sample="quota" bates="506282427" isource="rjr" decade="1980" class="ui" date="19870506" MEDICAL INFORMATION RELEASE FORM I. During orientation meetings to describe the experimental studies you have volunteered for, it was explained that one goal of the study was to monitor any changes in body physiology that might occur as a result of smoking the test product. To this end, pre- and post-study physicals are part of the test, along with periodic monitoring of certain physiological measures taken from blood and urine. The physiological and demographic measures relevant to the study are as follows: * AGE, WEIGHT, SEX, % BODY FAT, # OF CIGARETTES SMOKED PER DAY A variety of measures will be made on the blood and urine collected in these studies. It should be noted that all the compounds measured are compounds normally found in human blood and urine. * Nicotine and Cotinine - normally found in significant amounts in smokers only * Protein Profile - normally circulating proteins will be monitored Electrolyte Profile - normally circulating electrolytes will be monitored * Hormones - Thyroid and Adrenal hormones will be monitored. Metabolitic by-products of catecholamine release will be monitored. * Cell Counts - cell counts will be made on whole blood collected * Miscellaneous - thiocyanate (used by some doctors to estimate smoke exposure), uric acid, glucose and iron will all be monitored. II. As also explained previously, to protect the health of both the volunteers and the personnel conducting the studies, certain tests of a highly personal nature were made during the pre-study physical. The tests which involved obtaining data of a highly personal nature are: * testing for use of illicit drugs * pregnancy test for female subjects * testing for exposure to hepatitis or sexually transmitted diseases * testing for exposure to the AIDS virus By signing this form you give your permission for the RJRT Medical Department to provide all the measures OF A NON-PERSONAL NATURE (described in Section I above) to the personnel conducting the studies so the physiological monitoring can begin. AT NOT TIME WILL ANY OF THE MEASURES PREVIOUSLY DESCRIBED AS HIGHLY PERSONAL (DESCRIBED IN SECTION II ABOVE) BE PROVIDED TO ANYONE OUTSIDE THE RJRT MEDICAL DEPARTMENT. In signing this form I, , hereby grant permission for the RJRT Medical Department to provide to the R&D personnel conducting the studies all physiological data described in Section I. Signature Date