sample="quota" bates="2048925980" isource="pm" decade="1960" class="ui" date="19641000" H.W. T.S. 5-12 R. F. B1044 STRICTLY CONFIDENTIAL COPY REPORT ON POLICY ASPECTS OF THE SMOKING AND HEALTH SITUATION IN U.S.A. P.J.R. October 1964 G.F.T. INTRODUCTION We were in U.S.A. from 10th September to 15th October, 1964, and had discussions with:- The Presidents of the six main cigarette firms in U.S.A., one ex-President and several Directors, The Legal Advisors of four of the firms and another lawyer advising two of the firms, The Directors of Research and other scientists of five of the firms. Mr. J. M. Gregory and Mr. D. A. Coulson of the Imperial Tobacco Co. (of Great Britain and Ireland) Ltd., The Administrator of the U.S. Cigarette Advertising Code (Governor Robert B. Meyner), Senator J. Sherman Cooper (Republican, Ky.). The American Medical Assoication - Senior Executives, and the Chairman and two other members of the A.M.A. Committee for Research on Tobacco and Health, The Council for Tobacco Research - U.S.A. and its Scientific Advisory Board, Mr. George Allen and Mr. DeHart of the Tobacco Institute. Hill and Knowlton, New York, Two senior members of the National Cancer Institute and two of the National Heart Institute, Dr. E. L. Wynder and his senior staff; Dr. E. C. Hammond; Dr. W. Weiss, Dr. J. Berkson, Dr. P. Bernfeld, Dr. C. C. Seltzer, The complete list of people with whom we had discussions is given in Appendix I. This report deals only with policy aspects of smoking and health problems in U.S.A. A separate report on research aspects has been prepared. This report may be clearer if we record at the outset that Mr. Bowman Gray (Reynolds), Mr. Walker (A.T.Co.) and Mr. Finch (B.&W.) firmly and sincerely believe that it has not been proved that smoking is harmful to health. On this important point, however, Mr. Cullman (Philip Morris), Mr. Harrington (L. & M.) and Mr. Cramer (Lorillard) would hedge a little. Of the six Presidents, Mr. Gray, by virtue of his personality, experience and his Company's share of the trade, is undoubtedly the leading personality. Mr. Walker is primarily a salesman and an advocate of the "hit-back", aggressive type of policy in smoking and health. Mr. Cullman has stopped assuring his stockholders annually that he is confident that smoking will eventually be exonerated. Mr. Cramer is distinguished among the Presidents by thinking highly of Dr. Wynder. Mr. Harrington has come up on the leaf side of Liggett & Myers, and has learnt about the smoking and health side of the business only after he has become President. Mr. Finch, like Messrs. Walker, Harrington & Cramer, has only recently been appointed President, but Mr. Bowman Gray has already appreciated Mr. Finch's contributions to discussions of smoking and health problems. Our reception everywhere was most friendly. Mr. Bowman Gray, in particular, expressed appreciation that we had taken the trouble to go to Winston-Salem to see him. LEGAL MATTERS Differences between U.S. and U.K. We should perhaps first emphasise that, despite the obvious similarities between the smoking and health situations in U.S.A. and U.K., there are major fundamental differences which prevent the two countries ever having anything like a complete identity of view. We emphasize this point because we found these differences under-appreciated by the cigarette manufacturers in U.S.A. In the U.S., by far the most important factor conditioning action by the manufacturers is the law suit situation and the danger of costly damages being awarded against the manufacturers in a flood of cases. Not so long ago the drug industry was faced with some 300 law suits with claims totalling $50-60,000,000, almost all of which in the end were settled out of Court, so this type of danger is real. The leadership in the U.S. smoking and health situation therefore lies with the powerful Policy Committee of senior lawyers advising the industry, and their policy, very understandably, in effect is "don't take any chances." It is a situation that does not encourage constructive or bold approaches to smoking and health problems, and it also means that the Policy Committee of lawyers exercises close control over all aspects of the problems. The different Companies have different ideas as to the broad characteristics of the successor to Lark that they are seeking. Mr. Harrington thought that the flavour of Lark had been an important factor in its success: he said that Lark also had relatively high tar and nicotine content, and he thought it important to keep the nicotine up. Mr. Walker, in Carlton, had followed Dr. Wynder's idea of a low tar, low nicotine cigarette. Dr. Seevers informed us that he had specifically told Dr. Hanmer, Director of Research at A.T. Co., that it was important to keep up the nicotine cont nent of the smoke, while reducing anything that ought to be reduced. Dr. Seevers' recommendation was that A.T. Co. should add nicotine to the cut tobacco and then reduce both nicotine and tar by filter and porous paper as in Carlton. Dr. Wakeham described Philip Morris' objective as a "high flavour/low delivery" cigarette. but it was low delivery of some smoke constituent that contributed largely to a biological reaction in some short term test. Mr. Galloway (RJR) thought that a reasonable amount of nicotine was necessary in a cigarette. Mr. Blunt firmly held the view that people smoked because of the nicotine. B. U.S. Opinion of TRC Research We outlined our research objectives and programme to all the Presidents and Directors of Research that we met. There should now be a much wider knowledge and understanding of our research. RJR, A.T. Co. and B & W criticized our approach to bio-assay research on three grounds - 1. It constituted an implied admission that tobacco contained health hazards, and this could be damaging in law suits in U.S.A. This has been discussed in the earlier Section of our report on Law Suits. 2. Mouse skin painting with smoke condensate, according to Dr. Little, was scientifically unsound and based on a fallacy (though C.T.R. had contracted with Bio-Research Inc. for research of this type). Against this, both L & M and Lorillard scientists told us quite bluntly that they considered TRC research was on the correct basis and CTRs largely without value. It is unlikely that Company scientists would speak so frankly unless they were pretty sure their principals held views not great dissimilar. 3. It could present the U.S. manufacturers in a bad light to the U.S. public since they could be represented by hostile writers as being negligent of public health in comparison with U.K. manufacturers. We pointed out that we kept the possible reactions in U.S.A. continuously in mind, and further that Dr. Wynder had contended that U.K. manufacturers were dragging their feet compared with U.S. manufacturers. There was particular interest in and approval by Messrs. Gray, Cullman and Cramer of research into the characteristics of the susceptible minorities being carried out for TRC by Prof. D.D. Reid and Dr. D. M. Kissen. Mr. Gray said that obviously there were some people who should not smoke - e.g. those with emphysema. Mr. Cullman, Mr. Cramer and others remarked that there was much more firm direction and push behind TRC's research programme than CTR's. The only criticisms in detail about TRC research were that TRC was years behind the U.S. manufacturers in research into mucus flow and ciliastasis, and that TRC was possibly neglecting virus research. Mr. Gray thought that "viral activity might well explain the statistics". C. The Search for a Cigarette with Less Long Term Activity We were naturally interested, since so much of TRC biological research had long term objectives, to find out what research in the U.S.A. was being carried out to reduce the long term activity of cigarette smoke. Only Ligget & Myers, through A.D. Little Co., have worked on smoke carcinogenesis. Some of their past work in this field is detailed in our report on research aspects of smoking and health, but we do not know whether they are still carrying out work in this field. Dr. Darkis (L & M) believes (contrary to the views of Dr. Wynder and some others) that a large part of the mouse skin carcinogenic effect of cigarette smoke condensate can be found to be concentrated in the higher polynuclears. L & M would remove these polynuclears from cigarette smoke if they conveniently could. They have worked on this problem for a number of years without success and state that they have run out of ideas. They would like to find a precursor of the polycyclics in some particularly abundant compound in unsmoked leaf, but consider this very unlikely, as some polynuclears arise on pyrolysis of any organic material and are not specific to tobacco smoke. Dr. Derkis is not particularly optimistic about being able to produce a cigarette that is satisfactory to smoke and will not produce cancer on the back of a mouse. X. PUBLIC RELATIONS POLICY There is a general feeling that the policy since the SGAC report of not making public statements, unless these are really necessary, has proved much more satisfactory than the previous policy. As Mr. Cramer said, TIRC had spoken far too much in the past, and this had merely stimulated adverse medical comment. Mr. Cullman also thought that TIRC's past public relations policy had done the industry great harm. There is no real regret that CTR did not publish a reply to the SGAC report, except by Mr. Walker. Mr. Walker wants the industry to take paid press space to advertise "the industry's case": he has to be repeatedly dissuaded by strong pressure from the other manufacturers. In place of public statements on behalf of CTR, there has been an increase in the lobbying of members of Congress - a well established American principle. Despite strenuous efforts, we could not meet T.I.'s chief lobbyist, Senator Earle C. Clements. Nor were we able to meet Mr. Abe Fortis, the other lobbyist. Both were travelling in areas which we could not fit in with our itinerary. Senator Clements is really close to President Johnson; he was Deputy Leader of the Democratic party in the Senate when Pres. Johnson was Leader, and he is Chairman of the Kentucky delegation to the Democratic Convention for nominating the Democratic candidate for President. Nevertheless, Johnson would not hesitate to drop Clements if this ever became politically expedient. The lobbyists are opposed to campaigns by Hill and Knowlton on congressional matters affecting the industry and want action left to them. It is, of course, not difficult to reach or entertain Senators and Representatives from the tobacco States, and, as we have reported, we had the pleasure of meeting Sen. Cooper of Kentucky. It is considered important that Congress should not feel the industry is recalcitrant. The direction of PR policy is essentially in the hands of the lawyers' Policy Committee. The lawyers are anxious to provide House and Senate Committees with witnesses favourable to their case, and generally to encourage statements by scientists attacking the SGAC report and its supporting evidence. Mr. Jacob is encouraging Dr. Sartori of Milan to hold a Conference in summer 1965 at which such statements can be made. Mr. D Yeaman (B & W) said that he did not quarrel with TRC's decision not to comment on causation, but this was not the right policy for U.S.A. Hill and Knowlton have been sidetracked; they have very little to do and know little of what is going on. They have not seen a President of a Company for a long time and are now responsible to the Policy Committee of the lawyers. XI. AMERICAN MEDICAL ASSOCIATION Research by the American Medical Association is being dealt with in more detail in our report on research. The policy adopted by the staff of the A.M.A. and the Committee for Research on Tobacco and Health, set up by the A.M.A. to operate the Research Fund to which the U.S. Cigarette manufacturers are contributing $10 million, is as follows: 1. The A.M.A. has no intention of itself conducting research. It is building a Bio-medical Laboratory but no direct research will be done on tobacco. 2. The A.M.A. intends to act only as a fund-holding and disbursing centre. It aims to allocate funds to approved grantees, arrange research on a contract basis when this is necessary to get projects carried out that it wishes to see done, and will try to get more good workers to carry out research in the field of smoking and health. 3. The Committee for Research on Tobacco and Health has no intention of carrying out research in fields that it believes the industry should do research. cover. This applies to means of eliminating harmful substances from cigarette smoke, and it may mean that support of research designed to identify harmful constituents may not be particularly comprehensive. 4. The A.M.A. will support research workers located anywhere, including the U.K. They have agreed to inform T.R.C. of any research work they support in the U.K., after their Committee has acted. They saw no reason why a research worker should not draw his funds from several sources. APPENDIX I LIST OF PEOPLE WITH WHOM WE HAD DISCUSSIONS R.J. REYNOLDS Mr. Bowman Gray Chairman of the Board Mr. Alex. Galloway President Mr. Henry H. Ramm Counsel Mr. Willard H. Bright Director of Research Dr. Murray Sincus Associate Director of Research AMERICAN TOBACCO CO. Mr. Barney Walker President Mr. Cy Hetsko Counsel Mr. R. K. Heimann Vicepresident, Sales & Marketing BROWN & WILLIAMSON TOBACCO CO. Mr. Ed. P. Finch President Mr. Addison Yeaman Vice-President and General Counsel Mr. T. M. Wade Vice-President; Research & Development Dr. R. B. Griffith Director of Research PHILIP MORRIS Mr. Joe Cullman III President Mr. George Weissman President, Philip Morris International Mr. Jim Bowling Vice President Dr. Helmut H. Wakeham Vice-President and Director of Research and Development Dr. Bravely Research Center Mr. Harvey M. Wilkinson Director (President of State Planter Bank, Richmond) LIGETT & Myers Mr. Milton Harrington President Mr. John Old Vice-President & Asst. to President Mr. Wm. Blunt Ex-President Dr. Fred R. Darkis Scientific Consultant Mr. Wm. W. Bates Director of Research Mr. Max Sanfield 2i/c, Research Department Mr Jim Moore i/c analytical work