lie ltas somethinm to concenl. Also, in regard to the smnking dog studies, you probably know that. Anerbach has refused to permit his microscopic slides to he cxautined bV an indepe.ndent, ptmcl. Senator Coos. Pon't you tltink it is ratdter straure tltat the Surgeon General and the HI)IC' shonld continue to refer 10 the A.ununnnd-~~ue.rbxeh st~.idc t0hen in fac.t it, has lvrn discxedited and its results h;tce been refused to be printed by anv rnedirtd journal in the i?tnted States, which, bc the wap, the Surffeon Gener.d oon- "miently nses en masse n-hen lte wa.uts to ntilize tltem for the pur- po es flutt ltts Itis bins. Dr. 5ovurrc. Yes, sir. I dmt't believe one should continnally repeat the statisticorl epidemiolognc data front the 19GO's and 16)6o's, as iE they were gospel, t+-Len we have learned consideratbly- morc about the techniques and abont innlttaari urt anal,}°scs. _ Senutnr Cootc. Leinu o;lc both of qott this question: i>ont y-ou bolievt• that tbev continue to refer to the 1Fvnder mice study sutd the IIaemmond -Auerbach dog study because tltcy haven't prormessed any fiirther thin thztt? 1)r. Pornrnns 'I'hat was t.he major work tchich seetned ta snpport the conrhtsion. That would be nrp answer. 1)r. IlorneYr. Iwrnuld say the s2me thinr. Seuatm Coorz. Do pou bclieNi-thereis any pressue ort scientists to acrept tl.e Sur,von (7eneral's view that sttokinr is danaerousg i)r. Sov.nras. ln terms of resatralt grants, many- scientists are delto.ndent nn gorernment for funding, and the.re haee been esamples rritere people mu!ild lil:e to appear before congresslonal <Yimmittees lreeseutin;; their own re.searelt tclhiol, rlidn't agree wit]t the concltr sious of the Sur,~ernt (Ienera.l's report, wlterc they Jtave lmrn prerented bv their admin&trutit-oe superiors from appearing under tlte beliefi that this wotild jeopardize iheir reseurt]t support. JI TI58461266
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142 b1'hether or not this is really a health issue is undecided siuco these smaller babies snrrive just as ts-ell, or perhap; sometitne3 better, as inf>mts of norinal birtAi weight. 5enator Coor., lll:y4 said 4hcy rrerc ao-are of the Ycruabsrlu,y rohort but beumnse tLere aas criticism, Ilicc tnade no rncutiou of it.. And yet in the iusrrtiou of chapter 9, relative to the inrrred,ieuts of smolce, on two oceasions they footnoted their report and said that there was not unanilnoas agreement on this yoinb. On thtdt basis, they shordd not have had chapcer 9 in there because there was rut hoitcst disAgrccanent between poople, ill 'tlu.t 1-day setuiuar. Tsn'fi thatt true? I)r. Sowxeus. That is t,rne. Senator Coox. But they felt courpelled to put it in, any-~ewe. Do you beliere tha,t the 1964 report of the Surgcon General's adeisory cotnmittee and the reports to Congress presented a bal:uiced review of the evidoncn on smokinr? Dr. Sonrnrrt>;s. No, sir. 1 lielieve tliey represcnt _elected retietcs with editorial cotmnents. with deletions or failures to cite studies tLut didrrt support tlreir conclrrions, and ill sotuce cases geuuitie inau- curacies. For example, thcre is ar staidy b_v Keys, on f+utors reluled to coron- arv disense, and in the 1971 Surr;eon GeneraPs report, on pat{re .°.A, in di~eussin" the. tnonohraplh, it says that sluokuin cctw not oottsidered in the t+o Jap,uiese poltulatimls. Ho.ceemr, if you refer to thc article itself, it turns out tlutt there is considorable iuformation on smoking of thc .Japancsc popnLation. tierwtor Cuox. As a matter of fa.ct, to buttress that up, Dr. Ihij'ai mentimied thc, fact tlmt Japan was mie of the countries that he referred to in his rernarks, and the chairnuui referred to Japa: as h,uving done extensivestudy in this field, did they not ? Dr. Sonr3i-ur,s. That is correct. So, tiou see, ne not only have omis- sions, but we have cditoriid cormuent:s and .:o have errors ill tLis report. Of conrse, nothinc is likely to be perfcet Homer-er, I hLink over tLe years, thc,.e reports have consistently shon-ed these trends. So, in tny opinion, they are not abulanced report, and they do not. roflect a fair rept•esentation of tite state of the art. Bc.nator Coor.. Do you feel that they intentLona,ll~r nerletted to state the fact, that the studn s t'.lat ii'ere ma<le in dap:ui were foutd to be byl far the heaviest smol:ers of zuzy of the othcr groups studied, and yet they r-ere found to haeT~ fhc lowest dexth ratc from heurt, disease@ 1)r. SoInrcns. T think, sir,tbut islikel}-. Senator Cooc Would it serve the pnrpose of the antisnol<inr teuor of the report since 15384 not to report that aa a matter of stttdy? Dr. Soarnnrars. They alwnye emphasize conccrginn cvidence. There- fore, they are inclined to ignore or to downrrado any evidence tb .t. does not cuncerge. penat.or Cuox. Do vou think that that rna, nlso hace somethirl to do with the fact that the 1969 a.ndd the 1970 stndy by the B'il a rehttive to smol.-ine and t.ho cmutamination of air in an aircraft wns conveniently not delivered to the Surgeon General untit 1971. And, tlierefore, not. made a part of the 1972 report e1-en tlrough it Was reported in Jack Anderson's column in 1950' TI58461265
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144 Also, there are cases of articles on various aspects of smoleinn and health that hai-e been in one ease accepted for publication, and then after a note from tt former Surgeou Gener.d, had beur rv,jec.ted by the journal, and there is another oxamplo of a paper w-hiclh is coming ont now which was refused pnblica6on on the basis that in part the inforv-uatimi was alreadv lamwn, but this is not t,4e truth. There is c.onsiderable new evidence in this paper which. I think will intluence our understanding of this part of the smoking and health problem. Senator Coorc. T ow, therc was a mentiou by Dr. Gori of the tobacco working e oup, and I believe sotrm IM W tob:o.co coope-ratior, groups. Now, are there two gronps or is there one, and what generally is bein,:; accomplished in this fie;d? Dr. Son[ytmns. Well, sir, this morning, I eaphuined itt in part, but the real point is, I have no relation to the tobacco workinv group. This other group is called the Subcommittee of the Joint Commit- tee on Smoking and I&alth, a-nd it involved an e/Fort on the part of represe.ntatices of the AIIiA-ERF, thatt is t.he foundation of the AJLA that undertakes smoking and health researdi, and then officials of the NIH and representatives of the Council for Tobacco Research. AF'e wcre asked to sco if we could dcvelop a dor,ument that would eXplain gapS in ]urowledge in the smoking and health ficld and priorities for research to fill these, gaps. 51re labored hard at this, and as I explained this rnornuig, n-e never achieved a single docurneut. That subcommittee is still in existenr,e. It has meetings at the call of I)r. (iori, who, I believe, has now become the chairrn:ni. From Lime to Lime we o3changc other information about prants that have been approved. It is our wish to cooperat.e with the A\iA- EIiF, and with the govermnent., VIH, insofar as this is possible, iu all fields of qnokuig and health researclr. Aj'e are somewhat handi- capp(,d because the present chairman, Dr. Gori, shows lit.tle entlmsi- asin for this committee, and is inclined, I think, to putt oil ca!ling me.etings. Senator Coor. Is this basically beo:a;se there is a disugrecinenC of the boginning prelnisc? Dr. Soxncsns. Sir, if we were to have ¢, joint docummnt, in essence, we wcre. required to accept the contention of the txo~ernment that aa c.ausal relafionship behNeen nigarette ;.Moking ard lnn~~ c;inr.er muse hc ac.:eptcd. We were not, of course, able to do this, and that was_ tlrc cliics single point ichioh prexeaited a sin~le documuit. The second point was that in the 1Qational Insti't.ntes of Ilealth's draft, there was frequcntly a budget pofe, so that in essenco, in their minds, the problem is solved, and now let's aet oi: with bndheting the steps we will take to implement tnis. And this is not the understand- in; of the st:d.c of tlie art on tlie partl of the ANA LRF or the Council of Tobacco ieSo.u•ch representati~es, and that is the main inhihitisig factor. Senator Coon. In other ticords, there really has been no pro,%ress made because, somo of those who had heeli askcd to participate and a=sociate with the depurtmcnt, woidd nott a,mree to begin with that the verdict is alrcady in on smoking and healtL? In ol:her words, ciqurettes canse diseases, so let's stu.rt from there is the attitaide of the Surgeon General'a OE'ice. Dr. Sonrnrrns. 1es, sir. TI58461267
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145 Senator Coos. Thank you very mnch, Dr. Somrners. Dr. Ilockett. are you in henent ditagreement with tlm Sargeon ('-coeral 5teinfcld'e report ml the hetdtlL and stnokingN Dr. IIocxixr. I am in disagreement also. I have Illed sevenil sfiate- iueuts before these commitlees, a.nd I hace spelled out some of these things, and this tnot~ti,ng I tuslmd leave to turn into this commitlee a paper that I presented at the Universitv of Teutneky last \Tiay in which I detailed many of the rcasons why various esperts cunsider the epidesniological evidcnce. to be incmachsi ce, or the work witli so- called tar. to ho inconclusive with reshect to any incrimination in re.l,ttion to hnman health. I spelled these thin-,s ont, and to sEn-c time I tntved iii this piper .chich goes into more detail, and C didn't repeat xll of thi;. Senator Cooae It is in the rceord, the chairmun te]Is mc. Dr. Hoaxe'rr. Yes. Senator Coorv. Now, in the present state of sc.ientific knoeledge, Doctor, could I characterize the setting of tar and nicotine, in ci~':a- re.ttes, mandatory limits, as pos`ibly memiingless and perhahs mis- leading? Dr. TTocincrvc I think they would be completely me~~.niut?lrs3, because as I said this motr6ng, I see no i:icrimiimiimi, either of tar as such. or of iucotinc as such, or, us 1 mesitiouod, carbon raonoside, nhich for the first tinm came into di7cnssioa in this cear's report. L thinl: these, hace not been ineriminated with reqpect to hnm;4n hcalth. tlnd again. Iwent into some of the reasons. Tar is not wholc smoke. Tt is otJc a part of the srnokc. It differs chemic,lly in ph.ysical properties from NAho'~e smoke, and it does not contaiii all the ingredients of vri-iolc smoke, ;uid this has lar"'e]y beern tested with the skin paintinl, by mice, and the mice-- Seuawr Coui.. But let's ret to somethiuh morc iniportant. Lcl s rct to l.Lc vcrp pEi,iuting itsa-f. How do tlier estrEtct fhc tair? Pr. 11o:.r.e.Tr. 1!. is not evtrn.cltirl_ Swoke, comes througlh a cold trap vvhich emtdenses it, entc-hl- it. tio the tar is smoke. Of conrse. it is cmnpletoly incorrect to speak about the tar t°rontent" of the i'arette Lec.anise there is uo tar in tho ci,,aratte. The ar is snioke. I.ntAtcr, it is a part Of thee sm.oke. It is that part thaicam bc eau-ht, if vort pass the whole suiola_" Ilumut;.'.i a cold trap, aui; it !r,ol:e sorne- rhin,n 7 ike tar. Scnator Coon. When it is taken in that artili,•ial_ co!tdition, nOlich is a crandition that mottld ccist !hnost nndcr no othet rircarultaucrs, that extreme cold. anil it is ptuntt+d nu tlie 'ozick Of a mousc -- Dr. ITocsarrc. Yeiintcd on tlic mice. Senator Coox. Now. that con,entratiot Of tar, a-hat ivould that represent to the indi~°idual in his emokin:~ habits'd Dr. I-Coatas:^t. ly'e.llL vn,rions estimates hace been r11ade. hnt, the amounts that are painted on a small pateh Of the skin ol' the iuoti-.. flxe really astrcuomical in relnkion to what a]nuuan Lein" nonld absorb in normal smoking. Itememtier. that the internal surfn- , ar„a, of the lmig is eciv lar~-'e and calculations havc bcen madc effect that it ivould talte-a man would have to smoke mav1>> cinarett~s .~. dae tn get comparrauh~ -- ~ Senator Coor,. ;,0,000 cigarettes day. TI58461268
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148 The Council conducted rather extensive studies alonm these lines, furd people who had had attacks of ulcers were subjected to quite sophistie.a.ted measurements to sce whatt happened to the gastric secretions tivhnn thov smol:ed r.il;arettes. Some nine di[ferent factors were studies. 1nd tkrcre ceas just no signilicaut efTect of smoking on these parameters, zchich almost forced us to the aonchusion that, as already had beeni su~-ested. nlcer is a]dnd of pscchosomatic clisease which attacks people who have a predisposition reflected in the wap they hrmdLe tension, frustration and the like, and this vnty type of person .cho is nlcer prone would tend to use tobacco perhaps more than other people beczxuse of its tranquilizing effect. It lcas quite unclear tlui.t there was any° causal reLationslup. I think the weight of the evidence is al;rainst trny sueh conccpt. Sonator Coor.. Putt if Z-ou have someone who smokes agreat derd and he Iras a peptic tilecr; thrn you rrutomatically nssociate the srnnkirra irith the nlcer. :oid not the fact that snokinn rnay- t_;ice Irim m' ontlet ~chieh could rclie'o tension that causrs ulcers. Dr. Hoorrn,rT. Yes. If tce c,ould develop nq sophisticated study it might be slrorcn that smokins would rednee the possibility of ulcers in people th;.t tlio oredisprne(l to it. 13ut this has not been wot'ked ont. Sermtor Coac T)id yon uialam your findings of this study available to tlre rrocernment? Dr. Hncuv;mm. les, tlrese We_re all pablished iu the litereture. All our studics wero prblished. Senator Ooor;. Published in Achet literature? 1)r. llocr,rrT. General literatnre. They pnbLisl_red in whatt journals they pleased. Senatnr Coor,. Were tlrey= picked up and utilixed in ans way by tho Federal (,overnment in its repm•t siuce 1964? Dr. Hoc]crerr. I do noi ¢~-en remeurber whather thev nrere referred to. I]nmw tive dciicctrd them to the Sur;,eou GencraPs corzunitte.e. Senator Cooh. Have ~ou read all r,f the rcpor'ts an srrtokinc and henlth sincc J-:)n4A Dr. HncInPTI•. Yes. Se.n.rtor Cboie Was therr ever any reference to the fact that the original claim that suiokinl, cansed peptic utcers, that canrceivablv that m,r1- hace been a false st;tement? i)r. ltl.lcWr.rit No, I c:r.mot recall thirt it n-as erer onr.ttnd from the churts on accrruut of tbis kirnd of work. Senator Coon. In other ivord.s. it is still staur9nrd opcratin;; pro- ccdure by-canse the.v (to not rcally want to admit that maybe what theC said wYS ntet corrQct ? I)r. Ii::oicr-~°r. There has not been any overt retraction. Maybe ulcer has notl beeu rnentirnu,ri so much lately. L3rtt they have not said this has beer removed from the list" of snspects, so far as I reonll. Sc.nator Coosc. In other words. HI.W`s position is what snpports my besis is reportecL but NrLat eontradicls mp basis is r:ot? I)o botlr of von think that there has been a neoleet on the part of the~c reports to reLer to scientifie rnrd medical studies that refute. the prerions reports of the Surgcon Gencral's ofiice? Dr. Sonrnrnre. I think it is cerv di(Iicult in a munber of Arneric;m medical jom'nals to get a pnblica.tion accepted that does not fall in line with the conchision of the. Surgeon Gwumral's report. I tl~ink TI58461271
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162 Mr. Gnaso. This is my point, sir. I am in agreement with you, and we are here, again reluctantly, to point out that the language of this whole cigar and cigarette and little cigar indnstry is rather ambiguous and confused. Senator Cooic. Let me tell vou how confused the- FTC is. In its report issued December 31, 1971, report to Congress, pursuant to the Public Health Cigarette Smoking IIealth Act on page 6, starts a sentence at the bottom of the page. '1'hc definition of the term ciga- rette contained in Section 3 of the Smoking Act is identical to the language of 26 U.S. Codo 5402 which dofinee the term cigarettes for tax purposes. u'hen ono turns to Chapter 26 of the United States Code, Chapter :i402, definitions, the first definition is the definition of a brewery. "The brewery shall consist of the land and buildings described under brewerv's notice." So maybe they got conl5ised because sonic peoplo allow tobacco for cigarettes to ferment. Maybe that is how they got into the section on breweries. Thank you,lllr. Garbo. I appreciate your testimony. Mr. Gexso. Thank you, sir. Senator Coox. We will recess these hearings until February the 10th. (Whercupon, at 3:40 p.m., the hearing was adjourned to reconvene on Thursday, February 10, 1972.) TI58461285
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159 1Vc had qnito a bit of discnssimz ssbont tLtrt actutilly being a little cigar, ~ind sinee I am just dependinn on my layman's back- grotntd m making that judgment I h,ave to accept the definition of those .rho are expert in the field. Bnt it still to mc has, ,yon know, a tremendons appearancce of beinr like a cigarette. «'el1. 1 tnnat leave now or 71vill- Atr. GnRno. Ti'ould yoit c:un to have photographs oI these for yotn repotl? 5r.ntttor Moss. Yes we would like photographs. llr. G.unso. We will 1>e gl:ad to make photographs of both ex- }iibits for iticlnsion if iltat pleases ron, sir. Senatorl]:,s-Thnnktiou, , i~ mttch. (T6, iltustration follows:) . L A B"f 0!om C I %J8 311ARS SMALL CIGARS CtGAR iF.T`3 E S I OR EITTLE CIGOWARS TI58461282
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152 'Phere is no more effective source for such init_;.atives than t-he. U.S. Govermnent, and the reoent rcl~rt by the ,9urs*eon G-enerat is indica- tire of interest on the part of Cxoi°erinnont Chapter 9 reiternte, fltr earlier U.S. PT3S observation that, mo-tnv citirens .c-il1 contiuuee to smoke, but that the typical cigarette might ~-er}- icell be imparoved. Mr. Chairman, cit,,arettec researclr remo-u, -- a, ehalle~i,~,ing area. Our cnmp,rny will be pleased to provide fuvthe.r ~'.ata on Cl?c abilit,y of charcoatl filters to remors ~,.1'~ !.•.ii"- nnw iilenuilieil as probable contributors or suspected contrib i irs to health haz.ards. Thank vou for tlris opportunitv to trr.l i]c I.fore tho cocnxnittee. Senator Moss.'tlmnk vou, Mr. Tiggelbech-, for cour contrib:tion to the record. The teferences that are printed to yonr appended state- rnent wi11 follow immediatelp after vonr testimony in the record. I do upprociate vour testimony and what Vou have pointed nnt ir,a.y be a accomplished by filtration of sinoke. Senator Cook'? Senator Cooi.. .Tush one rpuestion. Yon can'h elaborate any fxrtlier t.han the Surgeon Genera.l'r report that said, and cou quoted, "That there conceivably a.re probable contributors or snspecf,ed cmitribu- tors?" You cau't atlirmativelp say that there are in faot, contributms bv reason of zionfiltered cigarettes? ~~Mr. T;ecEr-nzCic. No, sir. _le a matter oE f;rct, I can't go that far. Senator CooK. Thank vou. Mr.'L'mor:r,nECic. 114sy I elaborate? Senator Coolc. Sure. A7r. TlocrnnFCK. Vely well. Wc have neN cr taken a i=sirion thnt cigarettes were either harmfol or not harmful, b, ~i i-1, w, haae little qralification in that area. jL'hat we hsve noted is a case being made against cigarettes which maintains that ceirtain components in eiga- rettes are harmful. Iu my judgment, there is an inconsistency in this case. While it acknowledges the existence of these components, and in chapter 9 identities several gas phasc componcnts which hal•en't received very n-.uch attention before, it, foils to tal:e the nest loQical step in pointing out, that cigarettes alrea.dv esist. that deliver widely varying quantities of these matet•ials. Some of these cigarettxs have been available for anywhere from 5 to 13 years, but the public has little awareness of them. Senator Coou. T+fav'be one of the main reasons is that bec:iusc the FTC said some years ago it was not going to allow the industry to say one cigarette was safer than another ore and prohibited what was commolrly referred to as the tar derby, is that not correct? Mr. TrsoE,.nEOK. Yes, sir, I believe thaf is correct. Senator Coor. Thank yon. Senator bloss. Thank you, Mr. Tiggrelbeck. (The references follow:) RFBr]nESCEF (1) Krane, M. H., 1). D- Tlgbclbeck, and J. R. Ltnchko, Determining Sedectiver Efficiency in Cigarette Charcoals, presented at the 19th Tobacco Chem- ists' Rescarch Conference, Lexington, I'ientucky, October 26-28. 1965. (2) Tiggelbeck, 1). D., Krane. M. F., and Joyce, It. S., Increasing selective efficiency in cigarette filter charcoals. Presented at 4th International Tobacco Scientific Congress, Athens, Oreece, September 19, 1968 (CORESTA Abstract No. 3110). (3) Tiggelback, D., Comments on Selective Cigarette-Smoke Filtraflon. NCI Monograph 28, Toward A Less Harmful Cigarette (First World Confer- ence on Smoking and Health) :249-258, 1968. TI58461275
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160 Senator DZoss. If you remain there until Senator Cook comes back, he will resume the hearing and present his questions. Thank you very much, ~Recess.) enator Coox (presiding). 3Tr. Garbo, I have a few questions I would like to ask you and I hope you take them in the spirit in which t,hev are. intended. First let me give you a hypothetie qucstion. What are you and the Genera.L Cigar Co. going to do when the 1974 report of the Itoval College of Physicians in London entitled "Smoking arid Health" states : The remarkable disharity of risk between smokers of cigars and users of snn1Y suggests thsGt mucL saviug of life and health might be achieved if cigar smokers were to change to snufY. I think the import of your testimony is, in all fairness, that the General Cigar Co. did not get into the little cigar market and that if these little cigars are not restricted you may have a reduction in sales. Also the Surgeon General's department madc it clear, that they wanted zero consumption of cigarettes. They want to p'rohibit. cigar- ettes. And what makes you think that the cigar industry is not next after they get through with cigarettes? How many people do you know that inhale cigars @ I know a lot of them. Mr. G.vuso. I do not know voty maiiy. I know some. Senator Cooic. I used to inhale A. S, C. Grenadiers every day. We are. here to discuss a problem. But what really bothers me is it is being used by the Gencral Cigar Co. to say let's ,et the little cigar business off our back, let's give them a new defimtimi so they are considered as cigarettes and let's keep producing large eigars so we can keep our part of the market. Is not that really what you are saying e Mr. GAnno. I honestly aui not trying to say that, Senator Cook. I am trying to say that there is confusion in the public mind as to when is a cigar a cigar, a large cigar, and when is it a little cigar, and when is it a c,igarette. _Viid I believc thaL construction-wise, and appcaranco-wise, and even in the character of the product, there are enoagii diIlerences that there should be three distinct classes, and the terminology at the moment is very confused. I have made it clear in the statement that we are not saying that the little cigar is a poor product. All we are saying is we do not know what that product has done in the marketplace from a health point of view, and I am not taking sides in that issue right now because, again, thn problem is that we are in the marketplace which is bom- barded with health claims and statements and press releases and we must live with that, and if we are to live with it, them we should certainly not have tlie publications and all of the announcements hit us whether they portain to onr business or not, and this is the prob- lem we are facing. Senator CooK. Mr. Gaabo, let me tell yon, we arc all in this to- gether. The whole Nation is in this right up to its ears. And what bothers me is that if HEW and FTC have their way and the Surgeon General has his way, that zero consumption is what they want, and they accomplish this in the cigarette field, what makes you think cigars are not next. TI58461283
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150 1°The Pealth Consequenres of tilmoking." With coln' permission, 1 would like to quotn briefly from that report as follows : Until thcre is u better under--tnnding of the rclative importance of the inter- action of ihe constituents of cigarette nmoke in the de-elopment of the dis- ene.es u,~ociated tv(th cigarette smoking, it wilt be difficult to asseSi, the signifi- miner of the redurtinn or elimiuutinu or nne or several of ihr rnn~tinuuta mimetl in this report. Iiotivever, it is reasonuhle to take iiie position that nnleus lLere is Posicive informatiliri to the cnntra.rr, cigsrettcs in which ol'eratl Inr snd nicutinr levels have been rellured Present to the smoker lower euncentci. tions of the harmfnl auhstnnces in the partienlate phase. Tf, at the same 5me, signiiicaut rednction5 are rnade in those gas phase cono- stitnents which alc,o conlriLUte to the hazanln of smokin>, the r,snltiltg nral- net shonitl Le less ha~nrdons to hcaith. The cmrsensns is that a prqtme,"sive ~md aimnltrmronu rerhirtion uf alt suhstaneea consiilererl likely to Le involveQ in the hculth hazarrls of smolang- shonlU he encom•aged as the most prmnising steD available at the prespnt timc tov;ard the rlevelopment of a nSF lmraraous ciGnrettc. A footnotc to the second quotcd parnt?raph -ives an alternatire opinion that there map br' a 1•ertain lecel for lowering nicotine at which one would inlrutiona.lia stop, to a~roid havina the smolcer in- cr'easo thee mmmber of cirrarettes smoi.ed the depth of inhalation, cuhis pnft' fregneucy "hi order to main an accustomed level:' Further research should be done, in this .urd allied aroas, since it is obcions that improved ri~.rarnttes must lie i>~sed in nrder to filliill thcir funetion. bnt preferablc bc used o]ily in moderation. Chapter 9 of thr Sardeon General's report identifies nnmerons partieulate (i.e. tar-liicotinc) phase and ,m,ascons or vapor phaso smolm coroponcnts, rankin,~, thGve iu three ,m,ronpinrs of potenrial e1}ect on or risk to t:hrv suokcr_ The distinction bohveen pa:rtienhlte and tras phases is defined accarcHnn to .vhether 50 percent or nrore of a given inaherial is either retained or not ret•lined, respectioeh', by a specitJ fibrous filter duriuff standardized smolcing. Of conlsc, tnany compoands so defined will be found distribnted betwecn both pliasts. With this a.s baclrgronud. I would like to offer some obsea°ratimis ou the sub,jec.t of cigaeette filters. In colmueraial filtrutinn practit•e, the particulate and tras phas<x are adjnsted by onc om• some com- hinatioit of tlrece ter}mique~. \i'hatt wo mig}ht classifv as a f°Type 1" filter is fotuld on the majoritc of filter-tipped cigarettes. This filter consists of cellulose acrtate fibers or paper and represents the first te.chnique. "°L-vpe P" filters affect the deli.-ery of particnlate matter, largelY as a ftmction of draw resistance, but have little or no effect on ras phase emzatitnents. a se~oud type of filter is an intm•estin;,r modifmation of thw "/Type I" filter. This see.mtd type contains perforations aromtd the circnm- fercnce of the fiiter n-rap. 'Phe perforatious ndmit air durinl,r pnflin;" , therebi v diluting both ptirticul;tte and ras phase smoke fractions to a filen de;qrce. The thiird basic filtcr tcpe ronhains activated charconl, which is added to tLe ordinar_ti or pei'forath,d filte.d. <lctivated charcoal con- tributes the phvsical phemmmenon of adsorptimt to the impaction and dilution principles of the other filters. enablinn manY gases to he retaired in the filter alon', with the particnlate matter. Thc. o,as reanovall e$iciene' Y of charcoal filter, depends on their desiml. plns thet~pe and amonnt of c.harcoal emploped. TI58461273
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149 that this is worse now thmi it was in 1.964. iS2ost investigators are ingenious enough and percistent enough to gott tdieir articles puL- lished sornewhere. jS'hen they are published, thev are often not pic.l-ed np. or Ira.ve not Laeuc pic'aed up or citetl in the Surgeon GeneraL's report: or if ther are cited, it will somehow downarade the study by sa>>ing there were too few animals or people involved. FIowecer, an equall}° small study that shows sonic. rclaticn between smoking and diseases is vers Gkel,v to be publislred and will alrnost aertainl y be picked up and included in the Surgeon General's reports. Dr. Ilocresl-r. I would sae they appcnr to be quite selective Senator Coon. I nm inclined to a-~rce with both of yon, and I wish to thank Aou very nmclr. I also wish to thsailr the (llhairma,n cel.v much for giving me the opportunity to ask pou back and ask t.hese question. Thank con_ Senato~• Dloss. Thank you, "eutlemon- Senxtor lfoss. Clur ne.>a Jitrmss is A1r. Donald Ti,rgelbeck, man- arer of market development, -- ~ Mr. Tiggelbeek, we are very glad to ha1°eyou, and you may proceed. STATwMENT 0r DONALD TIGGELRECK, MANAGER, MARKET DE- VESAPMENT, PI1'TSBURGH ACTIVATED CARBON DIVISION, CAL- GON CORP., PITTSSIIRGH, PA. Mr. 1arr,n!.otcic. Thank ;ou, lir. Ciaiiunan. I aei Donald Tihhcl- lieck, roanayrr of m.uisPk dn~elopment for the. Pittsburgh Mtivated Cnrbon Dtvision o! C'.aYon ('orp. Pittsb n•h Activ`,tc2{ Carbon is tLe leading producor of activated c}mrcoal tom• infhistrial, environ- mmntal and consnmer yroduet applicaiions. 1.monr these anpliratious is the irae of actirated charcoarl for cir.uetle filtral:ion. Ln support of our interest in tbe ch ucoal cigarette ;ilter are[r and in t.he underlying pursuitt of imprmwd pigarettc•ti, P`i.ISbw tr -lcfiv:hd Ca.rbon has maintaired a c.heurir r' ri~earclip.o,nxm ou cigarettefiltr:ution since tho earl} Tr ou;di thi ic carch, mnuiy of thee fimdarnmttal (bnraatei.lrc= ~ro~-crninm adsorbent fiitcrrs have been defined and puliliared. ~ I have maint,~i>ied prriodic conttut ~ritir ~.TO-,~rnmentul and private, institntio is which aro doin;t nsrarch :ii: thw c_•arettc hrv_.dtL zma, or are otdrerw,ise intnreated in the question. In connectiott wi!n tl, . .~ ticities, we h.ve pre5entc.d testirnoiv on the :'aliject of ci'_v~ : '' ~ 1iLters to tlris snbr•aiwnittee in 1907. to the I'TC'- in INW and LF, and havc P'iven papers at the Fust and Eccoud \S'orld Confcrwicos on Sraolcing, and 110.1017 . wui iuter- natinnnl CORI:STX mcotin,~;s. Tn nddifion, I'ittsbrngh Activated Carbon pr-rsonnal hate prr;cenled IJuce analctical chrnristrr papers ael tlre II.S. Tebacco C7remists' ltrtsearch Conference. In tlase lnrcions meetings and hearinrs, I have urged that more attention be focused omr chcmicxl c,onstitnents in the gas or vapor phase of aigtucMee sniokc. Tbis wori)d bring total rescnrcb effort into better bnlancc bet,crn tar' and uic.otino and these pes phase com- ponents. In this rr~ard, I have noted with interest a statement appeurine in chapter 9 of tlie 17)`t3 Smyeon Gencral's report eiditlyd TI58461272
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Ll PUBLIC HEALTH CIGARETTE AMENDMENTS OF 1971 TBURSDAY, FEBRUARY 10, 1972 I1.S. SENATL. CotaSMrrTI:R ON Co'4rAn!IICL, 51:RC0]Y]17TPDE FOR CQSBII]SnRS, IY'aaluny6orr., D.C. TILC snheramuittee me6 at, aJ>io u.m. in room G710. ~Tecc Senate Office I3uildiug, Hon. Frank E. Moss (ehairrnan of the subcommittee) presidin~. Present : Senators.lSoss, I3aher, Coolc, and Stevens. OPENING STATEMENT BY SENATOR MOSS Senator Tlosa. The hearing Ncill come to order. Today tlie, committee will reconvene in its consideration of legis- lation rchiclr I have introduced to amend the Public IIealth Cibarrette Smolan, Act to require the Federal Trade C:ommission to establish mat-imum levels of tar und nicotine content of ciga.rettes. Additionally, we have lvitnesses with us today who will discuss the marketing of little nigars and the application of the Federal Hazardons Substa.nees Act to cigarett.es. I would like to comment brio~fiy on some of tllc testimony we have hrr.viously heard. It, soems to me we have had a lot of people qnoting other people out of context in this hearing and I a.m disturbed to note that. Ccrttain witnesses quote the Snrl-eon General's rehort when it sup- ports their position and re$ite everything clsc in the report. Perhaps most disturbing tvas the testimony last week of Mr. Horace Forneray, president of the Tobacco Institnte, in tivhich he quoted Dr. tiS'illiam H. StezPaar't, former Surgeon General of hhe United States. The etatements attrihnted to Dr. Steivart indicaterl that the former Surgeon General would oppose legislation to estahlish maximum limits on tar and nicotine in cigarettes. It seems to tne when cou qnote someone ont of context you can invariablv quoto .vords zvhichh agree with your position. I.vould not be surprised if some6ody might be quoting me ouU of eontext and have mc support.ing their positimi on some matter related to ci~nuettes. ~In [any case, I wrote to Dr. Stewart ho is now chancellor of the LonisiaJUa State I;niversitv Medical (~ whoenter and asked him to corn- ment on Mr. liorneg,ay's testirnony on our efPort to establish masi- tnttm limits on tar and nicotine. I would like to rcad into t.he record 1)r. Stewart's leller to me in arun-er to that inqniry. It reads : (1(;3) TI58461286
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155 But these principal characteristics of cigarettes are today the chaructcristiue of small cigars, those weighing not more than 3 pounds per thousand. Hence, the type of tobacco used in the filler, a statnhory plrase intended to distinguish cigarettes frmn cinars, becomes the dec.isive factor in determining whether a roll of tobacco wrapped in any substance containing tobacco and weighing not more than 3 pounds per thousand is to be called and taxed as a cigarette at $T per thousand or as a small ciaar at 75 cents per thousand. Here aga.in, the, public does not se,c any difference, betwee.n flne- cured ci~arette tobacco and air-cured or fermented cigar tobacco. Nor c<Ln~the public visna.lly observe t.hat, chara.eteristically the smoke of ei«,r.ttes is acidic and thatl of cinavs is alkaline. However, the diffo,uiwe in cigarette and cigar tobaccos which escapes visual per- ception is detected during smolcing by the averane snoker. Thre popular irnpression of a cioarette vis-a-vis a ciga.r is its smoking charactar inchtding, inhaleabilifiy. A preponderance of smokers di>tinguish a cigar from a cigarette by their discomfort or even inab9lity to inhale the, smoke of cigar. This verv importuad difference is considered by many scientists as a si,m,nificant factor in the, statistias indioating that cigar srnoking is much less habardous to health than cigarette smoking. General Cigar has for vea.rs advertised its ci~ars with the. advice: You need not inhae to enjoyaci~~ru~. ~ The i5i2 report of tlre Surgcon General points out that, depth of inhalation (panc S)t is ono of the mcasnreq to which the, risk of decrlnpinr,v lun« r:.icer in both rnen and ramnrn smokers of cioarettes is directly ir.lated and that smokers of pipos or cigars have a lower rink of I, veloping lun-,, canv.e.r than cigarette smokers. The report frrther -t.~tes thatt studies demonstrate that the risk of develolrinIg kbin, 'I, r cancer incnpascs with inhalation and the mmmber of cigarett~: smoked (page 10). The 1971 report of the, lt.o- xal Collc3c of 1'h.-3icimrs of London, entitled Smoking and Health Now, states: '1ho remarkablo disparity of risk between smolcers of cigarettea and smolcm•s of pipes and cigars suggests that much savinm of 11fe anrl health might be achieved if the cigarette, smokca•s wcre to chnnce. to pipes or cil,ars (page. 13u1). Tn the face of such forccluL statcuicnts and man,y others made by the scientific communitti with respect to the reduced health hazards of ciuar smokn~.•, General Cipar believes it, is of utmost importaau.c that eury roll of tobacco weig;hing not morn than 3 ponnds per thousand which is not c:learly a cirar be not defined, reprusented or mistaken as a cigar partimilo.rly when it is inhaleable by a lu!*lt percentr-~'P of tlie people accustomed to srnokinrr c.ig;ar- ettes. "SmAll ci"ars°" are dirnensiona.lly and shructurally cigarette- like aurd :ure r-isuallv distin,mi5hable from ciaarettes merely by their brmvn c,olor, bnt not distingo.ishabl.e from brown cigarettes. 'hherefore. carePul evalua.tioi of the smokinr: character inclnding inha.leabilit}- of snch `°small cinrars'° vis-a-vis cigarettes is rrucial to protecting the public from i1 possible falsec sense of diminished health risks in smolcing, "small ci-,~ars" which are so cigarette-like that thel• Ni-iIl be snoked substantially as cigarettes. To reeapitnlate, "sma11 cigars" weighing not more than 3 pounds per thousruui and }having the, appearanre of a browu cip;arettc: deserve scrutiny to ensnre that thr-ir smoLing character including R 7 -o14-I2-II TI58461278
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lb3 (4) CrLanle, .7. F., Jooo'e, R. 0., et al., The IIi.:ai nC IIydrugsi (7ynnitlr iYmn Cbarettc ~Iumke, prev.^nted at -- ?I 'rohaeen Clenil,Ls' li...rclrCon[ereice.Ilnrliam,Nurth~.i..L..i .....i.lc_I.1'J67, ~ clc L., Crarettee in Heluti~n r. il 1.~ ~ 1;,z -ia ot Smohing. (5) Ti, , 11 Li , r ngs befoce Ihc I'edera7 Pra.'.. . a,u i.- ., 2], n,:.. (li) I'rt..- ,.L P., aud R. 1'. o-.I !lit.''trir (I~iQC in rl . . Pre-.ntol _ . , i . ` ReaeareS i . . ,. , i _ .. 4T ) 1'c. n. 41, -cm v,.n. L dtWd to tbe 1I I r-nDd m. I1P,V1i11. (bi Ti. . I. << ~ 'Ic, rv i -- rin„ eLS nr, ti i. lare-of-th(•-Art 1:. 1,;.,.. l ..t . ~.,1 \i:orn .z~ILr:ucn un 3mokiqr, ond I1c^'I1i.to-.IEngl..,1 uibcr?0'21.14)i1. (9) A~hP.~. 11., ni `v '.~--w:. IA;'., et aL, Ynifing T`reqnenc;r and Sicutine 1111.. (niret .-.BritlIIPAJ.'I 1ti6-I1,7Dif1. (10) gncnr.. A. AR, Qunuli*~I;..- detvi'cninatimi of phenol in ci„nr$te amolce- Annl Chcm 35:3'30;T3_ 1 (1l) A IIYicf Sw'vi;c of Fa'- ormrs Comlwnenta Tolivered by qcvettil Cmnmer- c3ul Cig;trette T:-fes I. Yittsbmgh Aetirnted Cnton 1)ivisiou. Av~,uvt, lfl€9. I1_) A 13eicf &lirrny of VaFm-n-,is /;nmponents Drticrred by Severnl Cmnmvr- cixl CigareIlc T~pes II. 15ttsburgh Activated CarLun Diviion, Snl,~, 1UT0. (13) M:n-vrell, 7. C.. Jr., A[_ltuirteav Chlisliuaf Survey of the Cigarctte Litlwstr?. CIRPenheimcr & Ca OrtnLeq IUil. (1-k) A Qunlifative Sluay oC letiruted lRoaro?al CiSnrCtte ].'ilte)'e 14mn tl,c Consume,r's i'oint of l-iew. PitthLnrgh ActIt•ated Carbon DiNSion. June, iscs. ;15) A Quantitaticc InVCStiFnliun uf Fonr Sc.v Sffirketing fitr~dcgivsfor Cliorcoal ^iltered (Agarelte5. Pittsburgh Activated CarLon Divislua. Decem- ner, 1968. Smlator 1loas. Our uest witness is Mr. P:uil1C. Glnfl)o. ecn,-iiltant and me.mber of the board of dirce.tors of the Gnleral Cigar Company. _11r. (>arbo, we arc nlad to have voiz, sir. STATEMENT OF PAUL W. GARBO, SCIENTIFIC CONSULTANT AND DIRECTOR, GENERAL CIGAR CO., INC.; ACCOMPANIED BY GEORGE B. REICHART, VICE PRESIDENT, MARKETING DIVISION 3ii'. Gnnno. AL. Chalrm.tn7 lentlemen of the comtniNce, I mn Paul til%. (xarbo: si scientific cmisvltant, andd n meir,ber of the board of director of Genoral Ci,Lar Compatp', witll oliices in New York City, and I am aecompzuvicd by N[r. Georlge Reicherf, vice preside_ut iu ottr marketin,v, division. Beforo presentiug cur paper today, I would like to thank tLe committee for (lie opportunity of malang oln' position in an involved situation elear, and in thamkiu;; )mt for that opportonity; I must confess we state our position with relnctance. I am remiuded ol' the xtory given by the hmnoifst, tiftiron Cohen, ~cl.en he talks about the two Israeli soldiers who were captm•ed durin', thc, short 6-duy war. They we-re marehed before a firinm squad, and one tarned toward the other and said, `°Abe, I think T rvilL ask for a blindfold,'' and Abe turned to Sam and said, a°ple.ase, don't make trouble." [Lauehter.] vG. Gexno. It is noU our position or our dcsire to make trottble, but the realities of the marketplave and of ELe coutroversy facc ns at every turn in the marketin¢ of cigars; it is for that reason that we ca,nnot. any longer lceep a blindfold on. TI58461276
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146 Dr. IlocHrrr. Or more, to get tlre same relatice rT,tautt.iti of tar, so-called, on a similar srrea of the internal lung sm-fnee, rmless con assnme thatt it all gocs to one spoh. Senator Coolz. Give me tbe- medical difTerence between tile te_xtrre of the surface of a luiO, <urd I he, te\tnro of one's~ skin? Ih•. Nora:r'rr. lt is qnite a rGffereut tisste The hm" tissue is coa.ted Nvith a mucous sort of material, a waler soluble material. Tire skin is covered witiL a scaly la}-er, and there is an oily sulr st.utco thal protects the skin. So it is a very difTerent kind of a tissnc ti•om the lmrr. Senator Coorc. Not the same at all? I)r. HoercnTr. Not tlre sarne at all. And ice hnve had actual esperi- nrcnls ~ehere smolce condensates have bel•u put directlp into the lnni-,s of animals. and the responses a.re not the same as thc_F are on the slcin. 19re ]mi~ is mncb more trsistant. T6ak mac be becanse it has sueh eflicicut cleansiny mcehsmisms. Tar is carried tmtrti'. Scnat.Mr CooN. Let's t*et to the smol:c in another instance, because T read oa report last nialit that, in many instances tests are made on thew streets ill rnany- cities tlrrou?hout the United States, wl.crc it is uot mtconnnon to cmne np .rith 100 pa.rls pcr nrillion of carbon n1onQS1dP l ll tlle air. Now, I)r. I)uVal in hi, testimony made ar"reat to-do about the smoke and said that t.herr had tested some snoLre.-filled rooms and ca.mee up with the horrilile conclnsion that the monoxide in that smoke-filled romn averaffed from 20 to SO parts per million of cetrbou iunnucidc. Would this distncb you? Dr. Hocr.rrr. It would riot disturb me verv rnach7 becanse some of these committees oil slaurdards have set 10[) parts per tnillion of carbon monoside as a safe level, or a safe maximum level, for carr sbanb inhalntion, as in industrial situations, for an 8-lmnrdaw. Senator Cootc. Aren't soole U.S. health standards hihher than 100 parts permillion in an 8-}rour dae? Dr. I-iurio=:rlt Yes, the Air Porce hn set up a whole series of standards. 'Phe safe. ]evcls are related to tinm. 'I'he shorter the time of exposnre, why. the more (hi,_,her level) you can tolcratc. They vsill a]low ti'ouo_r men to tro into all ruoa vrhere theq latow that the carbon mono~iclcc is 1,000 purln per urilliou fm- n shm-t psiod, and this carbon monoside. conmes baclc ontt uf fhe lunl-;s as soon as they aro ctiposed to prn-er a.ir. '1'he hemou_.lobin is nndanui~_red. All that the carbon mono~ide does is to take over sotm of the space in thc herno;,•lobin that otherwise n-ould carry oct;-en. Tt does not harm the hernorlohiu. It jnet rrets into the way of tlre oxygen. i;enator Coor.. Ihan-c heard about this, and if lort have anV latow]- erLic of it mavbo von could help me ill substantiatint_r it. I do not lcnotv. It is inc nnderstandin~ that ouc oi the tests tbat thcr- have relied on iu r<•]trtiou to blood levels and mrnno.ide levcls tv_d smoke lcvels n-as tlhat fliec pnt fonry-owtro_,' men in a Voll.-sn-ahen. rollcd tLe wiudolvs np, each one of them smoked a pack of ci;.,nrettes inside the volleswaLen, with tlie o--indows closed inside a. closed r!'arage. Is thatt trued. . Dr. TlnracxTr. Sometbing like thnt. It was atierv oontrived sihul- tion. It does nott seem to correspond to anvthin,r; that was liliely to TI58461269
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158 Those products wonld fall under the so-called present small cigar definition which, imfortmate.ly, currently is within the large cigar definition. Senator Moss. As part of that definition that we were discussing ea.rlier. that the requirernent that the filler not contain anp flavoring or added substance to chanee, the flavor, and then later cattle out that this would not applp to urentiiol in a sma11 cigar, what was your rcaction on that,? 7{r. G,vnao. If 1 ma,y sry so, mv statement, is that the flavorants shonld not be slantcd to give a eigarette-like taste. It was our ea- perlence-iuid we wcnt through this aaood manv years ago-I bclievee it was ngain about 12 ycars ago--that two different manu- fac.ttn•ers cs,rne out with aa mentholated cirar and it was verv unsec- cessfiil. Tn fact, thev said menthot and cigars are inc:ompatible and we tivorked orc this for ycars. Ferv frankly, in this country cigars havc a bad image, pnrtic.ularl,y icit:h thc fa,ir sex, becauso of their odor, aatd we we.re hyvip! to mask some of that odor. ll'e c,ame back to somethin,q that thep do accept which is a menthol odor and we fimillv succeeded. We o-ere relnctnnt at thn time to come ort with the product after we had blended the tobacco to be compatiblo with this flavoring, not for tlre purpose, of tnahing it citarette-lilce but to make it attrac- tive to the fnir sex when a m:m srnoked even a'Iiparillo, let's say. tiT''e went ont and had market research done on this and asked peoplr, .uid out of it came the idea that most men who were asked said, "i1'hy, that is a,-rc.at tastc. but it sounds awful." And t,hat 1wrs mre of tdre bYlincs of oirr ndvertising, when wo came out with t.he first mentholated Tipmillo. "Tt is a. great taste that; sounds awfttl." Sena.[or Noss. Well, thcrc is not anvthing that does change it from bcing a cinar jnst. because it has a menthol flavor? DL. Gn.zno. No. 11s a matter of fact, there are flavorunts that 1-ive You a pipe note. I am not'. sa,Finr_r thatt all flavorants should be banned. I am saiing they should~be restaicted to those that are not of the nsual~ cigarotte note and taste, and most cigarette people know what I a,m talkin', abottt. Se.nator Dloss.ll'ell. T do apprc.ciate your tcstimony. Seuator Cook went to cast his vote which is on rihht now, and I am sure lre will ha,rc aa qnestimr or two. So I will ask you to wait until Senator Cook retnrns. He said he would come directly back. tiT"e oulv havc a limit of 1:i minutes on a vote. So from the time of that betl. the time has started to run, and I am goinb to have to lcare shmtlp. 1II•. G,vasso. Senator 11loss, I bronnht hcre two exhibils whieh I think clearly demonstrate in one look what I have tried to say in a tl mttsan d wn rds. Here is tlre whole gamnt of representative cigars of the large class t,hat we produce, and I do not think that, you have to be very sophisticated in the tobacco businu5s to sec sorno sharp differemces betweeu the two cards. Senator Moss. Well, that is whert I wrrs probin, at earlier. I am not very knowledgeable or sophisticated about the production of ci,,ars or cigarettes, but it would seem to me that the appearance of that is so close to a cigarettc that if it were presented to me I would simply say it .vas a brown cigarette. TI58461281
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(The following information was subsequently received for the re.cord:) TnIA Toneoao IIYSTITLTE, ISa., Washington, D.C., Marah S, 1972. Hon. FRANK E. Moss, U.S. Senate, New Senate Office Buibding, Washimgton, D.C. Dxwu Sarvsrox Moss: Enclosed herewith you will find a copy of a letter which I have wricten to Dr. William H. Stewart. This letter was written by me in response to Dr, Stewart's letter to you which was placed in the record of the hearings on Thursday, February 1Q 1871 before your Subcommittee for Coneumers. I respectfully request that my letter to Dr. Stewart and this letter be placed in the record also. With kindest regards and best wishes, I am Sincerely yours, IlouACE R. KoRNEOAl, Preside.nt naul Rlxecetfve Director. TnP~ Ton9ca0 INSTITUTE, INO., Washingd`in, D.C., 3tarch'J, 1972. DDr. NN 1LLIAM H. .gTEwART, Chn>acedior, Louisiana State University Medical Center, New Ordearas. La. Dc.ue Dx. STEwaax: At the opening of the third day of hearings before the Senate Snbconrmittee for Consuners, Committoe on Commerce, considering Pro- ncjsed b~~i=lation S. 1454, the Chairman, Senator Moss, read into the record a , ilrr °h ii yon ]ntd ~ent to him comatenting on my testimony previously given befor_ I i~u Subcotmnittee on February 3. In your letter you made a general charge against The Tobacco Institute and specifically accused me of misrepresenting you by quoting you °out of context" Your statement was ". . I am not surprised by smythiug the Tobacco Insti- tute does or says. They are very good at the quote out of context and the misuse of facts for their own desires." 7-hese charges are not true tmd are insulting. Furthermore, they are demonstrably inaccurate. Doring the time yon served as Surgeon General, the President of The Tobacco Institute was Earle Clements, a man of unquestioned integrity. The Institute has, undor the leadership of Senator Clements and his predeecssors, maintained the highest ethical stnndnrds in conducting its activities an behalf of various 1'.S. tobacco product mnmtfaeturers. When Senator Clements retired in 1970, T hceame the Preident of The'I'obaceo Institute. I firmly believe that the Institute bas continued to maintain its high standards. In your letter, you statod that I had quoted you out of context. Neverthe- lesa, ynn ndinitted that you do not have copies of your 1;)Ei9 Congressional tes- tinuwty that I quoted you front and that you cannot "check with certaintyf' With such an obvions handicap it is disturbing that you would claim to have been quoted aut of context. So that N'mt may have an opportunity to correct your earlier letter to Sena- tor dlosa, I am enclosing a copy of Part 3- Ffearings Refore a Subcommittee of the Cunwlittec mt Appropriations. LIousc of Representatives, March. 1909, and a copy of my tertimony before the Subcommittee for Consumers. From these you will readily observe that you were neither "quoted out of contest" nor was t]rere any •'misuse of facts." ]otn• leth.,:-<orte that I was attribnHn.g to you a position that "tar' and nicotlne h:i „ir i'~ID_ to do with the health hazards of smoking. Such was not the case. Yonr ^,111110 a,s in regard to the possible significance of "tar" and nico- tine are ~% ell Lm un. The poiuC I was making in my Presentation in referring to your 1969 testi- mony (see lm~^e 18 of my statement) was thnt the American smoker is being advieed of i.~, "izr" and nicotine content of the various brands of cigarettes offered for .sale, and that he can and should be allowed to make a free choice. TI58461288
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16S Dr. Stewart savs that liee agrees with the conclusions of chapter 9 of the Surgeon General's report which was written after a 1-day seminar of people who agived with the Surgeon General's position who were brought into lYashington to write that chapter, and at the end of it t11ey had to put an asterisk and say this was not the Imnuimons agreement nf the connniitee, snmc disagreed. Senator ;47.oss. Now, how ridiculous can pou beie Medical witnesses who have. been studving the subjeat for years harve already written their coimnents on it and they are broul;ht into a room and they bring with lheni all the studies they have made and read and sit dolcn and t,ry to conic to a consensus among thern so that thev could isslo m report I would be astotmded if you b-routht in a lot oC medical pi•actitioners a.nd they agreed on absolutelv every word. You have to comc to a inajorit}~ consensus, and that ie what happened here. liut. Swlator. Senc you have used this a_ a pulpitt to try to campaign for vonr constituncy at these hearings. Let's get on with the hear- in,.-Lnt's hear the witnesses, and hear what they have to sav and not ltas e this c.onstant harangue about what the subject nlatter is in talk- in', about toys, as though we were talking about toys toda_c. Senator Coor.. Senalor, letme add a few thing~from people who wish to look after their constituents under those eircumstances. I. would like to have put into tlle record a statement of Congressm.rn M. G. Snv(Ter which he would lilcr, to have included in the record, a state- ment fronl Congressm;tn William P. Curlin from my State H-hieh I would lil:e, to have put into the record, and a statement of the Ilon. Cart I). Perkins that he would like to lrave put in the record, and all of theun assured me if the cotumittee wishes to ask Lhem any questions they will be delighted to s,ppear. ~ 9enator Moss. Thev will be included in the record in fnll. (The stntoments follow:) STATEMENT oF ROS. M. ('irNII 9NY[16n, U.S. REPRESENTATIVE FnOM KnNTUCSY bir. Chairman, thsnk you for allowing me the opportunity to present 3 state- ment fnr this enmmitl.ee today. I come before you today with great concern. I am not only concerned for the people involved in the tobacco industry of gentucly, but also for all of the people of the United States. As I look over the punitive measures that have been taken against tobacco over the years, I fear that the main proposal of this new bill to regulate the "tar"-nicotinc content in cigarettes, ma9 very well be just another step toward a back door to their total prohibition. In the past few years, the auti-snoking advocates have mounted a roten. tially disasterous Propaganda campaign. A campaign which is designed to to- tally annihilate one of the oldest and most well established industries in this country. About three million members of tobacco farm families earn their principal livelihood from the crop. They live in 22 states and iam more elmn 1.4 billion dollars yearly ffi•om the leaf. E1ore than 100,000 workers are gainfully em- ployed in tobacco mannfacturing and collect an annual payroll of more than half-a-billion dollars Federal, state and local governments receive five billion dollars in taxes frum the sale of tobacco products. In all, there are abont $29 indnetries directly or indirectly involved in selling their products to the to- bacco industry, ranging from cellophane and advertising to transportation and steel. h1r. Chairman, taking all into account this adds up to about eleven billion dollars. TI58461291
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157 cin.arettes. The assumption might ultimately prove to be correct but at this time therr is little basis to predict the health effects of smoking such product. Statistics favoring cigars over cigarettes are being much less dangerous to health were obtained prior to the arrival of the modern °small cigar" or `9ittle cigar" which is cigarette-like in construction and appearance. Thank you very ruuch. Senator _l'Ioss. Thank you very much, Mr. Garbo, for your inter- esting presonta6on. In your cxperienee in the cigar industry is the arrival of a small cigar of this appearance a rather re,cent innovation or has that been going on for a long tinie? Mr. G_~rno. A1}: recollection is that the first product without a filter of that nature appeared about 12. maybe 13 years ago; some- whores around 1959, T bolioN=e, was the date that the first product came to the market of this specific type, except it had no filter. Senator Moss. And much more recently then the filters have been placed on them that look like filters on cigarettes? bfrr. GArBO. liighty and this probably goes back eight or nine y ears, just guessing at the date. There have been a number of such product~s. Senator Moss. jirell. the thrust of your testimony is that there really ought I:o be a redefinitioa of terms in this field of cigars and small cioars and cigarettcs; is that right? Mr. GAnr.o. 1iTe11, perhaps a redcfinition, but certainly a clari- fication of lanl,nrage, becausu, obviouslr, we produce what is called uncirr the Triternal Revenue Code a large cigar which is of dimi.nu- bive sire and }ou just canuot write a paragraph to advertise that cigar. You use the language that is common to any man and you call it a small cigar. ,7Iy point is that the current little cigar distinguishes from a cil-ar in character and construction and appearance, so that a tlilTer- enis terar is needed. I do not care how close the term would be to "cigar", bnt, it wonld bo a distinct3vo term, whether it be cigarito or cigarino, or whatever intolligentt word can be used to distirI'uish it from a cigar and from a cigarette. I think this would bo to the advantage of the public. Senator Moss. Would a redefinition of a cigarette inelude the element of inhaleabilitv? Is that part of what, it ought to be do you think? Mr. GAnno. `Vell, in my opiniwr, a cigarette is fairly well defined in paragraph 1 of the preseirt, definition which is that it is any roll of tobacco wrapped in paper or in any substance not containing tobacco, and in my view that is what a cigarette is. We only get into para,nraph 2 for the pnrpose of trying to define a clear line, when one docs not exist, 1>Ntween cigarette and this other type of product that has been under the Internal Itevonno Code, designated as a snrall ci„ar. l think tlmre was no need for pe,criliar dcfmitions where one definition refers to the other and when you get to the other dafinition it refers back to the fist definition. This is nnfortunate because I think it is largely a matter of torminology. Whereas if, as I have proposed, a now terrn were established for this. I must say, hybrid product, then there would be no need, in my opinion, for paragraph 2 of the cigarette definition. T158461280
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147 happen ill real iife. I am 91110, :invbody' tizould be uncomfortable under those conditimis and wotdd ohen the Ivindows. Senator Ooox. I think t6set is whv the enins of tmtontobile Tnmut- fa<,turiug g.aive you st handle to roll tlie windorc down. I Laughter.J Bnt it is mti tutderstnntling_ that this type of test was conducLed. 7s that y-our undcestandio};? Ih. Sox~n,:r,e.. Yes. 1[y iuidcrskmding is tlhat a ratlmr wuoalistic tost with «*hoir pacicets of cirare.ttes sruoked ill a closed automobile witlt the windows rolled np ntrs oue of Hmee cae.d. it is au old idea that one takes a c•anarv inttr miuea because snmlt auiinaLs ivith these metabolisrns xre tnorv~snnsitivc, rnnd ono lvould ima6;iue a. cauaty wonld show signs of distaess befmr hnm:m beings. Senator Coor.. If they 7md four ui the ti'olkstvarren mmivbe thev ciid not have room for the cttins? y. !Laii ;•hter. I I)r. Hocke.tt, is y°our ability throqg$ technoloay to identiFv ingredi- ents or truce eleincuts or ehntcrcr ~.•reallv ~improced ntor rccent ycar52 Dr. Hocrnarr. It cerltinlv has. In the last 10 or -Al cears euorulots]v sensitive chemical methods of ideutiCYilig vcr-c snall coxcerrtratious of substancos have . beetl worked mrt. So a{ew Veats a;ro. Aott see, if somo of thcac questions had acisen chemists woulct not hare becu uble to detect ::ny- prrsertce at all of sonte of thesu things. ?VOw thec enn be detected ehentien.llv. but tliis does not nnsrer the qnestiou, the biologicat (jtu.stion: Is thrre rnonu„h presrnt4 tn he of auv rea,l eonseqnence under real life conditio)s? S'on can talce .tilmost :utvthing th[rt ..-e uso and consmrc :ntrl sub- jest it to tnoc.ern trretJrods of an.rla-sie, :ind ' Vou uill find iufmitrsiinal traces of tlunns that arc classed as poisons. Thcy: are eveiTwhera. Rutt now wo have thc questimr. what is the biologicai significaocc? Our bodies arc able to handle or detoxify and remoce aud eNcrete these thirtf_s. So thatecct lurve w wholi~, battcr;v of hiololical problems succced'uig lhe pnrel' v chemioa.L fiudiua;~ of sometlring ill traces. Senator Coor. AIxcbe rce should all~ascribe to what Sir. Stepliano said. Altuy-be the wav to get om~ side ovcr is to adopt thc law to ]mf c those rrho dist~,,R ,roe ~to haVc their publicatimis prinhed bp the Federal Corermncnt so that infonuatiot c.a,n he dissemiautr°d on hoti sides. \Sxcbcthxt is Na'hat we our:'httohatc. Dr. Hoceurrr. F.ryua1 tilne? SeitatoCoos. We hnd that equal time on tclevision one tiine, Doctor. and tlmt was t:rkeu awav frao us. Those thatt have equal time with trs nov havro all thc time. Pou rectrll that& Dr. IIorr,t:Tz. C recall that. Senator Cuofi. Does tlhe fact that somethLnl,, mav be identifiud mexn that it is incrirninated as the cause of any-thint 3 I)r. Hocrcz•:Ix. It certainly does not. Tt reryuires verF estcnsiv c nnd inganins biolot;ieal rccotnroh to find out. i f it rcullY docs harin. echy; rreae.cally t.hat far.t somi becomes prutty evident. Scnator Cooic. So.v, we hcard slot the othcr daS- about smolcin!* causinlr this nutt smoh--ing causina that. And one imte 1 made wxs snolcin; eausina peplic ulccrs. R'hat abouLthis? Dr. Hocicturr. lFhen the statistical t;iudics cattle ouL pcptic nlc.er was one, of thc diseases that was statisticalh-linked. orin other .cordsN occnre~l more freqneutly in smokers. . . f T158461270
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156 inhalcabIlitS is not so cinarette-like that by and large they will be smoked as cigarettes. Consistcnt with such scrutiny, certain manir- facturing requirements for °`small ci~r;ars" are also believed nssential, namelv : 1. Air-cured and fermented cigar tobaccos should be used esc}hi- sivcly even in the tobacco sheet wrapper. 2. The filler should be thrashed tobacco and nu6 cu6 into shreds like cigarette filler. 3. Flavorants should be restricted to those not contributing a eigarette-like taste to the srnoke. 4. The t,obacco content of the tobacco sheet wrapper and of any tobacco sheet used in the filler should be not less than 60 perrrrnt on a, di;p Wcit;ht basis ru required by an esisting rcgulation of the PTC., but 1Lc stalks of tobacco plauts, if used, should not be con- sidered as cmrtribnting to the tobacco content. Preferably, the manufacturer of a small cigar tireinhing not more than 3 honnds per thonsand should provide written csrtification of compliance with the proposed mannfacturing requi.rerrrents. At this point, it should be noted that traditionally a cigar has been rrrade with three component parts: filler tobaeco, a binder made of tnhn,cco to hold the filler tobacco in the form of a. roll, an([ it wrapp,•r made of tobacc:o wrapped around the roll. All of the ci^.tirs Io-educ,,~l by Genora,l Ci~ar have these three component parts.lfany foreign countries includinr Canada require, the presence of thcsc t1c, ~component parts if a roll of tobacco is to qualify as a 2,ioall civars or little eigars in this country have elimi- nated the binder so that they are made with only filler tobacco and a )crappcr imdc of tobacco. The tenn 1°suiall cirar°1 tivhich applies only to rolls of tobaeco having the weight and appearance of a brown cigarette is so ambiguons and confusin~ that "large cirars" (as defined in the. Internal Revenue Code),~e-hen made in diminutive form such as Tijuana Smalls and 'Iiparillo cigars, are easily mistake.n by the public as small cigars. Therefore, the need for a new distinctive terrn is stronglv indicated. The confusion has been aggravated by the fact that cven the statutory term'`small cigar" is not consistentlv used. Several manufacturers of sma11 cigars have preferred to call their prodncts "9itlle cigars" and the Lntornal Revenue Service has accepted the term "little cigars" as the optional equivalent of small ci,nu.rs. All confireion would be dispelled by the substitution of a di IFerent torm such as "eigarito" for the stautorv term °°sm:ell cigar°0 and its widely used alternative form, "little cigar." '1'his presentationhas been made for thcs purpose of pinpointing the confwsion and related problems which have come to the fore with the recent sales growth of "small cigars" or "little cigars'" that are cinitrcttc-likc in wci~~ht, size, confi;~uration and packagginr, Some propostds have been advanced to help ensure that "small cigars" or "1iLl.lc cigars" are cigar-likc in composition and that their smoleime cLirracter inclnd'uz3inhaleabilit.q is more cigar-like than it is cir=arettc-lilsc. Any error in cliassifying a product as a "sotall or "little cigar" whett it is essentially cieurette-like in sn;okurg clurracter might rneta.n far more than a revetnm loss of $32n per thousand. It might lead countless smokers to assume that smoking such product is less hazardous to health than smol>urg TI58461279
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166 As I pointed out in my testimmiy, it i3 one thing to InCorm consurners of "titr" and nicotine contentt bIrt quitc, aumther to ban cigi¢ettes ahove a certain level of "tac" and nicotine. In this setting, I used all ceact yuotation from your tes- timuny betore the Appropriations Crrmmittee of the ponse of 16eprc=entitivus in 1969 (:sce page 57 of the heaiings ): "Mr. H<dl. Pr. Stt<wart would you like to see cigarettes abeve a certain level of tar and iucotine banned from the marketphicc? "Dr. Stewart. No. I would rather have the fact that when people choose a cigarette they ean nhoove a lower tar cmd nicotine or aa higher tar and nicoline assuming that they lavn had all tLe information related to cigarette smnking and the hnza.l'ds to henlth." Thus, this quote from the 1909 hearings is directly applicable to the issues before the Subcommittee on considering S. 1454 in 1972. P'nrthermore, un pnge 58 of the 19fi9 hearings yon elaborated on the distinc- tion betweu the si;;niflcancc of "tar" and nicotine and the frcedom n£ the individual to choose. "llr. Ste\Cart. I t11inlC the S'ignihcance of tar and nicotine is a. differl'nt kind of duetiun tlmn whethcr people hurc tLC ahilit~to ehoose a cigurette oP highcr or lower tar nnd nieofine. "\4e are offering a erude index of dose-response to a person where they can ehoone a lower dose if they wnnt PheN ' enn dn the a;nne thing by entting thcir smeking in half or not smoLilig quite as much, too:" I no.`e that in your letter to Senator Stoss you state your position "was" that it cvtts better to havc "tar" and nicotine informn.tion given in Iahelling and advertising so that the pllhlin could ^choose.° Clearly you were not calling for gnvernuient uhuice by waS of governmenDimposed prohlbitian of certain ci_arettes, bnt ralher for an infurmed choice hy the individlm1 cmisnmer. As I reported in my enclosed testimony given before the hubeommittee for Consumers, infuumatiun concerning 'Ya.r' und uicothic content is avnitable to every smeher from a v:lrietF of 60llrces inCltnling_ Cig_arette advel'ti6ing_ nnd periodic reports by the Pederal Trade Commission. If ruu inive chnngpQ your pueiliun since yuur tesliinnni' rePerred to above you certainly sdiould make it known. I3o<lever, I am confident that a fair read- ing of yonr previous Cungeessiomil testimony ttunted by nme beforc tim Subcom- mittee imr Cvnsnmers lvould noL lend uttir snppvrt Lo pour assertion Umt you .vere qiloted "ont of conteQt" Sinco cnnr letter to Senator Moss was read into tlie record of the hearings of S. 14G}, T nm sending a ropy of this letter to the Conuuittce wilh a reunest thatit also be made a Dart of thc record. Now that Sou have an opportunity to read your exact te5timmleS as set out in the euclosed henrtnRS <tud as it war nsed in my tes8mony, if you still feel you were quoted "out of context", I wonld appi'eciate a letter from you esplnining ynur reasona. In the ahsence of some further word from you, I will assmne that Sou stand eorrected and no longer contend tfuit vou r.ere t]nohed "<rnt of contest." Sincerely, Horzncrs Tt. Iiorzsennr. P're.r63ent mud F.:xer,ietive Dire:ctor. Tir_Ilonecm R.ISoxnr.uAr, Pr, e'nt mxi lgaew<tdme Direotor, TE , 'r., p..,,..,.: Inef lbutc-. Irm.. MAxcrl 9, 1972. I1r.An ]Iu. lioeivr.ees: I have yonr letter of 37urch i. T have revie~ced my reply to $enator Moss' inquiry. I believe it was quite responsive and I see no 1'eusun to chnuSe it. Sincerely pour5, WILLLSM FI. C'rE W AET. M.D., UttOYViceltAr. Senator Coolc. Mr. Chairman? Senator RToss. Yes 9 Senator Coor.. In response to this letter I would lilre to also get into record that Mr. Pornetap saw fit to avail himself- of this romn- TI58461289
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151 Tn terms of chapter 9, each of chese filtrntion approar.hos related difFerentlv to tlte enmponents of interest. The first grauping, Wble 1 in r-hapter 9, discussed "Most Likely" cstntributors to health ]tazurds tmd l iste tar, nicotine and airbon moto- oxide. all three filter tvpes can rednce tar and nic.otine. The per- fornted filter adds the capahilitp to dilute carbon rnotmxide to lower le.'elc. The extent of this dilut~mi is limited for pructiral purposeS by the simnltxneous dilution of tar and esper~ially nicotine as men- tioned earlier. Normal activated ehnrooal does not adsorb carbon tuonoxide afi c.ifaretfie filter tnnAitions, althourh spe,ciallv tre;rted esperimental fm'ms ran contribnte a minor rednction of H}-15 per- cant tchile still removing other ~nses. Tlte sxcond section, table 2, lists "Probuble Contri6utors to health hxzard;. Fonr of the six materials liste(l are gas phase components. Urdin:nv filters wit] reduce tdte proportions of caeh component associated Acith the pairticalate matter, and treated forms of cellulose. «cebate.cill furthm• redncc phenol, one of the par8iculato emnprntents. Perfmnted fiLters affa1n will dihtta a certain proPortion of both partie.ulate and gn, unnpouents. :lctit-ated charconl filters will tptite efPeetively reduce, acrolein, h,ydrogea cyanide or hvdroe~~ani^ acid, and nitrcn;c.n dioside, three 01 tlte ;ras pltaso materials listed. Several olts,rcoai filters now u~tlilable to the pabftc renrove 30 pcrr.ent or morc of these Rasca, >ifl iniird.ed in ,ttta<•lvnents to our hesttmone. The fonrth its, uil:riec o.itle, can lie reduced aLout. 30 percenc Nsitlt special I}° treited clutrcoal that also enhancos hydro" en cvutide reduc- tion. Itlnallv, charcoa.l filters or pcrforatsd-charcoal ~cornbinstions will reduco lhe va.porons portions of cresols and plhenol, the two particulatte emtstitneuts. Table 3, tlte';tinspected Contrihutor°D section, idenfifies 23 mate- ria;-1.K of ich ich are zoas pha;e. 'Cho fnregnin;; considerations st;,•ain hohL Ordiua.rc lilterstit•ill raducetdtn particrilrttem.e(e•.riktls,;rir dihttiou .dll add a, further reductiun of botdt particulate, and gus phase cotn- ponents, mtd eharcoal filters will forther reduce itll the foasee listed plus thc t-npocnus portione of those tnater tls tlessiix d as pnrticulate. To summarize. re:etirch indicates that all ei'aretto Illters notiv xt~ulxblo\ bonoihnte sontetlhin„" positico in terms of chapter 9. Char- coti p.'tiorsted, and charcnal p.t tcrated conbinutic in arr, cel~ocia7l,Y intcrestm"„ ill that they crm reduce tlll t6e conlxwwtrts ntentim.ed ill thc report. I+rotn these observations and other data iAhioh hs.re nr V ill reuctt this foilwt, it; nmc 1-re concluded that iotpro~ed or safer t.t:%arcttc' (cersus perfo,i o: Stte c9l,n,rettea), flro now al -nilaltle. To be roztlistic, howec__. we nnr,t r„tlrniee thtt aia:n^i.i, . in .v1Lnt alr pwtuto Le tl , p; , I.r...,! .'I~-,Q i,- are not niJelt ~~,ted by thc snjok6u; public aro F ~r ,;aanple, tlre mark i -:nnt, m9tich iuclndcs ~hau;~,at f~i >. I„~i, .i filtets, and,ur ud b,ttiru:c low tar .md r.icotire filters pt, !ttiy _rW , ot( onla tiNo to 9 ~ -"ut'per tcnr ~utdsc.creslu-.;etlntumic,inaG:.i i,i,n-e. 1llarket re~earc3t Nrc hat-e preriously reported imiic.dt.qs thut manV muol:erF -te surpritied to lea.rn t.fmt some tape_s of filtors otfer twique adruultates oVer oth,rs. Most are presently- nuatcnre tha.t there is un c t h i mr in cigurettc smol.a esccpt f u r itud ni cot i o V. This confnoion in tlic mind of the typical emoker rlearlY indirntes the uced for initiatit-cs ill cigaretde mse:trcil and smol:er edua:ition. TI58461274
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101 Now, when the cigarette market is gone and cigars are-]cfty and the consnnhig public starts to inhale these, then big brotller at the Sur- geon General's Office and at HEZV are going to say these also will llave to go. N ow, don'b you really believe that is true? Mr. Cxeruso. That is a possibility, sir. Senatar Coorc. That is t.he only point I wa.nted to ra.ise, andd that is wh' v I give you the hypothetical of the Rova1 College of Physicians. Because I want to know what the cigar industrN, is going to do when so.nebody gets on their ba.ch- arld sags now ie Is yonr turn and yon are goin,, to go, and then we can look back and eay, well, I wonder if T really contribute,d to the whole lree enterprise system and the econourc wlmn I had an opportunity to say this is a good, legal, vi al ,l e industrv, and it ought to be left alone. lnd I tlLiri7< that is ishat .tie lu'e reallN talking about, and tlris is what reallv bothers me. Leo me i!ive i-ou nnother thing t11at hotshcrs rrrc.. I was rather am:r. rd t1u11t we Irad alt of those hearings the other day, t.hat we had peoplo from ITEW that cmztradictetl each ot.her, that they didn't kno3v schat thcN ~ were falking about. We had a. situation where III+)W saidL thrmigh bhe Slrrheon (seneral's departmealt, vve doa't even want to admit there is a, =afe eigarette, so we arc not going to lmlp the li'C('. 1'heN - s,n.id, v-e v.an't rlo anvthinr unless we get their help. I'tter confusion oeer S.1L1Le4' and in the[17ashin~•hon Star, the Wa;Llinr,.tou Post and the New York Times the nc-at. day there- was nct eno ilit of uc.„n cJ>+>el l:o:r I L•c ITMV, unl' t'u, Snrgron GeneraPs office. and the F7Y; ticere ahsolnte.lv eoniused abont what they were 5npposed to do. Now, docsn't thalbothor you? _11r. C; .,nrso. Tt cci°tainlv does, Senator Cook, and aL'ain I repeat, we eamw here irith reluetance, and we are not taking sides, but we want thee iaatrruage, when it hit5, to hit rtis fairly rurd souarelv. If it is cilpars, let it be cigars. All we xro s:.ving is that at the moment, the laiin_ rmr*e in the indnstr-j• is eonfu>ed and at least we ought to have t}re benefit of having clear langirage. as to wha.t kind of product we make and what kind of product other people rrnlke. Selmtrn•Cao1{.Well,I--- - '_lir. C rrzso. We believe in what you say to this extent: That we hn.re even heard that fairly soon little cigart, as cttrrentlv defined, mat be on the FT(C machine for mensnrement of tar and nicotine. TL'a;~ na=:nmotu,eerl in- Fcnator Cimc. That onght to tell yon smuething very important after they get through with the little cigars, they are going to the bi~ cil•ars. :Ue. ('-r,nrzr.n. 1 arn saying, Senator, thnt I read this in Lldvertis~m,q E1qF, that this is coining, and there again, I want to env, that the F'CC perhaps hasrt, any expertise in this matber and ma_v be unaware that a cigar is smoked ditFerently front a cigarette_ There is an or!-Yanization in Luropc for tTle te=ting of cigars that is so different thnro t11ev haree a committee trvinl- to work the tests for cigars as disringoished from cigarettes. ~ Senautor Coor. Did it ever dawn ou you thxt the FTC may not care? TI58461284
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170 research. I;o, it has chosen to impose a special five cent cigarette tax to finance additional research. Isn't this more to the point than making ash trays that cough, or selling sterling-silver adult pacifiers, or clipping the name of a city off television be- cause it also happens to be the name of a cigarette? But which side gets ac- cused of "7mcksteling" and "propaganda"? Mr. Chairman, I believe this is a serious business, worthy of a higher level of concern than that shown to datc by the tobacco prohibit.tonists. You, sir, have publicly commended the tobacco industry for volunteering to proceed with many measures to educate the public concerning the alleged haz- ards of smoking. You, sir, have advocated research, such as that being sponsored by the in- dusryy and the state of Kentucky. But you, sir, have also introduced a hill in the Senate to raise the federal cscise tax on cigarettes to 30 cents a package. A bill which also would phase out Lhe entire tobacco crop support program to be replaced by a Commission on Tobacco Adjustrnent AssisUmce. I cannot agree, just as umy colleague, Senator Cook, could not agree when he stated: "At a time when the T:nitel States economy needs all the help it can gec from all segments of socicty, it is im:olmeivable to attempt to destroy the tobacco segment in lur attempt to do what Carrie Nation failed to do in the 19-0's " Make no mistake nbout the economic import of tobacco among the people of Kentucky. Wc have 170,000 farm families in thrv state, many of them with to- bacco i>Atches& lmst year they harvested over 350 million pounds of what many consider the world's best vs.riecy of this crep, accounting for a tLird of the cash receipts in I{entnclq•'sfarm incorne. We had over 27,000 retail ontletx handling about .$7:i8 million in oiga.rette bnsiness in last year alena And since 1938, when tlie eseise tax was first ap- plievl to ciAarettea, my state tlas received more than 246 million dollars in rev- enue. Tho.t's almost a quarter of a billion dollnrs hclping underwrite programs the state ronld omt hrn'e otherwise afforded. Bnt. hir. Chairman, you know thatt tobacco has a significant economic im- pact. ita greateFt criUCS know it has a significant economic impact. But its significance in eemromics should have no besring on its role in healLh. That is a matter to lie decided impartially and scientifically, and I submit that the jury is still out and is far frmn a verdict of condemnatlon- Tar-and-uicotine regnlntinn wnnld pamish the farmers of my district without walting for fectual evidence. It would represent yielding to hysteria instead of a.dherin4T to I'easan. -lla Chairmnn, m?- people have done no wrong. I aek that no wrong be done unto them. Thank yon. 4TATFNCNT OF 11ON. CARL Il. YsiHI\s, L.S. ILEPRESE]TA2IGE L'Rnnx KENrrcrr Mr. Cha,innnn : Thank you for giving rne the opportunity to comment on your latest leifislative proposal in the field of tobacco and health, S. 1454. Over t.he years a speclal relationship has developed between us. I represent the Seventh Distriet of 6entucky where tobacco is an essential flement in our economy and our vay of life. Yotl have become the leading advocate of what is a vocal anti-tobacco movement in tiris country. Thus my constituents try to grow tobacco and your constituents try to re- strict it. And ns long as tlmse attempts continue, I will be active in opposing them-not, I hasten Lo add, for the sake of mere obstructionism, bnt because I simvrely believe the anti-tobacno enuse to bc an oversimplified solution to tre- mendonsly complex and unsolved medical enigma. In the i3ri0's the nalion was beset by complex domestic and international prablemc. 9'here were those who attcmpted to solve them with a single, simpde answer. It was all due to a Communist plot, and Communists were found mlder every bed. '1'oda,v, the same tendency seems to be operating in the tield of public health, ar,d there are those, most notably the Surgeon General, who find smoldering tnbacco at the scene of every public health icsue, Let me say that it is my sincere belief that witch hnnting is as wrong now as it was t1len. I challcrzlge the credibility of the promise that cigarette smok- TI58461293
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167 mitte.e, not only to give his statement, but to be cross-examined by any member of this committee who either aEreed or disaereed with his stsatcment. Y'ou have seen fit to scnd his testlmonv to Dr. Stewart to com- ment by lehte.r. I wonld request of this committee that it invite Dr. Sewart to come before this coimnittee becanse there are many things in his letter that can be absolutely refuted without >uuy tluestion. Further, if it is not tbe desire of this conmtittce to invite hirn, then I zcou]r]] like to take the matter to the whole cormnittce so that we might gct a, su}ipena issued to Dr. Stewart so that lie, might be uslced to como before this conuuittee if he does not wish to do so. Senator Moss. Z'i elI, the Senator knows very well thut. I1r. Stewart can be invited, I am sure he is willing to testify. lle has testified before us ntunerous times. What I did was send down the testimony in which a witness quoted Dr. Stewart and quoted him in a. Ncav that Dr. Stewart refutes in his let.ter. I Ir, savs that, those statements were out of context and do not sn pport lus- position. If you want Dr. Stewart to come and say that in so many words, why, we c.an have Dr. Stewart. Scnator Cooh. I ito indeed, becatuse Dr. Stewart says in his own letter: "I do nott have copies of my numerous testin.onies on cigarette smoking during lAfiB-653, so I cannot cheek with certainty." So I can only say to vou in all fairness he should check his testimony before ]ie comes before this conmiittee so that what he said can be in fact docunzented as it has alreadv been doctrnrented before tbis committee, anrl iC lie mants tn refute it he =hould do so in person nnd not by letter. The reason I say this, Mr. Chairman, is if you will check the lat,est issue of Fortune magazine thero is a. wonderfnl article on onr Toy Safetv Act and it is called "'Pempest in Toyland," and the reason I bring this up is 1I do not, think this c,ominittee or the public should be stampeded into soenethint; t1m.C everpbody has already biasedly am•eed the.v are ~oint,• to do something a~out,invluding thc Surgeon General of-the T;nitedStates. Scnator 1YLoss. I miRht say the adiuinistration. Senator Coox. I nu~ht say to you that I am reading from "Tom- ]iestt iu Toylxaid'" in Fortunc ma;iaaiue. For ex.umple, the Commission reported that in the United States more than 15,000 childron under 15 die each year from acc.idents and another 17 milliou are injured severely enough to restrict normal activity or re,cpure medieal attention. A staff report of the National Commission on Product Sa.fety dated Tune 19 79, estimated that in 1961 a number of children under 15 who died of accidents clearly involving toys tivas not 15,000 but was 7~. Senator Moss. What, does that have to do with tha hearing we have today on cigarettes? Senator Coorc. It has to do exactly with this: we hni•e been given facts and figues on studies that ti-.-o have attampterl to refnte with logical studies and logical re;ezwr.h, aml we have been told by HF~i' that hhere is a lot of oriticism about those reports, so they really do not ha.ve ary value. T158461290
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169 This cigxrette controversy-end make note that I employ the word oontro- v.'nrsy-may very well be a microcosm of one of the principles formulated as a bnihling block in the creation of this great nation of ours. And that principle simnly is this: 3hall we as a nation scrap the historical principle that anybody-an indns- try as well as an individual-is innocent until proven guilty? Shall we impose on the bosiness conununity a cruel and uuusual assumption of guilt and force it to prove its innocence of all charges, however irresponsi- ble? If Q:is nerv standard is imposed on businecre then we can say good-bye to the ceonomic syctem as we L'now it. And for the 170,000 Kentuclcy farm families as well as the rest of the indus- try that would spell nothing but devastation. I think that tobacco smoking must be the most widely.aecirsed product on the consaimer market Tobacco has in one way or another been linked to more ailments than I care to even think about. R'ell, >Ic Chairman, it's more than high time that something be dnne to re- plncc the malicious scare campaigns raging on against tobacco with objective facts. It's high lime that the people of this industry not only speak up, but that they aro also listened to. i'he anti-smoking advocates have truly succmubed to their lowest point when one nowslulper editorial recently refcrmd to scientists who accept tobacco in- dustry mmlcy for smot3ng-heatth research as "tobacco industry prostitutes." The tobacco industry, in the interest of scientific obJectivity has given mil- lious of- dollars toward an increased campaign to futd the answers to thc ques- tione abont suolai.- ^ nm. 1.~lth II,-ii rvennin unsolved. This money has gone to socne of the mosl I ~ iri] ',rt =;ienti=- an,l researcherc_ in bnc world-and totally on n no-strimn;-all: .~ 7.1 P, ~is. And I tell yon ilfr•- Cilairman that it is more than a soeial curse to r i-, r oI such i~ :-rl - dentists as "prosututec" Tho Cnrgeon Genernl of tbo Ln'., d >iat. has no rmi scientific case against tobacco. IIC is basing his rn.e ^n L-i I -d data that from a purely scientific nn'urt of v!c, r,mnnl hr necrptcrl :- pnal truth. il'hc truth mupt be madc avail- ah}e, bntt it can only ho obteined thrmizh dedicated scientific research. We zve placing the lives of huudrrda of thousands of growers and their fam- ilies in jeopardy. Cnn we do this on the basis of stntisdcs and emotional eru- sading? Over a hundred ycars ago, the b]nglisll writer William Ilazlitc put his finger on t.he problem. He said: "'Che oriein of nil science Is in the desire to know censes 7 and the origln of all false science and imposture is in the desire to ac- cept false causes rather than none: or which ts the same thing, in the unwill- inguess to acknowledge our own ingnorance." A statistical crus2de is no way to get at scientific truth, and I submit to yoa Mr. Chairman, that. the American people deserve better- A1'd'fEM&iY'1' OID IION. R'1LLIAM P. CiORLIN, d8., U.S. ICLl'RIDSRNI'ATLOR PHOM IUtTTIIDKY Mr. Chailvlau: I appear before your committee today to speak on behalf of the thousands of £nrm familics in the Sixth Congressional District of gen- tucky wlto have suffered public abuse time and again without the chance to reply. These families raise tobacco and they sell tobacco. They are not s-ubver- +ires trpirrg lo lurdermine the health of the nation. They arc not climinals spreading evil through the land. My people are law-abiding. God-fearing, hard-working farm families who de- pend on a eash crop called tobacco to kecp them going. And tho tobacco indus- try whirh buys their produce is a legitimate business that is just as concerned abont tbe public heath and lvell-beina as an•y person hcrc today- Iiut neither the farmers nor the industry is willing to go along with a smoke-screen of fear in the absence of facts. Long before the first report on smoking and health was submitted to Con- greac, the tobaceo indiutry had already began a mu1t5-million dollar resenren campaign on its own. The Counuomvealth of Sentucky. ccrtainly not willing to sacrifice the health nf its peoplc in the nanre of economy, wants to find the real ans-wers to the smoking-health question. Rnt thc stntc doesn't accept progaganda in place of TI58461292
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1G4 Dear Senatnr Mose: I appreciate (he uppoctunity to conmnent on S. 1454 and, particularly, on the testimony prepared hy Mr. Korucgo.^„ President of the Tobacco htstittttc. First let me say that I arn not surprised by anything the Tnbacco Institute does or says. They are very good at the qnote out of context aud the misuse of facts for their own desires. Mr. ]iorncgny has quoted me in severull places from testimony I gave in 1960 cconcerning "tar" and nicotine levels in cigarettes. I was asked innumerable timcs during that Year whetier or not T felt Ibere should be a ceiling on the level of 'tar' and nicotine allowed in cigarettes. I did not fccl, at the timc, tlrat: there should be a ceiling on the ]owels of "tar" und nicotine allowed in eigarettes. My basis for this position was that to establish an apparent health hazard threshold would imply that there was a safe cigurette. This, of course, is. not true. There is no puch thing a9 a safe cigarette. );xposure to cigarette smoke is more than the type of cigarette smoked. The exposure to "t¢r' and nicotine increases rapidly as the last half of the ciga- rette is smoked. Fcposure ohviously increases by the number of eigarettes smoked per day and by the mmtber of years of smoking. IC was my position thaR It was better to have the package and all advcrtis- ing labeled with the °tar" and nicotine levels along with the hazardous prod- uct label so that the public could choose a cigarette with lower "tar" and nico- tine content if thcy found that the pressures to smoke were ench that cessation of smoking was impossible. I believe there is some evidence now that the public is, in fact, choosing more cigarettes with lower "tar" and nicotine content. I do not have copies of my numerous testimonics on cigarette smoking during 1968-69, so I cannot check with certainty. However, I believe it was the statements I made supporting that position that Mr. Pornegay f.c quoting. Of course, I was stating my position because I feared that setting a thresh- old would lull the poeple into the assumption that any cigarettes in any quan- tity that were below that level could he smoked with imptmitv. Thut wn.ild only serve to increase the health hazard to the pnbHc of cigarette smNdng. Mr. Kornegay, on the other hand, quotes my statements in part to imply that "tar" and nicotine have nothing to do with the health hazards of ciga- rette smoking. This, of course, has characteriv.ed the controversy from the beginning. I believe that S. 1454 represents a new and broader approach to the setting of 'tar" and nicotine limits in cigarettes which avoid the threshold problem. S. 1454 is based on a public health principle which has been used for many centuries as public health measures to avoid health hazards. A modern example would be radiation protection at low levels of radiation exposure. There is substantial scientific agreement tha.t all radiation is hazard- ons ond that no threshold exists All raFation protection measures that I know of are based on that premise. Rndiation protection measrres are all aimed at allowing only tha4 exposure that cannot absolntely be avoided or the heneHts outweigh the risk of the huzards. I think the same holds trae for cigarettes, Any exposure to cigarette smoke or the contents of that amoke which can be avoided should be avoided. If the public will not accept prohibition of cignrettac, and I don't think they would, then the purdent public health posture is to do those things that decreose exposure to the maximum degree acceptable to the puhlic. This is a worknble program which will, in the long run, cut down on the hazard to health. There is good nvidtn(!c the public will accept cigarette~ that are low in exposurc to'tar' and nicofine. I believe the tcsrimnny presented to the Subcommittee by Dr, DuCal is con- sistent with what I have jnst snid. I believe Chapter 9 of t]the 1972 Surgeon General's reportsuppmts it. I would a„rce with Dr. I)nvs that the bill should bs amended so that nuc- cessive reductions in the permissible levels should not he made solely depe_nd- ent upon the avoldance of'unreasonahie' health hazards. I would like to mneratnlate yon on all of your efforts towards solving this health problem and I hope you are aurceccful in securing Senate approv:d of your bill. Signed William 13. Stewart. M.D., Chancellm•, l.onisiana @late i7oiversity Medical Center. -A TI58461287
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154 Ueneral Citeu• Co.. Ine, rnxunfac.t.ure, sen-eral hr.inds of ci11ars of which the mole widely known inclnde White Owl, 7:obt. Burus. Wm. 1'enu, Coriure. Gold Ltebcl, 8hakc.spearc. Tipo:illo and'I9justn:( ~nutlls .111 of tho cipars prodttce:9 bv General Ci~>ir are "large cloat "ns dcfincrl in tit]o 26, Intotval ReX-arle Codc, be,lnsc theh It.ll oei)!h mm•e 1L.~u 3 potunds per tLousand- Those weighin:~ rot more tbteu ;; potnuls per thonsuid arc defined ns "stnalll cidtus" bnt General Cigzr itoes not mRkc this t' NPc of product. For the sake of cl;lriiy, it must be ernhhasized t.hnt the tac cldcilory of "9.Lrc;e ci~rttcs" r.ctoulls frout large c.oroitu..s tlorvn to smti]l c.ilurillos isei-ihing in escrss of '4 pmmds per thousand, whercns lhr ta.\ cate,orv of '`small e.i~ars', nflsen cnlled little, cignrs, applies onh• Ln rolls of toba«co tlnatt in appeartutce aud weight are ei;;titntte-lilce_ B.y stabutorv definition in subscation (n) of section 5702, "`cirnr' means auy roll of lobacco .vaappod in 1cxf tollaeat or in any sub- zt:ntce codtt.inin,r,= lobuceo (otltcr dtun ¢tuN roll of tobacco tahich is a cir:uette within thr inea,nii>;,~ nf snbsection (b) (2)." It is tmfortlmatco that thc. st.atadosc definition of a ciaar does not stand clearlp Ly itsl°.lf lmt raqnires re.Fereuce to tLe definii:ion of "cigircl.te" liv stntutory definition in subsection (b) of section 5702, "r_iqa- reLto° mettns- Il )An.Y roll of tobacco inrapPed in itnper or in any suhstrmee cot eUntnining .nnrl `. -~ dnq troll of tobncco ¢'rrtpperl tn any substance containing toDacco which, ~, itn aPPt'urauee. the tylte oi' tobarco useti in rhe filler, or its p0ekrlEy'- i, noQ lakeling, is lil:ely to be oft'ered 1, , or purcliaeeJ Lc, enn5uoiers as 2 ciµ:~ rMle desoribet7 in Uw•ngeahh (1). Au"ain, it is nnfottnnnte thal: t7iis statutorc definition in hnra- vrapL (3) defines `t "cig.rr.tto" on tLr bnsis of one matcual s,.-i- fic:uion, nautelc. "tlhe, n-po of tobseco nsed in t11a filler" andtv `i snbje(ti,ro c)-alual.inus, narnclc. "rpp tr:mec' of t6c ltrcdm: ti.r.l "its paclcar_rin-, and LrheliiiL'." P.rarraph (2) nf thn °p,.i;;.tr,4ii ... defintion i~;is ain.ed partic.ularly ad, slnall cigiets, thosc wcil-.I,til .c not iiimr than 3 nounds per tiousmid, to prrvent snrh stmll ci.~rs from silnuLttinrr eigarcurs. In the opillion of (7enermil C7ivtu. .u lon~l-timc mmufnctnrer oF 1ru1me cinais, tLe tlclniitimt has faileti to Itmclndc~ the production of stnall ci„ars which not on!y sinnllato eignrcttes but esn actnally be confused o:ith ttivaila.ble brown-colored cil,atrettcs. 'I'6c f.~reufi balk of the pr.blic is certuinly not familiar with thv statntori' acflnitions, hut it hus rc.isonably clcar impressions of w6nt a<•il-nrette is natd n-l-iat a ci);aur is. Apart Frotn the ustml wittte. watqplter of ino t(igttrcttos, nltlimi~llt cirrarett 5 tne ulso mude in rnuic colors itwlndinl~, Y.cotien, tLe priucipal cltm'actnristk s of ci~li- rcttes 1s ~'ieivcd by tlle pnbht, n.rc,: a pcrfccile c~°lindricIl. slLn.po ez- ce.pl_ for aut occxsioial or,il shapc; a diameter;;encrallp not ecceedin" S ntill;mcttire ot nplnoxianntul~- 'a/16 inch; n. ]rngt3t nenuralit- not c~<cacdin;.;r.hont 1t)0 nli7limetcrh or upprocitir.utoh- d l inches; and a mouuth-cud v:] ich iraqucntly has acvlindrictl Itttaolnncnt in the foriu of a tihliino, strip, a filter or rt rcacssrtl hlnstic. or cardbonrc' inscat or 1~~'n ~.:ion of such attacluncuts. '1'hc public lina also rotnc to r~li l tLut ci~~aret.tos arr sokl in packs ef 20 nnils, tho pacl:;. 1.ii-,~ -p _ucd at tlie tup wLe.re the tr:ouWi-encL•• of the cil-ctrettes nre. TI58461277
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183 [?Y' LL:.':_..., C~ f.. zeo .- f`"" E. _E NON FILTER 11011 F-l FILTER (IO+YR51 (63] INO. CASES] (39) 0 ~61 13a1 k .; 1 ~ ..~ I~s 1o-2D 21-40 41 CIGARETTkFPkR OAY T158461306
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174 befo•o the committee. -Wlrat I was trying to straighten ont with Dr. Stewart's letter is that he was quoted by those opposed to the lerislation as supporting the opposition point of view, whereas, Dr. Stewart w:wds to be rmderstood as supporting the thrust of this legislntion that, is before us, and I think t.hat. is trying to clarify the record. We have rennests frmn other Senators. Senator Thurmond was to appear this ~nmrning. If he comes in, he will be called upon, and Senator Cooper indicated be would come in to this hearin', sonre time, during the henrin~g. Either of thase Senators, when they ar- rive. we will have them testify_ and I, t}rerei'ore. would lilce to get on with the business of hearing the very important witnesses that we have invited to cornc aud testify before us today. I hope that rnry elements oC <onIlict that have appearcd here will not impede a very thoughtfnl and orderly hearin~,, because that is the whole purhose. ~ It~is not for me and Senator Cook to hnve any kind of debatr., and I apolo1ize for surv emotional. conflict tliat appears. What we want to do, and I a.m sure he does, as well as I, is get as clearly nard as fully as we can on the record atll of thc information. Our obiective is simply one of pnblicr health. Se.rrator Cook said in part of his riposte there, that he, would advise a person not to smoke att all. `'Vell, I would so advise. but, I think we all are realists and know that total prohibition is just an imposeible a political and sooial move. and therafore we are searching for somethinm less than that., whiclr at the same time will be an improvcment to the pnblic health of our people. Owr first witness this mornin;,~~ will be Dr. Ernest L. Wynder, who is president of t.he American Health I`oundation, from New York. 1)r. Wynder has heeu before onr committee before. He has spent nuuiy yefrs in this urea of research on cigarette smoking and disease, and we look forward to hearin4, from Dr. FVynder. If tiou woutd wine to the table, 1)r. til'ynder, we will be pleased to heaa• vou now. STATEBiENT OF DR. ERNEST L. WYNDER, PRESIDENT, AMERICAN HEALTH FOUNDATION. NEW YORK, N.Y. Dr. Wr-mnnit. Senator _17oss, Senator Cook, Senator Baker: It is a!rreat priviletie for me to testify on this important issue. Speaknn of constituents, f think it is important to state that those of ns who are physicians hnti-e onlv one constitntent: our paticait. I would like to invite you to come ,with mc on some rounds to see patients who havee snfPered from c:mcTr of the lunlg, cancer of the mouth, canccr of the osopbalrns and study their smokinl~ habits. I wish tion worild corne with me to learn how relati.vely poorlg ZFe haeo donc in treating these cancer,s. Therefore, after hrevinr~ served for 90 vcars at 3Temorial Sloa.n-Ketterin- Cancer Cci d.er, I decided that I would hromote rnv fnll-time effort to t}rm prevention of disease, particularly since we~have learned t3mt many of these diseases relate to envirorunental factors. Many of the TI58461297
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172 pollution. The rate in our large metropolitun areas is twice the rural rate, ancrn ¢fbar fudl adloxca+ece id mude for difjnreneex in armo7aing habits." But the Surgeon General ignores this crucial evidence in his crusade against stnoking. The President's Council on Environmental Quality in its first annual report to Congress in 1970 was properl9 cautious. It stated that: "The causes of chronic diseases which constitute the major public health problem of our time are difficult to determine. Assessing the contribution of particular pollutants to these conditions is complicatcd by the seemingly infl- nite variety of pollutants to which persons, particularly those in urban areas, are esposed from the day of their birth. And it is di8icnlt to separate pnlln- Lion from the other biological und physical stresses to which people are sub- jected." Sfy eonstitntents and I wonder why when il: comes to tobacco the very same difficulties, complications, infinite varieties of chemicals, biological and physical stresses are ignored out of hand. My constitotents and I wonder why it is so easy for the Snrgaon General to determine that smoking causes chronic dis- eases and so difficult for the Environmenta.l Counril to make the same determi- nation regarding pollution. Can it he that tobacen is the easier tnigetl Whatever the reason, the trath is we cannot have it both ways. IL it is difficult to determine the cause of chronie disease from pollution it must be equally as diffiisilt i:o assess cimsa- liou frnm tobacco. The tnrth is. Mn Chairman, that we do not know the truth. dnd it is t,lme that we ,°ot the truth. ,,mlator Cour. T will sav to the Chairman. in regard to his last rcvuarks., I aut not. using Lhis ns a pnlnit nnd I have 110 intention nf doini_r sa 1<lo nofemolm. rls n mattcr of fart, whon lfi•. Carnegie 1aid, if }on rec.all, voa asked Liln if you would tell someone that ihc onjht 1o ssnokc lozci~r tti.r nnd n~cntinc rin 'rtte, he said that ha would leave thlt choice up ro the vounn man. I told fllis c.omnitta,re if thal irare riven to mo, mi ehoice oanld lbe. I v.ould 1i,y to colwinc,c him not to srookc. '1'he only point I tlen trNing to make is that it is a legitimate Lusinoss, an3 you are nitpiclcin~ it to deattl. I object to it, and I object to it sbrennnusly.1 am not quitc snre who ie ml what pedestal to satisfy whose conitituents. tienu(or li,ixur,. .lfr. Chaixonan, before yon answer that, and I sense Yon may_. Iet ine also offer a statement for the reMrd and comment thatt as n, member of tho Commerce Comxnittec T am _raLiGed t~ s, that both points of view are beirn, ener,r;'otically represented in tlus hearinr. I lhn~~e n~-~^~-:Irilv been at u6her snbemmnittee heariligs, involving the r•umpio, -iiiniis industl;y since, these hearinhs have been going on :uld I wnuLto coinrnend both of ymi for making sure that n-n important -nl,iect ';Iel:s impoitiant, attentiml and to apologize to the sr..bcolnmith, and to the committe+e for not havin', given it more :ittcntion ill the pust. 13ut I thinle you will build a e'ood record. I tbinlc thcrr Will be substantial cases rnade on both sides. I think the connnitt^t~ will act in its usmal good way. So. if 1nti statement ui full can be placed in the record, Mr. Chair- man, I will be glad to supplement it as you niay require. I intend to watch with grcaC interest as you and Senator Cook continue vour debate. , Senator Moss. Thank you, Senator. Your statement will be printed in full. (The statement follows:) TI58461295
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C 184 60 .o 30 SJ ~~- t-- - - t;onv:H,veesro'rso i~s 1o-zo 21 ~ao n. (wo. rne31: UI (7I (s7l (7e) '(ss; -, (~ LC-..r.1i T158461307
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173 sTAr£MCV'I' OC HOY. HOWAaD H. BAKER, 11.S. SC.I'A'f0n I!'ROM 2'ENNESSliE ]lr. Chairman, I am pleased to have this opportunity to make a statement for the record on S. 1454, a bill to require tire Federal Trade Commission to estawlish acceptable levels nf tar and nicotine content of cigarettes. I regrot that I have been unable to attend the previcus hearings on this measure, but I understand that a good deal of e~cellwt testimony has been presented, by my colleagues in the Senate and by representatives of the tobacco industry and the medical profession, in an elTont to point out the potential effects of this legislation. I would lil:c to express ::.tt this time my own concern about the possible eco- nomic impact of this measure on the state of Tennessee, and my feeling that the hill is unneeded and unwan'anted by the evidence which is now available. In weighing the relative merits of legislation such as this, Mr. Chairman, I believe it is important that we remember that we are dealing here with an in- dustry lhar is as old as this nation itdelf- it is an indust.y which is vitally importnntt to the cconomic stability of one whole area of the country, which mal:es a sizcablc eontribution to our trade balance each year, and which is an enormou,s source of reveuue for federal, state, and local governments. I know of no agricultural commodit.l' which returns more for investment than the to- bacco crop. I understund from reviewing the testimony presented by witnesses at these hearings that there is considerable controversy about exactly how an "accepta- ble" level of tar and nicotine content in cigarettes would be determined- Even if such a determination could be made easily, however, the setting of any level could do irreversible damage to tobacco growers who have no control over cli- matic conditions which determine, in many cases the amount of tar and nico- tine in their crop. The tobacco industry has been much maligned in recent years by those who seeG the prohibition of cigarettes in this ceuntry. I submit that the industry has dhoivn a cooperative spirit that all ef us can be proud of aud tlmlr it has diecL::r~,d il., r,~s;~onslbility to the ,3uierican consumer in a most honorablc fashiou. It has volilntarily devoted millions of dollars to medical and scientific research into the effects of smol:ing upon health. It has voluntarily agreed to discontinue advertising over radio and television. It has printed in its adveo- tisementa the ku and nicotine content of various brands of cigarettes. It has displaycd the Surgeon (3eneral's waruing on cigarette paclcages, and it haa now volunteered to rhow this warning in all printed advertisements. In addition, the iuduetry has responded to concern about the possible effects of tar and ui- cotine by devr3oping cigarettes with lower tar and nicotine content and any smolcer Who desires to reduce his intake of these substances has a wide vari- ety of redurd tar and nicotine brands to choose from. Mr. Chairmun, samcly no one can argue that the American citizen does not have adequate information to make an intelligent and informed decision for himself as to whether or noC to smoke and as to which cigarette he will srooke. Surely he doee not need f.he help of the federal government in making this decision, and I seriously doubt that he wants that decision made for him. Thcre iS a growing body of statisticai and clinical evidence of a linkage be- twcen cigarette smoking and health; but ft seems to me that the basic issue confroncing us is whether to make the Congress the universal guardian of the medical welfare of the public, or to provide a full and appropriate disclosure of the ef1'eets of a given product or practice so that informed individuals can make their own ftecisions. As I have said on the tioor of the Senate during debate on the Public Health (`igarette Snroking Act, I would be equally concerned for health hazard warnings on alcoholic beverages, for automobiles, or for any number of lmtcnt mevlicatiorre which are sold in voluminous quantities without proscription. I anr not nrguing, therofore, agaimit the action which we have already talcen in this area, but I feel that if we go further, as many propose, we will be aban- doning thc role of legislative policy determination and assnming the role of public N'otecLm•. I very much doubt that that is what the Congress should do- Senaisor iStese. We ce.rttiiltly are trying to gather all points of vie.w, aul~L ts tSro Senat.urs bot1l know, we have invited as ma.ny of what, could be called connter-witnhsses as pro witnesses. We cer- taililv don't want to suppress ana information that can be brought TI58461296
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182 TAR AND idICOTiNE CO~lTENT OF CEST-SELLiNG U. S. CIGARETTES` 31 re, -l30 23 L r-7--(r--rvr-r~r 1558 '0 '62 '64 Ycar °&D> of total salos: 7-20 brands 7-F-rF--1 --110 '66 '6II 1970 I T158461305
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171 lag is the Nation's number one public health problem, worse Lhan hePoin ad,iic- tion, marijmine, alcoholism or automobile accidents. I challenge tlw credibility of a Surgeon General who would advance such a premise. The distiru;ui3hed chairIDan, however, accepts the premis'e, and as n result. he prolroseu in H.H. ]464 to limit tile "tar" and nicotinc cont:eld'. of :igarettes to pl'o(}TUs8iVe1$ lower and lower limits until the practice and the product eventually dlsePpear. fLr the naeenc la:°t, the Chailwan under the same gard of biased public health i'eperts proposed the clinlination of the t90acco price support prognm. I oppr.e-rl the 1--islatton becanse it would have been economically disasterous to the I„bv, v growcrs of Ifentu:9cy and it was unsupported by scientific evi- dence. AF'ir]l lo-- evidence than would have justified snbmitting a ea.se to a jurY, this llr,i,-'.il would have driven mauy Of the Nation's 636,0(NJ tobaccu growers and their families off their land and intn the urban ghettuos, offering them job retraiuing aud welPnre payments as consohttion. As ehairman of the House Committee on Education and Lubor I have been as strong a snppartel' a3 anyone ef Legisiation Lo help all Alnerl(.211s achieve as high a living standard as they could attain. Consequently, I was totally op- pnsed to a mcasnre sehicu in the nalne of fightiug an alleged health hazard would uproot productive farmers and make them welfare recipients in our big cities. In my district a man with a half acre or one acre of tobacco is able-on his own-to raise nnd educate his family. lIe has always hcen his own best provi- dor and I hope ho will always be so. But let nie get to the heart of the mattcr and question the ba?is an which the anti-t0bacco advocates are now advancvlg this legislation. The Surgeon General's extreme insisteuce that cigarette snwking is the nnmber one health probleriin the Nation fails to be slpported by the evidence. The tobacco growers of Kentucky have long asked to k:mw what ingredient in tobacco as it is satohed is the canse of humun disease, so that it could be removed. And so have I. The Surgeon General ]uss not named it, which faet should bc rnonnb for nnpoue to re,iect this legislation. 1 for one favor eft'ectve medical rose:lrnh to find tho cause or catlscs Of cancer brrt the tobaceo growers of Kentucky wonder why the Congress and the 1'residern. ho:ve decided to spend $1.6 billion to conquer cancer if, as the Sur- ge0n General says, :5garette smoking is the major cause. This inconsistency rlnes not enhance the case the Surgeon General or advoclites Of this legislation al.tempt Lo make. The tobacc0 farmers of Kentucky are aware of the puzzling fact that most smokers do not get the terrible diseases linked to tOhacao while mmiy non- smokers do. And so nm 1. 'I'he Surgeon General's exclusive interest in climinat- ing tohacco does not improve the case fOr tllis or eimihtr punitive legislation. 1'hc peopic o2 hentur.ky are cnrious about why it is so difRault. for nne Uraneh of HL'W to deterrnine that the inhalation of coal dust causes black lung discztse while it is so easy for another branch of }Iblw to determine that smoking cauees emphyseula. Thc inconvistent uppmxch Of H};1p orr thnee two martcrs in I{cntucky seeks to deprive coal miners of Ulach lung benefits on one hand and tobacco growers of cash for his crop on the other. Fimrlly, &Ir. Chairman, I would 61ae to offer for your serious consideration some of the apparent contradie6ons tA the SurgeUn General's hnti4obacco p,rei- tion that have croased my desk. They rcpres0nt to mc, at least, grave causes £or alnccrn ahout thc policy deternrinations being rnade in the Public He:ilth Service. 1. '17ie Council ou Fuvironmental Quality in its c_ccond annual rport links empnysema, bronchiti€ and lung cancer to air pollution. The Snrge-n Genernl linke them to tobaceo. a. The Environmental Protection Agency data shows that in 19" oll f,rms of teansportation, bnt priucipally the antomobile, released more thni, It- i rui4 linn tons of narbon monoxide into t:he air. The Sura on General r:'nl- I, nro- Idbit smuhing in public places to out down on the aunount Of carhko F ll r-de relcased. S. A 19G7 Public Health Service publication dealing with air pollution stu ted : "Deaths from hmg canccr have been increasing eapidly in recent years, and while Inany factors are probably Involved, the striking difference between the urban +rnd rural murtxllt-y rates fur Im:g cxncer points to one of them air ,i-QI1-~-,_ -C.. TI58461294
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Dr. Wvsor.r.. That is a good question, Senator Baker. There is obviotcly a link to dnratimt. This, in fact, is fnrther evidence that tobacco smoke by itself is a relatively weak carcinogen. lly relatively weak, I mean compared with, say, radiation. And so, you must smoke for a lona period of time. Most lung cancer patients we interview in onr studies have smoked for more than 20 ,years. It is duration and amount. The phvsiolo,vical changes that occur in the body through smoking are reversible, up to a point, if you stop smol:ing. Because the carcinogenic activity of tobacco smoke is relatively weak, we feel that we can prodnce a c,irarette from which the asso- ciated risk of developing cancer wil1l be relatively low. Senator Moss. lsn't it also true that there, is a rather dramatic drop after cessation of smoking so far as luny; cancer and other diseases? Dr. Wi'xvrs. From our studies we notedd that if an individual has smoked for more than 20 ycars, and he gives it up, and even if he has smoked relatively heavily, in the first; 1 or 2 ycars nothing will happen in terms of his risk. ~Then it will gradttally decline. There is an intriQUing finding thatt we have learne.d abont occupa- tional turnors. An individaal can work'in say, Ehe iipe 'mflustry,'ieave the job, and up to 10 cears later still have an incrcased risk of bladde.r cancer. For hmg cancer, we have observed a relatively rapid drap in risk When cou stop smoking. I consider a decline a.fter 4 y~ears relatively rapid.~ ln terms of cardiovascrilar rli,ea're, it is thought hhe drop mar bc e, .-e-n more rauid. Our data su,,-ests that the etTect of cit_arette smok- inp, is morc of an acute nature. The next slide shows data from a study among veterans. It shows again that t,he mnre you smoke the orcatr.r the risk for mvocardial infraction. The data here shows that the risk ie far greatcr in yomtrer patients than in o,lderpatients. ~ So nntclt for the background on dose response. This last illtestration I am showing is a key one, and I would like for all of you to look at it carefnllv. ZVe can come here as witnessas and telL_hon it is verv difficult to' produce this t,ype of cancer in anitnals, and with all the millions of dollars that we are going to spend in the next 10 years, we may never quite succeed in this. ll'c ma~= also sav that it is verc difficult to studv the interrelation- ship of all thce different carcinogens in tobacco. (v.oal tar was one of the first materials known as being carciuolgenic to tnan as early as 1 tT5 altbou,rh at that time the presence of carcinogens was nott known. It was shown to be experimentally carcinogenic,in 1916 and actual carc,inogens responsible were identified in 1933. There are so many diffcront carcinogens in coal tar that to identifS all of them and their interrolofionship is vi.'tua113* impossible even todav. I dare sa.y that in spite of the fact that we have worked very hard to identifv all the possible c.iscinqGens in tobacco, we will never succeed in interrelating all of them or in identifving all of them. Therefore, the kev data that we onght to establish is whether the various kinds of tobacco products that appear on the ma.rket have dift'erent effects on man. T158461303
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176 Thc qnestion needs to he posed as to what avidence there is that certain cigarettes are less injurious than others to smokers. The, _1rne1-ican Health Foundation is en;laged in long-term epidemi- ologicall statdies to test this question in the human environment. We have alreadv shown thals smokers of filter cioa.rettes for more than 10 years har-o ann appreciablp lower risk of developing lmr~~ cancer than smokers of nonfilter cimarettes. We are observing similar evidence re,m,ardin, cancer of the rnouth. Tt is of interast to note that studies of individuals who switched from high tar and nicotine cip•arettes to low tar and low nicotine cigarnbtcs slrow khat thc srnokcr dor5 not oorrospondinpgly inarcarsc tlm nnmbsr nf ei_aare.ttes smoked per dap. While filters appear to he nsefnl, the majoritc do not selec,tivelv reduco a sigrnificant portion of toxic or carcinoge,nic components, thus snggestinm that tar appears to be the most importantt indicator of carclnogenic actiRity. Yopulation stndies of lmmans. as well as studies with laboratorq animals, have established that tho lower the tar dosage. the lower the risk of cancer. The evidence therefore clearly points to the rednction of tar as an important step towards reducinn the car- cina,*enic potential of smoking. For cardiovascular discasd, two factors have been suggested to rela.te to this prohlean-nicotino and carbon monozide. Epidemi- olollic.ally, a clear doseiresponse, effect has been shotivn to exist bet«eeu the smoking of cigarettes axid hcart attacks. Experirnentallv, cae have shown that nicotine in tobacco smoke increaaes arlrenalin lcvels in the Mood which =ub.equcntly leads to an increase of factors which may be et:iologicallti relaterl to artrriosclerosis. It has also been su,we.sted that nicotine, via adrenalin reiease, can induce irre,talarheartr beats in an alrcady damaged heart. Preliminarti- fndins of a study by our =ronp sungestt that filter cigarclaes wilh a. relatiecl.- low nieotiue content are associztted with a. redaceed risk for herut attack arrd for peripheral vascular disease. Tf these data are confirmed in large-sc21c investi,ations, it mitbt indicaSce that the nicotine is responsible for the. effect on the haa.rt and cirenla.torr svstr•ms .vhile carbon monoN~idds role is nevlirible or nor-oxistcnt.. Also carbnn monoside has lon~- been sugffested to be a9 ha.rmfnl component in cigarette smoke it is enrrentlc not rednced bY av;riln.ble filtri ci.zareti.es. Tlms, defircitive <'r'iden«_• of its role wonld be %+clcomc,. As far as chronic bronchitis and emph}serna are cmruerned. a clear riuse/respousc rela.tionship to ciharette smohinr has also been established. The evidence inccirninat.e.s the pai•ticrilate phase vrhile the -,aseons pha_se, could also play a role in the etiolog.e uf this disease. The cornbined role of the two phasos needs further eXamina- tion_ AL irorad- F.n,lish stardv onl this problem did not produce conchwive evidenceand fnrl;her, research in this area is indicated. (hi tho basis of our present lmowlodgc, what should our recom- menrlations bel Pased oil su-ailable erddenc.e on the relationship of tar to various types of cancers and bhe relationship of nieotine to cardiovuscular rlisewse, we are recommendin, the establisimzent of mazimmu permissible tar and nicotine levels in American cizarettes which shonld, in vear's to come, lead to a fru•ther rednction of diseases related to cigarette smol:ina~. TI58461299
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178 discrnmt.ed by lookink at the hinh tar and nicotinc levels prevalent in Hic rnid-1t160's compare.d with today's °fbestt sellers.f° The dav rma5 nover come whon we can inhsle tobaceo smolm as safelv as luipollulcd air. In lifc, howevcr, we ncvd to he realletie as well as idealistic. tive need to apply the theory of llealpolitik to the current situation in thatt we must look at the problem as it is. This applies to those of ns who want everpone to give up snokin- as well as to those representing the tobacco intcrests. While healtLi edncators me doinr their best to get evcrpone to stop smokin_, zve ILa.ve to re:ilire that in the framcwork of our current sonietv their i nflnence rvill alw.tvs be limitcd. ZFe should lcrun from the history of inedicine thnt the rreatest advances in discase prevenlion have not comc from what individnals har) c bcrn abin to do for thernsclvcs, but rather have come from 6he madifirurion of the environment. or of a producl. tknongh engi- ncerin;;, mana_cxitrl, or regilatorv ehan„~,es. The, establishment of less harmful tubacco products is realistic. It c•an co_rubine, the desire of- the tobacco industrg to continue to sell its produrts with Ihrr de,ire of a population that wants to satisfv its smokim_r habits, the desire of the medical profession to prevent nmica_sarv illness, aud Ilrc desire of a a*overnment tlhat w tunts to sitisfv all of its citizens. Settnr;; rnaximnm tar and nirotine let-els is nn importvit practical etep in ac]iieving the aims of all thesc ;tronps. Congress has a partionlar opportnnitv in this rednrd becatrsc it rrn, more thau ;mv otlrcr sinLde institntion in a free sorietv, cater to lhc dr,irc.s of nll of these factions. A foremost role of Con-ress is to safe-(nuird the hea.lth of all the citizens of this Nation. The les-islation nnder discaission, and the sug',estions made herc, are directcd toward advanc.ing the health of our people and_ thus, of onr Nation. It is therefore :drnnd at reaching the mcdical goal that we, in the American Ilealth P'oundation have set for ourselves- "to hclp pcopli die vmm~,: r l,rte ashossible." Bioa•. I Icotild lil e to show con the charts that go with mv presen- tatioaan. Someone befo[e me }has said that pictures speak londe.r than words. The first graph shows what has hsppeaae to the tar and nicotine levels of ciaaretta.s in the United States in rucent years. As vou can see. lhese levels have declined dramatically. In thc last 1.0 io 00 pears, the American tobacco indastry has succeeded in produoin,, tobacco products which are significatttlc lower in tar and nic_otine. The next chart shows that experimental studies demonstrzated vcars ago that the Imver the amount, of tar applied to an animal, the lower the finnor yield to that animnl. Therc are a few points I would likc to m.>ye oari animal staulie=. 1Ve have never claimed that u mouse or a monkey are like man. lvhat wr are sacin, is that we use aninmis as ;r test tonl. As yon know, the Delane,v amendment states that any' food additive that produces tmiors in anv kind of animal, in ;ury consentr.rtion, is to be banned fronr lniman c.onsumption. So the Conb ess has decided that animal experiments are itnportant. Now, jnst becanse tobacco tar produces caneKr in mice it dnes not ne.cessarilv follow that this material is carcinogenic to man. It is only of t'ahre N~hen viewed together with tlie human data. T158461301
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175 diseases of which we suffer today are preventabla The Americau Health Foundation, a nonproiit voluntary organization, is devoting iLs energy to reducing unnecessary illness in the United Status, indeed in the world. This is our goal. Our constitnency is our Nation. Novv,brieHy,thetestimony: We believe thfdt a causative association betwcen cigarette smoking and lung cancer, a variety of other types of cancers, heart attacks, and certain other types of cardiovascular diseases, as well as with emphvsema and chronie bronchitis, is now renarded as well estab- lishod bv the majority of scientific opinion. 'lhe evidence for such conclusions has been reviewed in a series of reports by the U.S. Surgeon Ueneral, the British $oya_1 Collere of Phvsieians, and by the World lle.alth Orn;iuixotion. While theree will always be people who questiou the scicnt.ific evidence Lhat the earth is round, our present rlaay thinkin,q is ccrtainl,v based on the majority opinion that it is indeed round. Thc evideucc of the harmfuhvess of cigarettes will mmdcubte•itly be questioned by some forever, but wo ought to act on the majoritp opinion now. Thns, the question mrder discussion at these Senate hearinn's is not whel:har ca~la.rette smolcing is injurious to man but, rather, what wc arc _~,oinnr to do with the established evidence. It appears to me that there are milc two patlis to be followed: (1) Get in- dividna.ls to cease the smoking, habits, and. (3) have individuals smoke in a less harmful fashion such as not inhaling the smoke, decreasin;{ the mambe.r of cigarettes smoked, nott smoking cigarettes to tlie z-erv end, and nsin!.; less barm[ud snoking produc6s. Ednaational efforts have succeeded in encouraging many .lmeri- cans to stop smol:in, cigaretkes or to smoke more cautiously, but the fact remains that, aa large number of individuals contiuue to smoke cit,+arettes despite. all wxrnings. ICe do not want to discuss hcre the reasons why so many people continue to smoke or why they started smoking iu Che first place. It appears evident however, that complete cessation of smoking by the entire population is unlilrely to occur within the foreseeable future as is the likelihood that our society will prohibit the produc- tion of cigarettes. lt would seem, therefore, that the second approach is necessary to combat the snolzin~/health problem; that is, the establishment of less harrnful smoking products and habits. This suggestion ropreseats an area in which the independent scientific community and scientists from the tobacco industrv should have a mutual interest. It has been of interest to observe in recent years that the scientists aaid top rnanagement of some of Lhe major tobacco companies appear to be pnrsuinh the establishment of less harmful tobacco products. b9hile they may not admit this pnblicly, their elCores in this aur.a speak for themselves. As a result of this, we have seen that the tar and nicotine levels have be.rvr dramerticrrlly reduced in American cigasettes during the last 20 cears. It makes little differenec whether the tobacco in- dustry has done this bt,~ause of its interest in the health status of individuals or because smokers desire cigarettes with low tar and nicotine yields. TI58461298
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Isl AVe now have established evidence that the smoking of filter ciga- rettes with lower tar contents from unfiltered cigarettes, do result in a lower risk of lung cancer. 6i staidies done on man the smoker oP filter cigarettes for more than 10 years ha, a lowcr rislc of lung cancer than the individual who continues to smokP nonfilter cigarettes. Our data show that the major dilTerene.c betwecn these kinds of cigarettes relates to the tar content. It so happens 11iat these dose response studies that we can now dunnonstrcdc for man are consistent with those denionst.rated for aninmis. Thn Anmrican tobr,eco industry is capable of producing cigarettes which are lower in tar content and which produce less discase. Our current studies continue to suggest that for different brands of filter and nonfilter oigarettes, the lower the tar content, the lower the risk of cancer of tha lung. Let me emphasize what I said before. 'I`he tobaeco industry and our group may perhaps have different reasons why we do things, but the end results can be the same. As scientists, we face a difficult role. ;Ve are often approached by people who believe that we should sa.y that evervbody should stop smo]-,ing, and I, porsonally, believe that everybody should. And we are approachedb,y the tobacco industry, who say that we are infer- fering with their business. But. S said before, we have only one con.stituent, tind that is the health of the people of this country. It seems to mo that the scientists within the tobacco industr,v are work- ing hn~~d in =ec to it 46at the day ma'y come wPien \ce can produce cig,u•elie:; which will be less hu,rm$il. And so, I emphasize, .ve need to srpport thew hcalth oi,danizations who are trying to encourage peohle to sto smoking. 1Ve need also the help of the tobaceo in- dustrv and t~e assistance of Congress in order to Let man to help hims.elf. bec.zuse it is a truism of preventive nmdicine that man believes himself to be immortal. 1Z'e. ceu: arrange to have the most brilliant advertising on television on surolcing, drug addict'ron. seat belts, obesity, but still we tend to believe that it is for the other man. Those things cannot happen to us. Yet ths:y can, and do. If we are going to advance the health statns of our \ at.ion, we have got to rcoinyinecr a>>d modify the tmoducts in oui- environment, and that is whatthe American Hea.lth Foundation is all about. To accomplish our goal, the scientific and medical communitius need yonr help, we need the help of the industr,y, and by working at the problem together we can improve the health of our -Nation. ('Che chnrts roforrod to earlier follow:) T158461304
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179 Another point I would like to make: Tt has been stated that the amount of tar applied to tnice is equivalent to a human smoking from 30,000 to 1'a0,000 cigarettes a day. Thiss statement is obviously wrong and can only apply if we were to spread out the lung, using alll the alveoli. But lung cancer rarely occurs in the alveoli. It occurs in the bronchial tree. If you mcasure the surface area of tlie bronchial tree of the human and tlre anrountt of tar that settles there, it is roughly comparable with the amount of tar that we apply to these animals. Let me emphasize another point: It has been said that we rnight not be ablee to develop an animal system that would duplicate rnan. This is a key question for us scientists to consider in view of the new Cancer Act that yon gentlemen have passed and for whieh we are very grateful. We need to recognize in cancer research, there are situations where the human situation cannot be duplicated in the animal. One of these is the inhalat:ion of tobacco smoke. All of these small laboratory anim,ils a.re oblinatory nose breathers. They have been crawling on the ground for millions of years and have doveloped a nasal passage svstem which absorbs the dust that they would other- wise inlrale and from which the_v would die if it entered the hmgs. IIurnan bein;s, however, have been walkin"I upright fur a few hundreds of thousands of years. Thus our nasal passage dcfense sys- tems are relatively poor compa.red with the arowid animals. 'Phero- fore, the nse of small animals for inhalation studies, partimalarly with toxic sttbstanc.es likee tohacc.o mav nott bo useful. This limitation may also apply to laboratory research into ca,ncers of the colon and pancreas. Tnthis case the human diet is so complex that animals cannot adjust to it. IIere, we have another situation where conditions in animals cannot be used as a reasonable facsimile of conditions in man. Numerous investigators in this count.ry and abroad have shown a dose%response relationship of cigarette smokinr to lung camaer. 'llic moro you stnoke, the greater is the risk of cancer of the lungs. 1Vow. T know many jokes that have been written about statistics, and that you can lie with startistics. Again, I invite you to visit with mc any group of lung cancer patients and we shall observe the rarity, with which epidermoid luri;,, c•rr.ncer occurs in nonsmokers. ("Bpidor- rnoirP' is the medical type of ltuig cauraar that is a.soeiated with cigarette smoke.) Ctt is so rare, that over thc last ~-)0 5-ears I have written two papers on the occttrre.nce of t}ris histologic t.~pe of lnng cancer iu nonsmokers. We seo about I in 100. The major portion of hmg canr,er patients smoke two or three par,ks a day. tij%c are dealing here with relative ratios of 1 to 60: In other words, we are dealing with mmnben of such magnihrde that you do not nerd a derree in hi;{her statistics to uuderstand that thcse diII'et•- ences are rea.l. To t,he statistician who says, well, there could be ait element oC bias, we need to stress that these results have been con- rrnted on ]nng cancer patiertts throuthmrt• the wortd. lt has also been shown that people whu give up snoking will significantly reduce thoir risk o41ung canccr. Senafi.or Basnr:. Doctor, is there. some sort of statistical relation- ship between the length of tirne one smol:es versus the amount of smoking in relation to the incidence of cancer Y T158461302
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177 }7romu esisbin-, data it is clear that the nverane smoker of todur smokes ciaa.rettes that are abrnrt 40 pcrcent lower in tar and nicotine o.ontent thMu thc smolccr of 20 years ago. Few people wonld have predicted this to be possible in 1950 when we were. reportinn the first epiduniological studV on the subjec,t. From current cil,-are.tte sales it is also apparent that an ap- preciable mrmber of Americans today are smoking cigarettes r,on- twining less than 20 ro:,. of tar and 1.2 mg. of nicotine as measured accordine to staardarrl FTC teclmiqnes. These are much lower than would have been acceptable 10-20 years ago. ~~~'e sn~_';,>est that these levels now become the upper permissible tar and nicotine levels for all domestic and irnported cirarettes. Since certain manufac- tnrers may need to alter the makenp of their cigarettes, we recom- meird sonnc interval period to bring all of their brands to, or below. these masinnmi levels. 11'fore ar,,i more cioarettes aro r~ppearin~,~ on t,he market tivihh I:n~ contents reuwin;,= helween 10-15 mg. of tar and with nicotine leveis at ahont /1.mn. li'e sn,rest incentive. svstems-be thcy in terms of tax col'. ~>--ons or price incentives-that would enconrare i.he in- dividnal to prefer these cigarettes over thc higher 4us und nicotine brauds, being wary of any incentivee that wmild ac.tually encourap"e pcople to take 111) the hnbit. While we h,r,vc been primaril} stressing, tar and nicotine levels. we and otho.r iaccstitators aree also interested in selectively redncirn, otlrer specific components in tobacco sinoke that appear to contr-ibuta to the do,-elopnwnt of nrmc.cr, emphysema and chronic brmichitis. As rnore eeidrirce trccrmnrlates a.bout. 6hese harmful oomponents, we should have aprovision in the law whereby masimum permissiblc levels fm' each <uui also be in6roduced. We su;*,~est two courses of actiou nherebv upper limibs can be set for sjmc-iJic luermfrd coiuponents in tobacco. (hre mi_,ht be Lhrougli tlie formation of azr advisory couunittec, Jreaded hN an appointee, of the Secretary of T11:1Z' and made op of represe.ntatiwes of Llre Gove.rnriunb. the acadmnic community. and the tobaeco in- dusLrti,. 'Ihjs r~ronp w=ould be char~ed with the responsibilitY of deiclinL, esactly rvhatr limits shoiild be set, ho`rever diflicult that task ruigld: hc at presnnt.. The scrxm_i, and possibly the most promising, approach to tho prahlem of horv to briul,~ t.a.r and nicotinc levels down to lowor limits would bc the retnlation of the ir:duslr.p br' it.selt in cooperation wihlr the Govcrmn.ent. Knowir.g how 3merican business shudders at the thott~•ht of "govenvnent i nterPerence°° on anv level, vohmtarv com- plisenee in this :Lrea wonld obviousl), be preferable to all courerned. The problem of lrarrnful tob.rceo prodncts is one of the rua;jor hea.lth concerns of the da1'. Wo can understand why the tobacco indnsnry doe~ not joiu health educators in their attempt to persuade the pulAic to give rtp srnoking. We c:rrrnot, horvever, nndercLand NV}rythe indnstr}= should not join in full force with the scicntific eomrnnniCy iii its efl'mts, inelndini' bhee recmnmendationss m:rdc here, to a:;hieve thee point ;vhen inhalation of tobacco smoke would Uccomc i.ncrcaFlina'lv ]css harrnful. The indnstry specter that these lon- tar/ nicotine cigarettes would not be acceptable Co consumern can be T158461300
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MORTAI.ITY RATIOS AND CORONAP,Y DCATHS AMONG U. S. VETEP.ANS AGEU 33 -L4 BY NUMBER OF CIGARETIES SMOKED 320 59 --I -------- _ TOTP.L Only SMOKERS occasionally 528 _ J Li;` ... I L... . lta9 lOta20 21to39 40t Ci~arc:tes Sr.io:cePDaily (Kahn, 1956) Senator AToss. Thank you, Dr. Wynder, for a cer,y eloquent and thoughtful preecntation. We know the years that you have put, into this field and the work that you are current.lv doing. I think yon described rather dramatically one of the problems in the bill that ticee ha\e before us. On one hand, some groop sa,l'ing you ought to have total prohibition, nobody ought to snoL-e. And while we conld agree that would be a desirable thing, it just is socially and politically impossible. On the other hand, we have those who say, you are interferiiLg if you try to cut down and get a less dangerous cigarctte, and con- sequentlv, }iTe are assai led from both sides. The S°urgeon Gcncral has recently published another r_eport, au updating of his previous reports, and no donbt you are famihar with that report. When we had Dr. ,S'ommers and Dr. Hockett before us, they both said that in elTect, there was nothing new on cigarettes and health, and they woiild rathcr dismiss this as not containing anv nen information. This does not seern likely to me, and I wondered if you conld conunent on that general subjeet. Are wu getting addit.ional information out of this repert, and out of research that is going on now ? Dr. Wrvm,rm Well, t1m case of smoking and lnr_g cancer was, in my view, quite well eetablisbod in 19,',0, and since this tunq every Z°ear, studies coine out from various countries to stren~,~.hen the findmgs. Recently a study from Japan showed the relationship of smoking to lung cancer. This was of interest because it occnrred in a racially different kind of people. T158461308
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186 Thc evidenc- ~nll~~i,,d by any of the review committees that has ever looked into Li> i ~ iii i , r lu i; been overwhelming. I snppose i f I~cu.i ~cen c.,iplopee of the American tobacco industry or related to it in one way or the other, I would hace no choice bnt to deny existing evidenre. Tt is, of course, my hope that all the moneys that are being spent by the American tobacco industr,y are being speut fruitfullv. I was very pleased to hear DIr. Kornegaf say that suue 19u4 the Aenecic.m tobacco industry has spent $40 million on tobacco and health rescarch. - how, T would sa.v to Mn Kornegay a,nd to all the scientists in the tobacco industry: That if they had sl,ent that S10 million in support- in,n, scientists who believed there was a problem, we would have been much further along. If tho tobacco iiidnstry had expended their energics on the problem it,elf rnther than spendinl,, so much of tlioir energy on refuting the evidence, we would be nearer the day when we would have less harmful stnoking products. Is is not irnporlant what a scientist says as mueh as what he does, und within the tobacco industry excellent work is being carried out in their laboratories in precisely the same areas as in our laboratories. Slany of the indnstry saientists ha.ve expressed an interest in h:tving more frceclom to work with independent scientists, and that w-ould hasten the day when e•e lrould solve t]ie problem thut is beforc us. So 1 tlunlc I would salute that portion of the tobacco industrc which tmderstauds a problem exists tnd work at it. If you tcll people who n ork for you that no problem cai,:t.., they camtot be eapected to do ,i good ood job. II Congress could free the tobacco industry of their fear of le,~al suits, perhaps they would change their emphasis and not be worried about further litigatiou but work with us toward the eornmon ob,j ective. Swiator A7oes. Rnt does this report update any of the, in formation, or isit justcumnlatire8 Dr. AVrxnEtz Well, it is to a large extent. camnlative. You may always ask yoorself, 5enat.or,_ ai which time is further evidence really not necessnry, and as far as I am concerned, the evide.nce that ciga- rrtte snokiul- relates to the various diseases is very caqrcnt. Where more evidence is roquired is on specific factors relating to cancer, cardiovnscnlar disease, chronic bronchitis and so forth. On these aspects wee will ahravs have to do more work. 17ierefore, I «-oiild welcome the continuous support of the tobacco industry in these arcas. Senafior 1lfosy. Isn't the eficct of carbon monoxide a rather new arcu, that is just cominginto at,tention now 3 Dr. T6'rNnsr.. TVcll, carbon monoxicle has been inrrimuutted for a grcat numher of years, and various studies have stiggested that at leastt in animals, the lnesence of carbon monoside relates to artorio- scterosis. I think this area needs Co be investigated further, and 1 can sec ttoth sides of the argument on the, issue of cnrbon monoxide. This is preciscly the kind of n.renq where I would lil.c to see further rescareh being done. Senator Moss. '17rnn1: ron. Have yon done resen,reh on little cigars? j'ire had oonsiderablc testimony here before on little cigars now being marketed. T158461309
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194 Suppose onr lone-rangc data show that the lmig cancer risk was relatively low of somcone who smoked cigarettes that fall into this io.ce_r t.ar/nicotine bracket (nnless lac smoked so cigarettes a day) this would be. something that the tobacco industry can do. Senator Cooi.. Let's put it in perspective, becanse I think this is only fair. In effect, what you are saymg, and you said in y~om~ state- ment, from the cmrent ~•tgarette sales, it is also apparent that. an appreeiable number of American smolcers today are smolcinh ciga- retl.cs containing less than 20 milligrams of tar and 1.2 milligrams of nicotine. Now, tny only argtmtent would be, then you say, measured accord- in},, to standard NTC techniquc.s. These figures came from the FTC. Are we pickinr,, somet-hing out of the air and savin, this mav be a good thing to stsirt with? Do you have anyresearch to bacl: up the 20 and the L3? Could you furnish us with any supportive research? Dr. tiVrmma<. As a scientist I must go along with the statement of Dr. DuVal that there is no deterinined threriltold level. This prob- 1em we face time and time again when we talk about what is a safe level for it fuod additivq fur esample, and I 1:aee tallzed lo Commis- sioner Ddmards about this. Aiy own feeling is that in some cases, like in respect to cyclatnates, we really go to one extreme, and then in another r.ase we have no limits at all. Senator Coon. '<1'e (lid go to quite an extreme in that, didn't we? Dr. IVr-Nui.R. It is my own view that in certain food additives, we have none to the estreme. But the hands of the coxnmission were tied bectntse the Delaney ameadinmit passed by the Congress, says that a food additive that in any concentration produces twaors in animals amst be banned front }mman consumption. Thus, when we arrived at a point from which to start, we picked it level which half Lhe Ame.rican eit.arettes nlready had reached. It tcas technically & 2sible, it x:s acceptable to consmne s. At first we cho,o 20 milhgrams of tar and 10 milligram of nico- tine but I ivas told that was not feasible at the present time with the kinds of tobacco atailabin. tienator Cootc. But von remember you can't do that, any more, beeau:e the. TTC baek in tl.e 1950's banned the industry from doing that and said they vveren't going to let the industry get into this "txr derby;" as they called it.. Do yoa recall that? Dr. i~rsorat. I~rirall this, and I was one of the people who have urged the 1!°CC to dispense from this particular regulation, beeause I:un impressed with .vhat American industry can do. I would rather have them spend their advertising dollar on behalf of the health of this Nation. We are using the v-alues as a starting point, Senator Cook, but another commit.tee may arrive at different val ues. I think this is the kind of regulatory step that the industry conld also do by itself. Afher all, industry has done it in tcrms of advertis- ing, and as I stressed in my test,imony, if we can do anvthing vohm- totrily in this coimtty, I prefer it to any legal steps of the Cougress. TI58461317
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1S8 I would like, to su~rn•est that a committee be appointed by the Secretary~ of I1liIV to ~oool: into this question of the definition of.rhat e\actly is a cigar in line with our current scientific ei-idence to define differences between cigarcttcs and cigars. I thiiilc tliis is important toda.y because Congress in its wi=dom laid down legislation that speciffically exempted cigars and, therefore, I think Congress ought to define again what rcally is a cigsr and what reall}• is a ci,mrette. Sentor Mos's. We had considerable discussion about the Winchester little cigars at onr previous hearing. Are you faniiliaa witli this product, this AVinchester, little cigar? It comes in a parkane that loolcs just like a oigarette. Tf you have any familiarity with it, I can ask another question or two. I don't laiow whether you are or not. It has a filter on it. It is the same diamcter as a cigarette, bnt it does havo a brown paper on the smoking part of the cigarette, and witnesses testified that this is made of 60 percent tobacco leaf and other unidentified products that are put .rith the tobzicco leaf to make that wrapper around there. Now, I don't know. Does this have the alkaline content that you were talking about of a cigar, or do you ]znow N Dr. WYSnnit. tii'ell, as I indicated, we are looking ah this and all other tobacco prodncts on the market. Our data snggests that this product conforms in terms of qual it.ative factors with .rha.t we gcaicr- ally expect from a eignr. Lm-gels, burley t}~pes of tobaccos have been used, and the Ph docs turn all~,line at the very end of the smol:e, but our data suggests that the nicotine and tar content is very lotc. This question can, in my vierc, only be answered by a legal opinion, that is why I suggest that ~-ou or tie IiliZV appoint a speeial com- mittee on this. Senator Moss. As a matter of definition, the IRS apparently, for tasation pnrposes, has classilied this as a]ittle cigar, tind, of conrse, tasution is very important. Ci«arettes arc tas:d several times as much ns little r:igo.re. Dr. WrnuEU. I think this is obviously a problem for the tobacco industry itself to police. Tt seems to me that the tobacco industry ought to help defne what little cigars are and what the differences between cigars and cigurette.s are. I just pointed ont that in terms of the epidemiologc of cancer, the major difference is not so xmich related I.o the chemical con- stitnents of the prodnct, but whether or uot smoke of the productt can be inhaled. Senator BZoss. IIere is an advertisement for Winchestets stressing the faci that it costs ]ess than cigarettes, and saying at the bottom, it is not a cigarettc, it is not just another little cigar. Dr. Wvrmmut. T wmdd like to emphssize aoain that this product is an esample of the ingenuity of the tobacao inciustrv. It is the in- genuity of tlte tobacco chemiste and the produc_ers of tobanco product5 that they can manipulate the tar and nieol:ine content ahuost to anv leccl thut they desire. I for one would have thona-ht it .cas vcrr difl'icult to pro$uce a smolcing product made essentiallv oiu, of eigar- type toba.cco and with a ciaar wrapper that is as low in tar and nicotine as tl:i.s particular product. It alwavs comes back to the fackt that the tobacco industrv has the capacity Lo do a]nrost anything if they are given the right ~lireetion. TI58461311
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I Senator ;AIoss. 'Chat mip_*ht be 901110, kind of an emnomic irncontiVe. perhaps, or d.isincentire_, that 'wonld induce them to prodnec lower nicotine and tar conteit ill cirrarettes and cit.;ars. Would con agree Ncith tlmt? I)r. lVrvusrz. Naturtdlti. l1Te are cerr lmtch interested ill health motivution. We :dreat's asl: how enn .vc moticato people to tarlce better care of tlumeelves aud the motil°ntional pspcholor'ists come uy with all kinds of ideas, but it alwal's comrs do.rn to rico fnctors. The two prinupal motivatin,, forces in mrr lifc appear to Ix> money and fcar. ]n thn cu>c, of prcventive medic.iuc, fau-, tmfortunatelv, often comhs too late, and so a kcy incentivc, obvioush-, nmst be ecmlosnie. It is for that n>}lsnn tliat in mh testimonv- I su'~"ested that we give ecouolnic inccntices to the lnanufacturcrs to produce prochicts low in tar and uicotinc. Senator ASoss. Talk about faar, have yon cn-er s.ern one of those.? Dr. n'rsnxa. Actuall)'. Senator Moss, as I said before. the fear componeut of motivating ueople to take better care of themselves unfoliatnatclv comcs too latt+. S rwnenlber as a young intern here in ]l'ashinlgton, I intcrvicviced 8enator 6andenberv, .vho ut that time mas dying from cancer and who- incidentallc, vvas a heivy cigli.r smolce.r. Ae vcus obvionsly afraid, like all of us are when IVe are abont to die. 1 have not really acen cet;v many patients die Ivho at that point are not afraid, but fear of illness comes too late. Therefore, in all of our adcertisinn, and all of orn' henlUr ealnpai;nn-be tllev a.eainst FI) or for seat bcll:;, tho fem' campair,nn ha.rdly vrorl:e. It is for this rc:uson thaa e-e emphnsiue thc necesaity for mana- gerial changcs of products. I a.ppeared before Congressman jVilbur Dtills' contmitee on the s:tme issue. If we a.re going to chanre the health scstem of our cotuttry. 1vu hace rot to hive '°P,rotvnie points" for stay-ing well. We must change our prodncts and chanl;'e our environrnent because by and la.rke people will not chanec-Nvell ingrained habits bN - themsel ces. Senator Moss. Zfiell. thlmk pon very mnch, Dr. FVynder. Senator Cook wilt probabl,y hav e somc questions. Senator Cook? Senator CooK. Thankyou, Mr. Chairman. I)r. Wynder, first of all, I think 5-ou sr~.,,ested what line of questionit.g I nught ask cou. But, I think you ere going to lro ~i~ron;;. - Many of the rv;marks thatt you made. in pour statement I think vou ought to be commended for. - Bnt in rcaard to smokinrr-health research funds, I s-ould like to read frorn aaI article in the C-iizcivm¢di Inquirei,. The 'Pobacco Institute has allocated ~5 million for caucer and bealth re- scarch for 1971. Tim brealcdon'n is 82.8 million for the Council for Tobacco He- search grants, $2 mlllion for the Aroerican Medical Aosociation F.ducational and Research Foundation. $400,000 for Washington IInivcrs,ity of St. Louip, the total Washington University grant is for $2 million over a G-year Ix.riod. By comparison, the American Cancer Society Las allocated a total of $1,3 million fo- such research in 1971, according to its Cancer Facts and Figures for that year of 1971. 'Phe II.S. Department of IIealth, Fducation, nnrl R'elrare has allocated $1.2 million for similar research. TI58461312
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1sQ The Department of Agriculture has allocated $3.2. The Lnirrrsty of Sen[nck,y is npenfling 92.6 million on tobuccoand health research, the pi'oGram lleing funAed through an inctease ill the state cigarrtte taa which went into effeet f n 1970. So I think we ou~jht to in all fairness; overcome the idca that all of their researc6 is to prove that they are right and lliat all of their resoarch is totally and completclv controlled rrsenrch. T Itace been critical of people from I1L11F ard from the Slur;_.reon Gencral's departtnent becaaise I n-onde,r wby there isn't sonm pub- licatimr of the rescau•clt that has been giveat by witnesses before thesc hearitg's. \mic of this appears ill their studies. 'Pbev start with the premise that it, is all wrong, and that there is not a safe cig arette. AVhat they really want, ill essearc.e. is prohibition. I don't think even the che~irman would disagree with M. Duval's testimony, or with the tcstimony of gentlemen from the Federal Trade Commission, that what they really want is prohibition. I would like to set the record straight because i think in many instances there is a failure on the part of tbose who feal that they are alrcady on the right track and don't want to go on any othcr track, and gain it olcur perspeetive of the total picture. For instance, I dorrt expect that anybody"s study got more publicity than yours on tar in mice, when you produced a remarkable figlue of cancerous growth of 44.3 percent. And yet no study since that timc has ever been abl.e to comc aoywlir-ra near that figure. No study by the College of Surgeons in England or anywhere else has been able to come any closer to a figure than from thrce to 5 percent. But these things are lmnl for HEIV to gct into its report. Now, we have S.71:i1 before its. It provides that the FTC shall set ts.r and nicotine nmcimnms, that, they shall review those every year. Tow, the FTC carne before us and said that they had no idea bow they could scientifically make this de.ternlination and that they necded the help of HP:«'. Well, I1E'.'r' had previously testilied before its that they weran't going_ to make such a determinat.ion and had no intention of malcing such it tertnination because they thought the only safe cigaretto was no cigarette and therefore, they wexen°t going to help anybedy ustablish such ligures because they weren't going to be a part of it. \ow, with your knowlcdgc and your expertise in this field, Doctor, just whafi direefiion dn vcc gn? 'Wlutt snggestion can cou n*ive this suhcounnitte.e to wmk out the problems that are inherent in 8.1454, when you have the multitude of departments of the Federal Gov- ernment that, are going to control and handle this thing, say, in elfeat, we dou't Imse the expcrtise and it is going to be itnpossible for ns to do it wiless SdFaY helps it,, and HE1V says, don't look to us because we are notoing to help you. Now, Iet's explore this, because, and this is the probletu that, ce have. had since thcse ]rearings started, I)r. 1M1rr.vrn~:r.. The first point you made related to the arnoant of monec spcnt by the tobacco indttstry. I pointod out in m,y Lcsti.urony TI58461313
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1S7 Dr. Wrsmu;. A't'e11, Dr. Hofmann and our sta1T at the Foundation are mntinually looking at new products that appear on the market. V['s haen test systems by which we test materials both for tlteir chemical composition and for biological ar,tivity. Studies in regard to cigars, little cigars, new tobacco prodncts, neti nontob;uco products, are in contimiing progress in our laboratory. Let me take tho opportunity to invite snymic of vou to come to our labo atoic to see the kind of work that we are doing, and the extent to which we are couimitted to the ptrobletn. l5'e hacc reported in the past that the smoking of cigars will result in a lower risk than cigurettes, primarily because of the difference in i nilizil rdion. iCe have demmistrated that in animals the carcinogenic act.ivity of cigar and pipe tobaccos was quite similar to that of ciga.rette.s. In- deed, thev contain higher tucotine levels, so they are more toxic to animals. But, the lower risk of cigar smokers cornpxred wit,h ciga- rette smokeis is related to the fact that cigar sntoker,, for the most part, do not inhalo. The reasons that cilgar snioke is not inhaled are thatt the niaotino content is reasonablv high. the Ph is also relatirely high, and ci;;ar tobarco, contain othcr types of alkaloid products wh ich make deep inhalation nnplcasant. Therefore, we have always stressed that cigar smoking was less jurious to health, with the exception of its rciatimiship to etmaer of the 1nontli. For catnc•er of the month, ihe risk auion-,, citar snokers is identical to that of cigarette smokers. But for n,outh cancer there is all :nlditional hnpa'tant variable. We itre workiu„ on other faretor~ such as heavy alcohol cousutnption and have demonstcated that the risk of mouth caneec is relatively small nnless more than secen shots of tirhiskuy are consmnud a day. This is a problcui I Nron't tackle todac: Wo liave gott enough problems with tobacco. On thee other hmnd, there are not, too many people ill this rowu mho would adunit to cousutnin,g seven shots of alcohol a day, which is a reminder of how di1T'icutt it sometimes is to take a good and mo;iuinrfal historv. I nns att•c trciuig to dr.uimnstrate how we take xt hi>torv. Nee asked a pat.ieut with cance.r of the esophagus "how oiuch alcohol do vou consume per dtiv?" and he replied "1o shots of whiekey." I said `is thaC all o" He said, "no, 1 also drink at night " (Laui~hter. ) - A"e have to be very careful in the ti~~ae we ask questions of our patiems, a.ud wu havc learned a great deal about how we ctui acoid s'c.h error". Rr,t to ,nsner e1Lo question aboirt c-igar smokin_, tlie um,jor dil"oreuccv brloceen ci'~ars, pipe~ and cigttrettes, lies in rorhwNhoc or not the-e produrts r.auho inhalcid. 13y and larlle. little cirars ha~~e reasonably higli tar lcvels, and 1 1 artietlntlv liirlt nirotine lex-el in an allrelhte Ph and theref:>re are not rcndily :nhulable. ?,ow, i-f senu~ne cvme along with a pror_lnr.t.chere the nicetir.c was ~erv looc, in spite of t;ie fact that it-t mav be in an alkaline media in flie 1<1.,t fow pr,±T:: of t1~e smoke, thcn the yneetion rcall,: is, is this stnoke rvndily inl.alad 1 ~ 7'lus is ti ]:ey question that 7 think necds to be invedihatedl I beliece that :uly product whidi cnuld be inhaled :u rciuGlv as a cigatette would be rnore similar to n, ribnretfie iu its hnrm fnl,elYucts than to a cigar. zr-0a~ ,.. 13 T158461310
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193 This chana'e applies more to some cigarettes than to others mrd tuda v eeitnin ri-Tarette( are les-. harrnful Urn n otlrer=.I wonldlike to sce all .lmeri-~ani srnokers smoking the le:rstt hd.rmfid cigarettc possible. In this line, rrury I sac that we s.re doing some exherimentation now with the Dep:uetment of 2kgriculture for whom we are cornpar- in-,, the cdiomical eonstitneuts ol ditFerent parts of tohacen p'anbs- the unper, lou-cr, and middle portion:r-and wc are finding distinct di 11'ermrcea, Genetic e.ueriments done h4t7ie Department of Ag'riciilture show other possibilities that may load to less hn,rmfiil products. titiltat I :uu rtreI ig i= that we 1Ltn•e tdree capacity, Senator Cook, to produce ecen less hat7nful produotn. One reason why we do relativelv we] 1 in otn-labma.torc is becauae my colleague, Dr. IlofTluann who has been Ncith rne for 1k yexirs, and I beliece th:t we have an urgent prolilem facine the hvelth of onr Nation, and that we can solve it. Four last question related to arriving at a specific level. lI was rendinnthe7bbarro Bepo~fei,, anrl Iiv as-- S - enator Coox. Senator 1'ross got a far better one frorn an organi- zation thatis a,n,ainst smoking. He got his picture in color, but mine .rasinblacl: and.rhilc, Ircallv feel second-rated. LLaughter.] Dr. lVrmue,x. It tiras cerv effecti "e. Senator Coos. Pr-rrbably yon feel that all Christmas wreaths should be ntadc out of tobacco stalks and tobacco should not even be nced for the, purpose of large, small orlittlc uigars. Dr. SVysumt. The pcoplc at the University of Kentucky are work- ing in this snme general area. Itt is my hope that we could collabo- arte more closely than we have in the past. I urge vou, in any way that you can to help us interchan.qe our information more openly nith the tobacco industr;v. This would be very welcome, becanse, n~ost tobactio chemists workine for the indnstry hesitate to exchange i.uformation, I don't know if this requires a law of Congress. I wish yon would sug,est it. Senator Coos. I get the feeling that some people below the Sur- geon General in the LTnited States that are in that research feel the Snme dcgrec of hesitancy that eou referred to, some of the chernists in the indnstsv. Dr. 1Frsrnts Tn the independent t•rnip of scientists, Senntor. 1rc work quite alosely together. The point is, there are not enough of us. I was cbairman of a conference on less harmfiil tobacco products in London a few months ago. There was verv ]ittle representation from industry. 'I'here aru also very few people in t,he independent scientific c,omnnmity who want to go into this type of research. You kuow, for eserv, sing~Le pcrson inrok-ed in tohaeT,o research, there are qe~-cral ]utndred people v.-ho want to study viruses and cancer. I dou't rea.lly know whV they don't want to enter this field, although it is a. diffieult areai and the chmnistrv is complicated. I wish that alyiong yoan=• people who listen to this testimony some would join us in our elTorts. Readin;, (lie( reports in the Tobnr-o Re.pni2er•--and I must say I enjoy readinr• this jomnal -L get alot of information, and in general thr rcports •.rr qnile balnnced. They are talking about. the tar and picoaine levels iir this coautrv. and tYiec indicate that, in regard to 20 mitlignuns of tnr and Y.9 of nicotinc that, ?ome 6o percent of all slmerie:an rigare.ttes now aold fall in this arrn. So it is acceptabLt. TI58461316
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198 Senator Moss. Very good. That, will be included in the record. I have no more qnestious, and I thank Senator Cook for his. I wanted to make one addition: Dr. DuVal of LIFIV wa.s quoted as saying that HliW had no intention of coming up with a- masi- mum leveL tls I understood Dr. DuVal's testimony, he testifies thatt he belioved, and the Surgcon General believed that there was no such thing as a safe ciQaretta, and therefore they didn't want to fix a position at which itt could be said that this is a safe cigarette. '1'he;y would rather leave it to thc acceptabiliby side as low as possible in tar and nicotine, and still have enough degree of acAxpta- bilit,v that it conld be marketcd. That is the reason that they felt that on the health side they shouldn't get into it. But the_v would leace it to the, FTC, which would determino the margin of acceptability and t.he,refore put it dowu to wherever it would be acceptable and not lower, because if it was driven too low in acer.ptability, then a blackmarl;e.t sets up. 1Vc11, of conrse, it is in the record. lt. speaks for itself. But that was my undrrstandinh of the, thrust of the testimony. Thank you very much, Dr. }Vynden As al.cays y on have been an escellent witness and very responsive.lVe appreciate it greatly. Senator 3loss. Senator Sherman Cooper of Kentucky wants to make a atatement. You may proceed. STATEMENT OF HON. JOHN SHERMAN COOPER, U.S. SENATOR FROM $ENTUC%Y Senator CtiorEn. Senator .lSoss and Senator Cook, I want to thnnk yon for the opportunity to appear before this suboonmiittee. I must say my statement is relatively short, and I do not attempt to get into the question in depth thatt is before us. But I do wa.nt to ra:se the question concerning the impracticability of the bill that is bofore ns, and also to raise some questions about the, ultunate an- thority of the, couumittee or the Congress to enac,t auch a bill. I opposo S. 1154, which would amend Section 3 of the Federal Cigarette Labeling and Advert.ising 1ct chiefly by providing to the FTC ruletnaking authority to esta6lish tnaximum permissiblc, levels in the tar and niwrthrc wntent of cigarettes. You may recall thatt when the issue of labeling cigarettes was be- fore this Senate in 1'JRG, I argued before this committee and on the SenaYe floor that the, Federal Trade Comruission does not have such rulemalcing authority unless the Congross specifically delegates euch authoritv to the commissioa. I think the Congress upheld that, argument. It prohibited the np- plication of such rules being promulgated by the commission for a specified period o1' time, until Congress had an opportunity to re- view the question. Congress then enacted legislation in two fields with which vr-e are all familiar. The first was the requirement that a warning label be printed on the cigarette package, and by later legislation the label was modifedto read as foLlows in its present form: "Warning: The Surgeon Cenera,l has determined that cigarette smol.-ing is dangerous to your health." 1 ~ i TI58461321
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201 To ;,,ive another example of the impracticabilil,y of this bill's ap- proach, I take the libortv of calling attention to Seatator Moss' state- nwrd, wbicb was quoted hy rn,v collcae~re, Senator Cook. ~lccordin~* to Senator Cook's statement, Senator Moss said on an edncetion,il tr.elej-ision II rot;rau,, ,°lhe A( 1- es, Xdu.n tslced Xrh.- it Niotild not be effective to reduce the alcoholic content in whiskey to 60 proof- tltc ansiscr: "Because if 60-proof whiskey wcre sold, 1I assumetliat two drirncs instoad of one would give the person the same result." It seems to me that, the same reasoning could be applied to a ta.r and nicotuio level for cigarettes-if such a level could be es-tablished. I think that you mitht ask a scientist or a researcher, that should such a lower level tar and nicotine be established, then by the same analogy ns in your example, wheeher smoking an additional nnmber of ciearettes would not achieve the same results of the higher level. Senator bloss. If I may interrupt just there. Dr. Wynder did ad- dress himself to that matter by pointing out that the cinarette com- panies have reduced the tar and nicotane content of cigarettes very drastieallp in the last 20 yeass, and the research indicated that pco- ple did not smoke more cigarettes by reason of t,ha.t reduction, so we have some hope that they wottldn't smoke two in the place of one. Okay. Senator Coori':n. I think it is trtto that filter cio-n.rettes and ciha- m,ttes of low tar and nicotine content are helpful to people who wish to rednce their smolcing in individual cases. But to give the impres- sion that. some arbitrary level is necessarily safer would be an illu- sion in the ti-crY odueational proce.bs that many are encouraging. In sc%.cral of our debates on the tobacco program, debates raised bv bills by Senator Moss and others to abolish the tobacco produc- tion control program, I have not heard any of the proponents of t6c;e ~~arious mezLsures advocate the prohibition of production, man- ufiicture and sale of cirarettes. In fact,, when thoy have spoken, as Senator -1{oss has, they have forthrinhtly said they were against prohibition. Vevertheless, the effect of these measures, beyond commun sense xnd practicability, nre ateps toward prohibition. This is a threat ogainst an industry wluch provides a living for thousands of farm families and workers. There are over 600,000 farm familiag growing tobacco. Over 150,000 live in my State. Over 510 billion is paid by the consumer of whiclr over $} billion is paid to Federal, State, and local govern- ments in taxes. Only about 25 percent of the total paid for tobacco is received by the farmers. As T have said above, noae cf those who propose con- trols of varions forms ou cinarette advertising and smoking advocate prohibition of the production, manufacture, and use of cigarette to- bacco. Bnt these rarion, rneasm•es which are proposed impose some kind of prohibition upon individnu.ls. For example, cigarotte snickers denied cigarehtes of certain levels of tar and nicotine properties after boina made aware of the infor- mation provided by the Labeling Act, that tltey may be harmful to use, still may desire to snol:e a particular cigarette. If another pro- vision of tlns bill should be followed, the yearly reduction of levels T158461324
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190 Tn 14,)7D, Cojt;,~ress enacted additional legislation makin~ it unla~c- fnL to advertisecigarettes by telerision or radio broactc_aqing aCter .lauuarv ] 1971. fiiw bill, S. 1-4G4, itscll', reco, ~nir_es that tile F'1'C dn,- not lra',-e rule.makinn uztlhority to determine acecptablc letels of tat', ntcotme,, :rnd othcr incriminated abe.nts in cioarettes. ihe- question then arises as to whatt is tcmn.- with ~. 1I6;1 which Nvould provide to the FTC this additional anthority. I httee read ite staturne.nt of 111r. 1Lobert Pitofs:y, direc+tor, Bn- resu of Consumer Protection of tlte FTC, before this subcmmnlttec. and itt appears to me that he ]nts made Very good areuments against this bill. First, it is correct that the FTC has not asked for tile authority to se_t twceptablc levels of tar and nicotine in cit;arettes. F.econd, R'Ir. Pitolslcy made it clear that the FTC has no stafP with t]e expertise to establi>h such ]evnls7 if, indeed, they are at all possi- ble to establish. I am very glad that I vcas here when Dr. IVynder was testifying, because it secans to me that part of his statcment indicates the dffi- cnlty, the expertise and t6e time required to make such a determina- tion. Third, even based on the hypothesis of the controvetsial health issue, Mr. Pitofsk}- pointed out that to establish arbitrarily levels of tar and nicotine could lead a cigarette snloker to believe that smok- ing of cigarettes below these levels would not irupair ]realth. I Loint ont thnt it would be ae diflicnlt to establish or provrthat there is a direct ca.nso.-and-efl'ect relationship between certain levels of tn.r and nicotine as to determine the issue of srnokin, and health whiclr we know his been the subject, of years of scientific research resnlting in aurflictinc* claims even to this day. AIr. Pitofsky pointed out .e trovision of the bill which, if one ac- cepted the hypothesis of Senator D7oss' bill, would in eiTect. nnllif,y the bill. '17tat is if the establi,hment of standards would not meet, public acceptabilitp and lherefore resnlted in crcating a market for the illicit salee and plnrhase of si},mificant qnautities of ci_t,rarettes, then the standards H°ould Ila.e to be abrorated. I:;crI no point in the bill. if yon say it is necessary to establish t6ese levels, t.hen if the public wotrt accept these levels, no matter tvhat the d.ulrer to heriltli may be, then the bill would luece no e$'ect. I point up these matters to indicate the contradictions and there- fore the impracticabilities of the bill itself. As 1 have noted aboce,, the controversy over the cansal relationship between smokinr and Lealth eqntiunes, and it would certainlv be irrore difficult to establish acceptable limits of tar and nicotine content. I think at this point, to -,,ire you my own attitude, I made a state- mont on the floor of tlte Senate, on March 10, 1970, which expressed my view then and expresses my view today. I know that all of us aro concernefl about these health problems. nte people of niy 2tnte nre coneerned becnuee of their Lirge investment in the tobaeco in- dustry. mid their concern about health. b7fPorts are being made in my State at the Dnivcrsity of Eentucltiv, and through research by the tobacco industry, as n'ell an many great scientiets throughout the country to determine the truth orP:rlsity nf tilo otairns of the relationship of Lobacco to ]realth. TI58461322
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206 The cmntact of the, hydrocarbon, benzpy-rene, with lung tissae involves a completely ditterent system than the contact of benzpyr- ene with the skin of the back of a mouse. I fear that nll views are not being presanted-thnre is an apparent sed;irvg for unanimity tihere unanimity doe= oot exist. Those, whose views are not fairly reflected may be intimidated- tLiose..cha have no vieas may bc misled. Sirs, I am an eNperirnentalist. Over a period of time I have learned to rely much more upon the results of good reseiireh than :ury interpretations and impltcations that a nonexperimentalist tnakes. T have a plea, one I have made bc~fore. Why cannot the Senate. committee insist upon good, sophisticated, research once and for a1L Whv not insist that before vast sums of money are spent for research that the protocols for major projects he available for seient.ific scrutiny, evaluations and constructive Sugaerqtions. '1'~Ficre arc man,y- scientists who can set up criteria for good research. We have the manpower and technology to carry out such research. In the field of cigarette tobacco research, we must insist• that the work be condneted so as to simulat.e, as closely as we can, the human experience. It is essential to know the source of any compound said to be identified. Was it obtained from tJie leaf, the smoke as a whole, the ga,seous phasc~ the particulate matter, or the condensate? tiice should~lurow the chemical or instrumental method used to detect and identify that material. Once chemicals are identified, the biological experiments rnust be conducted. Listing a group of chemicals tells us nothing-absolutely nothing-about biological clCects. Identification is not implicution. We must do individual biological eval-aations and then evaluate the chemicals in groups of two or more. Without this, we can have no understanding of their significance, or larkof yigni[icauc. Wo must always keep in u.ind: Was the human experience dupli- caInd? I am not going to be al] negative. I recognize that much has been done in the experimental field under discussion. tiYc know a good deal now about the state of the art on inhalation. We are aware of the need for the further development of good auimal models. The phurmacology of nic•nt•ine is being investigated. Biochemical phartuacology, behavioral pharmacology, and stress faetors (yes, the emotional makeup of animals can influence resrilts), arc al] anderiuvestigad:imr. Biochmnists; biostat,istiuians, and other•s are seeking answers. It is encouratiing that sc,ientists, including those from government and tobacco companies, maintain liaison under Dr. (sio Uori's direc- tion. I think that is very good. TI58461329
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205 -1nd this refusal, by the way, was not mentioned in the 19i1 report. Since beagle do}s do get hwg cancer spontancously, a discussion of this faot would hnve been useful to readcrs interested in evalnat- in g the Auerbac] r.vom-k. 1'o (to anc a.nimal experimentation which has meaning requires a great deal of sophistication. It is no longer acceptnble to comluct research xrithmrt regard to the parameters that can be measurcd when a human smokes a cigarette. In in, section of the A.P.G. symposium, series 18 Tnhalation Car- cinogenesis. I delineated the minimum criteria which must be met if a u,n,arette inhalation ehperiment can be considered meaningful. The syauposiunr was in 1970 but the criteria are nott mentioned ui either the 1971 or 1972 reports. Without meaninhfnI inhalation oxperiments, it is premature to assign siguificiuice to any ingredient or group of ingi•ediente reported to bee present in cigarette smoke. In chapter 9 of the 1972 Surgeon General's report, I find a list of ehemicals. I also find judgnents about these chemicals conched in such terms as: which mnS lie, which probably, snspected contribu- tion, potentially hartnful, may interact, might be. The.re are too many unanswered questions to make this chapter at all useful, a nd where is the supportive research ? If I may ask a simple question at the moment, where is the report of this mecting? I cannot find it in the literature. (This was a 1-day meeting which was abstracted for the information given in chapter 9.) I would like to read it aaid read verbatim, what had taken place. I have not been able to find a repnrb ou this. 1Vlay I next diacuss, witi reference to research, at specific gas, nickel carbonyl ? Sonie years ago the Doctor Sunderman postulated that this gas couldbe formed in the main sta•emn smoke of cigarettes. That was in 19si. in 196t5 1 wrote a published objection to this on chemical grolmds whic•.h has never been rebutted. The staitr,ment continues to be made, however, that this gus doca esist in e.iaarettv. smoke. A positive statement, whether correct or not, is somehow move appealing. Negative reports that something has not been found-iu• does not seem related to something else--make little impact. More is now being published on nickel carbonyl and how it inhib- its enzymes. This may be interesting to nickel researcher, but it has no application to cigarettes. tiVhy, at this late date, is t,he Snndermans' theory still being cited in the Surgeon General's annual reports without reservation? 14nch is being made of the fact that bcuzpvrene has been found in vei.y minute quantities in tobacco condensate or in the smoke. Dr. Harry Gelboin of the National Cancer Institute has written some outstauding papers on the metabolism and deactivation of benzpyrene by enzymes induced in various body tissues and organs. Whv is his work not diroussed in the reports? TI58461328
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204 As a research consultant to the Council for Tobacco Research- U.S.A.. I review proposals for funding, particularly those requiring the analysis of experimental design. -1It, n:ork in cunccr research began in Id-47 and my interest is a continning one For ex:tmple, last week I gave three papers covering my experi- mental work at the annual meeting of the Western Pha.rmacology' SocietY and my paper for the American Association for Cancer Research mecting in llfay has been accepted. I hacr_ published a nnmber of scientific papers on various aupccts of cancer. These include pnblications in all major journals dealing with cancer chemotherapy, cancer biology, biochemistry of cancer and mathematical models. I am uow engaged in experimental c.arcinob nesis, vvhich involves learning mere about tho geneSis-be~,*inning-of carcinoma-cancer. All of this has helped lead to my developing new techniques, intrndnrin~ new approachea, and suggesting new hypotheses. I believe~I am one of the very few scientists in the conntry who has read nearly everv scientific reference related to cancer tlia.t is cited in the ammal,Surgeon General reports. I have aLo reviewed the majority of other references set out in those publications. I am bothered by these reports. They.give only one side of the problem. The apparent selection of material reinforces only one point of view. I am espeoially bothered by the omissions-why the omissions? As a nitizon I feel the Dfembers of Conqress should have all infoi•- mation available. _11v basic interest has been in the experimental induction of cmtcer. I have followed the reporrted literature on tobacco smoke and smokc condeneates and have myself experimented with tobacco smoke. Some years ago I constructed smoking machines to evaluate the effect of cigarette smoke ou aninmals. After many long and frustrating years, 1I reevaluated my research and all otlror publiskhed Nrork in the field. I concluded that all of Llie work, including our own, was estremcly primitive. Only in the last couple of cears have scientists been able to apprcaiato the real difficulty of doing tobacco smoke inhalation experiments. I also concluded that while we have been able to induce lung cancer in animals by the inhalation of various substances, we have not been able to do this using tob.acco smoke. In the M1 Surgeon General's report I read with interest the account of the Auerbach beagle dog experiment. I asked myself. why was theree no exnphasis on the fact that the dogs reneived the snol.-e through a tracheostoma? This in no way rescrnbles inmnan smoking, and unless the pictures I have seen are wrong. the smoke was initially forced into the lungs through the trachca by use of a pump. This esperiunent has no meaning in relation to the human experi- ence and any reports of tutnors should be considered in light of thc fact that thc experimental data was not made available to an inde- pendent panel for evaluation, as requested. . TI58461327
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I think we urorlld al] be happS to learn the U'uth of falsity of the rlaim made against cigarettes. I do not know. I do not think any of us know. From the research vieHpoint three tests have been reuwgnized: One is statistical as- siciation. which was the chief bnsis on which the Surgeon (3e,neraPe rep~rt was made bnt is not conclusive; the second test is idcutifiealion of the agent whic-h caneea the diseaGe, and it is known that research has not been able to identif, such an agent I and the third test is the ability to pruduce the disease in hnman hebi,GS. 'Phis has not been accomplished to my knowledge. I knew the work the committee has done on this matter and the efforts of everyone to try to solvee this problem. I support the bill. But this act is to inform St can- not le°islate the cause of disease. Only qualified scientisls and objective re- scureh will finally snlve this issne. Reading the statement of Dr. 11Telvin J. DuVal, assistant. secretary for Healtlr, Scientific All'airs, Department of HEIV, before this sub- committee. on February 1, 1972, I note his interesting comment that despite all the research that has been done, and as I said, I am not a scientist, that no Grm conclusions have been reached. IIe comments on the chapter of the 1972 report t.hat is rrwst pcr- tineut this yoar, and deals with the harmfitl constituents of oip;a- rette smoke. Iie lists an array of compounds. The first compounds listed are those jndoed most likely to contribute to the health hazard of smoking, carbon rnonoxide, nicotine and tar, bhc last being after nicotino end moistln•o have been removed. The second series comprise a total of six substanees judged as probable-and I emphasiz,e the word probabte--contributors for the health hazard in smoking. Xnd, finally, the third series comprises a larger number of com- pounds judged as suspected-I emphasize suspected-a;ontribld'.ors to health hazards 9n Srnoking. That was tbe statement of the seeretary in the Department of IiliV`v which does have staff and expertise in trying to determine thess issues, but the words he uses are certaililv not conclusive. The Cigarette Labelin- Act passed by t.he Congress, and I voted for it, provides to consucners information that in the view of the Conhress, is proper. Manv do not believe that it is a correct st.ate- rnent and that the hazards ilave not been proved, but nevertheless Congress enacted this legislation to provide information to the public. The cigarette manufacturery have voluntarily taken the fol~owing steps: In the fall of J970, the cigarette industry volnntarily agreed to list the tar and nicotine contents in all its ciaarette advertising, and this is tbe aurre.nt practice. Any smoker can easily compare the tar and nicotine contents of the various brands and take this factor into consideration about smokin,,,. Second, in t.Le past few weeks, t;le cigarette industry has agreed to carry the warlung label which now appears on all oigarette pack- ages in a black box in all its newspapors, magazine and billboard advertising. As I am infornied, the P'TC has not yet finally agreed upon these voluntu•_v consent orders. But the fact that thcv have been worked out witlt the Commission and the fact that the industry has cooper- ated with the Comrniasiou itt developing these consent orders, would indirethc. that the Commission considers tlrem of value and that they will he accepted. This is a further example of the industry's cooper- ation in providing broad information to the public. TI58461323
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19 1 thut these '~14 nrillion that hnve been spont since 1954, _ropresent a tremendons efFort in ternis of total c~penditnre. IFhat 7 pointed out, lrowever. artd I arn rcllect.in5 disenssions I had rvitJr seieutiGc dire.rioms of a nnmber of tobacco companics--mu that even they volrmtcered that tl:ey thom„ht these monevs could have becn spent rnorc w-isclc. And perhaps you, sir, might want to look into this. If tho money wus spent by people who believed they had a probleny on research that was not moving into mearungless direction, but rather rclatel dircetly to this probleni fhon lhis motrey conld undoubtedly hat•e been spent in ti better faslriou. Nmtator ("oorc. But Doctor, you arc not rcally sr.~•iiyq that :ome of the v=.ientists :urd =.ome of tlre doctors and xcse:udr institntes that hrwe been working on this problem, that you are familiar .vith, nrc absolutely slanting their rescarch to satisfy the requirements of the grant? I)r. AVYNner,. I am not saying thxt some of the work that rsus donn was not very good. All I am saying, and I think I nrn reflecting the opinion of most of t,he scientific directors of the tobacco industry, thsrt they thouglit that at least a portion of these funds could hace been spentt more productively. _A"eXty lmu referred to a reportt that we made in 19is3 where we reported 44 percent tttmors in mice. Notc, it is this kiud of thing whiclr 1 personally would not hace brought np nryself, but since you brought it rqr-- Senator Coort. You alluded to it in your presentation. Dr. ZYzvnnrz. Right. Senakor Coort. That is the only reoson that I sngqested it. Dr. WTNUr.k. Yes. This lurdina' has been repeatedly alluded to by the tobacco in- dnstrv, and since cou raised it, let me g-ire you a brief explanation. 6en:dor Coorc. All t'ight. Dr. Nrsnr:r,. ljte reported a dose respotvse to the ammmt of tar 17int we zcpplied to auiuntls. Now-, specifieall,y, it was stated that Dr. Passey had reported only a very few tumors in bis 1962 study. Now, Dr. Passey was a aoed investigator and a very good friend of mine. l.n this particulttr etttdy, hotcever, he applied tobneco tar with x rlass rod, in low concentratiory to tlrc unshaven slcin of mice. 'I'here is no question that as the dosage of tar applied to animals i: lou-ered, we get a lomer responsc in terms of tumors. So even in 1953 , if insterd of painting .50 percent tar solntion, we had applied n]0 or 5 or 3 percent solutions, we wonld also havee gotten a lowcr responne in terms of tumors. So the difference in the results relates to the amount of material applied to the skin. Another point that the tobacco industry has f:riled to stress is that in subsequent yea.rs, we have reported a con- tinning deTrease in mmmber of tumors that we obtained with nnimals with tar obtained from tbe same brands of cigarettes bought over- ihc-counter. Rt other words, t}ro report in ]9:i3 was based upon tobaccos that ccere produced in 194'.), 1950 or 1951, r-h[vr ehey were far higher in tur rnntent than tiiey are today. TI58461314
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196 one snall cigar hhat has beea) prodncec] which is called Between the tlcts, a,nd 1 think thaL cigar has been on the market for over 50 years. The same small cigar with the saine type of wrapper, the sa)ne alkaline cigar type. I heard a few pcople snicker in the audieneee about, here is another attetapt to get into the market. There have been cicats in this tnarl.cC for many, mrny years. You are aware of this, are you uot? Dr. «rSnt:R. Yes. Senator Coox. But the. point I am trvin~; to make is that here is an arr;ument of try'in,~, to say that a little cigar is now trying to get into the ciearette market because the pressure is on the ci_arette rnarket, and yet we kno.c that this product has been in existence and on the market place for many, many, many yeara. Is that not true? Now, as far as thee alkaline content of these, hace You made any research studies on the ¢tlkalinee content of sntall cigars S~ Dr. WYNDER. Yes. Senator Coos. Could You putt this in the record so that we can see it@ _lre they by brand8' Dr. Z1YyNniR. We ltave looked into this, and as I indicated, Dr. Hotfmann and his staff att the Anlerican Health Foundation are looking into it further. And -xe, of course, ask ourselces what is the definition of a, little cigar and to Nvhat extent is it different from a cigarette. I mentioned that from a point of view of epidemiology, they are re•ally different, aas it is related to whether or not tte prod- ttct could he inhaled. If You take a product that has an excess of 2 milligrams of nico- tine, only the tonrhest smoker can really inhale it. It is up to ~~ou gentlcmen to decide what really is the definition of a cigar, or little cigar. Is it sufficient to just say it is wrapped in a cigar wrapper, or should other parameters be used? Senator Coox. P>ot if you make the test that it is inhalable, that it has got to be considered as a cigarette, I have got to tell You I know some tanyh souls that even inhale dark Certified Bonds. I don't know how they get away with it. If this is going to be a basis, that we have got sontee gentlemen in here that hare pipes in their mouths right now, and they can't tell me that every once in awhile they don't inhale that tobacco smoke, beaause they da. Dr. Wrr-nRx. Senator Cook, I have also known some tough souls who can inhale deeply a bir cigar. The question is: What will the majority of people be able to do? I am 7nst raising this as a question. But it seems to me that thee cigar industry itself has got to ask this question, because as You know they stressed in smne advertising campaigns that you do not need to inhale cigar stnoke to enjoy it. Senator COOK. You inean it has got to look like a cigar? Dr. 1VYVnna. Alrell, I am not really so much concerned whether it looks like a r,igar. I asn concerned whether or not individuals can inhale it deeply. The.re are different depths of inhalaticn. You emi brin{z i1 to your throat or You can inhale it deeply. TI58461319
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202 of tar and nic,ot,ine if pursued to zero, or near-zero, prohibition on cigarettes for aLl prar,ticable purposes would have been achieved. You would end up by smoking hot a,ir. I do not think there is suty le!,al authority for prohibition to be ar]iirved by indirection as this bill proposes. 1 have not voted against any acty or any bill which proridcs full information to the consimior of ciharettes or to cil,*arette smokers re- ,qardiiii; possible hazards to health, and I have no objection to sucb information as lon_r ns the information directed by the heder,il Trade Commiseion or the Congre_s: is itself hone.stt and b>ved on Fict. Bnt I do oppose strongly the.se bi11s which attempt to control the choices of individuals aud could re5iilt in the prohihitton or use of a comruodity without leo~al or constitutional authority to do so. I think we should recodnize that following the example of the prohibition of liquor, that such prohibition could only be done by constitutional ame.ndment. I would say that in essence, the. committee is following this course, and if it came to the logical conclusion, it would be for the prohibi- tion of this one commodity. I point out. again, that this comniittee and the Congress embarked upon the course of gi.ving the fullest information it could to one who smoked cigarettes, and now this bill, with its inconsistencies and imprac;ticabilities and contradictions,.is embarking upon another course, that of prohibition. Senator Moss. Thank you, Senator. I appreciate your statement. You haee discussed the problem very well. We are glad to have yom• views in the record. I do think we have cotne a long way in giving informat.iovi to the consumers and relieving-what appeared to the Congress to be-es- cessive cigarette advertising on television. Some vvitnesses have testi- fied that cigarettes are now mttch lower in tar and nicotinee content than they used to bc, and Filters vvhich haze a beaieficial cil'ect haVc become the prepondmant item in the ciparette industry, so there bas been a lot of progress made. The one, thing t.liat I think I should point out is tha.t in an at- tempt not to go to prohibition, the bill does provide that the level of acceptability must be considered by the P'TC, and presumabll- therc is a level at which people that like to smoke would stop smoking , be- c.ause the level became too low, and as you say, it became hot. air. But the idea of the bill is to try to get the tar and nicotinc level do.rn a, far a, . tAe can before we cross that hhresbold where, it is ttn- acceprtable and not marketable and the black market would groav np in cigarettes. That is a hard line to talk abont, lLavbe it n•ill be mo fully ~hard to find, but at least it would assure us tha.t we .von't go to total prohibition on cirarettes. Senator CoorEa. I nndcrstand, I believe that section afone sions the irnpracticability and the contradiction of the bill. Thank You all very mucb. ~Senator Moss. Any qnestions of yonr colleague, Senator Cook @ Senator Cooic. Senator, I only want to add to what you said, when Mr. Pitofsky said thev would have to be a.dmaated. During the qnestionina period, I asked him what that degree of acceptatiility would then be, and he said it would be the consumer acceptability, TI58461325
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19i I think the cigar industry has benefited to some extent from the evideuce agauust cigarettes and should help in setting the parmneters for defining ci"srs. One of the tbin--s that need to be. considered is that, if you come along with a smol:in;,g product that is inhalable and it becomes so snccr.ssful that other rinars can't compete agaimst it, the mannfaottu'- ers will reenrrineer thn.ic products so they a7so will become vihalable. This to me is a key question. The cigar industry should ponder on it. Cer.ator Cooic. Aren't we really saying in these hearings, abmtt the indictabilitv of tho ~~'inohester is that they look like a eigarette and therefore we. shorild rihange it so they don't look like a cigarette. And if we make it lool: difCerent, then nobody is going to inhale it because we makee it look dilPerent. Isn't this what we are really gett.ing at? Dr. R'rrunn. It may look lilce a cigarette. If you take an H:i-milli- meter produet and wrap it iu a eigar type of cover, how the public responds depends in part on the advcrtising campait,rzr. Cenator Coor. lFe turn r.hat around and make cigarettes that look like Tiparillos and go right back on the market and go right back to advertisinrr and say this is a cigar. But thezt everybody is going to find out pretty socl 4hnt it is~nothing bnt a long cigtirotto and tn- hale it', all hhey want to? . Dr. Wrrvuunz YmU hai-e a dileurma here because the law whiclr you passed sper.ifically relaten to cigarettes and exempts cigars. I wil l suggest that you form a committee that includes member.hip of the tobacco indusGry, including the cigar industry, to answer this particular question. Our dnta sug eest that this partimilar product has been spccilically desinned to be similnr to cigars in view of its 1,11 and in view of the type of tobacco it has. But. it has also been specifically designted to keep the tar and nicotine mmsnallv low, to kecp_ other alkaloids unu- stnlly low, so that this product ctui be inhaled. Smiator Ooorc. But have yon taken some of the other cigars such as Tijuana Smalls, Tiparillos, you name them, tltorre are all kinds of therrr. Have von run the same tests ou those and found that the tar and nieobine~is here, or eqnivalent to? Dr. lj't-snr.a. Yes, sir. Senator Ooos. -11av we have those figures for the record? I)r. 1i%rvurar. tiCell, we are testing a few. IVe can test sorne more. But in general you can aay, and I think the gentlemen of the little cigar industry can certainly give further data, that in most little cigars the nicotine content is abrive 2 millihrams. Scmrtnr Ooor;. But what I am trying to Fay is that this line of qnestioning wns startnd by tho chairma.n, and what I want is, if you have got any information on the research that you have. already done so far, that you can pnt into this record with no problems whatsoever. I think it is n.lnable to this record and 1 think it ought to be in it. I1r. Aj'r.nrr li'e are glad to submit to you what we have alrendy done. Senator Comc. Tlmnk you. T158461320
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210 large number of grant requests, it appears to him that a lot of scien- tists believe, the information on smoking and health is not conclu- sive, and therefore that would seem to negate this statement that becanse t,he problmns have already been solved, or they have hee.n told that itt is solved, that none of them want to go into research. Isn't thcre a coiil:radictiort there? 7)r_ FttnsT. lpparently, yes, Senator. What. 7 am saying is that-well, I should say this: The number of grant requests does not mean necessarily all these grants are funded. Thero is rcally a grea.t discrepancy there. A number of men do ausner quustiais. I am not thinking of the 5 or 10 requests that conie ttp, I arn thinking of maybe 50 or 100 ought to he in this field. So, it is a matter of quant:tative difference. I am not saying ereryone is intimidated. I am not sayin' that everybody is staying away. I:un saying tttat manv are staying away. A few are conurg in, but in my mind not nctirly eiough. Seiurtor lbloss. Well, I am, of course, quite concerned about the qne,tious raised about the, Surgeon General's report. If I interpret it rrght, whcn you m:tide some additional comments, you spoke about some mectin,q. and you said you corildrrt find any record of the mcctiui, and y ou wonderod whether the meotin« occurred. This, it seems to me, is a. very strange indictment to be leveling aguinzt the report published officially by the Surgeon General. 1)r. Fur.sm. We11, sit•; if I left that implic.ation, I apologize. I did not mean to say that the meeting did not occur. I think I was objecting to the fact that the publication of that meeting is not availablc. I can not find, shalll we say, ttte detailed report of that mcctiu~~. I find a resume of it in the Surgeon General's report on cbapter 9, and I think I was referring to the fact that I would like to rcad the proceedings myself. _llal-be it is publisGed, maybe I missed it. I don't lmow, but I didn't mean to imply it nas nat there. Senator bfoss. Do you fecl that there would be a verbatim tran- script taken of all tho.t went ou at the meeting so a sumn>ary would not snffiee'! - Dr. Fr-usl'. tiomething as important a's this, I feel we should know what was said, what details were given out. A short summary, even wikh a number of references, to me, is not adequate, no. Smtator DLoss. Do you charge than tha,t tlie Surgeon General's report is slanted and ~that counter evidence luis been eliminated or suppressed? Dr. FunsT. Sir, I belicve the term suppression is a little bit too strong. 7 ou know, a person gets over zealous, and lie can be pushing a point and ma}~be in his rnind (or whoever helped him in the writ- ing, in tlieir minds), these other things arennimportant. I snbmit Dr. tlelhoin's work is extremely important. There is no discussion of it. I submit the fact, ar*ain, if I may be personal, that lchen I expressed a doubt, clmmically, that nickel carbonyl cotild exist in the main-streant smoke of cigarettes, nothing was sai.d about that. In the Gatlingbnn, Conference on Inhalation Carcinogenicies, there was a. list of certain ingredients in smoke, which are supposed to be very bad, and there is a statement made that nickel carbonyl exlstF. TI58461333
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192 ln the jonrnal, Science, turd in the Journal of the A-nericn.n 11lcdi- eal Associ:u.ron, Dr. Iloffmarut iwrd I have reported ou how we have been gettrn~~ fewer t.nnors in recent years. It has also bcen sucgested tkrat we have given no explanation for this. That i; not correc.t. Wn pointed out that in these years the benrpvreue cnntent, as one indicator, had fallen. The reason we believe is that we are growing tobaccos that are, lower in tar yield than ?0 rcars ako. We lrave stated that not only is the tar content of our cigarettes lower, but the tar collstituents are also diff"erent on a gram to graln level. This is ti•ery Lnporttrnt since we slrowed when we applied a 50 per- cent ta.r/aeetone solution, we got significantly fewer tumors than Fve got 20 years ago. Srn^tor Coon. Bnt at the same time you got significantly fewer tumors, did yon rnal>e a total analysis of tile tar that yon got by reason of the chill tunnel so that you corild make a determination wbether there had been this tremendous decrease? In other words, did you make an analysis of the original experi- ment in 1953 so that you oonld tell the tar and nicotine content as opposed_to that that, has been Itsvd since? Dr.IlSSnnR. Yee. ObN °iolusly, Senator Cook, iI we get a 59 perceut reduction in tar ti.nd nicotiue level, we must have a different tobacco product, because this reduction is only partially due to filtration, because we also got a reduction in nonfilter cigarettes. What has happened? The tobacco industry began to use reconstituted tobaccos. They began to put more stems in their ci,qaret.tes, which from our point of view lui.d two beucfits. Both of these products lower the tar yield, and wo and others have shown that if you ma]<e cigarettes wholly of tile reconstituted tobacco, you reduce the completa carcinogenic activity of the result- ing tar. Senator Coor.. Let's tako that equation, because. I think that is verv intrresting. Bccausc what you aro saying is, let's say they reduced it., and use the fignre lb percent, woll, the roduetion in the e.~pc.rimeuts from your original 1953 experiment, to the sixties, or the late, sixties experiments, that came up with figures of 3 to 5 per- cent, does not show a 50 percent decrease, but shows a 12 to 14 per- cent decrea,e. Dr. tiC'vsnsx. It does not go quit.e thah low in our experiment. It gocs to 20 percent. We were the first ones to stress that we had a difTerent tobacco product in the 19g0's than we had in the 1950's, because of tile resr nnse of the animals. In addition we showed that the chelnical constituents differ. I"sing beuzpyrene as rtn indicator, it came to 1.2 harts per million. But we are now rtmnin-, 11.8 or 0.0 parts per million, which is a. reflection, in nry view, of the greater eominrstibility of the product. I guess vou know, my colleagnes aud i have spent tho las6 20 years dctermininm that carcinogenic fnetors in tobacco ha.r and how we can re.dnce them. We have published our reports. The tobacco industry may not hava given n.s accolades, but tlmy used our sui;ges- tions iu reengineering the product. So on a gram to-grain hasis vice have a positive change. TI58461315
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203 and we would ha.ct to n-~itt tliat lecel. And so if t.hey set it at 20 and the consurnc.r .cmtted 's or "-~, they would irnmcdiately xbrogate Iheir stand u•ds and t;o to or 34. So 7 can onh* say that whn( hou are sayin~z is indeed a facl, and I mi;;Lt add, 5cazator, that although it has been said by 1)r. l~'i~ndaand mnny other people aud the chnixJnmr repeatedlS, thnt cigorrottes have coirv+ down tremendons.lv in tar and n9cotine, those statistics ha.e not appeared in any of the Surbeon ElenersrPs reports, nor have dre.~• appearcd by trqyhody wbo hns testified i-et here to put iuto the record the decrease in tar and nlcobine other than the one cbart that was s(iven by Dr. Wcnder today, tind that indicated no pa.rticiilar brand of cillarette, no particular industry, as a particular corpora- tion that is in the production of cigarettes, and we have no knowl- edge of larowing whether one. particiilnr brand is pielced out or whether an analysis was done of alt brands to make a determination of whether in fact this is rcally re.ality. ~'enntor Coornrz. Thank yon cery rnneh. Senator Moss. Thank yory Senator Cooper. Senator Moss. Our next witness is Dr. Arthur Furst. director, Tnstitnte of CJreanica.l 13io1ogy, 1'uiversilV of San Francisco. S`"e are glad to haae yon, Dr. Furst. Wil l,you proceed 3 STATEMENT OF DR. ARTHUR FURST, DIRECTOR, INSTITUTE OF CHEMICAL BIOLCGY, UNIVERSITY OF SAN FRANCISCO, SAN FRANCISCO, CALIF. Pr. FcrsT. 'Pha nlz cnu..:ir. Senator llos.<. We nre pleased to lncce von, sir, and we note your record and baclcnrmmd. Ii'e loolc farn-ard to yorntestimony. T)r. 1ntsit I appre.ciate that. Ser:nt.or Vfoss, Soiiutor Coolc. Semrtor Ba.l:e, : I am Dr. artlnn1<iast, clirector of tho . Tnstitnte of (`hemiJ ~al Biol- o9s and professor of chonristry at tlre Unirersitr of 5;nt Francis~•o. DIy baclc~"ronnd is as follorrs: I received my'barhelor's and mas- tor's degic.c4 in chen istr.N from the T,niwr=ity of Califoi n'.a at Lo: .>vigeles. I was awarded a Ph. I). dearee in chernistrti- by Sta.uford lFnirer- sim My cnrrienlnm eitne_, which is attached, hns been brottght np to date since the last lime I appeared before a conrr.-;Omal conuditee. Tlna was in April lfltiD, rr°hen I te:tificd on Ore 7.rctte Laibel- ing t.nd Advert.isint bill. Parentheticaily, mttii° I aalc permissi,on to piee you my list of pub- 1 iea.tions ich ich ia not appmrded hera T shall scard those in. Senator Moss. That will be included in the record 1'olloocing }-otlr st dLtCfnent. Dr. Frrr.sr. I.eppreciirte it. Tharlk yon. Since that appearance, I have published ocer 25 additional arti- <les, bringn g me tot tl Trnlilicatrons to nbout 1S]. Ihavc eavcd as a clinical professor at the Collere of Phtsicians and qureeons of Cohunbis IInicer;ity for a rear. been appointed srn tempora.ry consultant to the jSrortd Health (h'ganiration and am to he listed in lVho%s tiVho in America, 1972 edition. ~j-ora- -~_-r3 TI58461326
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211 On page 180 of the irilnalation carcinogenesis confcrcnec, the one I mentioned in mc tallc, there is a stntement lmrn that "nic]<ei letra.- carhony] +p0 is present in cigarettes. Ion see, in 196,3, 1 said it cannot be, and i feel that there is sornc bias, because if they had said, weil, Dr. Sumierman said it is poshr L•rted, and Dr, Fttrst doubts tlrat} bnt ire think iC is prex:nt. To simply say posrfiively' that timle it rs, sr'ithout rwy statement flrtt thorc mxy he a donbt, I thin};, sir, is biased. Senator 111oss. 1M1?lhV do you think this has pcrsisted throngh sec- cral surgeons general who hace preceded ono another and certainly through several administrations as far as the top politieal stnrcluro of the depxrtmmrt is concerned@ Wh~ has this bias continued8 Dr.~Fcrsr. SWell, it is very dil#'iciilt for me to get into somebody else's mind, but I do feel that the people wlro are in this field, who write the reports. feel the importsurce of: °ci~arettca are so L;umfaP' that it is necessary to submit one point of riew. And I think that this has been done. L'm-tainly the Government has far, far better chances of getting literature ~than 1 have. I happen to be a professor of a school of 3,000 students. We do not hace a~,n-adnate school and I hace to spend a fair amount of my time in the libraries reading the.=.o thints, and since I aaar find reforenac after refereueo drat tbey have not quoted, this bothers me. Iwould think with their computer, they conld liet "All right. here ore the following t1Lin'L~s, but there are other publications .vhich don't quite al-reo." r'uid I find this is lacking, and that is what both- ec:s m,c. And I certainiy will not question their motives as others ha.ve dawrc to me. Sow, I har-e mentionod about intimidation. Ilfay I pleasc, sir, one mom ent ? Senator Moss. I es. Dr. FcnsT. The j'i'orld Health Organization as:rs American scien- tists to set up a littlc conference in Enrope on inhalatior of tobacco srwke I"rot a tonq dishurce Call from Chicago inviting me tu be a urember of that working group. Three or four weeks later, 1 rot a long di5tance call from the same chairman, cery embrrrassed, s:.ys, i)r. Furst I tcm embarrassed to tetl vou_. tion hace been disin~it.ed. I hace too mnnlr respec•.t for the man to ash him wh v. TLis to me, is something which bot.hers me. ~ At tho taatlinburg conference, when nickel carbonyl was men- 6oned, at the end Il_ot up and ~tid I would like to lav t.he nickcl problem to rest. Now, this is not in the proceeding, but aaiy man who attended that conference will bcar tne out. The spcaker then turned to me and eaid, we firnsted vortr work until you took your pr~ent assir.nmci~t.. Now I admit tlrat startled niee to no end. 111y present. assignment was to read the research request submitted to the Conncil for Tobacco Peseare1r1L8.A., Inc. I read experime.ntal desi~-1n, I makc sr"'estions I ask, is this experiment good enrniph? "" . TI58461334
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20S 19-10-47, instructor, Chemistry Department, San Francisco City College. During iear, part time ut: University oP California, war trninhl; San Ifrattciseo State College; University of San Francisco. 1947-49, assistnnt professor of chemistry, University of San Francisco. 1949-62, assnelate professor of chcmistry, l:niversity of San Fraurcisco. 1949, research assaiate, Mount Zion Hospital, San Francisco. 1952-61, :eclatrer, Chemistry Department, University of San Francisco. Y362-G7, associate professor of pharmacology (medichmt chemistry), Stan- forrl Lniversity. 7967-91, professor of medicinal chemistry, Pharmacology Department, Stan- ford University. 1961, director, institute of Chemical Biology, University of San Francisco. 1969-70, Leave of absence: research consultant: Council for Tobaeco Re- scarch-U.B.A.; clinical professor of pathology, College Yhysidans and Surgewts, Columbia lJniversity. 1970. Appointed to W.II.O. Temporary consultant on Ocenpatimial Cancer. .14c,rnLear nJ.-American Association for the Advancement of Science (k'ellorv 19G6): American Association for Cancer Research; American Chemical So- ciety (member, executive board, 3 years) : American Society of Plrarmacol- ogy and Experintenbnl Therapeuties; California Assoeiatiun Ciu.mistrp Tenchers (orgnnir,er, first president); New York Acadenty of Science (Fe4 lorv 19G6) ; Phi Lambda Upsilon (honorary srholastic chentlcal society) ; Jay- ane.se Pharruacentical Association; Society Sigma %i (life member) ; Toxiuol- ogy Society: and Western 1'harmacologT Society (charter member). Zk&tsd in-Who's Who in America (1972) ; American Men of Science: 7nternational Biography: Wh~i's Who in American Education; Who's Who in College and University Admintstration; Who's Who on the Paciflc Coast: Who's Who in the West; and',S'orlds Wlro's Who in Science. Fe,fic¢tione.-see attaehed list. As of this rinte: February 1, 1972; 148 papers in print; 1 paper accepted and in press; and 3 papers submitted. Tn fields of: (1) organic synthesis; (2) cancer research, carcinugenesis, chernot?.erapy; (3) chernotherapy of, virus, tubercnlosis; (4) CA8, puFChn- pharmacology, biochnmistry. Senator 3foss. Tha,nk yon.. Dr. Furst, for your appearance before this committee, and I was, of course, intcrestcd in what rou have to sat'. T am a little bit concerned; yon rriticize tlte tllmrbaeh research becausn von said the experimenhal data had not been made availnh7c to an independent panol for evaluation. Is thatt the nsual procedure when resestrch is done on a certain problern and a paper is published? Is it all subrnittcd to a panel even after it is pnblished ? Dr. FtasT. Well, sir, my laboratory is open. I do publish papers- T do gret visits from many scientists who like to see my notebooks. I feel this should be standard procedure. If a group of scientists or a scientist asks for specific data, specific slides, they should be permit- ted to see those. ,~cnator bLoss. Well, von say it should be. arld perhaps it should be, bnt is it'? Aren't papers published all the time by medical research that arrear'fi submitted to a pancl for critical nnalvsis and evaluation ?, Dr. FcxsT. I agree with you, sir. That is the case. Senator Moss. And you state that research protocols for major projects should be submitted to scicnt.ific scrutiny, evaluations, and constructive snggestions, prior to the expenditure of funds, and I believe that is a good suggestion. Now, doesn't the tobacco working group out of the National Cancer lnstitlrt.e have a number of researchers from tha tobacco indttatr,y working rviQi it in the developmeut of Ilte.se protocols? TI58461331
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212 Nobodv in the audience stood up to protest that statement. 1 finallv clid mcself, and then he said, and again I can't quote vm~ba- tini. hnt this is on the tape, if the tapes are available. L'eside_: the, present assigimient, a well-know-n paper has appeared rcti•cntly tlrat refrztes your work. I submit: that paper does not exist. Iie slrecified the jonrnal: f°-kitalytical Chemistry." I had the editor rmt the tnpes. That paper does not exist. n ow. i i t.hatis not intimida.tion, I woul.d likc to know what is. Noi~ I admit aU the time I was devastated. I did not say another word at the entire conference. I remained there, but said notlrine else. ! frrl this is lxu'e intimidation. And the third point, when the Surgcon Uenerill says there is no honest rliss'-reement, a-ain 1 had to go through this znNself. I disau_rco that sonic of these thins are we11 estabished. 1 hare nn honest rlisagreemcut -~ tienatur J1oss. Tlrand. you. Senator Cook• Senrtor Coor:. Doctor, uoi5 tire Smr'-'eon Generil',; department ha~e copies of (hose tapes that were made at Gatlinburo that will establish that you were told beeausc ' =oon took a research gr:tnt from the indns- tr' N , that yuu were nn longer trustworthy within the cnnOne.s of that confcrcnceP Dr. Ft nsr. Sir. I rlo not know if the tapes still esist.. They were taped at the (,atlinbur-; conference, and T never did follow that np. Se~rator C'oox. In otlier «ords, that also indicates if you look at the reverse of that, that no grant or no ability to study a particular mattea• is made by the agency rniless they know the result they arc rroin- to ret m- tlmy aro not going to acceht the resnlt if it, is not What thev want? Wonld that be a fair assumption. Dr. Fcncsm. I hate to be that strong, Senator, bnt I think there is a little imlAicatimi there. You see, time and time again, if I say I ha~-e a trant from the council for tobacco research, or I arn a con- snltant where T read other proposals, introdnc,e something-if you permit n.c, sir, to di~res.~I should like to say, the ~•ants given by the conncil for tobacco research or those of the AbfA, are funded after thop are recommended by a scientific advisorV board who a.re notmeiubers of tlie industrv. They are deans of,medical schools, profes=ors at varions universitics, and nobndy, but nobody tells them you ma e or ma' v not grant this request. This i~ done completely independently. and there is no anronnt of monev or otherwise, that will buy t3~e deflns of these medical schools. Sow, this is ovorlooked so often. They talk abont money from the tobacco dnstrv. The -l.l'I1 hss its otivn scientific advisory board, and the Council for Tnbac.cn Research has its own advisorv board. 'Ihec are both difTerent. The general feeling is that the chips will fall Mhere fhev mav. The res.ea rcli mnst be ood. Senalor Coox. Lett me ask you. Do vou hace any 1:nowledl,•e of vour owr.. whefhca 61re Federal Govermnent participated in uny tiray in the Ilnnds Ilrat were expended on t.he ArterLach study? Dr. Frns'r. I hav-e no knowledge of my o.i'n, no, except that i laiow it hns Lren al.id.ed sis beinl- ha.rt of the Veterans Administra- tion. 7.ts.=nme. But I hnce no persmnal knowlalge, nq sir. TI58461335
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195 Seuator Coor.. Maybe I am incorrect when I say they didn't want it. So, at least the original position was that even if someone, for instance, advertises what his milligrams of tar and milligrams of nicotine are, that the FTC said, originally at least, that they didn't want industry to do this. Dr. tiVssnLn. Well, I liked it when the iudustrv was given thet freedom to publish tar and nicotine levels, I think it has a great deal to do with lowerinl- the tar and nicotine levels, when there is consumer awareness of these levels. The industry has not suffered, becanse per capita smoking has remained about the same. Let me stress again, a completely safe tobacco product is probably not pocsible bnt, as I stressed in my testimonv, we have got to be realistic, and if the industry would~work witli us, then I think we coidd accomplish rnure. lrmther point that I stressed, and perhaps I can use this occasion to tell you a bit about the prohlems that we have in animal experi- mentation, and that when you read about the new Cancer Authoritv _Act, you realize that we harc more problems than just money. And one of the problems that we have iu cancer researeh is to intcrrclate the esperimentalist's work with that of the epideutiolo- R i st. We have manv researchers who only.work with mice, rabbits, guinea pigs, and oc,oasional ly with a monkey, 14c have epidemi.oL orists who never see a laboratory. We have got to bring them together. We have "ot to recognize that ccrtain problems, including the tar and nicotine importarnce to bumart disease, in the long run c.aat ouLy be solverl bv what we can show in num. In the American Health Foundation we a.rc continuing our studies that are designed to show Whether m• not ono kind of tobacco product or brand has a diflbrent risk from another for certain diseases. I run cmivi.nced that we zcill be able to show that this is the case. I arn equally convinced that t.hc day will come when we can smoke with agreater anmrwt of safety than we do today. Already we are doi n" it wit,h a rreatec amonnt of safety than 20 years a(m. Thfs,.of conrse, is not good enmigh. The Amerrcan Cancer Soclety has done a trmnendous job in educating the American people. As I stre.,sed in rny testimony-nnd even if I nury lose somo friends amouv bealth edncators I have to say this as a phvsieian and someone interested in health-we have got to do what is practicable. People obciously will continue to smoke, and you can help us to make such smokinr* safer, Senator Czwx, Let me ask you a couple of questions. Who :nakes Winchestere I don't really know. It says here the), arc made by R. .J. Reynolds Tobaaco Co., Cigar Marketing Division, lYinstnn-Salem. The only thing that bothers me about this is for the last 3 days we have been talking about, l4in- chestcr, and I durrt know anvbody at R,. J. ]2evnolds, but the thing is that there are probablv about 25 or 30 small cigars on the marke.t today. They happen to be only one of the ma,nufactarers of small cigars. Some of these have been on the market, a,qentleman said, since 1958, and it has been my opportunity to check back, for instance, on TI58461318
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209 I noticnd you mentioned Dr. Gori in your paper, and it is rnI tutdorsta,ud i fig h e is ad uti nistrator of the tobacco worku ig >roup. Dr. h'cr.;.F,r. I was thinking, of a philosophical theme. rchich is probably a little, shall we etav, radical in ihis sense. T ci,ualize before a multimillion dollar proiect is started that Ihose, protocols should be published in a scientific journal lih-e Sci- ence, (and I e.vt appreciate that somebodT maF want aYear to rva.l- nate the procedures This would make no senee.) I would feel that a finite period of time be given to outside iuees- tit±ators to look ovcr the protocols, evuluiito flzom_, and make eonstructive sagcestions. This is not being done no1c. I do not know if I as a scientist, not On this cmnmittre have the privilrge of asking for the protocols. I thuik this is important; Cince I have a certain amount of expertise I think I can malm cou- structite critlciEms. This is not the way it is now being done. Procedures shotild he open to all scientiets, and I am rccornmendina it. Senator bioss. I remember reading your testimon)• bofore the 1[nuse Committee in 1969, and in that I~believe )'on said that scien- tists are ge:rtcaall4 disinterested in inil.iatinb atudies ol problcros which they are told are alrcadv solved and out of that I take it the.re is xn impliaation that because of the propaaandn, about ci~ga- rette; there is mi inadequate number of- scicutists who arc initiating studies. Ts there a relatil-o death of scicntists who are cmiductinc stndies in the smoking and health problem? I>r. Lr'i'RSr. I think the first spcakcr prettc much sxid the samc thing, that there shonld be more. There are too mtury unsolved questions for the few people in the field. Let's take chapter 7 0l the 19'72 reports. There are majn~ chemical6 listed. The implication is that ire should stndy these indiVidnalls, we should also stud~r these in pairs, imt ilhcre is a tremendmus amolutt of guessin, which ca,u be done. We can even devise ma.the.- matical models tolrelp us make decisions.. and there is practicalhnobody in the field trmlrin~ in mathernatical mude.ls. There nre too few scientists working in the low level dosage area. We talk about zero toleranee. IVhat does happen at cery loalerels? Let mc go baclc to mp personal axpericnce in research which I have published. This is not smoking, but in drulps. 'tI`c Look tranquilirers and went to lower and lower dosage levels to see what would happen, and we came to a rather inten+stiug snr- prisep at rather low Im•els we got a r_ompletr, inversion. Those tran- qnilize.rs at, these low levels become escit.ers. '.I'hin me puhlishecl in a journal. You can not predic.t by simply looking at chemicals or at rnaubers representing (lose level .1 what is going to happen in lecrl 13. There are just not sufficient peopte invostigating cornbimr.tions; not sudicient peoplee working on a variety of dose levels, and I snbntit mice again this is not a predictablc aaea. The e.kperimental wmk mnst be done. and it is notbeitiv done. Senator Moss. 1)r. Sonm)crs. Scientilic lliredor of the Council on '1'obace(f lle.e:urh, ~r-hen l:e was betore us. enrted that chre to thr TI58461332
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207 If we are not stalnpedcd, I feel that in time much real informa- tion will be ava,ilable on smoking and health. This should illclude ansvere to tlle matry qnestions which pres- cutdy esisfi ahout tar, nicotine., carbon monoxide, Imd other compolmds mentimled in chaptcr 9 of thc 1l372 report. I do hope, however, that I have been able to convey to you the importance of your demanding good scientific research as a prelimi- nary to dccisionmakulg in this area. In cloeine, may I say that I lrave been, for tna)ry years, a grcat adinirer of Jesse Steinfeld, SID., the present Surgeon General. I know him pcrsonally; I served with him some years ago rm t.he spe- cial rrmlts committee of the California section of the Americ.ul Cancer SoaieLV. He was engaged in v.linical cancer liliemotherapy and was oae, of tltee ontstmiding cancmchemothcrapists on the wust coast. However, I do 7)ave an honest disngree.lnent rti-ith him on what is proven and whatt is conjecture iu the smolcnig-cnncer question. His statement that there is no honest disagreement is a disservice. to aa number of scientists and to science. The previous spenker said that we need more people in cancer rescarcl., this I have said in my la.st appearancT, and I would like to sa.y it again. it is estrelnely essential we get more scientists, espe- cialh- yotutger scientists iu this field. 1Vhen you say there is no honest disagrelanent, vou aro simply saying that people who disagree nre not honest, and this I resent. In further commeut, let tne ask these questions : F7ven iC 'na helieves sincerely that his cnuse is just, is it sclentlfie to 5up- portt such a cuu: e with doubtfttt results? Is i1 firir I,, mit or neglect important research results4 I; Il ne•->.uy to qnestion the honesty and sincerity of a scientist bec:uisc he insi;ls on p, "I seientific research before reaehing conclusionzs 7 I am as ~oneernc.d as mlyone for the health of the American pcople_ ~ I am also cmlcerned for thc LeaJbh af the scientific method, prop- erly implemented. I cannot help but lm. convinced that respect for the latter nlti- mahelv 1)est serves t}ha former. It, is this conviction that has brought Ine licre to say that setting limits ort componnds formed in tobacco srrtoke or condensate wonld be to act ill what is nearlv a scientific vacuum as far as good esperi- mental data is concerned. ~ Thank you. (The Iuaterial referred to earlier fol lows :) Couxroci.uni yrrns or Airraun FUesv Pe.rxnnnd.-Eorn Miuneapolis, Slimr., 1lecember 25, 1914; married, four cliil- dmn. 7?ddmatfon,-Los Angeles City College, 103'2 35, phychnlogy, chemistry, A.A.; University of Califmalla at Los Angeles (UCLA), 1935z37, chomistry, psS- chology, physics. edncation, A.R.; UCLA, 1037 3l), ,liemistry, mathematics cred.; UCLA, 1J3o, (hemistry, ]LA.; Dtanford University. 1N48, chemistry, Pit- 1). prnjesaiunai eapcrienco.- 1a3i 3ll, teaching assistnnt, University of California at Ims Angeles. 1J39-1q teacher, scienee mid mathematics, Pacific Military Acudemy. Culver City, Calif. T158461330
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l 213 Senator Ooorc Do yon thiuk then we should write into any fur- ther le,islation for Fedcral grants on research that any c ant Imide thA, are utilized in a rescarch that the results of those researchea should be mude public atrd that the Federal Govcrnment assumes the re,ponsibilitv of makin.g those research papers public? Ur. I'orm-r. _ll.w I just have a mornent to thiuk about that, Sena- tor, becanse t~here is a qrea,t implication tliere. 7 would be concerned a bit about 'vivasion of privacy, as some other pcoplc w}ro feel this. tienator Coox. If thc Federal Government is paying for a research study tlart you are making, are they entitled to your results? Do pou pice thetn to them? llr.' Trt:a•r. I would certainly think that anybody who funds a r~c:rrch pruject is entitledto the results. Senator Coor.. If it, is the Federal Government, aron't the people, «-ho are in f»,ct the Federal Government, entitled to see those resultss Dr. FvresT. 1j'ell, if you put it tliat way, sir, yes. I would sti11 say I would like to be sure that the scientist has a certain de;;ree of protection of his own integrity and so nn. But in tdre long rnn, if a project is done under Federal money, the investi- gator should publish Che work, however few journals publish raw data. 'I'he raw data should be available for scrutiny. And anybody is welcometo conic into mv labs and look over my notebooks. Senator Coos. .lust ~a short time ago, tliern were a number oL pcople here who had buttons orn thnt said individuals should stop smokinh becanse it may be danperous to another individual's health. We will have sonic testuuonv on that. The example I really want to ;,•ive to ti-on is that in colloboration the FAA and IILW and the tiu-geon General's Department agreed that the F1Lti would do an iu-depth stidv as to smokinp; in confined places, particularly air- craft. There has been a lot of discussion about it. The FAA did an extenshe report, 80 some odd papers, full of diagrams, full of statistics, and came to the conclusion that the problem wasn't really as serious as some would make it. I ask why it was not madc a part of this 1971 report? I was told that it didn't ,mt in there nntil Der,ember of 1961. But itt was amusint to have to tell the gentleman from HEW, and particularly Dr. Horn, that this senator read it in .Jack Anderson's column in Deeember of 1970, and if Jack _Snderson could nct that iuforrnation from the FAA, it ratlier secrns straire to jne that 11EW couldn't. As a matter of fact, I could go farther than you, Doctor, because the rorord will show exactlv how Dr. IIorn feclss about smolcing, and he is the one that coordinates the research for the yenrly studics. Hc wuuts zero consumption. :klso, I might sac that you asked about Dr. Gori's group. Dr. Gori hass not called thatt group together in months and mmlths, and the reason it has not. been called together is because the people from tbe industr,Y ~lo nnt amre Ncith tfie oril_rinal premi,'c, aud that is, that von mast start tndac, says Dr. Gori, with the theorv that smokine is bad and tbadt it oan ne.er be macle aoocL and thcre is uo snch thing as a rood cigarette. And they say we can't start from that T158461336
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215 Senator Cooic. May I mcrel,v say,, I:un mcrelv doing this, Dr. Rurst, becmre you ,aid, to begin .vtth, that you fclt like you were being told yoiusoJf hy the Sm•~'eoa General of the United States that yon are not honest because he said in his report, there is no lon,=er an honest disarreemont. L rnu mrrely asking o-ha.t went on in that 1-day discussion that was tlie rcsnlt of chapter 9. 1'orn a;kcd this commitkce, and we have no answer for you, vary thc Sur;;eon Gencral said that everybody that disanrees with lum is no lonhe~r honest. So Ithinlz we ou_lrt to put it in perspective. I rnight say, this is also the same Surgeon General that I said before that made the speech before a national organization in Chi- cago and said there were seven former presidents of the United Shitec that smolced marihuamr. And by the way, referred to a doctor who was a research gentleman at the Smithsonian Inst.itution. 1`he only problem is the Smithsonian Institution never could find that doctor that made up that report. Now, let me ask you this: Are all tobacco smoke condensates pretty much the same thing? i)r. h'mw•rr. Oh, by no nreans. 1'his is .chere the e.zperimentalist comes in. Condensates are made by really condensing the smoke matter under certain c.onditions. We have to know tire burning tern- pcraturc of tlie cigarette. If you have difPerent burning tempera- tnres, cmt will have different chemical compositions oozmg out of the end of the cicarette. A4o must know the distance from the end of the ciga.rette to the eondensiun tubes. Wo have to know sornethine about the composition of t.he tobacco. Senator Coorc. Well, idong, that earnc line, let rne ask y-ou this, and you can answer them together: Does a test that shows condensate, only by vreicht, tell us anything about the content? llr. Fuitsr. No, not at all. It simply says that they are 20 milli- grarns by weight. It tells nothing abnut content, nothing about com- hositimi, and it does not say tkiatrthis is tlic problem, you see, that we haNe all the tirne. We are so terribly simplistic in what we say. Itt is easier to-I am sorry for the reporter. I am moving around, bnt I couldn't help but smile at this, onc of my own papers, tehieh is not listed herq when I said one sc,ien6fic ntetdiod appears to be: If von c:urt understand ti.e phenomena, you name it. Now when we talk about condr:nsai.e, we, feel we understand it. Condensales will va.ry de.tienclin~l- on the conditions of bnrning and on the conpositiwi of ci;,r:aette.s; unless you absolutely specify eti-er_v sinOe factor, mois- tnre content, tobacco content, burnin1- zone, rate of burnin1g, you «•ill eet dilCerent condensates. ~ Senntor Coor.. '1'herc. lios I'ceu a lot of discns.sion about, Il,e advu.rr tage ol' lorcerinh tar cOntent. Aoic, if-wo assume just for the salce of the qucstion that I am about to ask yoy that thero are comt,onnds in mnolic Zvhich aro harmful, is it t:uces:arily goin, to irnpro~-e t.ite sitt- ation to reduce tar contcirt? Ilr. Fm;sl% Ncccssarily the answer, I am afraid, ticould have to be no, bce_tiuse we don't know how these things act ir, concert. When you rednc.e one rbin-, you may find somcthinc else may appear. This is a complex mixture which has to be considered in its totality. TI58461338
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214 prernise, and the.refore, that is wlry that group of inen will never function and tlrev will never make anv contribution to this discus- sion. As a scientist, thnt is kind of distnrbing, isn't it? Dr. TtineT. Yery muclr ao. S:on r.2nnot start an experiment and sar I am ~,'oing to prove aotrvllring. You :ure goinQ to inrestinate. You are going to start wibh certain hypoLlreses. You are not going to say this is it, and we are not going to get dnta to show this is enr- rect. That is not hossible. Senator Coov. Is there a representative of HDIG hero for these hearings? Sena,tor Moss. None were summoned today. Senator Oons. I was wondering .aheUicr onc would be here during the course of the hearings as obsmr.-er=. We u,arally find that this is what occurs. I would like to put into the record and aslk thatt this committee send a request to the Snrteon that it Igive rts the tapes or the tran- scrlpt of the 1-day conference in June of 1970, a 1-day cmiference, that wa.s the result of chapter 0, harm{al constitae~nts of ci~-na.rett.e snrokina. Itt merely says to ns, Doctor, in the footnote, that this is not to implp that there was mr:wiinrous agreement ou all statements con- tained herein. And it further goes on to say a.t another footnote in the report, the consensts is t1m.t t}rere is inadeqnate evidenc,o to support a chan~e in that, view at the present time in relation to one particular thin,. At least we have that much. 1rid it also savs on page 216 in a footnote, an alternative point of view held by sorne is that smol:ing behaz~ior is a response to the need ct cetera, et cotera. So none of these, except in footnote, were contained in that chap- ter, and yet the chapter attempted to be totally and completely alfirmat.ive on a subject that was only discussed in a 1-day confer- cnce. So I urut only say to yon that I wonld like to nraLe a request to the Sur,a,eon Csenc.ral" departmeut, that if these lapos (1r thc tran- script from those tapes is available, we would eRrtr.mly like to have tlmm and they onalit to be a,vailable. Dr. Fuizc,r. And I, certainly, sir, +cotdd like to soe them. Senator Moss. The Sena.tor, of course, has the righttn make that rerlne.et., aaid I would hope lie raould. lf he belie) es that n1l scientists who beliere that smoking is bnrmful and therefore slanted and biased and wonldn't permit •ury counter-information to come, whereas, all who have some doubt are pure and have no bias at all, lie certainly call look into that. I woold~ say that tdiis comuittee bas been trying to hear both sides. Otherwise, we wouldn't have invited you, Dr. Furst. You have teatiGed again and again, basically as ymr have teatified today, and rco waait to havee it in the record, vve hope to have it in the record. I am not willing to accept the Surgeon General and Dr. Horn of the National Clearinghouse or others of a preconceived bias and that tbey suppress information that come from other scientists_, but the rev,ord will }iavo to shealr for itself. TI58461337
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220 baimmg the adr°crtisement of cigarettes mt electronic medi:i sub,ject to tbs jmisdiction of the FCC, tt roted with rcgud to mi]y one to- b;zeco product. -cigarettes. At an l:rter point T would lil,-c to mglce an obscrvatiou as to tlrc ef- fect of this proscriptive legislation on cigarette smoking acceptance, and constrmption. But first, I would llke to outline eertain prohlems of enfmcemmd with respect to this act. As I noted, the acc is luuite.d to cigarette products aS drfin~,d in section 3. '1'herefore, the threshold question undcr the act, and ibe one nhich really triggers its applicability, is whetlter the product in question is a cigarette as defined in section 3. '1'his issue first comes up as a tax ;uatter, in that little cigars arc tazed at a rtd.e roughly one-fifth of thatt for cigttrettes. The proce- clnree adopted by tobucco companies seeking a litt,le aigar determina- tion has been to pre.sent the product in question to the Alcohol, To- bacco and 1+'icearms Division of the IRS. The IRS anal vzes aml evahurtes the product's tobacco content and wrapper, along with its packaging and labeling and wlnrtever clse the ntaautfactnr.r wisltes to sttbrrtit. I,$S, looking to the statutory definitions of °`cigar,° which is codi- fied in 26 U.S.C.G708(a), and of `cigarette;' containcd in ~)i0~?(b), makes a determina.tion of the product's classification. The Internal Pevemre Code's definition of a cigarette was trans- ferred in lraee verba to the Cigarette Labeling and Advertising Act, as amended bp the Public Health Cigarette Smoking Act. Conse- qnent.ly, n-hon the Tnternal Revenue Sercice deLermini-s LLc appro- priate c:Ltegory for a product, and this determination is rclicd upon by the manufacturer, a snbsequent esrittrary interpretation by the Departnent nf Justic,e shou]d, it seems to mc, be ntnde only in cases of c1earerror bv the TTiti. Itut the dillirnltg does not end therc. The statute presenHy defincs a cigarette, as anr roll of tobacco wra.ppe.d in pnper nr in ane sub- stmice not containing tobacco, and any rolll of tobacco wrapped in any sttbstanc.e containing tobacco whic.lt, because of its appearauee, the type of tobac.co need in the tiller, or its paclcuging and labutin-, is likely to be offcred to or purchased by consumera as a cinarettc. This terhnie.a.l 1ungttagn presmds, T think, few o'ustacles to anc to- bacco cornpatty which desires to develop a product >1=hich will be taxed ot a fraction of 11te rate for cigarettes, does not require tlie Smgeon (materal's ivarning label' and ctnz utilizc ull of the mass nuxli:t for its promntion i f s.o clesircd. Ono eaae in point to which thC cha.irman has alrcadp referred this morniag is "Muchester Little Cigars," a product of It. J. I:eYnolds Tobacco Co. After initially faaling to obtain a cigar status rttl'urg for Winchester fronr the Internal Revenue Sc+rvice, Rcynolds made tbo ne.cesssary adjust.iue,nts and was clas:;ificd as a cigar on Jannary 1`~, 1J'71. Shortly tliereafter, test m;rrket.ing began in Dayton and I;oston. '1'he marketint strategy included radio and television advertisin-,,. lt is clear that if this product was a cigarette, it violated t.he act in two ways. First, it did not bear the required warning statemert and. second, it was bcing advcrtieed on radio and television. TI58461343
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216 Senator Coos. There scems to be somc opinion that a reduction in nicotines eould cause some people to smoke more. What is your opiu- iou of that? Dr. F17r118°r. There is a paper in one of the journals where there Was more puffing with cigarettes of 1olcer nicetine content. Sonatm- Comt Was that in that Surgeon Generai's report g We have asked about animal work involving tar. What about anunal work involving nicotineB Dr. Fur,ar. There has been a fair amount, of work in that respect. Probaebly the dean of the pbarmacologists would be the F.meritns Professor Burns of Oxford, who has done much reszarch on this. Ificotiie has been studied various ways. Again, I find myse]f awed, and aqain I do not have the referenee at my finnert.ips, but Dr. Burns clid say there were beneficial eHects in nicotine. This may sound ridiculous. But nicotine has been help- ful. IIc fonnd in certain cases that for some if the excited people, it works as a tranquilizer, and convcrselp. I'here have been a few papers on the learning process. Now, when a rat runs a maze, he does not really learn that imme- diately. He runs a maze. and then there is a time before it be.comes consoliduted, before it becomes piu1. of his mernorv process. And if you give nicotine to rats after they r-im a nnaze, their consolidation tirne is shortened, it becomes part of their brain storage faster. Well, to me, that is positive. Senator Coo7t. Dr. DuVal said that the Anerbac}h dol,, study indi- cated that filter cigarettes tiere luss hazardous than nonfilter c,iga- rc6tcs. Would you say that in axpzvay that studv proved his statc- ment? Dr. Fbr,s,r. Let's go back experimentally. And again, I have to depend on my reading. I was not there. My understanding is that Dc. Aucrhaeh ta,k iilter civarettes for his ea:- periment and then literally tore off the filter. I asked, how does this relate to reztlity? What ia he proving? T don't know. I am snrry. I cau't answer,yourquestion. Senator Cooic. Doctor, I just have one or two short questions. You zaid that when y-ou stood up at Gatlinhurg and said that you had made this study on nickel carbonyl, that the dniinnan said we trt~sted your report-now, what was the phrase that lie said? Dr. I'cicsr. Not the chairman, the speaker. Senator Coos. The speaker. Dr. FcaL,r. Again, this is a couple of years ago, but I thinlc I h~re i verbatim. We trusted your work until you took your present a--l"nmcnt. vcnator Coor.. Who was the individual at that rne.etiug Clint made that statement? Dr. Ftasr. That was Dr. FIoiPman. Sena.tor Cooa. Doctor2 Dr. Fnasm. IIoffman. Senator Comc. And at that stage of the ,n,arne, whatever You had to contribute to that conference had come to an end? Dr. Ft-Rer. I did not sav another word in discus~ion. Senator Coor.. At least the indication is that it came to an end as far as Dr. Hoffman was concerned, wasn't it? $eaause lie said what- TI58461339
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219 shonld dediarte, omsolves ill snrh a wav t]tat no scientific investil;a- tion i s inh iVii I erl- zmd ua responsi blc douF:ter i= i mi ored. Iiaving enlil,dhter.ed onr peoplr ns to their rhoices in an objecti~-e n-ay, is it not the, aim mtd duty of government to permit them to de- cide frecdy for themselves what use to make of all things put at their disposal ? As 1 previously stnted. che relationship between smoking and healtlt has not been dufinitelc, ascci•taiaed. No such regtilatimis sre imposed on the aleoholic beverage industries and vet statistics show far grcater harm resulting from thc~ nse of alcoholic beverages. We must not assumo the role of protectors of .i0 million Ameri- cans a.s S. 1451 contemplates. The Senatc and the Congrress have a higher obl3gation. I wish to thank vou. Afr. C}tairmt>st. Senator Dloss. Thank vou very much, Senator Thurmond, for your statement. We are glad to have it in the record for this com- m i ttce_ to rmnsidcr. I have no questions. Do ron h:u-e any qnestions? Senator Coojt \ o. Th.enlc yo tt vcry much. Senator 1Toss. Thank you.tiVe a,ppreciate it. f tcant to call tifr. 13ruce Wilson, the Depnty Assistant .'lttornep (leneral. i. tvant to explain to thee remainder of the witnesses we will takc a vet,v brief recess after Mn 'Wilson has finished his testimony prubsbly only abont 30 minutes. So if any of you want to go down to the eafeteria which is in the basernent of this building and you are goin<• to be on as a tcitness-Dr. Olcmi, for esample, who probablc ~zonld be the next witness-you mip,,ht want to leave a little ahead of time. A-ll right. ';'Ve will proceed with AIr. Wilson from the Attorney GeneraPs office. STATEMENT OF BRUCE B. WILSON. DEPUTY ASSISTANT ATTORNEY GENERAL, AN'PITRUST DIVISION, DEPARTMENT OF JUSTICE Mr. Wrtmx. Thank vou. _11r. Ghairman. Vtr. Chairman and 7nembers of the suhcommittec: I appreciate t.he opportunity to appeor before yon toila,y~ to discuss the esperience .rnd vicws of tha Departmmntt of Jnstice with respect to the Federal Giertrettc Labeling and Advert.ising Act, as ainended by tJhe Public Health Cigiucttc 5nrolcing t>ct. '1'he Departmen't of Jnstice is charged with the responsibility for enforcing this statute. As a meruber of the Interagenav Ciga.rette Li- aisou Committee, jo$iod by represorilatices of the FTC, the FCC .wd the IRS, we attemptt to c,ont,innously monitor developme,nts in the tobacco indastxv. One snch development in which I know this stbcomtnittce is espe- einlly interested is the advent of the little cigar and its apparent popularity. '1'his development, wiuch has occurrnd largelv after the paasagr, of t1:e 1969 amenii~nent, is, I believq ;ignificant in any ap- praisal of the e$ectiveness of this legislwtion. When Congress xexnended the 1965 act by strengthening the Snr- geor t3eneral's precautionary warning on cigarettec packages and 77-014 - , _ 15 TI58461342
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a1s \Ir. Chairman, I am advised that the lehislatiou beforo this sub- commitfee would establish a sort of miniproliibitiou law, and I tliink the pnblic should know it. Ruticularlv, I um cmicerned about I.ve thin_s: First, the itnpact of snch resl.rikive le~islation upon the people and economy of tnc Stat~~o of ;ioutlx Ca~~olina; and second. the threatened abuse to orr traditional way of life intlti; coluttry and otu' ronstitutional prerog- ntives. In the fir-t instnnce, I atn happy and prond to associatc m,vself with the interest of mnre than 250,1000 people in South Carolina, a part oi all of whrnrrs livelibood depends apon tobaec.o. It, is the nunr ber one money crop in South Carolina and in 1971 had a c.rop vaLte iu evicess of $101 million. It directly affects tLe lives and well being of more than 25,000 farm fatnilies in Bouth Carolina. The mtmuf:a:tmed product is distributed throngh 59 .v}iolesalc and over 19,000 rntail outlcta in mtr State. South Carolina has 31 icarehonses far the sale of the leaf, and altogether it is conserva- tivelv esthnated that the crop is responsible foc more than one-half a bil lion dollars per year in the rconotnic ]i Fe ol' Soutb Carolina. Mr. Chainnan, itseems to me that no one lcnoocs the exact rela- tionship between smoking and health. There have been many stndies and nmeh research in this area, rntd I hope it will contimae. Tha rc- sult of thin research only proves that this is an uncertain area, at Ica,t thatt is all it seems to harn prove.d today. 1b reach any couclusion, and in fact to enact legislation on the basis of tim iuemnpiete research and predetermined facts, would not be in t1m best intcrest of this coimtry. At best, all that can be said of findings today is that thev arc inclueivc. At u-orst, they can and arc beigpresente.d to the public in an exeessive form thut olten crcates onlv confnsiou and ansiety. f shongiy fee.l that the tobacco industry, along tivitfi all of us, is inu=rested 'ui conquering cancer-the dreaded disease u-hieh we still Inno.v so little about. Ou lranniented information, however, tive shmtld not, enact rnpris- als npon such an important segtnent of our economv, which provides a livelihood for so many thousands of people. 5. 1#5I seems to eice to the PTC authority to prmnulgatc stand- ards, Mr. Chairman, nhich are rcquired to be esurci~ed by an acenep which has no expertise in the field. lddinioually, the ;•en' proeass relieves the citiaens of 3ny State and country of thew privilege we all eherish; natnrly. tho privilege to choose on om- omi aiud not have the Goaerurnent c.hoose for us. We ca.tutot staud idly by andd sw thwo titnc-hoaorcd rights snatched atvay bc;ore, v.e re.ilh• know what wc are doingr, e.eu thongh t.he ob,icctive tnay I~~- a uoble one. 3ir. Citairw.an. I atn cmtvinrn:ld that it heionn•s to the Governnicut to enlie;Ltea 1~ ~J, . as to their choices iu an objeetiNe ~eav and witli- out evioi~nsu I ~ iL 'lb aceom.plis.L this puipo;u, we mnst bend ecerv efl.tt t..~.rmine facts and not, fiction. to find tbe cintse of diseasa and n(, __ 6,:--s. Isu't it poss~ ~lo that false assumptions cxn set back grcat researoh programs into tho true causes of cancer and heart discase? We TI58461341
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217 ever contributimn cott make, in es_salce, bc ren~on of your presont a= signment, it, is immaterial-pou tile now on the other side of tile fence. Isn't that what hee said'< Dr. FrrrcT. 'Cha'r Zea; tile implicatimt I took. aaid therefore I re- mainecf at the ronference, .~ithont di=,°nesiuo. and y-ou ear_l,er. sir. T mm a rather rrrbi~l person, aud eith abnost 3o yeai, of experim('ntal Nti-ork. I think t can tnll. ahoirt these. I did spend a li(11e tirnc wilh indiciduals, hut I did not :-peak att the conferenco anv more in opcn session. I don't thinlc T wottld do that aiain. Rut aY that lime, I did. Senator Coos. Well, Doctor, I think thatt answers the point of in- timidation rery well, and I zrppreciate your cntning here. I arn glad this commil.tee, inahiding thi; chairrnan, gave. }-on tlre fornm here that yon did not have an opporhtnity to have in regard to contribn- tions that were roin' g to be made to a rrport that meut to the entire American people by the Surgeon General of the T7nited Statcs. I)r. Furs-r. Thank von. sir. Senator 1lfoss. Thiulk you. Ur. hurst. I am glad you wercn't in- timidatecL and neithcr was Scnator Cook. Dr. PuesT. Somrtor Il4oss, i thank you all. Senator Cooic. ACa.v I just ask oue qnertion? Dr. P'm"sb, ,y-ou say Ilrat the p'enblemem that wa5 eonducting the rominar that you were talking abmrt was Dr. NofTman. Is that Dr. Dietrich Iloffrnfur who is rlnef of the. division of eni-irmimental carcinogenesis of the American ITealth Foundation in New 1"o'k? Dr. PunsT. Yes. IIc was not conduc•ting tile seminar. IIc was one of the speakers. Senator Coox. But he was the one that made that remark? Dr. Ftrzs,r. I"es, it was. Smurtor Coorc. Is this the, same one that Dr, jFvnd.cr 1c'tiGcd at great length this morning t.hat he :vid Dr. IToffman hnrl been to- gother on several esperiments? Dr. PursT. Yes, sir. They have published a number of papers to- gether. Senator COOK. Thank yon. Senator Moss. Our colleague, Senator Tlmrmond from South ('.ar- olina is here, and he has a statemrnit, and wn will be glad to bear you, Senator. STATEMENT OF HON. STROM THUF.MOND, U.S. SENATOR FROM SOUTH CAROLINA Snnator Trruxnc):vo. Thank you eery much, 114r. Chairman, and gentlemen of the committee. I understaard that these hearings before your subcommittee are pri- marilv designed to produce legis~latson to set, masimnm limits for tar and ni<arGne content irt cioarettes. To accomplish this ptu'po_e, S. 14:54 is before the committee for consideration. Of amrrse, I a,m appearinv in the interest and welfare of my peo- plc in South Carolina. I also sndgest that I am similarly appea.ring on behalf of the people of the United States, whom, as a U.S. Seala- tor, I represcnt just as surclv as does each of us in the Senate. 'I'he way it is propose.d, as is in the ease in S. 1454, that the Congress es- pLoit the welfare and the rights of each constituency, I must protest. T158461340
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222 HoWcver, I woald ]ike to re.turn to a pouit to wliich I alluded ear- lier in iny testimoiiy. I o1Per this thought more as a mntfer of per- somel obsnrvation than of scicntilic an2lTsis, a.ll:hough I be7ievc that some moticational zud marke.tiny_ shidies in this area rni;_;ht be ire- ful. I believe that therc is some question as to the ell'icacy of banuin', smoking advcrtismnenis a,e a meaa1s to achiece the ultimate goal of reduaiug amokinc in this cottntre. This is sc hecuuse, when tha ciga- rette cmmnercinls r.:ime off the air, nn byprodnrt of this devclopment was that tls auticigarAte eomme,rcials which had been aired undor the hederal Comnnmications Commission's fairre5s doctrine also caome off. I believe that. the st.2i,tistics wilt show that there was no noticcable speodup iu the dcr,line of vi;;arette smolcing aftcr tho ban. As Dr. Wvnder testified earlier this mornin¢, fear coines too late, iuid I aur inelincd to bcliev~ that it comes even later if pooplo do not think about what they are doing. 1 think the anticigaretW comtrmrcials made people think about what they were doing. 'fhis is the reason why I question wliether simply bazwing cigarette cmnmerc,ials, in the context of the fairness doctrine, is an effective way of ineeting the goal of reducing ciga- rette suoking in fhis country. Dir. Chairman, that concludes my statement. Senator Noss. Thank vou very much for your $at,ement and your explanation of the hroblems surrounding the advertising and label- iu,, of little cigais. You indicated that when the'tVvrohesters were first offered in this committco on whieh you served, some adjustments were required to be made bef'ore they go6 clearam.e as little cigars. I don't know what those adju~tmcnts .vere, but what would you have done if the adjust- mmnts Averc not uuide? Mr. WtLsox% Itt was not the interagency committee which required those adjustnienls. lt was the IRS which requircd them, and I believe they ase sorncwhat techuicrrl. in t.hat arca, I woidd ha~e to defer to the 11tS. Senator Moss. You are not aware of what adjustments they reqaired? Mr. R'tLsos. I am, eir. '1'o some extent thero w:ts an adjustment of the filler which is used in tile 1Vinchester little cigar. Senator Dloss. And that, apparently Nsoiild luvc to do with inbala- bility as you understand it? yir. Wnsox. As I understand it, Senntor, it did have to do with the aJkalinity factor abont wduch Dr. Wyrder testified earlier this nxorning. Senator 111oss. Do you think in defining, if the Congress should undertake a redefinition of cigarette and cicar, that the definition of a eigarette ought to have its in-usc definitimr that would take into account this inhaJability which seems to be coupled with acid rather than an alkaline t,ype of tobacco? Mr. 1'Vilsov. I think that is a possible way to do it. Senator. I think, as someone said earlier this morninb, there are some very strong souls who even inhalc pipes, so 1 quory whether, if we had a TI58461345
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221 The Department of Sustice mude a detailod review of lhe ll'in- rhnste.r sit.untion and determined that it could not, in view of the identical definitimts eonrained in the tus code and thc cigareitc ad- verbising le,n,islation, eonclude that, the ruling of the Internal Reve- nne 5ervice-the >tl;enca which initialy detca•mines whethr.r or not a tnbmcco produet is a cigarette-was clearly iu error. 'I7uis it is our view that if C1ottgress wishes to prohibit telcvision and radio udvertisement of litt]e cigars or. indeed, if it wishes to prohibit such advertising with respect to all tobacco prodncts, new legislation will he neces,arv. The present Act cannot be stretched to cover products lvhich were not contemplatrd at the tinte of iis enac•t- menn or which are ele:uWc not eovered by the ac.i. The confttsion preseutecl by the little c.igar ndaertisemrtds is. hiw~°- ever, not without basis. 11Ttnn- little eigars are packaged like cita- rettes, 20 to a package. Becuusc of this uniform size they cin be marketed from cigarette vending machines and traditional cigarette r:icks. They aro eomcwhatt similar in appearance to cigarettes c.cept for their brown toba<ro wrapper. However, the on11- indicia which can, as a rnatter of law, bc con- sidered when making a legal detcrmination of the product's c•harue- ter under the Qinarette. Advertising Act are, those set forth in the statute. SSipntifieantdyg nll of the prodncts of which I am aware which ttre preseid.lv marketed as little cigars ure wrapped in reconstituted brotvn tobacco. noC cigarette paper. All =uch products are now elearlv designated as little cigau's in their pnrkagio~_ iutd labeling. These prodacte taste. Fmell and burn like tradltional~cigars. But hc- amtse tho dePutit.ion of a rigareNe prescutly cwdainud in scvrtimt 3 of the act does riot include marketing or advertising , as detertnining factors, there can lic no consideration of where or how zi produat is sold or promotcad. The fact that little cyar adverdserncnts uLilize tho ca6clry jingles along with promises of popularity and romantic attractivenc,s which were so ch,lract-eristic of cigarette advertisctnents prior to thc hau doc not bring thcp advertised product within the statntorc defi- nitiou of a cigaretp. 1Vc beliecre,lmwever, that the esistin;+bmt on cigarettc advertising coutd be expanded hy Con¢_;mss if it so desires to eill tobacco prod- ttcts. As this si!bcommittee is aware, tho em~satitntimiulihof the es- ta6inp statnte ie presc;ntly Ueinh challenged in a case broubht on behalf of certaiu broaticast.iun, interests iu thc 1'.S. District ("ourt: for the District of Columbia. 'Ihe art,mrnentm ntade by bhe planitilTs in that ease is that the present statnla is nncmtstitntiomil as a eiola- tiorn nP the fiist ornondment right of free ~peectt and as a vi.olation of the tiftlt amendmcnrf, xip,ht to cyual protection. The District Co3irt uphe.ld tlis•, statute's cuustitntionttlit}° and de- ni.ed the plainl.ifP's reqnest for injimcti,-e and dedm•atnrp relief. That caso is now on appeal to the Supreme Court and in dne course I es- pect we will htn-e a final resolution of the issucs involved. 14 tho constitutionalit,y of the statnte is nltimately npheld, as the Department is nrging, thcre wonld seem to be no legal reason wlty Congress cnuld not legislate mm•e broadly with respect to radio and television advertising of tobacco products if it shouLd desire to do so. TI58461344
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224 'lhe filler, as Dr. TVynder testified this morning, ac,cording to the notes that I made, conforms in qualitative terms to a cigar. So we couldn't proceed against it in that area. The only way that it, might possibly be argued to violate the statute would ~be in its paclcac ng and labeling, and, if we sued for an injunction, then the company simply could have mooted the case by changing the packaging or labeling. The, test is one which is phrased in tcrms of whether the prodnct is likely to be offered to or purchased by' the consumer as a cigarette. Sinceo we had n situation in whicL the company could moott thn law- snit by changing the laboli.~;, I iequested t}to cotnpany conte in and sngtiested that smne changes be made in thc labelinm so the product crntld clearly and conspicuously be designated as a little cigar. I believe those ohanges hane been made. At least, I have no evi- donce that they have not. I understand the company has moved into the New York ntarlceting arcti and is marketing the product there, and the labeling is now in conformity, I believe, with the statute, sir. Senator A1oss. I notioo in this advertisement that I held up once before Ihat it says down near the bottom of the ad, it is not a cifra- retto, not jost another little cigar. It seems to me they aro disclaim- ing tlmt it is nott just another little cigar, so II don't know what it means. Mr. Wa.soN. Under the statute, Senator, I aun afraid it has to be 7 a cigarette or a cigar, and if it is not a ciaaret,te, we can't, get it. Senalor D1oss. 'PLey sa.y clearly it is not a cigarette, but they say it is not just anothcr little cigar. ;enntor tlook? 5enntor Coo[c. Alr. l1 ilson, you said jnst a minr.te ago t.hat it, is wraPped in brown paper. Now. you latow that, isn't so, and you ]:now that the Intern;t) Revetme llepartment has statutorily through its rep;nlations mtder tho statute has sa:id that that paper, which is not a paper, xnust eontain (ilt peresnt M1obaoco leaf. Mr. li"ttsoN. Yes, Senator. I misspolre mysetf. It is R-rapped in brot~ntobacco-rceonstituted tobaeco with c,ertttin binders. `.ienator Cnotc. That is the saine thing, tltat Tipperillo are wrapped in, that is the aame thing that Tijnana 7malla are wrapped in. The reztl herplexin, problem is thatt if vott can stop tltis as a ci~har, which in fax•t it is, and Dr. Ai'ynder said that it was, then you aro rettin* into tho ci~~~ar business, and tliexi you get to the next cirar tutd ~dm next cipar. lsu't it faunv that we nre roing, to talce away the inin-enttitv of bnsines, to come nlt with sontething, be.eiutse now it is bad even if it looks like a cigarette? Tf that doesn't me.an that you want to pro- hibit ci~~arrettes, thon I don't really know what the lcey qaest,ion that wee are discnssing is alt about, because in your analysis of what it was, yon first called it a brown paper, Rt essence; you were Ayrong, aaid you corrected it. Let me tell you a couple of other things that Ymt recall in your dep.nrtnwnt were wronr about. And that is that when Yron answered tLe case in the 5upreuio Court of the IInited Sl.atcs of the Cni1ra? Ilroadr2xtia-,iq L'oroo.Taty v. John l7IzGeTieTl,-you, yourself, made a couple of serious mistakes, in the pleadings. TI58461347
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223 statute like that. we «otdd not Lelce the sa.me enforcclnentt problems that, we have witlt the present definition. Senatc~r Ittoss. I ani sure it couldrt bu preoise, bec:aisc I suppose as ]ana as smol:ing of tobacco is carried on, there will be some deqree of inhalation, be it very slight or fall, but the other witnesses ha~eo testificd, and I guess it is the general obseraations that ciga- rette suukcrs ;;enerally inhale, and in fa(rt vNhen we bad the cig<r tette ads on the telcvision it was often shown how decply they would inhale the cigarette, and ihat isn't characteristin of citar smol.ers front obset atimt, anyway. Hacc Non ecer tried your hand at a redefinition of ci-arettes and ci-ars that mil~,ltt be helpfal to the cmmnittece if we .cant to think about that3 iL7r. Wjr.,eoN. I hav-c tltontht a))out it, Senator I haren't. come np with a really ;;ood one, ye.t- Settatot PToss. If yon get a;,rood one, would you sond it over? 7his i_ a pcrplexing problem as yon pointed out; besidcs tho factor that this ntiqht be an inhalable product, and therefore subject to the same criticisms thatt we lcecled against the cigarette, it is also a considerable economic ihe-tor, as you pointed out. The t.aaation on this is about onu-fifth. Mr. ti'v'n.soN. Iioughly one-fifth, sir. . Seuator mos's. Onc-fifth. That is compa.red to a cigarette, and yet in size and diameter, e~~erything elx, it looks just like a cigarette to me escept Lhat it. is brown. \1r. 1VirsoN. In general, Senator, with respect to the draft.ing problem and the question of precision and so on, may I mal.e this sahgestion: 1Vc have hcre a statute which is qnite precise and there- foro very easy to desirn ar•otutd. so to speak. To the extent that we lo to lea, prrci~r. statules eliiv.li Uive ihe cnurl.stnore discrelion, INcoulrl urge that the remedies be limited to tl-io civil side rather than includino, criminal penalties. If this is dmie, we will have a lot buttr;r vm,ncc of l;ettinh its constitutionality sustaitwd. Senator Aloss. In this agrcvement that Revnolds entered into, did it have anything to do with the labeling of the package, as i'ar as you luio.v? llr. Wte.cor. No, sir. That was their agreement with the. Jostice Depa.rtment. Lct me go back and expand a littlee bit on this history. Since we had an initial determination hv the Internal Revenue 5crvlce that the prot .cas aa litl.le ci;rur, f concluded rather early in onr inres- ti;;ution that it would not be appropriate for the U.S. Govermuent to proceed on a criminal bn.sis in this case. Once you hare had a determination by one ll;ency, I don't thinl: the Governmenl: of the I"nited States ought to ;,>o arounrl indictin;; people who hace relied upon that determination. 1 concluded that the onlv possible case we 1+-ould have would be a casc+ for injnactive relief. '1'hat being trne, had we sued, the compan_v conld hat-e made certain changes in its lahelinff. The suit woiild hace hnd to be based, in my opinion, ott the laboling of Winchester, beeause iu its appearance, a.s you latow, it is a brown cigar-broHm papcr-and most ciuarrelte smokcrs, the consnmers who are goinr, to smoke an;y-how, are, not going to mistake that thing for a m~arette because. of its appearance. TI58461346
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234 TLc type of tobavcn, .chcre the tobacco is grown ou th., plant, su-.d whether sheets are used, stems are used, et cetera, or whether it is chemically treated. All these things bear on the quality of tar. You may find that the weight of tax between a cigarette is t~Tto same, but qualihativcly quite di (forent. Senator COOK. Am I correct that this tar is then tested by paint- ing it on the skins of mice? Now, what can we tell by this espcri- ment? Dr. Oxrv. Well, it is not good paint. I don'h think vmt e.an tell verv much in all ]mne.5tv. I think that~bcars very little relationship, if any, at all to the hum.~n lung. I tLinli that paintina on shin is an escrc; ise that is done bccanae it is easier to do in the laboratory than an attempt to devise the rigorously controlled experiments that need to be done. I think it has almost no validitv whatsoever. Scnator Coor.. A'ovr, it has been soggested that a norm might be 1.2 for nicotine. Now, itt is tny understanding that because there is so little nicotine in cigarettes and that thesc small amounts are qnickly eliatinutrd by the body, that nicotine as suc,h has not been determined to hre- sent a healt.l i harard. Is that correct or isn't it? Dr. OxcN. 'hhat is correct. Senator COOK. Can _von elaborate on this at all ? llr. picus. Well, lhere are several factors involvecL Small amomnts of nicotine are generally-first, nicotine from cigarettes is absorbed verv poorly, because it tends to reqttii-e more aJkaline sur- roimdings. So while there is some absorbed, it is a relatively small amoiurt. It is handled very qniday by the body and lost from snolce in the air. We commonly see it rvhen we are analyzing for other chmnicals, a very sna11 trace of nicot.ine mctabolite. it is deactivated ver,y quickly. Senator COOK. 13nt in large quantities, itt can be dangerous, though, catrt it? Dr. OxrN-. Yes, yes, certainly. Almost anytliing can. Seuator Coux. Doctor, do 'you believe that with the work that you have done and the calaaimentation that vou have been a part of, do you believe that the Surgeon General's Report gives a fair and com- plete report to not only the I'niAcd States but to the Congress, which he is empolvetrod to do? 1)r. Oxux. No, sir, I do not. Senator COOK. Could I ask you to discuss the study that was done in Great Britain by doctors on smoking habits? Would you enlarge on what that report really purported to say and whether it came to any conclusions t,hat coutd be substantiated'e Dr. Oxr1N. I am not sure I am referring to the same one vou mean. If You are referring to the one which pointed out the Briiish smoking habits, for example, where ehere, is a, higher rate of lung cancer and a lower rate of cigarette smoking, this data is entirely in- consistent with the thesis that the more cigarettes you smoke, the higher the incidence of lung cancer and t.he more likelv chance there should be of deve.loping lung cancer. ' TI58461357
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233 Dr. Orcrv. I don't thin7c I ovcr hace. I thinl: I liacc pointed out to thom the c~-idenae as I see it. for smolcinr and the evidenco that I think is consistentt and point out to them some physicans feel that to 4op smol:ing abrnhtly is to cause an anxiety provoking sttnation mrd a great deil of stress. And so I]euve it np to tllem to ma l;e the decision. I hace remuined nnconvinced tluit cigarette smoking relates to enrdioi-a?cnlar disease, so I do not feel strongly they should discon- tinne it. Senator Bloss. Ymn' unswer then is that Voa do not over so ud+ise thctn? Dr. niccs-. Yes. . Se,nator Moss. `I9imik ;-ou. Saut,tor C.oole? . . Senator Cooit Yes. 'I'imn6 :ou, llr. Olam. Doctm ~ do rou htl,ce tm honest disa~rcunent .citli the Surgeon (_7enera l of td ~c I uited States in re,q_ ard l o the Y9'1 re-port? Dr. (h \] es, r, I do. S('.nato < oor. I)oesLimt malcc con smne 1: ind of a bad cre"Anrc? 1)r. Oir v. I hope not. I don t think so. Senator ('omc As yon l.noc~ the bill that we have before izs, and tlie one th:J )ou li ne tidreesed ~our'se1L to, propo.e_ to set muncla- torv liinits of tnr un~L nicotine. ~ow, first is fhrre anp such thing as tar, as ace ]aiow it, tar in ri;;arertrv, or ir+ it as I nnrlernisutd iP., smnnthin,g that is produeed bo, Islhoratory met}hnds? I.)r. Oru~. -No. T.ccu the n.una Yar is very nnforttmatc. It implie; somothing frotn petroletn i rn mn^ i<li cicric2ere. Senator ( umc. D nn't tuat plua:c really come as a result of the lirst rspm•inulltations that were rnade and the fact that the,v ei- :rarted the.suhstauce out of piti-in~ c,i~arette saoke throeqh a cery clri llin~ ol~c~ation .enrl wottnd np ~ritli 8ris s,.tbsi acncc S Dr. Oxci'~. V~, :enrl t:hr, subs6nncc loolcefl dark, and it ints called hu-, and it is an idiomatic plrase, tlntt, is ull. It has no oHmr meaning tivhatsoecer. Yonr qucstion, peol~le don't smolce tar. Tar is pnrely an arbitrarv n~mie. It is derived in the laboratory. There is no snch abilit3• of pcoplc to mioke i1. People dou't inhale tar. Theti- don't ingest tar. The tnr that is yrodnced 'is a fnnction of the laboratory tech- niqnes. tho maehinerv used in the laboratory, bhc tomperaturc drop, and tLe ahparatos used to get the nicotine and carbon tnonoside rc- moved. and that derirative is tar. It lrrarrs no signiGnancc to smoking Senator Coox. Do I understuid that thev both may be rlnanti- tati.-eh> and qnalitativelv ditFerent frotn that in annttcer cit;arettc? \I'ould vou explain that$ Dr. Osvs. Thatt is quite correet. There are tmny thinge that hoar on tar content of a cigaretto that ituce to do with more than just the grams of tobacco that exist in a ci2arette : T158461356
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235 So this kind of dada, wLicli I tlwik seems to xne to tm comhletely inconsistent tiyith thc thc=is tixl.en by the Surceon General and the people who support his point of cien- has been rather neglected, to put it mildlv. Scnator Coort. i)o you think there is somc merit to the ar-tmrent thnt if vou reduce tac and nicotine tLat yon may increeise (lie inrli- vidnuI's dc ire to smol e mm•e cinarettes? Dr. (h t v. Well, a study showed that a person milght take more puffs, for esample. I think this is quitc possible. I can onlc sav in all honesty, I do not know, and I don't believe that anyone knows. the eWects tha( might occur $rom lo«ering nico- tine, carbon monoside a.ud tar content frmn ei;,arett,es. Senator Coor- If this really occurs then and people take more puH's and snok-e morc aigtirettes, tien this is absolutely contrsry to what Dr. IIorn, ander the auspices of the Congress of the lhited States, has been instrncted to tell the American people for years, smol.-e7esg, don't smolce as far down. TLis just rnns totally contra.ry to that, doesn't it? 1)r. Osia. 1Ncould think it cfoes, yes, sir. Senator Coor,. Yon know, it Las just dawned on me, we hace been listening to the chnirman tkGlk about t.he Winchester snalt cigar, and lie talked to Dr. ll'ynder about it, and thct- h.l},od about the fact that most cigars air hlt;iier in eonlenh nmd nicotine; and apprn-ently lahxt we have t.o do is ~,-et this b:zclc up, the contvnt of tar aud nico- tine, instead of loweri.4i it so that we cnn honestly call it a cigar in- stcad of someM1hina else. I3ut Dr. l1'ynder stated that he. thouelrt the tar and nicotine was coming down iii snaller cir_,mrs. I~nt in this instancp, n•c find onrseh-es meeting onrsehes coming bacLc. besuuse if it werc higher in tar and nicotine, then we could licm, -.-i ly call it a small cirar and we wouldn't be ur~,,liine about ichehher 1:-,ple oueht to smoke it or not. D- :- t.hau, mnke somc sense? Dr. ~)stut. Yes, sir. sane sense. Senator Comc It doesn7t mnl.e, n areal dcal of sense to me. Senator 111oss. Or me, either. Senator Coor.Iint I hace noticed that one of thc points that has been made to the ;,*entlemen who testified is that they have lowered t.lie (ar tuu( nicutine in (heee sma11 cigars, smd thatt this kind of ml them bad, and ma Vbe if 1.1icy would raise the nicotine in little u irs w little, tltev could keep thean in the categorv of bein~e (.i,ars- Senaten~ Tlo~s. Tf I m:w inte.rject. I think the testimony was that 6he tar and nicotine in ci;,rarettes has been decreased very markedly in the last 15 or 20 years. Senator Coox. 11'e heeve had a discussion on the tar and nicotine iu the little cigars quite extensively, and 1 think the record will show that. Doctor, thank tiou vcry much. Dr. Ost'*r.'t'hanlc you. Senator Moss. Thank you, Dr. Oktut. T4'o appreciate it very much. (The references re.ferred to earlier follow:) ~v oia -rr-ic TI58461358
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230 71us co;nplox subject is made cven more difficult to andces.nnd by the N-nrtiin-, lc.vels of thc r, ohemieals, depending on thi types of tobaeco, the v.ay it is arown, tile part of tile plant that it is tahen frony the ~cay it tv is cured er cetxra. In addition, no oue has identified disease-producing cmnponents in tnbarc.o smoke in sigmilicant amonnts or forma aeailable to the humern bod,y. ~ From data, in tlre literatnre, it appears f.ha.h thern are iuan,y .eacs to vairytar content of eigareties by filtra.tion, t.he nse o-F tobaccos lovc in tat, bt' usinrr less tobacco per ciyrarette, by the nec of tobacco shuts and stems, by the use of porous paper, chemicfilly tretdod tobEreco, et cetera. Furthcr; of course, if eirare.ttos are smolred down to tile Samo bn'tt len,llt, an increase in the nnmbo.r of pnffs causes an increaso in tar yield. And, a recent etndv has fuiled to show any s-tatisti<ally si;;ailicant diH'err.uces in nnim:~he.tfects between tar frmn one type of ci;*nro.tte ivitlL a nortrml tar-nicotine content and the tar from filter-tipped cigarettes made from other types of tobacco with rednced tar-nico- tine. T6ese many , c.onsiderations show that there would not appear to be sufficient reason at this time to advocate the mamifxcturee of c,iga- rettes .riLh cettain ta.r content. Thcre apponr to be too many variables beside.a a laboratory deter- rnination of tar, nicotine, and oxrbou monoxide to say wLat exposure a smoker t;ets. Tho tnany reports available in the literxture do consisCently, point out tbat there are manv other variables, not controlled by the esper- iment. and that each 1-ndiridttal snolier sceins to be a special case unto himself, quite dilferent from the smolcing machines nscd in tile laboratories. The smokinh of differentt tobaccos may result in different amounts and types of tars. iluman beings do not snokc. tar and no sii*nilfic,ance of ]aboratory reporls on tar yield to human healtlh h,ts been established. The claims of cause and effect relationship of ciga,rette snolcing to eiumous diseases tend to pool all smol:inl- data into one qnestimlible conolttsiolt. aiuce the type of tar is qnalitativel,y and quantitatiycly different, it fullowa tlrat we imnnot pool all this information into one big pot and imply I bab all tar is the same. If a disease-prodnein;,r stibstancc is present in the tar, it mav be prescnt in a ver_v small hart and tile amotmt of total tar may be irre.lec:uit. A rro.nt rleal of data is available concerning nicotine in man. In low concentrations, nicotine stimnlatss tile s3amiatbetic and para- svnipathetio gvnL;lia and in iiir. 66 concentrations, paralvzes fhem. 'Phus, nicotute c.an cause liberation of oatecbolamines from the adrenal glund. . TLierc are many other observations, vvhicb T need not dctaiL here. Aovoever, ihc nct resnlts nre transient, noncumulati~-e and reversible increases in beait rate, cardiae outpit, and so forth. TI58461353
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225 Thc Department said in paragraph 4 of the pleadings that section 3 of the Cinarette and Labeling and Advertising .lct, 15 L:.S.C 1333, required cigarette manufacturers to place conspicuous cautionary labels upon cigarette paclcages. Then you proceeded to say, and I emphasize tllis, such labeling was intended to inform the purchaser of tl ie het3th dangers found to be iuheresrt. in ci ;arette smoking. Let lae read you esactly what Cone ess said, not 611o Surgeon Cxeneral of the T'nited States, \fr. Wilson, but the Congress of tile United Statcs said in Public Law 91-'222: "nIDCdR3TTON 08 POLrf.S ' Sr.c. 2. It is the pNtcp of the Oongrese, metl the purpose of this Amt, to e=- taldirL u cornpreltenstye Federal program to dea1 with cigarette laheling and adycrlising wlth resp(ct to any mlationship betneen smoking and hetlth, whrrebv- "(1) the public may be adequately informed that cigarette smoking may he hazarrlons to health by incluaion of a warning to that effect coi each package uP cigarettes; onfl ^(?) couimerce amd the uatton.II economy may be (A) protected to the muxiumur eN-tent conslxitent wiUt this declared potiey and (B) not impeded Lp dircrse, rmmniforw, mod conrning cigarettc luLeiing and adrertitting reguLktious with respect to any relatinuship between smoking and health.' I repeat, the Congress said it may be hazardous to your healt.h. In t.he pleadinp, of the Attorney General, Ite said such labelinh Ncas intended to inform the publio of the heulth dangei'` found to be inherent in cil,arette snolrln', and the baleful medical eIl'ects of cil,a- rette slnol:inr. This .va.sl't the intent of Conl,,ress. Now, it is the intent oP the Surgeon General, there ian'C a,nl- qnes- tion about that. And it is the intent of the c.hairlnmr of this commit- tee, u-td therc also isn't sahy qu~estion about that. 14nt, the Congress didn't lutcc that intent Tt ]msnt establislted that intent to this very dar. lfr. 1Cu.co.N. Seitator, I thil>Jc in the passage from tlro statute lrhich , vou read, tile Cougress ccxtainly reco(_*niued that this is a con- troversial i.sne. timitrtcr Coolc. tio rilht. lfr. IlltsoN. Thr.rs is no doubt about that. Indeed, this had been reconnized befoie tlwt by tLe Federal Conirnunications Comtni<sion end bv the cnnrts_ '1'he llepartntcnt of Jnstice is char-m.d with rnplloldirth t]le statlrtes o-hiclt Hte Congress passes, :uld upholdiu;,r their constitutionality when Iltev tue attacl_cec_l, and as I rrtd those statements in-I pre- snme iu tile a:Iswm-is that in thc district conr6, sir, because I don't brte. e.i-e hule yet iiled onr responsc in the Sttpreme Court? Seuatot' Cooi.. '17rese are two e.xcerpes from the pleadings that Ini.~~c becv fiie.d bv tile Justice De(rartmr~nt. Mr. lT'lx,~oc. 1'erhaps, in our advocate's desire to uphold the stnt- ote's ooustihrtionalitN" rce au•e not as precise as perhaps wee shonld be, hut we Iry to bn. Senator C"oos- T can understand that. Mr. }pnson, 'I'ite rnerr e.istouec of hhe controversv, it ~codd se,enl to me, Srnatm, is snfficient to uphold the statute's constitutionality. Sonator Cnol:. 1 atn not nrguiug that point. The chairman of this committe,e, mysolf, the entire snbcommittee, about radio mtd tolerisimt, and as a. matter of fact, n-e calne to an TI58461348
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232 we burn candles at our dinner table, and so forth, and yet, while we muy get mac,h higher eaposnro from these situations, neither cardiac oliscas; nor other human il Is have been so associated. The Sm'gecm General's 1972 report relating to smoking and health concerned itself at length with the e[leets of cigaretto smoke in a timall room. In terms of lona-term esposures, concern with industrial situa- tions would Le xnore pertinent. This is particularly so because, as a practical matter, the levels of carbon morroxide frorn cigarette smoke cnnsidered in tdle 1J72 roport do not rise to estraordinaiy conc.entra- limts even in tl.e artiCicial situations prescarted. i:ren, according to the report, the high concentration, long-term rlnirnal efperiments are of limitod siglificance becanee it is lnesentl y impossible to be c.ertain from animal especimentxtion about tho extent of the dama.ge that may occur during long terln in- termitteut ealmsure to lower couceutrations." From what I have said above, the data as to the intermittent es- posnes to carbon unwrwside of snolre.rs naul nonsmokers simply does not estalilish such caposure to be sufficient to warrant implication as a hcalth haaard. Since the constitnents of cigarette smoke have not been esnablished as Irealtlh hazarcL, the reduction or eliminat2on of these constituents tor rcasons o f health is not jnstified. Anain quotink from the Surgeon (aeneral's recent repmt: Cntit Iherc i; a better nnde'-i "ding oi tlle relative imPUrt^,n~.if rne inter- ,l - I m of the onnetitneni < oP ~ i 1 rtsroke und tlle de''I1'~ rd the dis- I ~i-•-, lated with et-, . retb " r~Ling, I will lrn r)ittirult --- '-c aip-1tili- Ud$l. rJduction or C.limirsr,ip i: onC cr 6everLLl of thn cUa..lLLnrnts nflmCd in this report. The report "oes on hovv ..r t, t.nke the 1>nsition that ttnless there is positive infarme,tion t.o i b lon iarv (beingconsiderect guilty nnt,il pr'osen innoecart, in my l~i~'urionj oigarettes iu whicir tlre tar aucl nicotine levels Ira.re bcen n1r, d t prr_aent to the srnolcer lower concen- trations of thc harmfrd sub-1 al,ces in the particular phase. I find this latter remarl: to be inconsistent vvith good scientifie prineiplcs and judgment. 1'rout rny oXpericnce and review of the scientific, literatnre and the reeent Surgeon (}eneral's report, I cannot tell the sigrnificance of ni- cntine conte.nt, tar content, and poteutial carbon raonoside lecels de- riced from cigarette srnoke on health. IIowecer, a false sense of si;,*nifiaance, if not security, caat be de- rired by the nonscicnlific public, from government establislmient or np7oro, -al of iuamiorun Irrols of lheac ronaiif uents. We shonld not fostor meaningless linritations. T7rarefore, I see no nerd to ,ef. these levels to misl ea d the publi.c. Senator 11oss. Thank you very much, Dr. Okun. Your vitae and the bibliography that are appended to your statement will all be printed in the irocord in full and we appreciate having them. I notc that as' wcll as being an assoctato profrssor of nmdicine, you are attending physician in cardiology at the Veterans' Administra- t.ion Hospital, and so I assutne that yoa advise patients. Do yoti ever advise any of your patients not to smoke? TI58461355
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239 C. A,irpmmii, IT. L., and L'.. Olcuu: Fasudilatin,, Arrnts iu the Prevention of .lcare )t~oc[Ird',al Tnfaretions. C'ardio-Fascnlar Rrseurch. 47J3, 8epteln- hcr 1970 _ _lrticiae b2 l".eFarnSJow. - liaruemn. IL I,.. ,lud I{. Ukmr: The L'lace of Caandilator Drqqs in Prriph- "rnl Vnsrnlar llisCrxr. Zinrinuau, IL L., anS It. (H<an: Arlideti Ps T9sceLo in the Treatrncnt of Cl7rudiexxtiou. Kert, AI..I., L. W. 'I'nrr, S. ]frunklia, I't. Gold, It. (Ihnu, M. LInca-ell, and C. Rlwwrui: P]sperirnce mith tLe Cde of eut Aldoatzrone Antagonist in Se- Ieeteii ]Icp( rtrusive Patients. tienatur \Inss. I)r. F,di.ar(k, xrc are pleased to }have con, sir. STATEMENT OF DR. CHARLES C. EDWARDS, COMMISSIONER, FOOD AND DRUG ADMINISTRATION; ACCOMPANIED BY PETER B. HUTT, ASSISTANT GENERAL COUNSEL FOR FOOD, DRUGS, AND PRODUCT SAFETY DIVISION T)r. Ir.u,i'.cnne. Thanlc yon, D'Ir. Chairman. Wo appreciatee the ep- poriinire lo he tcitlr con today to discnss the rplestiou of the FDA's jnriscliction o~-er ci~rarettes. 11'e, first of alL recognize the huzards of cic;arette smol.-in, an(1 ta~nr.utv realistic me,ans of minimizing thenl. Indred, wr stroucly scqtport control of ciharette adrertising to re- /lur.e lls psyldlologicrrl impact on onr youth, and I bcliel=e zse should coul'nme 6o di,s('mintul.e informationon the llazards of smokinn. Tlcee quesl.imt of the FI)A's :rntlrarilc over cinm~ettes in.vlves two la\ls ~~Lic7r .ce adiuinister-namel}, the Food,~Drut.. rntd Cosrnclic Acr,nndtheFedmmlIlazardousSubstances Act. TT-0EB.1L POOn. nr.UC, ASD CUSMlirIC,APT Ci;tarettcs and other tobacco products wonld be drags snbject to the Federal Food, llrug, and Cosmetic Act if medical claims are nimdr for the prodnrl (/=vriterZ ~C'tnte,v v. JyC Oartoos ... Frti~.fas Ciga- u lt-rs. 118 FSupp. P S6, We ltavr on oceaslou proceeded ag;iinst citarette- reeomme.nded frn• nso in controlliur appetite or otherwi=e recommended as it .rci1"ht rcducini?• nid (T'vrited b'tnt^s V. J5!t l3ulk Crcrtolna ... 1'rinz !.n- rl?ir 1uq.li 7( rqr~rrttrs. 118 F. snph-Rki. 1 IIotcl,cer, cigarettes recnmmrnded for smokina pleistire are be- con(I the Federal Food, Drnr, and Cosmetic Act. In l+'ederal Ti°ade 'nvziiaissdnn. v. Liqr~ett aiul .lhiera To7)arr~o ('arrzy>a~ts/ (108 I''. Snplt. - Fi.",, 1863), i_t, was~ held thnt.1 cilrnrettes are not drugs witliln the moZ1ninh of tlre act nuloss a thcrapcutic hcuposcie claiined. hnlcrrl, i If cif-':lvettrs wern to 6e classtfied as druts, they mould haNc to Ime rclnoce(l from Wc market beeanse it .aoulcl be impossiblee to yrm-e thcy «ere s:>,fe for their intended rts. I%SDLll:.v, uAZ.kEnoIIs BimsTAxCrS ACT It ]ras been suggested from time to time ovcr the ' yearq that ciga- rettl_s are snbject to tlte Federal Ilazardons Snbstanees Act. A copy of aa' '-Wtv 23, 1963, FDA mesnorandum concluding tdrat tobacco is TI58461362
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z_s tion of a cigarette presently contained iu section 3 of the Aet does not include umeketing nn advertising as detcrmiuing 8icwrs, there can 6c nn considelation of where and how the product Is sold and promoted, [rhe fact that littlv Cig;lr adveetisemenis utilize the uatehti jingles uloug with proici~ia of populnrity untd ronuuttic attruet,iveness, that were so eharacterislic of c- , adtertivetnents prior iu the han, doen not hriqg the advertistxl prodr>-i A Ltlun the 'ntxtrdori definition of a eigarette; indeed, it is legally irrelev.mt. We believe tlmt the existing hiul on cigarette advnrising conld be expanded by Congress, if it so desires, to all tobacco products. Tnis. hotveTer, is the fuuction of thc legishttivc branch, not a huv enfmroement agencc. As this Subcommlttee is aware, the constitutiona.lity of tim existing statute is presently bcing chnllengtvi iu n ivse braught mt hehalf of cerhtiu brandenst- iog interests in thc Lnited States 1Jistrict Ooust for tilc District of Coiumbia.' The ar~qnnent made hy the plaintifPS in that case is ihat the present statute is unconstitutianll as n violatioal of the Firal. Amcudmcnt rig'ht of free spceuh and as a violation of the Fifth Amendment right to equnl prolection. The dis- trict court upheld the statnte's constitutionnltty and denied the Naintiff's re- rptest for injrmctive and declaratory relief, The cnse is now uu apPeal to the Supreme Cuurt of Bue tinited :_tates and in due cuurae we wlll Lave a final resnlutimt of the lssne involvetl. Tf the coustitntionality of the stvtut is ultirnatcl) uphctQ ihero "nuld seovt to he no legal reasou whyy [hc Congress conld not 1ee s'late more broadly Mtlt respect to tubaeco prodncts, il' it should desire to do so. 'Phe Depyrtn,eut of Justicc has no partieuiar expertise to hring to the 'ccien- tific qnestions of whether eigurettc srnoldng and morc g'enerally the snmkiug of other tobacco prodncts, is hnrmnu to helUth. On these r)nc_.tionc, we defer to the Department of ITealflh, Fdncation and R'clfarc. llcwever, ~.e see no rea- son why, if Congress eleot,s to prohibit the advertising of all tobacw prodrlrts over radio and television airwaves ae at means to furlher proteel, the pnhlic heulth, it conld not emrvtitntlon[dly do so. Homever-and 1 now return to the 6*rint alluded to earlier in my tc>thnany- - there is vome tjvestion as to the elficney of haomiog smnldng nlcerriseiuenh; to achieve the ultilnato goal of rednc,ing or elintinating sumking in this conn- tr,v. One cannot hctp but qnestion, in light of tlre recont slntistics, whether tls goal of reducing tobacco con5umption in this country might not be better serve6 hy reverting to thc frce flow of idcas that suurunndetl the smuking i.vsue in•ior to the enachnent of the ban. The extensimr, of the 1nirnes~ dnctrine to lhe advertiselneut of ull tnbaceo prodncter-nuM1 Snst dgareltes-l'i ould nnce again permit the pnblie to nalce an iofonmed choice on thia contrw'errial i3.ue of potentinlly grave conscqnences. "1'his suggestion is based on the prpmisa substantiaied by the nDPnrent ssrc- cess uf the anti-s'ruokiug measoges, that-given nn rnady and abuadant snpply of iofnrnuttion ahout smoldng-the indiridnal, deriding for himself, wiil chonsc a coiu'~e of action wffirh tvili hest pravidc him and his familc n'Cth a lvhole.some, prolon}:ed nnd eafer lifcin a niore suitsilrle ond plcxaint eltvirotuueut. .A[r. CLairman, this ronchl]es mp prepared statement SenatorllToss. l~7e wil] nmv tal.-e a 30-minute recess. We will reslTme at 1 :30. (Whercupon, at 1 jT.m., the hearin', was recessed, to reconcene at 1 ii0 p.m., this samc day.) nPTTCnIFooN SBn"sION Senator A[os.a. The committee will come to ordcn•- Senat,or Cook is on his n-xy and should be here any minute. AVo will ilear now from Dr. Ronald Oliun director of clinical pliarrnncolo;y at Cedars-Sinai 3ledica,l Center, ).os Anaeles. Wo turc very blad to have you, Dr. Okttu, and rou may proceed. ' Caplbo Broadcnatiog Co. r. Sfitehcil, Civil Actimt So. 3495-70, jvrfsd4cf6onui afale- rnant filad in Suprnme CorzrA, Ko. 71-6IB. TI58461351
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231 Thnt is why t11e Surgeon Cxencral's advisory committee, in its 1961 report, refnsed to fuld Idlut nicotine rcpreseldect a sicnificant health haz.lyd. 6ince nhnt report, the medical literature, again, cloes not allow a person to make any other conchrsion in relationship to nicotine. At tlto present state of our kno.vled,R,e, it is posslble to hypotllesize that t]re, release of endogenons catecholamines through nicot.ine ab- sorption maY prodncc tnouir.nt inc.rclees in platelet al"'regation in somc people. However, even if this turns out to be true, it is rot lihcly to be mcauiur;ful in tcrms of discase cnusation. It is wcll known that endog'enons catecholamines can be released , by virtnn.1ly ;ury stress, c+a;unples of tlssc ilccladc runninff t walking upstairs, cinotionally agilalin" situations, imd so forth. It has not been shotivn that cakerholamine relca,sc in tlus fashion causes disease. Snperficiallv, olle mi~~ht assunle that because larne doses of nic.o- tine call be lul.rmful, any dose of nicotine is bad-this is scientifically not correcb. First, mnny common house.hold materials are harmful in lnrl;c doses bnt qnite acceptable and perlraps evon necessary in small doses; for exa.mp]e, txble salt in htrco nrnomrts can kill many people, butt iu small amounts is iu,ceptablc bv allnost cvery person. However, small doses of salt may be harmful to certain pcople, sueh as those wil.li lieurt faihcln or ]lvpcrtension. But this is a problem of alt indi- vidlral patient which lnnst be determined by the phyniciiul for e.ach patient and no heneral ru]cs rxn be ruade.. Second, therii are cLatu whiell indicate that the effects of nicofiine npon conditionina and learning are toward improvrmmit of Narious types of performitnce; oven lmre, however, the effects are complex and sarv between Jndividuals, et celcrw. .1.guin I emphasize that no general lllles can be made regnrding nicotine content and hhy~aiolo~;icul e.flect. Studies have shown that carbon Inonoxide present in cigarette smoko does inc.rease the level of-carboxylremotlobin, when heavy cig- arette smokers and nonsnoker5 were compared. In essence, this eauses displacnment of oxyllemoglobin and in total results in a decreased release of osygen at the tissue level. jhhile there are vcry few clinical investigations bearing on tbis findinr, there is no indication bhat 11m carboxyhcalloglobin levels ob- served in smokers are ho.rmful to their health. Several points shauld be noted: 1. Snmking is oniy an inlermitteLt nctivity, so llrat carLaxSliemogLobin levels are reduced when not smoking. 2. People develop inerensed tolerance Icvrls to carboxyhemoglobin nver time. 3. 77rere ttppears to he a sigruflcant rlifterencc betwcen i«tlividnals in tews of carbon monoxide nptulce after cigarette amkinfi, hnt there does not appexr to be uny dilTerence when smoking, different klnde of r_igarettes- 4. There is also a siguiflcant difterence in curbon umnoxide uptaice at tliffer- ent times of das. 5. Pnlmmnnry fiirmtiou and iniuil4timl practices may be mnre important to carLOn mr,noside intxke than the tcl>r of cignretre. For these rea.sons. one must qnestion the significanec of limitingthe carbon monoxide output of cicarettes. IVc are all exposed acutely to high levels of carbon monoxidc for short periods of time if we stand by a fireplace that is operating, if TI58461354
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6 229 STATEMENT OF DR. RONALD OKUN, DIRECTOR OF CLINICAL PHARMACOLOGY, CEDARS-SINAI MEDICAL CENTER, LOS ANGELES, CALIF. Dr. Olaut.'Cbank you, ;ienator, ladics and <twitlenen. I am Ronald Okml, DIJD., and associate professor of medicine aud medicul pllarloacology and tbcrapentirs at tbe Ilnicei.vity of Califor- nia, California Colletee of ,lle.clicine in Ircine, Ualif., and president. elect of the _hncrl'~m aendemi; of Clinieal Toaicolo;,y. I run a hrodnate of the I;ni~crsity of ('alifornia where I receiced degrees of 3t.I)., and 1LS., in pharinacology and tosicnlogy. after ]laving complete.d aa fellowsltip in cilinical lihannacolol,y at .Toblts 7lophins School of 1lfedicine, I became, a;sistant professor of ntedicimi and plianuau:olor-y at liniversity of Colifornia, Los Ange- les, school of Inedieine and director of clinical phatrolacolog.y at Cedars-Bina,i ill:,diral CenPer, Los Angeles, Caif. llly enrricnlmn titao is athulictil. I con:e Lem at tl:e invitatimi of people representing the tobacco industry, and I w:ult to m:dce thnt clear at this point; holrecer, tlm views I espress are minc dcriced from orer 10 yeats of research and trniniu", after meclieel scltool, including research on e.lYects of envi- ronmentld stress in toxicology. wbich have convincad me tlmt scien- titic research and not guessrvorl: should settle questions of plq•si.olog- i:.nl and medical e8'ects of various pharmacolocric atrents. 'l'hese views, on the gencral question af smolcing and health, were presented to the Comme.rc,e Committee of the 0.S. Ltonse of Repre- aentatives in 1Nfi9 (Ser. No. 91-7?, pp. 11Y1r?i), and 1 will not repcat tliem herc. ltather, let. vme simply note that I do not believe that any research since that time hns s~tcceeded in establishing a causal relationebip bet,icoen smchin.* and healtb, and turv dire.ctly to tho qu,.4tions of possible harmful efl'ects of cigarette smohe const.itnents presently befm'o this committee. 'hhe ratc :uid amount oP absorption of cigarette snoke e.onstitueatts from tlle svnoki:~ of a ci~aretto probably depcnds upon at least the followinq; factors, nols listed in anv order of importance: 1. The nnmber, size aml frequency of pnffF. 2. 'Phe lenhth and t/me I,t:e mnoke remuins in cuntect mith tLe mucrn:a mem- hrune. 3. The nciBitS of LLe bu:ly fitida with whir_h the Fmohe emnes in contaut. 'Phe depth .rnd dofiree of inluWitiou,. 6. Itorv necustnu:ed the prrsan i~ to suu$inl;. 6. TLe ehemicat content af the tnb::rco snmke. 7. The moistura content of the tubnceo emoke. & The chnracterietics vf the Iohaccu. J. The uee nf a filter. 10. The acidity of thc tobnro smok,•. 11. The aggiumerntion uf e,nr,lce partlcles. 12. The anrolmt nf n:nivtnre over wl:ich the sutoKe trucels. Al1 these variables muat be carefnllv studied and held constant bofore a scientist rut accurvtcly prediet absorption. ljom then is n herson goin, to be able to predict the effect of urty suioke constituents in hiutself wit.h all tlmse variable6 a There it re many diffexent chemicals in tobacco. TI58461352
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240 not rnverad liy tLe I''ederal ITa.zardaus Snbstances Act is being sub- Initted thi5 afternornl for the rec•.ord. (17te letter folloors:) hY1~ANT3365T ur IIeALTrr, F,oUCAZVOS, AND WGISAnE, P/nou aSU I)nCG Au]QIAt6TAATroS, ti1'ashbn.gbala, D.C.. May 341963. 'I'o: I)irectors of Buremts aud Divisions and Directors of Districts. L'rom: Buretut of Pnforeexnent. SuL,in'r: l:E Koid,diu,~; '1'nbauen Prorlncte withont 'Pberapeutic Claims nnt SnL- ject to B'DC Act or 1lazardoas BLWSbtnces I.nbeling Act. OC/Congrrnsnic,nnl Letter )lay 20, 1962. This iv i¢ further resyoase to your letter in which you rniac four qnestimis abnnt the iqtplicatinn of 1nR's wLich we adtuinister tn the dintribntion of fnllucco cnntaining products. We will res4ond to thu qnretioiw in tlLc order tit wbi0i yon nsk thcm. 1. '1'he st;ttntory bnsis fer tlle exclnsion of tobnceo products from FDA's jn- risdletion is the fact that tnbucin markeled for chewhig or smoking without ne- cotnnmiying theropentic ~i,,ii, -. dora not rnect the definitions in the Food, Drug, antl Coonetic Ard f t f~nd, drug, device or cosmetic. 2. /bngrrss did nm , ~nsiP,,r problems that might arise from the nsc of to- bacco when it con.airlered the bills dm'ing the 1933-38 period, whieh led to the euactment of thc F- -L Drll~r and Cosmetic Act. 3. We bciievc thel. I.I:n-, does not qnalifc as a Imzarrlons suhstnnce tmder the Federal llnzn?Di..- "dstances 7.abeling Acn of IJGII. .Is you know, this Act specifies six 1,'p, _ if i , mpotmds that are cuvered by the ternt "7tarardous .sub,tttmcrs." Tol.i-,. &ic_s not appear to fit in an:' of these six classifilxtions. Rurthcr, tit uo tiwe during tLn Congressional cousicleratfon of the Act was there any indicntion that it was intended to cover tobacco. 4. Whether the Fl, Drug, snd Coametic Act or the Federal liazurdons Substn.ncee 7abeling Act should be changed to cover tobacco is a mattor to which we have given a great deal of tbought. As you know, the Suryxon Con- eral of lhe Publia Henlth Service has appointed an Advisory Comuitt,ce on srrolcing and lienith- We anticil>xte thnt its report on the natlre and nmgni- tude of the heall9t hazards of tobacco sntoldng will provide a sonnd anientific havn for evahtntin.g possible I'ederIl action in this field. Ake would like to have the comments of this arlvisory cominittee Lefore nttempl3ug to make a reconmtendation in the matter. Begnlar Distrilrution. Dr. Ruwnnos. Iiornter Senator \touher,n,cr stated darinn Ilor.se hen.rili,>` on the Federal Ci~a.rette Labeline- and Advertisin;{ Act in 19(i-I that the de('mit.ion o}-hazardotls substances as ane subst:mce wllicll has tLc clq>aclty to produce illncss to man tln'ouEfi inhaiatimi "dearlti, eucompnssas tlte c igarerte."'Phe Depa rtnlent of I II:TC' rejected tllis t.osit.ion oil the b;Isis of thc le;.rislative Listorv u1' the act. wLicil shotts that Con Ic~;e n-as hllmarilv inlent ullon le,ula.t.inl~ llousehold clteroica.ls and did not contetnplsRc ret?'rlntin;_r cigttrettee. 9A copy of an exahamre betireen ('outrressmnn Poberts and FDA llepr.tti' Com- nlissionerTLtrvey durinltlhe 19G4Lcarulgson this subject is also heiur slbinitted for the record. ('Phe maurial follows:) SIr. Rmn.nTs. WLat amendutettte wotild gon-do you htm in mind? Dr, Tesar. May bIn Lllcnbogen answer that, AIr. Roberts? Atr- Rosexrs. Yes. sir. Mr. Pht.KNnoors. Sir, we have not fully explored the precise amendments, nnr tbe prceise cnnteut if the amontl¢. cmtx, that would lie ncetled in nrd,•r to umake the Federal IIazarduns Substances LaPwliu;; Act a suitable vehicle for litis purPose. 'lhe preseut provisions of the act, an yon know, provide by st:lt- ute exactly what the labcl of the hazardous eubstance package must say, snb- ject to ecrtain anthority in the Secretary to vary these requirements. These prorl,iods-und 1 wulutl tlefer t:> Nr. klnrvcy nn t'his-1 am satisfrvl rvould not he fully suitable for the pnrposc that we have in mind here. TI58461363
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a,tn-emnrnt with hhe industry lon~; before 19rat statii,,e went into effect that tle industry wantod to go off of radio and television. The only reason that a statute was passed by t1lc G'mlh ess of the l;nited States was because bho industry itself did not want to be accased of v'iolabint the antitrust laws of the Ulutod States, I wantt to sas for t.he record right no.v-, _lir. Wilson, that the advertising heople, the radio and telnvi5ion, wanted us to entor into an aMr,c,ment with the tobacco indnstry that they ti•ouldn't be forced off radio and tele6- eion for 3 or 4 years, and t]lat it would be a decreasing thing, 1 was umazed one day when I sat at a meotirig back in this very room when tho president of the Aational Association of Broadcasters said, if cou will decrease this revenuo so we ca.u stand it year by year, we will increaso our nmismohinr advertisements and we may reach what j'ou wnnt, convince mmr, peoplr, not to qnoke, while we are talang the industry's money to keep them on the air and keep them on tele- tiision ove.r a longer period of litne, I)ras absolutely amazetl. T'hec said in e.ssence, that we ).-a.nt yotr money, bot we mant to gnt you at the time we are doing it, and if you give it to us ov°er a longer period of tinte, we will phase you out fastcr. So T just, really want you to know that it was the tobacco industrv that set a (late to get off of television, and it wanted to gett off of teL- evision fastm' th;tn rhe. st,d.ute llrorided. Mr. Wmeou. I recall those scssions, Senator, and T thini: T wa= one, of those who was qneslinning the )visdnni of the antitrust e.aeinptiolt at that time. Scuator Cooh. T')a.tt is correct. Thard: von, BSr. Chrtirrnan. Scnator~ Moss. Thanic you, Mr. WlnsoN. We appreciate it very nmcPr. D[ r. 11'Tr,s(D~. 'hhtmlc yon, D1r. Chairman. (The statement follows:) SL1'rC)SI.N'r Or BRirCP1 IS. wILSVN, DF:P6'TY [t68tPTAST ATTORFRr GP.VTRdr, a1 V TPPaU FT I)IF1sION, i)LPART][IDST OF ,Tii 9TT6F. Mr. Chainnan and blemUcrs of the Snbconunittce: I appr'eciatc this opprtrtunity to appear hefore you today to dinc-uas thc espe- rierce und vietss of the llepartruent of jusliee tiv1t1l reepect In Lhe Federal Clg- arette Labeling and Advertising Act, ae anrended bc tire I'nblic ]3enlth CibZt- rette Smoking Act oP 1969 (15 U.S.C. 1331. et aeq.). The Department of .Tnvlice, Ihrough its reuently established Consumrr Affairs $ertion in the Antitrnst Divisiml, is charged with responcihiliLF for en- forcement of this statute. As a member of the Intcragency Cigarette Liaisnu Committe, joined by rePresentatives of the Fedeal 'Prnde CommisFiolt (lie Federal Conrmunicatimrs Couuuission and the Internal Iievernrc Service, thc Departauent is contimrously matutoring devdnpnnents in the tnbacco industry. One snch devetopment is the advent uf the "little cigar" nnd its ayperant poptnarity, This development, whicli oeeurred largely after the paseage nf the 19f,9 Act, is, I bclieve, signifirant in any aPpraisal of the effectivenesn uf thiet legislation. Whon C;ungres amended the 19fni Avt by s-trenarthening the Snrgeon Gener- al's precantionary warning on cigarette pack[tge nud Lanuing the adventise- ment nf cigarettes mr electronic media aubject to the jnriediotinn of thr lred- eral Cammunicattons Conuuission, it acted with regard tn only one tobacco product--cignrettes. At a Inter point. I woultl lilee to tliscnPs the nllimate- result of thLs yroscrip- five legislatien as it has affected cigarette smo.l-ing acceptance nnd conenmp- tion. Bnt first, I would like to outline the prohlenn nf enZorcing certain Taroci- TI58461349
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243 Mr. Ronr.nrs. sinee cou havo that authority, have you rn;ide any plann, or are you unalcug nuy ptans, to establislr euch a0 nleninghonse° Dr. Pranr. 1 es, rve m•e runking very dofinile plans, M r. Aobert. Actually tLo haair oruvriealio~mi struotnre ot the cianringhonss is already in nlmrtttlou und hss bocn for screra] wveks. We have not, up until this moment adopted the for:n:Q litle, hut oe have been asnembling part-time nnr7 a few rilll-time per- swme.t to work tnward tha objectives which I outiined as the Ar'Imary objec- tiles tnr rhe ntionul clearinz':wune. \Ir. ttuur-xTn- I wunlrl li6-e to cnmmcrd thn gentlemsa I would litce, with thc cLairman': permLs=ion, at 5onie otlrer dafe, to have the Surgeon Generztl come Lefure u-m :urd esYtain what this Dlan has accomplished. That is all I Lnvc. 1)r. Elnvann.z. Subseqnent actiolts b.y= thc Conirress ou lhis aubject- ntuneh°, ihe enactment of the b'ederal. Ci~aret_te Labelint,r and ,krl- crlisili_~ 'rct of 14(S5 and the Public ICeetlth Citrarette Sniolcing Act wbiclt bectune law in 1`JTO-elesrrlv dcuronstrat.e that the Con~ress had not intended to snbject ci~.nrettes to the federal Hazardons Snb- stance Ar.t. The follolvine, statement by Representative Oren Harris, then chxirmml of tile House Committee on Interstate and Foreiffn Cmn- nterce durin"' heariitgs ou the 1965 act beal s on this point: Only I'onr }'eurs atru the Hnznrdons stthstanees Act lvas develope[7 und there wa, no rhought m:fl I believe it ,vas not ever mentioomd in the harrinGS or in the le°ialative histo.y, yet herc fulu. years later arRtirnents are made that the Act covrns rignrettes. 7:hnt ie tile sort of thine that does eause cne sonre cmo- cern rvith the re,tmlHtory ngencias of Governmentt inlerPretinG Ln~:-un.p.nn -hnt it extends their Lroad =eueral anthority. (llearings before il~'I .ilu.Sh• Tn[erc[aie mld Ii'orei>al Clmnmerrc, Ilonsc of Itr•Pr'esenhrhiceq ;~s: ri,_ce,s, 24 Cev.ion, t'isarette LtrbelinK and .Ad certieing, Sane 2R, 1964.) Tlle Ferleral Havn.rdous 5ubstauoe Ar-r has been sul -tantia,llv mnendrd since 1966- onc,o ul 1966 rand itasin in 1960. Ilower•er, nei- tlror sct of anrendlnenM1s indicated that the Food and Drug Adminis- trarion .css inlcnded to hace auy authority o.er cirrarettes. A1 luu•- licular, Ilrc ]!)6B amentlnienle naire FD,:~ n.uthoritv for tile first time to ban certain h:rzardous subatanees. 111 is inconreivable to ns thot (bu;~,res conld have intended that authority to apply to c.i":uettes e-ithr,ut arla consideradion or diseussion 11-hatever of that matter. (ht tLe otler hand, Congress has clearly emmeiated its poliey on ,i;tarrttes in section 2 of the Rlblic Ilenlth Cigarette Smoking Act. '1'his provides that the pub]ic shotild be adcqnately informed about the hazards of smolein-, and that commerce and the national econ- omv should be protected to the lmaaimnm extent cmisistcnt with this derlnred lloliey..As Ihe latest rongressionn] stirtement on this sub,jet•1, it clenrhnrei:tils ol-er rutv elulier statutes ;urd reinforclls ollce agotin that tl ie F7-1S:A il-as not intendul to appl v. This rnct also Nvo holiece detnonpfrate,, that the regultrtion of ciga- rettes is to be the domain of Crnrgre=s. No st.atement relating to smolein_ and health cau be required on cigarettes except the v1•arninr llresrribed by Conrrress. Before the FTC can issue trade re:ultttions rocerlun:,r ci,n,arette ~idvertisinr (other than broadcast adverti=in;• nchich ~~as~prohibitecl bT the aet)-the _% ~wu;y' must stlLmit the t'ade rewulation to thc Cmi- gress. Reports to Cong-ress are also reqnired to be submitted an- unalhy by ilT:AV and FTC. lnaulil, labeling or b.uminh cigarettes is astep tltat enn be take only by the Conl,nvess. Any snch more hy FDA would be inconsisltint with tile clear congreasional intent. . T158461365
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343 ,ts vou have heard, Dfr. Chairman, fronr tlm _lssisttuil Secretrrc for Ifealtlr and ScicuGfic Afl!rira, Dr.3ierlin P.IlrrI';il, dnrin" cour hear- ings last tiveek. ttrc I)epurtment of HEAV i:, netivcly dissrmin.ding iriformcrtion on the irazards of smokine and is strongly disconraging stnolcmt;. TTany rescarch prorrams are rmdcrwtiy in the I)epartnreut in all cfFort to wiilrol tho diacases a=soeiated .cith smoking, nnd I wholc- Lenrtedlc snpport tlrosce efforts. 'Tlhu Y.~r~reityI oP the problmn demnnda that il rccc.ivc this a.ttention, and Ibelieve errry fensil>le mexus of rcducing the ha.zards of smokinl,, should ho nudcrlaken by appropri- atn ~nccrnmcrrtal at,mncics. Hyou have :ury questimrs, 1[r. Chairnrun, Ircill be happy- to :urse-or them. Senat-or 1\lus.s. Theurk yon ver;v mnch, I)r. Edwards. We apprc- ciatc your statenreirt swrd cxplanatimr. Onsr of the nicn tLinrs abont a hicmuerrIl legislatnrvv is that wo hace hearin«s in cithr.r trodv. Iun -~d,"i.~~l the 1061ICousc interprctation of tJre Ifai.irdonc: Sub- st:ur, , , .- .A, -r, what it did covcr and tirh at it didn't coti-cr. II would like to read from the 1965 SSenate heariugs on the same questimti. Saudm. H.u'tke ,aid, "Isn't it true thab no one er-rr ~Irranred Ihut I;lris act would epply to a lot of items duit iecre not ;nsidcred at the itesn hccause tlre fact of the mal:ier rcas th.tit it knolwt that tlrere were harardoas snbstances att the tirnq" and _11r. Pllcuho- gen from HEIS' said "There are many procLncts being Ii eaoped day after duy whiclr .r-cre not eXelr in existence wlrea Uris ac6 was enacted, a tirould sac in a hroa.d vie.c, the)- cwnre zvithinl the general prrvimv of the intent of those people ndin dercloperl the act xt that And then fnrther. during the course of the ]reariug, Senator Hartkc, Semtitor Venberger, Senator i\1agnus7ry all went on to soy that the Haaardous,"iubstance Act would apply to cirarettes. I Hrinlc particuLrrlv pcrtinent etre the comments of Sonator Hmrtlce who clraired tlre lrearsnl;s in tlre summei of 19:i(), rurd the comurmrts of Chairman biaglrusorr, who said tlrat with reg'ard to tho application of the Idazardons Substance Act of cig.irettes. and I qnote, "'Phe. ~Let is brorrd and it miglrt apply. This is not unusual in the Con*tcss. }Ir hnve mtim acts wlnch some people tldnl is iartlimi ) - to do r i r t nn fliinrs bnt for ome reason or other ber 2use they think it is not clear. they don't do rt And this conumittcctrme is taken np quite r lot with giving connres~ronal directives on thesc ruatters. One of thc rca.sons that these bills, cigarette labelrn,~, Were introductd is i~ there rv;uc zny questiou ars Lo the attttrorit- v, the matter .vwdd LLen hmd in the courts. Out object is getting at this proble.nr.°' Now, if we are "oinr to use the legislatire history }ou not acting on cigarcttcs, nc nright trlso exxunine how the Food and I)rug _tdministration interpretR-d the IHtizardrnrs Sulistance Act to permit tlre esL•rblisiurrenL of rnaXirumn lirrrits of sodium lrydroside iu liquid draiii (~leancrs. I am not referring to the I'oison Prevention Packnrhinl., Act, because the original proposal srtting a ceiling on the quantity of sodium hydroxiitc in liquid tlrain clcrurcrs wxs published in thc Ycd- TI58461366
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244 eral Reffister a fnll i weelis prior to the enactment of f.be poison hrec-ention act. The insert nsrd as nnthoritc the Hazardous Substance Act. lIy question is, where in the lehislative historv of the llelzardons Fubst.urce Act is (here an)~ indication that vou have this authmitp to setmatimnm levelr on sodium hydroxide in liquid drain cleaners? 1)r. I3nu•.Nnns. May S ask the general counsel, sir? Senator Zloss. Yes, snreh-. \fr. IIi= Mr. Chairman. as _vou kuok>. there is a, definition in the Hazardous Substance Act which was added to the act in 1966, _to define a "bannedhazardorssubetance." That is in scction 3(q) of the ac•.t. jFc Lerve irderpre.ted tLut to givc us nnthm•ity to set limits above .vhich a snbstance wonld be banned and below which either labeling . or adequate packaging wonld he suffieient to avoid banning There is no question, and never was any question, abotu the appli- cabilit' v of the, act itself to liquid drain cleanrr=, .vhich are obviottslv pa,elca;ted honsehold substances and which I beliere all ot ns Nvi1t arrree can be hazardous. Senator 1[oss. ,11y question svas, where in the legislative histor)' Nvas am-thing clireetecl torcijrds lirnlting any substances in liquid drain cleaners, since Dr. Ld.vards testified that there is no leg~sla- tive histoi,v on tobacco, and for tlrat rcaeon. Yon felt there was no jnrisdiction'? lfr. llcTr. tiernator, T have not read.(lrc letislati;e historv of tLe HaMuclons Sul)starces Act to see if drain deaners Cere specificallN meat ionetl, bnt T clo lcuom thatt snbstances of that Icind, you wight snY, Iroaschold produc(s llialbnrn owcorrodei the esophn;?cs, w'itL a lrietor}' ot' inrestion by children. 1cere one of fl)e prin~ie eon=iderutioas of the (Cou~rrescin euac`inhthi=lnic. I» short, tbep fall Avitliin tlrebroad eaterorv to rdricli Dr. Edwards referred as hein~; honseholcl cLernic.nls ii-ed wherc children are prrs- ci:t. nr c.-here the chilitren mi,,rLt misr.se flhem. 6cnaror AiosS. You very o'ell construe thnt so that ~-on cau set mntiinnmr lrcol.,, brd. vou cn'rn do tlntt as to tobicco, is flrat what cou accs:n'inc % Mr. Iir.r.r. ~R'<+ll. no. T wonld not say that. Senator, and I tbink n-e sbonld urako it elear first that neither Ilc. Ed+cards nor I were in thr I'ond xnd T)rnz? Administration in t'.)(i"', )N°hen tltis police n-:rs initiallc oiumciat.ed. This iIas, Ce beliere n conteraporaneons construction oP the statrtee ftom it~ ineeption, which Las been arppliecl np rmtil flle time that both 1)r. EdN,ards and I iu'rived on tlre scene. 'She quvstion that we are now faced with is whetlrer the statutr clearlc rpqnires ns llo overtara this 1o1~-,standin;z interhrrtntimi of lrisior.c. and iii rending g the statute., liartiVnlarlV in eonjunetimt Witlt the rccet;t ('onrrressional eztactmernts, .vc do irot foel thrit Irc can ovcrturn that positinn. Senator Moss. AYett, T agroe that the le~islative histor;v doesn't show that tion atre directeil to do it on cigaretles. I don't think }'on cau lirnd tLa.t in thcre. Bnt tbere scesns to ure that it does hace a broad area, of jurisdie- tion, and that Sor. might well use it. I realize }'ott har-e many priori- TI58461367
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2:3s 38. FauLnan, J. J., lI. 11. Maxwell, J. D. Crziven, and R. Olcun: UCLA Con- Yerence. H_.pertension-Primary and Secondary. Ann. lut. Med. :Su1-i7G, 1971. 75 39. Olmn, R., H. Dfaibach, and'l. Cntes: Acute Acvelform Eruption `,ecuvt3arp to ?11S6S2. Arch Derm. 1P2:583, Nov_ 1971. 40. Farpman, Il. L., and R.. OY.un: The Place of Vasodilator Drugs in Periph- era vascnhtr Ilisease. (:eriatrirs. IN PREBS 41. Chenii lon, G. D., H. E. 1'aulus, E. Hongan, R. Ol:nn, C. M. PealSOn: The Pair.r of Aspirin on Scrnm Indomethacin. Clin. I'hxrm & Therap. (In 42. Olan., R.: Treatment of Sedative Drug Overdose. Clin. Tox. (In press.) CEaa-pters ~,, a book.- Olaln. R.: Developwent of New Druga. C7lnptur in h'ssrnrtiaLV of Pharnrarnl- ogg Editnr: John A. Bevan. Publisher Hoeber Medical Division, 1Iarper ft Rorv. 1909. lry. 29-35. Ou,ui4 R.: I'harmaeolog)' of Placebos. Chapter in T4ssonztia7s of P7tarntocoingg Rditor t John A. Bevlut. Publishrs Hocber 1icdical Division, Harper h Row 19(i9 pp 3Crg2. Oknn, It.: Drug Dependence. Chaptor in Essevatiads of Pharmmcolopll. Editor: John A. Bevan. Publisher Hueber 4lslical Division. IIarper 3. Itow 19ti9, pn 59-G8. Olam, R.: Acute Drug I'oisouin6. Chapter itt Easetstials of Phannaco7opy. Liditor: John A. Rcvan. Pnblisker IIocbcr Medical Division, Harpcr .L'- Raw, 1909 pll 75--34. Olcnn, 11.: Psychopharmacologic Agents. Chapter in Exsentialx of l'hm-neacoL oD?/ Editm': John A. Revan. Publisher Hoeber Melical Division, Hurper & Row, 1969, pp 197-2I2. Olrnu, R..: Alcuhol (Ethanul) and Tetracthylthiurtun DisulHde. Clhaqrter itt L'erentiad.s of 1'honraaoWonl/. Editor: John A. Revan. Publisher Aoeber 3iedhalDiv'siou,Harper.'l-ROr,I9(ta,pp3y7 3F79. Ol:un, R.: Antilipid Agents. Chapter in tr'sscrttiais of PLarnrbacolopH. Editor: John A. 13cvan. lhiblishcr Hocbcr Dledical Division, Harpcr 8: Row, 19G9, pp (i00-(i03. Okun, R.: General Principles of Clinical Pharlnacology and Ps5'chopharma- cnlu;iy and Hlnrly tlliniwl Druy; lllvulnntion6. Chaptor in I'ritaci-Blex of P.ry- cNonAara'acodog7l Pditors: W. C. Clark and J. del Ciudice_ Publislrer Aca- rlemie Press, Vew Yot9c, Now York. 1970 pp 3S1-190. Okta, R, : II,ce of Diuretics in the nInnngementt of IIyperten,cion. Chapter in Diuretics in the Management of Fluid Reteution, Editor Henry O. Heine- marm, M.D., in Modern Treatnuen.t, Volume 7, Number 2, March 1970, I'ub- 1lsber Iloeber nfedical Division, Ilarper and Row, New ,l'orA, N.Y. Silverman, A. G., and R. Okun : Depressant Drug Overdose. Chapter in Cur- rent lharapv, 1971 Section ld, pages 772-774. Publisher W. 13. Saundcrs Compzmc, 7'hilssdelphia, Pa. Silvermatt, A. G., nnd R. Oknn: Depressant Drug Ovcrdose. Chapter in Cetr- rant TheraP?7 1972, 5Section 15, pages 83irti3Q 1'ublisher 1)`. R. Sattndera Company, 1'hiladolphiu, 1'a. d bstracts.- 1. S3ege1, 1f., E_ ]Imtgan, R. Olrun, J. J- Calabro, and H. E. Paulue: The Self-Sustaining Survival of High Serum Salieylate Levels in Patients with Rhenmataid Arthritls. Arthritis and Rheumatism. P. (i97, Daccinber 1969, _2. Paulns, II. Il, R. Olnm, and J. J. Calabro: Grannlonrte Response to Prednisoneand Fltiocholanolmaa C'lin. Re?.7N:139, 197u, 3. Pmrhis, IL E.. R. Oknn, and J. J. Calabro: Depression of Ronc Marrow Granuloc9te Reserves in Systemic T.upus Erpthenuttosas (SLE). Arthrifls xutl Rnenmatism. 13(3) :3d4, May 1970. 4. Paulus, H- NI., E. S. Ntongan, AT. Siegel, R. Okml and C. M. Pearson: Per- sietence of Serum Salicylate Levels in Patients with Chronic Rhemuatoid Arthritis. Thc Pharmacologist 12: (2) : 291, fa111970. 5. Champion. D., P:. Mongan. H. Paulns, E. Sarkissian, R. Okun, and 0. Pearson: Effcct of Concnrrent Aspirin (ASA) Administration on Serum Coucentnrtions of Sndomel.hacin (1). Arthritis. ArthriHa and Rheumatism. 14:375, 1971. TI58461361
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23 7 12. Olctm, It., S. N7. Roth, A. Gordon, and M. H. dlaxwelL: 'Che Long Ter'tu F.ff'ectireness of DWthpldopa in Hspertension. Calif. Blcd. 16L:4fi-50, 19610. 13. P.leeman, C. I2., It. Olinn, and R. J. Heller: The Renul ltegulatiun of So- diwu aud Putasaiuu, in Pxtienta with Chronic Renal Failure and the Ef- fl-et of Uihu'atice on the I:xcretion of these Ians. Ann. Saw York Acad- l:tnv Sci. 139:5@t1-58(61JG6. 14. Snkol, A., ST. 14 _ RuihneG R. Olcun: He*hrotic Syndrome Oansed by 1'robouccid. J11lA 199:h3-44, 79fiY. 15. natte3, l9..'1'. Nllli,,on. L, l.evp, and It. (]latu: 9Tn ]lfrt,:h.,tic FaCe oI d-Am- phetamine-II Sulfate Thephaninarnlogist 8-=-'i, 16. Oklm, I2,: Uiurrtics-l"dc nnll Ahl_.. '1'he Bl, il-.I [Belecivion Sehaorlk UCLA, Center for the Ileslth Sci~:.' s. "- IS. Okmi, It. vnd C- R- C.leeman: RrnI Dfse Seeondar9 to Metabolic Di5- nrdees ur Phcaiolo;;iral Di•ficieur~ ~i i tec. Calif. hLed. 107:8 10, i911i. 1.C. Gcrsrein_, A. Ii., It. Oicnu, II. C. Ci bi., H. 1. R'ilnrr. O. lt. ]qeemmri, and VI. I C Itlaxwell : Prolnnge l TJse of AIuthcnamine Ilippuzate vl 1Spabuent of Urinat;v Tract Infection. :I. llrol Yn~;T07. I9iB. II/. 8ie~v1, AI., 'I'. P1llLuun, A. G. NLvermnu, aud it. uknn: Tispr.e SliStrlbtqian of dl=lhainphetnuine TiII ' ~ TP.raurt anQ -Nontolerant Cats. Proc. H'est.l'haruauuL Soc. 11!li ~:i I''N. 20. Ellison, T., 1L Siegel, '- G. ' I , i m ., and IL. Olaln: CmnParalive 9IeL`Iho- 71m ot dl-'H_AinPlletmuine Ii-lrnrhloridu in 'I'c.lervrt und Voutulei:uit Cats. Proc. A1'est I'harmao~l Soc. 11 :7i.-77, IDUB. _.. Silvoenuui. A. (1,. :u'd R. f:L_n:: IuoProlerimi nnA DnPi ';u the 'I'rtett- mmt of ACeP~'o6alunte Ovci in (lafis. Ihrmc. R"osh. Ph:tr:nncol So'. 11:!1a-95_, 191i3. 22. Ol:nn, It.: 11:•diral I'aln ]trdivf- L Ho,p- Dpnttd I9'nelice lt:".'d-~i/i, 10i/F. _,. Olam, It.: Io elnd Al.nsc uf Autihintic, .1. 11o'p. IRVtnl RrnMiuc II.; `,a-.fr?, 79nb: ^d. Silreruuun, A. 0., II. 1. iA-ilnrr, and It. Okun; A COse Remort of oiastroin- testinnl ]Slucdiq;' Follolving Ilte Use of'1'olnaoIine. Tox and 0.DD1. 1'harri. 7(i:3I1:3Illl, 1470- - _e. n'llvcr,nan, A. C., 11. 1. lFilucr, rnld R. Okwn: A Cuxc oY R.rtideuGll Parcn- teral In]eetion af I'uvnn.'fox aud AppI.I'harm. ili:7+n 7 L IUSD. _°G 8iiv~rmm, d. G.. nnd R. Oknn: 33,oulc ut. Smnc ct thc Idilveixe llrug it,a,liatu. .I1. 11qipitnl Dmihil l'~aelice. lipril 15;:_ _ ,: r i6. _,. II1J1=nn, T.. L. T. L'olq'cr, mid R. Olcuu: The AIeta'Nolic ~:.t,: of SII- bc:ulcIiina iu ltno. L:nropean Jl Yhvrmacoing,v 13:1^3-IZ. 7PS0. ^_R. Iali.ou. i. 1. In, ~irr, I- TPOlp,cr, uuq It. tllaun: AtetubaliIm ' OrDhetta- ,h-ine /1lralc iu AL¢i. T. 1'harm & P1sB- Thcc11D. 178 (2) S, 1'Y1. °_9. Uili,-,,u. U'., li. ''nu, A. Sijvermau, and DI. Sicgel :}ICtabolic Firte of Am- phet,miine in the Cat Tnrin: D,i-elopment of Toler:t.nce. Areh. LlI. Plutrmu:.oiicn l'.a'.13..-149, ]970. 30. nilicli, ~„- A . r. „ I R. OLw.: A Dor,ble Blind 79ealnnM1ion of CaDaride in 'I're:, lv -_ li-- . 1 I.ed Tatlonts Su['fering from Loss of SIeeD. T. Clin. P1LO.=1 .11::. `'In 31.11171. 31 , -lGUn. P..: 'ii .i. I,v of hnrbluurale Ovcrdore. Gertairiu4 26:17`.3, 1971. o-. y alleereian. d 73. Olam: '/'he T/sc of vtn AVReYte SnD nrrseunt illi- ~.~ i~IBliPrnr,. ~~~Ia13'drno.htr.riri(') Ini 1'r[tg.mnc}. Curr. ShcraP- Ites. Yt: (itN~i53. OttoLCr 1971 33. Silvermlui, V- an,i R. Okwi: Osytrtracpcline-~,SStntin in Rle Proreotiou of Oandidnl Faginiri:. Am. J. 01; GT\ I11:39n, Octoher ]971. 84. Okuu, lt. , l^inlcal Stmlies inr Aihenal Con'tical Cnrcinumn: Currenr Stnrl_ irs. Proeculin;;saf the ChemotheraDY Couferencn on Ortho Para-DJID. Ad. Brndcr, I.. T7. and Carter S. li.-N:rtiannl Cancer Inetitute. I'gs 7// 7D, No.. 1970. 3 5. Ro;:, T. I"., R'. L. Hcwit, C. N. Wahl, R. Okim, B. J. Shnpiro, P. F Slatr- Eu, and Il. S. Slmeidman: The hianagement of the Presuicidal, Suicidal a-::1 1'at auicidal 1'alient iCI A Conference. Annals of ]nt hICd. 76 W41, °.Ii .' hcr I.ir1. 3C. I'o I: . 1C. Pu., AI. 8iegcl, !7. ]4ongan, R, Okun, and 7. J. Calahro: Caru- .bun ~J Sernur Concentrations and Ilalf-Life of SalicSlate in Patients " ttL Iihonnultsid Arthritls. Arthritia & Rheumnti.ui 14:535. I:171. 37. Ol:nn, R.: PrinciPles of TreaUnent: 1,letsboliam and Excretion of Toxic sabsCmre,y. Clin. Toxicolug} Bullctin 3(5):f)-bl, 1971. T158461360
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247 Hnzsudoua Snbstances Act to cigarettes, nnd my staff did some, cllcr.l.iug luld fonnd onn bhlit Dr. Albert holb,ye, of the FDA, Irho I lmderslalid is both Lul attornev tuld n ph}'siciau, prepared ti brief IlisclLw;aing llorv the act collld and slwttlii bo applicl.L Lo cioalretlcs, vct, we havca been lmable to obtain this rlocnment. t7onld ' von make nvnilable a copy of ffiat brief for the commit'tee to rcld'z Dr. T.uwv.us. Yos. 7I om not aware of the doctlment, Mr. (71air- mm~, but wo will certaiiilylook into it and, if ava,ilablc,~provide y-on Icith a copy. Senalar Moss. We would appreciate that lrerv Rmch We would l ike to 1'ev i elr it, and see vv'll at was said. We will insert in the record at this point the jI'hiteside eirticle so cou c:m plainly see it x'hel you get the transeript. (The article follolvs : ) UExnnanncnl Pereaxsrervx or HenI.Tr., ]n,unc.rmrv, wnn 1F'z:Li PenLIC 73FALTH $Gltl'1e0, I'OOII dND r1SC6 An>]IY1sV¢A9'IoN, PCLrvrpry (8, 197'. 'Ib: The Cnmmivsioner, LClurnugh: The Lepnt,r Cummissioner, llirector, Burea~u of Foods. R'ruiu: DePU[,v DirecLor', IDm'eau u1 Foods. sttbject: s'ubcunnnittec ou tlle Consolucr, Cmntneroe Cnmmittee, P.cinirsC ar Iiebruili 10 Hearing n Cig:u:eti, -, -Iilformatlon lllemorm,dulu. Dur)ng the above-mentioned henring, C~-lirnian Frnuik 31oys uslced ?ou to vuPPll' fur ihe rerrord s brtef I had rrriiI-i ~ i. aning l,n(v the ]redera7 Ilarnrdnns Substaeces Aet conld arn,] slwold aptrl.v 1„ .. Atthnngh I h:n'c writtGn 1'nrious p1m2,1 drlling nirh smol;ing and healnr ,ronernlly. I har-e not authored nng puper n~iling wilh the Ie',oul aspecte_ of the F'edn'al ilaz:ndona BuLst:onces Act :md its relalionshi]1 to cigaretles. aLnsrcr C. ICor.nYF, Tr., dfJ)„ J.D. [From The New Rcpublic. aliar. 27, 1P1I] C[GANESYE Au,4IN TIIG lAlAGAZ194:5 ,gELLI36 nEATI3 (lSy Thomns Ztihitesifle) tn the period preceding the relnovul, bs acl: of Congress, of all ci-nrefh, a 7- arl:isiqg hnru rvdio nnd telerision at tbe beginning of this year, -Imb, n:for v:nion,: toblcco eonpmlles wcre insistent, in interviews tvith rilntelv; rhak the indnstrc plalned no undne increose in the enlonnt of cig:¢eii-.:dvel'- tirtng in fhe pr'cas rr0en the ban r+n eigurette commorcinls ivuli int., ed, '. . aomc lreclcr: llave now passed shlce vigarette comruereiala n'ere Wken off ibi, air. Ilurulg IhaL time I have been ]nteiested in tvhether the pI'ess .~ud in par- ficulnr magszine, icoldd nbstnin from taldng advanta£c of tbis nlination by solicifing or acoepting. for proflt anp additional print xdvertiSLlg fr a DI'od- nch tinit hns barn Fhonu in medical etndi" (Nchich hAVe hren 1' "rted iu ID" ln'c&s itself) lo Le the leading eause of inng cnncer ammtg men I a riqni5- ., r rnnt eoirtribn.tiog factor to prewahre destth from mronuirp hctirt ai-i ph,v.emal and nt rumlbnr of other disensls. I hare utso becn intervoted iu eaLior- ing thr r,,ttnt to irhich t71e tobacco Irumafautnrexs hnve felt fhomsclrrr+ restrained, in planning their Cigaretteadrerusing campaigns ]n the print merlui fm' the period after thc b:ut on radio und TV nigrn•ette eommcricals, by the re- at]aafion that eny eccessive ]nerease in the number of print ud; thcy tnolc out might provoke the 1•'<slerill Trxde Comrniasion to lulce smne hnd of ragulntncy action, for example, reqniring health warnings to be dJi in all;nrint ad- vertising. 13,V anF .nurh standnrds or re,traint Wc bchnvim' of the tabncco companihe and Rle maga2inee n11Fe since the han oil eignlrtte commercialx went into ef- fect lhus been a:arming, A prinre 2xnmPle esists in the advarGein£ pages of T158461370
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232 Senator STrvrvs. That marihuana is- D[r. IfuTT. Marihuana is beyond our purview. It is an illegal drug and hence outside our authority except to the estents that a researcher requests our permission to conduct research on it. Than we look at the research protocol and determine whether it may safely be used for that particular research purpose. That is our sole connection with it. Senator STiavLSS. But you come down to the point, and if we can believe what is said in the paper last night, that about one-fifth of our young people are trying marihuana, those that try cigarettes have a warning on the side of the package, those that acquire mari- huana, don't have anv warnings at all from the FDA, could they 8 Mr. 7rIrrrT. None whatever. Dr. Euwucos. The hDA is not the one that requires the warning on cigarettes, either. Senator COOK. If you don't mind my adding to that, Senator Ste- vens, I would say to Dr. Edwards, if we put a limit on the manufac- turer of tar and nicotine content in cigarettes, and people start buying a call of Iialf and Ilalf and get the old roll type paper and make their own cigarettes, I want to tell you, they are really going to get a load of tar and nicotine out of that. Senator SxLVLss. It seems to me, in connection with the research. if you are doing this research on the amount of tar and nicotine in regular cigarettes, there should be some iesearch in the terms of- Dr. FnwARus. I want to rnake it clear, that we at the FDA are not doing the research ourselves. We are merely monitm•ing the research that someone else is doing. However, the National lnstitute of Mentai Health could speak to this perhaps better than we, because I think they are sponsoring some research. Senator Cocnc. Mr. Chairrnan, may I make one other comment to counsel. Senator Moss. Yes. Senator CooK. tii~'hen vou talk to the chief counsel relative to anv proposed lawsuits, I wmild suggest that if ;on want, to got a deter- mination, of the Federal Drug and Cosmetic Act and how it applies to cignrette.s, that this uiatter has been in the courts on at least three difl'-,rent occasions that I know of, one is the casee of the United r+r~es v. F¢ii,h i, 8tes, 113 Federal Supplement 330; United v. 1'd ( , nzrrirr~, 178 Federal Supplement II i; and the / i»i ,. v,r" i:.m ,a v. LiygeGt, anul Myers iabu.aco, 303 led:r,el c,, ond &u:i. In a11 these instances, the coart ruled that there was no jurisdiction under the i)rng and Cosmetic Act over the industry unless tdie industry itself advertised a product to have therapeutic attributes. Mr. Ilv'rr. Thank}ou, sir. Senator Jloss. Thank yoa very muc.h, gentlemen. We appreciate your a.ppearance here and your testimony. We appreciate your fvrnishing the other information. Our nexA witness is P1r. John F. Banzl:af, executive director of Action on Smoking and IIealth. 11-e know Professor Banzhaf from his work. We are very glad to ]mar froui you today profcesor. TI58461375
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245 ties, but it seems to me cig:uettes also have a hi~,rlt priority on public health. How would cmt feel about tukina this matter to the oourt for test to see if vou had jurisdietion 9 Mr. ] Ivrr. I would have to think about that, Senator. It would me:m that the I)epartment acould have to rese.ree this 10-year posi- tion which it has taken, and I am riot certain that, I wotdd be in it positiml to do that. I will he happy to consnlt with the generxl counsel of the. i)epartmeut and determine whether lie would wish me to do that. Let Inc go into the ramifications that this would have so we under- st:md the probleuls Ihat we face. If aigarettes were plae.cd under the Haznrdous pubstances Act by the Conhress, and oertainlv it is tc-ithin the province of the Oou- gress to mnlce that dehermination, I think Dr. Edwards and I would aprree that they x*onld then fall within the defuriticm of toxic in scc- tion 2(g) of the act, in that t1u,c would produce illne:tis as it result of n1hfllRtloil. This deterinination would then reqnire ns to rnalce anotber series of deterniiuatious under the act. It is Iluite clenr under the 19iU legiJa- timt of the Conl-ress thitt we wonld be precluded froiu mquirin« iun- tvpe of a tcarninlg statcment, or requiring it. on the laltel, because the Cbngress]Las pree.mpre-l that. Tlle only determiuidion we would then be in it position to niuke lcider the Lr~r mntJd be n-]tetber cigarettes tconld be required to be bmined under the bannetl hnzardous snbstauces prot-i=ion. now, that is in section 2 (q) of the act, as I mentioned earlier. "I'hern ihe le_IIifilative standard is Ncluther cauliooarv 1au!,-naIe is suf- fi,-iclt to protect the pnblic. from the particnlar liarard involrr(l. I)r. E"h~anls and I have di'cn=,ed it, and as we 1111derst;exl the sitna- timi. thou_'h we are not e_~pert, in this tield, and there is no one who ithat it s:d'e locel of inhalation of ciexrelto sniok. or com- ponenl-s i,. As it re=ult, if rkie f on«re=s dirl pluCe cirurelte.=_ under the F31S.1, ire mould hace no nlternxtive br,t to tleclare tlten Iiaiined ha%ardons snbst;tnce; and to mal:c thrn l il Ic,n l. C'onrn•ss decided in 1970 tltat ci'vtrettes =honld not be ba.nnerl, that they should be allotied to remain in remmere.e with the waru- ings dccided on bp Cout;ress, and we therefmr, fevl that we have no basis for niakinn iulc kinrl of determination IiternJlY coutrar.N to the conhressimml detertniunt ion. ;+o, to retnrn to your que.atiou as to whether we would stnrt a court criscj, mc o-,vn per:onal belief is that we would be on no grolwd %cltat.evr.r for doing Ilu1t. But, oucc a;iain, if ynu tvislt, I Nconlcl be hMpy to t.ike it np with the huic tl comisel of the depnrtment. ('1'hi• lollowin_ ~nionuanon was sub.eqnentlc ric eived for the ~rcnrrl') ileraierMrsr OF Itner.Tn, N:nuc>mros, eso 1Ccrs'n¢e. Oxrtcr oe iam gecau:Tanr, aoet:z,am. _va. Ilmi. P'lra,~x E. ]Iass. U.S. A'us7dngtow, D.C. lic,ue Fec.rrwe \IOUS ~ 1a gmi renucAVl during the henrinti held on D'eUrunrv 111 on the nced for umeodmeuts to ihe Pu61ir Health Oieurettr 5moktu, Act if ]J69, I llitve r]isan[:ael milh A[r. 1A"ilmot It. liastiua , Geuerat Conuye: of ihe TI58461368
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250 \o~c, the chairman has referred to the, fact that Senator FIartkes iu these connnittees madn shatrments, and Scnator Sia;;nusmq but. Pr. Edw.nds, let mc giVe }Ou the best lerislative intent of all. In 1;M:i, n-hon the Cirarettc Labeling and Arlvertising tlct was befmr the 1Loor, there wa.s all ri.mendment proposed to place ciga- rettcs imdrr the FIdS3, and that amendment was defeated. \ow, don't you think that is the bcst Iegislal.ice record, rather th.ui to tnkc. out of context what a Senator AIa}' havn said dnring the conrse of thiwec he.iringsF Becii,use if von take the legislative intcnt of the hearinds that ae rainn on rinliL no~a', and use that as a basis, von havc got. (ue opi.niou, if you quote Senator BSoss, and you have not another opinion if yon quote Senator Cool:, so that doesn't maka poudle;;islativchistory, does it? Dr, Emsamus. No. There are some problems there. ( La uwhter. ) Senator Coor.. So in eJfect: ivhen you quoto Senator IIartke, you qnote Senator :1Tag, mson. and you quote Senator \enberter, and you didn't qnote somc of the other Senators at that same time, von get iuto a, little problem, don't you? 1)r. I think it does certaiidv den~m~ctratc the differences of opinion on this particular subject, biti~l think as both of you gentle- men knoic, aou can rest assured that if the Congress were to want to give us this responsibility we would certainly earrp it out. Seualor Conic. As a nmtter of fact, when that amendment was defeated itt 1965, thec hmve specificallv takmi control and legislated ou the subject exchsivels ei-e.r since, have thcy not, under their own mn.ndatc? Dr, P:nw.~rzos. That is correr;t. Scnator t'ons. Now, I think this is the point R-e might to make cdear. I mcrch- want to do it bocause T think many of us arc c~pcrt.s in one field or another, hut I think as we rcview this subject legisLa- ticelv, if the Congress has repeatedls failed to take this position on the floor of debate, then 1 think this speaks quite well for its lcgisla- tive intent, and I might say to both of pon that I waa very inlee- ested to Lnar this line nf debnte becanse ever since wc started tlic3e hearin; s. the chaiirman has nnade it very clear that lre doesn't Naant a prohibition. and he feels that politicallv this is wronc and can't he accomplished, and I was ver,y delighted to hettr him go into this in detail with you on what txactl,y the FI)A would have to do if it had jurisdictionof this, and you said under terms it iconld have to be banned aud )ou would havn to prohibit its snle or its passage in interstnte commerce. So I might suggest to vou that what ti-c have been talking about all along haa b_cen prohibition. 1'hanl: von, S'Ir. Chairman. Seuator D1oss. Just so it isn't misscd, I should point out that since the witness quoted from the House side, I was quoting somebody on the Senate side. Senator Stevens? Scuator S•revnss. I am sorry to come in late. Let me ask you just a couple of questions. I am continually pressured by the young people in mp State to )oin those who se.elc to legalize the sale of rutu•ilmEUia. Most of thut is used in cigarettes. . TI58461373
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2.51 Pardon me if this has been belabored before I came in, but have you conducted a study to see whether or not marijttana in cigarette form is dangerous? Dr. Enwexos. No. We are involved to the extent that we work veiy closely with the Vational Institute of Mental Health, and in tllose studies where marilinami i, being used c~perio~ontalty a,s a rh1n1_', we are., of course, in.°olverL lmt we are doing no studies omschrs. Senator S'rrrvFxs. I was alarmed and shocked to come back into town after a trip horne and find that a former member of the Department of .7ustice, who had the job of enforcing theee laws, suddenly decided to shift over to the other side. On the one hand, we seem to be belaboring those who sntol:e tobacco, and you will notice that I am aw subject to the deviltrics of the, pipe. Yet, at the same time .ve seem to be rushin" pellmcll into kL"alizing the use of a drug in cigarettes. I just; wonder whether there isn't a mure prolific field in terms of trying to find out what effects marihuana has on the hnman body as opposed to cigarettes. Dr. Ebwnttns. li'cll, there is, as you probablv know, a national conl- mission which has been very actively mvolve4 in trving to both fmd out what is going on in research in the meir6mana ficld and stimulate additional research in this area. I know, speaking for Sreretftr,v Richardson, that lie is vety much interested in this, and the 1Vational Institute of Mental Ilealth is working vety hard to develop new re- search programs, and we are trying to cooperato as best we can. I think that sonte Tncaningful results will be seen from these research s ctiv i Ii es in the n nt too d istan t fiRu re. Smiator ,,5'ta:vss& 11ay-bo I tuu helaboring the point, but it secros to me that Congress has taken action in terms of labeling or requir- ing cigarettes to be labcled. The question comes down to what we are doing to warn the people that not only if you are right abont ciga- rettes, not only are thcy involviug the.msEalves in 1,hat danger, but also nnlalown dangera as far as the use of marihuana as a substitute fort.obaccn. Am I w'ong to have the impression that you arc dealing with trees and not tivith the forest as far as the problems of smoking are eoncerncd? Dr. EDwaaos. I don'tt think that is necessarily true. I can't speak o$ciallv for the Department. An- I indicated earlier, the only direct responsibility regarding that the Food and Drup Administration has regarding marilnaana, is where marihuana is being used as a drng in the research that is going on. We have little or notdiiug to (10 with the illegal use of tnarihufuia, and anyone, that is spessking from the Department of Justice is not neeessarilyspeakingfortheFoodandT)rug Administration. Your point is well taken, but I have no official position on it. blr. Ht,*a•T. Senator, there have been two reports thus far from thc National Institute of Mental Health to the Congress on marihuana. In addition, there is due, I believe, in March of this year, a report to the President from the national commission established under the 1970 drug abuse law that will be directed solelv and specificalh- to the problems of marihuana. So I believe that with the two reports already issued and fhr one fortltcoming, this subject will be well eovered, and I would second Dr. Edwards' statement that it is beyond the ptrview of the FDA. i i-01i-4'_---17 TI58461374
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2;i3 STATEMENT OF JOHN F. BANZHAF III, EXECUTIVE DIRECTOR, ACTION ON SMOKING AND HEALTH, WASHINGTON, D.C. l[rt BAxzii.kr,. Thank you vezy much, Mr. Chainnan. Mr. CnnrnMAN, memhers of the comnuttee: Senator Moss, ~2 years ago you led this Congress in banning ciga- rette commercials on radio and television. The commercials were hanned because the Surgeon General, the FTC, the FCC, and the U.S. Congress-in short, every organ of the Government wtiich care- fiilly studied this problem-conclnded that these commercials were contrary to the public interest and substantially contributed to the Nation's No. 1 health problem-an epidemic which each vear kills mmn Americans than we have lost in all the years of Vietnam. But, Mr. Chairman, these commercials are not gone, and in fact arc growing in number because the cigarette industry has found a loophole-and because the public agencies charged with interpreting and enforcing the law huve been enbaging in some very questionable proc-ednres with regard to their responsibility. Unless something is done very quickly, we could easily roturn to the days when the Marlboro ma.n and Miss Springtime saturated and polluted our Va- t.ion's airwaves. If- }-ou were watching television not too long ago in Boston, or in Dayton, or more recently in Albany or New York City, you might hace seen and heard a new commercial. On the screen you would have seen a collage of short clips depictin¢ a rugged looldng out door nun, a young girl walking through u sprin;,,time woods, and other scenes whieh would immediately remind yon of the cigarette coamiercials which were banned. In fact, in watching that commercial, I was reminded of the short movie depicting jnst such scenes which your committee used in 1969. The similarity would be ecen more striking because in each scene people are smolcwg things that look just 7ike cigarettes. The audio portion of the comimrciad features a bouncy rock-type song promis- ing ''new golden taste," "new easy smootLness;' and a"mild and light" smoke, exactly as the cigarette commercial of old nsed to. The product being advertised is the sarne size and shape a; a cit*a- rette, has the same kind of cigarette-ty.pe filter, comes 20 in a soft- pach just like cigarettes, is mitde in ci~,rarette-malcing machines, is freqnetttly sold with cigarettes in stores, and is now even being sold in cigarette vending machines. Like cigarettes, they can be inhaled, and the commercial_s appear to encourage this. But, say the manu- factnrets, the IL. J. &eynolds Tobacco Co., they are not cigarettes be- cause they arewrapped in a substanee containing substantial amounts of tobac,eq and thus are immune from the ban and from eigarette tases. The new product is called °°T4"inchesters." When the matter of the ZVuichester wmmercials was first brought to om• attention in September 1971, we investigaroed and concladed that lt'inchestcrs appeareii to us to Le a. `bigarette' tnrder the second part of the statutory definition of the 00 act We promptly filed with the llepartment of Justice on October 1 a len,*thy legal bri,ef setting out our factual findings and legal argu- ments, and requesting prompt action by the Department. The first TI58461376
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254 thing thcy did with the brief was to lose it. Some time later they read in thc newspaper about our filing, and requested additional copies. But the tobacco industry had also heard about it, and the Reynolds Co. imrnediately requested a secret conference to plead their case. 'f'he Justice Department promptly acceded to their request, and on the morning of October 7 officials of the company met with Mr. Howard Epstein and his staff behind elosed doors. No amiouncement was made then or thereafter of this meeting, and no effort was made then or thereafter to obtain the responsive views of the organization which had presented this entire matter to the Department of Justice. Nothing further was heard until, on January 18, the Department announced that it had agreed with the Reynolds Co. to take no ac- tion against the 11:'inchester commercials in return for some minor changes in the packaging and point of display promotion. No change whatsoever was made in the conmiorcials, and the agreement, str.wge]y enough, was draftod by the R. J. Reynolds Tobacco Co. If at any time dnring its so-called investigation the Department lutid sought the views of any other government agency or health or- ganization, we have been unable to learn about it, and the Depart- ment has refused to make public any of the documents in its file. With all due respect,NIr. Chairman, this process of investigation by off-the-record meetings and secret negotiations reflects no credit on an agency of government designed to protect the public interest and, or so tts nan e implies, to do justice. If I niav for a mmncnt depa.rt from the prepared text: Since I was here this morning, I was able to learn for the first time some- thing, of the vicws of the Department of Justice as to why they did not take aetion. AVith all due respect, I think they were wrong in at least four major ways. Mr. Wilson indicated that the language used in the Cigarette Act of 1969 is the same lan~niage as used in the IRS tax statute, and of course, that is quite true. Ono of tlie fiist things we teach -votmg law students in statutorv analysis is that the same words may be used in nninv ditlerent statiites and havc as many different meanings. One cannot assume that the same words used in many statutes ad- ways mean the sanie thing, becansc Coneress in its wisdom often uses the exa,ct, same words to mean different things. We teach them in the first year that they must look to the purpose of the act. They nmst look to the legislative iutent. They must look to the legislative historc. They must look to the evil a,i.~ainst which the act was di- reeted. Undno reliance simply upon the words of the act is highly inappropriat.e. I suggestt very stronglv that Mr. Wilson ignored the rather lengthy legislatice history'behind the 1969 act with which you are cerv familiar. 'Phe FCC repmt and proposal that eil,-aa-ette commercials be banned on tho air, the FTC report and its recommendation that ci,n,arette crnnmcrcials be banned on the air, and rather extensive heaxings bcforc the Senate and lIouse cotmnittees, all testified to the evil of cigarette commercials. TI58461377
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236 Senator STEVENS. It is absolutely identical. Between-the-Acts has been snoked by cigar smokers for a number of years, and I am cer- tain that, those of us that are cigar smokers and don't happen to be- lieve that there is the sa,me problem, if there is a problem, with ciga- rettes, would have been heard if there was any indication that we were going to ban those little cigars. Mr. BAVZnAa. Do you recall advertisements of t,hat type, Senator? Senator STEVnxs. Advertisements of little cigars I have heard for a long, long time. Mr. BsvzrrsF•. IIavent been advertising them like that, so far as I know. I think reasonable men might differ on the legislative history. This is very clear, and reasonable men have been doing it all morning. Sonator Srsvn:Ns. Thonk you. That is what I am trying to get you to admit. That t,he gentleman is reasonable. Mr. Baszsar. I am sayin„ he apparently didn't look at it. There is not one word in his testimony ielating to lea slative history. He savs: "I look at the words, the words seem to be the same as some- tlung else, and therefore they mnst he the same as something else". Senator STe:vr:rs. That, is my question. You don't have anv legis- lative history tlut indicates the conn essional intent to regulate air media adveatising of aigars? You admit there is none. Now ,vou want him to come up and go through the legislative his- tory for which yon have already admitted there is none. Mr. Baxzrsar. No. I said I think a fair reading of the legislative history would indicate that Congress directed it at exactly this type of commercial. Senator SFf:vnss. For cigarettzs? Mr. I3.aNZUan. This t;ype of conimercinl. The whole issue is whether or not it is a cigarette, and I think that by svitching the wo~ds °9itkle cirai" for "sit;a.rette," you do not clarify the issue. What was it that the Congress was concerned about? Whatt was it that the public was concerned about? It was commercials of this type. Returning to my remarks, I would like to suggest third that the Justice Department placed agrcata deal of undne reliance upon the determination of the IRS. Mr. Wilson categoried their determina- tions as espcrt. As I will indicate in a moment, t:hey are far from that. Thev are by their own adruis~ian very subjeetive. Furthermore, I would argue, very, veiy sushoct.. Firtlmrmore, the IRS does not, and their posi- tinn-at least as stated in print-is that thev cannot and do not, consider a wide variety of factors which the Department of Justice can and should consider in making its determination as to whether or not conitnercials for this product violate the aet. Finally, Nr. Wilson said that, he caimot ittcludo marketing or ad- vertising as determuting factors in making his decision. With all dne respect, this is nonsense. The statute says, "it is likely to be offered to consmners as a cigarette." Now, exe.rv bit of legislative history that I know of nsing the word "olPcre~30° includes very clearly the advertisement, sale and pro- motion. Here we have a vehicle offered with an advertisement where the video is like the cigarette commercial, the andio is like the ciga- TI58461379
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GJJ \Iention after mention of the kind of effect that thcsc commercials had upon young people, the kind of seenes, the kind of almost sub- liminal messages which.vere beamed at tlre yormg people, was heard again and again and again. I might contrast tho position of the Department of Justice jusG for a moment with the analysis and testimony of Commissioner Ed- wards. IIe indieates, I believe on page 2, that althongh cigarettes might fall within the language of the Ifazardous Substance Act, nevertheless, he is going to look at the legislative history. I have not esamined the legislative history, so I don't know if his determina- tion i= correct, but I think his approach is entirely proper; that one mnst look to the legislative history of any act anrl tnake a. determi- nation based upon it. Very clearly, I think, in reviewing this issue, DSr. Wilson did nnt eaamine the legislative history and the evil against which the 1969 act was directed. Senator Srnviss. Could I interrupt, Mr. Chairman 4 Senator Moss. Yes. Senator Smnvess. Would you esamine that history, and would vou tell me whether there is any mention anywhere of cigars and pipe tobacco in the legislative h istory of that 1969 act? If there is, I am not aware of it. Mr. Basataer•. Thercc is quite a bit, of legislative history related to it, but, not aimed d'nectly at it. - Senator Srcvmss. There is nothing that indicates- '_VIr. BAnziaar. The evit to wlui:h the act is directed is vnrv clearlv tlu snme type as thc~-.e ads that appear on radio and television. Senator STnvexs. I don't know of any leb slativc action by which Conpress intended to control the use of pipe tobacco or cigars? Mr. Bnxznnr. Congrvss intended to legislate against the evils of commerrials of that tvpe. Furthermore, my o~icntion at this point is not that Mr. Wilson mi~rcad the legislalive history. From his statemc.nt, it appears lie never even looked at it. I3o lnoked no further than the express words of the statute. Senator STrrouNs. That is what I am asking. Can cou give me a.liy le.;,.islative. history vvhereby Congress in- tcnded±o control arhertising in the air rnediai conecrning cigars? Mr. BnxznnF. Concerning cinars as Congress then knew them_, no. I can give you esteneive legislative history that they intended to leg- islate against thn e6l of ach°ertisementp, particularly on television, particularly relatinn to ehildren, fenturin: masculine virility, ses- ual itr, social acceptance and so on of smokin;,g. Seirator SaENmvs. The same kind of advs,rtising is used to adver- tise wine, too. I have smoked tdicse little Betwee.n-the-Act:s type cigars for 20 yeotiv- i)o you mean to tell mee that we didn't know those that were 100 percent tobacco existed a.t the time we passed that law that banned advertising a cigaretke2 Mr. Bnszrnun. I am sure vau knew about them, Senator. I don't think that t7ie type of cigarette we are t.all,-ing abmtt here, the Win- chester tobacco prodncty was available then. TI58461378
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I 257 rette commercial, the size is like the cigarette, the filter is like the cigarette, the package is like the cigarette, it is sold in stores with ci~,rasettes, and in cigarette vending machines. This clearly is part of the offering of this product. Again, I do not necessarily say that a fairer weighing of t.his might not produce the opposite eonclusion. But Mr. Wilson states that his eyes are closed, that he cannot loolc att tliese factors. I sungest that a fair reading of the statute and the legislative his- tory would be that this is exactly the kind of thing that he should be weiching, and that he should decide whether or not these com- nmrcials and this product are more like the evil against which Con- gress IeRi,lated in 1969 than the large cigars, such as the gentleman behind von is smoking, and the ads as they appeared at that time. l[r. Lhairman, the DepartmenM1 of Justice relied heavily upon the determination of the IRS that ~'inchesters were a cigar and not a cigarette. Although the definitions are the same in the two statutes, the IRS has clcarly stated that it does no feel that its judgnient has an}-thing to do witIl televisiun commercials-whioh in fact tlmv do not examine-and that their determination is solely for tax pnr- poses. Ncvertheless, had the Justice Department investigated just a ]rttlc bit, they would have found somc very strange goings on. Al- though the IRS h xs so far likewise refused ns access to its files re- lating to jVinchesterr--while privately admitting that we are proba- bly entitled to them under the Freedom of Information Act-sve lhr~ e been able to learn sornething about the way the Service mishan- dlcd this determination. 1Chen lCinchestsrs were first =nbmitted to the Alcohol, Tobacco, and I'irearm., Division of the IRS (ATF) they were referred for chemical testing, where certain factors-principally total ash and ethanol ectract~ould be compared with other cigarette and cigar tobaccos. These parameters, as tbe IRS has stated in internal memo- randa, are "the most definitive of the analytical parameters pres- ently used in the tobacco analyses procedttres" for comparing cigars and-little cigarettes. The tests showed that with respect to these two critorin, 1Vinchesters were between the normal values for cigars and cignrett.es, although they were slightly closer to values for cigarettes. In addition to the laboratory study, thc product was submitted to a snokina~ panel. On this panel the majority considered tha product to be a cigarette and, in light of all of these fintlinh , Reynolds was advir,ed that the product would be classified as a cica.rette. Revnolds then met with the IRS team and presented its case, arb iing that their product was similar to the Antonia y Cleopatra little cigar and should not be classified as a cigarette. Snbseqnently, the IRS re- tested and discover tliat with re,_•ard to these two key chemical crite- ria, the A&C cigar had values characteristic of ciga.rs whereas 4ti'in- chesters had values closer to a normal cigarette. The Recnolds peoplo again cnme in and conferred with Service officials but at the close of the conference on or about November 21, 1970, tj~e IRS for a third time held fast to tlmir initial detettinination to treat the prednct as a cigarette and not a little eigar. Snb:equently, for rea- sons which wc do not know, but in view of all of the facts appear Terv snspicdous, the IRS eventually reversed itsclf and classified t'he product as a little cigar. . T158461380
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248 Life. In thn fall of 1Mifl, in rcaponso to a letter from Se.n. Frank 79. Moss of Utah, attempting to determine the atlitude of various pnblishers to accepting an inL1•mi5ed volnme of Cignrcttc advrrtising after a cutoff of cigarette Co[¢- niercials frum lhe alr, Andretiv 14eiskell, the ehssirntan af Tlme, 7oc.; puhllclras.sured tlle senator that his compauy would continue to take cigarette ads hnt that ilt had nn iutentimr af accepting irny °oierwhelming" amomrt of cigarettc vdverti,=ing as a resnlt of tile TV cutoff. What has happened since this aaeur- ance can be gathered by the fact that whereas Llre frrsL three issues of Life in 15i0 carried twelve-and-a-half pages of cigcu'ette adccrtising, the first three is- sues of the same magaeine in 1971, imnrediately afLCr the ban on cipurette ads on TV went into offect, carried twcnty-two pages of cigarette advertisin.G-all of them in color. And a c,nurparismt of tile nlnnber of ads carried ut the P'ebrn- ar'y 5 issrro of Lifc this year with that in the first issue in Frl.rnary of 1n=1 yeur shows Lhat the ntuuber of cigarette ad pagcs hs< jtlmpcd from two w eight. On February 8 of this year, Life carricd a furit-pnge ad in Thr New York 'i'imrs in lnaise of what it called `Life's Editorial Power." The acl asked, rhe- torically, "Who else had the photo of the NnSOnai Cuard about to fire at the Keut Stnte kid.'r 1he reiuiniecenee of Nilcitu Khrushchev7 The li1 picl.uees aC one rveelc3 American w:n' dead in VietnamT' It went on, "That kind of edi- toriul excellence gives Life mor'e impact than any other magazine. And gicrs ymir ad more impact tlmn it can get any.e9iere else." IIow can any respotwible pubiishing corporuflun nse a claim of etlitorial r>- cellence to hold forth the unblushing assm'ance, appl~ing in (his case to cigx- rette mmtufacturn's, that ads for a produet, tlre use of whiclr is onlcially rec- ognized as a nmjor cause of diNeane and death each ycrr, wontd have "more unpnct° thnn nnywhere clsn'! Jt Life, which cu'ried thoso "24'3 picturea of one week's .lrnerican war dead in Vietnam,° were to ctury pictures of the rmmber of Ameican rigarrtte smokers who suceumUcd to lung cancer nlone iu the- conrse of an average wetek, it would necd not 242 pictlrres, bat at least fonr timty that mmthcr. Hoev nnn anS publishur--2qune-mukc mwreS ent nf sell- ing advcrtia,,ments for a prodttct that is knotvn to cause death ml a disaatrous natimral s~ ale -,car aftcr year'r 7^'rrecord of 'Cime is no more cnennruging thmi Life 'm tii~s respect. The Orsc Ihree issues of Tiure for 1970 carried eight pages of i enrotte advertisurg. The fir-I ']rrce is.mes of tLe eunm magaaine fei' 19i1 ca.rrie Ii little ~~ds than 21 paC" , 1 cigarette advertieing. And V'ews%leak is nnt nmch b~flm tlcmi Timc_ ln ;Ifrst threc mmrths of 1970, -N'evaereck carried 23 p^f rignrette ad~erli~lrr,e, and fnr thn firnt yuarter of 14i71. Nemac~9c I, : -,~ :1, ditled 50 pa•e s, 1 cl<urettu adverlising-an increase of 1(f¢ perc+it. And iran aCcudc tb.+Ai[nrs of Nuwsweclc, any morc thsn one canh iiIli, lib,:s of 'Iuue aul Life, of not lcnoeN'inn tlie facts nbout the caustrl rel[:i u~ ]rip between cigarette smolung and lnng cancer and other 1'stnl ditietnst". A,r cun Ihe vdilors uf Lenl< rlaiur Innerenee alroat the fYrcls eonrern- ing cigarette smol;ing aal disease. The fact that Life and Loolc are in fluaneial imuhle cau hnrdlc he rielced as an nceept:ihr.e eccuse for tlmir trcing to proD np thrir corpurute health at hhc ecpense of thc hralth nf thcir raarler.v. Wilh r_erruin h~mor.tble ecceptions, such ns A4udamoisclle and Glmnour, t>v-o C,tutleSSSt pl:bltrrrynnss that, hcoanse they are meant to appeal ro yomra womcu, hnve duviflv,i ng:thrct tnking cigarette advertising, thc waroen's mngn- aines a,s a whnle ar„ -oiiciting and accepting a new flood of cigarette adverti.r- ing. Mwt ura5^- !I, n-~of this meQium of advectising so purtlcalarly dete,ata- hle is the lrnov, I„- I h :,t alllroufih women are less prone to lung cancer t]mu men, 1'hr Irmg-car., r rnr, amnng women smnkei3 in the last fifteen ge:u'5 has shown :ue alurmin, ru.e. Fuether, lconren, when ihe7 try tn stup smuldntS ap- pear to hare grea',, r difHcnlty Lhun meu in brenkhrg ilrenrselve~ r.f the hubit- To coturtcrsct tlrc tirnd amoug the slnokiug Pnpulritiun geucrally toword ent- ling doIcu uu eiKarette crmsuurpLiun, 1nLaccu u,uuufactm'crs are rnaking g;reat effor`s to davdep [hc market among wenren--in particular by puttiog out new br:rnilN a{ rig;ltutte "imagefl" in suclr a wa>' as to seem p.rrricalilrly al3raetico in Ihc fenralu nmr9:et. ILrge suurs hnve bce!u pmrrnl iutu the prnmotlou of new "wozncn's" ciRarettTs sne.h as Vire niu Slims, put ont by 1'hilip Illorris, and Eve, which Ligget & biyers has introdnced this year on n natimral sealc witli hn~e dmihle-pnge color spreads in the major nmbv.zines or genorsl cirrulnrinn and in thc wotnens magazines. Thc introductm.y nds for nvnreu arc headed, "Farrwcll to the ugly cigarette. Smoim pretty. 1Cvo," 'I'he acconrpanSing ropy goes on, "SleTlo to Eve. The first truly fcrninine eigarette-it's oIImost as prct.ty TI58461371
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236 BIOGHAPHLOdL GgR'PCFI oP ])n. ILOSAI.n (/fGL1P Dute of Atrth---ingust 7, 1932. dturi(ai sieedaae.-AFife, Satherine G. Okun-W ree cluldreu. Focio2 ser.IndtPl-:>•r,ti-31-317u. Hr/nnlt-I'nirer,<itc nL Califmnio, Los Angele,, Calif., 1!14n-:-~A, 19.A.: I-:d- vervity oi California, San Frsrnciseo, CaliP.: 195A -58, 8chool of hfedicine, 196ri, lf.L.; I'harmacolo„g, ]9:i9, lVLB. Troitlory. 'Peaching assietvnt, University of California, San L'rancisco, Calif., P'ebrmuy 1:15R Jut, 1958: intern, General Medical and b'urgicnl Hospitril, Ceterons Administration Hoepital, ].os Urfiele.s, Calif., 1958-611; resident. Caccrnun adroiui-trn,tion lfohpitnl, Los Angcles, Calif., 10.1fl ; frRow, clinii ca1 pLurr i i:uS - ns Hou6i,rs Ho-Ldtxi, II.Iltimore, Jid., 1961 63. Poraent npVnirll, -._-Direl :''r, clinieal ph^rmacalo-y, Cednrs-Sinai DTedical Centor, 1.,.- Au_, I~ - r,liY., July bl v3 to 1".._enl aSnishu,[ pi.Pssor of phar' nracolog5 (in rei „r-lil G,lil.lirua, Los Aucl l, :, Calif., Sep- ternher Illu3 to I'resentl~iil li~~h-.-, r„f medicine, 11.sity of Cali- forura, Lua An rv, ,. .1 it. .Id, i~- ITnn June 1 r 1 , P. LI profe.isor meqieine. werlicnl phnrma and i ,,ir~ I .,r, nf C.;utrrv rwr, I.cinc~-Cnlifnrnirt Col c of 1.,c1r; nr" I " pr„-eu6; re=earclr pL;unic-lo,giat, l'etermus Admiii.-rr. L 1; .~ .r 1 >.iulveda, C%Ji£., 1:0.3 71: cuu.ullnot iu Dharru.oloky, l1lalo , 1 llii.r1a. ;',pdeLnui[ ot Pnblic Health, 131,9 71; at' 9hig phyai.ian'ii : rl ,..rans Admin- istr.atwn II,xq,ital, Los AnF I,°. Calif.. .. ) t~ In'.- r ',enti:ic advisor to the buard of d r,~ tnn-. ".,l,. r--~inai Af ' '~-v. 1Pto pu._ _nt, nssu- ciale editur of Anmm: 1,i I'harci,1 ,dilo,. II,,O; :,itnndlug staff in in- tern,l .rrdlrinr Intt~kndor' u.ily i 'H[oLo-t Gur ut l[oEPi- ral Ins Angule., CrJIL. Y n; :: nl I' A,:.._..i-al I,nlle3c of Clinirrl I'Imrwaenlogy, JnneR, 1!)71. Prnlr x.rrtr;i .vneh'If .rumr6c'v.d - IJG`; 1inericmt Federatinrn for Clin;col RescrrreL. ]:Jlil: An c,.rnn ; n l - Advaucement ol Science. 191,?, Ne,v ]ork nArademy oT Screur -. I , Ai.,, rlcnn Society for Pha.rrnacnL s~:urd Fsl;erimeutul T.ree,ricnt.... . An.r!can Acarlemy uf Clinical Tu~ rr~ AC. Jf164; ;;nd Ame; r.ni Sorirl-c lw` ~icu.' I 1'haewacoio;., :utd Thrr- apeuticr, 11)71. ; pcci,rl ovmnds ,IVrd hnnor's.-Legge Preverdive piodicine Award, L'niversity oi tlnlli"•.nnia lledicul (Souior, I'rLrnrrry Tnne ] 1 Olcun, R., and IL VC. Elliotl.: Acute LR¢truru-d.._i.;t1 rrzdi,- (If Some Aew 111urPhine llerivativcn .7. Plmrlntlcol lh-p. ,: Tl.r. '...p,',9, 10',';. 2. Okun, R-. 4. C Liddoiy .urQ I].a*u3'r n: Tii . 1:.1I f A - --tion, Laec+ hic Shnrlc nnd .lrlrenrr°ie B1oclcing Dnlgs on lnhihition I-'-I~AFrill:ing 5y'ndroura J. Plr,rrmacolt l1xp. & Ther 14):3 !1) :107-lier. l:n .,- R'llson, lt, It Olaou: T11c Auute Henod,vnamin oi ]Jiazoside in AIo n. (lircnlution 3B :9& 93, l9fia. 4. jV-olfi, R. AP., AF. W. 1'afinle)'. IC. TPhite, and li. Olcnn: Drug Induced Ilin- hetes .L.UTA ].5::,86-fi7k, 1363_ 5. AA'ih+on. W It., R. Oiam, L. 'I'eL'rvuilt, aud N. lrnllic_: Iliefl,lpdolln and IIy-- drocRlnrothlruide in Primttry Hypertcnsion: Controlled Clinical Trial of LI'u°s. Singly and in Cnmliinntion, 7Ah1A 1H.:819-5215, 1963, C. AA"emlhcrg. J. bl., It. l IS. J. Ilirmmn, R C. Nortlavtt, R. J. Griep, and R'. G. 1A'allcer: ltennl Toxinity of Ornl Cfioiecywtographic ille.9ia. JAVL3. 136:9G1-dG7, 1103. r. (llnur, It., It. I'. Huascll, and R'. R. a'ilnon: IIyn nf Diazozitle wiYh Tri- chlonuethiaripe for Hcpertension. Arc91 Intern. A!e7 112:F8"_-ri35, 1:!6%. N- Oknn. It.. R'. It. WiLsou, and 11. 1). Gelfandi The Tymi:glyceinic I?ITectl of Hypotcnsice Drul J. Chron. Dls. 17:31-39. 1964. 9. C;trlinoq N. II„ .J. @drelliug. R. i'. Russell, R. O1aru, und ?l. Auvis: '1'hin- zide and Phtalinmidine Induced Hyperglymmia. in Hypertenaive Patients. JAM.1 101 :3RR, 196a. 10. Oknn, Il.: Principles of Clinicel Drug Evaluation. Proc 6Ceni. PLarur. Soc. .ti .'_,3-32. 1465. 11. {I'inters, It. H_, L. Levy, W. Thurman, and R. Olntn; Studies on the Me- tndroliarn and Distribution of Radioactive Amphetamine. Proc. of R'est. Pharm. Soc. 9:1-3, 1966. TI58461359
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227 sicns of the Aet for which the Deparhnent of Juslice has pfitnary res;.nxrsibility. This enforeemcut is 16niteQ, by Congress, t.o cigarette prroducte ns (fofined I ti ' ." -{ Of t'1, .. '1'hcreforc. the fhreshn:d qne5lion under the dct is whctlmr~IL.1dnct in ym tion is aClgurcttc. 'fhis ir^.e flr:-'nl i-,. s a tu~ matter in tL;tt ]ittle cigtrs are tnced at a rate enuglily on' iiftii I t9n'1 Y--r ci~::rettc< 7'he proeednre udopted by tobacco c~:wPtmios :tec6ln;r :t ':li, I-.~r il ' ierntinatinn has i>ocn to Pr eent their 1:^ndnct to thr Vl~ , hL ' I' J n . ~. , nnd P'ireto7n6 llivision af the Intm'nal licve- tu:e Sexvicc fo; n:.cu a lit:l'1Rte Interuiil I{evcime: Serviec :uml)"ze mid oralunt" ihe brndnclu ILlrul aud v:raPPcr along with its p+tckaging uud h:bcling nud wlnr, ri ./I, manofactnrer wishes tn suhmit. ILtE, loot.- ing lu the etntntnry (lehniu I ~- -igvr" codifial in °G Il S U. n70Y(al aud uf "cignrette," rontained in 5., l-l iI un;k, s n deiermin,itinu of Ibv prorhrct's clas- vficrl:ion. - 'I'he In`en:nl Rere: nr- (~.I. I, Cnition nf a cigarete in J4 i-ul`., ,t7pl(.h) nvs trnn.7:odetl i2 Ha i : en-¢tte I:ttli:r; c ~~.ri =iag Act as amended bp ihc 1'uhli.. lirilll ii ., . :~inalutg =1et ~fr i I 1 .1 . t',..n.qnrntly, i. n'hcu nce Tntcrnal Rr'., n:e : ~.t:.i ~rn,iues the apl' 4ni. . ~'ry fnr a prudnet- :mtl thi9 Ii ii i- relfed upon hy the mara nrer-a snhxe qnrnt eontrary it.~ 'rp ~ ihc Department of Justicv ahunld, it secmn to ute. Le m,:1e unlc' tu ca- ~', . ., r crror b3 tlte 1T(5. The .liIIlrull~ dors nut endthere-'1'he statute presently tletincs u"eignrette" vc tnl' roll of te"a( ~, I tcrapped in pnper ur in nnT smintnnce not contain- SnF Iq . :-:1nt1 ',: i r i•Il of tobe:cco ivrapPCrl in nny sabstance contnining tohnmo .rhu ., bt T-, of 1ts apPeafance, the t7pe of tnt lccn nscl in tho filler, or its t:TCl:agine and labelirg, ic likely to he nffered to. or T.urchased b.r, rnnn-nmur. az a eiF;arelte tiescriF~ed iu snbpnragra,dt ( 11." 7his lechuical I.ugnnre Presents fetr oh5lacles to any ioLncco emnpatp' .rhich desires to tlrve:oV tT prorlnet which trill l:a lnxad at a fiy:ctlnn of eiga- rettes, duc,; nnt reqnire tLe tvaming ]uhel, and ran ntilize ::ll of the msss me- dia for ils pnnnotiun if so Acsirci9. Une snch case in point is "Winchester l,ittle Cignrs," a prnduct of R.J. Ttey- nolrls Tobnecu Company irhieh wns rereTLLly introdnecd iuto the Tnafcet-111'ter initlally failir,g lu oLlsin a cigar sta4>.s ruling frum the Internal Recenue Seriice fnr "R'inehester," Reynnlds mndn rlte nocesNary ndJn.mnents anrl was clnsafied a cigar on .Tu:tnary 73, 1A71-on its secnnd atlempt. shortly therenf- ter, thc tt-st rnetrlcting of -R'inchester." Legan in Boston and Daytou, Ohio. The warkel.iug atracl:y inclnded radio and ttJevision adcertising. It was clenr that if thii, product was il cigarette, it violaterl the Act in two ways. First, it did not bear the required ir:uning stutement. Becontl, it was being ndccrlised on rndio rmd telccieiun. 'Phe Depnrttnent nf Jnslice made n Qetailod revicw of the "Ninchester" sitn- ation nm<7 deternuuwd it condfl nnt. ill vier nf the identiv.al delinition= crm- tainrd in the tax ende and the cigvrette advertising lrgislation, conclode that tile ruling nf thr Intenml Ttorenne Cerrice-the Agencc expert in tletcrmiuing whetlmr mnot a toh,tc-ru Drodnct i_s a cigarette-wns clcarly ill evror. 'lhns, it iv om- T'ie¢- that. if Congrass a'ishes to prulribit telecislon antl rndin niiven9soment of little cig-url stmh ns "~i'incheter"- op irvlll ~1- if it wi=hes to prnhitrit =urh ndaertising rcifit restaket to a'.1 tnLnco,o pro&n:= -new le~-islatiun will ba necaaear,r. 'I'he preNOnt Act camtot be stretchcI to .•.cr prodnrt9 which Trcre noc eonteu:platrd rrt the time of its enactux:ntl nr Achlch ure cienrly not coceeM by the presant Aet. '1'Ite eolifn'inn presrtded hy tihe little eignr adrertiaemcal< is, howeaer. not rLOnt Lssi,. 1Atm,c 1ittle cig.u,s are packagetl lll:e eignrette., 20 to a l,nck:p'r_ Recauer nf this nuiform siv.e, they can hr mntketed frotu ciSarette rendinn rna- chinos anA h:allitionnl cigarelte racka. '1'liey are simi'ru• in nptmuranec to rifin- rrtlrs c>eept fnr thPir brmvn Inbltcco wrttpVrr. llowe-er, tlie only indicia atihieh ran bc onnski.~I 'hem miking a legal detecminatinn (If 1'l nmAnel's ehnrn^ter nr, T1l -<„t Iurth in the stxtute. 8ignifieurtlc, all thc Ivl its pres- cntly mnt7cclru .~Iln.le cigars are wrapped in recnnstitnted li<l,l Inown to- buceo. not cign, tte VaPer. A11 sneh ptnducls zure now clearly d, I_ 1 . rl +l i ]it- tle cignrs in their paclcaging slnd labcling. These prnducts i -i~T . nu,ell. nnd bwu lilce a cigar, sal do not aPPerr lil:eh ' ta bc inlutled. Rec:n--I tl:e clofini- T158461350
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249 :!s cou are_ With lvettp filter tiPPretty puck. 1{ich get gentle liµcor , . V1-'ooon haeee been femiuine sLtee Ece. Voiv cigarettes are feminine. Sinc•e I:" .' U'he ud is illustrnteft With a color pictnre of aNVmuutis ]umA, ondfl wilU flmcers, ]mlding a pa^_k of Eve, anQ the paok tlesign shows thc heud of :tn in- no, ~•u',-- d„ug womun gazing (,ut from a profnsiou of Il(ocers and greenerv de- pir~., ~I iu ncnclc-tnpesrrg sf, le. The deliberately contrived themee in this partic- nlur adrertisement of innucenee and of temptntinn, ano au equallp tleliberntc co~i.,.nluteut, by fllo hand that is ato).'n holding the Dackngc, of ihe messagc priuted on the side, "Warning: The Surgeon (ICm,rttl Has Uetermined That Cir f'e Smolcing Ir Uary;crons ro qonr Health,," surell make this ome ot the most Ilce.oitfnl uigarette adrertiving cnmLaigns yct decLVed. \Shat 18 yerfectly elear from all this is that the legal measures tbat hun'e bcen tal:rn so far to lnin~ some meaaure of goveflunenlai cnntrol ocrr ciga- rette a<lvertising are altogether insnf5cicnt to restrain thc tobaeco industry frout ]mge advertising cnu:paigns in the ft¢titerance of nlutt cnn atlv t:c re- /;;Irrled-considerinu whut is known ahon[ Ihe relnliunship behr'een eignrette smoking aml variuud disc:lsr~-ns mnnsltlugLter on a mossiae scale. Anll the press as u whnle 1ms been undeterred from netL•tg ns co-coospirxtnr in thln manslangl:ter for thc s;lke of whatever adr)itimutl profirs pnhliahers bave breu ahie to seize ax a re.Zilt of tlle ban on cigarette coinmercials on the nir. Ob- N-ionsly, sou:e tlrvntic action bas to be lal.eu to correct this situntion. L"utler the I'ublic Health Cigarrtt.e Smokinq Act ol' 1070 the F'ederal Tra;lo f unw;is- sioi is Precmpted nntil July 1, 1941 frnm prohibiting cigarette atlcertising or ucen Pnun reqniring that hc;tllh wnrningd be plxlnly risiblc in all eigarette ad- vertising; th;rcafter, if tlle FTC a•ishea to uct in tliece respects, it tmtst grire Caugress sis monWs' nutice nf its intention to do so. 'IItis precmption was tn- nerled in tltr Act thrmigh tLe pressure of totmcco indnstry lohbsis(=, ~i9ro cll- cuiatet] Htnt en,y sucL moves by the EPC might ]ie foreetnlled in Cnngre>s n-ith [hc help uf Lbc tohacco in<lostrti and its cowmereinl anA political alties. Ecen if such morr: against ci,rarette advertising by the FTC nere yertuiitol by Cen„c<ss, the resuttin;; dcing of aPProsimatefc one Tcar in cnnlrrulliuF or pro- hiblting cigxretto ntlt-erflsing vollid ct•rtainlp hwe a contriLnmrc effect on the seores oP thm;s;m;ls of ]nunan futnlities timt occnr in this munlry onch yeur as a result of cig`:rette Snnoking. Cnder tltc cirromstances, it dues not seem to me that the FTC is ill ,1 Dositiou to hring an cffective enQ to thc :cystctnulic promotion fur proflt , l this cltarly lethal prrociuct. Conseriucntly, T sn~gvsc thnt Ihe problem of ci~aretla atlcortising be pLtce;i under i1LC jnrisdiminu not only of the 1"I'C bot atan -f'-b"' i'ood and Drug Adminis!ratiml, and 17hai all ci,d,!r rt4te nclverti:dr;s ia t,!. . mtmbe banued Iw;ler Iha prorivions of tlte Phtlernl 1:Iaz:!rdans Sui~i t: ,, - 1~'- nhlch autboriza, the FD_A to Tmn or control tite >':do or prumntiv '~-i: , that hvrJttue of tlloir tosicitynre har:tr.Lou,~ to pnblic Iwulth. The n~~. aubstances cor;IreQ by- the ter;us of the H:;znrQmis Stll;etnuces Act inchnirn thoce iLi;t are enpnble of causing harm to Llwums ^tMron,qh inlutlntim!." 'fhla de.finitiou fits Cigarettes antl eigarelte smokinA mutc precisel,v, a.nd T belieVc tlmt if tl;e Fou;l and I)rng Administt:atlon doe; xmove prontptlr io phtcc elpnreIAes nud cignrette Eumldng un{ier the provisions of tLe Ft;zardolls Bnlistances Act for ffie pnrpove of briuging the prmmotion of eiga- rottes nnder;tJC;lttute fr<lernl re(;nintion, thc FrAerfll '1'i-;;le Co;un;in,~iuu ~c-uuld thc•n also he al;le either to halt all cgarette atlverti;ins or to rclpurc tlwt strcng hcnltli waruing,a he praninenlic dis:lagrtl in the cigarette atlverflsinn_ ihnt Is allotit-ed. f,rnator f-'ool<. I)r. I:dmard-" 1vLilccou arc :tt it. do con titia: 1-on ulit~ht aci: tllc Snr~~ron Clcr,cral if lle~cau get irs a copy of il:c study ml chapler 9 ill the~rcport that lle Gled for 1;171'd T'Pcllticllt lbe able. to accompliat t.Fo thints nt tlutt ticlu. Dr. Eov.mus. I tvill briny thnt to his :t6telttiott. ~enator (`,ootc. l.cgiel:dieo intcnt and history is ve.y intcrestin- ~ a!ul tce lutt-e gnne irtto thi~ be£ore. TnrinsM1nnce, Ace n-eIrt klnok to the 1905 de,hates iu the Hotlse, and tt.at legiclzition ori"in:lterl in the Hotlsc. For illstutrc, one of t.hr, sponsors of tllzt bill, Contiressmall Hoberts, suxt thnt 6e arreed with then .JoLn lltrte,y, «ho tcss llcpnt~~ Food ltnd Drng Commissioner~ that itt lca5 nt-l-er the intent ttnder that bill to includc cigarctecs. TI58461372
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258 Even giving the IItS every reasonable doubt, their determination should still not be accepted at its face value, and given any great weight, particularly with regard to whether these commercials sholdd be allowed to continue on radio and television. In an IRS memorandum discussing the Winc.hest.er tests and the testino proce- dnre for little cigars in general, it was stated that: To date, these efforts [to develop standards to distingnish dgarettes from little eigars] have not identified such criteria and ATE" determinations con- linue to have a high degree of subjectivity. The problem of dassifying tobacco products for tax determinations has be- come more difl5cnlt due to changing technology in the tobacco industry, inade- quatk modern instrumentatiows to 1cecD abreast of this'chaoging technology, and shortage of manpower to fnlly ntilize the prcaent limited laboratory facili- ties. It oppears that the tobacco industry is developing many new little cigars, probably as a reaction to the law banning the advertisements of cigarettes on radio and television, as of January 2, 1971. Additional resources are needed in the ATP' laboratory in order to ade qtbttely cope with the problem of determining whether rolls of tobacco wrapped in reconstituted tobacco are cigars or cigarettes. Tn short and in surnmaty, Mr. Chairman, the peoplo at the Alcohol, Tobacco, and Firearms Division of the IRS admit themselves that t11cv have no adeqnate criteria by which to determine the difference belwcen cil;ars and cinarettes, that they do not have the resources e'-mx to make the tests which appear to be neccssary, and that their provedm-es are highly subjective. All of this sti11 does not esplain tsdtv the Service eventuallp caved in to the tobacco interests after their own procedures and testing three times indicated that-even without re.tard to considerahons of advc~tisinl,_r-jpinchesters should havebeen classified as cigarettes and not cigars. Mr. Chairman, what doas all of this mean@ In a, recent article in the Tobacco Journal, citsd by It. J. Reynolds and placed in the Con- hressional Record by the distinnnished Junior Senator from North Carolina in attachinh our efi'orts. it is reported that the tobac.co in- dustrv's best analyst }tas predicte(I that "the little cigar is where the action is, and ** * this section of the industry could well be up an- other 31) percent phis in 7971." b'lu•ther, it "is showing some of the same trends as the cigarette indstry." T}ms, if ]na9acts such as 1'r'inclresters contitnle to be clas- sified ac little cinars, thev can be sold with no health warnin, what- soever. Thev can be frcelv advertised on radio and television with no restrictions. And be.canse thev pay- less tLan one-fonrth of the tases of other cigarettes, ihey can be sold for 2G cents less per pack than coulpeting cil;>trettcs. Senator Coolc That jnst shows you how high the tases are on cifi- arettes. DIr. 13nrzlcnr. I am deeply hnrt.. As a resnlt, td-ie Federn.l (7overnment finds itself losing a large amount of tax dollars which are in eftect subsidizing the growth of a product whiclt has all of the potential for causing death and disti- bilitv as conve.nt.ional ci,r,arcttrs. According to the argnmeut advanced by the company and appar- entlr bought by flte Department of Justice. there wonld he nothing to prevent a 1ittle cigar from being named"Winston" so long as it was wrappe.d in a paper-lihe tobacco product and cle.arly carrled the word "little cigar." These they could then freely advertise on televi- TI58461381
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l4(i Depurrlucnt of TlcnLth, 17dncatiml, nnd Welf.ure, whether a te=t canc might be bro',li,ht to drtern:ine rrhetlter FDA lcls jm9sdictLon over ugarettes, ll v- HantiIig" and I helieve that earh a test case wotLLd bc ',vithout sotu:d legnl hasis, acd Ilms nlronldnnt beinrl i t uteQ. The three legal docisions vitcd in Dr. L/'dwards testlmony han-e already calnhLisheQ tLe paran.etel5 of FDA jm•isdiution orer cigarettes nndcr the [rederat P'ooil, Trng, and Cnslnefic Act, and ~ce dn naL helievc that addiLioual envev of thi,a kind ~s'ou1Q smre anp u9eful Pcn'Poee, with resPect to the Feleral Iiaz:vd- nus 6ubstnurces Act. Cnngrea5 has e,L/licitlr preemplen this aroa in the PuLlic Health Cigarette Smokiu~g Act of 19fiD- }7ven iT FL1A were nn,v f u reverse tLe .Sgenrss l0-year com;i,ytent admirastra[ive interpretation of the Ft2S_A a., not apylyiug to cigarettes thcrefore. It wwmild ne Preclnded fronr re(lnirirg addi [iolnl l lnlreling n r f rmu b:uming ciga rettas. A.s I testified at the heariua the FIISA perinits FDA to impose laheling rrrlnireaneuts to Luzardonc snhstnnces, to require Pornlulatian or other produrt chau(;os in order to avoid banning them, m' to ban them completely. Tha 1'lIDlic Health Cigarette Snloking Act of 19@9 dnes not allow FDA eitLer to require addlliona ll:arniug stutements on the lnbel or to bait cigarettes from interstnte cni:ummea_ Wl).A presently hav uo iuform:rtion thnt lvortld Pernilt it to set a Safe level for tar, nicotine, or other rhnrneteristfcs of cigarette,<. and tlms conld nnt ns a fi:ctnal matter ntitize an upproach that 1vonLl invNva the settiuG of condi[ions lln[ier wLich the grodnct nlay safely ba marlaoledd lheu if tlurt inform&tion uere to beenmo nvnilnble, moreover, any such reGnhltion wnnld clem9y conflict with the Public IIeaILh Cigaarette Smol:ing_ Act of 1910, R-hirh expresse,a the Congrescional determinn.tion that cigarettes may be mnrketeil in 9ntcr,tnte eommeree if PropeNy Iabeled nnder I hat Act. Aoeordingly. Mr. Ihl rtine, ::ml I h:ere conclnded thut, as a legal mntter, er test case lvonld be schollti fr0ltlfss. Sincerely $olll'9, PNrF.iL 1{ART(lY Ill*IT, Ae.si.slmlt (IencraZ Cmavrsci, Fool, I1nro,, amd Prodnct:4a}rtv Dirision. Seonf or Rloys. TS'ell, T wisli cou would rl i=enss it. >,i•ith him. Tn rradin;* those 19:i9 hearings T noticod Commissioner Larirk said. °`T nonld ~tvonilr nrne the Con;ress not to leave a. ]oophole in a measnre which deal;with public+llealtll." Do vou think we left. •,I, loopholc as to ci/oarettes? Trr. IIcrrr. I woulrl not presnme, Genator, to spealc for the Con- gress on that issue. I believe that the Departlnent of ITPWs posi- tion on the hazards of cilLiarettn smolcint= is w-ell-lalo',ill tun3 has bccn set ntlt by Dr. D uFal. Senator _lioss. Do Yon think ci-arettes onaht to be exempted from product safety stanrlnrds lmrler thrw ornnibne product safnl;v Iehisla- tion vvhich thc cmnmitLcc is now eonsideru~? ~ Mr. Ilurr. lW havclrt considered that issue. .lIr. Chairman. I don't feel that I w onld be in a position to comment on that. Dr. P:nwAlens. Nor woald I. Senator Aiosa Well, Dr. I:dwnrds. if a cigarette manufactnrer lve.re to wrap his product in some sort of defective paper that would ,qive off toxic gasses, sap, chlorine, or if when it is 1it;hted it was suddenlv vel flammable, bursling iuto flames. do yon thinl.- von would also be powerless to move against Yhat 4 Dr. P:nwnnns. ~To, I snspcctt in snch a situation. }vee could. i\Ir. ITvTT. There we rvould be dealing not with tobtteco- Sentitor. AIoss. 9ometlLing else in the cigarette? Mr. TTc1r. The lhazards of paper as a hazardous substance. I wuuld put it tltis w2v : Either the FllJ or lhe FTC, or both in concert, Ilvonld hope could find legal anthoritT to do that. Senator _hloss. Abont a year ago, Thomas Whiteside published in the "New Republic" an article oa the application of the Federal TI58461369
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241 So we wolild h.n-c to decide in exploring this, first of all, whethcr thc stat- nre itaoif shonld sct fm'th the words of the warning tlmt should be mr the I'ackagxc-assunling that there shonid lie a wariiing-or whether this should he left tn re{n_tlutiou. Alno whether t.u,,re should be authority to reqnire. ingrrdi- entc to be stated on the labcl. F~ ~- aecretary's iuterim report anggeeh that the stAUnte itself not require this, rIl.lw is as tar as we Llave ;:otten tn ihie point. Tlleve hearin€s werc n.+l b~ t,re we were rcady to fnlly esldore this mattcr. I dmi t l:uow ~chs.l,._~ I, ILavey wunts to suy more on thiv Iluh,t at this atage or nor. Mr. Henvel'. Mr. CJ!tticm~ a, and 9Ir. Roberts. tile contment in the Snrgonl Cencral's atatemcat was iWk mL~7 to reflect a view that the Iluznrdnus ;;uL- alimcen Labeutz Act, with nimnendntent to clen'IV inchide tohaceo and with a specific prnvisimr und de, l.irafiun of public poiicy us to tlte kind of labeliug it >hmJu hnvq tho Haz,irduns sl0I -> ncen Lahelulg hrr is a going cnncern irirh alt ol'}91ItIZatitnl elnil1p011 t/l eni, l', " li and carry fOrwlt'd. ACith nll alllendlnent lu itlchlcle dgafe[tes lt n'ouidW he 1'vlatively simPle to itpply 8lis ach to tile prublem. I thinl: it id reasonaLlv chae that the aet does nnt preaently cover eLarettes or tobaeen. Certainly the coveraGe of cigurettes was not in contetn- 14ation of the Cunares nt t1Le time of the e!acl.mvnt nt tlle bPi and the law would need 'mmre modification to cover cigarettes properly hecausc it deo13 sep- aratelv with difinront chtssis of hazardous substances, such a> roric, corroAvc, irritant and sn forih. Otn' vicw here is thnt the Haznrdous Snhstanms Laheting Act is a;Noin;; ve- hicle on wltich cigarotte htbcling could readily be attached. .llr, Ruxe.nrs. I agrre v'ith yon benAnrsc I spaneored that uct mul I rcmumber that we aertaiuly did nut trt titxt tLue ilrteud to cnrer tohaeco, I clon't tllink tubaeco was even uteutioned in the heurings. It was designefl to covcr Poisan or toxic slbenmoes prhmrily. ]tr. Hnwcex. llousehold cheinicals primarily. I thirOc. Mr. Roaumre. That is rlght. Thero ic nue sMltence wlurh Sen¢tor NeuLerger mcufinurcl in her lesliu!ouy thul mlghl cuvee Lhis particnlar suhject~ It fs a definiiion where ymt drfine hazardons suhstmlce, aw those lihich hnve it.e crt- pacitc to produeeo i0ne5s to m:tn thrnugh inhalation. 3re you fnmiliar with tl!at section? Mr. Haavnx. Tea, I am fitmilinr with it. liauaars. I assnwe in 1]u2t hearing we were tsli:ing abnnt acid>, or tcpos of detergmits ni:ich mlfilih poesihiy he in;lnrious to lung tlsear in the r_nsc of iuhalntion. Mr. Ilnnvrv. Aetualle, that sPruog primarily unt of deaths and injurioa frmn nning carbnn trtrnrhlnridc in nnudl rouw.v su!3 eonfined epace`. 'Ch.tt wus thc l.riumr,v geutUis if that inLalatiun insertion there, as cou rnay reclll. lr. Ronm rs. Gning #ack to the statement of the Surgttm Cunarnl Ac I tatc it, other thnn w9tnl: vou meufiun ahont tlre pusilhilita' of amne x!uendmetits in thc Beld of labetin„; ,rnu feel that fhe bast thing the Corrrnment call do in this pat'ticnlar field is lo onter into a prneram of ecincatiml trt.iuh w mld he primnrily deri,ZUed to kcep ymmg Fcoplc froln bvcauling addicted or to kccp thenl fnvu furwiug u hablt of usiug tobacco in this 1ianirnlnr wuy i ia th[rt ri;rht? Dr. Tt.nrcr. I ihinlc, AIt'. 12oLert,., tha.t thc progrnm of thc ArLlic Hcoith Netmice and Ihe one a-e envision shuuld he a two-pronged atttck In the first plaec onc prong shnnld he that of the disscruinatinn of inforulntinn and the croudncting und nuppwtiug ol' edueational uatnpnign5. The secoud shonltl be thc tt+march aspect, hecnvse, as I mentimted in mp report to you, them are a lot nf things that ue do not l:uow ahont this question yct. At the saune time I wunld husten to add Ihere nre n lot of things thar " dn knmc lle,r tlline nf which I am completely convineed is that cigarettc smokin,g is a definite henlth Lazard. Prneeediug ou this basis I think there nre areas for aclion m-dside of resenrch or in addition to mntinuing resourch mt tlle aubjart. \tr_ Ronenrs. `iou mentioned that this sort of proeram would p'oPerly he cocered by, as yon eall it, a prajected natlnnal rleauinglrouse arr smohing and health. 1Votdd it be canr opinimt ihot You idready hu.-e sume corerinu authun- ity in rhis Held which wmild not mily include lhis alleged dnnger, but also dangcrs 11rom drng,s tilat may he sirniLU• to this [haiidomide sitnation'f Dr. TmcnY. Let ma ansmer speeifietlly with regard to this question, Mr. Rob- ertg The stndy of our staff and with the Ceneral Coousel has ted ne tn halicve tlmt we h!ive adeqUate authority for the establishment of sitch a cleringhnmir and for condneting cnch a progruntin reinfionuhip to emoking and hcuftL. TI58461364
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260 I haven't had a chance to sit down and trv my hand. but I would do something lilce this, and I suggest a far better job could be done by the industry itself, because I think the manufacturers of the gen- uine little cigars are ju,t as concerned about this as we are. P,ut I would say that these products should bo classified as ciga- rettes except anrl unless hv every one of these criteria they are clearly distinguishable from cigarettes: Appearance, color, aize, shape, packaging, advertising, promotion, et cetera; and that the harden of making this proof shonld be on the produet seeking to exempt itself from the ban on eigarette commercials, from the stat- ute requiring health warnings, and the hiah tax rates. I think such legislation could be worked out. If not, I see offhand no reason why these things should be e:.cap- in,- the tax burden. Mr. Chairman. Senator Moss. ji'ould you include in the definition the question of thc inha.htbil ity which seems to be the breaking point in many ways between cigars and cigarettes? _17r. B.wzn_ia. I think that would be one of the many criteria which it would have to meet, and I think we could dcsign standards here to esc.lude the unusually hardy person who will inhale euiy- thing. Senator Coon. How do you exclude him? You are getting into a field whereI got a, notion you and the chairman are going to be swimming pretty deep in a minute. Senator Moss. You got us off the hook, you intervened right there. Senator Coox. Let's say a mmn comes from the Federal Covenr ment and savs, "I snoke A and C Grenadiers, they are about that long and that big around, and I inhalc all of them:" By your criteria does the Goveniment automatically say it is a cigarette and it is taxed as a cigarette and it will bo qualified as a cigarette now aiidhenceforth and forevermore? _14r. RaNZxai. No, Senator. I would start by giving the rnan a medal. This is a problem that the law deals with all the time. We talk about the reasonable man, the average man. We could tallc about eer- ta.in standards. 1Ve could say a panel of reasonable people. What happens when a panel of reasona,ble people inhale these? I pointt out to yon, Senator, with respect to Winchester, just such a panel, the majority regarded fhem as cigarettes. Senator Coorf. I aidn't mean to interrttpt vou.. lYlr. Chairman. I just wanted to laiow what you were going to do. I was a little bi6 worried. Senator Moss. \ow, I t:hink you documented the nurnber of times that the IRS considered this matter. Over what length of time do they carry on these considerations where ZVinchesters were recom- mended to be classified as cigairttes? Mr. Baszxar. I a.in not sure I have all that information. 3s I say, the IRS has not been very kind about letting us in on these things. Their eventual determination was January of 1971. 1 am not sure when they initially submitted the produet, although I think that TI58461383
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261 information is contained in Senator Jordon's submission in Phe Con- gressional Record. T don't see it in glancing through it. The information that I have is that as late as November 21 of 1970, the IPS had advised Winchester that they were classifird as a cigarette rather than a little cigar, so that sometime between Novem- ber 24 of 79'i0 and January of 1971, so~nething changed ed their mind. I don't lflzow, what it tvas that changed their mind. Senator Moss. Have von in vonr observation observed other brands that you would thinlc deserve thaL classificatioa of cigarette, the now called little c.igar, other than Winchester? _ Tl'e havc had names like "Between t.he.lcts." Mr. BAszanF. This one is called Omega, little cigars. Ag'ain, they scetn to be very, ver.p similar to cigarettes in all of these criteria that T am able to apply by eyesight, by the fact that what appears to be paper-and I nutice even Mr. Bruce Wilson, by perhaps a Frendian slip of the tont,ruc. referred to it as "paper"-is brown, and does contain substantial amowtts of reconstituted tobacco. Senator Coox. Ezcnse me. From a legal standpoint, a Freudian slip of the tougue really doesn't mal.e any differcnce, does it, Profes- sor? Mr. Bnrerrna. No, sir. I would not hold him to it in court. Senator Cootc. All right. Senator 11Toss. Your answer is that vou think there are other little ci~nix m1 the market that would rome under this criticism ? ylr. BaszxjeF. This appears to be. onc. Winchester is the only une about which I have knowledge tliwt they are being advertised on tel- evision and the only one about which I can assert, with reasonahle certainty that the conincrc.ial is a virtnnl copy of the kind of com- mereials that you legisiated against in 1969. Senator Moss. -Well, 1: call on Se.nator Cook, now. Senator Coos. Mr. ~Banzhaf, I say this with all due respect to the chairmtui, it is apparent to cne tltat you knew more about the tenor of these hearings than I did. I had no idea the day that we started these hearingss that little cigars were even to be considered or even to be discussed. This bill deals with Lhc right of the FTC to determine the tar and nicotine in cigarette9. You have not, spoken orm word to tlie merits or demcrits of the bill that is before Hxis emnmittee. Now, Iain going to ask you questions re.lative to your statement, but I must say it is disappointing, and 1 an sure it is disappointing to the minority staff, and it is certainly disappointing to this Sena- tor, that these hearings were called for the purpose of considering Senator Moss' bill to allow the FTC to determine tar and nicotine levels for ac.cessiLiility to the public, and yet, this entire statement says not one word about that bi11. Mr. B_ti.'~uar. Might I rrply? Senator Moss. j9'ould you vicld for just a moment. I would like to place in the record rnv release dated the 1st of February, which also is repeated in the openine statement, and call attention to the TI58461384
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263 maximum limits for tar and nicotine and other hazardons ingredients. At the present time carbon monoxide is one of those other hazardous inEredienta. Thus we meet today to discuss wilh several representatives Of gnvernment agencies involved as well as with the Tobacco Snstitute both the legislation at ]ranr] nnd other matters which may w'1se in the course Of uur discussiunsJ' Senator Coox. T ran only say that is finee in a personal release by a Senator to the puhlic bnt theissre that was submitted to my otficc from the committee said that we were to have hearings on this bill S. 1404. Let mo ask you something. Mr. BANZHAF. Could I reply to }'otr initial comment? Senator Coorc. Yes. Mr. BaxzneV. In Senator Afoss' initial letter to me he indiceted that, lie would invite me to come and testify because we had been involved in legal matters relatin-,, to the Winchester controvorsy. tiVe have, therefore, come before this snbconuuittee strictly on that rnattcr. Senator Coos. SVell, I can only rcad- ]lr. Ba~znar. Could I furthermore state. Senator, that it appears to me if yon are going to be considering a~bill to possibly limit the 411 and nicotine content of cigarettes, and if it further appears that things coming out having the same health properties as cigarettes would escape that, I would think a verv logical amendment and thing to be considered along with such a bill would be whether or not to expand the definition of a"cigarette." Senator Coos. You have alluded to that in your statement. You have not discussed the problem of the tar and nicotine in cig- arettes. We can build all the record we want to, but here is the release that we received from the Senate Committee on Commeree, Suhcmm- mittco for Consumers, witness Hst, hearings on S. 14;F4, to amend the Federal cigarette labeling and advertising act to require the FTC to establish acceptable levels of tar and nicotine content of cigarettes. Now, that is the purpose for which these hearings were called. and I must say to you, if yor received a letter from the Senator that outlined to you that he would like to hear from you ou the sub- ject that you discussed and that. you testified oit today, it would have been very easy for the majority side Of the co]nmittee to have added a second sentence, to let at least the minority members of this conr mibtee know what is going on before a cornrnittee hearing. Mr. Beszner'. AIigrt I further add, Senator, that I have not, dia- cussed my testimony with the Senator, with his aides, with the aides for the subcommittee, or any Senator on the majority or minority side. Senator Cooic. You didn't feel that your testimony was in any way out Of line in relation to the subject matter that the committee was hearing testimony on, did you'3 Mr. RnNrcrar•. Senator, as )'on just said, vott havc been hearing testimony on the Winchester thing ever since the heariug startcd. Senator Coor.. 'I'hat was last week. DIr. BA~zuer. Is this week a different week, a differcnt hearing@ Senatom• Coos. What do you teach in law school 3 Mr. Bnvzn.u•. At the mmnent, I teach torts, unfair trade prac- tices, and administrative pracedure. TI58461386
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264 Senator Coox. When You teach administrative procedure and everybody comes to your class prepared for it, do you teach them crimmal law? Mr. BaNzaar. No, sir. Senator Coox. I think I made my point. Mr. I3evzaaF. I do tcach them when hearings have been opened on one subject, they are nsnally opened on that subject, that when hearings aro adjourned from week to week-. one would normally expect they would be the same hearings. Senator Coor. Would you tell us the names and addresses of the present antisnoking organizations with which yott are involved? Mr. B9hztmr•. What do you mean by involved, sir? Senator Coox. Involved. I hope you don't consider that that is a bad word like somebody has a closed door hearing or something in a secret meeting, as I think you said. Which ones are pon assonia.tcd with, if that is a better word? Mr. I3aNzxaxw. I am executive director of an organization called Action on Smoking and Health, 2000 H Street NW., Washington, I).C. 20006. Senator Coox. Do you have a tax-exempt status? Mr. Bexziian. Yes, we do. I am also associated with an organization called Legislative Actiou on Smoking and Health. That organization does not have the section G01(c) (3) tax-exempt status. It is free to lobby. That is the pirposc for which it was created. Senator Coox. Let me ask y ou something : As an instructor on a collere campus- I haaee three children in c.ol- lege, and eatremely proud of it- are cou rather enthused about the activities on college c.ampttses these dacs in re-ard t,o the freedom of the student and his abiHtv to learn and to studv and be a free indivi- dual within the institution? Mr. BANZHAF. I am enthused about some of them. I am not enthused about others. Se.nu.tor Coox. Do you allow any of your students to smoke in your classroom? Alr. 13ANZ1HL`. N0, sir. Senator Coox. jFould you think it would be wrong if those decided that they would like to smoke in a college classroom that they have paid almost S4.000 a year to attend, if they took over your classroom, so they could decide to exercise freedom of choice? Mr. Bsvznaia I think that would bc wrong. Scnator Coox. You dmrt want people to smoke in your room? Dlr. BAZ`zaar. No, sir. It is an illegal act. I would regard it as being illegal. Senator Coou. Where is it an illegal act, Mr. 13anzhaf ? il1r. BeNmien•. Taking over classrooms is an illegal act. It is tres- passing. Smoking is banned in our classroom by action of the fac- ulty. 'lhere are no smoking signs in all t.lie clasrooms. Smiator (",ootc. Would you allow smoldng if the students wanted to change the rules and the majority decided that it was per- fectly all right to smoke in c.lasses and therefore a majority of the studults think that this rale should be overcome? Mr. BANzti.nr. At the moment. sir, the laws and rules and regula- tions relating to the campus are made by the faculty subject to the TI58461387
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259 sion and give the original Winston cigarettes a free ride. The dauger_ .llr. Chairman, is not-as the Jnstice llepartment appar- entlc believes-that someone will bay these new products by mis- take believing them to be cigarettos, but that a highly emotional and all too effective pitch fmsmoking in general will be able to return to the Nation's airwaves. 1Tore,over, accorduig to the IIi,S criteria, a tobarco company woald be free to market a so-called little cigar like Winchester even if they rnlm•ed the wrapping white so tha.t it looked esactlv like a cigau-ette. In view of their tremendous adcan.c®s of te.chnology, I think this is certain]c within their limits. Mr. Chairman, if the little ci,m,ar is where the action is, that is also whcre the health hazard is. and where the tax dollars should be. \Chv should onr yomig people again be snbjected to the same seduc- hive appeals that lead so many of those before them to take up a habft which Ieads to death and disabilit.v. Mr. CLairrnan, in the aerv strongest of terms I ask you and call upon sou and pour cnmmittee to take the following steps without ftu•ther dclav - (1) CarePully investigate tha, decisions made bv t.he Internal Rev- enne Service and the Departanact of Justice eoneerni.cig the ll'inehes- ter tobacco prodnnt, with particular attention to the manner in which these very vital decisions were arrived at. Assnre yourself that these agencios have dmte everything within their power to pro- tect the public interest with regard to this rnalter and, if the,% have nnt ecc thttthe}•dn (d) In cny event this loophole must be closed. If this is where the actcon » it should be whe.re the tas dollars are collected. I would cm c you to introdnce legislation taxing all small cigars at or above the tax iatte applicable to cigarettes. miless your sta1F-in con7 tmc- tion with repre.sentat.ives from the tobacco industrv and knowled gea- ble health organizations-can draft the bill so as to exempt only tho.,r products which are de_arlp little cigars and not just cigirettes iu 111,01711 coats. (S} If the little ci,gar is where ihe action is. it also is where the health harard is. I therefore urge yott to introduce legis]ation ban- ning nll rndio and TV c.ommercials for such little cigars and requir- ing a. health warning mt 911 such packages, unless again it is possible br careful draftsm:uc;}cip to esempt gennine little cigars. Mr. Chairman, tho wilt of C`ongress is being flouted and the public heal[h endangered. 'I'he cigarette industxy has too long been allowed to get away with too much. Now is the time to act. '1'he health of our V ation's youth is at stake. I thank you, 31r. Chairman, for votulrmd invitation to testifc on tdiis matter, and Lvoulrl be de] iohted to respond to your inqui ries. Senator _l'Ioss. Th:uik von. Mr. B.inzhaf, for vour statement. You talk about. elempt,ing gerutine ]itt]e cigars. What do you eon- sidcr genuine little cigars 9 ]L•. BAN'zHnm. I.cocdd consider genuine little cigars the ones whicli are clcarlv distingztished from ciearettes by all the rriteria whic.li huvc been discussed here toda}. 5omcbodS tvas asked before udietber lie could draft such leg_isla- tion. TI58461382
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265 approval of the Board of Trustees. The students are not yet making the. rides. Senator Coou. You think they shonldn't make any sueh rules on coll e gc campuses 9 Mr. B.vszziAF. At the mommit, they do not have the power to make sich rules. Senator CooR. Would }°ou ,n,ive them that. authority e Mr. BtiNZtiAF. To mnkc all rnles. no. Senator Coor,. I thinlc we nnderstand each ohhec Mr. BANZHAr. To decide whether or not to smoke in the class- rocvn? Senator Coor,. Ycs. Mr. B.nsznAF. I doubt it. Senator Coox. In other words, your activities in filing apetition with the Justice Department werc to advise thm Justice I)eparttnent of what cou thonght was ivronh and that t3rey should pursue to your satisfaction what yon thought was incorrect and improper? Mr. B.tNznAF. T adv3sed them what I thought was wrong and a'sked tliem to makc a full investigation of it and take appropriate aetion on it. T believe they wcnt aboutt it in an improper and inappropriatn manner. I believe they reached the wrong conclusion. S,nnator CooK. Why didn'tvon file a suit against thern? Mr. 13eszrrAF. We are now in the process of t.rying to get discov- crc from them. We may e~'entually seek legal remedics. ~Senator Cooic. And that is really your recourse, isn't it? '_11r. BASZttAV. tiVhen } ou sav mV recourse, ves. I do not ler slate. However, Tbelieve that as long :ts this subcom- mittee ona way or another is considering the matter. and since it has heard testimony from _l-ir. Wilson as to his decision. it should be advised of a11 thc factors going into that decision, and I believe, it should make an investig_ atimr of the procedttre by which these deci- sions are made. If tie decision as to whether or not these commercinls can con- tinue to be on the air is made on the basis of very subjective critoria of who on a saroking panel happens to thinlc this is a cigar or ciga- rette. to my way of thinking, that is not a very good way to make that decision. Ser_a.tar Comc. Ilow long before you will be back beforo this sub- committee if you are successful with Winchester and trv to take the Muriel cigar advertisement off of TV because she walks across the floor and sai-s,:`IIcy, big spender"'? _llr. 19n~ztrAF. I am not presently contemplating that.. sir. Senator Coo.x. Are you ~nre you aren't? Mr. BASZrrAF. Ycs, sir. Smiator Coore. In other words, nhat is going to be okay? Mr. BaNzirnr. I haven't seen the ad or I don't know anything about. it. Senator Cooi.. Arr• ynn telling me that you have seen Winchester ads and they reallv galled you and thep have really bugged you and yoa ha1-en'tseen any _l~Luriel cigar ads on televisiou? _llr. BwzitAr. I,iw one ad becaucc I ~ isited Boston. in part for the pnrpose of sceing it, whun it was adrertic=ed only in Boston and Dayton, and Dayton was a little bit too far away. TI58461388
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266 So far as I know, `Vinchesters are not advertised on television in Washington. Senator Coor.. If you had come to my office and asked to see the ads, I don't know anybody in the company but I would have sure said, you have got an ad that is bothering somebody, we will send it down here and show it to you. Mr. Bexzava. I thank tha Sena tor for his offer. Senator Coox. I read your statement and with all due respect, I wonder whether you think you can be everybody's big brother at that law school? ' Mr. Bsazx+v. My testinrony here has nothing to do with the law - school. Senator Coox. I am not talking about that. Suppose the same ads and the same pretty music and the same pretty girls start tomorrow, and someone is smoking an El Producto cigar. Are we going to be back here with tbe same sweet music, the same Miss Springtime as you put it? Mr. Ba-NzxaF. I doubt it very much, Senator, because that even from here does not appear at all to be a cigarette. It doesn't look likc a cigarette, doesn't smoke like a cigarette, doesn't have a filter, it is not 20 to a pack, it is not advertrsed like cigarettes, and you ean't put it in a cigarette vending machine. You are singling out one factor out of a great many. Senator Coox. You caxrt put this iti a vending machine. I suggest to you, sir, when you leave here, you go straight to the basement of this building and walk through the tunnel to the old Senate Build- ing and the second machine that you will sea on your right as you walk through will be a vending machine which dispenses six types of cigars in packages. Mr. BANZHAF. That is right. It does not dispense them in a form of 20 to a pack as the conventional cigarctte dispensing machine. It is a cigar dispensing machine. Senator Coox. Suppose they nrake one big enough to put 20 of these though, is that all right$ Mr. BANZHAF. If you take that one, you shrink it down, you put 20 to a pack, you advertise it like cigarettes and do a few other thina , then I might be back before you and suggest it is a cigarette. Senator Coox. Suppose I turn this into a c;igarette. Suppose I make this a cigarette instead of a cigar and I go back to television, and I tell everybody this isn't really a cigar, but you are going to think it is a greater cigar when you smoke it, but it is going to romind you of those good old days. FVhat are you going to do then? DIr. Bsxzu-inrt I would ask the Justice Department to prosecute you, sir. Serrator Coox. Y ou know what you are worried about, you are worried about milligrams and millimeters, and you are not really trying to make a distinction between cigarettes and cigars. ~b1r. BANZHAF. It did occur to me, if you do want figures on tar and nicotine and other criteria, the best place to get them would be the IP.S. They have been malflng this test for years. If you are going to- TI58461389
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268 Would you have any objection if your Government subjected a degree of censorship on somebody for what they wanted to say if it was contrary to something that yoa believed in8 Okay. That is what 1 was trying to get et at. Senator Moss. If yotl wottld yield. I don't think there was any testimony that the Government was in any way involved in the exchange that was recited there by Dr. Furst. He said the cha.irman of the nneetiug, and later lie named him, mado some statement similar to what you said, hut it wasn't the Government tlmt was telling the man that. Senator Coox. May I say to you that in my colloquy with Dr. Horn tlm other day, I ce.n toll you with all fairness, and I hope Dr. Horn will accept this in the best intended way, that I am afraid that many people have submitted research papers in the United States that have been ignored bp Dr. Horn in relation to giving a full-fledged report, to the American people on all of the hazards of smoking. Now, .l(r. Ranzhaf, you filed a pet.ition for ralemaking before the FAA asking for a separation of smokers and nonsmokers on com- mercial passenger aircraft- As aa part of your petition, yon said, and I qttote: Unregulated cigarette snrolcing on airlines crcates a significant health Laaard for all nonsmohing passengers who are to,be forced to inhale the suolce cre- ated by other passengers. Have you seen the FAA report that exonerates smoking as a hazard to nonsmokers? Mr. Ra]NztteF. No, sir, they hacc not made it available to me, although, as you properly state, I am a party to tlm action, and I desire to see it. Senator Cootc. I will mako a copy for you, because they say it is not a hazard. I might say to you that the way I found out that that report had been made and it was due to be given to IIEW was in the Jack Anderson column in 1970, although it is not alluded to at all in the 197"L or 1971 report of the Snrreon General on smoking. ]1ir. 13ANznAF. If I could reply, Senator, the FAA determination stands fonr-square to the contrary of the determination of the Sur- geon General in its most recent report and HEjV's decision which I just learned ahmtt that they are now going to be providing either bans on smoking in certain areas or nonsnoking sections. If I could say further, Senator, that if I had a problem with my airplane, I woiddn'tt go to HEW to gett it fixed, and if I want to find out whether some things are hazardous to health, I woiildn't go directly to the FAA. Senator COOK. Let, me let you understand the sequence of this, so you can understand it, because I think what they did was logical. They went to FAA because they have jurisdiction over aircraft, and they said would you do this study in conjunction with HEW? They did a very definite and a very scientific study. Mr. 13axzn.v^. For what it nta.}- bee worth, Senator, we have been doing soma research, that, is, exploring the published papers in this area, doing so for quite a while before the Suu'geon General got around to it, .md you will see a nttmber of citations in our petition. TI58461391
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269 For what it may be worth, it seems to me those do indicate a very real health problem. T point out particnlarly to you a great many Americans with a variety of medical susceptibilities who are imme- diately adversely afl'eeted by ci Rarett,e smoking. Senator Coox. We have 30 ~a,vs, I think, from the closo of these hearinf,rg to get statements. I.vill make you a copy of the FAA report with all the statistical analyses in it, the type of tests they ran, the type of equipment they had on the aircraft, and I would lilce you to report. Mr. RA.r-znar•. I am not sure I will be qualified, but I will try my best, Senator. Senator COOK. Fine. I wonld like your c.omment5 on it. I might say to jyou this is not available to the public, and it was not a part of the bnrgeou (iencraPs report on smoking and health. Mr. BA>\zrrvF. Is the Senator aware that approximately half of the airlines in the T"nited States arr~ now voluntarily complying with the suggestion that they provide separate no smoking sections. Senator Coox. I am absolutely aware of it. And are you aware that one of the presidents of one of the. airlines said we made it available for the people, and they are not even using it? He also said we don't know what to do because we are making it, available and no one is using it. Mr. Basuxer. The problem is, they are not giving it very much publicity and that contradicts the statements of other airlines Senator CooK. If you have any information in your files on that, I would like you to put it in the record. Mr. BnxzxAr. I will give you what I have at the time, Senator. Senator Coox. Thank you, Mr. Chairmaai. Senator STrvFSS. I would like to ask you a couple of questions about this little cigar business. I have been a cigar smoker for almost 30 years uow. T may not make it through the end of the hear- ing, says Senator Cook. Let me ask you this: I assume you are not a cigar smoker, but I also assmne that you realize that a cigar is to be sruoked when some- one has some time. I assume you also agree that. the little Between- the-Acts aigars came. out for exactly what they are called, for between the acts. The first time I ever ran into them, as a matter of fact, was between the acts of a play. Do you agree that the industry has a right to try and meet a demand for those who want little cagars 9 Mr. BaNzuAF. I agree they have a right to meet that demand. 1 am not so sure that it would go so far as to defeat the intent of Congress with respect to the commercials. fienator, it is the commercials that I am much more concerned about. Senator Szevs:vs. I understand that, too. You also nmentioned the cost factor. It disturbs you, I take it, that a little eigar cost less than a cigarette because of the tax factor; is that ril,ht? Mr. B.ixzner. Yes, sir. Senakor SrEvxss. And ,your suggestion is that you increase the tax on littJe cigars to where they are equivalent to cigarettes; is that right e T158461392
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262 fact thatt there were other things that had come to light and were going to be heard, and one was the marketing of little cigars. (The press release follows:) Dloss HoLns H.-vunOS On Lrc*so.aTloN To LralIr LEVrLS OF Tnn AND TICOI4FE CONTENT OF CIGAAETTEB wasnsioxoN, D.C-The following Is the text of the opening stntement of Senator Frank F7. Moss, D-Utah, at the beginning of hearings conducted by the Consumer Subcommittee on legislation to limit the levels of tar and nicotine content of cigarettes : The Consumer Subcommittce is meeting today and on February 3ed and Feb- ruary SOtII to discuss legislation which I have introduced to amend the Public llealth Cigarette Smoking Act to require the Fedcral Trade Commission to e,tablish maximum levels of tar and nicotine content of cigarettes. Addition- ally. dnring the course of the hearings we will discuss several other aspects of smoking nnd health which have come to light in recentt months. These are: 1. the marketing of little Cigars. 2. ihe status of Federal Trade Cummission efforts to require conspicuous health warnings-in cigarette advertis-ing- J. the implication in the recent report on the Health Conseqnences of Smok- ing that confirm the legitimacy of complaints by many people of the effects of other people's smoking. Also we will disenss during the eourse of these hear- iqgs nnti-smoking commei•cials in the broadcast media, smoking edurntional programs and other related matters that may come to light. Back in 1966 the Chairman of the Senate Commerce Committee, Senator Warren G. btaguson asked the Secretary of the Department of Henlth, lu'dn- cation and Welfare to review the evidence on the hazardous ingredients in cig- arettA` smoke. That review, which was made public in January 1'Jfi7, stated that: 1. the preponderance of scientific evidence strongly suggests that tllc lower the tar and nicotine content of cigarette auwking the Iess harmful wmlld be the effvat and 2. we recommend to the Surgeon General that action be encouraged which will result in the progressive reduction of the tar nicotine content of ciga- rettc smokc. Subsequently this Consumer Subcommittee held three days of hearings dur- ing the summer of 1967 to review progress made toward the development and thee mariceting of a less hazardous cigvrette. As an outgrowth uf those hear- ings, Chairman Magnuson requested that the FTC periodically test and report the tar and nicotine content of the various cigarettes sold in the United Statcs. '1'he first of these reports was made public in November 196i. ceveral cigtu'etle marketers as well as the Public Health Scrvice have umde significant efforts to promote low tar and nicotinc content. That activity is to be corn- mended since much of it has been done in a fairly responsible manner. The nezt chapter of this saga consists of a request from Chairman Magml- son to the Public Health Service to prepare an authoritntive report on other hazardous ingredicnts in cigarette smoke. Particularly those that might be present in Ihe gas pbase. Prior to the issuanee of that report I appeared in January 19711 on the PBS proFrnm 'The Advocates' to discuss whether or not the Federnl government should establish mandatory limits on tar and nicotine content. Although the most traditional way for the government to deal with product hazards is to han the hazard, this is impractical and undesirable in the rase of cigarettes. The alternative remains, however, to set standnrds to eliminate the most haz- ardons aspects of the product. Following the broadcast of that program I re- viewed the literatnre which had come to my attention and decided that it i.•as an appropriatz time to introduce legislation tu establish iust such limits. Chainnan Magnuson has authorized me to state that he joins in calling for such ]egislnfion. We now move to January 1972 and the release of this year's report on the health consequences of smoking. Chapter 9 which constitutes the Secretary's respense tn the Chiairman's reqnest for mt nu.thoritntlve review of the knowl• edge concerning the significance of lmzacdous ingmdients in cigarette smoke tmelnivlcally confirms my conviction that the next logical step is the setting of TI58461385
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I 267 Senator Coos. We have thern. 11'o ean put them in the record. I think thcy hace already been put in the record, in relation to many pWple. .oho hxtire testi6ed. Tovc, in yorrr 1969 teatimony yon ecpressed :i belief in proriding people in a free seciety a chomce to tal:e various risks and you said that ('onrrress slionld notprohibitciharette srnol:int; any more than it might prohibit skyinr or skydiving or anything else shich might be dangerous. Is this still your position or would you now deprive the people of a free choice? Mr. Be.zn.~r. I.vould not suggest to Congress that it ban ci-,a- rette smoleinr. Ts that your question? Senator (`oorc. That is wh.rt 7 um asking. Dfr. BeNrrr.u. T would not suggest to this Congress that it han cigarette smoking. Senator C'noi<. In othm- words, you aree hcre, for the purpose of tes- tifyin, as to what vmr refer to as the little cigar, as to Winchester? D[r. R.x~-zn.kr% T ahvars have been coneer-ned with the problems of prornotion and advrrtising of cigarettes. I think a person hxs the Urivile;te to smoke a citarctte if lie wants. The only objec.tion I hswe is wheu he smolccs il too uemr to me. I hare been concerned about getting repl.- timee so tliat the ot6er side of the cirarette-health con- hncersY would be heard. T 1L:rce becn con(trneel with mideadinr prornntions. T hine ')een eoneerne.d with the tobacco indastry which spends uionec to get tm article put into a marazine, promotin~ their prodnets, und doesn't tell you that their public relations mem wrote it. T have heen oonrerned with a wide irniety of deceptive promo- tious. I haw not cowe before this Congress or filed a legal action whieh wmdd scek to han the sale or eonsnmtrtion of cil'arettes. Senator Coor,. Yrnr ivere here this morning when Dr. Fnrst testi- flcd rhat lic oas told by a scicutist that his papcr was of no ealrm beeanse of his preent rescarch and beT:mso of his present, ecnploy- ment. Wonlrl that concern von? DIr. 13.i~zu.~r-. Does it concMrn me? Senator (bmi. Yes. JIr. BeNzitnF. ln What zcar? Sraxroa Cooic. T)oes it conecin vou that he was told at a, meeting that hrr.uise of his prosent reseurch with fnnds finrn the tobacco industrr thar .ch;d li(, , said beforcc is all right, bnt now that he is incolce.d with the industry whttt he says is 110 lour;•er of any .alue? Mr. li%szn.v=. T ilon't nnderstand quite frevikly .chsrfi you mean by couacru. Are von saving, "ani I roinr to do somethirrg about it?O° Srsxron Cornc. You are mrviuo~ what }on eur coicerned abont within the fr:r~neNcork of the indiwtrvr are ti-on coneerned when vonr Gocernment in elTer•t saNs to somebodc we are not concerned about «hat you say- beronse you disa_•ree with-us? DIr. iksrnmr. Conrcrned in Nv{rat seiise? 'I'hat I would go ont and do somrthin;,'d Thnt I nm ontraged? I don't know .ahat yon mean, Senamr? Srnatnr ("oorc It reenrs to me tire are playing pumes with each other, and lot me ;,mt it down real c.old. S9-m9 0-7.-10 T158461390
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272 Senator SrEt-n;re. I am talking about the little cigars that look like little cigarettes exeept they are pure little cigars and they are packaged like little cigarettes, except they are pure little cigars. What I am basically interested in is the advertising aspects. You see_, up my way, we bwve very small television stations. We happen to be the only place iu the world where there are three television stations for 70,000 people. They are now „etting some of this little cigar adcertising, and it appears in some of my fai rorite programs. I am wondering whether you people are now going to try to c.onvince the Congress, fact that this advertising money that these national people pay up our way is wrong because again it is sort of seductive adkertising for little cigars. 14r. B.~szunia I am not so much concerned with the problem of seduction, Senator, but would you explain to me how it serves the public iutsrest for these things to be broadcast on these television stations, bearing in mind that the operators of such stations are trustees of the pnblic.interest9 Senator STFVr,vs. I could gie-e you a lecturo on that for a long tirne, because it brings the shut-ins and people who can't afford cable television and other things, free TV The public enterprise system, the system of private enterprise, has brought soanethiig that my country has never had before. Mr. BANziiAr. Why nott advertise heroin, mari,jnana, and all this stalf @ Senator STcvHas. I am glad you mentioned that. I would like to go into that with you a little bit. As a practicail matter, I want to know where vott pe,oplc arec going in terms of this suggestion that we ban advertising these little cigars becanse you think t.hey are cigarettes and 1 think thcv are cigars. 111r. B:kN-znar. I wu suggesting only that where they are not really distingniishable fironi cigarettes by llie criteria whicti ha\ro keen dis- cussedtoda,y, then they should be classified as little cigars, that the procedure currently being used clearly is not an o-tidequate one, and must be cleaned up. And the process by which these decisions are arrived at quite frankly astonishes me. I don't think, qnite frankly, II can sit here with ymi and draft an appropriate statnte which would do it. I could take a good stab at it back in mti office. I think~the appropriate thing to do would be to have the people who iuanufactnre the cigars come in and if w'e can reach some kind of cottsonsns as to alkaline content, total tar, extract., size, shape, and so on, fine. Senator CooR. I am in the sarno boat that vou are in. I neither smoke cigarettes or cigars. I jnst, happen to have that cigar here as au <urarople. ll[r. IiAszuAr. Yes. I sce the one you hold. Scualor SrxvsN-s. Well, I am not in that same position. I am more interested in where you are going, because it does seem to me that Senatnr Cook has madr a point. 1f cou ire successful iu your cnrrent endeavor, then I take it that the ach-ertisiu~~ money that the tobacco industry has available will T158461395
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270 Mr. I3.rNzanr. I see no reason for exemptinh them from the cur- rent tax. I would argue that they are cigarettes and therefore enti- tled to the. tax. If they are technicully excluded from it because of a loophole, I don't see the justification. Senator STt;vFNs. And, therefore. being part Scotchman, as I am, when I buy a little cigar, because I don't want to throw away three-quarters of a cigar because I have only had 5 minutes to smoke it, what you rcallc want to do is t!et to the, point where it cost rne the same, amrnmt for a little cigar as it would for the big cigar; so the Scotcbmau is defeated in oWer words? lUr. Rnxzic%r-. No, sir. I think even if they were taxable, you will be paying the ssune amoimt - Senator arr:er:vs. You said 25 cent.s a packless2 Mr. Ba~-zrIAr. That is right. Senator Srr:vr.Ns. Ha,ve yon priced these cigars t.hat. Senator Cook mentioned which come five or six in a box8 lUn BASZnAr. Vo. air. I haVerrt. Senator SrFir:xsS and the price of these AVinehestcrs? Mr. I3.Nxzrrar. No. Senator S'rn~i,Ns. And added the ?5 cents to it and see whnkt you corne np with? Mr. liAxnr~r. ATO, sir. It is not 25 cents. It is about 4 to I in tax ratio. 1 meant 2a ce.nts off. In rnturti cases, that is ruore than half thn price of the pack of cigarettes. ~ Surator S,rrvrss. That is my point. Today •2:i crnts au ot pnck of tlwse '.Vinc6esters, I mirlit as well buy the biF• cigars kurd throw them aecac. I take it you would hace no oLjection to that? Mr. 13.~szu.w. I would hare no objcction at all if you want to throw away cigars. Senator Srra=is-Ns, I would hacc an object,imr. If II had to pay for one, I wonldn't want to throw it away. Mr. R.~~runr. I objeet to subsidiziuo sometbing tbnt causes death. Do you see any reason why they should be exempted from tax? Seuator S'rr:cr.Ns. Yes. They are c.igaus to rne.. I don't happen to srnoke eiga.rcttes. It, is just my own per;sonal choice. I never smokcd cirr,arc.tles. 1?•ut Ihavc bccu srnokiu~,~ cigars since I started flying, when I was 18. Mr. AXxznAP_ Aside from the fact that the tax personally alTncts you, is there auy pnblic policy reason why they should be exempted? Senator S'rEAr-~s. 'Phat is wrapped np in the cm•rent t`ongres- sional intent. Yon want to tax my cigars and cigarettes because they are small. Mr. BASZUAr. I certainly would, yes. Senator SrLar:~s. Thev ure cigars to me. Mr. BeszirAr. You say they are cigars. I respectfully disagree with von. Senator You are a lawyer and I am a lawyer. You say, it looks like a duck, it smel]s like a dnck, and it walks like a ducl.-; thus it nnust hc a duclc. I tbink that sometimes law