Tobacco Documents Online

4 5 6 7 B 9 10 11 12 14 15 16 17 18 19 20 ZZ 13 2~ 2S S~IOKING AND ~ALTH P~S5 CQ.~FE~NCE by JULIUS RIC~0~D January 12, 1981 MODERATOR: -- ~e~.ical di=ector ~F that o.~fice. Seated over to the left are Dr. David Bur~s, U~versity of Cali~-ornlat San D~ego; D~. Ell~n Gritzt University of Cal~fornia School of Ha~!clne; D~. Jeffrey Har~s cf M~T~ and Dr~ John Holhrookj Un/verslt~ ~ ~tah, ~iI of whom w~ra con$~itlng $clen~/f~c editors for the i 81 ~eport. ~t should ba -~ an~ De. Rich~ will rea~ it an changed. Thirty~three parcent -- in th~ first para~Taph, ~3 percent a~d ~5 milligra~. ~re you ~ady n~? Dr. Ri~d. • DR: RIC~OND: Good mo~ni~. The i~sua o~! !cwe~ ~ar a.~d l~e~ ni~otlna clga~e~e$ has become a" majo~ public health i~sue ove~ the past f~ yaa-"~. Ci~r~-tte $moker~ by the million5 have been turnln~ t~ these new ~duc~s o.~ ~he assumption that t~ may ~eh~ o~! • other reduce t~e ~isks of the/~ sm~k/n~. So~e 3~ ~e-~cent ~f all clga-~et~e s~okers today ~mo~e ~ga~et~es wi~h ~'eld~ cf le~s than 15 mi~l~_ams of t~. The p~D~se of ~he report we a~'e £~u/ng this m~.~i~q is t~ assess the ~cienti-~i~ ~lidity o~ t~..$ ~remlse. A~L A.~CCIAT~, InC.

1 I 3 4 S 6 7 8 9 10 11 12 14 IS 16 17 18 19 10 ll 22 23 2$ 2 The report alsa replies ~o two Congressional directives. One requires ~ t¢ repor~ annually on the health consequences of s~klmg. The other calls upon us to study a~d repo-~t on ~he relat/ve health effects of smoki=g cigarettes with vaEylng yeilds of t~r, tricotine and carbon m~noxide, and the health risks associated with s=~klnq cSqarettes containing a~y suhstanc~-s co.only added to co~ercially manufactured cigarettes, For at least 25 years, we have known that ~gare~.~e smoking is a m~Jo= cause of disease and death. Th~ evidence S~pp~rtiDg this is ovsrwhelming and public response to this i~ormation has been encoura~_ng. Per capita consumption of ui~arettes is n~ lower than at any time since ~he 1950'st and the percentages of both adult and 1~unger smokers are ~h declining. Almost everyone is convinced ~hat sm~klng is hazar~aus. As many as 90 percent of people who still smoke wo~Id q~i~ if there were an easy way to do so. Yet a tb/~:d of O~r pop~l~o~, some 54 ~illions Of people, con~:Lnue to USe ciqarettes. The c~nseq.uences are quite ter_-ible. $5,000 smokers will die in 1981 from l~g c~nce.~ alone, contracted as a result of smoking and l~.ng C~-nce-~ ks no~ only or eve.~ the major ca,lse of death assoc~zted with c/garet~es. Even lar~er numbers of Americans will di~ pr~m~-turely A~L AI~AT~S. In~.

I $ 6 7 0 9 10 11 12 ~3 14 I$ 16 17 18 19 2O 21 23 2~ 2S 3 of cardlovaseular disease because of clga.~et~ smo~=n~. The public heal~h ser'zlce has sp~n~ =a~y ~onths in making this assessment of I~ tar an~ low yield clga~ett~s. A confe-~e~ce of scie/%~.is~s .has bee~ hel~. The worldJs li~ematuxe has been searched, add scientists from a half a ¢Iozen dlsci~llnas rocrult~ from w~h~n add ou~ido %ho government have r~viewed t~hi~ llte.-a~ure. Their workt in t~xn, has been care~ully a~l c=i~ically rQ~ewe~ by their p~ers. ~h~ ~v~dence which indicates ~iga=e~ ~m~kin~ as a cause ~ il~ness a~d death remai.~s ~e~hmlmlnq. Informati~n on the re1~tive ri~ks af high an~ i~ yial~ cigarettes is l~ss ex'.enslve. In ~roviding these ¢o~lu~ons, we,are s~a~-ing wha~ the state of the art permits us to say a~ this¸ time. What are repoxt' 8 ~a~clu~ion$? They a=a not mu~h di~fe~n~ from the ~ud~,~n~s arrived at by the PUhllc ~ealUh Service in 19~6 rei'.e~ated an~ rafined mos~ r~ently in 1979. There is no such thin~ as a 0ale ciga.~atte. In the case of lung c~nce~, sore8 Cigarettes appe~ to be less h~zardous th~n ~the~s~ although the reduction in risk is mi. ~nimal and limltsd. ~o s~ch conclusion ~an be reached f~ ca-~dio- vascul~ disease, ~phvsema, br0nchiuis ~r precnanc~ ef.~e~s. Smokers who a.-~ t~-;~il!ing or '~nable ~o q~it

! Z 3 4 5 6 7 8 9 i0 11 13 14 15 16 17 18 Ig 2O 2l ~2 ~3 2~ Z$ 4 will be well advised to switch ~o lower yield cigarettes as long as ~hey do.~'t com De~isate for the lOW yields by smmking more, inhaling more deeply, closinq off ~he f/iters, or c.hangimg 5heir smoking exp. os~re i~- other ways. But they will be best advised to quit entirely. These, then, are the major findings of this report. They call for response by government, by the scien~iflc co,unity and by public and private health and educational agencies. In transm/tui~g the report to Congress, the secretary has called for an end to the •present 8talema~-e on the issue of cigarette additives. A~ present, we do no~ even know what these additives are because we have no means of obtaiuinq t~s information from the I~a~ tt~a ~LtT e r S. I h~ve sUqqest~ to the industry tha~ we Wo-~k together to confront this issue. ~ believe a method c~ be worked out so that oo~pauies can tell us what substances they use and that we can protect ~he confiden- tiality of those da~a. I think a mutually agreed upon ~es~ing pro~Tam ~nd review program is necessar-.~ to determine possible acute and lonq-te.~n tDuic a?.d taratoqer~c effects ¢,f eKch s~bstanoe ~sed so ~*hat t~hos~ ~o~r~ to be a ~.hraat A~ AS~OCIAT'~, I~.

! 2 3 S 6 ? 8 9 10 11 12 13 14 15 16 17 19 ZO 2~ 23 2~ 25 5 to health can be r~-~oved. We would ~refe.~ to have no new $ '~bsuancas in~rc~u=ed ~-~l this renew process is complet-~, ar~ the~ ~-y thosa suhs~an=is whose possible health effacts have been evaluated, Tbls protocol, incidentally, is n~t ~tn~ t-hat n~ in effe~ in Great Britain to which American companies selling clgarett~s An that cou~ have subscribed. ~ka many of he= pradecesso-~s as s~c=etary, ~. Ha==is ~s aske~ that ~eps be taken to give th~ consumers ~o~e infor~atlo~ about the ci~ette p=oduct. At least level~ of tar, ~coti~e ar~ oth~ incrimina~ve substances¸ should be listed in all ~dvertisements a~d on all packages. The ~=re~-ary ~$ called upon ~ove~ent amd pzlvate agen~es to inc~easa th~ educational e.=for~s ~o ramin~ the public of the hazards of smoP~n~ a,~ to assist ~hose who do smoke to qui~ and to persuade yo~g pe~pla not t~ take u.~ the habit in the firs~- place.. The wisdom cf these re~endat~ons a~peam¸ to me to be sel.~-a~d~. T,his report finds that ~:wer ta=, lower nicotine cigarettes appear to provide $¢,m~ s~al~ protection to the smokar, ass~ the ~s~¢:e of changes in the smo~nq behavior. We ca~ accept ~.~s as reasonable a~ce t~-, the i~div~dual $~ke-~, b~ we ca=~ot ac=ep= t~s a~ A~L ~O~ATES. X~.

| 2 3 4 $ 6 7 $ 9 l0 11 12 13 14 1S 16 17 18 2O 23 23 24 25 6 Societal ~er to ~.~a s~g i~sue. Only by r~duclng the n~mbe=s of smokers in our popular/on can we hopa to reduce significantly the illness and death which smoking brings about. We must continue and do better in helping present smoke~s to give u~ the habit, We must also continue and do much better in encouraging young people not ~o start* That ¢on~l~s the state~nt. We will n~ take questions. Yes. (0uestion from the audience. ) DR. RICBMOND: The q~estion is how we would charac~rizm the ir~%~stry's .DOS~%~e in relationship tO ~he requests ~nce1"~ing addihives. ~as i% be~21 foo%- drag~-ng? I can he descriptive, and you can fo~ your ~n judgements. Toward the mn~ Of the s~e; -. it may have been the early fall -- we addressed a comunication to all of ~he tobacco fir'ms that manufacture ~ga~ettes in this country asking them for such information. The response was ~enerally to pro~/de us with i~for~atlon which is gemerally in the literature. ~n o~er words, w*kich is already in the p,mblic domain. W~ were not, however, provided with any infor-ma~.ion concerning WP~ Specific additives are i.n specific clgare~.tes. SO that whil~ we do ~%-e ~he entire lis~ of A~L AK~IAT'=S. Inc.

S 6 7 8 g lO 11 12 13 14 1S 16 17 18 lg 20 21 2~ 2~ 2~ 7 addi',ives which may be used in ciNarettes, we dc not know precisely which of those really ~e in Cur.-ent u~e. We foll~ed this rip. wi~h another c~mm~nication to the tobacco firms, and subsequently had a maetin~ in response ~.o ~hat c~u~cation with Mr. Carne~e, the presidant of the ~obacco institute, and t~r general counsel, to ~alk about ways by which w~ migh~ learn more about tbese additives so tbet we, in t~, can £nf~rm cons~ers more appropriately. SO tha~ i~ the ~ta~e a~ which we are at th~ present time, ar~ we are n~ anti~ipa~,i.~g so~e resp0~se from ~hem. (~u~s~i~n from the a~n~e.) D.~. RIChmOND: Well~ in -- oertai~ly our fac~.~ to-faoe mee~n~, I think the~ took very seriousl~ 0u~ request, and I think ~hey ~ook very seriously o~r concern about the pot~nhial role of a~ditives in public health. Yes. (Ques~on from the audience.) DR. ~If~0ND: Well, we ca~'~- an~e~ tha~ q~estio~ very effectively, A~ you knc~, th~ r~l~ Of the non- s~ok~_~ i~hali.~ s~oke, so-oalled side-s~re~ s.~ok~, is no~ as clearly understood as we .~ou!d like, in ~eneral. We h~ve had recent i~dica~io~s tha~ there ~ro

f l 2 3 4 5 6 7 8 9 1o 1i 12 14 ~5 16 17 18 19 2O 21 23 2~ 2~ 8 somg signiflea~t mffe~ts o.~ p~i~onary f%~ion, in particu- lar, for ~on-smokers who inhale slde-stream s~ke. The potential role of addltlves An this ks something which needs ta ~e studied, bu~ Obviously we can't study that ve-~ well if we don't k~ow what the compounds are so that at the present time, I can't answe: your question ve.~y directly. (Question from the audiex%ce.) DR. RICHMOND: X think it's fair to say ~/ult we have a rathe= good approximation, yes, At least all of those which the tobacco farms say are curren~.ly used. (Question from the aDdienGe. ) DR. RICHMOND: No, I doni~ have any reason to be~ieve that at the ~ment. (Question f=om the audience. } DR. RIC~OND: Well, we don't k~ow precisely what the additives are t~ heqin with. (Question: But yo~ 5ald you have a list of --) DR. RIC~OND: Wellr but we don't know wha~.,s in any given cigarette. I~e have a llst of hundreds of compounds. They're not all in eve~ cicare~te. See, wha~ we don'~ ~-~4 is precisely what is !~ each bra~d-.~Ime cigaretten for ex~/~ple. {Question from the audience. )

I : I Z 4 5 6 7 8 9 lO 11 12 13 14 15 16 17 18 19 20 21 Z2 2~ Z5 9 DR. R-TC.~-O~ND: B~ we have no q~antitative data, se=-. We don't know precisely wha~. a/~ou.~ts of these substances. Yes, we do have a g~od deal of iJ:formation about various of these co~u~ds. FOr e~plew the.~e's shellac in -- as one compound that has been lis~ed. We don't know to wh~t extent that appears in any ~!v~n cigaEet~e. ~-~pelica rote extra,t, ~riethylene ~lyco, o~e ¢ou~ 9o on lis~ing hund.-eds of compo~u~s. (Question from the a~di~ce.) DR. RfC~MOND: Well, ~'ve just mantion~ a (Quest/on from the audience. ) DR. RIChMOnd: Well/one ca.% talk about glycero, c~erin, eu~enal, gyocol, s~a~s -- if yo~ wa.%~ to look¸ at thQ lis~ which the Bt/tish have published fairly recently -- the Hu.~e= C~mmlttee report -- it's a ~ist of some 300 ¢ompo~uds. (Question from ~he audience.) DR. RIC~MO~D: Yes, we can ~ake so~e j~cm~n~s. Sure, we ~n~4 wh/ch compounds a~ !~ast on the basi~ of ~ast scLentifi¢ track r~c~rd a.~e ~ore c~rci~ogerC~.-~ potent/ally, th~n ouh~rs. But the point is, we don!t know w~hich of those c~mpo~nds are currently being used i.~ a~y qiven cigarette. iQu~s~lon: S~a of them are carclno~c?) A~ AbS~C~T£S, I~.

I 2 10 11 lZ 13 14 15 16 17 18 19 20 21 ~3 ~4 ld DR. RIC~0ND: Oh, ~'es, yes, yes. Let's get some othe." people. (Question from the audience. ) DR. E/C~MOND: That's precisely why we want to know mDr~ abo~t ad~itlvest see, but ~ can't an~e-~ your ques~£on dire~ly. They po~entlally could be m~re carcinogenic, h~~. we ~o~'t have any data. Yes.¸ [O~stlon from the ;,.edie:ce, ] DR. RIC~0ND: Well, various s~lentists at ~lous timas, as they have s~died the carclno~e.~¢ effects of compounds have stu~/Qd many of these, ~: can't off the top of my head ~ive you the p=ecise deta/is of each of these com DO'%LndS bu~ .- (0uestlon from the audience. ) DR. RICHMOND: Yes, many of these are knc%rn to be, that is particularly the products of comhus~ion of many of these com~_o~u%~s are ~own to he Carc~-noI2enic, a~d yo~ have to really think of this in at least ~-%ro stages. Some of these compounds are knOWn ~o be poten~lally carcinogenic in and of themselves. But the prod~ct~ of combustion, in addi~,ion, D~ay be carclnogenic. (Queshion from the audience. ) DR. RICE40h~: Well, we are telling them that we are concerned, and we wa~t to ~w. ABL AS3~A~,~, I~.