PRIVATE AND CONFIDENTIAL
VISIT REPORT
Visit to: Dr. V. Knott
of: Royal Ottawa Hospital, Ottawa.,
Author: R.E. Thornton
Date: 14tb July, 1982
Cirulation: Dr. L.C.F. Blackman
Mr. A.L. Heard
Dr. C.I. Ayr--s
Dr. K.D. KilDurn
Dr. M. Oldman
Mrs. A.K. Comer
Mr. R.S. Wade, Canada
Dr. P.J. Dunn, Canada
RET/KPN/46D
28th July, 1982
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BATCo document for Province of BritiSh Columbia 14 April 1999

Visit To: Dr. V. Knott, Royal Ottawa Hospital , Ottawa-
Present: Dr. V. Knott
Mr. R. S. Wade
Dr. R. E. Thornton
1. Dr. Knott is Surrently a grantee of the C.T.M.C. The
purpose of the visit was to discuss his new grant
application, which is for a five-year study. I had
met Dr. Knott before, both at the Chelvood Smoking
Behaviour Conference (1977) and also, with Kay Comer,
at the conference on nicotine held by S. E. 1 T. A. in
Paris in 1978.
2. Dr. Knott's most recent proposals for a five year
longitudinal study (1982-6) have already been
discussed extensively at C.T.M.C. and in GR&DC. The
U.S. companies in C. T. M. C. have decided not to support
the new proposals, which is essentially an EEG assess-
ment of children (age 11) and the relation of these
measurements to subsequent smoking habits. However,
I.T.P. and Rothmans (largely as a reslt of a visit by
P. W. Brown) are, in principle, in favour of support.
3. Before leaving the UK I discussed the proposal with
A. K. Comer (Kay and I had looked at the EEG patterns
of smokers and non-smokers in collaboration with
Dr. C. Binnie of St. Bartholomew's Hospital) and
K.D. Kilburn who had made suggestions for the up-
grading of equipment.
4. PROTOCOL
It was suggested that the protocol would be improved
if subjects were re-analysed at the end of the 5-yc ar
study. Hopefully, this before- and after- study would
demonstrate that smokers' EEG's altered at the same
rate as non-smokers' 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 non-smokers of similar ages) but could not be
definitely proved. Also, the differences in smokers
and non-smokers noted in the BAT Study could have
been due either to differences between the subjects
in the two groups, or to an acute of smoking.
Otherwise, the protocol is detailed and relevant,
as expected from Dr. Knott. (See also section 6 for
proposed extension to protocol).
5. EQUIPMENT
Dr. Knott said that be now wished to add equipment to
measure brain-stem response, newly considered to be df
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MN care 1-mm,
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considerable importance in this area. This would
add about $25,000 to the cost. It was agreed that,
since the study was going to last five years, ttis
equipment should be included in the proposal. It
would not be possible to alter the protocol at a
later date.
With regard to the equipment suggested by Dr. Kilburn,
Dr. Knott said tha,t his most recent proposals for
equipment largely anticipated Dr. Kilburn's suggestions
for improved methods of data-acquisition, and had been
made after discussion with EEG experts.
It was agreed that Dr. Knott would base his application
on his own list of equipment; it was considered that
this was entirely satisfactory for the analysis-envis-
aged by Dr. Knott. Analysis of the results elsewhere
was considered unlikely.
6. ETHICAL PROBLEMS
One of tte advantages of carrying out con 1@ a
research Is that any ethical problems become those
of the University/Hospital rather than of the funding
Organisation. In the present case this is particularly
important since children are to be studied, and their
smoking/non-smoking habits determined. The accept-
ance of the proposals by the Ottawa School Board and
by the Royal Ottawa Hospital is important. The former
bave already agreed to them - the latter are expected
to (and must do so before the project ca.n continue).
Within tlaese provisos, and providing the C.
fund the Royal Ottawa Hospital (ratber than Knott
directly) the project should be as well isolated from
the tobacco industry as can be reasonably expected.
Any project supported by the Tobacco Industry is
potentially open to attack by anti-smoking funda-
mentalists; however, the agreements noted above
should be sufficient for the rationally-minded.
7. GENERAL COMMENT
Dr. F. Roe, in discussing likely future pressures
on the industry, suggested that 'nicotine as an addictive
agent' was a likely threat. The present study is likely
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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 harmful.
However, it should be borne in mind that it is not
a certainty that these results will be established.
The sample size (300) is relatively small and there
is always the possibility that the differences will be
lost in noises. It will 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 (L. S. E. 1) on subject re-call strategies
in longitudinal studies.
9ea'@2z@
R.E. THORNTON
(Written by R.E. Thornton, but signed out in his absence.)
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BATCo document for Province of British Columbia 14 April 1999