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C a t a 1 o g o f T h e m e s a n d A n t i - S m o k i n g R e c o m m e n d a t i o n s National Commission on Smoking & Public Policy (American Cancer Society appointed and funded) "Public" hearings March 22 - June 16, 1977 TIMN 288507 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION

SCHEDULE OF REGIONAL FORUMS THE NATlONAL COMMISSION ON SMOKING AND PUBLIC POLICY Los Angeles Tuesday, March 22, 1977 Denver Thursday, May 12, 1977 Seattle Tuesday, May 17, 1977 St. Louis Thursday, May 19, 1977 Chicago Wednesday, May 25, 1977 Boston Thursday, June 2, 1977 Atlanta Tuesday, June 14, 1977 Philadelphia Thursday, June 16, 1977 Please address inquiries to: Victor Weingarten Executive Director National Commission on Smoking and Public Policy 801 Second Avenue New York; New York 10017 212/889-6760 Code no. 0580 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION TIMN 288508

. THE NATIONAL COMMISSION ON SMOKING AND PUSLIC POLICY : The Agenda While the Commission recognizes the difficulty in fixing precise boundaries for its inquiry it is adopting a broad view of its charge and will specifically explore the following questions: 1. Estimated number of deaths in the region due to cigarette smoking and the economic costs of such preventable illness. 2. Assessment of effectiveness of the anti-smoking campaign. 3. Proposed legislation or regulatory actions which might be considered: a. Increased tax on high nicotine cigarettes or on all cigarettes. b. Further controls over cigarette advertising. c. Stronger and more prominent warning labels on all cigarette packages. d. Strengthening controls of cigarette sales to minors. e. Smoking in public places. f. Mandated tar and nicotine levels in cigarettes. g. Federal support for purchase of television time for anti-smoking messages. 4. Problems of teenage smokers. 5. Smoking rooms in schools. 6. Special smoking and non-smoking sections in restaurants. 7. Mandated school education programs on the dangers of smoking. 8. Employee rights to non-smoking environment. 9. Effectiveness and ability of smoking cessation clinics. 10. Regulation of outdoor billboard advertising. 11. Efforts on a regional basis to obtain coopera- tion on a sustained and organized basis from physicians, dentists, nurses, and other health personnel. 12. Efforts by industry and labor to curb the sale of cigarettes in plants and offices and other joint management-labor programs to help curtail smoking. In performing its assigned task the Commission welcomes the active participation of all individuals, organizations and institutions concerned with develo- ping a broad and realistic mandate which would lead to more effective control of cigarette smoking and its resulting health hazards. TIMN 288509 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION

- -- These, among others, were the reasons the Board of Directors of the American Cancer Society has em- barked upon an ambitious five-year program to reduce smoking among adults by 25 percent (12'h million men and women); among teenagers by 50 percent (4'/z million youngsters); to reduce the tar and nicotine content in cigarettes by 50 percent; and to work to phase out the tobacco subsidy. Fact-Finding The formation of the National Commission is a major element in this effort. The Commission will seek to determine, on the basis of testimony it will take from knowledgeable and expert witnesses in eight regions of the country, what is being done, what is not being done that might be attempted, how effective or ineffective various cigarette cessation pro- grams are, and what might be proposed to strengthen the ability of regulatory agencies, legislative bodies and voluntary organizations on a local, state, and federal level to deal with the problems caused by excessive cigarette smoking. To help in its fact-finding, eight Regional Forums are planned to provide an opportunity for persons concerned with this problem to discuss with the Commission their activities and programs and to des- cribe their needs and plans for future work. This testimony will be supplemented by other data gathered directly from those providing major resources and services in this field. Analysis and Evaluation A major portion of the Commission's activity will be devoted to analyzing the data gathered. It will seek to identify the factors that are currently effected as well as those that act as impediments to a suc- cessful effort to reduce the health risks involved in cigarette smoking. Recommendations Following this analysis, the Commission will rec- ommend to the Society new approaches and pro- grams, as well as possible new directions to help the Society achieve its goals and objectives. Whether those recommendationswili involve public or private responsibilities or a combination of both will remain open-ended until the initial fact-finding and evaluation phases of the Commission's work are completed. CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION The Agenda While the Commission recognizes the difficulty in fixing precise boundaries for its inquiry it is adopting a broad view of its charge and will specifically explore the following questions: 1. Estimated number of deaths in the region due to cigarette smoking and the economic costs of such preventable illness. 2. Assessment of effectiveness of the anti-smoking campaign. 3. Proposed legislation or' regulatory actions which might be considered: a. Increased tax on high nicotine cigarettes or on all cigarettes. b. Further controls over cigarette advertising. c. Stronger and more prominent warning labels on all cigarette packages. d. Strengthening controls of cigarette sales to minors. e. Smoking in public places. f. Mandated tar and nicotine levels in cigarettes. g. Federal support for purchase of television time for anti-smoking messages. 4. Problems of teenage smokers. 5. Smoking rooms in schools. 6. Special smoking and non-smoking sections in restaurants. 7. Mandated school education programs on the dangers of smoking. 8. Employee rights to non-smoking environment. 9. Effectiveness and ability of smoking cessation clinics. 10. Regulation of outdoor billboard advertising. 11. Efforts on a regional basis to obtain coopera- tion on a sustained and organized basis from physicians, dentists, nurses, and other health personnel. 12. Efforts by industry and labor to curb the sale of cigarettes in plants and offices and other joint management-labor programs to help curtail smoking. In performing its assigned task the Commission welcomes the active participation of all individuals, organizations and institutions concerned with develo- ping a broad and realistic mandate which would lead to more effective control of cigarette smoking and its resulting health hazards. TIMN 288510

C a t a 1 o g C o_n -E e n t s P age ACS Criticism 1 - 7 Addiction 8 - 15 Advertising 16 - 27 Allergy 28 - 29 Anti-Smoking Spots 30 - 34 Behavioral Research 35_ - 39 Concessions 40 - 61a Contradictions 62 - 69 Education 70 - 87 Exaggeration 88 - 125a Excess Health Costs 126 - 133 Farm Support & P.L. 480 134 - 140 Fire Hazard 141 - 144 Health Professional Role 145 - 149 Heart Disease 150 - 154 Inadequacy of Evidence 155 - 157 Ingredient Limitation 158 - 158a CONFIDENTIAL: TIMN 288511 MINNESOTA TOBACCO LITIGATION

Contents -2 Page Insurance 159 - 163 Legislation - Misc. 164 - 189a Lung Cancer 190 - 205 Lung Disease 206 - 208 Nonsmoker Enforcement 209 - 211 Nonsmoker "may-can" Evasion 212 - 213 Nonsmoker Health Harm 214 - 222a Nonsmoker Health Harm - Children 223 - 224a Oral Disease 225 - 225a Peptic Ulcer 226 Pregnancy 227 - 231 Promotion Restrictions 232 Quit Smoking Methods 233 - 239 Safe Cigarette 240 - 249a Sales Curtailment 250 - 254 Smoking Restriction - Employment 255 - 265 Smoking Restriction - Hospitals 266 - 267 Smoking Restriction - Public 268.- 280a TIMN 288512

Contents -3 Page Smoking Restriction - TV, Films 281 Smoking Trends 282 - 287 Social Unacceptability 288 - 294 Tar, Nicotine & Carbon Monoxide 295 - 301 302 - 309 Taxes 310 - 314 Warning Label TIMN 288513 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION

A C S C R I T I C I S M What you are doing now is actually taking the heat off the industry. The American Cancer Society, if they are really to solve the problems of health of the American public, will have to take an entirely different approach. Ida Honorof, publisher of consumer newsletters, Sherman Oaks, California, 3/22 LA Tape 6, Rev. 02. The only way I heard about this conference you were having, or seminar, or whatever you want to call it, was through Dr. Sterling, who called me from Canada. Which is strange, because I have a radio show. In fact, I've received numerous awards for the type of program that I do. I have a radio show on National Public Radio ((unintelligible)). They didn't get a copy. They had no notification of the fact that your meeting would be held today. I learned about it through Dr. Sterling. Now would you like to ask me some questions? After all, I have challenged the American Cancer Society. Allan Jonas: I have no questions, but I wonder if I might just make a comment. First of all, we're delighted you came. Honorof: Thank you very much. Allan Jonas: Sorry we couldn't get greater publicity. We are operating on a very close budget. Every one of the witnesses came and .go from out of town at their own expense. Honorof• You had an awful lot of media here this morning, I was told. • The press showed up, which means you are going to get a lot of coverage. A11an'Jonas: Well, I hope so, because it is so complex an issue. This ~ commission is concerned with cigarette smoking--tobacco abuse, rather--and public policy. Honorof: But it's only the tip of the iceberg, sir. - Allan Jonas: We agree. And I just wanted to assure you and anyone in the room who wondered whether this was the end-all and be-all of the American Cancer Society's thrust against environmental carcinogens. Let me assure you it isn't. We are committed as you, maybe not as well informed at the moment as you, to see this committee through the whole field of environmental carcinogens, not just tobacco. Ida Honorof, publisher of consumer newsletters, Sherman Oaks, California, 3/22 LA Tape 6, Rev. 163. If you people are really interested in doing something about cancer, not only lung cancer but overall cancer, you're going to have to change your whole scope. Ida Honorof, as cited by ACS LA Film, 3/22 LA. CONFIDENTIAL: TIMN 288514 MINNESOTA TOBACCO LITIGATION

A C S C R I T I C I S M (page two) Program priorities within the American Cancer Society are misplaced. Dexter T. Suzuki, Student Activities, Coordinator, Kailua High School, Honolulu, Hawaii, 3/22 LA statement, p. 1. 1) The "Target 5" program, to reduce the number of smoking adults by 25% and the number of smoking teenagers by 50%, is somewhat too ambitious. Salvatore V. Zagona, Assoc, prof. of psychology, Univ. of Arizona, Director-Center for Research on Smoking & Health, 3/22 LA statement, p.5. It would seem more productive to set more realistic goals, and to proceed by increments. Salvatore V. Zagona, Assoc. prof. of psychology, Univ. of Arizona, Director-Center for Research on Smoking & Health, 3/22 LA statement, pp. 5-6. Commission member: Dr. Horn, if you'll come back just a minute to Mr. Jonas' question about the younger age, I think you're familiar with the Yankelovitch survey and you'll recall that one of the findings there was that 6 out of 10 of the girls ((unintelligible)) commenced before they were 13. Is this a reliable statistic? Horn: NO. Daniel Horn, Director NCSH, 3/22 LA Tape, 6, Rev. 530. The policy of the North Carolina Division is not to engage in political or legislative actions against any product or industry. It confines its efforts to fighting the total cancer problem. J.E.McDowell, President, N.C. Div. of ACS, 6/l4 Atlanta p. 1. The legislative platform and the tobacco subsidy elimination portions of Target 5 az'e particuarly onerous to many of our citizens, and we have had repercussions from around the state. The general statement from long-time volunteers and contributors has been, "I thought I was working for (or contributing to) the fight against cancer, not against tobacco! Let me know when you stop fighting tobacco and start fighting cancer and maybe I will work as a volunteer (or contribute) again." It is apparent from this that efforts to curtail cigarette production through legislation or tax penalties, in North Carolina, is counter-productive. J.E.McDowell, President, N.C. Div. of ACS, 6/11+ Atlanta p.3. CONFIDENTIAL: TIMN 288515 MINNESOTA TOBACCO LITIGATION

A C S C R I T I C I S M (page three) If the ultimate goal of Target 5 (to reduce tobacco related disease and death) is to be realized in North Carolina, we must not antagonize a major portion of our population. J.E.McDowell, President, N.C. Div. of ACS, 6/14 Atlanta p.4. We must confine our activities to "fighting cancer"--not tobacco--and this does not include engaging in political or legislative actions against any product or industry. We will dedicate ourselves to fighting the total cancer problem through ever-increasing education and service efforts. J.E.McDowell, President, N.C.Div. of ACS, 6/l4 Atlanta p.1+. Now another shibboleth -- and this will be painful to the American Cancer Society -- I'm sorry to say this -- but there's no evidence that people are going to the doctor any earlier than they used to. Looking at incidence statistics and data from 30 years ago, the time for advanced lung cancer now that's most likely to be symptomatic -- the time from onset of symptoms to diagnosis was five months 30 years ago, in our data. It was five months 20 years ago and it was five months 10 years and it's still five months. So there's no particular reason to think that people seek medical attention earlier. Frederick F. Holmes, M.D., Professor of Medicine, U. of Kansas Medical Center and Director of Cancer Data Service, Mid-America Cancer Center Program, 5/19 St. Louis, Tape. 2, Side 1, Rev. 1078. ...the rhetoric of extremism that has often characterized public pro- nouncements and policy solutions on both sides. Kenneth M. Friedman, Ph.D., Assistant Professor, Purdue University, Dept. of Political Science, West Lafayette, Indiana, 5/25 Chicago, page 3. Cheyenne has an active cancer society, lung organization and heart association. I have been upset with all of these organizations, in that none of them have made any effort to inform the general public about the dangers of cigarette smoking and the major roles that cigarettes play in causing cancer, heart disease and lung problems. I have wondered how these organizations could have their fund drives and not mention the major cause of the disease. Robert Taylor, M.D., Orthopedic Surgeon, Cheyenne, Wyoming, 5/12 Denver, p.6. CONFIDENTIAL: TIMN 288516 MINNESOTA TOBACCO LITIGATION