Tobacco Documents Online

Background on an International Conspiracy Against Cigarette Smoking The American Cancer Society's last big campaign against cigarettes, Target Five (1976-1981), was a resounding flop. Of close to 100 "recommendations" made by two separate volunteer groups, only three have come to fruition. The ACS beefed up its Washington lobbying capability, employing Marvella Bayh and, after her death from cancer, her husband, ex-Sen. Birch Bayh, for its former- ly part-time capital operation. It talked ex-smoker Joe Califano into ordering HEW to issue a "new" Surgeon General's report, in 1979. And it initiated and made an annual November publicity event the Great American Smokeout. Aside from these minor Target Five wins, it appeared that the voluntary health association's staff, its officers, delegates and volunteers had been talking to themselves. New Guidelines Now they've taken a page from a book that ACS helped to write in 1976 and they're going about their war on cigarettes in a more organized manner. The book is "Guidelines for Smoking Control," a 170-page volume designed "to help concerned organisa- tions to design, develop and carry out smoking control programmes." Two ACS representatives attended a five-day workshop session in December 1976 in Geneva at the offices of the International Union Against Cancer (UICC), a nongovernmental organization of 215 voluntary, private and public cancer research groups from 70-odd countries. A dozen other men there were from as many CONFIDENTIAL: TIMN 308685 MINNESOTA TOBACCO LITIGATION

-2- industrialized nations, called together by Nigel Gray, director of the Anti-Cancer Council of Victoria, Australia. In 1975, following the Third World Conference on Smoking and Health, Gray was asked by the UICC board to set up a Special Project on Smoking and Lung Cancer. The purpose of the project in Gray's own words in early 1977 was to assume "international leadership in the campaign against the habit of self-inflicted health impairment [and to] exhort cancer societies -- and other health-related agencies -- to launch aggressive smoking control programs and provide comprehen- sive and practical guidance for this task." Gray emphasized that "success would be most readily achieved by those who adopted a coordinated approach, including the fullest collaboration with concerned individuals and organisa- tions and ensuring that all community resources are exploited." International Incest Gray's project was-funded by a $100,000 grant from the International Cancer Foundation (ICF), incorporated in Geneva in 1971 "to enable the UICC to expand its activities in various directions which urgently call for attention on an international basis...to promote all new forms of international cooperation in the fight against cancer." ICF Corporate and Foundation Members were expected to contribute $25,000-$50,000,annually, according to a letter received by one U.S. company in 1974. The letter listed Lane Adams, longtime ACS executive vice president, as the USA member of the three-man ICF governing board. CONFIDENTIAL: TI~N 308686 MINNESOTA TOBACCO LITIGATION

-3- The ACS representative at the Geneva workshop meeting in 1976 was Irving Rimer, veteran public information chief, who was accompanied by a wealthy Orlando, Florida, industrialist who the following year as an ACS volunteer would be an outspoken anti- smoking "witness" at one of the "public forums" scheduled around the country by the ACS-appointed National Commission on Smoking and Public Policy (NCSPP). This last group was the showpiece of the anti-smoking Target Five operation devised by an ACS-ap- pointed National Task Force on Tobacco and Cancer and adopted by the ACS board in late 1976. A Grass-Roots Manual Rimer and his star volunteer and Gray's other appointees wrote the guidebook for smoking conrol. That first edition, Reuter news service said in early 1978, read "like a politician's primer." The second edition, published in 1980, is even more of a how-to text, providing the basics for grass-roots lobbying, from how to win press coverage for the cause to how to approach legislators -- and then how to publicize the fact they've said no, if they turn down the proposed restriction on tobacco. "From the information presented in this manual organisations concerned to reduce smoking should be able to develop policies, establish priorities within their policy framework and start work on specific smoking control projects," explains the second edition. The first objective, it says, is "to maintain liaison with other health organisations and authorities to ensure maximum effectiveness and avoid conflict of activities." C ONFIDENTIAL e TIMN 308687 MINNESOTA TOBACCO LITIGATION

-4- The first step, says the forward, should be a workshop r meeting to "encourage regional rou s to cooperate, pool their experience and resources and mount a more effective attack on the problem.... "Coordination is essential for efficiency. It is a basic principle that the various groups working toward smoking control work together," says the manual. "Concerned groups must agree on basic op licy and must resolve any differences before launching programmes. "Targets must be established and priorities agreed. "Specific tasks must be given to those groups most suited for them." The point that anti-smoking groups must speak with one voice (and, it might be added, preferably not just to themselves) is made again and again in the guidebook. And, sure enough, in early 1981 UICC formed the International Liaison Committee on Smoking Control in conjunction with international cardiology and tuberculosis groups. UICC also obtained (we're told probably for free) the services of J. Walter Thompson, which one observer has ventured will probably be involved in fund-raising. This may not involve the anti-cigarette campaign but may free up other funds for such purposes. ACS's Target Five program had been planned too early to take advantage of Gray's allegedly winning anti-smoking formula: CONFIDENTIAL: TIMN 308688 MINNESOTA TOBACCO LITIGATION

e -5- Coordination + Collaboration = Success. But the society has now pulled the American Heart Association, the American Lung Associa- tion and 19 other U.S. groups into its anti-smoking coalition to write a Blueprint for Action. One Voice, One Goal Target Five ended in 1981 with no final report, not even a whimper, as the new Smoking OR Health conference arranged and paid for by ACS began. There was no public mention of the late, lamented, five-year, $600,000 ACS program. In fact, Dr..Charles LeMaistre, chairman of the ACS invitational affair announced right off that it was not an ACS meeting and called upon the 250 participants to produce a document to unite the 21 cosponsoring groups "to awaken America by producing a national Blueprint for Action that is realistic and achievable." ACS had learned from the guidebook it helped to write that it was fruitless to go it alone. In the only apparent media coverage of the three-day meeting, Medical World News quotes Birch Bayh: "I'm amazed there hasn't been more coordination before." The former Indiana Senator, whom the medical weekly said had been retained by ACS to represent it, the American Lung Association and the American Heart Association in Washington, added, "Historically, they've traveled separate roads toward the same goal, but now there's great willingness to work together." . TIM~ 3~g689 . MINNESOT ® TOBACC jAL: . . . . , . . O LITIGATION ~ ~ . ~ ~ . . .. . .

-6- Medical World News commented, "In the past, some of the health groups haven't strung together at all." In the same article, Dr. Philip R. Lee, former Assistant HEW Secretary for Health, former NCSPP member and current director of the Institute for Health Policy studies at the University of California, San Francisco, recalled that the heart and lung groups had taken opposing issues on smoking and airplanes. "Cooperation will develop slowly," Dr. LeMaistre told the magazine. But he noted that the three voluntary health associa- tions had all pledged in advance to support the final Blueprint for Action. So far only a draft is available. An Ignored Policy Objective Due originally right after the first of the year, the final document is not expected now until early April and so far there's no sign that the American group has paid any atten- tion to one of the UICC "policy objectives," adopted as well by the World Health Organization in 1979: "To achieve up blic health control of relevant industrial and environmental factors which contribute to lung cancer." The only recorded mention of industrial factors so far, as , researchers urge more tobacco and health research, public rela-, tions people recommend new anti-smoking "public infQrmation" campaigns and advertising executives call for paid government advertising against cigarettes, is in the draft recommendations CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION .TIMN 308690

-7- of the group working on "Use of 'High Risk' Concept in Smoking Control." Forget about the nonsmoker's occupational exposure, that group said by implication, "formulate and encourage adoption of standards of practice for dealing with smokers at high risk because of occupational exposure" -- inform them, documenting that you've informed them, "emphasizing control both of occupa- tional and cigarette smoking hazards." Health and personnel specialists from IBM, Johnson & Johnson, N.Y. Telephone, General Mills, Citibank and Citicorp, Dow Chemical, Pitney Bowes, Boeing, Control Data Corporation, AT&T and the handful of insurance companies who participated in the "workplace" group appeared, from their final recommendations, to be more interested in workplace control of smoking than in any occupational exposure. Representatives from NIOSH (the assis- tant director for occupational safety and health practice) and EPA (Repace) served on the tobacco-related research and "strate- gies for a changing cigarette" panels. The lack of concern about*workplace occupational exposure is typical of the ACS's zeroing in on cigarette smoking with little or no mention of any other cancer risk factors. Indeed, the society's "Program of Action Against Cigarette Smoking," adopted ~ in 1979 as the result of both Task Force on Tobacco and Cancer and the NCSPP reports said nothing of any dangers of occupational exposure, merely called, among its 13 points, for "Launch[ing] an informational and education campaign promoting the workplace as a smoke-free environment." CONFIDENTIAL: TIMN 308691 MINNESOTA TOBACCO LITIGATION •

A -8- The ACS made one small nod to occupational causes of cancer in the late 1950's, when it included a question about on-the-job exposure to smoke or dust in its first million-persons study. And, in the new ACS Cancer Prevention study that's to begin this fall there are six questions about occupation, years on the job and self-determined exposure to 12 listed groups of industrial materials from asbestos to X-rays. There is no mention of petroleum refining or work with rubber, exposure to both of which is recognized as posing high risks for the smoking-related cancers -- whether or not the worker smokes. Conspiracy Within a Conspiracy Invitations to the November conference went out in June, less than a month after the Federal Trade Commission sent to the Congress and released publicly a staff report proposing more specific, rotating warnings in cigarette advertising, a concept so popular with the ACS conferees last fall that several of the working groups and panelist Edwin Newman got in on the act with suggestions for additional labels. In their report to the commission in May, the FTC staffers noted that no one of the suggested options "will eliminate;the [awareness] problems in this report...the adoption of these remedial actions as part of an overall educational effort by Congress, the commission or other relevant organizations appears to offer the most effective way of informing the public about significant health risks of smoking." -"- 7 TIMN 308692 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION.

-9- In its long overdue annual report to Congress on cigarette advertising in September, the commission noted that the "remedial options suggested in the staff report are not limited to action by the agency; they may well be appropriate for consideration by other entities, including private organizations." In between the two, we learn from ALA correspondence with the commission, Matt Myers, the program advisor for the staff report, attended a meeting of the Smoking and Health Committee of the ALA board. "Discussion at the meeting," wrote Managing Director James Swomley to the acting FTC chairman later, "helped us zero in on key issues affecting our positions about cigarette advertising." Swomley said ALA had brought the FTC staff report to the atten- tion of local lung associations, soliciting their reaction and comment for the ALA filing with the commission. Said Swomley, "How governmental and voluntary actions can begin to alter the present situation is a matter of enormous importance to us and everyone concerned about the well-being and health of the American people." It appears reasonable to assume that Swomley, outspoken against cigarettes for years as head of the Connecticut ALA and since 1980 the national managing director, was not speaking of any "voluntary actions" of the tobacco industry, but initiatives of the voluntary health associations. As his group is affiliated with the International Union Against Tuberculosis and the heart association with the Inter- national Society and Federation of Cardiology, and the ACS TIMN 308693 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION

-10- with UICC, and all of them with the new International Liaison on Smoking Control, we can expect a trans-Atlantic cross-breeding of ideas for the UICC's stated goal of "international control of smoking." The voluntaries are already in close touch with appropriate committee and subcommittee chairmen in Congress. When Waxman introduced his Comprehensive Smoking Prevention Act November 12, 1981, he thanked the AHA for "technical assistance." When Orin Hatch introduced his and Packwood's bill on December 11, he announced that the ACS, AHA and ALA had all endorsed it already. Indeed they had, with a recommendation in Smoking OR Health Group 10. Group 5, however, touted the Waxman bill, although it is doubtful most of the participants knew the differences in the two bills. Looking to the Future It's not impossible that one of the single voluntaries, or the new coalition, could win the support and sponsorship for a special project such as the National Safety Council did last year with the National Highway Safety Administration. The latter financed a safety council mailing to 3,000 churches and synagogues with prayers and a special message from Billy Graham for qbser- ~ vance of National Safety Sabbath, which occurs this next weekend. . The agency supplied the funds ($2,800) and the safety council did the mailing, and some libertarians, according to The Washington Post recently,; are concerned about church/state separation. CONFIDENTIAL: . : MINNESOTA TOBACCO LITIGATION. TIMN 308694