sample="rhetorical" bates="TIMN 272022" isource="ti" decade="1960" class="ue" date="19610700" Tobacco and the Health of a Nation When Europeans discovered America nearly 500 years ago, they also discovered tobacco. In the centuries since, tobacco has given pleasure and relaxation to people throughout the world. For centuries before, native Indians had given tobacco a place in their social and economic lives, and even in their ceremonial rites. Over 100 years ago, one medical publication described tobacco as "the solace of life." As with most pleasures of life, this solace has never been without its opponents. Probably no single plant in our vegetable kingdom has had so many songs and words of praise sung for it! Nor as many diatribes shouted against it! Leaf Once Called "Divine Herb" If we were to believe all that has been said, we could think tobacco to be the "divine herb" -- a cure for all man's ills. Or we could believe it to be the bane of mankind and would wonder what ailed man before tobacco was ever used by him! Tobacco, especially in its most popular form, the cigarette, has recently attracted much publicity as one of the suspects in lung cancer and heart disease. Less attention has been given to numerous reports which present differing views. Not long ago claims for so-called "cancer cures" got headlines. Today, headlines are frequently given to claims that a "cancer cause" has been found. However, both the cause of cancer and its cure continue to be sought through intensive scientific research. Many organizations are devoting large sums each year for this purpose. This pamphlet gives a few facts about the state of the nation's health and about the continuing medical research into tobacco use and health. The Tobacco Institute, Inc., provides factual information about the industry. Those whose daily bread is derived from tobacco are more concerned with knowing facts about tobacco and health questions. How is the Nation's Health? General health and longevity have increased substantially during the past two generations. To get a complete picture of the improving health and longer life of the American people, many facts have to be considered. Diseases that formerly took lives of young people are now readily cured. This means people are living much longer to become subject to causes of death not common a few decades ago. Toll from Lung Ills Decline Medical advances in the past half-century have helped to cut death rates from lung ailments to about one-seventh of what they were in 1900. This chart shows the trend in reported death rates from major respiratory diseases: Part of this decline is due to the discovery of the cause and cure of lung tuberculosis -- once blamed on smoking until the real cause was found to be the tuberculosis germ. Many scientists find a connection between the drop in deaths from tuberculosis, pneumonia and influenza, and the rise in reported lung cancer. Studies indicate that many deaths in the past attributed to other respiratory diseases were, in fact, due to unrecognized lung cancer. Of the increase in reported lung cancer deaths in recent decades, a leading insurance actuary reported: "Approximately half this increase reflects merely the growth and aging of the population, and a considerable part of the remainder represents improved diagnosis and more complete case finding." What About Lung Cancer? Lung cancer has been known for hundreds of years. Many scientists and doctors think the increased number of cases being reported is more apparent than real. They give many reasons: More people are living to the cancer-prone age than before. There are better diagnoses, better medical tests and improved equipment to find out what is really wrong with a patient. Death recording has become more accurate. Doctors have become more aware of this disease and look for it more often. Out of 1,656,814 deaths in the U.S. during 1959 there were 34,302, or about 2.07% of the total, attributed to cancer of the lung and bronchus. Of these, 17,163 were reported as originating in these organs. It was not recorded how many of the other 17,139 began in another part of the body and, as frequently happens, eventually spread to the lungs. Causes of Lung Cancer Not Known Millions of dollars have been spent in the past few years in research on lung cancer. Scientists still do not know the basic causes of lung cancer, but they feel sure many factors interact to produce this disease. Tobacco use has been publicized as one suspect factor. However -- · People who never smoke get lung cancer. · Most smokers do not get lung cancer. These two facts are often cited to show that the problem of lung cancer is complex and probably has no simple, single answer. Smoking got attention because of some statistical studies that seemed to show a relationship between the increased use of cigarettes and the increase in lung cancer incidence. Scientific research is studying the meaning of these statistics, including peculiarities and contradictions in them. What About Statistical Studies? Top-rated medical statisticians have questioned the meaning and validity of several statistical studies claiming an association between smoking and lung cancer. Other statistical studies have reported associations between lung cancer and a number of factors, such as previous lung ailments, occupation, economic level, air pollution, and place of birth or early life. Scientists generally agree that statistical associations do not prove cause and effect. Publicity given to studies about smoking, however, usually does not make this point clear. CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION What About Studies With Animals? In numerous experiments here and abroad, animals inhaled tobacco smoke for long periods of time -- sometimes for years -- without any lung cancers resulting from this. Other studies have tested the effect of concentrated whole tobacco smoke condensates when painted on the skins of mice. Results differed considerably, but under certain conditions, some of the treated animals developed tumors on the skin. However, it has been noted that skin cancer and other tumors can be induced in such animals with a wide variety of substances commonly used every day by people without any harmful effects. Animal tests now being conducted by several research groups suggest that viruses and lung damage in animals may lead to lung cancer. Scientists caution that tests on animals cannot be interpreted as applying directly to human beings. What About Heart Ailments? Extensive research into influences on cardiovascular diseases is covering practically every known influence on living people -- what they eat and drink and smoke, how they work, how they exercise, how they play and what they are. The following chart shows the recorded death rates for major cardiovascular diseases as age-adjusted -- that is, making allowances for more people in the older age groups: It will be seen that the age-adjusted death rates have been declining since 1928, even though the total number of deaths has been rising. What is Being Done? Hundreds of doctors and scientists, here and abroad, continue to seek more knowledge about lung cancer, known to be a complex disease that cannot now be explained by any simple cause and effect answer. This work is supported by millions of dollars from public and private agencies. An extensive program in this area is supported by the Tobacco Industry Research Committee which by 1962 had provided $5,450,000 for scientific research grants into such problems as cancer and heart disease. The sole objective is to get the facts. Grants are made by a Scientific Advisory Board to independent scientists who then conduct their work and publish their findings in the accepted scientific manner. Scientific studies show that much more research needs to be conducted into many possible factors before definite answers to cancer, including lung cancer, will be forthcoming. The Tobacco Industry Research Committee also sponsors research into heart disease. While some statistical studies have linked smoking with cardiovascular disease rates, other studies show contrary findings. Efforts are being made to coordinate research grants so as to reinforce studies under way and avoid duplication. Health Advances Continue One indication of improvement in the nation's health is the steady increase in height and weight of young people. Armed Forces records show that Korean War servicemen were over one inch taller and 12 pounds heavier than those of World War I. As a specific example, the longer-range figures on Yale University freshmen clearly showed this trend: More People are Living Longer More Americans are living longer than they used to. This means medical attention is concerned more and more with health problems of older people who reach an age when ailments such as cancer and heart disease are more likely to strike. This chart shows the increased average span of life for Americans since 1900. Most of the improvement is due to better care for young people, but life expectancy is higher for each age group. Search for Facts Continues The search for facts about the questions of tobacco use and health will continue. Dr. Clarence Cook Little, Scientific Director of the Tobacco Industry Research Committee, in his annual report on research progress said: "Let us be perfectly sure of what we call established causal factors, and let us be honest in our evaluation of what we advocate -- of the soundness and value of evidence -- before we attempt to convince the public of any proven guilt or lack of guilt in any widespread human usage or custom, whether tobacco use or something else." The Tobacco Institute, Inc. 910 Seventeenth Street, N.W. Washington 6, D. C. no names George V. Allen President Edward F. Ragland Frank J. Welch Vice President Vice President (Additional copies upon request) R761.10 CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION