sample="rhetorical" bates="TIMN 396066" isource="ti" decade="1960" class="ui" date="19610404 " 1 As per 2/15 draft The Health of a Nation When Europeans discovered America nearly 400 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 that 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! Everyone who reads knows that recently t Tobacco, especially in its most popular form, the cigarette, was has recently been singled out by some for much attention as a possible suspect in lung cancer and heart disease. The charges of suspicion, without proof, attracted continuing publicity whenever those claims were repeated. They also aroused those who opposed tobacco - for whatever reason - to keep repeating the charges. These claims have attracted continuing publicity but less attention has been given to reports of a divergent point of view. The attacks on tobacco are aimed primarily at cigarettes, which have gained great popularity since about World War I. Not long ago claims for so-called "cancer cures" got headlines. Now headlines can be made by claiming a "cancer cause" has been found! Today, headlines are frequently given to claims that a "cancer cause" has been found. However, neither the cause of cancer nor its cure has been established by either laboratory or clinical proof. The fact is that, year after year, tens of millions of dollars from the public are spent in scientific efforts to find the causes and cures of cancer. Many organizations are devoting large sums each year for this purpose. The Tobacco Institute was established by the tobacco industry in 1958 for the dissemination of information about tobacco because those whose daily bread is derived from tobacco are, and must continue to be, directly concerned with tobacco and health. This pamphlet gives a few facts about these the state of the nation's health and about the continuing medical research into tobacco use and health. "health scares." 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, not just a few, have to be considered. Diseases that formerly took lives of young people are now curable. This means people are living much longer to become subject to causes of death that were 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 lung diseases, including lung cancer: Part of this has been due to the discovery of the cause and cure of lung tuberculosis - a disease which a few years ago was also being blamed on smoking! Many scientists find reason to say there may be a connection between the fall of deaths from tuberculosis, pneumonia and influenza and the rise in reported lung cancer deaths. Hundreds of studies show that lung cancer deaths in the past actually were recorded as being due to a different respiratory or other disease. Which was sometimes attributed to smoking until the real cause was found to be the tuberculosis germ. Many scientists believe there may be a connection between the fall of deaths from tuberculosis, pneumonia and influenza and the rise in reported lung cancer deaths. Many recent studies indicate the deaths formerly attributed to pneumonia, tuberculosis, and other respiratory disease were, in fact, due to unrecognized lung cancer. Today, lung cancer deaths are accurately reported. 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 1,633,178 deaths in the U.S. during 1957 1,647,866 1958 there were 30,776, or about 1.8% 32,203 1.95% of the total, attributed to cancer of the lung and bronchus. Of these, 14,617 were reported as originating in the 15.720 lung. It was not recorded how many other 16,159 began in another part of the body and, as 16,483 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. The answer still is not know, any more than it is known about other types of cancer. Still doctors do not agree on what causes lung cancer, just as they cannot agree on the origins of may other types of cancer. Tobacco use has been publicized as one suspect factor, but - · People who never smoke get lung cancer. · Most smokers never do not get lung cancer. These two facts are often cited to show that the problem of lung cancer is much more complex than the opponents of cigarettes try to make it. Smoking got publicity because some statistical reports showed that the use of cigarettes is complex and probably has no simple, single answer. Smoking began to get attention when some statistics showed that the use of of cigarettes increased about the time of an increase in recorded lung cancer deaths. Scientific researchers are trying to find out whether there is a connection between these coincidental developments What About Statistical Studies? Top-rated medical statisticians have questioned the meaning and validity of several statistical studies claiming to show that lung cancer is more likely to occur in smokers than in non-smokers. Other statistical studies have reported associations between more frequent lung cancer incidence and a number of factors such as previous medical history, occupation, economic level, urban air pollution, and even place of birth or early life. Scientists generally agree that statistical associations do not prove a cause and effect relationship, but publicity given to the cigarette studies does not usually make this clear. Scientists generally agree that statistical associations do not of themselves prove cause and effect. Because two events happen at the same time does not establish that they are in any way related to each other, or that one causes the other. The fact that after a spring shower, frogs appear on the banks of a river, does not prove that it has rained frogs. Publicity given to statistical studies about smoking and lung cancer do not usually make clear that the relationship between the two has not been established as cause and effect, or that there may be a wide variety of other factors involved. What About Studies With Animals? In numerous experiments in this country and abroad, animals were made to inhale tobacco smoke for long periods of time -- sometimes for years -- without any lung cancers resulting from this. Substances condensed from tobacco smoke have been injected and implanted in animals without any cancers arising. Many experiments with concentrated whole tobacco smoke condensates applied to animal skins have not resulted in skin cancer. Much publicity, however, was given to reports of a few experiments conducted under laboratory conditions in which a minority of mice bred for skin cancer susceptibility developed skin cancer. Skin cancers and other tumors have been produced in such animals with a wide variety of substances not considered harmful to people and, indeed, with some substances commonly used by people. (Note: Following was suggested but subsequently GVA proposed new version for this to be developed:) One study suggested that cancer has been induced by this method, but other scientists xxx have been unable to reproduce such results, although reportedly using the same methods. While many experiments with concentrated whole tobacco smoke condensates applied to shaved animal skins have not resulted in skin cancer, cancers and other tumors have been produced by this very same technique with a wide variety of substances not considered harmful to people and, indeed, with some substances commonly used for human consumption. 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 who 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: From this it will be seen that the reported age-adjusted death rates for these ailments have actually been declining since 1928 , although the actual numbers of such deaths have 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 1960 has provided $3,700,000 for independent 1961 has provided $4,650,000 for independent scientific research into such problems as cancer and heart disease. These funds were made available to independent research scientists by the tobacco industry. The sole objective is to get the facts. Grants are made to research scientists who then independently conduct their work and publish their own findings. 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. Authorities assert that evidence does not show cigarette smoking to be a cause of heart or circulatory ailments. Despite this, those whom make health charges against smoking also link cigarette use and cardiovascular diseases, because of some statistical studies. While some statistical studies have linked smoking with cardiovascular disease rates, different studies show contradictory findings. Efforts are being made to coordinate research grants so as to reinforce studies along similar lines 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: (If better example than Yale freshman is available, GVA suggests re-doing chart and text here.) 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 American 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 Those who are against tobacco will probably continue to try to scare the life out of those who like to use tobacco - regardless of facts. The search for facts will continue. The search for facts about the question of tobacco use and health will continue. Dr. Clarence Cook Little, Scientific Director of the Tobacco Industry Research Committee, in his recent 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. (Additional copies upon request) CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION