O Co C Q3 BAfCo document for Legal Services : Health Canada 19 May 1999 II· b·~ ·r~ p~ · See Distribution Below: ;$:" B,E, TbOrPtOP, GBIDC , Southamp ton, pi: BBflDIIIBD ::,, aBth dull, 1982. DB, V, II ~OTT I enclose a note written airer a ~isit made to Dr, VILI Inott u O~·. B1El ~POPN~OB (Dictrted by B,El Tboraton, but signed in his absence) Eacl, DistribPtion:- Drl LIC,P, Blacirman Dr,_r,_Qldm_a~ Yr, B,LI Beard Dr, C,II agres Yr, B,8, wade Dr, IID~ IllbPrn Dr, P,J, DPnt WDUt~ll~T# w 56JUll~ o !~t- ---··- !~----- BATCo document fb~ legal Services : Health Canada 19 May 1999 Q o~o IJD~tlOP;1IB1 PRIVATE AID CONFIDENTIAL VISIT REPORT Visit to: Dr, V, ppgtt of: Royal Ottawa Hospital, Ottawa, Author: RIEI Thornton Date: 14tb July, 1982 Cirularioo: Dr. 1ICIF, Blackman Mr, A,L, Heard 9r~ C,i, Ivr-s Dr. E.~, Il~nurn Dr, M, Oldman Mrs, A,K, Comer ~rl R,S1 lade, Canada Dr, P,J, Dunn, Canada RETlgpNI46D 28th July, 1982 h, ·Q BATCo document far Legal Services : Health Canada 19 May 1999 ~ Isr~ ~~nai~i~al Sc~ visit Tot Drl Y~ gaott, Royal Ottawa Bqspitll, Ottawa, Present: Drl V1 gnott IrI R,SI lade Dr, R,E, Tbaraton 1~ Dr, I(nott is currently a grantee of the C,TIY,C, The ,. purpose of th; visit ~as to discuss his pep grant application, rbich is for a il~elpear studgl I had met Drl gnott before, both at the Chelwood Smoking Behaviour Conference (1979) and also, with gay Comer, at the conference on nicotine held by S,B,l,T,A, in Paris in 19781 2, Dr, gnott's most recent proposals for a five year longitudinal study (1982j6) have already beeP discussed extensively at CIT,UICI and in GR~DCI The U,S, companies in CITIYLCI have decided not to support the new proposals, which is essentially an PEG assess- ment of children (age ii) and the relation of these measurements to subsequent smoking habits, However, 1,TIP, and Rathmans (largely as a reslt of a visit by P.F, Brown) are, in principle, in favour of support, 3~ Before leaving the UK I discussed the proposal with A,g, Comer (Kay and 1 bad looked at the EE patterns of smokers nod oonlsmokeFs in collaboration with Dr, CI Binnie of St, Bartholomew's hospital) and g,D, gilburn who had made suggestions for the up- grading of equipment, 4, PROTOCOL It was suggested that the protocol would be improved II subjects were re·analysed at the end of the 5-gfar study, hopefully, this beiorel and aiter- study would demonstrate that smokers' EEG's altered at the same rate as noolsmokers' EEG's which would be good evidence that smoking was not addictive, This had been inferred from the BAT study (comparison of the EEG's of smokers and o~olsmokers of similar ages) but coaid not be definitely proved, Also, the differences in smokers and non-smokers noted in the BET Study could have been due either to differences between the subjects in the two groups, or to an acute of smoking, Otherpise, the protocol is detailed and releornt, d· as expected from Dr, gnott, (See also section 6 for proposed extension to protocol)l 5~ ~PUIPYIENT Dr, gnott said that he now wished to add equipment to S measure brainlstem response, newly considered to be dl ---*I~ I --- BATCo document for Legal Services : Health Canada l9 May 1999 .,· Irst~rl ~llm~pme~ Ent~e considerable importance in this area, This rould add about a25,000 to the cost, It ~as agreed that, since the study ~ap going to last five years, this equipment should be included in the proposal, It aould not be possible to alter the protocol at a later date, lith regard to the egaipment suggested by Dr, lilburn, Dr. Knott said that his most recent proposals for equipPen: largely anticipated Dr, Iilburn's suggestions for improoed methods of data-acqnisitfon, and bad been made after discussion ~ith gBG experts. It lRas agreed that Dr, goott rould base his application on his o~n list of equipment; it aas considered that this ~as entirely satisfactory for the anbllsisenvis- aged by Dr, Inott, bnalysfs of the results else~here ~as considered unlilrely, 61 PTBICB1 PBO~1EYS One of the advantages of carrying opt contact research is that any ethical problems become those of the l;niversitg/Rospital rather than of the funding organisatian, In the present case this is particularly important since children are to be studied, and their smokinglnon-ssohiPg habits deter~ined, The ~ccept- Lnce of the proposals by the Ottath School Board and by the Royal Ottara Bospital is important, The former have already agreed to them - the latter are expected to (aad must do so~beiore the project can continue), ll'ithin these proiiPos, and providing the C,T~Y,C, fund the Royal Ottana Haspit~l (rather than Inott directly) t~e project should be as nell isolated from the tobacco industry as can be reasonably expected, ~ projscr sP)parted by the Tobacco Industry 16 potentially open to attack by batilt~o~ipg iandnl mentalists: ho~ever, the agreements Pored above should be sufficient for the rationillglpipdadl 7, GEBPBI1 COYYEIT Dr, P,J,C, Boe, in discussing likely future pressures on the industry, suggested that 'nicotine as an addictive O agent' ~as a likely threat, The present study is litely BATCo document for Legal Services : Health Canada 19 May 1999 LI1 Ilest~al Ilt80nn~bd ~3- to demonstrate a constitutional basis for smoking, and a lack of chronic (5 year) effects on brain activity, Both would be useful pieces of information bearing on the fact that smoking is not addictive, and as measured by EEG not harmfull BaPever, it should be borne in mind that it is not a certainty that these results nill be established, The sample size (300) is relatively small and there is alnags the possibility that the differences nill be lost in noises, It nill be important to quantify, as far as possible, the anti-smoking pressures on the children, ADDENDUM 8, RET undertook to obtain information from Nicola Cherry (1,S,E,) on subject relcall strategies in longitudinal studies, s~a3aw~ R,E, THORNTON (Iritten bg k.E. Tharnton, but signed out in his absence,] -- BATCo document for Legal Services : Health Canada 19 May 1999 Couh~ac Page 30 C) I~JATION Ihe major thrust Of innovation and develo~ent tt~t will rake place in F'83 will be a cewplete rev~rmping of aur su~rey in· fonration into an integrated rhole which will see us through the BO's, The C,1Y..4, and Mcnthly Monitor ~ve served ~ well, but they no longer suit the clirrem ~amics of the market nor take advan- tage of today's level of i~ormation processing ted~nologl (information processing covers the areas of data collection through to computer reporting and analysis), Project Brand fD and various other studies leading Irp to that project, pla ~un~rous opinions in and out of Research ~ve identified the draw backs of our current survev tools, An overall approach to overcome these flaws, t~t is not cost prohibitive, will be tackled and resol~ed in F'83, 'Ihis undertaking is a major one and involves the forn~ulation of a critical path which will aid us in meeting our ccmmitnumt, The sin focus of this restructuring is titled Project Survey, Which basically calls for a monthly telephone surrey -- --- BATCo document for Legal Services : Health Canada 19 May 1999 Page jl supplemented by an annual and~an in-home interview, The monthly survey will replace the C,~~A~ with a shortened computer assisted questionnaire concentrating on switching. fmage data will be collected in the annual in-home survey kfiiCh will also probe an issues which require, or are better delt with, using a visual stimulus, Tracking cur- rently being done in the C,K,cZ, over the telephone is un- responsive in providing proper measures of new brand or ad perion~nce, and will be removed and replaced with a more appropriate methodology, In stmn~rj then, the focw of the Research Group for F'83 is on three major projects: Survey, fi~ge, and Track, 'Ihere are numerous secondary projects to these three but all have i~lications on one another, They are currently scheduled and managed independently, In April, a master plan will be developed to indicate the critical paints and implications each has on the other, Ihe following is a description of each of these projects. -- BATCo document for legal Services : Health Canada 19 May 1999 Page 32 1) Project h~ ~e C~~~A, is currently conducted ~~g a quota sqle of rh smokers collected monthly using a telephdne r~d- ology and typed ~estirire with numerous ski3 Patterns and VQB's, Rriam inadequacies dst because of such a m~bla~: - a brar;d iden:ification prabla Qe to the ~dilig through the ns~ictd me oi words to identifY the proper bred; - length oi questionnaire a it is weighted ~ t tracking, image sotaats and Mrious other questions is driving dslin the completion rate and quality ai response and at the same time driving up cost; - because of tie restrictions and the type of scaling fge data is c~mtly inadequate; a~ - lack cf randcmr sampling methodology lnrposes restrictions O the form of ~lysis that can take place. project Survey will initially be a feasibility study on the use of a CoIPuter assisted ~cstimain ahinisttr~ to a u~a sample ~eh probes pr~riry on dmgrqMcs, u~l brand, BATCo document for legal Services : Heath Canada 19 May 1999 Page 33 and previcus brand. X cor~uter assisted questio~naire can make better we of deep probes for proper brand identification by alla;ing detailed question blocks for every brand wt the Rlarket. hilt in editing can occur to help reduce coding and secondary editing, Flow of questic~naires will be flawless and less ti~- conslaning thus reducing length of questionnaire, thus reducing cost and increasing quality of response. As a means to secure the right s~plier for this proposed design, we will be considering a proposal to be submitted by Adcom before the end of F' 82 as well as explore what other suppliers have to offer, - -1 ·- BATCa document for legal Services : Health Canada 19 May 1999 Page jq 2) q~ject I~ge Pmjec: ~nage L an ua6rellaproject. Ia ultimate goal is to develop and implement a ccnrprehensit~e, quantitative instnrment to measure and interpret conslrmers' attitudes and beliefs towards cigarettes, Phase I of tkis pn;ject us the developn~nt of a constrmer making vc~cabularl, Constructs, dimensions, and their meanings, as erployed by smokers, was wal- uated. Phase Ii of this project was a refinement of ~ our cigarette typology, the relative positioning of brands on image dime~ions, as well as further assess- ment of methodological considerations. Phase III of this project will be a large ad hoc research PMjeCt desi~ed to give relative positionings of relevant brands on i~mage dimensions; in order to provide a comprehensive description of brand i~ages in the Ca~dian cigarette ~rj~et. d Pilot Stud~ on 10 brands and 10 dimensions will be undertaken, Areas such as: switching, aroking a health, price sensitivity and "ideal" needs and wants will be collected at the same time, The we of nn~il:ivariate analysis wil hew ~eawr the complex relationships that exist and help in our ~mderstanding of the Farketplace, BATCo document for Legal Services : Health Canada 19 May 1999 Page 35 3] Project 'Irack There is a need to set up and implement a system incorporating a set of benc~rks (criteria, standards) t~t can be utilized to trac)i new cigarette brands both own and opposition. We presently track new brands with various tools: - retail audits; -C,~,A, -awareness, purdase, trial; and focus groups, The system tf~t will be set up may or may not differ from our present systern, Present tools will be evaluated and possible additional/alte~te tools will be looked into, Benc~n~Mrks will be set ~ utilizing a cor~ination of our historical data (i,e, aureness at time intervals of first generation, second generation, etc,j and possibly some external consultation, money has been set aside for such consultation, however. 4) C.~.A, Reporting Cwrently, we an reporting C,M.A, consumer data based on crossed tabulation of key variables for market analysis, ~t is difficult iar users to identify wi~en trends occur. Also, our information is sconetimes not wrj neaning~u! to most, in certain areas such O -- BAfCo document for Legal Services : Health Canada 19 May 1999 Page 36 as irragerl, tracking, etc, t~nce, they us~aly rery an ~ricet researc~ to hand our comprehensive sumnar! and analysis, In order to respond more adequately to our users, we rm~st lake futl advantage of system ~exibility, 'Ihw, in F'8J we will undertake the necessary steps to do so by validating, testing, and ~lementing adificatians to our survey reponing system. The presentation of the information will be in response to various identified needs such as target group sliitching, i~ager! for non-users ai a product, media target groups, etc. Tne project will be broken into p~ses that will see separate e~ca~i~tions of the different components of the information. T~lemptatio~ of new approaches will most probably be staged depending on the above, 5) Cordcall Project Cordcall is to establish a means of measure of conn~ner data t~t does not generate a bias resulting fmm consumer memory, Currently ~der investigation is the implementation of a diary panel study of smokers to monitorat different tin~s of th year, conslmrption levels ct' cigarettes, product de~cts, and purchasing ~~vior, P~se I currently ~der progress, whicfi is a rest-study -- BATCo document for Legal Services : Health Canada 19 May 1999 Page 37 of this methodolagj, should have results available by mid~tarch 1982, Upon positive assessment of the rest, we would proceed with two waves of diaries. 6) PlusMinus Project PluslMinus delves into the areas of our market which we cannot predict accurately~ The specific area of interest is young sr~kers between the ages of 15 and 19. Among the things t~t we do not have, besides quantitative incidence and branded information, are the causal factors that create these resprmses, In 1978, e~loratorj research was dome an this issue. Subsequent to this study, switching data shows that the y0~p are fallok~ing their elders with regards to starting cm lower tar products, As the youth stream frwn the baby bocrm diminishes and market potential Iratures, we s~outd better ~nderstand k6at tI~ir smoking and quitting be~v- iors are today, ~fsve these attitudes and be~viors clanged in the past tfiree to four yearsl i2re we respon- ding to their n~edsl How do they perceive current advereisng trends? The purpose of project Plusnfinus is to ilpdate our portraits of starters and quitters, BA~Co document for Legal Services : Health Canada 19 May 1999 Page 38 exDlore starters' smoking history, attitudes and behaviors, explore causal factors leading to quitting and ultimately provide better predictors. A two-pronged approach will be taken an this proj- ect, one involving quantitative desk research on starters and q3itsers ;mn~g the young as well as qualitative work an the youth, both smokers and non-smokers . I] ~no4i?g&Heal·jl We are currently gathering infatmation twice a year on sm]kers' perceptions of smoking a~i health. The method or' obtaining this infonraticol has been con- stant since the early 'IO's, Prang the latest results, one can find little dange over time on the issues, Moreso, our actual at~ans of collecting the data may n6t reflect t~ concerns t~t exist today, such as social enviro~nent pressure, prices, quality of prod- uct, CO issue, etc. Project image will e;tplcre this issue initially with the we of the consonanceldisso· nance approd employed by B.A.T. The stn~cture of cwr questions appear weak and could benefit from a redesi~~ Ihe purpose of doing a smoking and health review is to better define and bring up·to-date BATCo document for Legal Services : Health Canada 19 May 1999 Page 39 our methodology (i.e, more in ame with reality and pertinent to the concerns of smokers), Possible ap- proaches to resolving these issues are: Ij qualitative work on smo~cers around a point time khen certain issues are more relevant; 2) evaluate relative strengths of difieTent items of concern in s~kers' mind; and 3) redesign the VQB adopted Ear the 80's for samkers' concern , 8) Regional ~nlonratian A project to be undertaken by Varketing Research in response to in~rmation needs involves providing better regional infonation; a response to the establislnt of regional nrketing analysis. The current information for~vanled to regions is not meeting their market a~lysis needs, 'Ihe strategy for establishing what regional infor- mation needs are, involves having the four R~'s participate on an orientation program in Research the first two weeks oi~hrch. They iJill be putting together a position paper an their inforn~tian Heeds,' ~s paper will be presented -- BATCo document for Legal Services : Health Canada 19 May 1999 Page 40 on the last day of the orientation after having been exposed to all the data that exists in Research. Marketing Research will theft we this as a brief fmn ktich work can proceed to better satisfying regicmal inibrmation needs, 9) Eniulcement of Current Arralytical Techniques Usin~ Ewisrinq Data It is our concern in Resea~h that the existing data we have has not been milked to the extent that it can be in providing an interpretation of the market. With the computing capacity ~at we mn~e~rly t~ve and the advance- ment in analytical techniques currently being practiced by outside suppliers, there is certainly row for inq~rov~me~t, In the types of analysis performed by ~8rketing Research, we have set an objective for ourselves that over the course of the year and prior to the annual planning update, we will incorporate new forms of analytical techniques currently in use today to better explain the market, One of these tec~Pliques will be multivariate analysis wfiich Peter Illich ~as assumed responsibility for, -- BATCo document for legal Services : Health Canada 19 May 1999 Page 41 10) integration of Infonaation iZs a result of today's technology, the ability to i~tegrate information is at our door step, Ps is stands now, we ~Ve various fcras of survey in· formation an line being used and analyzed in iso- latic~. Data such as t~t collected in the C,M,A,, the Monthly Monitor, massive snitching studies, Fbia, sales, advertising expenditures, etc., should be readily available far cross analysis, A ccaa- mittee project headed by Carole Brohman win work towards the integration of this information for purposes of analysis, Tne initial stage of this project requires a position paper on how infonaation can t~e integrated tither internally or externally, part of this project will be the elimination of redundant information. -- BATCo document for Legal Services : Health Canada 19 May 1999 Page 4t 11) Price Sensitivity Historically, the Canadian cigarette market has not se~nenred on price. Recently, Loblaws in Ontario intro~ced a no-nan~ pro~h~ct in its stores with ap- parent success, Is the market ripe for such a concept? With the govenrmenrs raising taxes on to- bacco products continuously and a worsening econcric clirate, is there a measurable lever of price swwi- tivity in the Canadian arket? wt has caused the sudden platea~ing in the decline of the fine cut marketl Why is incidence in RYO and tailor-made ca~ined up? Our Current measurements do not penrit us to record accurately Shifts in the market as a result of price if there are any taking place. ?he day may soon cone, if it ~isa't alread~, when cigarette derrand will be significantly sensitive to price and part of a consu~ners' p~rrchasing decision Hill be price. Project Barker will explore the concept for low-priced cigarettes for n, while Project Price Sensitivity, the one discussed here, will hope~lly give us insight into shifts in attitude and be~vior as a result of price and allow us to monitor its r~gnitude on an ongoing basis. BATCo document for Legal Senrices : Health Canada 19 May 1999 Page 43 It) low·level Incidence Currently, we are faced with increasingly high research costs. These costs increase exponentially wfien the product's incideMe level drops. We must find research tec~iques to give us answers without prohibitive costs with regards to product incidence. ~ie, tf~reiore, will undez~ake to find the mast appropriate research tech- niques for low incidence tobacco pro~ucts~ Tnis project comes as a follow-up to Project Brand ID, in which it was fa~md to be cor;t pTahibieive or tao impractical to io~le~nent the proposed methodologies. 'Ihis project is not in response to cons~mer confusion towards new brand data, but rather on reliability in representativig of our survey method for quantitative approaches, 13] Project Product Tnis project has two overall objectives: 1) assesrment of our current product-testing methodology with the ultimate goal being an inqrrovanent in the instr~nent in tens of time, cost, and information supplied; and BATCo document for Legal Services : Health Canada 19 May 1999 Page 44 2] integration of smoker taste and sensory perceptions to better develop our ~a~zderslandinr! of attitudes, images, and market segmentation. A meeting ~s been scheduled in late F'82 with Pro~ct 8 Packaging and R & D along with Vartin Ol~an to discuss issues in this area, Hopefully, a result of this session will be to set new directions in the area of produa mea· surement and testing, id) Expanded industry ~xchange The expanded industry exchange is an exchange of sales data by the r~nufacturers which measure companylbrand performance in a previousl~ defined submarket, Tne submarkets have been iscla~ed with the submissior, of "clusters" [gToups of ~hole- sales), A5 expanded sales data becomes available, regims will be approaching Research for direction on how to use and analyze this information, It is our role to Imderstand the composition of the iniarmation and how it can be used in analysis. -- BATCo document for Legal Services : Health Canada 19 May 1999 Page 45 15) Price Audits As the federal and provincial governments continue to increase taxes on cigarettes, it has bec~m~ essential that ne gain a better insight into price variance in Canada. presently, the instruments ke use to measure retail prices of cigarettes ~o not optima!ly reflect price differences and their impact on sales. Tne initial steZI in developing a test to measure price more effectively will be an analysis of all existing vehicles. k the completion of this stage, proposals kill be ~de to inpJrove our seans of tracking and measuring retail cigarette prices. 16) Retail Audits There is a need to i~rove our ability in measuring brand perfon~nce at retail, Retail audits uill be studied this year. At the present time, our sophistication is to a level of conducting mini audits in selected markets for specific brand tracking, ---------- BATCo document for legal Services : Health Canada 19 May 1999 Page 46 The reliability of these samples and their representativity is questionable, A position paper on the subject will he pur forewa·rd by Research recolnrending that nth infa~natian should be purchased by a supplier. However, before designing any approach, a clearer definition of infonation needs is required, Are we concerned with only a measure of gross inventories to adjust safes or should we be looking into the future at store se~nentation, retail ranagement and retail inventory control? Ifj Tradelnventpri Paalysis 'Irade inve~torj analysis will be an in-house investigation of tobacco and associated products inventories, The objec· tive is to r~asure the influences of economic conditicPls on inventory levels at various points in time, wt~ile in~raving our power to predict trade reactions to c~nging econ~e conditions, Thisprojectwill be done in conj~a~ctionwith retail audits, 18) Sales Force Activities Sales force activities interact with virt~ally evert other phase of the mar~eting system, Each par, millions of dollars are spend in support a~ field activities, either BATCo document for legal Services : Health Canada 19 May 1999 Page 47 directly, or indirectly. Yet, our only meafl~nent of the execution of the field activity (or strateeyj depends largely upon intuition. The objective of this project is to develop a statistical measurement which will assess tfie execution of field activ- ities. 19) Distribution Network In 1950, ITL sersiced 3,700 direct acco~mts, ~ r981, t~s figure had dropped to bBj, The total nwlber of retail outlets selling tobacco in 1981 was 43,'146, although if present trends continue, we estin~te t~t only 21,000 retailers will sell to- bacco by the end of the 8015, This project will e~lore the danges which ~ve been taking place at the wholesale and retail level, i,e, why are distributors closingl ~efe? are there new "kinds" of distributors opening? what are the ramiiicatiom of t~e c~nging retail envimnr~ntl will we need more salesmen? fewerl etc, hhile there are few distributors, these fewer are controlling greater arormcs o~ r~rchandise, and are in a position to ulti- mte~y exert a tremendous ~fuence on w~t manufacturers might BATCo document for legal Services : Health Canada 19 May 1999 Page 48 do in the marketplace, As a result, we r~st be aware of any "pawer shift" from the manufacturer to the distributor in order to dwelap strategies to preserve the present balance between ~Farmfactt~er and distributor, 20) Proj~dt ~Preh~est At the present time, nolch of the advertising research which is conducted utilizes a qualitative methodology, Fools Rroups are e~sployed to assess different creatives imd to evaluate new concepts. ~T~LiS does pravi~ general direction, and will remain weful in discri~inating EmQn~st nt~rous concepts and aeatives, However, this methadol6gl is i~dequate in teres of deter- rining the inrpact of an advertisement, particularly when cwnpared to industrl nor~ns. Further, qualitative research will never be able to ~urnish answers to various questions ~nic~exist~ Pllong these are; - the use of black borders on d~riet advertising; · red on red for m~b~aurier light; · is the low awareness of the Peter Jackson Extra bigfit campai~ a result of the creative?; - can black and ~nite deliver the same message as color?; BATCo document for Legal Services : Health Canada 19 May 1999 page 49 -kbat irmvreefiective interms of cost; ~fapage, full page, or dwb~e page advertisements?; - average viewing time fat an advertisement; · average viewing t~n~ for e4ch specific ad element; · the percentage of respondents h110 read hea~i~ an~ bodl copy, bath partially and fully; ~ etc. ~ere is an American firm, Telca REsear~ inc,, a leader in the field of eypmwerneat traddng, k;hich is wrently expanding in the Canadian market, Ihey suggest t~t they can prwide a~swers to all these areas of concern, As an initial step, flesearch intends to conrmission a pilot study an existing Peter Jad(son Extra light and duMmrrier light creatives, 'Xhe results will t~ be compared to various nctms whic~, although scant~, ~ve already been collected in t~u~ Canadian Industry, tl) hl~ect Incidence There is growing need for a cmtinuous, accurate measure of incidence of smoking, Historically, we have relied on two armual readings frw the spring and fall ~nitars, t~wever, various factors in the market, particularly price and the BATCo document for Legal Services : Health Canada 19 May 1999 Page 50 possible Mlatility of the market to price, necessitate a more frequent measure, ~n agreement ~w been established with Benscn i f~dges and Canadian Facts ~ieh wi~l allow Its access to an in- cidence measure for 11 m3nth of t~e year, The fi~al methodological design of Project Surrey and Project Image may ca~se a change in this arranga~nt however, and the issue of how best to measure incidence in the cigarette market in terms of accJracj and cost will be closely examined, t:) Project librarl Ihe development of a research library was s~ething t~t was to be completed in F'g2, However, ch~e to t~ Im- planned for complexity and size of the project, we do not expect this to be completed ~Pltil s~metime in F'83, As a review, the library is to provide a continuity of information that was previously lacking in ~search, Almost all research projects will involve, in their early stages, a review of past research into the area in question, A research library will greatly facilitate this rjpe of research, BATCo document for legal Services : Health Canada 19 May 1999 inyierialTobacco limitedjlimit~e June S, 1982 """:' Dr, Martin Oldman British-American Tobacco Regents Park Road Southampton S09 1PE England Dear Martin; Ruth and I follaned your tour plan except that we Cut out the westenrmost swing in order to do less driving and mate walkling, So from lalvor:h Cove we spent a night at a pub at Peter Tavey near Tavistack, then vent directly to lynton for two nights, and then on to Bath, We thoroughly enjoyed every minute in every place, but our vote for the best of all is the area around Lynron, and we are most grateful to you for pointing us in that direction~ k'e lolea before we started we had not given ourselves enough time but perhaps it's all for the best, because the taste we had makes it certain we'll be back far more , Please don't fail to give us a call whenever you're in Montreal, We'll enjoy seeing you, With kind regards. Yours sincerely, :1 GROU~ P C B Ct~tPi~ I R, M, Glbb i aevd: 14JUNr#O i~ck: 1~R b~ .. O ~Ue: .~, .~.~..... .~...,......-... I tu u o vl ----- · BATCo document for legal Services : Health Canada 19 May 1999 Dldf rnAu1982 KB1 W~t~Me lb aR ImperialTobacco limitedjlimit~ ~Olu~ to April 20, 1982 Mrl Martin Oldman Group Research and Develonment Centre British American Tobacco Company f~td, Regent's Park Road Southa~nDtdn, ENGLAND so9 1PE Dear Martin: A few weeks have past since our adventure at the Viking Inc. i enjoyed very much the opportunity to see the work that Rob and yourself have been conducting in the last little while, I was particularly impressed with your knowledge and thoroughness in each area, As is the case in most of these get~togethers, we at- tempt to cover much in such a short period of time and never really get an opportunity to discuss in depth how it relates to the peeularities of the Canadian market and the research ITL is Conducting on that market. What: excited Bob Reichelt and myself was the relevance of the areas you have been delving into. Bob and I have repeatedly expressed how unfortunate it is that an ocean separates GR and OC and ITL. In an attempt to bridge that ocean, as promised, I am sending the portion of Marketing Research's plans for F'83 which describes internal development work. IIopefully, BATCo document foil Legal Senices : Health Canada 19 May 1999 eage 2 April?O, 1982 Mr. Martin Oldman this will give you a better appreciation for the state of art at ITL and provide a basis for future discussion, 1 would like to again extend my gratitude and appreciz- tion to Rob and yourself for making your recent trek. Yours truly, W. H, Rose Manager Research Group WHR/rm Enclosure cc: R. Reichelt j~ Uniacice h, BATCo document for Legal Services : Health Canada 19 May 1999 ,YAL'.'OrrAWA HOSYI~AL ~PlfAI ROYAL D'OTTA~Y~ --- Irl V,J, Knott, llB CAA1ING, OTT~Wq ONTARIO K1~ 1K1TEL. 613C122Q21 ;pccialltg Clinics, november 271 19811 canadian Tobacco I~anufacturers Council, 1808 Sherbro6ke St, vest, I!antreall Quebec, fi]H li5~ Dear CT~I:C Icmbersl In Bovember of 19791 I proPosed that CTEC funl!in,: of ny research be extended for an additional five yeu period so that I could further my work on stress·reduetion aspects of tobacco snaking~ Attached is a copy of the brief proposal~ which I considered to be o: critical relevance to the motivational understanding of the smoking habit, Of the projects suggested, the lon~itudinal study ( which involved Year I, Year II and Year Y) was considered to be of greatest potential in elucidatinp, motivational mechanisms, Attached is a research proposal which provides, in addition to methodology, the theory, rationale, fr~ck'o:k and sir3lifie~ce of this study~ Specific details re~lrdinl details or the methodoioey have purposely been left out so as to allow the C~I:IC members a clear scope of the general procedures without distraction by a myriad of detail, If however, specific details of tests, re~ardine procedures etc, are required, this can be done on request, Attached also is a list of budget requests and their rationale, ~ly greatest concern and embarrassment here is with the amount of monies requested as it is the largest budget (~aZ,7B91DO) I have requested to date, The greatest need of course is technical assistance, I am in the laboratory from 9100 a,m,'· 5:00 plml and as such readingi summarizing and writing reports and papers is extremely difficult, An ajditio- nal member, at the technical level, would definitely relieve · the pressure, The rationale for the additional requests is attached so I will not elaborate here, The large reauest of , i course pertains only to Year I of the five year plan. The 2nd to 5tb year budget request~ will be greatly reduced as these will only involve the two salaries and approximate~y $1010001yearl ru 'a BATCo document for Legal Services : Health Canada 19 May 1999 I. -~-c~--·-- ~--·~L --*· -J-- ~ I I As observed in the additional proposalsl the purpose of the protocols in Year ITI ad Year IV a~el YearIIfl fo determine whether the phydological, behavioral and psychological symptoms experienced during tobacco abstinence are Indicative of a "return to an enduring ~· psyehophysioloeical makeup" or are indicative of a temporary "withdrawal syndrome", Y~ar~YI To determine whether tobacco smoking alleviates attentional deficits in psychia- tric patients exhibiting suchldisorders in the extreme leg, anxiety patients, schizo· phrenies etc,) The written proposals for each of these studie~ will be submitted prior to each specific deadline date, Thank you for your consideration of this research, · I~ Your support and interest in my work over the past four years is greatly appreciated, Yours Sincerely, Yerner J, Knott, D,Phil, ·rv· i., BATCo document for Legal Services : Health Canada 19 May 1999 ·~*·I · I~?~ ~ Rationale for Bu~et Requests~ Year i, Jan/82 - lec/8t, This budget is the largest (Sa5,7891oo) r have req~estcd to date and although I have tried to be very conservative in my needs and expenditures for this longitudinal study, the first phase (Year I) just necessitates more staff and equipment if a high quality product is desired in the fifth year, Salar~esl Principal Investiaatarl The salary request here is in line with the updated salaries of the ROHI For a Registered Psychologist in the province of Ontario, the beginning salary is $30,478,00 and the yearly increment is $r,~78,00, As I now have 4 years of experience, the salary level is $35,990,00, As CT~C kindly added additional monies to cover my benefits last year, I included this 10J with asrmnption of course that this is purely optional to C~)IC, Research Teehniciant Two full-time research technicians are required for assistance in this studyl One technician is needed in the laboratory in assisting psychophysiologica~ recordings and a second technician is required in assisting, initiating and maintaining sample records, and for coding, storing and analysing of data, As two full time salaries at a technical level is a heavy expense, I have decided to take on only one lull time technician for psychophysiological records and to spend less than half of the amount of the salary (to be used for a second technician) in hiring a part-time computer programmer to develop the software capacity of the micro- Processor in the laboratory so that it can take over the major work and time involved in coding, storing and analysing data, At the AGH, a full-time psycho-technieian starts at Q14,332.00 with yearly increments of 5730,00, Bs the technician I have in mind already has 9 months of relevant experience elsewhere and will be available for a full-time position in January, a salary of $151000 would be appropriate for this position, Salary for a computer irogrammcr on a part-time Contract is estimated to run at 7,000,00, It should be made clear here, that the salary for this ~art·time position would only be required for one year and it would then terminate, ~a~j~g~l At present my Beekman polygraph houses four amplifiers and this simply means f can anly record b measures, 1 To go into a longitudinal study of such potential with this restricted number of physiological measures would be a catastrophe I" · 10 · and it is proposed here that we at least double the number of amplifiers to eight, As geckman prices have greatly increased BATCo document for Legal Senices : Health Canada 19 May 1999 -- w~th Inflation etc, tile, to purchase b acid~ti~nal amplifiers and associated couplers from Deckman uould;cost approximately $10,000,00) I intend to purchase B separate stand-alone amplifiers or similar clualitY which are compatible with my microprocessor's A-D converter but are much less expensive than aeckman, the price of these isS6, ooo, oo, Xn order to carry out some of the sophisticated data acquisition and analysis of "attentional" and "co~itive" components of brain event related potentials, specific physiological tilters are required to get rid of unwanted electrical noise in order to examine the extremely small but si~ifrcant brain responses, The price of these b filters is S4,000,001 Up to this point I have been presenting auditory stimuli via an external tone generator which is triggered,by~the microproeessor~ This has faltered several times and has required repairs, probably because of its age, In addition, in order to elicit specific brain potentials~ high quality control over auditory stimulus characteristics leg, frequency, duration, Intervalsr rise and decay time etc,) and this necessitates a new sould generator which incorporates these facets. The price of this is $2,500,00, The inDedanee meter is required to ensure that electrode- skin resistance levels are at a sufficiently low level so as to obtain clean noise-free electrical responses, The price of this is $3001001 S_upplies: The polygraph paper, ink and electrodes (51,500·00) are of course self·explanata~y and the computer disks ($21000,00) are necessary for data storage, S~biect Payment~ The biggest strategic problem facin6 this investigation is getting the family (both the parent for the interview and the child for the recording) motivated to be involved in the study, From past experience and in relating to researchers who have done research within the school system, Rone;lq paynen: definitely enhwces this prsbibility, It t ~ ·is proposed here that a miniaum of 510,00,00 be paid to each p,l: as both parent and child will devote two hours of his or her time. Total cost is $6,000,00, niscellaneaou~: Published questionnaires on personality and psy~Ii~lcal tests must be purchased and the cost is estimated to be $11000100, Rail is an essential process if contact is to re maintained with the sample pool and the cost here is estimated at $100"00, Piling cablnets.are needed for physical O -- BATCo document for Legal Services : Health Canada 19 May 1999 · c · ·-,e --·--I~------ --· -- ------- · Itorya ol the gulstlomdt~~l plnrPpb paper etc, ($600,00)1 A ealeulater It needed for Piner dlsetiptice tests and aJsistanCe within the lab (Eoat~is $200,00), B fP~~I and Is stated in the epvcrink letlr, I r eat that th~s 11 a 18r6e flnenclal request but I trust that CT5lC ~i~l ~scp h rind that this bolds aall for the demands or the first year ol the 5 year grant, The flnanefal edlittncnt Ior the 2nd to the 5th Years will be siPlla in nature to xh~ was bainl repuested B my Ilaf4 years, Ib this ease 2 salariesl the Principal ~tbtiblt0r and tl~feir) and arolls~thJ 5r0,000,0d extra ior laboratory denands , O m i . ~. BA~Co document for legal Services : Health Canada 19 May 1999 ·· · ·:·' ~' :il' :'~·,·: ·· : .~-I-~- ·. ·. ·----·1--.-·-·`-- -~·-- -- lo~al...e rluI Jjibl:O~dlEB1 i Salariest Dr, V, Knott $35,9901oo (plus 10S for benefit coverage) 3,5F9.oo Research Technician $15,000,00 Software Development 2;000,00 Fsuipmentl Physiol6gical Paplifiere 6, ooo, to Physiologrcal Filters 4,000,00 Stimulators ~2,500.00 Impedance i~~ter 300100 SupEliesl Polygraph paper, ink, electrodes 1,500.00 Coraputer Disks 2,000,00 Su~ect P~ynentl Ten dollarsl subject and Ten dollars/ parent interview 6,000,00 Niseellaneousl Questionnaires 11600~00 Mail 100,00 Piling Cabinets 600,00 Calculator 200,00 Total $85,p891oo d TV 'O BATCo document for Legal Services : Health Canada 19 May 1999 ; ~ · ~ullji, -.L".-"~'~- -·-I~- IOIAL OTI~WA I1()SF~~L HOPIUI ~QrAL D'O~A~ · ""~" -~-- Dr, Y,JI G~~tt, · I Ns CARUNG, OTTAWb ONIA~O ~I /KI tEL ~f 3~6~1 S~eialitJ elinle3 ~ovcnbct 11, 19t9~ ~h~~eci~niirir lil~ratiirc·h~s eon~istently rais~d a 1 -Lin: in rclcrenec to fal'torr; ihich both relate nuabar of qLe to the ncqul:lli6? n~, ~3lntenalec of:Po~in~ bchavior~ It 1R ~ brronr bc\irr ba~c~ on ly o~ laboratory lindin~o nd studici of ~iro~?si, ~riti!h s~~ laaricp~ labaratoric;, that the Ptthnls~r Iln~~rlyin~ Pe~3i3ition-aai~thnree processes pre in part SnP~~ on the jnhcrent or intrinsic p~yeho- phyeiolo~ical ~a~ca~ or the indiridua~ rao~cr~ E~rc' pnceiTieally, it jb 5it~~l rcaron to speculate that ~Pokers, prier to a !~?sein· ~i~t3PY, exhibit a Ptychsp~y~iolopic~~ profile ~hic~, rolstite to future non-a704rr3, ie charjet- crist~ ~p a rrc~t~r vul~cr3bllity to otrr:t A: rc9lectad ~I CPlltrlL, ~~~~9~1ie ~II skolctnl-nusculRr :yste~s rid a dnrlclc~t Sc~i:io~al r~t~onsivlty is rcllcctp4 in attentional ~l~Or~itj 7R-"'5]m~:i~r n;d (eeikian ~a~inr lunetio~s~ :ith t~~ 'B~1' inherently c=ts~~i~hc(, tht cnora~rg b!tr~rlil~ or !Il!a~r~ Ijp~ in itF Dbili~~ to Hnor9~1i~?~ PagChl~~r~iol~l iCnl rc~non:ivity mHI th~r allow for Pore *Pfiei?it b~~~:jlr~l pnrlor~~~ea iid incrcasen su~jecflv! tell·haidq, ''Ith r·-r'·l ts ~lryS arcupptiin:, It ir su~hseted that the fall?~!ne ~:~othe:c~ Sc exapinedi II Intri~~ir r·yd~,pbyri,~o~lenl raetori aparatr in Fo~a i~~iri~url· t~ n~h~isnoec tha3 to thb denui:ltii~ of a s~~~in~ ~~~li~ ~ ~~;t~~y or te~t~ - Feychayhy~iolo~icR1 , p~yr~~l~·ir?l, ~i·h~viornl ni~l P~cinl·sult~r~l uoul~ b~ !;J y~:c~~ chil~ren (S·9 yrs, of thCY ro~l ~ h* rglln~ol UP OYCF a I'F YCRr PCri~~ for th? 81*11~;' ~r ~·lls~linr ~le inci~c~c~ or ~~ohcrr ~~ no~-·m~~l·- ~i~ ~!n~~~in~ the rcl~tinii~hip of thc~e tc~t I~llf~~i~. ~~ L~li~ Pnl~in~~ : non-::~~C~1~ Itstuc~ ft noulll pr 41POCC"~ Sb~l ~~O~CrX ~lrl non-:rl?~crn Foul~ be luite ~i"Trrinl ril~ rr~·~Ct to tbcir initinl trst re~slt~, d~~itto~nl 'Ill~c-ii~~ (5Y~9~5, ]0, fSI 20 III)COU1~ ~e i?itilt·" ~1 Ur~ sl~a rroup to detst~ine the ]on~-ts~ :~?2or s·ri I.ai'?n~"r Statu; of thin D3~C;roup =arplc, i" BATCo document for Legal Services : Health Canada 19 May 1999 I - ' ~ --~ ·L L'--~-· ·e --- ----~ ~ ---"· ~ · - -- · It g()UI OT~IYA Ir()SrtM1 I1QPIML 90r~l I)'Of m~ II I 11:5 CARLIMG, OT~W. OHTARIO KIZ IK1 ~EL Ll~nl·~21 2, dlthcl·h :In~inr nbPtincncl is corrcl~tc4 rith tPapor8~ ~~yr~3!11 i,~ll ~~i~t6~3, 3~ is th~ ~i~eontb~~atii~ of ~lll~rln~ 'ti~it', t~~ yhy~lo~orical altcr~tionn occur·in~~ nt th4 ti~r of nbF~inbneC are not trPnsitory IhnPranli~i?: rcl~tea to a" :ao~in~-rithdr~:21* phcnoPeno ~hich retlin\ t6"ndr~al' Iltdr an clnn~ed tiae period, It Is ~v~~l~~~l her: thst the ~hyPioio~icnl ~ltarations are rell"ctiic of 3 return to an en~ii:in~ pslehophysioloqicar xi2c~~ rhicb is chpracteristie of :~14srs, thp~l ~~o4.r: Irir tobscro-sbntinence clinit3 will be ~?nit7r9~1 ~.'Jrr ~~rl for 1 yrar sftcr (ja 1 a3nt4 intervals) Tl~\inT co·::i~isii ~ith re~arl~ to a bnttcrg of tests in~lll~in* pr~cSa~$;siol3ric31, p~ycholo4ie~l s~d ~ahpviorst n3r~~t~rs, It r~P1A be sxpeeted rnat phy~ia- Ilcica~ r~Snr~e P1'11~ not ehnc~ over ti~e mrl that =~a~cr~, r·lntite t~ nan-~~a~crs wsule ccntiaue to exhibit rulnir~~i!i~! to ·t·rs! tsl inerrici~nt pcrlar~pice evP~ ~Ttcf 1 :·~~. ~i?r~rt of ~~cte fin~inr~ C3U1~ ~i:li~: the rl~r~jri~lli711 Or tOh3CCO as a "dc~cn~enc~" ~i~ordcr as -~~~irl~~ is cr~ctnl to the ~~~inition of Iru* ~sp~~·~~I~"l 1, ~r ~oSacei "~~~~ir I11CV13fC~ Otf?:: Cr (8) fP~ilc!nr thC i~n?C~ oP 7*"rlitP r~i;ulatl~n an~ If (5) inerpa~i~r in ;~ r~~ t i ~'I· r':! ~" "" i ~ ~ an n ~ t ten t i on II- r i It? rin ~ c~ ns c i t~ , ··a·~-1:l~l~ to hvnolhe~lz~ th~t it Fo~l~ ~a~e ~~riniz~ Ii!i~i·?l Iitilit~ T~r ~~ycbiJtric patients ~~o ~~h!~it .~I~C :i·)r~rrs i~ r~e cttrc~c, Thir receiver; i~lin~Ct ~7:ll~)rt ffOR thC F~Ct tbnt nsychlntric nnti:nt~ Irii~it n rnr4·~lr hi5or ean~u~gtim rate than Inc n~r*nl ~,niln~ioi~ Ind they ?xhJbit aar~cd Il~tre=s ~hen ~u~~lies nr~ 13e, "c~~~ll ~·gcholl~ic~l ~~ ~~havior~l (i,,, ~lli'i~ ~1~~~~~CC pnticn~n) ~i'~lp~ ,'II n'' ~~ I~l~cCS ~nJ~i~~. :St"~~t~ ~ill nl~o he ·?~~ ta ~:· synp~,~~ n~n CKnf~rT~tpl 1,'1 1 l~v: of 4b3tinC7Cr ~~ K~ether they ar? ~?r~:li~· ' ?r?`r siyarrtte ~ao4inr O '· BATCo document for legal Services : Health Canada 19 May 1999 ROYAL 0774W11 I1OSAln~ IIOPIML ROYnL I)'~IIIA\YA _ ~__~_ IlnS CnllllNC, D~TAWA, bnfnlll0 K1Z IK1 TEL. 613112246521 Th~ call'il!~'l ~~cnal~o)~ ;If:lll)~;ll= COllln bl! e3rriod out over R initi:11 Ir;t 2 Ilcara ~oul~! bC raeur,ed an Fropl4~1:\6~ II ilr,, F?llnltins a Inrlle rn~ple of cbil2r"n,uld ~eS!lil.in~ nrPril~r; for fublfe rn:ercnee in the Sth ~C3fl ':hC tbi!'l anrl I~!~rth years ~o~l~d be foeu~cd on the 2nd ,2nd jyrl rrl)t,lSr)t~ tone ycnr for c3ch1 nr~~l the 5th year co~lll 4? ~e~lie:ll·ll to follo~inrt~p the cpPplr: of ehil~ren for the final c~ll~ctlPn of ~3tnl ~r tll?r~ r.:"n:~h ~rotlcol~ am ace~pted for sipy~~rt it i:: ultjcinnt~~' iP initiaten fallo~inr Phase IlI of:~ ~·c~cnt r~~:··~·r,L~ ~rajeC~ On *TJhnCCO I]PdIICt~311* rit!l rlll~~nrch bod~Pt p~~ Iln~u~n shoulrl ey?n!innte t!ii! I~rln!l:l~ r;ltr) ::ith ainor aleerst;i~ns to l'a'' C3r:tr~ r~lncr~l Of LI~SnCCI) S'BOI: in~l !·;I" L.'.: I·l·iCi(?l ,r 1Stil:StiS!L3I rain: behind I i:''~'':rll tittl? Fl!l~e~nir: plneen an th·"~rl~! Ind :·i t· · ·'~'" I~f ci ar·i~o rill rcoiilt i~i a :nr" Ii~rid I~nlinr:;t~rirlinn of nttraction of thF :Q~~6eO :':"''C;'1'' ntll,il, BA~Co document for Legal Services : Health Canada 19 May 1999 _I--~ ~~ ,,-.,- -.--.,-ecl-rj. - · -·-·I-----~-- ----·L-~ IDWlnIIC PSYC~PAYS~O~OGI~L P~M~~ bP ~~CCO~1 I1 ~an~~: a ~W-YWB P~SPP~~ ~GI~UU~IU S~~ Lsea~ P~ossl Dr, ~~cr J. ~nott byal Ottva ~seital S~mittad to CPadiP mbaffo endaetoaa Ccaell, ~o~19el, o -- BATCo document ~r logd Ipntc~ : He~th Clnldl 19 Yly Ilss .... ~~.1-I.~ I-- ·"~. COHTENTI I, Introduction 1,1 Statistics 1,2 Psycbcsocial Factors I,J Individual Differences II, State of the organism ITr, gtiology of Tobacco Smoking Genetics III,2, aorphol6gy 111,3, Personality Neurophysiology Prenatal Hechanisms IF, Empirical Integration leed for a tongltudinal study V, Tobacco and stress Reduction: An operational Framework V,1, Affect V,1, Performance V.3, Psychophygial~ leumghsyioldgy PI, summary, Rationale and objective of Study significance of the study VIII Methodolaqy PZII,1,Subjects 9II~,2,6cneral Design and Procedures PIII,3 ,Prymopbpsiolagical Test battery nrI,~,statis~ cal Analyses Bibliography BATCo document for Legal Services : Health Canada 19 May 1999 IOENTIfYING PSYCHOPHYSIOLOGICXL; PREDICTORS OF TOBACCO USE IN QllfiDREN:' A FI~E-YEAR PROSPECTIVE' fX]NCITUaINAL STUDY Verner J, Knott, D, Phil~ r- INTRODUCTION i, Statistics The recent report of smoking habits of Canadian school children by the Department of National Health and welfare" (1980) has shown that students start experimenting with cigarettes at an early age, The major conclusions regarding Prevalence of the habit were as follows: · By age 12, one half of Canadian school children have at lees t tried smokingt · Besular smoking is established in the early teens by many e~L~ Canad~an students; I School aged boys experinrot with cigarettes earlier than girls, but girls beg~n regular smoking earlier t~an boys, From the early teens, a higher proportion of girls than boys srake dailyr ~ By age 14, LT$ of boys and 23% of girls are daily smokers and by age 17 these figures have increased to 27% of boys and 308 of girls, Na significant change occurs in the proportion of students who report daily smoking beyond this age, These figures are remarkably similar to the studies reviewed by Russell (1971) in which it was found that of those children who smoked more than one or two casual cigarettes before the age of 19, 908 went on to become regular smokers as adults, It is only the teenager who never attempts, or who has attempted no more than once and decided that he dislikes it and will not take it up, who has much chance of being a non·sroking adult, the matter is largely settled by the age of 19; if a person still is a non-smoker at this age he is unlikely to take it up, 'U~Z: see BKwn, Oer~ and ~a~s [r980) far reference to a~a~ data ch . CC) · BATCo document for Legal Services : Health Canada 19 May 1999 i, Psychosocial Factors But to establish t~e prevalence of cigarette s~king in children and adolescents does not explain how it is contracted, There is a general consensus that the motivating factors mediating the onset of the smoking habit are distinct from those factors maintaining the habit, This has been discussed by Russell t1971) and the argument will not be repeated here other than to say that after initiation to smoking has been mediated by various psychosocial motives, the pharmacological effects of nicotine take over as prime rein:orcers, There is strong evidence that starting to smoke is related to social factors, particularly the influence of parents, siblings and peers (Mausncr and Platt, 1911), The effect of the behavior of parents, peers and siblings on childhood smoking is pres;lmably mediated partly through increased exposure to cigarettes, partly through imitation and example and partly through psychological and social pressures to smoke, Evidence for social factors ;uch as parent's attitude and health education is to a great extent derived from cross-sectional correlational studies which give little insight into how these influences Jet: on the sehcollgaing child, Evens, Hendcrson, Hill and Raines' (1979) review of the psychological factors reveals that smoking in children is related to lower levels of perceived land real) aeade~e achievement, to rebelliousness, anti~duth~rity behavior, lan self·esteern and that children who begin to smoke at an earlier age show a higher rate of sensatidn- seeking behaviors than nan-smoking peers, 3, Individual Differences Although it is generally stated that social and psychological factors are responsible for the initiation of smoking, it is clear that no sharp line divides the biological from the psychological and sociological, The kinds of inner emotions that people experience in relation to environmental conditions and events is at the same time an expression of both psychological and biological factors, These 'em3tions and the environnu3ntal situations that are perceived as rewarding or aversive will determine, at least in part, a wide variety of behaviors including one's response to cigarette smoke (Jaffe and Jarvik, 1918), Individual differences in persanality- and particularly in orientation twards the kind of psychological rewards offered by smoking are considered to be of paramount importance O · BATCo document for Legal Services : Health Canada 19 May 1999 in determining both smoker/non-smoker status and type of· smoking behavior, This is illustrated with respect to early experimentation with cigarettes, The reasons most people give for their first experiments with smoking are curiosity, conformity, bravado or to appear grown-up (Horn, Courts, Taylor and Solomon, 1959), The first cigarette is almost invariably unpleasant, HeaEly evc.yone has experienced the shock of the first inhalation, often accompanied by gagging and nauseousness - a physiologieal response which presumably has a pharmacological basis, On the other hand, nearly everyone who has continued smoking more cigarettes can recall the pleasantness of the light·headedness which followed inhalation, a sensory experience that could be made to recur following a brief time lapse between cigarettes, Tolerance is said to develop to the unpleasant side-effects and skill is quickly acquired to limit the intake of smoke to a comfortable level, thus lowering the threshold for further attempts, Herein lies a possible cause of the virtual inevitability of escalation after only a few cigarettes (Russell, 1971), With curiosity satisfied by the first cigarette, the act is likely to be repeated only if the physical discomfort is outweighed by the rewards of smoking, If these motives are sufficient to cause smelting to be repeated in the face of unpleasant side·effeets, there is little chance that smoking vill not continue as these side effects rapidly disappear, What then is the nature of these rewards and what are their basisl There is a growing consensus that organismic-disposi tional factors contribute to the development of the smoking habit but as to what extent such organismic factors can be attributed to genetic biological influences as opposed to acquired influences is as yet unclear (Battig, 19BO), The emphasis on organismic trait and state factors in influencing smoking behavior has been expressed in varying degrees by a number of reseachers, In attempting to extract meaning from their highly variable data on ,students, McArthur, Waldron and nickinson (1958) hypothesized ",llthat starting to smoke i:; largely broug]lt about by one's social environment but that reactions to smoking ,,, seem to depend in good part on the personal needs that the newly established habit is able to gratify [p. 272), Seltzer (1962) paraphrased these observations in biogcnetic terms: "Rather than a superficial habit overlaid iodiscriminatel ly u~n various persons, smoking appears to be a response O to a wide variety of personality and behavioral eha:actexisties N which: have their origin, in part, in the biologic and geneticO BATCo document for Legal Services : Health Canada 19 May 1999 .-.--.--.-- . :: :. ...... ·... ~Mke·up of the individual (p. 13).' Dilnn ;(1913) nade similar references to organismic variables with specific references to early experimentation with cigarettes: W,,,it is likely that we shall ultimately find that the critical mechanisms involved'in smoking require the synergistic presence of some ether factor, such as anxiety or possibly some constitutionally determined reactivity, The absentation that only about half of those w~t~y smoking cigarettes go on to take up the habit certainly suggests some kind of interaction process, Smoking apparently is not sufficiently pleasurable among the disinterested half of the trlers far the aversiveness of slK,king to be overridden, Smoke is smoke ~ whether its inhalation is pleasurable is dependent upon what the individual brings to the situation ,,, Whether or not the total experience is judged by'the smoker as positive or negative might in time prove to be associated with biochcmical, endocririalogical, or neurophysiological variables which are either constitutionally fixed or shaped by experience prior to initial experimentation with tobacco smoke (p, 101-102), ZT- STATE OF THE ORGANISE·] The average pack-a-day smoker takes 8-10 puffs per cigarette and absorbs approximately 50-150 ug of nicotine per puff, Each dose of nicotine reaches the brain within 1 seconds and exerts widespread and varied central and peripheral nervous system effects (both stimulation and depression, all of which are potential reinfarcers), via its capacity to affect the actions of and release of important neuroehernical transmitters (Russell, 1916), for t~e average smoker the behavior is reinforced approximately 50-70 thousand times a year and this consumption level would tend to suggest that organismic factors of a markedly compelling nature are oPerative in the inception and persistence of smoking behavior. While environmental cues and contingency factors play a crucial role in tobacco usage, a comprehensive analysis of smoking also must take into consideration the effects of tobacco in relation to organismic variables, The mode of interaction between a pharmacological agent and ongoing organismic state is of critical importance thcrapcutic- ally but its study has also proved valuable in furthering an understanding of target physiological systems by the known actions of such psychoactive drugs (~win, 1968), A similar approach can be taken in tobacco research, namely to determine tobacco's effects on the organism, taking into consideration ongoing states, so as to elucidate possible mechanisms and O sought for effects by the individual, Nicotine, as a chemical,. does not affect behavior directly but rather interacts with 0~ other chedcals at a cellular level to produce changes in C3 BATCo document for legal Services : Health Canada 19 May 1999 tissue, organ and systemic functioning, The resulting alteration in physiological state then determines the limits and manner by which the individual copes and interacts with his environment, Thus the mode of action of nicotine at the bioc~ernic'al and physiological, levels may provide useful information of its possible dissimilar effects in smokers and non-smokers that may result in differential behavioral patterns of Consumption, The issue is raised as to whether smokers are unique in their reasons for selection of and response to tobacco and hence consume this substance in an effort at modifying or manipulating a target system (cr systems), Their consumption therefore would have ultimately behavioral consequences that alter and possibly increase coping capabilities (~ills, 1978), Such an interpretation of tobacco usage has an obvious t~leological fld~or~insofar as it presupposes that smoking serves at least a potentially adaptive purpose, As will be elaborated upon more fully later, there is some indication that: this may indeed be the case for some smokers, However, before proceeding further, a conceptual framework is proposed so as to allow the zeadcr to establish a context ct perspective for the position to be outlined. If, as pointed out earlier, the organismic state is an important determinant of tobacco consumption, then it remains to be elucidated as to what target physiologicsl system or systems the person seeks to modify and toward what altered state the individual. is striving, Imin (!9681 surr~larised s~me cf the more salient 'I organ ismic eondi tions from psy chopharlnacological s tudies, All of the factors - including wakefulness, arousal, activity, endurance, biosocial drives, set, responsiveness to stimuli, information processing and autonomic, neurophsyidlogiedl and endocrine functioning have been investigated in tobacco research and have been suggested as reasons for consumption at one time or another (Ouon, 1973), A person who voluntarily takes a drug often does so with the intention of altering one or more of the organismic ~variables mentioned above,rke paint to be made here is that the motivation for and effect sought can vary between indiviLI;lar5 and sene diverse functions in a given person in different situations, This fact is of paramount importance in the study of smoking motivation, First, it emphasizes multiple causality ~cL in the onset of the habit and illustrates how consideration 0. al organismic states precludes unidin~nsianal etioloqical i BATCo document for Legal Services : Health Canada 19 May 1999 meehan~msms as explanations for all smokers, A second paint is that in addition to motivational needs and sought for' altered organismic stales that tobacco can induce, another factor for tobacco use may be intrinsic physiological disturbance that is rectified by tobacco, Thus a pre-smoker person vh~ is defective in one aspect of physiological functioning may seek tobacco with essentially medical intent, much as a person with adrenocortical insufficiency craves salt (Wilkens and Riebter, 1940), Thus, the study of tobacco consumption must incorporate into a comprehensive explanatory system in understanding of the state of the organism uhieh under appropriate environmental circusmtances (cues and contingencies) leads to experimentation and repeated use of tobacco by an individual for its perceived and/or real effects in modifying coping capacity through its mediating action on target physiologieal systems, IIfl ETIO~OCI OF TOBACCO SMOKING From the preceeding discussion it is apparent that the motivation for using pharmacological substance can vary betueen individuals, and that a given chemical may also possess unique effects for certain individuals, whose organismic state dispositionally distinguishes them from others, Among the results obtained in animal research in the last few years there has been numerous indications that psychogcnetic inheritance can influence the mode of action of pharmacological substances affecting the central neuropsychological systems and of substances having other kinds of effects as well (8roadhurst, 1977), Although Battig (19801 has cited animal evidence indicating response variability to nicotine as a function of psychagenetic strains, the extent such a disposition in man can be observed and attributed to genetic biological factors is open to question, 0~ the limit-less number of organismic variables that can lead to physiological and behavioral disruption and thus possible use of tobacco, the concept of disturbed arousal has probably received the most attention (Thornton, 19fB; Remand and Izard, 1479), Disturbances in arousal mechanisms have been implicated in a variety of 'psyehDpathalogical conditions such as hyperactivity ~Has:inqs and Barkley, 1918), anxiety and depression (badc~, 1915), sociopathy (Oua~, 19fi5) and schizophrenia (Venahles, 1977), Arousal disturbance has been theorized to be an eriological factor in children who as adults are at risk for these disorders, The question is raised as to whether tobacco may also have mamusal syndrome as an etiological substrate. The tentative hypothesis advanced is that within a population of children O there exists a subgroup whose symptoms of arousal disturbances N is premPrbidly extant. Such persons will exhibit higher probabi- o\ lity of acquiri~ng the tobacco habit on the basis that C3 initial experimentation with cigar~ttes vill result in BATCo document for Legal Services : Health Canada 19 May 1999 alterations of organismic states which ~i~3, be perceived. subjectively and behaviorally as reinforcing, The evidence implicating a premorbid difference in smokers and o6nesmokers is briefly reviewed below, i, Genetids Many studies that have implicated biological factors in the initiation of smoking behavior attribute the behavior to a genetic predisposition, Studies of twins are among the most popular means of assessing genetic factors, Initial twin studies by Fisher (1958) showed that monozygotie twins were more concordant in their smoking behavior than dizygotic twins, data by Shields (1962) on monozygotic twins reared apart indicated frequency of concordance in smoking status which was significantly different from chance expectancy, Subsequent studies however have both supported and denied a significant genetic influence on smoking behavior (Jarvik, 1979) and an example of negative results is shown in a study by Cederlaf, Friberg and Lundman (1977) in which the results of their monozygotic twin series speak strongly against the constitutional hypothesis, The presence of a substantial nunS~er of discordant twins in these studies indicates that genetic factors do not operate exclusively to determine smoking tendencies, Rs an example, an estimate of the amount of variance with regard to smoking in Shields' (1962) sample which can be accounted for by genetic factors is somewhat less than 33%, It seems reasonable to conclude that genetic factors operate significantly, but by no means exclusively, in the tendency to smoke; and they may do so in a wide variety of modes, including personality characteristics, and.social and psychological needs and values, rather than simply by producing an inborn craving or need which nicotine satisfies (Kety, 1973), This line of thought parallels Eysenck's(l9dO) conclusions on his most recent twin studies: "Our data do make us question the simple-minded exploitation of the twin design and its conventional genetic interpretation in relation to smoking, In particular, although we agree that dizygotic twins are less alike than monotygotics in aspects of the smoking habit, we are not so sure that the similarity of twins for onset and consumption of tobacco is purely genetic,,, 1111 in all, therefore, the picture emerges from the whole body of data that the onset of smoking and the consumption of cigarettes are governed by hath genetical and environmental factors (pl 281, 313),n, ·, Ci~ BATCo document for Legal Services : Health Canada 19 May 1939 2. b~bolod Mthoqh the above studies suggest the existence of qelltie mechanisms in the development of tobacco smoking, they give no clue as to what they might be, They only indicate that the smoker differs in some significant aspect from his non- smolting ecers, Early narphological work by Seltzer (1963). suggests that smokers differ fro noa·snoters on a variety of anthropometric measurements (c,g, height, weight, head circumference, etc,), On every single measure examined, smokers were found to exhibit larger mean, dimensions than the noPlsPkars, As the measures involved a strong genetic component, Scltter concluded that smoking behavior lay have a constitutional basis, Although thiJ data suffer from the fact that they may have been affected in turn by the smoking habits of the subjects investigated, this is not true of such studies as Thomas and Cohen (1960) on ability to taste phenylthiourea (PIC), a trait which has been dcaastratsd to have a genetic baoia; they found that heavy cigarette smokers shaved a significantly higher porportion of tasters than did ncne smokers, Although the functional significance of these findings is qpestionable, this is not the case with Seltzer's (1967) ~st recent longitudinal uor~~ Here, future smokers, compared to future oon-smXers, were found to have smaller tidal air values, an increased freguency of sighs and srallows, greater respiratory rate, a somewhat higher rec~~ant pulse rate, more palpitations, more sinus arrhythmia, more constipation, more loss of appetite, and a greater frequency of urination, The future non-smokers, on the other had, exhibited a consistent lack of physioloqicdl reaction to stress, suggesting that smokers are pore proae to patterns of reducin9 anxiety which involve phyoiotaqical change, This is in good agreement with the alleged tensionlredaelng properties of smoking (6ilbert, 1979)~ 3, Dcrsaoality The possible existence of a constitutional difference between smokers and non·slo&rs suggest a relationship between personality and smoking, Of the numerous measures available, the majority of research iP the alo~fag area (Eyscnck, 1980) has focused on three major dimensions: extravers ion-introvets ion (E) 1 oePratieiJ1-9 tabilf ty (g ) ; and psychotici st (P) . Each ma jor dimnsioa is a combination of intercorrelations between traits, Thus individuals with high scoffs E show traits such as sociability, i~pulsirtncss, carefIeeness, activity, etc, giqh P individuals exhibit such traits as worry, tenseness, anxiety, latidaalitt, etc,, ana hiC I individudls exhibit BATCo document for legal Services : Health Canada 19 May 1999 such traits as emotional coldness, hostility, egocentricity, lack of superego control, etc, There is good evidence for the genetic determination of these major personality variables and the behavioral manifestations of these personality traits would seem to be mediated through various anatomical and physialogical features oE the organism (Eyseck, 1967), In arousal terminology, extrJverts seem to be charactcriscd by low testing levels of cortical arousal, whereas introverts have relatively high resting levels of cortical arousal; these levels are presumably mediated by the ascending nticular formation, Relative to extraverts who are hypothesized as exhibiting strong inhibitory tendencies, low cortieal arousal and hypo-sensitive responsivity to stimuli, introverts are hypothesized to exhibit weak inhibitory and strong excitatory tendencies resulting in relatively high corticar arousal and hyper-sensitivity to stimuli. Differences in emotionality, characteristic of #, are governed by the visceral brain, a limbic system, coordinating the activity of the sympathetic and pdrasympathetic autonomic systems, Physiologically, high neurotic/anxiety subjects tend to respond more strongly to stimuli, show greater variability in response, and take a longer time to recover after the response, As far as psyeh6ticisn is concerned, the evidence suggests some degree of hormonal control, related to sex hormones in general, Physiologicslly, individuals with high P scores and individuals exhibiting psychopathic behavior tend to exhibit low tonic resting levels of arousal and concomitant hyper·reactivitp to stimuli and stress situations, Although inconsistencies are apparent, reviews of the smoking literature are in general in agreement that smokers exhibit higher scores on I;, N and P dimensions (Mataratto and Saslow, 1960; Eysenck, 1973; 19801 Kozlowski, 1979), and on average there seems to be a positive correlation between these dimensions and the degree of smoking within the smoking population, As with other studies and other variables however, whenever differences are reported between smokers and nonesmakers, it is usually impossible to determine whether the differences reflect ronsequences of smoking or possibly have a causal relationship to smoking behavior, This objection applies to a lesser extent to studies on child smokers and to studies where personality assessments were obtained prior to smoking onset. PoweU, Stevart and Grylls (1979] examined E, P, and N dimensions on a sample of 808 middle·class children between 7 and 16 years of age. More than half of the boys and girls BATCo document for legal Senrices : Health Canada 19 May 1999 ·10- had tried smoking cigarettes by the age of 15 years, Of the children who tried, they were found to be;particularly extreme on the P, N and Lie dimensions and high on the E dimension, The authors concluded thatthis pattern is identical to that of children k'ho misbehave and do not conform in a general sense, Similar studies indicating that rebelliousness and antisocial traits were correlated with smoking in children and persisted into adult smoking (Jamison, 1978; Steward and Livsonl 1966), Cherry and Kiernan's (1978) longitudinal study is of particular interest in that their data pertains to personality dimension pre-dating the smoking habit for those who took up smoking after 16 years of age. it is clear from their data, that those who become smokers are both more neurotic and more ertraverted than those who do not, and that the two personality dimensions.are independent and additive in their effect on the likelihood of becoming a regular smoker, ii. Neuroiohysioloqy Although admittedly the scalp recorded eleetroeneephalogram (EEC) and the event related potentials (ERPs) observed in the EEG ate gross measures of brain activity, they provide the best and most direct measure currently available for assessing the functional state of the central nervous system, The heritability of the EEG and ERPs has been firmly established, Trin studies have indicated that there is a significant genetic determination of EEC (Lykken, 1975) and of ERPs (Dustman and Beek, 1965), From these studies, it appears that approximately half of the variance of the EEC and ERP is genetically determined, In relation to the preceeding discussion on personality and its biological basis, there is evidence indicating that variations along the various behavioral dimensions such as extraversion-introversicn (E) may be reflected in neurcphyl siology, Gale, Goles and Blsydon 11969) have reviewed the literature on the EEG and have added their own important ~studies; they conclude that the evidence from the EEC is fairly convincing, Introverts tend to have higher alpha frequencies and lower amplitudes (i,e, higher arousal levels),. extraverts lower alpha frequencies and higher amplitudes lower arousal levels), Studies of ERPs have shown shorter latencies and greater amplitudes greater O · i~V BATCo document for Legal Services : Health Canada 19 May 1999 ·111 arouabilfty) for introverts, longer latencies and lesser a~aplitudes (i,e, lesser arousability) far'extraverts (Stelmak, hchorn and Elichaud, 1977), The ability to monitor braitl activity makes it possible for researchers to examine the relationship between subjective states, behavioral changes, individual differences, psychotropie drugs and the ereetr6physiology of the central nervous system, Tn the field cf tobacco smoking, interest has focussed primarily on investigations on the acute effects of tobacco an EEG and ERes (Thornton, 1978; R~mond and Itard, 1979), 13elatively few studies have examined the question of whether smokers exhibit quantitatively distinct EEG and Ei~P ehardctel ristics from non-smdke:s, If specific EEG and FRP activity are characteristic of the Smoker, those may point to a possible predisposing neural mechanism underlying smoking motivation, As is true in most research areas hovevc~r, what appears to be an easily answered question ~ do smokers show distinguishing EEC and ERP characteristics I turn out to be difficult to investigate, This question can break down into a series of questions requiring investigation, same of which present difficult athod~logical problems which make clear-cut answers hard to obtain, For example, with respect to EEG, one could make the general question more complex by asking whether the differences observed are (a) widespread or predominantly loealised in specific brain areas; (h~ stable during bath resting and activated (eg~ rjsk oriented) conditions and (c) related to the degree of smoking light, moderate. and heavy smoking) and length of abstinence! It is not within the scope of this section to consider all the studies that have been carried out in this area, For our purposes it is best to avoid the many controversies attendant upon this area and we shall simply and briefly present two studies on EEG alpha activity and two studies on visual E~s which reflect the inconsistency of the results to date, Brown (1968, 19'12) found that all active smokers and former heavy smokers exhibited significantly higher resting alpha frequencies than non~sn~okcrs and former average smoker groups, IThe abundance of alpha activity present in tl~e EEG was similar for all groups except that for very hea~y smokers who exhibited significantly hall the amount of alpha per unit of time, Xs with Brown's findings an alpha abundance, Knott and Venables ' (1977) observed no significant differences between smokers and non-smokers, but in contrast to their data on alpha frequency, these researchers found that non-smokers, in contrast to Brown's smokers, exhibited the higher resting dominant alpha frequency, Uith respect to ERPs to visual stimuli, I O brown (1968) observed that smokers exhibited slower latencies ;V and aaller amplitudes than n6nlsm~kers, Knott and Venables BATCo document for Legal Services : Health Canada 19 May 1999 1121~ (1979) however observed contradictory results in that smokers sbrd faster lataneics and larger amplitndes to visual stilpli compared to non-smoke a, Is with the previous studies on personality differences in ~~~en ad aon-sPters, these EEG and E~ findings are based on a single testing of au~jects with a long history of tobacco smoking and the temporal or causal relation between alectroccttical findings and smoker vs, non·smokcr differences is unclear, Two rival interpretations may be suggested: (1) the elactroeortlcal patterns precede tobacco snking and may be related to possible neurophysiolgoical and psychological states which predispose individuals to smoking; or (2) the electrocortical patterns are 1 neurophsyiologycal consequence of prolonged smoking, Again, as with the proceeding personality studies it is clear that (longitadinal stady it ntecsslg in order to ehboso between the rival hypotheses, 5, Prenatal mechanisms The predisposing factors thus far discussed have been those oat possibly related to genetic inherited biological mechanisms, There is, however, as additional and obviously different possibility for predisposition i,e,, the prolonged exposure to the fetus to high levels of tobacco sloke in atero, it is now widely accepted that maternal sakioq in pregnancy is associated with reduced faetal growth and therefore with an increased incidence of infants who are small far dates (SPD) (Simplan, 1957), As Searr (1969) has obse~ed an association of low birth weights (less than 2,500 grams) with deleterious effects in later brain and intellectual development, there has been an,increasing research interest on the long-term effects afslpking in pregnancy on the child, Whereas Hardy and Mallets (1972) found no difference in intellectual functions up to the age of 7 years between children of smokers and non·s~c~cer others have found significant differences In reading, mathematics and general ability skills ~hetweca the ages of 7-11 years, with children of mothers who srrmked exhibiting the slower development IDavie, Butler, and Goldstein, 1972; Goldstein, 1472,, butler and Qldstein, 1973), These latter findings were confined more recently in 7 year olds where children of mothers who smoked during pregnancy exhibited: a higher (nonesignifieant) frequency of neurological ~nonalities, including minimal cerebral dYsfnncrion Id abnormal and borderline oloctrosPgphalogra C (ggg]l lower IQIes in general on the Rehelar Intelligence BAtCo document for Legal Services : Health Canada 19 May 1999 ·13· Scale for Children (WISC),and more speciiically on sub-tests of vocabulary, block design and codingi higher adverse scares on Bdqgerty-Olson-IJiekman Behavior Rating Schedule scored by teachers; Igxam and Hunter, 19'17), Densen, Nanson and #cWatters (1975) have also noted an association between hyperkinetic children and smoking in that mothers of methylphenidate-sensitive hyperkinetic children were reported as smoking two to three times as many cigarettes as the mothers of normal controls, These studies ate in marked disagreement with Lefkowitz's (1981] recent findings which failed to find any significant differences in the 10 year old offsprings of mothers who smoked and did not smoke during pregnancy, Measures of physical, intellectual, affective and personal and social functioning were similar for both groups of children, At this stage one can only speculate an the possible biological mechanisms which may be operative in pregnancy and thus responsible for the developmental differences observed between children of smoking and non-smoking mothers, Carbon monoxide (CO) crosses the placenta during pregnancy and the CO concentrations of the fetus of smoking mothers is significantly higher than in the fetus of non-smoking mothers, As CO has a much higher affinity for hemoglobin than oxygen, relative hypoxin may be a major biological factor operating in the fetus, Nicotine may e:crt an effect at various levels, For example, tobacco smoking is known to reduce appetite and smoking mothers may exhibit reduced food consumption relative to non-smoking mothers and this may impair the nutritional state of the fetus, Nicotine also causes vasoconstriction and may constrict the uteroplacentJ1 vessels, thereby placing the fetus in a state of relative hypoxia, Nicotine may also operate on a more direct level by acting on neuronal systems within the developing brain of the fetus, Although all these factors Pay operate alone or in cwnbination, Yerushalmy (197181972) has raised the important question of whether differences between the outcome of pregnancy in smoking and non-smoking women might be due to the characteristics of smokers rather than the smoking per se, For example, Yerushalmy (1972) reported that the prevalence of low birth weight infants was higher for non-smoking women who later became smokers than for wolncn who never smoked, This is suggestive that the low birth weight was due more to the smelter than to the smoking, in accord with the genotype hypothesis, Yarushalny 119721 ala~eEerved thai lai binl veightr veri j _ significantly less prevalent among infants of smoking women who later stopped smoking than anong infants of regular O J BATCo document for Legal Services : Health Canada 19 May 1999 -14- continuing smokers. The birth weights of i;nfants of smok·ing women who were to become exlsmbkexs were rather comparable to the higher birth prevalence among infants of nonesmckiog rcmen, This is also compatible with the theory that low birth weight is more a consequence of the smoker than of onwking, IV, EMerRICAlr~TEGPRTIorJ i, Need for a longitudinal study The prececding discussion has focussed on traits of the organism as being important determining factors in tobacco use. In searching for organismic conditians~that result in a higher probability for tobacco use the qucsQan is posed as to "whaE is given", Central to this is the suscep- tibility of the individual. As poorly understood as are most mechanisms involved in the development of smoking behavior, the nature of increased individual susceptibility has been perhaps the least adequately explored, As observed in the previous discussions, this is probably true because of the theoretical and methodological difficulties in such studies, These difficulties revolve about the following points: (1) there is evidence that increased susceptibility may he genetic, neurophy~iologieal, developmental, physiologieal, psychologic, social or t~e consequence of prolonged tobacco use; (2) it is literally impossible to separate out the effects of these various influences because they all operate concomitantly; (3) the effects of prolonged tobacco use are particularly difficult to parcel out because the characteristics of tobacco smokers can only be determined in smokers who by definition show the effects of prolonged consumption of tobacco. These points emphasize the difficulty of developing etioloqical findings from studies based on individuals who are already smokers and they stress the long recoqnised need for the implementation of a longitudinal study which carries cut its ~measurements an a defined population prior to acquisition of smoking behavior, In a "real lime" prospective longitudinal study where the goal is to exanine predictors of specific future events or behavior, the researcher selects an appropriate aged child sample at time ii examines its mefiSers for frequency of the target behavior leg, smoker vs, nan-snoker status), collects measures which are to be used as predictors O and then waits for a suitable follow-up period to measure n, BATCo document for Legal Services : Health Canada 19 May 1999 -15- again at time 2 the frequency of the target behavior, Then, with appropriate statistical procedures, one examines the relationship of the proposed predictors collected at time 1 with the presence or absence of the target behavior at time 2, Robins (1980) has detailed the theoretical and technical aspects of working within longitudinal studies of normal and pathological develdpment and it is obvious from their presen- tation that there are certain methodological advantages in the longitudinal approach in the tobacco area: (r) the subjects are not yet smokers; they have not: experienced the epiphencmena of longltcrm smoking, Thus their reactions on tests and measures are not heavily colored by these epiphenomena; (2) the researchers, relatives, and the subject himself do not know that he will become a smoker, This relieves the data of a certain part of the burden of bias; (3) the information gathered is current, not retrosepctive; (4) the data~ are uniformly and systematically obtained, This is in contrast to retrospective studies which make use of childhood records concerning adult smokers; (5) one advantage of the longitudinal method is that the ideal controls for the children who become smokers are the children (matched for sex, sociocultural status, etc,) who remain non-smokers, Such controls are an integral part of the design, in summary, we have criticized research into primary etiology based on smoker populations because the resulting observations are so heavily contdminsted by nonprimary phenomena, Research on primary etiology is research into causes and the longitudinal approach is one of the best approximations to this goal, This is not to say that the prospective approach is Without problems, A long-term longitudinal study of a relatively large sample faces certain problems including maintaining the sample, loss of key personnel, appropriateness of measures, etc. In addition, the longitudinal procedure yields correlative data and it is extremely difficult to securely construct unequivocal causative statements without experimental manipulation, E.uperimental manipulation is the method of choice in research of the cause of a behJvior~ With this in mind, of the masses of research on the already smokers and the effects of tobacco on smokers there is doubtless much which does relate to etiologyl Information on premorbid characteristics would be of great value in culling these eti6rogically relevant findings, In this manner the two · methods may be mutually supportive. BATCo document for Legal Services : Health Canada 19 May 1999 -161 V, TOBPICCO I\NO STRESS RF100CTION: RN OeERA~IONRI FRAFIMOIU( Raving observed the need for longitudinal investigations in researching etiological mechanisms in smoking Sehavior, 6ne must formulate a paIsimoniou~ scientific framework or theory of susceptibility and proceed to test the hypothesis it generates. The bypothesi~cd increased response to tobacco smoke of the susceptible individual can be designated as an clement In the development of acquisition of the habit, regardless of whether that increased response is due to biochemical, physioloqical, ncutopbysiological, or psychological mechanisms, In each or any of these cases, the change is presumably from an aberrant state to a more anormal" one or from a "normal" state to a more "pleasant" one, and this change is translated into a psychologically rewarding experience, Thus within this frame of reference ysiological processes are translated into psychological reactivities on which the principles of the reward conditioning paradigm are fully operative, This may be conceptualized as a psychophysiologicjl paradigm, Under these circumstances each successive rewarding experience strengthens the conditioned response (smoking) and the habit develops. Given a susceptible population, the question still arises: why specifically do they smoke? Clues to the reasons why smokers smoke have been obtained by investigating the acute effects'o~ tobacco inhalation on psychological and psychophysiological functioning, i, Affect A key to the understanding of smoking behavior is to be found in the management of affect, If you ask smokers why they smoke, overwhelmingly they respond in sedational terms. In a study by EeZycr, Fricdman and r;lzersfeld (1973], smokers were asked, "why do you smoke!" The question could be interpreted historically (How did you get started smoking?) or instrumentally (What do you get out of smoking?), Of 126 respondents, 76 interpreted the question instrumentally, Of this group, 64% answered in ~aticnal terms, that is, with such replies as~ "It ,;laxes me," "It calms me down," and so on, Not a single respondent answered in terms that could be coded as indicating arousal, such as Wfl stimulates me,u or "It bucks me up." And these are typical results. nquE (1973) asked smokers to fill in a Mood Adjective Chock bist before and after smoking a cigarette at different tires of the day, Although there were interactions with time of day and test conditions, in general smoking was found to increase feelings of relaxation and decrease feelings\ ·of aggression, anxiety and tension. These effects vere greatest for' high nicotine eigsrettes, Tomkins (1962) has classified a number C of types of smokers in the slaoking population. Many of the smokers are "negative alfect" c: sedative smokers, They smoke then the negative affect (distress, anger, vorry, fear, shame, contempt, etc,) gets to a certain intensity or when they feel that negative affect r is increasing to a high level or indeed when they anticipate negative affect will increase in the near future, Russell, Peto and Pdtel (l9'f() found that many smokers report smoking when anxious or angry: BATCo document for Legal Services : Health Canada 19 May 1999 -17- the proportions were 741 of hospital workersi 931 of patients at a smoking clinic and 881 of a group of university studnets'(WJr- burton and wesnes, 1978)1 The outcome of these studies strongly parallel the findings on individual differences which were discussed earlier and which indicated that smokers tend to be Characterized by higher neurb- ticism (an.ui~ty) scores on personality tests than non-smokers, Thomas (1978) found that smoicers and non-smokers could be differentiated on personality scores with smokers exhibiting higher anxiety and anger scores than non-smokers, In addition very heavy smokurs lover 60 cigarettes per day) have been found to he more aggressive and anxious than heavy seekers (40·60 d3yl and the latter felt greater necative affect than average (1S-21) "3Y) smok ers, Non-smokers fel; the least anxious and aggressive, i" important here to keep in mind that these anxict~ differences do not seem to be a consequence of smoking as the prospective study by Cherry and Kiernan (1978) shoved that young people with high neuroticism (an,viety) scores were more likely to start smoking than more stable adolesccnts~ This is supported by McKennell's (19703 findings that situations of "nervouS irritation" were common occasions for smoking among adults and adolescents and by Hendcrson, levis, I~ouell and Rayner's (1981) study of a secondary school population where a significant positive association was found between the probability of a neurotic disorder and use of tobacco, That this association was significantly stronger in female adolescent smokers is of particular interest in that it concurs with Frith's (1971) observation that a greater proportion of female smokers than male smokers reported a desire to smoke in high-arousal situations, A common picture of smoking as a stress reducer emerges from these studies and they are to a great extent supported by lindenthal, Myers and Pepper's (1972) study on the relationship between smoking, psychological states and stress, Here, life crises were signifi- cantly related to psychologic'al impairment~and a significant Isitive association was observed between frequency and ~ntensity of rife crises, degree of psychological impairment and smoking intensity, These authors concluded that their data supported the notion that smoking served as an adaptive behavior for coping with life's exiqencies, Mills (1978) has discussed the possible role of tobacco as a coping mechanism in high-arousal situations and there is a growing consensus that tobacco functions as a psychological tool in the attenuation of stress (Stepney, 1979, 1980), Warbutton and Wesnes (1979) have suggested that tobacco (nicotine), like anxiolytics, acts as a negative reinforccr by reducing the unpleasant emotional experience of anxiety/arousal provoked by the internal or C external envi:cnment,· Rnxiolytics, hovever, do not exhibit 'hl similar bioehemical or electrophysioloqica 1 actions as G~ nicotine and furtbermore, dnxiolytics are of little aid in smoking cessation, In an attempt to elucidate specific mechanisms of action, a great deal of research has focussed on behavioral and C physiologieal conconrmitants of :obaeco-induced stress reduction, ·~ C" ~---- · BATCo document for Legal Services : Health Canada 19 May 1999 ·181 2, Performance Studies on the effects of cigarette smoking an human Performance suggest that nicotine and smoking may enhance behavioral efficiency on sensoIiatot and rognitive functions by increasing arousal, Ipprovements in sensorimotor tasks following smoking or oral ingestion of nicotine tablets have been repeatedly observed in long-ten vigilance and signal detection tasks which in Kahneman's (19'13) terms, require sustained mental effort IFrankenha~ser, Myrsten, Post and Johansson, 1971t Manqan and Golding, 19'18; Tonq, Leigh, Campbell and Smith, 1977; Wesnes and Warburton, 1978; E,yrstcn and Fndersson, 1978t Paller and Levander, 1980). These improvements are considerable, if comparisons are made between deprived smokers and non-deprived smokers, Typical non·smoker performances, however, usually lie between these two extremes. Both 9attig (19801' and Stepney (1979) have commented that it is difficult to interpret these results as the observed differences may be attributed to a performance reduction caused by nicotine dcprioation, to a performance improvement induced by the administration of nicotine, or to bath of them, Indications that improvement may actually reflect on nicotine-enhancement effect is seen in ~leirnstr3, Fallesen, Kinsley and Warner's (1980) study which showed that vigilance tasks were not Jflccted by smoking dcprivation and also by Wessnes and Warbllrton's (19'18) study which made use of nicotine tablets and found improvements in the performance of noncsrr~kers as well, Studies on cognitive functioning, or more specifically learning and memorl, have indicated that smoking exerts adverse effects on short·ten memory and improves long~term retention as measuerd by delayed recall (Rndersson and Post, 19711; Andcrsson, 1975; Myrsten and Andersson, 1978; William~, 1980), As studies on learning and arousal agree that high arousal during learning leads to improved ultimate memory (Kleinsmith and Kaplan, 1963; Berlyne, Borsa, Hamachcr and Koeing, 1966; dalket and Tarte, 1963) but leads to detrimental effects on immediate recall, the results of the above tobacco-learning studies were interpreted on the basis of the arousal-increasing properties of smoking, Although this proposed general arousal mechanism seems to be an adequate hypothesis for these tobacco-induced performance changes, an alternative second·order interpretation 'based on Easterbrook's (1959) data suggests that increased arousal may function by narrowing the focus of attention Ii,e,, subjects sample a smaller range of potentially distracting, irrelevant external and internal stimuli and focus selectively O on relevant stimuli), This increased ahility to attend ju· BATCo document for Legal Services : Health Canada 19 May 1999 -ls- selectively to certain relevant aspects of'the stimulus field while simultaneously inhibiting respollss to other asoects of the field may account for i\ndc:sson and Hockcyls 119'35) findings that smoking reduces the incidental learning of irrelevant stimulus material, The results imply that attentional processes are affected by cigarette smoking in the same way as by other r.rousar~increasing events, Eastcrbrook's hypothesis, proposing that the range of cues are reduced in states of high arousal, was supported by these findings, This increased selectivity of attention by tobacco may well be the basis of the frequent reports by smokers that smoking improves their concentration and that not smoking results in extreme difficulty in concentration, As with the cognitive studies, tobacco-induced improvement in vigilance performance has frequently been interpreted Within ~rousal theory, and indeed there is a solid body of data supporting *celationship between arousal and vigilance (Rackwart~, 1969; Tcng, fi~enderson and Chipperfield, 1980), However, this data n~y also be interpreted specifically within an attentional framework as Mangao and Golding's (1978) results indicated conclusively that smoking improves vigilance performance by decreasing the subjects errors of cormnission (false positive) rather than by improving his detection rate, The notion that the attraction of tobacco ny lie in its ability to screen or block out disruptive, distracting effects of irrelevant input on ongoing tasks and performance has been forwarded by a number of researchers (Dunn, 1978; Knott, 19781 19'19; #arburton and IJesncs, 1978, 1979; Wesnes and Warburton, 1978], The empirical basis far this approach is based in part on studies which have shown that tobacco does not appear to have any consistent: effect on short-term performance proficiency under Conditions conducive to good performance (Dunn, 19781 Stepney, 1979t, but it does seem to offer an advantage under conditions likely to interfere with performance, Initial support is forthcoming from studies which show that nicotine reduced the distractibi~ity on the Str`oop task (Wcsnes and warburton, .978) and that tobacco smoking counteracts the decrement in reaction time perfcr~nce observed under distracting noise conditions (Tong, Knott, McCraw and Leigh, 1974), In contrast to Wdrburtan and Wesnes (1979) who emphasize the impact of tobacco an performance as being an enhancement of signal or relevant target information, due to increased arousal, both Ounn (1978) and Knatt (1978r 1979l have emphasized the inhibitory role of nicotine and tobacco in dampening down the isgact of hyperarousal responsivity on task performance O '· Co BATCo document for Legal Services : Health Canada 19 May 1999 -201 induced by disruptive, distracting input, An initial study by Ounn [1978) on the disruptive effects of frustration on anger and performance proficiency in a complex perecptujl-lpk)tor task supported this notion, Here, smokers and non-smokers displayed the same increases in anger, but the performance proficiency scores of the smokers were significantly superior to the scores of bath deprived and nan-smokers during the anger-inducing period, In ounnls worals, ",,, the stooker is unwittingly triggering a physiologieal response sequence when he smokes which has the effect at the psychological level of improving his coping efficiency in face of otherwise disruptive influences.., I an suggesting that ,,, the subjects emotional or affective arousal had reached a level such as to impair ongoing task performance and that the arousal did in fact impair the performance of the non-smoking and placebo subjects, The smoking subjects, however, were invoking protective physiological mechanisms that had the Isychological effect of insulating ongoing performance from the isruptive influence of excessive arousal, Smoking.m3y be having a negative or inhibitory effect upon the intrusiveness of excessive affective arousal upon ongoing behavior (p. 22)," This data is to a great extent supported by studies which clearly show that nicotine can play a significant part in reducing the disruptive effects of stress [electrie shock) on behavior in animals (Stepney, 1979, 1980), Recently, based on his clcctrocortical findings which suggested that tobacco "normalizcd" central nervous system activity of smokers to a level comparable to that of non-smokers (Knott, and Venables, 1977, 19'18), a "Eilter model" was proposed by Knott (1978, 1979) to relate the relative attentional deficits in deprived smokers and improvement by tobacco to the frequently reported sedational or stress-reducing effects of smoking (Gilbert, 1979), The model iiypothesized that (a) relative to non-smokers, smokers deprived of tobacco exhibit an inefficient central filtering mechanism for qatinq out irrelevant, distracting stimuli and experience input more readily and mote strongly and as a result are characteriscd by a distressed state of relative stimulus overload inappropriate far efficient performance and the attraction of tobacco smoking may lie in its ability ~o normalize control of stimulus input thereby relieving distress and improving performance and subjective well-being, The filter ddel runs parallel to findings of greater irritability to intense stimulation and reduced pain thresholds, i,e,, greater sensitivity to pain, Observed in smokers relative to non-smokers and subsequent increasing pain thresholds and decreases in stimulus irritability following smoking (Nesbitt, 19'13; Schachter, 1973, 1978; Seltzer, Friedman, Siegelaub and, Collen, 1914),Initial behavioral support for smoker vs, non~smaker differdnees an susceptibility to distraction effects was Q BATCo document for Legal Services : Health Canada 19 May 1999 -21· observed by Xnottls tr980) finding that high intensity auditory noise significantly impaired smokers performance on a choice reaction time task but had no effect on ncnes;nokers, R subsel quent (1981d study further indicated that female smokers, who have been reported to have their greatest distraction induced deterioration in Choice reaction, Although this data is colored by possible secondary phenomena such as long-term tobacco effects and influences of deprivation, they may be suggestive of predisposltiona~ factors relating to the onset 31 the smoking habit, P_sychophysiology All of the evidence from the performance studies provide strong support far the notion that tobacco smoking reduces perceived stress by inhibiting indiscrimate arousal responses to ruptions by internal and external inaut,This neat picture is :umplicated, bowever, by what is prohaljly the least equivocal, best established fact about the physiological consequences of smoking - namely that it seems to lead to widespread increases in nervous system arousal with the most obvious alternations being exhibited within the peripheral autonomic nervous system. larsan, Haag and Silveete [19il) have remarked that there are so many peripheral effects of nicotine that the central effects seem to be obscured. Similarly, the Surgeon General's Report (1964) showed that "Snoking 1 to 2 cigarettes causes in most persons, bath smokers and nonsmokers, an increase in resting heart rates of 15 to 25 beats per minute, a rise in blood pressure of 10 to 20 mm Hq systolic and 5 to 15 mm Hg distolie, and an increase in cardiac output of about O,f l/minlsq,m, (p,318)l" In short, there are a host of transient increases in physiological responses to smoke inhalation and they include elevated heart rate, elevated coronary flow, elevated blood sugar level, lower cutaneous temperature in the extremities, increased blood flow in skeletal museulature, a reactive release of adrenalin and alterations in electrical potential patterns of the brain (Dunn, 1973), all of which are customarily associated with increased states of arousal activation or emotionality. As theories of emotion view L,.:reased autonomic arousal as an essential component of emotional processes, and as tobacco increases physiological arousal yet freguently reduces behavioral effects of arousal and self-report measures, an intriguing paradole pervades the motivational literature, Recently, there have been an increasing number of studies and theories (Gilbert, 1979; Schachter, 1973) that pertain to the resolution of these apparently contradictory findings and there is a general picture emerging which indicates physiological evidence for tobacco induced arousal reduction as apparent in specific electrophysioloc gieal measures and eliciting this response it is important to look G at the effects of nicotine, not in isolation, but in conjunction with the situation in which the nicotine is administered, and also c~ in relation to the personality of the subject, The combination of I these three factors: (amount o,F nicotine taken in, arousall producing situations and low or high-arousal organism) determines 1 ~ the outcome of any tobacco experiment, ... ~- ~3 m···l··-···,. ..lr·-·-.-· ..,,...... ~. ~..~1~___1__~~~~~1 ~---- - BATCo document far Legal Services : Health Canada 19 May 1999 -22- Neurophysiological studies in animals are in general agree- ment that the effects of small and medium does of nicotine on the central nervous system (CNS) are biphasic, there being a marked sequential effect, with a primary arousal phase being followed by a secondary depression effect on electro eorticcgrans (Sehaeppi, 1967; Goldstein, Seek and Mundschenk, 1967), There is also evidence that while small dose of nicotine increase arousal, larger doses may decrease arousal. Thus, Armitaqe, Hall and Sellers (1969) found that doses of 2 mg/kg every thirty seconds for twenty minutes. given intravenously to eats, caused desynchrcnization of the electra- cardiogram indicating eortical activation, and an increase in the release of eortical acetylcholine, However, a larger dose given less frequently 14 mg/kg every minute for twenty minutes) caused sometimes an increase and sometimes a decrease in cortica2 activity, such changes being accompanied by an increase or a decrease in corticsl acctylcholine output. On this basis and on the basis of the previously discussed distraction based stress pothesis, one would expect that the action of tbba~cd or Ilicotine on the human EEC should mimic the action of anxiolytics but the electrbphysi~logical evidence does not strongly support this notion, In a pioneering comparison of nicotine and an anxiolytic (Murphree, Ffeif~er and Price, 1967], the means and variance for the total energy increased across the spectrum of EEG activity alter the anxiolytic while there was a general reduction in means and variance across the whole spectrum for nicotine. It was concluded that the nicotine changes were more typical of a stimulant drug than an anti-anxiety compound. Sub- sequent EEG studies, reviewed by Conrin (1980l have far the most part focussed on 8·12 IIz alpha activity and are in general agreement that tobacco smoking increases the dominant alpha frequency,Knott and Vcnables (19771 observed a "normalizing" effect of tobacco inhalation on dominant frequency. Analysis of pre-smoking activity revealed a slower dominant frequency on deprived smokers relative to non-smokers and non-deprived smokers and the irrJnediate effect of smoking was to increase dominant alpha frequency in deprived smokers to a level comparable to non- smokers and non·deprived smokers. Instead of relating these findings ·to an arousal phenomena, Knoet and Venables cited a solid body of :tcrature which suggested that dominant alpha Irctlu~ncy reflected 2NS scanning or latinq process involved in stimulus-input and in cognitive processing (Lykken, 1975), As this tobacco-induced shift in EEG frequency may reflect improved corticJ1 scanning and speed of cognitive processing, the authors suggested that smokers may smoke in order to achieve the psychological state of increased vigilance and attention associated with this shift. On this basis it would seem that this repeatable shift in dominant frequency induced by smoking may have particular functional significance in relation to both the distraction hypothesis discussed earlier and in relation t6 predisposinq cleetr6physiolagical factors to the smoking habit. I The dcloinant rhythm appears to reflect CHS maturation, appearing i O at 3 or i months of age at 3-4 Hz and increases to the adult freqtlency of about 10 Hz at about 10 years of age. This rhythm, C~ althougl rerpPnsive to static factors, under notn~l Eircun~sranees remains constant day in and day out and month by month(lindsley O and RuSe?stein, 1431), Is it possible, that t~e slower rhythm in L"u BATCo document for legal Services : Health Canada 19 May 1999 -23- deprived smokers represents a delayed CNS maturation, and hence a relatively inherent perceptual deficit which may 'set up' a need or predisposition for tobacco (or some dther substance or activity) which is readily available and can specifically alter the rhythm at any given timel As it is reasonable to suppose that the satisfaction of tobacco smoking is ultimately dependent upon cerebral events, a number of studies have focussed an the measurement phasic potentials which sensory stimuli evoke (ERPsJ in the cortex as a way of studying cerebral processes, The initial study by Hall, RJppaport, Hopkins and Griffin (1973) on visual evoked potentials showed that tobacco smoking increased amplitudes of late components (more than 80 ms after stimulus onset), changes which are consistent with the contention that tobacco increases arousal, later studies by Friedman, GolJberg, HorvJth and Meares (1974), and Friedman : 1Meares (1980) suggested that the tobacco effect may be modality ;~?cifie, increasing late components of the visual dvoked poten- tial and decreasing late components of the auditory evoked potential, The reduction in late auditory cvokcd potential components is of interest in that Knott (1988) had shown that the performance of smokers as compared to non-smokers, was significantly more affected by high intensity noise, Knott and Venahles (1978) observed a "nonnaliting'' effect of tobacco smoking on visual cPrtical cvokcd responses in that deprived smokers evidenced faster latencies and larger amplitudes (i,e, more sensitive) than both non-smokers and deprived smokers who exhibited comparable responsiveness. The authors suggested that a possible attraction of tobacco smoking may lie in its ability to function as a "chemical stimulus filter" thereby reducing the distracting effect of irrelevant, adverse stimuli on performance efficiency and emotional tonus~ Complimentary results are provided by Vasqucz and TomJn's (1967) observ~'tionb~ a decrease in late E,AIP, amplitudes during smoking, an increase during abstinence, These evaked potential studies receive some support from an animal investigation by Pradhan and Cuha (1976) who recorded from the auditory cortex of cats and observed that the initial effect of smoking dosages of nicotine (12,5 mg/kq) reduced ~b"th amplitude and area measures of late components of the auditory ,ked response, This appeared to be an apparent selective effect as nicotine produced general CNS excitation at the same time, A number of additional elcctrapbysiologiea 1 studies have provided support far the notion that tobacco dampens CNS rcsponsivity to stimul input and therefore they are of particular interest for the distraction hypothesis. fricdman, Horvath and Mearcs (19741 and Manqan and Golding [1978) found that tobacco smoking increases the speed of habituation of CNS (alpha blocking) and ANS (skin O conductance responses) responding to repeated presentations of high h, intensity auditory stimulation. These authors suggested that a C~ possible means of reinforcement of tabacce smoking may lie in its cs ability to Itinilla:l CNl inhiSi~ory neehdnias (vithou~ iimd- taneous reductions in CNS cxcitatory processes) resulting in the "screening out" of irrelevant and irritating sensory input into consciousness, In this regard, it is interesting to note Mangan and Golding's (1978) observation that inhibition of momentary BATCo document for Legal Services : Health Canada 19 May 1999 124- spontanepus imbalances in autonomic arousal say he a Fhysial6gical basis of tobacco induced improvement in vigilance performance, During their vigilance task, it was observed that false positives occurred most often immediately following a spontaneous skin conduetance fluctuation, Rs smoking reduced both spontaneous fluctuations and false positives they inferred that performance improvement was due to the increased stability of the autonomic arousal system, The possibility that smokers may exhibit greater autonomic responsivity than non·smokcrs was confirmed by snott (1980) who observed that smokers exhibited significantly higher resting skin conductance levels, faster response latencies, large response amplitudes and significantly faster and larger cardiac accelerations to a high intensity auditory stimulus, More recently Knott (1981b)has observed that female smokers relative to male smokers and female and male non·smokcrs, exhibit significantly higher resting skin conductanee levels and larger skin conductance ponses to high intensity auditory stimuli. This is sin line with a previously discussed study which indicated that female smokers exhibit a mote frequent craving in high arousal/anxiety situations, The contingent negative variation ~CNV) is a small scalpl recorded negative potential which slowly builds up between a warning signal and an imperative signal (such as in a standard fare period reaction time task) requiring the subject to carry out some response, usually a motor res~onse such as pressing a button, This slow cortical potential occurs in an expectancy situation is sometimes referred to as an expectancy rave, Tcecc, Savignano-Bowman and Cole (1918) have proposed that tk'o pro- cesses ct arousal and attention become coupled under drug administration, such that over increase in attentional demand will increase arousal, but an over increase in arousal will reduce attentiveness and so attenuate optimal CNV devclopwnt, The function of self regulated drug administration such as smoking is thus presumably to adjust this distraction I arousal coupling to an optimal level according to task demand. As Ashton and Watson (1910) and Rshton, Savage, Telford, Thompson I `Watson (19'12) have shown that situational stress radically b.Lects smoking strategies (i,e., increases puff frequency and thus nicotine dosagc) this theory would predict that individuals differing in ~~ouSal levels would adjust their smoking parameters accordingly (e,4· puff frequency, duration, volume etc,) so as to bring CrJV development to an optimal level, Studies on CE~v, tobacco and individual differences have on the whole supported this contention and failure to take into account personality dificrcoccs may have been the basis for the non-significant tobacco effect on CBV observed by Knott and Venablcs (1980), The initial study by Ashton, Hillman, Terford and Thomps~n (1974) and a subse~uent study by Eysenck and O'Connor [19791 showed that individ;als O high in cortical arousal (introverts) exhibited consistent I CNV amplitude reductions (deprcssian) following tobacco soking while individuals rated low in cortical arousal (extraverts) P shoved consistent increases in CNV amplitude (stirnulation) following smoking, Estimates of nicotine intake (such as puff O volume, frequency, butt analysis) indicated that extraverrs C3 BATCo document for Legal Services : Health Canada 19 May 1999 ·25- took In more nicotine than introverts, Subjects who said they were relaxed by cigarette smoking tended to show a diminished CNV and these results parallel reports of a greater desire to smoke for tranquilization and stress-reduction in introverts (Cilbert, ~480~, Subsequent studies by Ashton, Marsh, Flillmanr Bwlinsr Telford and Thompson (1918) on effects of Intravenous injections of various smoking does of nicotine on the CNV produced a dose-response relationship in which smaller doses were found to have a stimulant effect and large doses a depressant one, On commenting on these findings, Stepney t1979) stated that smoking is capable of producing either stimulant or depressant CNS effects, depending on the smoker's environment and the dose of nicotine taken, and that the point at which the nicotine dose crosses over from having a stimulant effect to having a depressant one is within the range of dose that can be obtained from a cigarette. This would give the smoker an extremely useful tool :arousal control, The notion that smokers may use cigarettes L, Obtain a specific effect on arousal in the context df the demands of a specific envircllllocnt is supported by a study by ~yrsten, Anderssonlfrankenhaeuser and Elgerot (19f5), Here, smokers who selE~reported their strongest need to smoke under low- arousal conditions (low-arausal smokersl performed and felt better when smoking under laboratory tasks of low complexity and smokers who self-reported their strongest need to smoke under higblar~usdl conditions (high·arousal smokers), performed and felt better when smoking under laboratory tasks of high complexity. As with extraversion·introve~si~n, one may prediet from the above studies that under conditions of stress and overload, high neuroticism scoring subjects should benefit more from smoking than low neuroticism scoring subjects, Studies by tiucek t1975) andWarburton and Wesnes (1978) bear this out, In the former s