9 RMTry CONFIDENVAL Cony N,,mherl 1)
SPACKTNU AND MrTH
The recent report "Smoking and Health" of the
Royal College of
Physicians,- has had world-wide sales of over
90,000' copies. - In the U.K.
30,000 copies have been sold; separate editions
have been printed in the
U.S. and Canada; translations are being made into
a number of European
lanquager; Governmental and medical bodies
throughout the world are
taking note of It.
The report associated smoking with a number of
diseases but Its main
conclusion was that "cigarette smoking is the most
likely cause of the
recent world-wide Increase in deaths- from lung
cancer". The report also
said "most smokers suffer no serious Impairment of
health or shortening
of life as a result of their habit" and smoking
was "a habit which most
smokers enjoy without Injury to their health".
As a member of the tobacco industry you will be
expected to have an
Informed view on the smoking and health question.
There follow some
points (confined to the lung cancer question)
which you may find useful
in conversation.
I. The statistics
(a) To what extent is there a world-wide increase
in primary lung cancer?
Me figures do not always distinguish between
primary and secondary
lung cancers - only the first could be associated
with smoking).
Part at least of the recorded increases may be the
result of
Q) wrong diagnosis In the past
(ii) improved living conditions resulting in
people living Into the
older, more susceptible age groups
(Iii) Improved treatment of pneumonia and
tuberculosis, which has
greatly diminished a once frequent cause of death
from pulmonary
dis eas e. It has- been suggested that these
diseases, though
cured, may leave scars which could increase
susceptibility to
lung cancer lnter in life.
W Moderate cigarette smokers In a number of rural
areas have less lung
cancer then non-smokers or light smokers in urban
area!r.
W Lung cancer is higher in Immigrants frour
Britain to South Africa,
'Australia,; New Zealand and the U.S. than in
locally-born white people
-.despite the rame cigarette consumption. Even so,
such immigrants,
who on arrival in their new country usually smoke
more than those
they leave behind, have less lung cancer then
people who remain In
Britain.
W Cigarette consumption in the United States is
about double that in.'
the United Kingdom whereas the lung cancer rate Is
about half.
This discrepancy cannot be fully mtplained by the
fact that Americans-
smoke less of each cigarette. Similarly, cigarette
consumption Is
high in Japan and Ireland where lung cancer rates
are relatively low.
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(e) Lung cancer is found rrore frequently in
poorer classes than among
the well-to-do even where there is a similarity in
cigarette
consumption.
W Three studies have shown that among heavy
cigarette smokers inhalers
have no higher risk of lung cancer than
non-inhalers. (Admittedly
the- degree of inhalation as between smokers- is-
difficult to determine).
2. Other nosTible
(a) Air pollixtion, including industrial and
diczel/petrol fumes, is thought
by many emincia scientists to be the major cause
of lung cancer. The
Royal College of Physicians~ itself .-s preparing
a report on air
pollution. -Air pollution might well account for
the fact that the
lung cancer rate in the U.K. is the highest in the
world whereas
cigarette consumption is higher in a number of
other countries. .
Lung cancer has been caused in animals by exposure
to Influenza and
artificial smog.
(b) Recently some scientists have suggestnd that
virus-es are linked to
the origin of cancer, including lung-crincer (see
article in Life of
Jane 22, i962) and thus cancer uray be infections.
-Experiments are
continu-rg.
(c) Some ecientis-ts belie-.-e that lung cnnc.-r
originites in the periphery
of the 1-ing, rather than in the main bronchi. As
it IT the latter
which are in most contact with cign-ret:re smoko
(or atmospheric
pollution) some other caus-c is: Indicated.
3. rxtent of the r-s%
The average aq2 of death from lung wrincer in the
U.K. is 62 it is
mainly a disease o f the elderly. T~e phyzicl-~ns
admit that some people
die of lung cance-: -.-iho have nevnr smoked Lnd
thet the great majority of
smokers suffpx no h,--rm. 71? the U.K. ai,3vt I in
12 heavy cigarette
smokers (25 or Lxrc a dny) die- of 7vng cancer.
How does the heavy
smoker who dies of Ding c;nc--r differ from Vie 11
equally heavy smokers
who do not? Rct;enrch into zhe personal,
environmental, and other
characteristics of the susc3ptiblo ml-nority is
be!.ig undertaken. In
the long term, -this is a rrore realist!(-, and
practical npproach than
attempting tc discourage smoking by all.
4. Proof
The associatior betweon smoking and lung' cancer
still rests entirely
on statistics. There is still no laboratory proof
that cigarette smoke
causes cancer - in the lurgz of*animals or of
humans. Painting massive
quantities of cigarette smoke condensate ("tar")
an animal skins has
caused' tumours in some c=eT -but this is not
proof that cigarette. smoke
causes lung cancer.
5. Thp oradueft
What tobacco m3nufacturers, sell is smoke and we
are rightly expected
to know what our product consists of. -Frcm time
tu time a particular
coMponent of cigarette smoke is singled out as a
pas-sibld carcinogen
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(49acer-causing agent) in humans. At one time 3:4
benzpyrene was
considered to be a possible culprit until it was
found that the amount in
cigarette smoke was insufficient to be harmful.
Other components
receiving attention include phenols. ketones,
nitrosamines. Nf rtotine
Is not ennqldered tn be norrinoapnin. The R.C.I.
report stater that
the substances in tobacco smoke that may be
injurious to health have
not been Identified. It is, of course, in the best
interests of the
tobacco Industry to continue to seek any such
substances and If any be
found, to remove them. Vigorous research to this
end has been undertaken
and will continue.
6. F I I t ars
Until we can identify any component of cigarette
smoke which Is
proved to be harmful we cannot say what effect on
health a filter may
have. Ile can only say that if a smoker prefers
cigarettes with a filter
then he should smoke them and we as a Company can
offer the widest
selection of filter brands.
7. GenpraT
It is unrealistic to believe that the smoking and
health question
will gradually die way if the industry either
keeps quiet or dismisses
Its opponents as "fanaticz". It is equally so for
Governments and
doctors to believe that the habit of cigarette
smoking (which most smokers
find gives them genuine solace and a sens-e of
well-being) can be legislated
out of existence. The question whether or not
smoking is a cause of lung
cancer - and if so, to what extent - will In the
end only be answered as a
res-ult of research; not only research dealing
with lung cancer but also
much wider research into the causes and cure of
cancer itself, wherever it
may be found. The industry is as interested as the
doctors in finding
the answer and har played and will continue to
play its part In supporting
such research. Until research gives us the answer
- and the breakthrough
may occur at any moment or be delayed for a number
of years - what should
we say to the many sincere people who have doubts
about the safety of
smoking cigarettes? We should suggest :-
(I) that in the present !rtate of knowledge it can
neither be proved -
nor dirproved - that smoking is a rquiA of lung
cancer.
(ii) that while we do not deny the possibility
that the Physicians
may be jurtified in the conclusions they draw from
the statistics,
there can be no certainty without much more
research, with which
we and many others are pressing forward as fast as
possible. If
there researches should identify a component of
tobacco smoke
which Ir positively injurious to health we would
expect to be
able to eliminate it.
(III) that we have no wish to encourage excessive
smoking, any more
than excessive eating or drinking: nor do we wish
to encourage
children to smoke, any more than we would
encourage them to take
alcohol.
26 th July, 1962. (,-4
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WESTMINSTER HOUSE 7 MILLBANK LONDON SWI ABBEY 1222
STRICTTV CONFTMCIAL
26 th July. 1962.
SMOFUNG AND PFAITH
For some time we have thought It desirable that
responsible members
of our staff should be provided with a short list
of points on the smoking
and lung cancer question as- a guide to them when
the matter arises in
private conversation. I enclose two copies of the
note we have prepared
for this purpose numbered and
As you will see, the note does not set out to
refute the causal
hypothesis but does raise a number of points which
call for further
research. We do not intend that our staff should
use the note to
initiate convmations on the s-ubject but we think
that they should have
sufficient information to encble them to deal with
the matter In a
reasonably informed and responsible manner should
it crop up. If the
press approach any member of staff on this subject
the questioner S~ould
as in the past, be referred to the official
spokesman of the Compan
(which In this country Is myself).
We do not wish the note to fall into outside
hands: and we are
therefore giving it a restricted distribution to
Heads of Departments
here who will be asked to pass on the points-
contained In the note to
such members of their s-t2ff as they consider
should have the Information.
This they will do either verbally or by
circulating the note and ensuring
its return.
You mey care to inform responsible members of your
staff of the
points in the note and, if you do, wo suggest that
you too do it in a
similar manner, perhaps at meetings specially
convened for the purpose.
We would not wish you to have copies made of our
note for general
distribution to your staff.
Will you please acknowledge receipt of this letter
and, in due
course, let me know what action you have decided
to take.
/~D /t'1 '~k' ; jL'.c V/L
A.D. McCormick
P.S. I take this opportunity of sending you
extract from the U.S.
Congressional Record which contains a letter from
Dr. Little,
Scientific Director of T.I.R.C., to Congres3lan
Abbitt, which
I think you will find Interesting.
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BATCo document for Province of BritiSh Columbia 29
October 1999