r~· I. ..~.~~ C;::a·~~i" t EMPLQIEE ~10800( S~OKIIC AYO H~LTH mgcljt/19.I.B1 c.c.: H.lcsch 01, R, thomton, G,R, t O,C. H,J, Scott H.C. Clnnon ~I C j W i ClibPDF - v~~fastio.soni WHY THIS BOOKLET WAS WRITTEN All of us who work for the tobacco industry are aware of the controversy that surrounds our products. This booklet sets out the company's views on smoking with the intention of providing an informed and balanced view of the often ccmplex issues involved. There is a substantial body of scientific and medical opinion, which we recognise, that links smoking to various diseases. There is, however, another important side to the case, for some scientists have not accepted the d i rect I i nk between smoaing and ill-heal ih. B.A.T is concerned that our knowledge about smoking and its effects on people should be extended and last year alone invested more than E5 million into research. Outside the scientific debate, there is an active and skilled 16bby of pressure groups who devote their efforts to the campaign against smoking, In add i t ion, there i s di scuss ion in our soc i ery on a wi de range of issues such as individual freedoms, ecology, personal health and the relationship of the deve;ope~ world to the Third World where tobacco also figures prominently. By presenting a reasoned, balanced view the company hopes that all sides of the smoking argument will be aired so that we have the information we need to make up our own minds about smoking. This leaflet strives to be factual and it is hoped it will help us in our role as private citizens working for a tobacco company, S~atetents on the company's views, particularly to the media or public audiences, remain, of course, the responsibility of designated Renbers of the company. CRUX OF THE ISSUE Whilsr the'debate about smoking and health began to develop in the 1930'5C it was not until the 19501r that it becale a subject for detailed V~ scientific investigation. Despite extensive research, some of it ini t i ated and carr i ed out by the tobacco i ndustry i tsei f, there has d Seen no scientific proof that ImokinS causes an) diseases in humans. rSt) Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill I _· However, by studying the life·siyles of large groups of people and the incidence of disease(a technique known as epidemiology), it has been shown by staristical analysis that smokers are, on average, more likely to suffer from certain illnesses than are non·smoke~s~ Such diseases include lung cancer, bronchitis and emphysema, heart disease and artericsclerosis (thickening of the walls of the arteries). Much attention has also been focussed on the association between smoking and lung cancer, but it is a fact that the great majority of strokers do not die from lung cancer and that some non·smokers contract the disease, Of these it is heart disease that is by far the largest single cause of death in the U,K, and smoking is~only one of the factors associated with this condition by doctors. In the light of the statistical evidence a substantial number of doctors and scientists interpret the link between smoking and certain diseases as a clear·cut cause and effect relationship. To this body of opinion has been added, in recent years, a strongly-vocal, anti·smoking lobby which likes to point to smoking as the cause of many human ailments, Although the statistical association does not constitute proof that smoking causes disease, a number of Goverrvnents have adapted the view that cigarettes are hazardous to health. There are hcwever, many people, including eminent scientists, who do no:;ntrrpret this statistical association as simple cause and effect, and some believe that it is purely coincidental. Other factors which may be involved include the personality of smokers, diet, occupation, inherited characteristics and atmospheric pollution. Any or all of these factors may contribute to the incidence of the diseases which are associated with smoking. 2 - u Clit; PDF -!::!!::!!::!.f3 StlC.i: O'lil ··· RESEARCH LEADS TO REDUCTION IN'SHOKE ''DE1IVERY" As' a responsible manufacturer, B,A.T has been, and continues to be, closely attentive to the scientific and medical debate on smoking. Thus for 25 years, B.A.T has been investing in, and reporting on, extensive research into the issues involved in smoking and health. As a result it is in a strong position to respond to consumer demand which has been stimulated by the controversy. ihe preseor·day cigarette looks almost identical to the cigarette of the past, The deliveries, however, of the components considered harmful in early cigarettes are very different from those in the average modern cigarette, and indeed vastly different from those of the advanced c i pa rettes whi ch ate now ava i lable in many countri es, The extent to which deliveries have changed over the past two decades is illustrated by the following table. -3- Clil; PDF -!::!!::!!::!.f3 StlC.i: 0111 Llb Oa, I 1 4 3r~ A O 3 kE ~D arl 1E u rl VI 00J 101 N a) U tlOrJr( Idr; rid, 00 -I O P)=~ Llrl D~0 0*i rJL 5 L i I: lpu =o >ue ii U npl k ~3~L--___ I tc;'O I · f ---r " 00 D ~3 pl~ CL~ e IO J i k~ I ·1L S o ,, in ,, tC VILI) ) )C i ~t( o Trl Zll . . I r 0 3'1 C U Y ·., . ia\ ~c3~ CI J ~e 3 I O Y- -Y N d nl ~ nf C~ Il N a r ·~ 1 ( ' I L CI ·, T) r: >C U PI C; 03Lu t:plp ~3 O ·- '-U I: n ug U Ip ·- vl L gyl 11~DB ~- 3--m x :"t: ;0=111 CI~.- I r: ~·p ;I J L z d n va IL 2 v, CII~ O PIL u e )r=E 0 1 1O) r C~tp O 0 U k mJ U 0 -LLe 1 u3J~- I; ye PI Y 0 ~'- 'n C O 0 i n~ 0 ~ B Il) e~ ~ 2·- a pi au ~ hm to ">3m "U " ~c~ ~ E X d X U] I X II- O a O I Ou O E f ~d E E u ou O O O EPI O uUlr\~ 2aoE l0DE Y-~ 3(00 T~EE J Ic C g ~ E 0 1 E (P3(1 Lr)L ~hl T( O ~ O U LI O C~ILL 0\ e OP OP u ry o k ~~ o k OLtC ,,, 05-L ~O rJUu ~ ~ Z U ; E Z U m ~U~U. Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 IOWE~ DISEASE INCIDENCE FORECAST This draatic change in smoke deliveries has come about in two significant stages. firstly, the introduction of filters in the early 1960's · the effect of which was to filter out much of the "tar" in the smoke. The second major change came in the mid 197011 rith perforation or ventilation of filter tippingi to allow the entry of air to dilute the smoke that reaches the smoker. These two deveibpments, together with changes in the porosity of the paper a:i the selection of tobaccos , have tended to overlap in time. Bu~ the overall result has been the steady reduction in smoke deliveries. ~aoy medical authorities, including committed anti·smokers, believe there changer to be responsible for the significant reductions noted since 1968 in tne incidence of some of the diseases associated with smoking, Since such statistical associations are largely based on long-term observations, it follows that the reductions currently observed must be largely associated with the early ~ost·1960 move to filter cigarettes. I: is of particular interest that the development since the 1960'1 of lower delivery cigarettes has led many medical authorities to forecast further reductions in the incidence of diseases associated with smoking, O CT1 C~J -5- o\ TV C3 iV Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 SUMMING UP sA,T's position in the smoking and health issue then, is bared upon three elements: i, Ve actnowledpe the statistical association between tobacco and certain diseases. We do not accept the interpretation, however, that r~king is, therefore, proven to be i cause of there diseases. 2. The tojaccd industry has shown responsibility by undertaking research aod by Working closely Hith the medical authorities, At the lame time we have responded to the views of governments and the medical proiesjion by substantially reducing the substances in cigarette smoke which these authorities believe to be harmful. In doing so He have met the increasing consumer demand for these modified products, ~· Medical and scientific research specialists, are producing interesting neu evidence, In some countries the incidence of certain diseases associated with Imoiiing is failing, and this trend has no~ been related to the growing popularity of lower tar cigarettes, O UI Chj 0\ rV \O 03 CIJ Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 VHAT IS CIGAAE~IE SHOKE1 cigarette smoke is a collection of tiny droplets suspended in a mixture of gaser~ The droplets, can be collected On a very fine mesh filter and weighed. By weight the most important single constituents are water and n i cotine, "lar" refers to the mixture of ai 1 of the other chemical constituents present: at the last count scene three thousand compounds had been identified! That part of the smoke which cannot be collected on a filter is referred to as the Ibapour phase", The principal components are oxygen and nitrogen (from the air), carbon dioxide, carbon monoxide and water vapour. nEASUR EMEI;T When the Inount (or "deiivery") of a component of smoke is to be measured, for example to compare different brands of cigarettes for Government tar tables, cigarettes are smoked in a standard way by machines. Human beings smoke cigarettes with a very wide variety of patterns, which may, an average, approximate to the standard pattern. This wide variation in the way people smoke cigarettes will mean, however, that the amount of a given component of smoke which an individual obtains can be quite different iron that measured after machine-smoking, NICOTINE bNO CARBON HONOXIDE Besides tar, there are two other individual smoke components which are often i i 5:ed i n Government tables in various parts of the world. These are nicotine and carbon moncxide, Nicotine has complex effects on the smoker, appearing to act either as a stimulant or tranquilliser, depending on the needs of the smoker. In many s;-~kers it also causes a small, Ihort·lived, increase in heart rate. In the quantities absorbed during smoking, nicotine is not generally believed to present any problems for healthy smokers, and is very rapidly converted into other compounds in the body. 7 · P\ Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill I__· Carbon onooxide is always present in the human envirwuntnt, since it is p~odurad by burning a wide variety of substances such as ~aal, oil, petrol and plant material. it ii also produced by animals ad plants, Carbon onoxide is toxic in large aauntr because it affects the o~yqen·rarrying capacity of the blood, it is usually thaught, harever, that healthy individuals are well able to tolerate the effects of carbon monoxide in the a~rarphere and from tobacco smoicc. Heverthelelr if a patient is suffering from an illness which could be a99ravatad by an Increase in carbon moooxide level in the blood, then he should abstain from smoking if his doctor so adviser, - 8 · j \r Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 BENEFITS OF SrlOKINC in addition to the pleasure which "any people derive from smoking and the enjoyment of the taste and flavour of tobacco, there are effects of smoking which can be beneficial to many smokers. These effects includ e Improvements in memory and control of alertness. Smoking enabler smokers to adjust their alertness to a level which is appropriate to their ci r~umstances. Thus, smoking can be helpful to someone who is pe,formin9 monotonous tasks over long time periods. It has been shown too that smokers are better able to cope with stress and to ignore distractions when they can rmake. The elii~iency of learning and memory proceritr ii airo improved by inaiing. it is thought that it is the nicotine in the Imcke which is responsible fO' these effects, THE SHOKINC HABIT Smoking is not an addict iD"I but is better described as a habit. Habituation to tobacco is similar to the habit of coffee or tea drinking or tO normal usage of alcohol. Addiction iS defined aS the need to take ever increasing doser of a mareriai to produce a constant response. This is true of heroin and other "hard" addictive drugs, the discontinuation of wh ich causes physical withdrawal symptoms which may be severe. Harijuana is in a class of its own but in its disrupting effects on mental processer it iesables alcohol when the latter is taken to excess. PASSIVE SMOKING ---~ Passive smoking is a term used to describe the intake of tobacco smoke by non·ino~err land snokeri) flom the air around them. ,C~ it has been argued that this constitutes a health hazard to the non- 0\n, smoker., nurh has been made of the argument in the making contraeriy 2~ and the "rights of the non.smokerll hav e been advocated on trains, buses, aeroplanes and in other public places. Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill Although there are one or two scientific papers which claim that there is a link between passive smoking and sae illnesses, such as respiratory disorders, the balance of scientific and medical opinion is that passive smoking doer not constitute a hazard to health, except for the very few people in whom tobacco smoke can cause allergic reactions. In "~moking and Health", the 1979 report of the Surgeon General of the U,S,A, it is concluded that "healthy non·smokers exposed to cigarette smoke have little or no physiolcgical response to the smoke and what response does occur may be due to psychological factors". Smoking may cause annoyance to non·rmoke~l but common courtesy and a respect for the views of others, bath non-,rgkerr and smokers, should he sufficient to resolve the question of pass i ve smoking. SMOKING 8Y PREGNANT WOMEN Cne of the most emotional allegations against smoking is that it can affect the unborn child. Hany people are prepared to accept the adult's right to smoke, because adults have a freedom of choice. But this freedom obviously does not apply to the unborn child. Once more, the allegations are based on statistical associations, for example between InokinE by the mother and reduced birth weight, or Letueen smoking and impaired nental abi i ity in the chi Id, and can be interpreted in a variety of ways, again involving Cactoli such as personality, diet, occupation and inheri red characteristics· Nevertheless, we agree with the advice of many doctors that a modification in smoking habits during pregnancy is a sensible part of pre·na~ll behaviour and is similar to the advised reduction in aichohol consumption or in the use of non·prescribed medicines. Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill SnOKINC AHO tHE INDIVIDUAL It has already been indicated that whilst there is no proof of causation, Statistical studies indicate that smokers run a higher risk of ,j contracting certain diseases than non-smokers, For this reason, the decision to smoke or nor should be left to individual adult choice, for adults'are in a position to weigh any consideration of risk against the benefits they perceive from smoking, In this section we nill look at smoking and some of the questions that arise for us as individuals who work for B.A,~, Should Children Smoke? Hillions of adults Imoke~ It is quite understandable, therefore, that children become aware of smoking from an early age and in some cases want to copy adult behaviour. Consequently, there is a pressure on r~o4ers to give up the custom in order to prevent children starting. As with other customs and activities which might involve risk, smoking should be a choice for adults. Young people, therefore, should not be encouraged to smoke. For this reason, the tobacco industry has formally adopted a palicy of neither promoting its products to children nor of making cigarettes attractive to young minds, Advert ising Several research studies have sought to establish why people start to smoke but none has identified advertising as the primary motivation, One major U.K, study concluded recently that advertising does rot affect the total amount of cigarettes sold, and can be influential only in encouraging smokers to change brands, Should I rmrk for a tobacco companyl Ve have made that decision already. But perhaps it was made before the current high level of controversy or perhaps He have never really considered the question. Thr smoking controversy is unresolved and the tobacco i ndustry doer aeet a legitimate consumer dePnd by the supply of legal products which IzJ Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 ,, __·~C are enjoyed by millions of people. Tie industry spends millions of pounds each year funding research into the effects of smoking and into the development of new products. In the U.L alone, it employs more than 40,000 people directly and some 250,000 people derive some or ail of their living from involvement in the ~bles and distribution of tobacco. It contributes more than 13 billion (three thousand million) to govcm~cnt each year in taxation. It contributes nearly E3DO million each year to the U,K,'s export earnings. It has a record of respons;bility in the smoking and health debate and has always demonstrated its readiness to co·operate with government, Overseas, B.A,T has played a positive role which over the years has helped to ra i se I i v i ng standards i n many develop i ng count ri ct. The tobacco industry, therefore, plays a responsible and beneficial role in society that will compare favourably with any other industry. Does tobacco have a secure future? For the foreseeable future, smoking will continue to be enjoyed by mi Ilions and this industry is as secure as any other, Gr~th for the overall market in countries like the U.L is not likely and one of the reasons why tobacco cbmpanies like 8,A,T have invested in other businesses is because of that limitation of growth. ~hat is not to say that we are getting out of tobacco. Our presence will remain substantial, but there art other areas where growth potential is greater. Should we really carry an making cigarettes when so many doctors say it is bad for us? Smoking provides pleasure for millions of people and some doctors and O scientists also ray that the case against tobacco is not proven; that there i I no sc i en t i f i c p roo f th at smok i ng caus es d i s eas e, The manufactu re and sale of cigarettes, therefore, meets a legitimate consumer demand and it is perfectly reasonable for this company to meet that -12- ClibPDF - v~~fastio.soni ·_r·_· ~C_ requ i rement, At the sane time we must continue to respect medical views and carry out research into products which meet the demands created by the expression of these opinions, Why are tobacco companiesproducing lew tar cigarettes? The tar content of cigarettes has been the subject of much investigation by government and scientists and a body of scientific opinion has argued that tar is one of the harmful constituents of smoke, B.A,T is closely attentive to this view and produces cigarettes of lower tar deliveries so that in the light of information that is widely avaiiable consumers can choose the products they like, It is often stated that smoking kills 50,000 peoDie a year in the U.K. is that true? No, The figure of 50,000 deaths is from diseases which are associated with smoking. It has not been established that smoking causes these diseases, Sit Ceorce young, a committed anti-smoker and junior health minister, has told the U.K, ~ariiament that it is impossible to attribute this figure to deaths caused by smoking. In a written reply to a parliamentary question he said: 'The precise contribution of smoking to mortality is not known, but the annual number of premature deaths due specifically to smoking-related diseases has been estimated at 50,000 in the United Kingdom. This gives an approximate rate of 900 per million population." What about each c~arette taking 5f minutes offyour life? Again, only ii the case that cigarette smoking causes disease is accepted is it possible to make this sort of assertion, This very ecotive statement has captured many headlines, as it was designed to do, But it is purely a statistical propostion that depends on the acceptance of smoking as a cause of disease, Lh] -13- \o Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill ··~ Vhy is it that most snokerr ay they would like to give upf_ Uhat many smokers mean is that they might like to give up if it Here easy. Smoking fulfils complex needs and smokers rind, for example, that they became more tense and irritable when they give up smoking. It is clear that smoking has helped the smoker to alleviate tension and that is one of the reasons why he smokes, Giving up becwles d i ff i cu it and of ten we do not recogni se our reasons for J;nok i ng, Cost is also a factor and most of us would 1 i ke to save money in theory, but when it comes to a clear choice we really prefer to carry on smoking~ I'm sometimes criticised for working for a tobacco company What do i savl It is best for us to say what we believe. This booklet has been produced to give what it is hoped is a balanced view of some of the major areas fo controversy, and indeed it sums up the views of many people in the company, In summary, we can say that Smok i ng i s a I eg i t ima re soc i al custom enjoyed by mi 1 I ions. I Tobacco cocEpani es are perf ect ly ri ght i n marketi ng a product to meet a clearly expressed consumer demand. i The allegations against smoking are by no means conclusive and the industry does much to advance scientific knowledge of the issues~ In the light of scientific and medical controversy the industry has consistently acted responsibly and has met .government re~uirementr for promotional restraint and the modification of its products~ i Tobacco provides much employment and contributes substantially to the economy of the country. !: Overseas, B,A,T plays an important part in the development of a number of rapidly emerging countries. -14· ~O Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill The Anti-smokers There is a considerable difference between abn·rmokers and anti·rm3kers. The latter can be fanatical in their approach and do little to contribute to our understanding of smoking and health issues, Although the anti-smokers may gain considerable publicity the o~jeetive examination and illumination of the smoking and health issue is no further advanced. B.A.tlr interest in advancing the state of bowlLdge concerning reeking and health issues is directed more to the members of the medical and scientific community. They wish to see a reduction of the diseases associated with rskiog, and even though many may be non-smokers, are nevertheless open to new information and considered opinion, -IS· crl Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 BAT Ih''lKE THIRD k'SRID :PSaeeo is In impc:rmt reriwltpr~l co~oditg for nuny rapidly deveIopinl countries including, for exatplc, ~l~vi, Kenya and Nigeria, Bntil and Honduras, Sri t~nk~, Bangladesh and indonesia, the largest of the international tobacco companies, and many of our links r",th tbe Third ~crld were forged in the early yeats of this century, Since then we have continued to contribute significantly to the raising of living standards in several developing countries, For these territories we o:'tenrepresent one of the largest parts of the con~crcial sector, As an employer, source of trained manpover and as an often massive contributor to national txc~eque:~, we have played a most positive and important role in na:ic:al development over the years. These are achievements which are refopis~d by ~pvt:c;l~rs and of which we can be proud, 6ddicio:;lly, 9~T has done FJch to help farmers in developing countries increase production of food crops as well as tobacco through the application of new agricultural techniques and improved land cultivation, In tobacco areas increased yields of food crops have been recorded since the early 1969'5l ~aire production for exa~ple, in tobacco districts has risen considerably in Cuec.esra, Chile and Kenpa, in Bangladesh, rice sad jute production has risen in tobacco growing regions and in Ypsorc, india, there has been a considerable increase in yields of millet, in Nigeria, BAT advice on crop rotation and the use of residual fertiliscr has enabled tobacco farmers to grow up to five cites as much cassava as they did previously on the same land area, Tnis aCtiev2no.3t is of considerable value in a country where food production is a national priority, CPnridetatioor of Ilekill aod health ?re of as treat a concern to us in the O emergent nations as they are in the industrialised countries, A 1Pajor t~l ~J on which the coo)any mbarked soPe cine age was the introduction of worldwide IV Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 5-~2ing and health paricies, In [ur~pe and the United States, the vievt ~mich EB d other tobacco companies have adopted on smoking and health in the light of current medical, scientific and CovernmenC vievs and of consumer taste, have led to the development of lar tar.bnnds and to agreements on r:fS.pdS Of ahertising Id promotion. ~Ys'Zets in the industridliJed nations and those in the developing Mrld are very diiiarer.t and customer taste varies greatly. In certain parts of ;'p. vJrld, a typical smoker buys iw cigarettes and prefers a stronger taste and I higher nicotine intake per cigarette than is customary in Europe or the G,S,b. It is B,A.T,'s policy, hauever, that there should be a :~::::~!isa:iJr, of tat.delivery so the: an international brand sold in, say, ~ica does not vary greatly in tar deliverj from that available to the waer in Europe. Equally, B,A.T.'s policies on advertising and promotion ;'o: r~T1Icz~ian internationally by associated companies, so that campaigns ~I:t appeal to youth are avoided, that advertising does'not make exaggerated clai=s ad that pronational activity remains acceptable to local co~unieies, O Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 _ SHOI(Ih'C Mp SOCIETY Introduction SmZiPg tobacco has been a social cmta inmanp societies for centuries and was first brought to European attention in the 1490's by I sailor who sit ;C:crrCd fTOt:ht d;CtiCaS with Cnristopher Coldus, k'alter Raleigh did not therefore discover tobacco but was responsible for its introduction to the Englii: Csle: and for its pepularisation in the late 1SOq's. Si=~~ t'cP,n tO~EC:3 hd5 13eP11 2 Source Df Pleasure fOl sPokers and a source f :cve=i:e io; bvc33e~ts~ It was not until the 1880's however, that the ci;;:e::e be3r to e;a:~e as the most pop~ar method of Tna Feat p37clcisati0P of the eigaret:e was made possible by the la:ro~ue~ien oi production Icbinery and its growth has matched the growing in'.?lltrialisation and urbL;isltion of oar world. a \D VI Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 ~~--- Social Attitudes Social attitudes are constantly changing and attitudes to smoking are also changing, Some years ago, for example, smoking was eons ide red a masculine prese rye, and somehow s I i gh try dash i ng. Wi th the development of sexual equality it became less of a masculine pursuit and indeed smoking was often used as a symbol of the sexual revolution, Often film makers and dramatists used smoking as a visual shorthand to imply sophistication, This interpretation is somewhat dated now and society has moved to treating smoking much more as a matter of individual choice, rather than as a means of making social statements, An aim of the anti-smoking groups is to take this natural progression even further and create a climate where smoking is socially unacceptable or at least where the smoker is made to feel that it is so, This development is all part of the campaign against smoking and is indicative of the desires of some small yet influential groups who want to decide what is best for us, Information on smoking is so widely available that everyone~ is aware of the cent roversy, The decision to smoke or not must be left to the rational decision of adults, The Role of the Government A number of Governments have worked to reduce the incidence of smoking in thei r countries, However with hundreds of mi II ions of smokers around the world it would be impracticai to ban smoking and P~erica's experience with prohibition gives some idea of what could happen, Where legal products are concerned the role of Government in a free society is to provide information and allow individuals to decide whether or not to make use of those products, In the view of the industry it would be wrong for government to resort to unnecessary legislation as a means of regulating adult choice arbi trari ly or I imi t ing car~nercial freedom, fV Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill IN CONCLVSION Throughout the world, smokers enjoy B,A,T products, Our contribution to international economic progress through the manufacture and sale of our products is considerable and in the rapidly emerging countries the help we are able to give towards national advancement and the improvement of living standards has earned recognition from several Governments, Commercial life is never easy and there will always be new challenges to meet. fhe issues affecting smoking and health represent just such a challenge and we hope this booklet will have shown that they are being tackled in a responsible manner that reflects B,A,T's highstandards of corrJnercial and ethical behaviour, ·20· Clit; PDF -!::!!::!!::!.f3 StlC.i: 0111 _ __I ·· _ ____ ~ 4 '·3 T~~hr~f· 16th January, 1981 RET/JP SMOKING AND HEALTH ISSUES BOOKLET SOME CONSTRAINTS (By R.E~ Thcmton) i. This booklet will be issued to all employees. 2. This is equivalent to free publication. The booklet will be studied by company employees, the media, doctors and ASH. p.R, aspects of all four groups must be 'considered, 4, For company employees and the media: The booklet must be attractive, lucid and simple - otherwise it will be neither read nor understood. 5. For doctors: The booklet should be factually correct, within t.ie constraints of interpreting epiderniological data. 6. For ASH: The booklet will Se unacceptable, but we should be able to adequately defend any statements made. 7, As a result of 5 and 6: 7.1 We must be careful not to misquote statements by doctors. 7.2 We must be very careful about projections into the future. 8, In principle we should only quote from summaries of documents, otherwise we could easily be accused of misrepresentation ' i.e. "Half the conditions in table III were pcsitively related to smoking, some very strongly so, and one disease, Parkinsonism, was negdtively related. To say that these conditions were related to smoitinS does not necessarily imply that snaking caused for prevented) them. The relation may have been secondary in that smoking was associated with some other factor, such as alcohol consumption or a feature of the personality, that caused the disease. (Doll and Pete, 1976) " ilibout one in four regular cigarette smokers is killed prematnrell by smoking.) In the US, where cigarettes cause uell over 100,000 deaths every year from lung cancer or chronic obstructive lung disease, the tobacco industry refuses to accept in public that cigarettes cause either disease, let alone to collaborate in serious public information, and no epithet can suitably describe the collective efforts of their advertisers· O "No other industry kills people on anything.like the scale that the tobacco industry does.,. iCI~ (Peto, 1980) Clit; PDF -!::!!::!!::!.f3 StlC.i: Dill