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i 280 Recommendations of Conference Work Groups a. The knowledge that for some individuals smoking withdrawal is not as difficult as is generally believed; b. Demonstration of the short, as well as the long- term, benefits from cessation of smoking; c. If an individual finds it impossible to stop or re- duce cigarette smoking, consideration of the use of other forms of tobacco; d. Knowledge of other community resources such as smoking withdrawal clinics, other medical treatment services, and appropriate guidance for supportive care as long as necessary. 3. The conference recommends the preparation of edu- cational materials on smoking and health for the use of patients, to be used by the health counselor in his contact with individuals, to supplement his personal advice and guidance, and not to be used as a substitute for such per- sonal guidance. 4. The conference recommends efforts to procure the widest enlistment of professional health societies in smok ing withdrawal activities, including the adoption of strong position statements on this problem. WORK GROUP 8: ROLE OF PHYSICIAN AND OTHER EXEMPLARS Chairman: Sol R. Baker, M.D. Chairman, Committee on Tobacco and Cancer American Cancer Society Secretary: Kenneth Briney, Ph.D., Director of School Health, American Heart Association Recorder: Miss Dorothy Vickery, Educational Materials Director, American Heart Association The group adopts the position that the role of exemplars is' extremely important in influencing smoking behavior and that action programs should be undertaken immediately. 1. Persons who are in exemplar roles should not smoke. 2. Additional research should be conducted to document the effect of exemplars in influencing smoking behavior: a. to identify exemplars. Work Group 8: Physician and Other Exemplar Roles 281 b. to determine the relative influence of various ex- emplars. c. to determine ways in which exemplars can be more effective. 3. Smoking control programs should actively involve the allied medical professions both civilian and military, the allied education professions, youth-serving professions, and prominent public persons such as athletes, television personalities, and public officials. a. Schools preparing professional workers in the health, education, and youth-serving fields should in- corporate into the curricula-and implement informa- tion on the exemplar role in smoking. b. Persons already in these professions should re- ceive education for fulfilling their role as exemplars. c. Agencies and institutions related to health and ed- ucation (e.g., hospitals, medical schools, universities) should regulate and actively discourage smoking. 4. Since society itself is an exemplar, laws and regulations should be passed to control smoking. Existing laws and regulations related to smoking should be modified to meet current needs-and enforced. WORK GROUP 9: GOVERNMENT -ACTION AND LEGISLATION Chairman: Berwyn F. Mattison, M.D. Executive Director, American Public Health Association Secretary: James L. Troupin, M.D., Director of Pro- fessional Education, American Public Health Association Recorder: John T. Walden, Assistant to Associate Sur- geon General, United States Public Health Service Government action and legislation-What other govern- ment action is needed? 1. Product and Dosage Control a. Development of low tar and nicotine tobacco b. Outlaw over-length cigarettes -"':..4 ..,.. .. .: ~..

282 Recommendations of Conference Work Groups c. Research in filtration (without implying that a"safe" cigarette is possible) 2. Insurance Ratings Following the lead of some private insurers, government insurers should study their own life table data for smokers and non-smokers and the resulting insurance premium im- plications. 3. Advertising a. Bar where legally feasible. b. Discourage effect of indirect attempts, both de- liberate and otherwise, to influence people in behalf of cigarette smoking (i.e., cigarettes as movie props) c. Include warning in all advertising. d. Restrict exposure of children. 4. Regulations a. Restrictions on smoking in government facilities and other public places: schools, hospitals, transporta- tion media, etc. b. Restrictions of sales to minors (distribution of free cigarettes, vending machines, and health facilities). c. Urge promotion of communications media time to counteract cigarette advertising. 5. Education a. Government support for special education for the health and other concerned professions, e.g. teachers. b. lay education and information-including schools and military populations. 6. Labeling a. Require strong warning on all packages, including those in foreign trade. b. Tar and nicotine content labels on packages and in advertising (add other toxic agents as identified) 7. Taxes a. Differential taxation on basis of tar and nicotine content (add other toxic agents as identified) b. Differential for cigars and pipes. c. Urge consideration of advantages in central gov- ernment levy of cigarette taxes. 8. Production a. National governments and international agencies Work Group 9: Government-Group 10: The Media 283 ~ M adopt as agricultural policy the discouragement of the cultivation of tobacco and as economic policy the dis- ~ O couragement of cigarette production. b. National governments and international agencies ~ O encourage conversion of tobacco growing land to other purposes and diversification. End all promotion of cigarette industry abroad c ~ ~ . . 9. Therapy Intensify the use of all effective services to assist smok- ers to break the habit and remain free of it. 10. Research a. Fundamental research on all aspects of the smok ing and health problem. b. Promotion of continual research into the differen- tial effect of all measures established to curb cigarette smoking. WORK GROUP 10: COMMUNICATIONS- THE MEDIA Chairman: Thomas Carh'le, M.D. Radiologist, Mason Clinic Past President, American Cancer Society Secretary: Clifton R. Read, Vice President for Public Information, American Cancer Society Recorder: Irving Rimer, Assistant Vice President for E"', Public Information, American Cancer So- ciety Efforts to prevent and reduce cigarette smoking are crit- ically hampered by unregulated, massive cigarette adver- tising in all media. In England, the Scandinavian countries, Italy, the United States and other nations there is mounting evidence that the final objective of elimination of all cigarette advertising can be attained. Immediate steps should be initiated leading to the end of cigarette ad- vertising appealing to young people and to placing clear and adequate warnings in cigarette advertising of all kinds. In the United States, the single, most significant recent development has been the ruling of the Federal Communi- cations Commission requiring radio and television stations