Tobacco Institute
Congressional Record Proceedings an Debates of the 93d Congress, First Session Vol. 119 No. 22 the Cigarette Controversy [Congressional Record, the Cigarette Controversy. (C)]
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Vol. 119
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_
~njrcsMonat PROCEEDINGS AND DEBATES OF THE 9?,d CONGRESS, FIRST SESSION
WASHINGTON, WEDNESDAY, FEBRUARY 7, 1973 No. 22
Senate I intend to throw light on their dark
THE CIGARETTE CONTROVERSY
Mr. COOS. Mr. President, the war
against tobacco has been as protracted
as was the fighting in Vietnam. Both
have beeii waged for more than a decade.
Both have gone on far too long. Both
are harder to end than they were to
begin. Both were probably avoidable, at
least on the basis of hindsight. And both
have demonstrated at great cost that
there must be a better way to resolve
differences.
Hopefully, the combat in Southeast
Asia Ha.4-been brought to an end. But
sadly, no cease-fire, no armistice, no
peace, no light at the end of the tunnel
is in sight for the conflict that rages
around smoking.
Mr. President, I come from a State that
produces more burley tobacco than any
other State in the United States. Once
again, as In the past. January has
brought with it the opening of the an-
nual winter offensive against 50 million
adult Americans who choose to smoke
cigarettes. Once again, as in the past,
the campaign has been preceded by a
massive bombardment of charges that
masquerade as "overwhelming scientific
evidence."
The campaign against smoking looks
like science; It Is packaged like science;
it is promoted as science. But it sure Is
not science. It is a whole 'nother smoke-
screen.
It is, in fact, a dangerously deceptive
exercise In behavioral modification
through manipulating and controlling
the information on which decisions are
based.
Mr. President, I refer to the recent re-
port to Congress from the Department
of Health, Education, and Welfare on the
health consequences of smoking, the
seventh in a series of documents required
by law to inform Congress on the cur-
rent state of scientific knowledge in this
area.
In former years, these reports were
named after the Surgeon General. This
year, the gentleman was among a rather
large group whose resignations were ac-
cepted by the President, which met with
my blessings. Since he had departed be-
fore the christening, the only high HEW
official who could be mustered to give
the creature some sort of official send-
off was Dr. Merlin S. Duval. Assistant
Secretary for Health. He signed the pref-
ace 2 days before he resigned. And Sec-
retary Richardson, preoccupied with his
passage across the Potomac to the Pen-
tagon, perfunctorily signed the trans-
mittal letter.
Once again, as in the past, no one in
charge at HEW had taken the time to
read the contents. Presidents come and
go. So do Cabinet secretaries. But the
HEW staff stays on-secure in its ano-
nymity-and continues to turn out its
antismoking reports. These old and prac-
ticed hands continue to promote their
report to Congress, the medical com-
munity, and to the press as objective
and complete scientific evidence, when,
in fact, a more accurate label would be
a one-sided propaganda tract.
And once again, as in the past, they
have managed to carry off the same old
false, misleading, and deceptive practice.
The FTC demands that business sub-
stantiate its advertising claims, but
raises no complaint against false, mis-
leading, or deceptive practices of Govern-
ment officials.
"Women Smokers Warned of Fetal and
Infant Risks," said the New York Times
headline, as if receiving the news from
the Almighty, or Walter Cronkite.
"United States Links Smoking to Infant
Deaths; " was the Washington Star head-
line, as if they were reporting some kind
of national referendum. And that is the
way it went across the country from
front page to front page, from tube to
tube.
Mr. President, I do not blame the
headline writers, the newspaper report-
ers, or the television commentators. They
lack the time to check details or to look
behind the handouts. After all, why
should they mistrust their Government
on health matters? Perhaps they will in
the future bring to health and science
issues the same questioning attitude that
they manifest in other areas of Govern-
ment operations, such as the conduct of
war and foreign affairs.
For to extend the analogy between
Vietnam and tobacco, I believe it is per-
fectly proper to question the source of
information given out about smoking and
health. As an expert pointed out In a
masterpiece on military strategy:
A great part of th. infoemation in war is
contradictorJ, a still greater part Is faU.,, and
by far the greate.t part Is subject to consid-
erable uncertaiaty.
In the cigarette controversy, it is also
true that Congress, the press, the public,
and even the White House, operate under
a serious Information disa4vantage. They
are all' dependent on information col-
lected and controlled by entrenched Fed-
eral bureaucrats who operate anony-
mously in the dark nooks and crannies of
the Federal Establishment.
terrain, to turn over the rocks that shel-
ter them, and to let everyone see just
what and who emerges.
Title 42, section 241 of the United
States Code establishes the "general
powers and duties" of the Public Health
Service. That section reads in part:
Promote the coordination of, research, in-
vestigation, experiments, demonstrations,
and studies relating to the causes, diagnosis,
treatment, control and prevention of physical
and mental diseases and impairments of
man...
Certainly, such a broad and general
function would include the coordination
of all activities relating to diseases, and
not just those activities which tend to
support the theories of certain individ-
uals. To the contrary, unfortunately, the
activities of Dr. Daniel Horn and his staff
have failed to disclose any unbiased,
scientific research. Horn and company
were set up by Surgeon General Luther
Terry, who leaped into prominence with
the 1964 report on smoking and health.
By 1967, he had established his clearing-
house in the Public Health Service with
staff, funds, and mission.
From the start, Dr. Horn's mission has
been, on the one hand, to reduce the
number of cigarette smokers and, on the
other, to serve as a central source of
scientific information on smoking and
health. And be responsible for HEW to
Congress on this subject. To his credit,
our last Surgeon General, Dr. Steinfleld,
agreed that these functions should be
separated, because criticism of the ap-
parent conflict was an "excellent point "
I digress slightly at this point to say
that Dr. Steinfleld was the gentleman,
apparently on the advice of Dr. Horn,
who said in Chicago at one time that you
should not worry about some of these
things, that marihuana probably was not
any worse than cigarette smoking be-
cause five or six former Presidents had
smoked marihuana quite a bit during
their lifetime.
Incredibly, the first revelation is the
shocking fact that the same individual
who is charged with collecting and dis-
tributing all available material on the
subject of smoking and health and report
it to the Congress is the very same per-
son who is responsible for conducting the
Government's anti-smoking activities.
That is rather strange. One and the same
individual is iudge, iury, prosecuting at-
torney, and chief investigator. This state
of affairs has persisted since 1966.
The fox guarding the chicken house
Is Daniel Horn, Ph. D., a psychologist
who came to Government in 1963 from
the American Cancer Society, an orga-
`--- ~ CT
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nization which is frankly and honestly
dedicated to the elimination of cigarette
smoking in the United States.
So let us give credit where it is due.
The proper name is not the Surgeon Gen-
eral's report, but Is the "Horn Report "
and that is what I shall call it during
the remainder of my remarks.
Make no mistake, I am not critical of
Dr. Horn's role as a zealous anti-smoking
crusader, as an advocate of zero-level
consumption of cigarettes, or a skilled
propagandist, as an qFpert in the psy-
chology of behavior modification. I just
do not believe, and one may agree, that
such a commitment to a cause can work
for fairness, objectivity, or equity. I just
do not expect the prosecutor to be sitting
on the judge's bench and in the jury box,
and then, call the result a fair trial. This
is the crux of the issue.
However, as a Senator I am also con-
cerned by the excesses of Dr. Horn's zeal
especially when I read in the Washing-
ton Star:
The Nixon administratlon's anti-smoking
expert says there is enough evidence that
smoking Is so harmful to pregnant women
that the federal government is beginning a
national crusade to "give babies a fair
chance."
The United Press International reports
Dr. Horn "the chief statistical crusader
against smoking" as saying:
A rapidly increasing proportion of the
United States population favors an absolute
prohibition on the sale of cigarettes.
You, too, may share my concern when
the National Tatler, a sensational weekly,
reports that "he's out to wipe non-fil-
tered cigarettes off the face of the Na-
tion," and that-
His otilce, a subdivision of HEW, will have
to go to Congress to get a law forcing the
tobacco industry to conform to the low-haz-
ard smokes.
Interestingly, this story ran 2 months
after my distinguished colleague Senator
Moss held hearings on his bill to limit
and progressively lower the tar and nico-
tine content of cigarettes. True to form,
Dr. Horn favored a rapid reduction to the
zero level. By strange coincidence, one
day after the 1973 Horn report hit the
front pages, Senator Moss was announc-
ing a new bill to lower tar content of
cigarettes through repressive taxation.
You may become alarmed by Dr.
Horn's back-of-the-hand attitude to-
ward such a basic American concept as
freedom of choice, especially as it applies
to smoking:
I think you can develop a holier-tban-thou
attitude in this area by saying that people
have a freedom of choice and that we should
provide them with the information and let
them choose.
You may even grow agitated to dis-
cover that he Is planning to conquer new
worlds. "Everything we learn about how
to deal with the smoking problem" he has
said, "wili serve in dealing with other
problems in the control of gratification
behavior." What does he have In mind:
Eating? Drinking? Birth control? Sex
education?
I certainly hope Casper Weinberger
gets better acquainted with his adminis-,
tration's No. 1 smoke fighter than Elliot
Richardson did.
But, Mr. President, what really and
truly coincerns me-and should concern
every fairminded Senator regardless of
where he stands on the cigarette issue-
is the amazing fact that Dr. Horn is not
concerned. He sees absolutely no conflict
of interest, no inconsistency, no funda-
mental unfairness in his dual function in
being a zealous inquisitor and unbiased
evaluator. He does not admit the slight-
est doubt about his ability to prepare un-
biased,objective reports on smoking and
health to the Congress.
Mr. President, his reasoning is unten-
able, his attitude is unconscionable, and
his confiict of interest is unacceptable.
It is time for all fairminded people-
inside and outside the Government, and
especially in the press-to become aware
of and concerned about how scientific
literature is handled in the Horn reports
on smoking and health.
There is testimony before Congress
that these reports are one-sided and
biased. There is evidence that they are
not based on all the world literature on
the subject. There is ground to believe
that Dr. Horn and his staff ignore, mis-
interpret, or downplay scientific articles
that report findings that do not support
the anti-smoking party line.
The result Is a double deception. We
do not know that we do not know. We
are sold a half loaf which is advertised
as a whole loaf. You cannot sell bread
that way and, I submit, you should not
be able to sell science that way either.
Let me give a few examples of how Dr.
Horn operates.
Last year he prepared a chapter for
the report entitled "Pubiic Exposure to
Air Pollution from Tobacco Smoke." The
very words are an attempt to divert at-
tention away from the real sources of
air pollution.
The overall effect was calculated to
raise the fear that nonsmokers were
being harmed by their smoking neigh-
bors. We were led to believe that the
chapter contained "positive" evidence of
harm to nonsmokers in confined places
such as airplanes. And It was successful.
The now departed Surgeon General
raised the battle cry: "Ban smoking in
public places." We, therefore, see the
speptacle of HEW enforcing segregation
on its own employees who smoke. Rule-
making procedures to ban or segregate
smoking were started to enforce the
policy on air and train travei. Even the
presiding Chief Justice invoked the find-
ings of the Horn report in a personal
confrontation with a railroad oonductor,
and later in a letter to the Secretary of
Transportation. He accomplished more
than half the Members of Congress could
accomplish. Mayor Lindsay acted swiftly
to ban smoking on the decks of the
Staten Island ferry, regardless of the
pollution in the air above or the water
below.
Now this Is something that I know
about. Let me tell you the results of a
joint study performed by the FAA-HEW
which actually studied and measured the
air in passenger aircraft. This study was
started in 1969 and completed in 1970.
The principal finding of the study was
that smoking in passenger aircraft did
not represent a hazard to the nonsmok-
ing passengers.
This negative finding was reported by,
of all people, columnist Jack Anderson
on December 20, 1970. But, it was not
2
even mentioned by Dr. Horn in his 1972
report. It was completely ignored. I had
the opportunity to ask Dr. Horn about
this failure during his appearance be-
fore the Consumer Subcommittee last
February. Dr. Horn's excuse was that
the FAA-HEW study was "unavailable"
to him until almost a year after the
columnist had reported on it. Dr. Horn
said that when he did receive the report,
it was too late to include it in his chap-
ter. Dr. Horn assured me that the find-
ings of this Government-sponsored re-
search project would be in this year's
report.
However, the 1973 Horn report has
completely avoided the subject of "Air
pollution caused by tobacco smoking."
Instead, Dr. Horn buried the "unfavor-
able" FAA-HEW study with a brief cita-
tion in a chapter entitled "Non-neo-
plastic Bronchopulmonary Diseases."
True to his. technique, while he men-
tioned the study, Dr. Horn refused to
make public its basic finding that ciga-
rette smoke does not harm nonsmokers.
Why should Jack Anderson be a more
reliable reporter of Government-spon-
sored scientific research than Dr. Horn?
Why has Dr. Horn dropped this whole
matter of putilic smoking from this year's
report? Could it be, as I am informed,
that certain new and highly regarded
research has demonstrated that the fears
raised by Dr. Horn are not supportable?
My concern about Dr. Horn is height-
ened by other examples of his suppres-
sion or omission of evidence that goes
against him. During the same consumer
subcommittee hearings last February,
the chairman asked two witnesses before
us for a list of scientific articles which
were published in the last 10 years and
which had not been considered and dis-
cussed in the several reports on smoking
and health. This list of omission was sub-
mitted and made part of the record.
Would you believe that the total came to
approximately 2,000 articles which were
neither cited nor discussed by Dr. Horn
and his staff?
Mr. President, although quantity does
not always imply quality, the very size
of this list, especially those of recent
date, gives some inkling of the wide di-
versity of views among scientists about
the causes of various diseases linked to
smoking. If nothing else, the magnitude
of the omissions, strongly suggest an in-
vestigation by the Senate of Dr. Daniel
Horn's peculiar modus operandi.
Another example of how the Horn
report distorts the evidence is seen in
the handling of the health effect of
smoking during pregnancy. In last year's
Horn report, and again In this year's,
the meticulous work of Dr. Jacob Yer-
ushalmy was studiously brushed off, even
though it was supported by a grant from
the National Institute of Health. The
reason, I believe, is that Dr. Yerushalmy
concluded that the findings "raise doubt
and argue against" the proposition that
cigarette smoking harms the unborn.
On the contrary, he said, "evidence ap-
pears to support the hypothesis that the
higher incidence of low-birth-weight in-
f'Ma^nts is due to the smoker, not the smok-
~p
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0
I ask unanimous consent to insert in
the RECORD a copy of Dr. Yerushalmy's
correspondence regarding the criticism
of his work by Horn and company. This
letter should have been in the record of
the February 1972 hearings of the Con-
sulner Subcommittee but, although given
to the staff for this purpose, for some
reason it was omitted, as so often hap-
pens with evidence that goes against the
antismoking view.
There being no objection, the letter
was ordered to be printed in the RECORD,
as follows:
FBSVAaT 9, 1972.
Prof. JACOD Y£RIISRALMY,
Professor of Biostatistics School of Public
Health, Urtiuers{ty of California, Berkeley,
Calif.
DaAa Paorzssoa YaevsnALMT: During the
hearings on 8. 1454, a bill to require man-
datory levels of "tar" and nicotine content
of cigarettes, there was a reference to your
studies on smoking and pregnancy.
Doctor Daniel Horn stated that your studies
had been, "criticized" and he was asked to
supply copies of the "criticisms" for our
record. I have been much impressed by your
studies and would appreciate your providing
any observations you may have, also for our
record. We would be particularly interested
in your views on the statements made con-
cerning your work in the 1972 Report to
Congress, as expressed in Chapter 5, and
your views as to whether the 1971 and 1972
Reports fairly cover the pertinent litera-
ture on smoking and pregnancy.
Your recent article in the American Jour-
nal of Obstetrics and Gynecology, January
15, 1972, is extremely interesting. Any com-
ment you might have with respect to this
uticle and what it adds to our understand-
ng of the subject would be greatly appre-
ciated. I do not believe it was mentioned
either ln the 1972 Report, or by Doctor Hora
when he appeared before our Committee,
and wondered If he had received a copy.
Our record will remain open for approxi-
mately 30 days and I hope you will be able
to respond to my inquiries within that time.
I am sure that the Commitee will welcome
any light that you can shed to help guide its
deliberations.
Sincerely yours.
MASLOw W. Coos:,
U.S. Senator.
*TN1vasrrT or CALaoaxrA, Baaxx-
LST,
Berkeley, Calif., February 23,1972.
Senator MASLOw W. Coos
U.S. Senate. Committee on Commerce, Wash-
ington, D.C.
Dr.Aa SLNATOa COOS: This is In response
to your lettersof February 9 inviting me to
comment on the criticisms of my studies on
cigarette smoking and pregnancy contained
in the 1971 and 1972 Public Health Service
Reports to Congress. Since the reports singled
out my studies for criticism. I am glad to
comply with your request.
Although most of the arguments in the
reports hardly call for extensive rebuttal. I
will comment on each point In the order in
which it appears in the reports.
The 1971 report raises the following objec-
tions:
(a) Criticism:
"He referred to the small Lnfants of smok-
ing mothers aa being 'apparently healthier'
than those infants weighing less than 2500
grams who were born to nonsmoking moth-
ers ... but neither group can be considered
'healthy' having sharply elevated death
rates." (P-404)
Comment:
I did not state that low birthweight babies
of smokers were "healthy". I said thst they
were "healthier" than low birthweigh bnbies
of non-smoking mothers. No one can argue
with this statement, for low blrthweight in-
fants of smokers who died at a rate of 138
per 1,000-while certainly not healthy-are
nevertheless much healthier than low birth-
weight infants of non-smokers who died at a
rate of 232 per 1,000.
(b) Criticism:
That the excess of neonatal mortality for
smoking mothers in my study "is not slg-
niflcantly different from the 31 % excess
mortality reported by Butler et ai which is
statistically significant". (P-404)
Comment:
I suppose the least said about this strange
argument the better. Who ever heard of using
findings from one study (and a retrospective
one at that) as a standard by which to meas-
ure another one. In any casa, even this weak
argument Ss lost completely in view of my
1971 study which shows almost identical
neonatal mortality rates for infants of smok-
ers and non-smokers. (11.3 vs. 11.0)
(c) Critictsm:
"That the interpretation of the neonatal
mortality among the infants weighing less
than 2500 grams ts dimcult, because I con-
sidered only live births . . ." (P-404)
Comment:
If the authors of the report would have
consulted any obstetriciam, they would have
found that in testing for relationships with
birthweight (which after all is the major
topic under discussion) one must limit cort-
sideration to live births, because birthweight
of stillbirths are of questionable value sinca
a number of them remain dead In utero foe
varying periods of time and their birth-
weights are reduced, not to mention the rel-
atively large number of macerated fetuses.
In any case, since our 1964 paper, Dr. W. 1!
Taylor analyzed the fetal deaths in our study
and found no difference between smokers
and non-smokers from the very beginning of
pregnancy (abortions) and throughout the
pregnancy (stillbirths). In fact the 1972
report quotes Taylor's findings (P-129). In-
cidentaily, Taylor analyzed our fetal death
data correctly by the use of the life table
method. None of the other studies which
show increases in abortion rates used this
method. In fact, the one study on which
the supplement leans heavily in their at-
tempt to justify their statement that "wom-
en who smoke during pregnancy have a
significantly greater risk of unsuccessful
pregnancy than those who do not"-that of
Russell, et al-lumps abortions, stilIbirths
and neonatal deaths in one almost meaning-
less index.
The 1972 report states the following
criticisms:
(d) Criticism:
"That some of (my) findings are different
from those reported in other recent large-
soale prospective studies (5, 13, 17, 19), and
some of the differences may be a consequence
of the definition of 'smokeY used." (P-129)
Comment:
Again, a strange statement: "other recent
large-scale prospective studies". These are as
follows: Butler et ai study (5) which is not
a prospective but a retrospective study. The
reports refer to this study several times as a
"prospective" study (Pages 390 and 415 and
in the table on Page 395 of the 1971 repOrt
and Page 129 of the 1972 report ), and yet
they state and quote from the study that
"the smoking history was obtained shortly
after delivery of the infant" which obviously
shows that it was a retrospective study. (One
may question the propriety of a government-
al publication to make such a serious mis-
statement In a report to the Congress). The
other three studies are based on 6,376; 4,312;
and 2,200 respectively (gullander and Sa1len
(13): Palmgren and Wallsade (17), and
Russell et al (19)). It would therefore be
more correct to say that the findings from
these studies are different from the really
3
large-scale prospective studies: Underwood's
based on 48.000. Ratakallio's on 12,000 and
Yemat.,.y's on 13,000 pregnancies.
Moreover, In my 1972 paper I reviewed
the entire literature consisting of 33 studies.
I marked the discussion on Pages 277-278
in the enclosed paper. I have no doubt that
any unbiased critical review of all the evi-
dence must come to the same conclusion that
I have underscored on the bottom of Page
278 and top of Page 279.
As to their speculation on the effect of
the definition of "smoker;" I wonder why
they overlooked my extensive discussion of
the problem In my 1964 paper. See table on
Page 517 and the discussion of it beginning
with the last paragraph on Page 515 to top of
right hand column of Page 516. I wonder also
why the reports did not raise the same ques-
tion of definition when they discussed the
study of Russell et al which they quoted
so extensively to show the excess of unsuc-
cessful pregnancies among smokers. Rus-
sell's definition was stated as follows: -'The
smoking habits of women are recorded at the
tim,e they are chosen for the survey." In any
case, to keep the record straight, women were
defined as "smokers" in our studies if they
smoked throughout the pregnancy.
(e) Crtttcism:
They quote a comment from McMahon
et al that there are factors that effect birth
weight without Influencing mortality. The
example cited by McMahon is that of the
sex of the infant. (Page 130)
Comment:
It is Interesting that they found it neces-
sary to dig up an old paper (1965) which
comments on my 1964 paper, especially since
I commented in that paper as follows: "Al-
ways present 1s the possibility that smoking
during pregnancy indeed causes a reduction
ia the size of the Infant without any increase
in neonatal mortality."
The example of the sex of the infants
which McMahon uses flts well with my con-
tention in the 1971 and 1972 papers that the
effect of smoking appears to be much like
that of a biologic variable. I show that the
differences in reproductive performance of
smokers and non-smokera are very much
like those of the biologic characteristics of
short and tall women. Sex of the infant ob-
viously Is aiso a biologic and not an exoge-
nous variable. Thus McMahon's comment
strengthens rather than weakens my con-
tentioa.
You asked me also to comment on what I
think my recent article (January, 1972) adds
to the problem of smoking and health. Pri-
marily it is a contribution to the question
of causation. As you know, our knowledge on
casual factors !n conditions and disease in
humans is derived from uncontrolled or
poorly controlled observational studies. The
diiCculty Is that the groups being compared
are generally not alike in many pertinent
characteristics. Consequently, there is the
uncertainty whether any differences observed
are due to the factor studied or to the char-
acteriatics by which the groups are differen-
tiated. Th1s is especfilly disturbing when tpe
findings do not fit wen together as for ex-
ample in the case of smoking and low birth-
weight, where smokers have more low birth-
weight infants and their infants shou;d
therefore have higher perinatal death rates,
but such excess mortality is not found. We
therefore continued to investigate the prob-
lem and the latest results almost clinch the.
argument against causation. This conclusion
follows from the finding that women who ~
eventually became smokers, produced a large
proportion of low birthweight Infants even
before they started to amoke; although these
infaata were born under non-smoking condi-
tions. Also striking is the fact that women ~
who quit smoking produced a low propor-
tion of low blrthweight Infants even during
the period when they smoked, indicati:ng,
peathaps, that people who stop smoking are
TIMN 0078402

not smokers in the real sense of the word.
These ilndings suggest that the relationship
to low birthweight Is due to the smoker not
the smoking.
I would be less than candid if I did not
add, as I did in the paper, that these find-
ings must be considered tentative until con-
tirmed or denied by many more studies on
larger numbers with the inclusion of many
more variables.
I believe also that the paper f.s making a
contribution in its review of all the evidence
on the question of smoking and outcome of
pregnancy available in the literature. The
papers discussed in the reports to Congress
represent only a part of the available evi-
dence.
May I also add that I presented the data
from the 1971 and 1972 papers when I was
invited to give the annual invited address
before the Society for Epidemiologic Re-
search in May, 1971. The official discussant
was Dr. George B. Hutchinson. Professor of
Epidemiology. School of Public Health, Har-
vard University. Dr. Hutchinson is on record
aa accepting the antiamoking hypothesis.
In hia discussion he said in part:
"The piece of evidence that I cannot dis-
card is the new observation on pregnancies
of smoking mothers in which the pregnancy
preceded the onset of smoking ... This ob-
servation rests on 90 cases of low birth-
weight of future smokers. It requires repeat
demonstration in a different population and
with large numbers. For the present, how-
ever, I would accept the new evidence and
tentatively reject the casual hypothesis. It
no longer seems tenable to suppose that anti-
smoking efforts can cause a rise in birth-
weight ... '
You inqulred also whether Dr. Horn re-
oeived a copy of this paper. I do not know if
he reeclved one but last October, in response
to a form letter inquiring about studies in
the field of smoking, I sent him a reprint of
my 1971 paper and two manuscripts with the
notation that one of them was accepted for
publication in the American Journal of Ob-
stetrias and Gynecology (since published in
the January, 1972 issue) and the other sa-
oepted for publication in the proceedings of
the Berkeley Symposium on Mathematical
Statistics and Probability, to be published
later this year.
May I close this letter with a quotation of
a paragraph from a letter that I wrote to Dr.
Charles ]li. Fletcher of London who was the
chairman of the committee and editor of
the Royal College of Physicians' report on
smoking and health, and who wrote a joint
report on the same subject with Dr. Daniel
Horn in the W.H.O. Chronicle in October
1970. They dealt with the evidence on smok-
ing and pregnancy in much the same uncri-
ticai approach as that of the Public Health
Service reports. Since Dr. Fletcher is a friend.
I could be frank with him to write as follows:
"It seems to me that by adopting the
policy of quoting only evidence which sup-
ports one's hypothesis and neglecting all
other in the long run, defeats its purpose.
For example, I was able to aee in the area
of pregnancy, with which I am famIIiar, that
your review is not as objective as one would
desire. I am therefore forced to the conclu-
sion that I could not accept as unbiased the
evidence in the other subjects in your re-
view with which I am less famiilar."
In my view, a similar at}tement may be
made with respect to the data in the Sur-
geon General's Reports to Congress.
Sincerely yours,
J. YrzvaHALnsT,
Professor of Biostatisttos Director,
Child Health and Development Stud-
des.
Mr. COOK. Mr. President, I could go
on like this all day. Rather than take up
additional time I will supply more In-
formation on this matter at a later date.
But I must make one final point loud and
clear to disabuse any mistaken notion
that these are the rantings of a Senator
whose constituents' ox is being gored.
The Issue here is the abuse and misuse
of science. The examples happen to deal
with tobacco, but the impact is far wider.
Indeed it undermines intelligent deci-
sionmaking for sound policy on a dozen
fronts. Are you concerned about exposure
of industrial workers to dangerous sub-
stances on the job? Do not bother to
struggle for improved occupational
health; just put up a no smoking sign.
Are you concerned about increased in-
fant mortality, premature births, and
deaths of newborn babies in our urban
ghettos? Do not wrestle with the difficul-
ties of improving medical care delivery
in the slums; just put up a no smoking
sign. Are you concerned about cleaning
up the environment? Do not campaign to
reduce air pollution; just put a no smok-
ing sign up because "personal pollution;"
according to Dr. Horn, is more serious.
The crucial danger in all of these ma-
jor issues on the national agenda is that
science will follow some crusader's flag.
It is a danger of great seriousness, as
Justice Brandeis observed when he said:
Men born to freedom are naturally alert to
repel invasion of their liberty by evil-minded
rulers. The greatest dangers to liberty lurk
in insidious encroachment by men of zest,
well-meaning but without understanding.
Ironically, I borrowed this wise quota-
tion from a report issued last week by
the departing Secretary of Health. Edu-
cation, and Welfare. I commend it to his
successor.
Mr. President, the time is growing
short to end the unscientific, unobjec-
tive, immoral, and In all honesty what
I must call, the disgusting war against
tobacco farmers. Even as I speak, Dr.
Horn and his band of closed-minded,
antismoking crusaders are busily plot-
ting a sneak attack against smoking.
They are doing their work under the
cover of the bipartisan national cancer
attack program, and under the guise of
scientific advice to Congress and the
Presidency.
Wittingly or unwittingly, the National
Institutes are being Involved. Dr. Horn
and his band have prevailed on NIH to
set up an ad hoc advisory committee on
smoking and health. He prevailed on
NIH to approve of a secret meeting to
be held last month in, of all places, the
American Cancer Society office on 52d
Street in New York City. They prevailed
on these duly constituted Federal officials
to flout the spirit and letter of Public Law
92-4t?3, the Federal Advisory Committee
Act, and fail to list the meeting in the
Federal Register.
Fortunately Senator Eavix caught
them in the act. But nevertheless they
prevailed on the NIH to reschedule the
meeting for February 14~3t. Valentine
Day, perhaps with Al Capone's massacre
in mind, and they further fiouted the law
by listing the announcement of the meet-
ing, not in the Federal Register, but In
the classified advertising columns of the
Washington Post amid the lost-and-
found items, puppies-for-sale, and my-
wife-having-left-my-bed-and-board ads.
Flnally, when they were forced to use
4
the Federal Register, they prevailed on
F1EW to hold out to the bitter end, and
list the meeting as pursuant to an Execu-
tive order rather than the congres-
sionally enacted Public Law 92-543.
Mr. President, I now have in my pos-
session the agenda of this hanging jury
and would like to read it into the record
at this point:
AD Hoc COE[D2rrT&L ON S9[OKING AND HSALTH,
NATIONAL CANCER ADVISOBT BOARD
NATIONAL INaTITIITs Or HSALTH,
February 14,1973.
1. Charge to the Committee-Recommen-
dations on setting of levels of tar and nico-
tine through legislative means.
2. Analysis of current legislation that may
be used to establish maximum levels of tar
and nicotine.
3. Legislative recommendations for estab-
lishment and enforcement of maximum
levels of tar and nicotine.
4. Review of current NCI-NHLI efforts In
smoking and <health, and reoommendations
for their better organizations and funding.
5. Establishment of epidemiological mon-
itoring studies that may determine the ef-
fectivneas of legislation.
LIST Os PROPOSED E[EE[SEaSHIP
Ad Hoc Committee on Smoking and Health
Dr. Philippe Shublk (Chairman), Eppley
Institute.
Dr. Theodore Cooper, NELL
DLr. Emerson Foote, ACS.
Mr. James S. Gilmore, Gilmore Broadcast-
in&
Dr. Gio Gori (Executive Secretary), NCL
Dr. Daniel Horn, National Clearinghouse
for Smoking and Health.
Dr. Charles gensler, Arthur D. Little, Inc.
Dr. Kenneth Srabbeahoft, Wayne State
University. .
Mrs. Mary Laeker, Lasker Foundation.
Dr. Jonathan Rhoads, Univ. of Pennsyl-
vania.
Dr. Robert Ringier. NHLi.
Mr. Lauranee Rockefeller, Rockefeller
Brothers Fund.
Dr. Umberto SaIDotti, NCL
Mr. Benno Schmidt, J. H. Whitney & Co.
Dr. Frederick Seita, Rockefeller University.
Dr. Luther Terry, University Aseociatea,
Ine.
Dr. Ernest Wynder, American Health Foun-
dation.
Three of the five items are legislative
recommendations dealing with allegedly
Impartial advice to Congress. But which
are in fact propaganda support for bills
introduced by m1 distinguished colleague
from Utah (Mr. 112oss). Another item-
the fourth-is Dr. Horn's effort to re-
build his empire within NIH, when he
has failed to control behavior of Ameri-
cans in regard to smoking elsewhere in
HEW.
Now, finally, Mr. President, let me run
down the list of a few of the names of
this stacked Jury upon whose advice the
Congress and the presidency is depend-
ent. First, there is Dr. Horn, whose name
after this speech should be a household
word. He was a former employee of the
American Cancer Society. Second, there
is Mary Lasker. She is a health lobbyist
second to none, and a power behind the
scenes at NI8 under Presidents Kennedy,
Johnson, and now, I am afraid, my
President. She is a member of the board
of the American Cancer Society. Third,
there is Emerson Foote. He is a retired
advertising agency man who fattened on
'Newly e*tablfahed C4mmittae.
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r
s
cigarette accounts, and who now pro-
duces the Madison Avenue flourish to the
antismoking and birth control cam-
paigns. He is the author of full page ads
headlined, "The Population Bomb Is
Ticking." He is a member of the board
of the American Cancer Society. Fourth,
there is Luther Terry, the surgeon gen-
eral who in 1964 was propelled from bu-
reaucratic anonymity to media celebrity
through antismoking campaigns. He is
working for the American Cancer Society.
Fifth, there is Jonathan Rhoads, who is
a former president of the American Can-
cer Society. Sixth, there is Ernest Wyn-
der, a tireless worker, who has built his
career literally on the backs of the white
mice he has painted with smoke con-
densate. Last year his HEW grants
totalled nearly a million doliars and he
has received two million dollars this
year. Another on the panel is James Gil-
more. I do not know him and do not im-
pugn in any way his ability. But I must
wonder at his expertise. He owns an ad-
vertising agency, a broadcasting station,
and an automobile dealership in Kala-
mazoo. He is also heir to the Upjohn
drug fortune.
I do not question the intentions or
motivations of any of these men and
women. I ask only this, Mr. President:
How long will the Congress permit scien-
tific policy to be based on prejudice, no
matter how well intentioned, rather than
truth, no matter how painful? How long
will this body suffer from practices it has
suffered for far to long? The history of
progress in America has been built on the
surrender of fictions to fact, myths to
realities, falsehoods to truth. It is time
for this body to help America shake off
the chains of a prejudiced past, and to
begin right now.
What, then, should be done? First and
foremost, Mr. President, the Congress
should be innoculated against the possi-
bility of tainted Information caused by
a conflict of interest. Clearly, the Horn
report should cease publication. The
,acticity should be removed from h*
hands entiiely, and perhaps, removed to
a safe position entirely beyond the De-
partment of Health, Education, and Wel-
fare. The National Science Foundation,
the National Academy of Science or the
American Association for the Advance-
ment of Science are possibilities to be
explored. Perhaps the Congress should
develop its own capability by enhancing
the role of the newly established OfIIce
of Technological Assessment with this
and similar missions.
Let us frankly face the monumental
task before us. The health effects of en-
vironmental pollution, occupational
hazards, poverty, and cigarette smoking
are almost entirely unsolved problems, as
Is the nature and causation of the dis-
eases they have been associated with. The
present tendency, fostered by zealous
persons and crusading groups, is to un-
derplay the results of industrial air
pollution, occupational exposure, and
low-income living conditions while over-
estimating the effects of smoking.
No greater obstacle to progress exists
than the tendency to substitute guessing
for knowing and to fail to clearly and
openly distinguish one from the other. If
%
we cannot know the health effects of air
pollution because of the confounding
effect of cigarette smoking, then we also
cannot know the health effect of
cigarette smoking because of the con-
founding effect of air pollution. Let the
Congresss demand that HEW say so, and
end the separate-and-unequal. practice
of scapegoating tobacco.
Mr. HUDDLESTON. Mr. President, I
rise to speak briefly in response to the
remarks of my senior colleague from
Kentucky. I would like to emphasize the
necessity for the Government to be
very careful in taking any actions that
would have an adverse economic impact,
not only upon the farmers in my State
of Kentucky and in other tobacco grow-
ing States, but also upon this entire Na-
tion, by precipitously pursuing policies
that may be based upon inadequate re-
search and inadequate scientific know-
ledge in relation to smoking and the use
of tobacco in this country.
There are some 56,000 tobacco farmers
in my State. Most of them are small
farmers, which is typical throughout the
Nation in tobacco growing States. These
small Farmers could be seriously and ad-
versely affected by a number of recently
mentioned antitobacco proposals, which
may have little scientific backing.
It is important that we have a com-
plete scientific picture so that we know
what the health/smoking relationship
is and what various courses of action are
open and advisable before we take ad-
verse action at the tobacco production
and processing level.
Our State of Kentucky has tried to do
something along this line. We have im-
posed additional taxes on cigarette sales
for the purpose of research Into the prob-
lem. These tax revenues have been al-
lotted to the University of Kentucky,
which currently has some $4 million for
research and which anticipates receiving
some $3 million this year from the tax.
Those funds will be used to try to $nd
out what, if any, are the harmful effects
of tobacco and, whatever they are, how
they might be eliminated, so that this
crop may continue, and that those who
benefit from it can continue to receive
the economic advantages that result
from it.
Since tobacco is closely involved in our
export trade, it could be very detrimen-
tal to our balance of payments to act in
a manner that would seriously affect the
economic situation as it relates to tobac-
co, especially in light of current research
deficiencies. Therefore I would urge that
the Government be more concerned
about intensifying the effort that has
begun in our State of Kentucky to deter-
mine precisely what, if any, the harm-
ful effects are and how they might be
eliminated, rather than just trying to
eliminate this cash crop grown by thou-
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