Document 7MgkYnmbq38RnEr3xrmmvpp8e

FILE NAME: Kent (KNT) DATE: 1954 Apr 3 DOC#: KNT037 DOCUMENT DESCRIPTION: Editorial - Cigarette Hucksterism and the AMA Journal of American Medicine H80 EDITORIALS AND COMMENTS THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 535 N. DEARBORN ST....................CHICAGO 10, ILL. E d i t o r ........................................... AUSTIN SMITH, M.D. Associait E d i t o r ..............................JOHNSON P. HAMMOND. M.D. Editor tor M tdlcal L ittra tu rt A bstractt . GEORGE HALPERIN, M.D. Assistant E d i t o r ..............................WAYNB G. BRANDSTADT, M.D. Subscription price . . Fifteen dollars per annum in advance Cable A d d re s s .............................................. "Medic, Chicago" CIGARETTE HUCKSTERISM AND THE A. M. A. The unauthorized and medically unethical use of the prestige and reputation of the American Medical Asso ciation and T he J ournal in Kent cigarette advertise ments currently appearing in the American press and other channels of mass communication constitutes an outrageous example of commercial exploitation of the American medical profession. The implication in these advertisements that the American Medical Association authorizes, supports, or approves any particular brand of cigarettes or combination of claims made in their be half--whether pygmy-sized or king-sized, with or with out filters, nicotinized or denicotinized-- provides a most reprehensible instance of hucksterism. The manner in which the P. Lorillard Company has extolled its particu lar brand of cigarettes by reference in its advertisements to the American Medical Association and T h e Journal is to be strongly condemned. On the basis of only one factor isolated from many, the P. Lorillard Company blatantly implies that the efficiency of their brand of filter tip solves the health problems associated with cigarette smoking. This ap proach to a vital problem is ill-conceived and lacks fac tual medical support. The inference that any type of filter has the approval of the American Medical Asso ciation is equally without foundation. Until the clinical relationship between the amount of nicotine and tars and their effect on the individual smoker is conclusively es tablished, no filter can offer a panacea except one that possesses 100% efficiency. The hard facts of the matter are that a completely efficient filter would permit the smoker to inhale nothing but hot airf Certainly there is no adequate evidence to prove con clusively that the reduction of nicotine and tars by means of a filter that is 60% inefficient has any physiological significance. The amount of nicotine and tars that reach the smoker's oral cavity is the one factor of fundamental importance. This cannot be determined merely by es tablishing the efficiency of a filter. The presentation of one fact and the exclusion of all other pertinent facts can 1. luechMl. P. P,, and LaBoctett*. A. C.: Relationship of Tonsils and Adenoids to the Typ* of Poliomyelitis, Am. J. Dis. Child. SS : i (July) 1944. 2. Top, P. H.: Occurrence of Poliomyelitis in Relation to Tonsillec. lomiei at Various Intervals, J. A. M. A. tS O ; 33+ (O ct II) 1932. 1. Weinstein, L.; Votel, M. L., and Weinstein, N.: A Study of the Relationship of the Absence of Tonsils to the Incidence of Bulbar Poliomyelins, J. Pcdial. 4 4 : 14 (Jen ) 1934. J.A.M.A., April 3, 1954 result in a serious misrepresentation of the true status of health in relation to the smoking problem. Smokers who are misled are likely to obtain a false sense of secu rity without real protection. RELATION OF ABSENCE OF TONSILS TO BULBAR POLIOMYELITIS Data have been provided over a period of years to sug gest that mere absence of tonsils and adenoids, regardless of the time of their removal, leads to increased suscepti bility to bulbar poliomyelitis. In a study of 432 patients with acute anterior poliomyelitis, Lucchesi and LaBoccetta 1found that in 61% of patients whose tonsils were absent at the time the infection occurred the bulbospinal form of the disease developed while in 76% the bulbar type developed. A much higher incidence of bulbar involvement took place in these persons than in patients who still had tonsils and adenoids, the difference being apparent in all age groups. Seventy-eight per cent of the patients who died of poliomyelitis had neither tonsils nor adenoids when they became ill. In 1952, Top* investigated 1,947 patients who had been admitted to the Herman Kiefer Hospital in Detroit over a 10 year period because of poliomyelitis. In this group, 51.9% of the patients had neither tonsils aoc adenoids at the time the disease was contracted; 85.1% of the patients afflicted by bulbar poliomyelitis had pre viously been subjected to the tonsillectomy procedure, while 68.7% of the patients attacked by bulbospinal poliomyelitis had previously undergone tonsillectomy. Of the patients with nonparalytic forms 45.6%, and of the patients with spinal paralytic forms 43.1% had neither tonsils nor adenoids. Of the patients afflicted by bulbar poliomyelitis who had previously been subjected to tonsillectomy 93.5% died, as compared to 56.9% of patients with bulbospinal poliomyelitis who died. Weinstein, Vogel, and Weinstein * recently repeated the investigations of Lucchesi, LaBoccetta, and Top to determine whether the relation of absence of tonsils and adenoids to increased susceptibility to bulbar poliomye litis applied to their own patients. Records at Haynes Memorial Hospital, Boston, of 800 patients with polio myelitis, 500 of whom had been subjected to tonsillec tomy and adenoidectomy at some rime and 300 of whom had not been operated on, were studied. Ail patients had a clinical history pointing to poliomyelitis; physical find ings to indicate infection of the central nervous system; and sterile spinal fluid that contained more than 10 white blood ceils per cubic millimeter, an increased quantity of protein, and a normal sugar content. Analysis of the data suggested that the absence of tonsils and adenoids, regardless of the time of their re moval in relation to the onset of poliomyelitis, increased the risk that the bulbar form of the disease would de velop. Of 85 patients in whom bulbar poliomyelitis de veloped, 85.9% had previously been subjected to ton sillectomy; of those in whom tonsils were still present, bulbar poliomyelitis developed in only 14.1%. A similar relationship was observed in the case of patients attacked by bulbospinal poliomyelitis, the disease occurring a b o u t five times more frequently in patients subjected to ton-