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t CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION Conference between Secretary Wilbur J. Cohen, Dr. Philip R. Lee and Surgeon General R7i11iam H. Stewart and Senator Ear le C. Clements, Paul Smith, and H.H,. Ramm at the offices of the Secretary, 4:15 p.m., April 1, 1968. Senator Clements expressed appreciation for the conference and stated that he hoped that all were in agreement that there was a real justification for the meeting and that both industry and government were interested in f inding the truth about cigarette smoking and alleged health hazard wherever that may lead. He stated that there may possibly be some underlying strain in discussing the topic because of differences of opinion which have been expressed in the past but that he hoped that these feelings could be laid aside and that the Secretary and his associates would accept the Senator's dedication and sincerity with respect to the controversy. The Senator stated that he did not think that there had been enough mutual confidence and trust between the government and the industry and if we can improve this situation, this and future meetings would be fully justif ied. He stated that if he felt that the charges made against~cigarettes were justified he would be in favor of more drastic control measures than had been proposed. Statements have been made by both sides which have not been helpful to mutual understanding and cooperation. The Senator stated that he felt deeply that confidence in each other must be established at policy levels both in the govern- ment and in industry. The Senator stated that the Public Health Serv2ce has as one of its goals the supporting of research in the smoking and health contro- versy and as another-of its goals disseininating to the public factual ; 2'78'~7 TIMN 0081590

CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION information concerning the matter. Industry agrees with both of these goals and has in fact supported research extensively, origi- nally through its own research organization and in more recent years through the additional facility of the Education and Research Foundation of the American Medical Foundation. Apparently differences do exist in determining the research to be done, how it is to be ac- complished, and the facts communicated to the public. The Senator stated he felt there should be a cooperative effort between government and industry on research and that such cooperation could be accomplish- ed through meetings such as this. The Senator stated that he could assure the Secretary that he was not there to tell him that cigarette smoking had been proved to be harmless, but he was there to inform him that the views of the industry, which was shared by many researchers,'that scientific basis for the charges levied against cigarettes were weak,"indeed. No ingredient as found in cigarette smoke has been shown to cause any human disease. Reference was made by the Senator to the hearings held last August by Senator Magnuson's Subcommittee with reference to the Strickman filter. The Senator pointed out to the industry's credit even though the filter had the endorsement of a great university, there was no stampede on the part'of the industry to take advantage of the situation and all of the industry took the position that.ad- ditional scientif ic proof as to the claimed merits of the filter I were necessary before it should be used. At these hearings, Governmen~ 2. witnesses indicated desirability for cooperation with the industry in ~" 27878

CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION additional research. The principal remarks of Senator Clements were concluded by stating that he was convinced that representatives of the industry should meet at policy level with the Secretary and his associates 3. to discuss mutual problems and methods of solving such problems so that the interest of the public could best be served. Dr. Stewart inquired as to the areas of research proposed. Senator Clements stated among areas would be "whole smoke" and develop- ment of suitable test animals. Dr. Stewart replied "this means the whole problem of carcinogenicity?" Senator Clements replied in the affirmative and Mr. Ramm remarked that it was not only cancer that was involved but many other diseases had been implicat2d in statements made by government officials. Mr. Ramm also said that the industry had in- formation which he believed reliable to the effect that the Surgeon General's Advisory Committee had wanted to include an entire chapter in its 1964 Report devoted to setting forth the gaps of knowledge which existed and further research that needed to be done but that this chapter was not included because the then Surgeon General took the position that its inclusion would go beyond the scope of the report that the committee was to make. Perhaps the Surgeon General's decision on this was based on the assumption that there would be a H Phase 2, as originally announced, but it was never brought into being. Secretary Cohen stated that he had been in public life for 35 years, all of which were involved in controversy so that controversy was not a new thing to him. He stated that he had found that in controversial matters it was helpful to have discussions to determine / iZ7879

, CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION the areas of agreement and disagreement. In many instances it was thought that disagreement existed and f urther understanding resulting from discussion dissipated such disagreement. He gave as an example a very bitter and protracted disagreement with the American Medical Association which evolved over the concept of "regional health complexes." Discussion indicated that the cause of the disagreement was a misunderstanding of what was meant by the word "complex" and that when this was understood the AMA dropped its opinion and became a supporter of the concept. 4. Secretary Cohen a lso stated that he had experience indicating how helpful it can be for cooperation to exist between industry and government and cited as an example efforts being made to reduce air pollution. While many diff iculties were involved, a meeting was held with presidents of 55 companies having air pollution problems and as a result of this meeting these companies are now cooperating with the government and even in its efforts to obtain necessary government appropriations. Mr. Ramm stated•that one of the difficulties encountered by the industry was that the government's spokesmen were advising the public that smoking was responsible for the production of numerous diseases for which there is no scientific proof that smoking is the guilty agent. - TIMN 0081593 Dr. Stewart said that the only statements were that these diseases are "associated" with smoking and if on ly 55,000 deaths are caused -7" 2'7880

i l 5. Mr. Smith said that he understood that the Surgeon General claims that there has been shown to be a causal relationship between smoking and (1) lung cancer in men; (2) larynx cancer in men, and, (3) chronic CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION annually by smoking that is bad enough. General stated that he agreed. Secretary Cohen stated that he thought that a series of further meetings at the policy level were desirable. Senator Clements said that perhaps for the next meeting each side should outline what it regarded as important research to be done. Secretary Cohen said that he thought that this was premature and that details of research were probably not to be discussed at this level hut that he would, prior bronchitis, and, that he did not claim that there had been demonstrated a causal relationship between smoking and other diseases. The Surgeon to the.next meeting, discuss the entire matter with his associates, Drs. Lee and Stewart. Mr. Smith stated that he was in agreement with all that Senator Clements had said and he, Smith, felt that in spite of different ~. - opinions, discussions would lead to areas of agreement, particularly as to needed research. Secretary Cohen stated that he was going to be tied up with Senate Hearings.commencing this week but that as soon as these were, over he was going to devote his attention to our matter and that he would get in touch with the Senator and arrange for the next meeting. The conference adjourned at 5:00 p.m. TIMN 0081594 A`