Document XRjD3JRb3G46vgDpoG77N0nNJ

DownloadSearchable PDFRandom document
FILE NAME Newspaper & Magazine Articles NMA DATE 1955 DOC NMA002 DOCUMENT DESCRIPTION Cigarettes HUTCHINHUSTCOHINNSON FUSIC Cicarelles FUSIC CicarellesLIETARY Here are the results of CU's recent laboratory tests ae ae v . Pe . ea 7 oan aa - ee BS , aa 1 filter cigarettes give you less nicotine and tar than plain cigarettes What about the king cigarette which travels the smoke further or king size plus a filter What about the cigarettes which use a nicotine tobacco or a denicotinized tobacco there really less nicotine in their smoke And the popular brands do they compare with the other brands on the market with ; regard to their nicotine and tar content ; These are some of the questions to which smoker would like to have answers But no answers at least no reliale reliale ones are to be found in the hazy happy healthy world of cigarette advertising The purpose of this report is to provide some of the answers In February 1953 CU reported on laboratory tests of 27 widely sold brands of cigarettes and readers were informed of brand and type differences in terms of nicotine and tar content Since that time however many new king and filter cigarettes have appeared on the market and some of the older brands have changed their lengths and their filters CU's tests for nicotine and tar embrace the newcomers as well as the old standbys The following report covers tests of 37 brands of cigarettes purchased in 28 cities throughout the country They are of four broad types regular size filtered regular size unfiltered king filtered and king unfiltered Within these types are cigarettes made of American blends and Turkish cigarettes low nicotine ,. denicotinized and mentholated smokes regular price and premiumprice plain and tipped Sixteen cigarettes of each brand cach from a different pack were mechanically smoked in a laboratory apparatus in tests for nicotine and tar The test results there are summarized in the table on page 59. Apart from how the brands rank in nicotine and tar content conclusions which can be drawn from the figures the obvious determinations of are a number of interesting . _ First of all the test results indicate that the use of tobacco which is low in nico- a tine results in lower nicotine content in the smoke than regular tobacco even with z filter John Alden a regular cigarette without filter had far less nicotine in its smoke than any other cigarette this brand is made from a special nicotine tobacco Additional information was provided by some check tests for the five largest selling brands not only the smoke but the tobacco itself was analyzed for between nicotine content There was a direct correlation the nicotine content of the smoke and of the tobacco in each case Because crops of any given variety of nicotine tobacco vary in content from year to year and from region to region depending on such things as climatic and soil conditions the nicotine in the smoke of the cigarettes made from these tobaccos can also be expected to vary And in most cases it does ne Of the 20 brands included in both CU's previous tests and the current tests only the John Alden and Sano regular were found to be unchanged in the nicotine content of their smoke John Alden was lowest in nicotine content in both series of tests it averaged only 0.4 milligram of nicotine per cigarette in the 16 samples smoked by the laboratory apparatus Sano regular also remained at its previously found low nicotine level although it was not quite as low as recently introduced Sano king size with filter tip Sanos are made of a denicotinized tobacco that is tobacco from which a large part of the nicotine has been extracted _ Continued on next page CONSUMER REPORTS 57 - > cigarettes LABORATORY TESTS Nearly all the other cigarettes tested for both this and the 1953 report were higher in nicotine this time The nico- tine content in the smoke from Camels increased from 1.9 milligrams to 3 milligrams per cigarette the regular Old Golds Lucky Strikes Philip Morris and Chesterfields Chesterfields also rose in nicotine content although not as sharply as Camels The range in nicotine content except for John Alden and Sano was from about 1.5 milligrams for M regulars to 4 milligrams for Old Gold king size and the range among the five most popular regular brands was even less running from 2.3 milligrams to 3.3 milligrams There is no generally accepted definition of the tars so much talked about in connection with smoking and consequently no generally accepted method for their measurement In its new tests CU utilized a modification of its previous test method to obtain what is believed to be a strictly comparablesmoke more precise determination of the tar content of the the results therefore are not with those obtained the previous tests The range in tar con- tent among the 37 brands tested was not as great as the range in nicotine content By smoking John Alden you can conte cut your nicotine intake down to 10 of that of the brand highest in nicotine But the cigarette lowest in tar content M regular will still give you 40 of the tar content of the smoke of the cigarettes highest in tar content THE FILTER BRANDS Open up the filter tip of different cigarettes and will find a variety of absorbent cotton paper cyoonu- or taining activated carbon cellulose acetate fibers creped and uncreped paper asbestos fibers combinations of several of these materials No laboratory tests were run to determine whether it was the filters filters or other factors that were responsible for high or low nicotine content in each case The main concern was with the final product- the amount of nicotine and tar in the smoke The test results indicate however that for a cigarette of less far a given size there was in most cases in the smoke of the filter brands the average about a third less Within a given size too the filter cigarettes were also generally lower in nicotine content although there were several exceptions The brands whose smoke yielded the HOW CU TESTS CIGARETTES v * ii Pette 2g Fe -~ ~,, 58 FEBRUARY 1955 The testing of a cigarette begins with the collection of its smoke The cigarette is then smoked in the smoke drawn from the first fitted into a glass Laboratory apparatus cigarette is collected holder and left The in acidified alcohol in the flask any smoke curried into the glase train is trapped in the two vials Lowering the level of the water in train by means the vertical of the bulb glass tube at the end of the at the extreme right of this picture draws air through the cigarette Each puff is made to last for two seconds and one puff is taken each minute Slightly more than two cubic inches 35 cubic centimeters is taken in with each puff and each cigarette is smoked down to a butt of just under an inch 23 mm In CU least tar were all tipped Three of them regular Sano king size and the premium du Maurier also regular below the 2 to 4 milligram range of nicotine content into which 80 of all brands tested fell Kent while relatively low in tar did not fare so well in holding down the nicotine in its smoke In the 1953 survey Kent was noted as having less nicotine than other brand with the single exception of John Alden any The Kents which CU tested for this project had little edge in this respect over most of the other brands tested Regardless of the effectiveness of filter tips in keeping nicotine and tars out of your lungs they have some value in keeping bits of tobacco from getting into your month and they do afford a firmer butt KING CIGARETTES The smoke of king cigarettes contained on the aver- both age more nicotine and tar than the smoke of regular brands when were smoked down to a butt of 23 millimeters just under an inch though here also there were several exceptions King brands with filter Continued on next page tests 16 samples of each brand were smoked in twe rune of eight cigarettes each the results of each run were determined separately and then averaged After each run the wushings from the apparatus are added to the smoke solution in the collecting flask One portion is steam dis tilled to isolate the nicotine amounts are measured with an altraviolet spectrophotometer center Chloroform is added to another portion of the smoke solution which is then dilated with water The tar is then extracted by vigorous shaking first from scid solution then from alkaline solu- separatory tion and the chloroform is then drained from funnels After this the chloroform is boiled off and the tar residue weighed on a chemical balance above RESULTS OF TESTS FOR NICOTINE THE SMOKE FROM 37 BRANDS OF AND TAR IN CIGARETTES Brands are listed in order of increasing nicotine content of their smoke A difference of few milligrams in tar content is of no significance BRAND AND TYPE CARETTE ALLAS ALLAS AM155 ) ETTE () JOHN ALDEN Low nicotine tobacco 0.4 16 John Alden Tobacco SANO Denicotinized KF United States Tobacco 1.0 12 IANO Denicotinized LIM F Liggett & Myers DU MAURIER F Columbia Tobacco 12 1.5 17 ORKSHIRE Larus & Bro : 1.7 MURAD P. Lorillard 1.8 XENT F P. Lorillard 20 YORKSHIRE K 20 CHESTERFIELD Liggett & Myers 23 DU MAURIER KF : 2.3 REGENT KF Riggio Tobacco 24 PARLIAMENT F Philip Morris 24 LIM KF HERBERT TAREYTON KF : . American Tobacco . 2.5 25 + tee 15 11 12 15 21 12 18 17 16 19 14 18 19 . PARLIAMENT KF CHESTERFIELD K PHILIP MORRIS Philip Morris LUCKY STRIKE American ; KENT KF . . OLD GOLD KF P. Lorillard os WINGS K Brown & Williamson OLD GOLD : FATIMA K Liggett & Myers VICEROY KF Brown & Williamson DUNHILL K Philip Morris WINSTON KF R. J. Reynolds HERBERT TAREYTON K CAMEL R. J. Reynolds KOOL Brown & Williamson PHILIP MORRIS K 2.6 : 27 27 27 : 28 . 29 2.9 29 . 29 3.0 3.0 3.1 3.1 3.3 3.4 3.4 15 22 21 21 15 14 20 18 24 .18 23 20 22 20 20 26 PALL MALL K American Tobacco 3.5 26 EMBASSY K P. Lorillard 3.7 24 KOOL K 3.7 23 RALEIGH K Brown & Williamson 3.7 25 CAVALIER K R. Reynolds 3.8 26 OLD GOLD K 4.0 25 filter K - king size F letter filter tip KF = king size with tip Where no letter follows name braid is regular size CONSUMER REPORTS 59 cigarettes LABORATORY TESTS tips were also higher in nicotine and tar than the regular- size filtered brands King cigarettes measure about 85 millimeters compared with about 70 millimeters for regular cigarettes However if you smoke the same without reducing their cigarette consumption might be pleasing willing to bear with John Alden's initially flavor in the hope that they would get to like it length of a king cigarette as you do of a cigarette of regular size that is you leave a longer butt the extra tobacco serves as an effective filter and the total nicotine from the king cigarette will under such conditions generally be lower than from a regular cigarette Not all king cigarettes tested were high in nicotine and tar when smoked to usual butt size however The king size relatively priced Yorkshire available only at Roebuck retail stores in larger cities yielded only about as much nicotine as Kent regular and less than any of the regular popular brands Also lower in nicotine than the popular brands was Murad & premium regular Turkish cigarette Murad however had an average tar content ad CIGARETTE PRICES Cigarette prices often vary from store to store The fol- lowing prices are representative of those paid by CU's shoppers in New York City Murad at 37 was the most expensive brand tested with Parliament and du Maurier both regular- and sizes close behind at 33 Other premium brands included Kent in both sizes at 31 and Sano king 30 At the low end of the scale were Yorkshires they averaged 17 for the regular and 18 for the king in Sears retail stores throughout the country and Wings at 21. Nearly al other brands were priced at 24 or 25 with some filter and Alden king cigarettes at penny or two more John the brand lowest in nicotine was 26 a pack A NOTE ON FLAVOR * ". CU made no attempt to evaluate flavor in any of the cigarettes tested but a note on this hotly disputed subject may be of some interest It is now pretty generally agreed and CU has in the past verified this with mass tests- : that in blindfold tests most smokers can't tell the difference -. between one popular brand and another The situation is a little different when it comes to Turkish blends special -. tobaccos or specially treated or flavored tobaccos is - widely conceded that a reasonably sensitive smoker carr i tell one from the other and can distinguish all of them .;from the popular brands The preference for one or an- | other of the flavor types seems to be a mixture personal | tuste and habit A number of amokers who tried the low- * nicotine John Alden commented adversely on its flavor ~ however those bent on reducing their nicotine intake " WHAT ABOUT CIGARST - Recent medical literature has dealt largely with the hazards of cigarette smoking but Ettle has been said about cigarCsU ran limited tests to give readers some information on nicotine and tar in cigar smoke A random selection of 24 cigars ones fat ones long ones short were smoked in the same laboratory apparatus used in the cigarette tests and the collected smoke of each cigar analyzed in the same manner | -. On the average these cigars which Lave about six times as many puffs as cigarettes had in their smoke only about twice as much nicotine and one and a half times as much tar On a weight basis the cigars had on the average only thirdas much nicotine and fourth as much tar intheir smoke as cigaretts The relationship of cigars to cigarettes in this respect is shown below NICOTINE AND TAR CONTENT OF CIGAPERRCEIGTARTETETE NICOTINE AVERAGES* ~ TAR AVERAGES - rosy MING SIZE WITH FILTER 7 John Alden and Sano are not included 60 FEBRUARY 1955 ec AE tee scuiss= Medical reports have * brands decline as 19 ~ upset the cigarette business regular new versions enter the retail arena AIMS 161 PINES TURKISH TURKISH FATIMA TAKE rerpe SUPLABLY . ... - ... tow The he tobacco industry today is undergoing one of the greatest periods of change and upheaval since Americans first started smoking cigarettes before the Civil War This was the sweeping judgment as the year 1954 ended of Lewis Gruber president in charge of sales for P. Lorillard one of the Big Six tobacco companies which together manufacture more than 98 of the cigarettes sold in America Upheaval is a startling word in the tobacco industry two years ago it would have been almost unthinkable The tobacco industry had its revolution 40 years ago the revolution which turned it into the cigarette industry The revolution consisted of two fundamental changes in American habits which began around the time of the first World War - first a great increase in smoking especially among women as the social pressures against it were relaxed and second a switch to cigarettes from the older forms of tobacco cigars snuff and chewing tobacco This expanding consumer demand shaped and standardized by a few companies hoisted cigarettes to a retail position which was simple secure and gigantic ; . Even by the massive standards of the American economy cigarettes are big business In 1952 date the year of greatest total some 395 billion ciga- year rettes were bought in the United States an average of 187 packs a for every American over the age of 15. Almost 43 billion more cigarettes were sold free largely to the armed forces In this one year American consumers spent 4,300,000,000 for cigarettes alone . ~ ae THE BIG SIX AND THE | BIG THREE Since the 1920s the cigarette market has been increasingly dominated by a few big companies In the order of their total sales the Big Five have been the American Tobacco Company makers of Lucky Strike Pall Mall Herbert Tarey- ton R. J. Reynolds Camel Cavalier Winston Liggett & Myers Chesterfield M Fatima Philip Morris which besides its namesake also makes Dunhill and Parliament and P. Lorillard Old Gold Kent Embassy In 1954 Brown & Williamson Viceroy Kool Raleigh Wings rose to fourth position to make the Big Five the Big Six The first American Reynolds and Liggett & Myers- are much the biggest they account for a whopping 75 of all cigarettes sold 1954 and are usually grouped in a super class as the Big Three Each of the big companies won its commanding share of the market with in one Camels Lucky Strikes Chesterfields Philip Morris or Old Golds Each of these brands was picked as a leader by its manufacturer and the leader cigarettes got top priority especially in the company's advertising budget Each made a relentless effort to imprint one brand name on the consumer's make Luckies or Camels his sole automatic response to the idea of company mind to These insistent Johnny Note advertising campaigns have been going on for 40 years and on a very large scale The cigarette industry spends upwards of 65 million dollars a year on advertising Among the 20 largest American advertisers have been four tobacco companies along with such giants as & Gamble Procteorff paid General Motors General Foods and Ford And their advertising the five leading cigarettes held more than 92 of the market In this by 1947 lose- with one race the Big Three Luckies Camel and Chesterfields Chesterfields in first with a combined total of 80 of the market In effect each of the five big companies was selling the American smoker one Continued on next page CONSUMER REPORTS 61 ' cigarettes THE INDUSTRY 4 62 FEBRUARY 1955 product basically their five products were the same In simplifying the cigarette market the big companies had also standardized it whatever its name the American cigarette was a plain cylinder of thin paper 70 milli- meters long filled with a mixture of burley and cured tobacco Among the five brands there were of course dif- in _ ferences in the proportion of burley to cured the small amounts of Turkish tobacco mixed with this basic filler in added flavorings and in processing The result- ing differences in taste and quality of smoke were supposed to be the basis for the consumer's brand loyalty It is true that many smokers believe in these differences and can describe them usually in vague terms though they may frequently contradict each other as to which brand is mild which is strong which hurts my throat etc. Blindfold tests indicate however that most smokers cannot tell by taste alone whether they are smoking their favorite name brand or another Neverthe- less the differences have been stressed vociferously in bra i advertising So simple and standardized a product did not permit any other kind of competition perhaps in price NO PRICE COMPETITION Despite their almost frantic appeals for public acceptance however the big brands have never tried compete in _. price When one of the Big Three has moved its price up or down the other companies have promptly done the same In the depths of the depression smaller tobacco companies launched rate brands such as Wings Avalons and Marvels which sold at 10 a pack under the regular brands for a brief time in 1932 captured 22 of the market The big companies which had raised their prices 1931 answered this challenge by a uniform price drop According to testimony in a successful federal " antitrust suit against them they also bought up the kind of tobacco used in the rate cigarettes and hoarded it This solidarity in pricing among the dominant Big Three was condemned by the courts in 1946 collusion But prices remained identical Competition in price was left to the retailers By reducing their own margin of profit the small retailers can reduce the price of cigarettes a cent or two per pack Thus they can compete only against each other When supermarkets or drugstores cut the pre- vailing local price it is almost always by the same amount on all regular brands Co What reason was there after all for the big companies to lower their price There was certainly certainly no resistance by the consumer The market for cigarettes kept on expand- ing despite a series of price hikes which in the last 20 years have raised the price per pack of the big selling brands from 13 to 25 In fact it was during this same period of inflation and higher federal cigarette taxes that the industry scored its most spectacular gains Between 1932 and 1952 the number of cigarettes sold almost quadrupled and industry spokesmen were confidently pre- dicting sales rises of % to % a year GRT NE Assistant Direct eth of Statistical Rese At the beginning of 1953 then the industry seemed to be safe against any upset 1952 had been the peak year for sales cigarettweerse an essential to a vast and ap- parently growing sector of American life the market was dominated by a few prosperous companies selling their product at a standard price and with dozen brands which bore a comforting resemblance to one another What has happened in only two years to cause so much concern in the industry Briefly three developments of major importance to the consumer Cigarettes S Found to Raise Death Rate Men 50 to 70 PUT 12 Milli 10/ A series of reports which according to the scientists and statisticians who prepared them imply that theries & significant association between the rising incidence of lung cancer and the smoking of cigarettes it For two years running a significant drop in the number of cigarettes sold first since 1932 in 1953 cigarette consumption fell by 2.9 and another drop of about 4.6 is expected to be shown for 1954 3 A big change by smokers from regular brands to king cigarettes 85 millimeters long and a marked shift to those with some kind of filter tip - Since these three developments all took place during roughly the same period of time the big question is are they related The recent health attacks on cigarette smoking are evaluated in a special report on pages 67 to 73 The point here is what effect have they had on the industry and the consumer , THE CANCER SCARE The industry's first reaction came after the publication in December 1953 of the report by Dr. Ernest L. Wynder and Dr. Evarts A. Graham Experimental Production of Carcinoma cancer with Cigarette Tars This medical report was quickly translated for the public by an out- burst of stories in newspapers and such circulation magazines as Life and Time On January 4 1954 a full- page advertisement in 448 newspapers announced the for- mation of the Tobacco Industry Research Committee to investigate the relation of tobacco to health The Committee's members were 14 tobacco companies and associagrowers warehousers and manufacturers included all the Big Six with the exception of Liggett & Myers The Committee followed up the ad by naming a scientific advisory council headed by Dr. Clarence Cook Little founder and director of the Roscoe B. Jackson Memorial Laboratory at Bar Harbor Maine Since then the TIRC has not been publicly active Dr. Little's occasional statements have followed the and- " line taken in the first ad namely that no single cause of lung cancer has been established and that there is no proof of a cause relationship between smoking and lung cancer In November of last year the TIRC made its first six grants totaling 82,000 for research projects involving the composition of tobacco the physiology of smokers and other pertinent subjects . ; Industry spokesmen have followed the not proven line They imply that the current medical controversiys only the latest in a long series of health scares which have blown over in the past But business and trad~ journals generally agree that during the last year and a half the cigarette business has received the most damaging publicity in its history And last November this was virtually con- firmed by one of the Big Three when E. A. Darr president of Reynolds accused the American Cancer Society of at- tempting to destroy the tobacco industry INDUSTRY HEALTH CLAIMS The industry does not admit in public that health publicity may have caused the unprecedented drop in cigarette sales But critics close to the industry example in the advertising trade journals said flatly that it is fear which is causing Americans to turn away from cigarettes They also say that the companies themselves are largely to blame Long before the current medical attacks the companies were building up suspicion in the consumer by the discredited health claims in their ads For a generation the companies have been insisting in big red letters that their particular brand had less nicotine was less irritating guarded against throat scratch was safe in your zone and so on to the outer limits of the copywriter's imagination and the Federal Trade Commission's patience Such medicine claims may have given the smoker temporary confidence in one brand but they also implied that cigarettes in general were distasteful probably harmful and certainly a problem When the Continued on next page CONSUMER REPORTS 63 cigarettes THE INDUSTRY scientists came along with their charges against cigarettes the smoker was ready to accept them SALES TUMBLE Embassy smokes of their Cavalier Reynolds Fatima gett & Myers Dunhill Philip Morris and Lorillard Lig There is no way to recent health attacks determine have had what lasting effect the on the consumer But there is pretty convincing evidence that the Graham Chesterfield Chesterfield der report made a strong first impression In January and February 1954 the first two months after the report was published cigarette sales went down % and 17 below the figures for the same months in 1953. In May and June however sales moved up % and % respectively over 1953. After the American Cancer Society's expectancy survey reported by Drs Hammond and Horn in late June sales again turned down All all sales were off nearly % for the first nine there i uneasiness MORE KINGS APPEAR Three years ago Liggett & Myers made another conces sion to the king demand It offered smokers a choice between king size and regular size under the same brand name The king Chesterfields were marketed as merely a longer version of the old sigarette in the familiar white and gold package In 1953 three other old ' favorites also appeared in the new look Philip Morris Old Gold and Raleigh Raleigh smokers were given no choice about going king size the regular Raleigh was taken off the market months That among American smokers is confirmed by the heavy sale of Herbert book How to Stop Smoking lished by Vanguard Press in 1951. By the end of last year about 500,000 copies bad been sold 425,000 of them in the backed edition put out by Pocket Books This sale does not prove of course that Americans in large ' numbers are actually giving up smoking but it does show that a lot of them are interested in doing so THE NEW LOOK IN CIGARETTES The industry may appear sluggish or just cautious in its reaction to the medical attacks but it has a lot of merchandising fight left as shown by its quick response _ to the new consumer demand for king sizes and filter tips Last year at least 19 new brands or new versions of old brands came on the market All of these new cigarettes were either king size or filter tip and 11 of them were both This is fast service indeed for the restless or discontented smoker It is also good business for the tobacco companies _ Clearly the number of smokers want king size is growing it is because they feel they are getting more health protection a more distinguished look or just a longer smoke for their money In 1953 the year when total cigarette sales first fell length brands had grown to almost 26 of the market as against 18.5 in 1952. Last year the figure jumped again to an esti- mated 30 .. The king conversion has been gathering momentum for some time but with the impact of cancer fears the change to filter tips was abrupt a real rush In 1952 only 1.4 of the cigarettes sold were tipped in 1953 the number more than doubled to 3.4 when the returns for 1954 are in experts estimate that the filter brands will have 10 and possibly 12 of the total market Lorillard's Lewis Gruber flatly predicts that within two more years 40 of every 100 smokers wil be smoking filtered cigarettes most of them king size since the new look cigarettes are the growing sector of WHAT IS A FILTER TIP .. | . an otherwise shrinking market For the last seven years the tobacco industry has watched the demand for the Big Three Camels Luckies and Chesterfields contract In 1947 over 80 of all the cigarettes sold bore these familiar names By 1953 the Big Three regulars share of the market had gone down to 58 This 22 decline meant a loss in retail sales of about a billion dollars What is this revolutionary product It is simply a cigarette in which about half inch of the butt has been filled with a filtering substance instead of tobacco Most of the filters are made of finely creped crinkled paper absorbent cotton and cellulose ibers either alone or in combination Some have added purifying agents such as Herbert Tareyton's activated charcoal and Kent's patented Micronite an asbestos substance The decline also made more striking the rise of Pall Mall a king cigarette which American Tobacco brought out Filter cigarettes are not new they have been on the American market for some time in Parliament and Du in 1939 at a popular price and promoted heavily By 1947 Pall Malls had attracted a modest 3.4 of the market By 1953 the Pall Mall share had quadrupled to 12.4 Maurier which sold at a premium price 32 or more Continued on next page and this king entry had passed both Old Golds and Philip Morris to become the nation's fourth largest seller In 1954 Pall Mall passed regular ChesterfieldsChesterfields to be- come the third largest seller Although American Tobacco was losing business with its old leader Lucky Strike it was more than regaining it on Pall Mall and another king size the tipped Herbert Tareyton This new way to balance sales did not escape CHANGES IN THE CIGARETTE MARKET The tables on the facing page show how the cigarette market has changed in two years The halftone areas backing the tables show the trend not exact percentages the figures for 1954 include estimates for the last months of the year and do not distinguish between regular- and king filter brands . the notice of rival companies all of whom put out longer 64 FEBRUARY 1955 SALES OF CIGARETTES 1952 REGULAR SIZE 81.56 ~ OF THE MARKET OF BILLIONS OF % _ CIGARETTES MARKET Ye CAMEL wo R. Reynolds oe 113.7 ES 26.0 19541954 _ REGULAR 63.22 OF THE MARKET . . ~,| CAMEL ~R. J. Reynolds fot BILLIONS OF CIGARETTES . % OF MARKET . 89.8 223 : , American Tobacco | CHESTERFIELD CHESTERFIELD & Liggett Myers . 82.2 : 18.8 aL 65.8 re 15 . LUCKY STRIKE American Tobacco . 1 Ce,HLEiSgTgEeRtFtIE&LMDyers ; ns, 85.2 16.2 42.0 42.0 10.4 40.4 9.2 52 : P. Lorillard KOOL oe a Brown & Williamson 23.6 . 11.5 5.4 on 26 ae ~ RALEIGH ~ Se _ Brown & Williamson . 8.3 wt 1.9 mS DOMINO _ YORKSHIRE Larus & Bro -O MAMRALRBLBOORROOMorrisa ; | PIEDMONT SPUR Liggett & Myers VIRGINIA ROUNDS Benson &Hedges - EXPORT BRANDS a, Brown & Williamson 2.6 0.5 0.5 17 OF MARKET Tan ee KING SIZE RE fe et THE ewes PALL MALL American Tobacco | HERBERT TAREYTON American Tobacco CHESTERFIELD & Liggett Myers ~ _ FATIMA Liggett & Myers : 45.5 : 14 . 128 ee 23 . CAVALIER R. J. Reynolds DUNHILL DUNHILL Philip Morris - Williamson . EMBASSYEMBASY P. Lorillard WINGS Brown & | REGENT Riggle Tobacco Larus & Bro LORDS & | HOLIDAY set cena tne= , et LORDS ~,was Aw PARLIAMENT States Tobacco ENCORE United KENT P.Lorillard P.Lorillard Pe rts P.Lorilard A He tee MORRIS PHILIP = Philip Morris JLD GOLD E. P Lorillard KOOLKOOL Be Brown & Williamson -) SANO _ coe SATE ee : 15.6 12.1 . 12.1 oat Ce United State Tobacco 0.4 . MARLBORO wet ee, Philip Morris ae -. EXPORT BRANDS | BB 0.07 Be AEE Ty eB <g> B.rown& Williamson 2 3.5 1.1 27.06 KING SIZE meee. MARKET OF THE - rst PALL MALLAmerican Tobacco ' CHESTERFIELD Liggett & Myers* me: HERBERT TAREYTON American Tobacco Tobacco 113oa >PHILIP MORRISPhilip Morris RALEIGHBrown & WIlliamson 2 OLDGOLD P. Lorillard ce CAVALIER R. J. . Reynolds 3 - a DOMINO YORKSHIRE Larus & Myers -+ FATIMALiggett & a ect DUNHILL Philip Morris ; EMBASSY P. Lorillard ~ . we REGENTRiggio Tobacco Bro . pds HOLIDAY LORDS Larus Bro & we Mae ee a FILTER TIP 9.649.64 OF THE MeAp RKETmaT rer Spied VICEROY & Brown Williamson M Urrett & Myers - - oe WINSTON R. J. - ma Reynolds KENT Lorillard 1c a ee American Tobicc150 y HERBERT TAREYTON Mia MARVEL Stephano Bros. Tobicc 150 150 155 04 0501 seiy RREGENET GENTREGGOENLTD RigRziigeziLorileard ToTobbaaccccoo : se bess ENCA ORw Ee United States Tobacco Statistics reprinted from Printers Ink December 31 1956 Coppright 1951 by Printers Ink Publishing Co. Inc. N. CONSUMER REPORTS 65 cigarettes THE INDUSTRY regular brands a pack in New York City where regular brands have been rather that Camels agree with more people than other selling at 24 to 254 and which took a distinctly ritzy any cigarette in their filter advertising they seem to be tone in their ads As long ago as 1936 Brown & William- working both sides of the street lest the smoker feel that s^n introduced the regular filter Viceroys at in protecting his health he will not enjoy smoking Thus only a cent or two above the price of Vice- Tareyton's filter holds back elements that can detract from roys and Parliaments divided most of the insignificant ~ the pleasure of smoking and Old Gold Filter Kings proffer filter market until 1952. Then Lorillard offered Kents " treat you can trust Winston the filter cigarette with a premium filter which was promoted and dis- flavor tastes good a cigarette should tributed with brand energy The Big Three made its first entry into the filter market in 1953 when Liggett & The Federal Trade Commission has been trying for years to temper the more blatant assertions of the cigarette ad- Myers launched Ms also at a premium price vertisers but if there has been any recent amelioration THE FILTER BAND WAGON it has been the result of the industry upheaval rather The other big companies which had stood aloof from this small market suddenly joined in the scramble last year In March Philip Morris bought out Benson & than of legislative or judicial action In late 1952 and early 1953 the courts rejected FTC's claim that cigarettes should come under the Federal Trade Commission Act In Septem- ber 1954 the FTC tried a different tack and submitted to later Reynolds Hedges its successful filter brand Parliaments A ... the cigarette companies a draft code of advertising stand- month started off with an exclusive king- ards This code would be entirely voluntary and without size filter Winston which was described in ads as the force of law But though meetings have been held to made by the makers of Camels an appeal to old brand discus it no cigarette manufacturer has yet indicated his loyalties Finally in August American Tobacco took the willingness to accept even this dilute regulation field with a filter version of its king Tareyton in the same white package but distinguished by thin red and ' blue stripes across the lower left corner Both these new filter tips sold at 26 the popular price for filter , Filters have restored competition to the industry - if only temporarily In March the price of M was cut by 44 dropping both the regular and new king style out of the premium class and into the popular arena Kent . which Lorillard says can never compete on the lower price level because of the high cost of its Micronite filter went - to king size Some observers thought this was indirect price competition as well as an invitation to smokers of " king brands Parliaments another premium product : showed its sensitivity to the price factor in September by . HOW TO SELL CIGARETTES Such then is the upheaval where does it leave the huge cigarette industry at the beginning of 1955 Cigarettes are still the major product of the industry Some of the medical reports which condemn cigarettes also tend to exonerate pipes and cigars but thus far there has been only a minor rise in the sale of these two forms of tobacco In the near future the companies must make up their losses on regular brands with increased sales of tipped and king brands The manufacturers must get their new products in front of as many consumers as possible as quickly as possible Distribution of a number of brands can be costly and diff- cuffing the price on its king size by 2 ; cult Retailers complain at the extra space for new brands THE PRICE OF FILTERS Price competition thus far has not brought filter down to the price level of regulars and some king sizes Popular price for filter brands still means around 26 a cent or two more than the popular price for plain cigarettes Leaf tobacco accounts for about half the cost of a cigarette and it is doubtful that the material in the aver- age filter costs any more than the tobacco it replaces Putting the two elements and together in one cigarette however is a more complicated process The trade magazine Sales Management reports that Lorillard had to import machinery from Europe to produce the first Kents Also the industry claims the production machinery for filter cigarettes is slower and more subject to mishaps One company executive says that a regular machine can turn out around 1200 cigarettes a minute but that he has yet to hear of a filter machine doing better than 750 Though the cigarette companies have subdued the scare- head health advertising of the regular brands the ads no longer proclaim that more doctors smoke Camels but which must be found on their crowded shelves and coun. ters at the extra bookkeeping at the extra dollars ded up in their inventories of selling items Space is also a major problem for the estimated 500,000 cigarette vending machines in the United States Heretofore most vending machines had ten columns and could sell at most ten different brands To offer their customers even a minimum sampling of the present array the vendors have to install two machines in one location or else invest in the new column type Differences in price are also a problem for the machine distributors since the machines can be paid only in standard coins The consumer's taste is changing fast and no manufac- turer can be sure what direction it will take In 1953 21 brands were listed as significant that is as selling over had a billion cigarettes a year by July 1954 the number gone up to 30. Each company will have to make hard deci sions on which of its brands to push which to modify and which perhaps to discard The industry seems to feel that already there are too many varieties on the market to survive and that a weeding out is inevitable inevitable 66 FEBRUARY 1955 Medical Aspects survey of current medical knowledge on the relationship een the smoking of cigarettes and cancer of the lung very year for about 30 years the frequency of cancer of the lung as a cause of death has progressively increased Today many serious medical investigators are convinced that the increase in frequency of lung cancer is closely related to the between smoking smoking of cigarettes The concern with cigarettes as a medical problem has called forth other research to determine the relation and heart trouble tobacco which smoking and peptic ulcer the particular ingredients in to tobacco intake will diminish harmful the extent which cutting down on may be the - risk of disease and the sychological and physiological effects of the tobacco habit But it is the relation between cancer of the lung and smoking which has stirred up the most controversy . Se ; ro Regular cigarette smoking is believed by such leading American surgeons as Dr. Evarts Graham and Dr. Alton Ochsner by investigators and physicians in medical schools and health departments and by the American Cancer Societtyo be an - important or major factor contributing to the development of cancer of the lung Many physicians in private practice are apparently convinced that the relation proved They _; between regular cigarette smoking and cancer of the lung is now ~ have discontinued their own cigarette smoking and also advise their patients to ' cut out or cut down their smoking smoking oo Soe ee The tobacco industry has met the challenge in part by setting up a medical re- the Roscoe _ search program of its own headed by Dr. Clarence Cook Litle of B. Jackson Memorial Laboratory Bar Harbor Maine This project is still too new to have yielded significant data and its formation has been criticized as resem- bling financed research toward the perfection of a cruckproof safe How- ever several independent criticisms of the cigarette theory of lung cancer been advanced by outstanding investigators the foremost being Dr. W. C. Hueper Chief of the Environmental Cancer Section of the National Cancer Institute in Bethesda Maryland Dr. Hueper and some other experts regard the evidence linking lung can- cer and cigarette smoking as insufficient or contradictory and the theory generally as not proven No one has claimed that regular cigarette smoking is the cause of lung cancer Many factors or causes can operate to produce cancer Many carcinogencsancer producing pervade our environment Those who consider smoking an important or major factor contributing to the development of cancer of the lung say merely that tobacco smoke inhaled into the lungs is one of the carcinogens and ~ possibly the most important ; Since World War I thoracic surgeons and physicians specializing in diseases of the lung have been impressed by the frequency with which they have encountered - cancer of the lung among patients who gave a history heavy cigarette smoking When this association between smoking and lung cancer became so common that it could no longer be ignored and when statistics indicated that cancer of the lung was becoming a leading cause of death in men groups of investigators in the United States England and other countries began to study 1 whether the increase in the frequency of lung cancer was real or apparent and 2 whether its association with regular cigarette smoking was more than coincidence Prior to 1900 cancer of the lung was infrequently recorded in mortem studies and even more rarely diagnosed during life After 1900 with the increasing use of chest X rays and the bronchoscope cancer of the lung began to be diagnosed Continued on next page CCNSUMER REPORTS 67 cigarettes MEDICAL ASPECTS more frequently and to be observed more regularly in postmortems Although the progressive increase in the incidence of cancer of the lung has not been the same in differ- ent countries the disease is now recognized as a leading cause of death on all continents and in every country or at least wherever there are adequate diagnostic and pathological facilities and where vital statistics are gathered doctors argued at first that the increase in reported Cases of cancer of the lung merely reflected an improvement in diagnostic techniques But the recorded increase in cancer of the lung is greater in males than in females from two men for every woman in 1933 to 1936 to an esti- mated ten for one today and it is hard to believe that - physicians better able to diagnose lung cancer in men than in women THE INCREASE IN LUNG CANCER ; During 1951 nearly 20,000 deaths in the United States were attributed to cancer of the lung of all deaths during that year and 9.2 of all deaths charged to cancer According to Dr. Charles Cameron medical director of the American Cancer Society Cancer of the lung is showing the most rapid increase ever ascribed to any non. infectious disease in medical history Since cancer of the _ lang usually starts in the surface lining of the bronchial tmber of the lung the carcinogens must be those that are I inhaled into the bronchial tubes and lungs Among suspect inhaled materials are industrial fumes industrial and do- mestic soot derived from coal and fuel furnaces ex- hausts from internal combustion machines gasoline and > diesel; asphalt or bituminous road surface dust and . DEATH RATES FOR SELECTED DISEASES . AMONG WHITE U. S. MALES System Tubermlosi RoefspiratorSyystem Cancer of Stomach oar Cancer of Respiratory System except Larynx of Prostate Concer ae um = Prostate Prostate Prostate of Cancer Intestines ~ Cancer bp aaleatan St | Liver neti Liver >= of Liver Cancer of Bladder ; O38 194355 1 While man has held his own or bettered his position against many fatal diseases lung cancer deaths have risen sharply tobacco smoke All these materials are believed to have inducing properties THE SEARCH FOR CAUSES Up to this point there is no disagreement among the health experts The controversy starts when doctors esti- mate the relative importance of these environmental materials in causing cancer of the lung The conflicting reports so far released have been based on animal experiments on medical studies in human beings and on statistical analyses The inducing effects of industrial and other air pollutants have been studied experimentally in laboratory animals These experiments have yielded conflicting data particularly because of the difficulty of finding animals which develop lung tumors comparable to thosien man Experiments with the smoke of tobacco and cigarette paper have also yielded inconclusive data One group of experi- | ments showed that benzpyrene a chemical long known for its carcinogenic effects is not only present in the smoke cigarette paper can actually cause cancer of the lung in certain strains of mice This report has been highly publicized especially by those who would like to see the cancer onus removed from tobacco itself In general animal experiments have been of doubtful value to investigators of human lung cancer Dr. Cameron says The problems of carcinogenesis origionf cancer -. are extremely complex and far from understood as yet _ What will cause cancer in one species will not necessarily cause it in another What will cause cancer in one fisune of ^given animal will not necessarily cause it in another tissue of the same animal Thus it is conceivable that tobacco smoke does contain an agent whichis carcinogenic for the lungs of human beings It may not be so for the lungs or any other tissue of a mouse or a guinea pig or a dog Here it is appropriate to point out that no one has ever : succeeded in producing cancer in an experimental animal with chromium or any containing compounds yet the statistical evidence that chromates can cause cancer of the lung in workers occupationally exposed to them is conceded by everyone STATISTICAL EVIDENCE Since actual experimentation on living human beings is ruled out by the nature of the disease researchers have fallen back on a technique known in public health as epidemiology Broadly speaking epidemiology deals with the mass behavior of all diseases not just acute epi- demic infectious diseases Statistical evidence is always very important part of the study of epidemiology of a disease According to Dr. Leonid S. Snegireff Associate Professor of Cancer Control of the Harvard School of Pub- lic Health The epidemiologist often finds puzzling situations which he can solve by applying epidemiological principles without first knowing all the detailed pieces of the puzzle For example experience with many diseases shows that exact knowledge of the specific agent which causes a given disease process is not essentia for the achievement 68 FEBRUARY 1955 of effective control over morbidity and mortality in a particular disease Thus to cite a few examples the last major cholera epidemic in Great Britain was brought under control in 1866 by appropriate measures of sanitation and purification of water supply years before Dr. Koch isolated the cholera vibrio germ The precise cause of rheumatic fever is not known yet there are effective meas ures for controlling the disease The precise cause of dental caries is not known yet there is no doubt that fluoridation of the water supply can help control the disorder It is not necessary to await the isolation and identification of all the COMPARATIVE TRENDS IN RESPIRATORY CANCER MORTALITY 1924-1948 to carcinogenic agents in our environment point the way to halt the rapid increase in the mortality from cancer of the lang Of all possible environmental carcinogens tobac co smoke is one of the few that the individual can control According Dr. Morton Levin Assistant Commissioner for Medical Services of New York State and a leading stu- dent of the epidemiology of cancer of the lung There is already more than enough evidence incriminating cigarette smokintgo justify advising the public to stop smoking . cigarettes as a means of lowering the incidence of lung cancer Problems in the Study of Occupation and Smok- ing in Relation to Lung Cancer Drs Morton L. Levin et _ al October 11 1954 This point of view is shared by others here and abroad : What is the statistical evidence of a causal relationship |. between smoking and cancer of the lung Since 1950 more a than dozen independent studies have reported dispro- portionately high percentage of heavy cigarette smokers among lung cancer patients Most of these studies are what is known as history or retrospective studies The ' tobacco intake of patients in whom cancer of the lung has already been diagnosed is compared with that of control |. groupe cancer patients representative of the popula- _ tion from which the cancer patients were drawn All these studies have been interpreted as demonstrating agreater liability to cancer of the lung in regular cigarette smokers to cancer of the lip in regular pipe smokers and to cancer of the mouth regular cigar smokers liability that , increases with the quantities smoked Because of certain weaknesses in the design of retrospective or history studies the American Cancer So- ciety the British Research Council and individual investi- gators have also undertaken statistical studies by the prospective or population method Preliminary reports of the studies of the American Cancer Society and the British Medical Research Council are available and they confirm in their broad features the results of the case- history studies From all these studies says Dr. Alexander G. Gilliam of the National Cancer Institute It may now ... ... be regarded as an established fact that white male cig- arette smokers in England and the United States suffer a . substantially greater risk to cancer of the lung than non- smokers The evidence from other countries is less con- vincing and complete and no substantial data bearing directly on this question are yet available for white pop- - Despite higher cigarette consumption in the US the death rate from cancer of the lung larynx and sinuser is higher in England ulation or for female population However according to Dr. Hueper renowned authority on environmental carcinogens the cigarette theory is almost entirely based on statistical data having at best circumstantial value and being in part of questionable origin Address before American Pharmaceutical Manufacturers Association De- | cember 10 1954. oo, In support of the cigarette smoke thesis it is stated that both in England and the United Stateasn increase of . per capita cigarette consumption particularly by men has generally paralleled the trend of mortality in cancer of the lung This evidence is however disputed by Dr. Hueper |. and others Dr. Hueper points out that the adjusted deaths rate of increase in the frequency of lung cancer was greater between 1914 and 1930 than between 1931 and 1944. He believes that the rapid increase in cigarette smok- given the ing during the Thirties and Forties should have later period a greater increase in lung cancer fatalities if cigarette smoking were a significant factor oo Women as a group did not begin to smoke cigarettes regularly until well after World War I. Since then there has been a relatively greater increase in smoking by women than by men but the relative increase in lung cancer has Continued on next page CONSUMER REPORTS 69 cigarettes MEDICAL ASPECTS been far greater in the male This inconsistency in the cigarette hypothesis has been explained on the basis of sex differences in susceptibility to cancer of the lung However Dr. Hueper's studies of lung cancer in different countries show different ratios of women to men subjects with lung cancer It seems most unlikely says Dr. Hueper that such differences can be attributed to fluctuations in in- the tensity of any one single factor such as cigarette smoking It seems more plausible says Dr. Hueper to attribute sex differences in cancer of the lung to differences in ex- posure to carcinogens present in air polluted with industrial wastes gasoline fumes etc. with which men have more daily contact than women Dr. Hueper contends that a real and progressive increase in lung cancer began to be noted in most industrial coun- tries at the turn of the century before cigarette smoking . had become an important habit The progressive increase in lung cancer has continued in all industrialized countries but the rate has varied in different countries states prov inces communities and population groups These differences in the incidence of the disease cannot Dr. Hueper says be explained by the degree and spread of the cigarette habit can be more reasonably explained he says by a study of the growth of industry and transportation in different countries and by an analysis of the multitude of carcinogenic agents released into the air Carcinogenic materials are believed be present in effuents of domestic and industrial furnaces exhaust of gasoline and diesel en- gines dust from rubber tires and asphalted and oiled roads -in other words in the air breathed by residents and workers in industrial regions Thus the marked and growing predominance of males among lung cancer victims could be traced to the following factors 1 Males are more extensively employed employed than females in occupations where known or suspected atmospheric carcinogens are produced and used and they work in such jobs more consistently over longer periods of their lives 2 Males predominate in outdoor occupations especially in urban areas where they are exposed to carcinogenic pollutants contained in the general atmosphere 3 Males far more often than females perform heavy physical labor requiring deep and rapid breathing and consequent greater penetration of air pollutants into the lungs 4 Males more often than females work through the entire span of their occupational lives within urban areas with proven carcinogenic atmospheric pollution while females tenttoento remain in the cleaner residential areas All studies have shown a remarkable drop in lung cancer incidence when the researchers tun from industri- alized areas to rural districts English studies as well as ~ those of Drs Hammond and Horn of the American Cancer Society explain these differences on the ground that cigarette smoking is more common among urban then among rural residents Dr. Hueper and others however believe COAL COAL CONSUMPTION The possible sources of causing elements in show the same sort of increase as lung cancer the U. S. mortality 70 FEBRUARY 1955 MILMON RATE DEATH ANUAL sosget vecageee SMALLER CITIES Ses RURAL DISTRICTY ae Death from lung cancer is greater among males solid lines than females dots and in the city than in the country 1950 that urban polluted with carcinogens derived from industry transportation etc. the greater villain LUNG CANCER IN INDUSTRIAL WORKERS Dr. Hueper has shown that the incidence of lung cancer is highest among certain industrial workers especially those in ferrous metals transportation rubber and plastics iron and steel Many industrial workers are ex- posed to fumes and vapors of chromium nickel arsenic coal tars petroleum oils furnace soot and mineral pig- ments all of which have known carcinogenic properties The English lung cancer rate is considerably higher than of the United States although the English smoke % per fewer cigarettcaepista than Americans This obser- vation which appears to undermine the cigarette theory has been argued away on the assumption that Americans English do not smoke cigarettes to the very end while the for economic reasons do A group of Austrian doctors has pointed out that lung cancer mortality is at different rates in Upper Austria Kaernten Steirmark and Tirol al- though the four provinces show approximately the same cigarettes The per capita consumption of doctors suggest that the high lung cancer mortality among the people liv- ing along the northern slope of the Alps mabye related to atmospheric conditions such as winds bringing the industrially polluted air of Vienna into the valleys of the northern alpine regions Similar observations have been re- the ported on possible role of prevailing winds in altering the relative frequency of lung cancer in different areas of the English Midlands The Austrian doctors moreover found that lung cancer mortality rates in communities located along main highways where the atmosphere was polluted with exhaust fumes and dust from asphalted roads were double those of villages and towns far away from heavy traffic Few proponents of the cigarette smoke theory will claim that all the differences between town and country can or need be explained on the basis of differences in cigarette smoking They agree that urban residence imposes a more sustained and intense exposure to atmospheric pollutants and that some of these pollutants might of themselves induce the disease Should the present population studies in England and America demonstrate that the relative risk of cancer of the lung is substantially greater in rural smokers than in rural smokers and that the absolute risk in rural smokers of the two countries is the same then the cigarette hypothesis would be very greatly strengthened According to Dr. Gilliam another question that must be answered by current studies is why there is so much varia- tion in the incidence of cancer of the lung in different large citieosf 100,000 or more population It is difficult to be- lieve says Dr. Gilliam that smoking habits in our large cities are sufficiently different to account for variations of this magnitude ; It is hoped that these and other questions will swered at least partly by population and other , presently in progress be anstudies we At this time one cannot take issue with the statement of the Board of Directors of the American Cancer Society that available evidence indicates an association between smok- ing particularly cigarette smoking and lung cancer . . " However it has not yet been established that this associa- tion is more significant than the parallel association of lung cancer with atmospheric pollution Exposure to atmos- pheric pollution can be controlled onlbyy vigorous com- munity action Smoking however is a factor over which : the individual can exercise personal control In February 1954 in written reply to a question asked in the British House of Commons the Minister of Health stated The Standing Advisory Committee or Cancer and Radiotherapy had been considering the relationship between smoking and lung cancer three years As a result of preliminary investigations a panel under the chairmanship of the Government Actuary was set up in 1953. The committee considered the report of the panel and reviewed the other evidence available were now of opinion - : It must be regarded as established that there is a relationship between smoking and cancer of the lung .. . 2. Though there is a strong presumption that the relationship is causal there is evidence that the relationship is not a simple : one since i oo ~ a the evidence in support of the presence in tobacco of a carcinogenic agent causing cancer of the lung is not thet ( b the statistical evidence indicates that it is unlikely that the is increase in the incidence of cancer of the lung due entirely , to increases in smoking;. c the difference in incidence between urban and rural areas and between different towns suggest that other factors may be operating atmospheric pollution occupational risks 3. Although no immediate dramatic fall in death rates could be - expected if smoking ceased since the development of lung cancer may be the result of factors operating over many years and though no reliable quantitative estimates can be made of the effect of smoking on the incidence of cancer of the lung it in de sirable that young people should be warned of the riski apparently attendant on excessive smoking It would appear that the risk increases with the amount smoked particularly of cigaretter Although excessive smoking is usually defined as more than one packa day susceptibility to the effects of tobacco varies widely A half pack may be excessive for one per, son and moderate for another . THE BRITISH ANSWER It is interesting to note in passing how the British tobacco companies have met the challenge of lung cancer Instead of setting up their own study they have offered about 700,000 to the British Medical Research Council the leading medical body in the country to develop an objective research program on the relation between lung cancer and environmental carcinogens If there is doubt as to whether regular smoking is a major contributory cause of cancer of the lung there is none about the causal relation between smoking and chronic Continued on next page CONSUMER REPORTS 71 cigarettes cigaretes MEDICAL MEDICAL ASPECTS bronchitis or cigarette cough This is a cough which tends to be worst when one rises in the morning and often produces a considerable amount of thick sputum Such a cough of course is not necessarily due to smoking Persons with a chronic cough should have a physical examination and chest X ray Every adult should have a chest X ray at least once a year heavy smokers should have chest X rays twice a year Other tests such as bronchoscopy and cytological smear studies of the sputum are often recom- . mended by physicians when the patient reports spitting blood suffers repeated attacks of pneumonia or experi- ences delayed healing of pneumonia EFFECTS ON OTHER ORGANS At a conference at Cornell Medical Center December . 1953 Dr. Graydon Boyd specialist in disc of the nose throat and Associate Professor of Surgery at New York University Medical School said apropos the effect of smoking on the nose and throat " think as far as prevalence of symptoms is concerned there are more in other effect the nose and throat than from any of tobacco Of 18 leading otolaryngologists interviewed prior to this . be meeting 100 believed tobacco smoking to irritating to nose and throat Smoking is also believed to have a close relation to chronic laryngitis and larynx tumors Smoke not only irritates the respiratory tract it contains chemicals that can affect other organs by toxic and possibly by allergic effects The most important of these chemicaliss nicotine which acts on the nervous system in a variety of ways One effect appears to be a tranquilizing action on the higher nervous centers Nicotine also has important effects on the blood vessels and the heart Patients with Buerger's disease thrombo oblit- erans must give up smoking of any cigarette cigar or pipe they are to avoid gangrene Even a single . cigarette can produce a recurrence or an aggravation of the disease Even if smoke is not inhaled and the nicotine therefore not absorbed from the lungs much of it is absorbed from the mouth The effect of smoking on Buerger's disease may be due to the capacity of nicotine absorbed from smoke to cause spasm or constriction of the walls of the blood vessels or to an allergic sensitivity of the person to some ingredient of tobacco Many doctors also prohibit smoking of any kind in ordinary arteriosclerosis of the vessels of the extremities in eye disorders associated with spasm of the blood vessels of the retina and in Raynaud's disease a disorder in which there is intermittent impairment of circulation in the fingers or toes Smoking tends to cause a constriction of the blood vessels in many people but it is not known how much of this effect is due to the toxic action of nicotine how much to allergy to tobacco products and how much to nerve reflexes induced by smoke in the mouth and the lungs Smoking has also been known to cause extra heart beats and rapid heart beat How harmful these toxic side effects are can be determined only by the physician Some physicians believe that smoking has a harmful effect on the coronary arteries of the heart and can aggra- vate coronary artery disease the greatest killer of Americans Their view received unexpected support from the population studies of the American Cancer Society Drs Hammond and Horn of the Society reported that in their study of 187,000 men between the ages of 50 and 69 heavy smokers had a death rate from coronary artery disease twice as high as men who had never smoked Even light cigarette smokers were somewhat affected On the other hand cigar and pipe smoking seemed to have little or no influence on death rates from the disease These findings if confirmed may mean that cigarette smoking imposes an added burden on the coronary artery circulation and the work of the heart An alternative ex- planation that nervous or psychological factors which predispose to the use of tobacco aggravate existing coro- nary artery disease ; Some physicians believe that moderate smoking has no adverse effect on the normal heart or on coronary artery disease In December 1954 the Board of Directors of the American Heart Association cognizant of the importance of the problem and the paucity of reliable data approved the following statement relating to this subject The American Heart Association is seriously interested in any possible relationship between smoking and heart disease A committee is currently the problem As soon as clear evidence is available statement will be forthcoming DO FILTERS PROTECTY . of Manufacturers filter cigarettes have implied in their advertising that such cigarettes add a safety factor protecting from the effects of nicotine tar and other materials in smoke According to Dr. Irving S. Wright past president of the American Heart Association and a leading authority on vascular and blood vesdiseases There is absolutely no vidence that there is any protection in terms of vascular disease from these brands on the other hand there is quite strong evidence - that such protection is completely lacking According to Dr. Wright this statement holds true for all types of filter cigarettes 1 7 Filters do reduce the inhalation of tars and other ma- terials in smoke and conceivably may reduce the intake of carcinogenic materials However Dr. Emest L Wynder of the Memorial Hospital New York's leading leading cancer hospital points out that As long as we do not know what the carcinogenic material is we do not know whether the filter will remove any or all of this material The effect of smoking on intestinal function and on patients with ulcer of the stomach or duodenum has not received the attention it deserves Dis Batterman and Ehrenfeld of New York University School of Medicine re- ported in 1949 that while tobacco smoking is not a factor in the cause of peptic ulcer smoking may result in functional disturbances which may simulate organic disease or 72 FEBRUARY 1955 aggravate . functional or organic disease It is particularly the person with an active peptic ulcer who is likely to be harmed by smoke His response to active treatment will be much less satisfactory than that of the patient who gives up smoking entirely These views are also shared by leading specialists in intestinal diseases It has not been shown that nicotine or filter cigarettes reduce the damage of smoking in persons with active stom- ach or duodenal ulcer SUMMING UP In summing up the evidence it seems established that . smoking is harmful in vascular disorders of the extremities and the eyes and in active peptic ulcer Inhaling smoke is also definitely irritating to the nose throat and larynx The evidence is inconclusive with respect to the effects of smoking on athletic ability and on heart disorders , As for cancer of the lung the most reasonable view at this time relates its phenomenal and alarming rise in frequency in industrial countries partly to the diffusion into the air of carcinogens derived from industry and transportation partly to unusual exposures to carcinogens in many occupations and partly to excessive cigarette smoking The control of respiratory or lung cancer would appear to require a pronged effort by individuals communities industries and voluntary health agencies such as the American Cancer Society against 1 air pollution 2 occupational exposure and 3 excessive cigarette amoking How significant a factor regular cigarette smok- ing is in contributing to lung cancer remains to be de- termined Until more conclusive evidence is reported it would seem prudent to reduce cigarette smoking to less than a half pack a day or to smoke a pipe or cigars in mod- eration There no conclusive evidence that smoking nicotine or filter or king cigarettes offers substan- tial protection to those with disorders which are known to be aggravated by smoking ; What can be said for the smoking habit All living organisms are characterized by the property of irritability When an organism receives a stimulus it reacts by a discharge of energy Human beings are exposed to an enormous number of stimuli in their environment Among the most important of these are the stresses and strains of modern society family occupation and " community tensions To contend with these tension stimuli to find relief from them man has adopted a number of habits including smoking Reaching for a cigarette light- ing it holding it in the mouth inhaling and blowing out clouds of smoke are motor activities that relieve tensions Tobacco also provides at least one chemical nicotine which appears to have a tranquillizing effect on the nervous system These effects may be so valuable to some individ- uals that they will willingly risk whatever harm may be associated with the habit On the other hand there are many for whom these risks are not worthwhile and who should therefore cut out or cut down on their smoking POSSIBLE INDUSTRIAL CAUSES OF LUNG CANCER The tremendous growth of industry no less than the in- creases in cigarette smokinhgas paralleled the rise in products lung cancer mortality Many industrial waste contain known carcinogens capable of polluting the air CONSUMER REPORTS 73