Tobacco Documents Online

because they have persuaded themselves that it is in their own self-interest to do so. I said that we must: continue to encourage cessation as the only certain way to protect both the individual and society from the harmful effects of smoking. But I believe we must also work towards reducing the harmful effects of smoking. It is perfectly clear that however successful we may be in the future in persuading young people not to take up smoking, many present smokers will continue to smoke. The health and lives of these millions of present smokers are at risk and we must do what we can to protect them. We can do this by developing less hazardous cigarettes and encouraging less hazardous ways of smoking. An important section of the new report is devoted to a review of the harmful constituents of cigarette smoke. An array of compounds'are presented. The first series are compounds in cigarettes judged most likely to contribute to the health hazards of smoking, they comprise carbon mon- oxide, nicotine, and "tar", the last-named being the particulate matter collected from smoke after nicotine and moisture have been removed. The second series are six substances, judged as probable contributors to the health hazards of smoking; they comprise acrolein, cresol, hydrocyanic acid; nitric oxide, nitrogen dioxide, and phenol. A final, third series, 3. comprises a larger numb er of compounds judged as suspected contributors to the health hazards of smoking. This chapter on harmful ingredients is more than a simple "state of the art" review. To my mind it brings us closer to a suggestion by a number of persons, more recently by Drs. Fletcher and Horn in their report to the TIMN 0113439 T 1151 a-8

World Health Organization. This is that governments consider setting maximum limits on the harmful ingredients to be contained in cigarettes offered for sale. Such a provision is contained in legislation now before the Canadian government and it is a suggestion that I believe we in the United States should begin studying most carefully. Our chapter on harm- ful ingredients suggests three ingredients of smoke which might immediately be made subject to this control -- these being tar, nicotine and carbon monoxide. te There is an alternative method of encouraging the use of lower yield cigarettes, and that is through taxation. The City of New York now has a graduated tax on cigarettes based on their tar and nicotine content and this experiment should be watched carefully. New York City is not a typical market for cigarettes because so many persons employed there live in other jurisdictions and, I understand further, because a black market exists in cigarettes brought in from States where taxes are lower. This suggests that if the system works at all in New York City, it should be even more effective elsewhere. Research is going 'on towards developing a less hazardous product and we must applaud this research for the reasons I have already given - a great many persons will continue to smoke cigarettes, at least in our gen- eration, and their health is at risk. There need be no.:conflict, in my mind, between a search for less hazardous ways of smoking and our basic effort to encourage no more smoking at all. Those of you who were here last year on this occasion may remember that I concluded my address with a call for a Bill of Rights for the Non- smoker, which would include a ban on smoking in public places such as. restaurants, public transportation, and theaters, to provide respite for those who are allergic to smoke or.who are simply annoyed by having to TIMN 0113440 T115119

- 13 - breathe smokey air. I wasn't quite prepared for the response that followed. ;There was considerable editorial comment, both pro and con. Hundreds of letters were sent to me and to editnrial offices around the United States in enthusiastic support of the idea~tiiat the'nonsmoker 'Ecas 'at least as great' a right to a clean environment as the smoker has to pollute it. There were very few dissenting views. The time appears to have come in our free society for nonsmokers to assert their rights. Letters to newspapers, ,.,.. to Congress, to voluntary organizations and to me will all speed the day when the non-smoker's bill of rights -- his right to clean air -- will be accepted universally. That will be an accomplishment for health -- and we should strive toward it. Already we can see change. Many of the major airlines now provide separate_seating for smokers and nonsmokers. The Interstate Commerce Commission has made an initial determination that smokers must occupy seats separate from nonsmokers; however, this is still open to appeal and I fear that the bus companies will not look kindly on such a ruling. However, at least one state has passed legislation that requires virtually all railroads, bus firms and airlines to provide separate seating for nonsmoking passengers. Smoking was banned on the Staten Island Ferry. In yet another state legislation was I introduced to forbid smoking in restaurants; I reqret that I do not know the ` outcome of this effort, although it would be most surprising if such ` legislation could be put into effect. I We are making some progress in this direction within the Department of Health, Education, and Welfare, and I am proud that our Secretary, Mr. Richardson, has taken leadership in banning smoking in conference rooms and auditoriums in buildings occupied by HEW; in reserving separate areas in our cafeterias for nonsmokers; and in asking supervisors, to arrange smoke-free work areas for employees where this can be arranged rt TIMN 0113441 T115120

- 14 - without undue inconvenience. This is a bold step and one I hope other Department heads in the government and the leaders in industry will take to protect the well-being of their employees. Support for action such as this lies irx the information contained in two chapters of the 1972 report. Although we cannot say with certainty that exposure to tobacco smoke is causing serious illness in nonsmokers -- the long term research necessary for such a finding has not yet been done -- it is clear that such exposure can conttibute.to the discomfort of the nonsmoking individual and can produce exacerbation of allergic symptoms in those who are suffering from allergies of various other causes. There is ample proof that those who complain of discomfort in smoke-filled rooms are not disagreeable malcontents, but can have a legitimate cause for their complaint. This year, for the first time, data has been included in our report to Congress on the role of tobacco smoke as a source of air pollution for the nonsmoker. Experiments are cited in which measurements have been made of carbon monoxide in smoke filled rooms. In these studies the level of carbon monoxide has been shown to equal and at times to exceed the legal limits for maximum air pollution permitted for ambient air quality in several ~ localities. Under certain conditions these levels can albo exceed the occupational Threshold Limit Value for a normal work period presently in effect for the United States as a whole. The CO levels in these "smoked" rooms which ranged from 20 to 80 ppm may be associated with adverse health effects as measured by impaired performance TIMN 0113442 T115i21 ~

on certain psychomotor tests. Other investigators have noted that exposure to CO levels of 50 ppm and up has resulted in altered auditory discrim- ination, visual acuity and the ability to distinguish relative brightness. The average individual probably may not often be exposed to such high concentrations of smoke for long periods of time without relief; but the fact that such dangerous conditions can develop should sound a warning to us. We can not overlook the.fact that exposure to these con- centrations of carbon monoxide may be especially hazardous for those who are suffering from heart disease or chronic bronchopulmonary disease. And to what extent may this affect driving performance in a poorly ventilated car with several occupants smoking? There is no question that cigarette smoking continues to be a major public health problem. New data in the current report to Congress establishes that there is a hazard in this habit for those who smoke and for some who do not. The challenge ahead for those who have the responsibility for Smoking Education Week is a great one, but I think we are equal to it. Let me return to a matter I touched upon at the beginning of my'talk today, cigarette consumption. On the positive side, 29 million Americans have stopped smoking. In great part, I believe we can say this is the result of the efforts of the member organizations of their Interagency Council. But on the negative side, 44 million Americanp, continue to smoke. I said at yesterday's press briefing that the Department of Health, Education, and Welfare intends to follow the curve of"consumption most carefully. If it curves upward, or even if it continues at its present level, it will be a sign to us that we are not doing enough to control TIMN 0113443 T115122

- 16 - what is clearly one of this country's most important public health p rob lems . Traditionally, our society has been most successful in combatting public hzalth problems when the citizen has been passive. That is, we have purified our water supplies, prevented sewage from entering our drink- ing water, pasteurized our milk, made certain that meat products did not transmit trichinosis, brucellosis, and'tuberculosis, and immunized our citizens with vaccines against smallpox; polio, measles, and the like. But we have not been successful when the citizen has to take an active .and responsible role: when he must exercise, when he must choose foods to avoid obesity and arteriosclerosis, when he must restrict his alcohol intake and when he must restrict or eliminate smoking of cigarettes. What is the role of government beyond education, when education doesn't do the job? Without.question, this Government and other Governments in the industrial world will be considering new action in the years to come to try to reduce the death and disability which cigarette smoking brings. The World Health Organization has circulated among its member nations a series of recommendations. Two which I have already mentioned are setting upper limits for various constituents of tobacco smoke and adopting a system of differential taxation so as to discourage the smoking of cigarettes with a high tar or nicotine content. Another major recommendation is taking action to curtail the adver- tising of cigarettes with a view to its eventual elimination. Canada is considering eliminating advertising at the present time. And still another recommendation is raising taxes on cigarettes. Many of our State and.Iocal governments have done this for revenue purposes, TIMN 0113444 T115123

although the Federal Government has not changed its rates for some nearly 20 years. The fundamental purpose of this Council is education, and the event we are celebrating today marks the beginning of a Smoking Education Week. By all means, let us pursue our efforts. But let us be prepared to do even more than this, if the need continues. . ,•. TIMN 0113445 T115129~ ~: -

- 17 - although the Federal Government has not changed its rates for some nearly 20 years. The fundamental purpose of this Council is education, and the event we are celebrating today marks the beginning of a Smoking Education Week. By all means, let us pursue our efforts. But let us be prepared to do even more than this, if the need continues. TIMN 0113446 . T115125