Tob Control: first published as 10.1136/tc.6.1.1 on 1 March 1997. Downloaded from

34 Pauly, Stegmeier3 Mayer, Lessesi Sireck AN IN TERN ATIO N A L JOURNAL if we did not control the individuals' normal gap, no charcoal (low); >1 gap, no charcoal smoking behaviour. We know of no other pub- (medium); and >1 gap, with charcoal in the lished studies that have used human subjects to gap (high). Editorial test cigarette filter integrity or defects. For ail tests, a formal measure of the degree of association (for example, agreement) of the Methods counts recorded by three independent observ- 10 SUBJECTS ers was computed using the K test. What shouldAl bl protocole thse an elementd procedures useds oinf th ean humay nsettlemenFor comparisont wit, othehr cigarettethe s of various smoking study were approved by the clinical popular American brands were included as tobacco industryinvestigation? s committee of the Roswell Park controls. These control cigarettes had filters Cancer Institute. Subjects were adult (5* 25 that did not contain charcoal. years of age) long term smokers who were smoking currently at least 20 cigarettes pefectlr dayy congruen. MODIFIEt (thD eCIGARETT state attorneyE HOLDEs general)R ; (c) ongoing Introduction The volunteers were informed verbally of the With the safeguards against contamination Hie epidemic of disease caused by tobacco use has largely litigation poses a major financial threat to the industry, and purpose and scope of this study. Thereafterprovide, as a (sesteade below)y strea,m a o fcigarett incriminatine holdeg evidencr was usee againsd to t been a twentieth centursigney phenomenond and witnesse. Ads consenthis centurt was yobtained. All measure the release of charcoal granules from draws to a close, reaction by both the public and private the industry and media coverage about tobacco and health; participants were compensated financiallyand. (d) in charcoathe pastl , congressionafilter cigarettel legislativs durine compromiseg human s sectors has focused on the role of the major tobacco manu- smoking. The efficiency of the holder and facturers in creating and maintaining demand for an to secure industry buy-in have diminished or subverted the CIGARETTES USED entrapment device was qualified initially in addictive product marketed to children that kills a large original policy objective^ Moreover) other questions have Cigarettes analysed were Lark cigarettesbee. Larn raisek drepeate aboutd th triale implications in whichs Larof ak settlement.and other brand6 s fraction of those whocigarette use ist araes manufacturethe manufacturerd by Liggets t Group. of cigarettes fixed to the holder were smoked However, if settlement negotiations or legislation begin recommend. Lark cigarettes have a triple granular filter mechanically. to move forward meaningfully and the public health com- The causal relationshicomposep betweed n osmokinf cellulosg ane d acetatdiseasee , fibres and A conventional cigarette holder (Denicotea; munity adopts the position that no solution is acceptable, and the addictive naturactivatee odf charcoacigarettesl an,d havare e widelbeen ydescribed in Denicotea Co (Germany^ distributed by 3 3 fi then it is likely that public health concerns will be peri- recognised by the generadetail publicl elsewhere.. The impac' A trecentl of tobaccy publisheo d book Lane), purchased from a local retail shop, was pheral rather than central to the resulting legislation ox advertising and marketinprovideg practiced a shistorica on smokinl overvieg initiatiow of nthe origin of first removed from its cardboard packaging. agreement. Because this may be a once-in-a-generation by children is also a principacharcoal concerl filterns oanf dth the publie developmenc health t of the fil- The cartridge of Denicotea crystals was community. Local, state, and federal action9 s have situation, the public health community must fight for a ter on the^Lark cigarettes. An exploded view of removed and discarded. The cigarette holder 5

comprehensive package of truly effective tobacco policies. http://tobaccocontrol.bmj.com/ increased the cost of, ana dtripl decreasee granulad adolescenr filter is tillustrate access tod ,in fig 1. was then soaked in 20% bleach for 30 minutes cigarettes; but adolescent tobacco use has recently What arane thd erinse minimud witmh deioniseelementsd thawatert th. eThi publis wac shealt fol- h increased,' reversing a decline over the last two decades. community feels are essential to any legislation or ANALYSIS OF FILTERS FOR CHARCOAL GRANULES lowed by a second wash with Palmolive deter- The United States FoodMan andy Druof g Administratiothe tests reporten (FDAd ) heresettlement were ?gen Tht e(Colgate-Palmoliv relief sought by the eCompany tobacco ,companie New Yorsk is has asserted jurisdictionperforme over nicotind wite ha s 2a0 drugpack, san odf oveLarrk cigarettecomprehensivs Citye) anandd woul repeated limid rinsint liabilitg iyn fo deioniser the damaged waters .or cigarettes and smokelesswhic tobacch hao dproduct been purchases as drugd delivery locally- (twoinjurie packss causeAfted byr theithe rcigarett producte sholde or actionr hads tbeeo daten drie. Thered in - devices, and they have promulgated regulations to reduce fore, the appropriate exchange should include both accept- from each of 10 vendors). Each3 pack of Lark an oven at 56°C, an entrapment device was tobacco advertising and cigarettemarketins greceive targetedd aa t codchildren.e number, anancd ewa osf responsibilitadded. Thiys devicby thee consistetobaccod ocompanief an 85x25s 0fo mr mthe A large number of statthene openeattorneyd scarefull generay l inhav thee suelaboratoryd problem. The s thepolyurethany have createde spong, aned cylindeactionsr on(produc their part Ntc to tobacco companies to toobtaip wrappen reimbursemenr of each pactk wafor s custatt eoff witreduch scise- the 1030death; 1.01and 6disabilit densityy ;cause 30 ILDd b;y Foamax smoking, Arcad as rapide - expenditures for smoking-attributablsors. Without removine diseasg the e ancigaretted to s frolym a s thpossiblee Ne.w York). Positioned on the upstream end o prohibit tobacco marketinpackg to, childrenthe filte.r Severasurfacel class osf actiothe nnon-smokeThed minimathe cylindel corporatr waes aresponsibilit white, fine ymesh expecte, polyestd oef a lawsuits have been filedcigarette on behals werf oef examinethose addicted withd at ostereocompan zoom y manufacturinscreen (FN 5720-010g a produc; cut that offt injure- 0.1 s|im thos; Polye wh) o on September 23, 2021 by guest. Protected copyright. cigarette smoking and microscopthose exposee (Stereomasterd to environmenta; Fisher lScientific)use it .is forite) tha. t company to admit that the risk of injury is tobacco smoke. In our initial examinations, the filters realof ran, to- redresThs e existinentrapmeng damaget devic, ean wad st positioneo mitigatde infutur th e As a result of thesdomle multiply selectee pressuresd cigarettes, an,d witmosh ant d withoudamaget. Anproximay proposel segmend limitatiot of nth oef liabilittwo piecy foer holdetobacci o particularly the litigatiocharcoan pressurel filters, th, ewer tobacce inspecteo industrd fory the presencmanufacturere Whes nmus a cigarettt fulfille wathess epositione criteriad. Iint this eusefu holdeli to may be willing to moderatofe charcoaits 40-yearl granule historsy oanf ddenia thel integritand ydefin of the ein somthee en detaid ofl thwhae cigarettt these eobligation filter wass approximatemight generat! e obstruction. Tobacco manufacturerwrapping paperss ma. Foy rb quantitative willing eto analysisas term, thes of3 a nto actua 5 mlm agreement from the . entrapment screen. Th accept a negotiated settlemenstereo t zooto maddres microscops the probleme was sadjusted to cigarette filter was not permitted to contact th created by their behavioupermir andt viewintheir productsg of the. wholRepresentae cut surfac- eAcceptanc of the screene of responsibilit. The assembley d smoking apparatus ws tives of several tobacco manufacturercigarette filtesr hav(15-fole suggested magnificationd that Limitin; xl.5g thtransportee industry'd s inliabilit a cappey musd t Falcobe accompanien polystyredr by they might be willing to objectivpay a substantiae and xlOl price ocular), an.d A changt x8 magnificatione an acceptance, tube, publicl(17x10y an0 d mmfor ;purpose No s2051 of formatio; Bectoni of a number of their practices,, in exchange for limitation of public policy that tobacco use is a major cause of death 34 the resolution was about 13.7 (im; at x40, the Dickinson, Franklin Lakes, New Jersey). their liability. resolution was about 7.4 |im (personaand disabilitl y and that nicotine is an addictive agent. Sim- Rumours continue to communicationcirculate about , thCartoe possibilitn Opticay of la Industriesple logi,c mandateSAFEGUARs thaD AGAINSt the tobaccT AIRBORNo companieE CONTAMINANTs should Sonly settlement with the tobaccTokyoo , Japan)industry. , mediated by or be freed ofT liabilito preveny fotr ththose contaminatioe damages orn injurieof screens thas ta nthey through Congress. These Charcoarumoursl granuleforce thse observe questiond os no thf e filteracknowledg sur- othee tor bmateriale real. Tso useabsolvd ine thtobacce studo ymanufacturer by airbor s whether the public healtfach ecommunit were ycounte should supporby eact thhe of of liabilitthree y fibresfor damages and debris, while, allowinthe following themg toprecauti continuo e to concept of a settlement;investigators and if so, wha. Tht shoule thred eb ereader the cores examinedend yth thae t theiwerre product implementeds cause .an yAl damagesl glass , slideswould, bcoe* both principles that the publientirc ehealt filterh communitand then ycounte definde thaes numbehypocriticar of glassesl and ,a ninstruments extremely , pooandr otheprecedenr itemt sfo user dpublic essential to any agreementwel?l defined conspicuous carbon particlepolicys i.n the study were precleaned and—immediaR There are several reasoneachs otof thbee "waryfour filte" orf quadrantsa legislativ. eThe numbeAcceptancr before oef thusing—flamee risks caused bywit tobacch 100o %smok etha*e expo1 - settlement, including: (aof) particlethe publis wac shealt thehn scorecommunitd as:y 0 (nil)sur, e 1-mus5 t Inspectioinclude nthos ofe riskthe s slideproduces andd bcovey exposurr gla^e to does not have a seat at th(low)e negotiatin, 6-10 (medium)g table; (b, >1) th0 eparticle other s (high)environmenta. beforl tobacce use showeo smoked tha. Ont thee demonstratioy contained no o cf this Parties involved have specifiThereafterc interest, s ththae t tippinare completelg papers—thy eacceptanc wrap- ebo wouln particled be a swithdrawa or fibres.l o fOthe oppositior than taco tclean contrary to ours (the tobaccpingo industrypapers )tha ort atsurroun least nodt perthe- filterindoo (fir gair smokinglaws an,d al supporl proceduret fors finawerle promulgatioperformed uiKn and Editorial

expeditious implementation of the Occupational Safety long-term pharmacological substitutes for addicted smok- Tob Control: first published as 10.1136/tc.6.1.1 on 1 March 1997. Downloaded from and Health Administration's proposed regulations on ers as part of a harm reduction strategy.15 smoking in the work environment.7 It is likely that the immediate future will provide products with cigarette-like satisfaction of the nicotine needs of addicted smokers through formulations of pure Redress the damage that has been created nicotine that do not contain the other toxic and The simplest form of redress, and the most common pro- carcinogenic constituents present in cigarette smoke. vided through the court system, is monetary compensation These formulations could allow the FDA to mandate for the damages caused. However, monetary compensation removal of nicotine from all cigarettes, removing their cannot be the sole basis of any agreement for release of addictive potential, without creating a black-market liability from tobacco, because the damages created exceed demand for nicotine-containing cigarettes. Those who are the resources of tobacco industry. Tobacco is a $45 billion addicted to nicotine could satisfy their addiction through industry,8 and estimates of just the direct, smoking- ingestion of formulations of pure nicotine, without attributable healthcare costs for 1993 in the United States exposure to other toxic and carcinogenic compounds. are $50 billion9 with another $50 billion in indirect costs. Smokers of nicotine-free cigarettes would have a free, non- Clearly any monetary redress would have to be provided at addicted choice about continuing their exposure to the a discount. The sums currently being suggested3" as a risks of smoking, and most would likely quit. basis of settlement ($6-12 billion per year) translate into a A minimum requirement for providing limitation of licence for the tobacco companies to continue to kill more liability is the acceptance by tobacco manufacturers of than 400 000 Americans per year10 for a payment of SI5- FDA jurisdiction over the nicotine content of tobacco 25 000 per death. A yardstick for the monetary damages products, with a mandate for the FDA to require removal the industry could pay is the $32 billion that might be gen- of nicotine from these products as soon as it is feasible. erated through monopoly profit-maximising pricing of Research funding, provided by the agreement should be cigarettes." dedicated to the discovery of the most effective nicotine Absolving the tobacco industry of its liability for replacement strategies and the development of ways that 400 000 deaths each year, while allowing them to continue would help addicted smokers change to these nicotine to market freely an addictive product that causes those delivery approaches. As soon as reasonable alternatives for deaths, is morally repugnant, as well as contrary to our tra- converting nicotine-addicted smokers are available, the ditions of justice and protection of public health. As a FDA should mandate the removal of nicotine from all result, any agreement to limit the liability of the tobacco tobacco products provided in the American market. industry for the damages caused by its products must As part of FDA jurisdiction, tobacco manufacturers include modifications to tobacco products that reduce should be required to publicly disclose the additives in their capacity to continue to cause damage. their tobacco products and any research performed to The disease burden created by tobacco results from rwo evaluate the safety of these additives. The manufacturing, http://tobaccocontrol.bmj.com/ characteristics of tobacco use. Tobacco, and tobacco labelling, and marketing of tobacco products, including smoke, contain a variety of toxic and carcinogenic use of additives, should be subject to FDA jurisdiction, as compounds that cause disease when ingested over a are all other forms of nicotine delivery currently on the prolonged period of time. Also, the nicotine in tobacco market. causes addiction, and it is addiction which maintains the repetitive ingestion of these toxic and carcinogenic Mitigation of future damage substances. Addiction robs many individuals of a free Perhaps the most objectionable current behaviour of choice about whether to continue to be exposed to the risks tobacco manufacturers is continued advertising and of smoking. promotion of tobacco products, particularly to children. The FDA has asserted jurisdiction over nicotine as an There is substantial public concern and outrage over use of addictive agent, and there is no question that maintaining cartoon characters in tobacco advertising, and even the an addictive agent in a formulation as hazardous as the tobacco manufacturers claim to agree that marketing on September 23, 2021 by guest. Protected copyright. cigarette is contrary to both the public health and the approaches targeting children are unacceptable. mandate of the FDA. However, there has been concern Once the enormous magnitude of disease risks is that, if nicotine levels were reduced in cigarettes, smokers acknowledged, it is unclear what legitimate justification might compensate by smoking more cigarettes per day, exists for encouraging anyone of any age to start smoking, puffing more frequently, or inhaling more deeply, and such or for discouraging anyone of any age from stopping. Even compensatory behaviour might actually increase their marketing practices directed at brand loyalty and brand risks. Removal of nicotine from cigarettes is possible, but switching lose their legitimacy, as it is hardly ethical to sudden elimination of nicotine might precipitate attempt to increase the burden of the death and disability withdrawal in many smokers, most of whom are addicted, for which an individual company is responsible. also an unacceptable alternative. Nicotine replacement A core element of the mitigation of future damage is therapy is available over the counter as a cessation aid, and avoidance of any influence that might encourage these formulations provide substantial relief of the non-smokers to begin smoking or smokers to continue. withdrawal syndrome. One way these influences can be avoided with certainty is Experimental formulations of nicotine more closely to eliminate all tobacco advertising and promotional activ- mimicking the pattern of nicotine delivery available from ity, other than FDA-approved activities for pure nicotine cigarettes are being examined,12 including nasal sprays and replacement. This could be done by limiting liability for inhalers as well as other formulations.l3 M These past promotional activity, while explicitly defining liability formulations rapidly deliver nicotine to the circulation in a for any future promotional activity judged to encourage pattern similar to that provided by a cigarette, raising the initiation, discourage cessation, or promote use- expectation that they, or other formulations, may be much Elimination of advertising and -promotional activity has the more acceptable to addicted smokers; and they may also be additional benefit of allowing transfer of the approximately much better substitutes for cigarettes in avoiding $5-6 billion per year spent by the tobacco industry on withdrawal and breaking addiction. In addition, these and these activities"5" to an account used to repair the other newer formulations offer the promise of acceptable damages done by their products. Monetary compensation Ultimately they would arrive at bankruptcy, but they would Tob Control: first published as 10.1136/tc.6.1.1 on 1 March 1997. Downloaded from Financial reparation by the tobacco companies could be preserve profits in the short run. structured in two parts: a fixed sum and a per-pack charge. However, much has changed in the structure of the An annual sum of $5-6 billion would be available if all major cigarette companies during the past four decades, advertising and promotional expenditures were aban- including diversification into food and other businesses doned. This sum equals the 1993/1994 advertising and and growth of the international segments of these compa- promotional expenditures by the tobacco manu- nies. Stock values for these diversified companies, based on facturers16 '7 and could be paid without increasing the net a price/earnings ratio, are depressed by threats of tobacco expenditures by each company. It should be adjusted regulation and litigation,18 and it is likely that these threats annually for inflation and paid proportionate to each com- will inflict real damage on the industry in the next months pany's current market share. Using the 1993 expenditure to years, further depressing stock values. Currently the of $6 billion, $5 billion of this sum could be paid to the stock values of several of these companies are depressed by states to compensate them for their smoking-attributable litigation risks by as much as 50%.3 Medicaid expenditures, and $1 billion could be allocated The depression in stock values is large enough that the to tobacco control programmes and research. Eighty per domestic tobacco earnings could be eliminated with the cent of the tobacco control funds could be allocated residual company having a price/earnings ratio comparable directly to the states with 20% retained for allocation by to that of the stocks of other American companies. This the federal government. suggests that the net value of domestic tobacco earnings to The fixed payment described above would not necessar- the stock price is roughly counterbalanced by the decline ily increase the cost of cigarettes because it is a transfer of in stock value produced by the threat of litigation. There- advertising and promotional expenditures. However, it is fore, domestic tobacco earnings could be traded for limita- appropriate that the cost of cigarettes be increased both to tion of liability without a sharp decline in stock values. If decrease consumption and to compensate society for the one or more of the current actions by the state attorney disease burden and social costs caused by tobacco compa- general are successful, then tobacco stocks are likely to fall nies and their products. The monopoly profit-maximising sharply; and even a resolution of tobacco liability that sac- price of cigarettes (54.08 per pack, compared with the cur- rificed all of the domestic tobacco earnings could result in rent price of $1.88) would yield more than $32 billion stable stock values. annually for liability payments or pre-tax profits." Therefore, an additional payment per pack of cigarettes could be required. Payment of an additional %l per pack Summary initially, increasing to $2 per pack once the FDA mandates Litigation and regulatory assaults on the tobacco removal of nicotine from tobacco products, would provide companies may create a willingness among tobacco manu-

partial compensation for the societal burdens resulting http://tobaccocontrol.bmj.com/ facturers to bargain resources and acceptance of public from smoking. A fraction of these payments would cover policy changes for limitations of liability/ * as has been cessation assistance for addicted smokers, transitional aid seen by the recent settlement with the Liggett Group. i9 for tobacco farmers, and whatever compensation is judged Two elements absolutely critical to any plan are the elimi- appropriate for individual smokers. Additionally, a nation of tobacco advertising and promotion and the substantial, professionally designed and implemented, removal of addiction as a reason for tobacco use. national anti-tobacco broadcast media campaign should be Minimal components of any settlement should include; funded to help correct the results of decades of tobacco advertising. The remainder of the funding could be used (a) acceptance by the tobacco manufacturers of the causal for national priorities such as funding the Medicare relationship between tobacco use and disease, and the programme and solving the indigent healthcare problem. addictive nature of nicotine; (b) a total ban on tobacco advertising and promotion;

Transitional aid for tobacco farmers (c) FDA jurisdiction over tobacco products and their on September 23, 2021 by guest. Protected copyright. One of the groups most likely to be affected by the nicotine content, with the intent of removing nicotine proposed changes is tobacco farmers. Declining American as soon as acceptable nicotine substitution products cigarette consumption would place financial pressures on are available; tobacco farmers. It can be argued that these changes are (d) reimbursement to the states for Medicaid and other inevitable and that tobacco farmers deserve no special state expenditures attributable to smoking, to the consideration, but both political and humanitarian motiva- maximum extent feasible; tions support providing assistance to tobacco farmers as (e) funding for local, state, and federal programmes and they change to other crops. Several states in the southeast research in tobacco control; are disproportionately dependent on tobacco as a crop, (f) acceptance of legislation and regulations protecting the and much of the investment in equipment and infrastruc- right of non-smokers to breathe air free of tobacco ture for growing tobacco cannot easily be transferred to • smoke; other crops. Economic dislocation from changes in (g) funding for a large, national, media-led, anti-tobacco tobacco may be considerable in some counties of these campaign; and states, and assistance could minimise the impact. (h) cessation assistance for addicted smokers. If negotiations toward a settlement proceed, it is Effects on stockholders of tobacco manufacturers essential that the public health community participate in It is apparent that the changes proposed above would lead defining the elements of any agreement to ensure that to a much more rapid decline in tobacco use than would whatever agreement develops is focused on reducing occur otherwise. Indeed, no solution to this problem that tobacco-related disease rather than continuing the does not lead to a more rapid decline in tobacco consump- profitability of American tobacco companies. That partici- tion will be acceptable to the public health community. A pation requires articulation of the core elements essential superficial examination of this conflict suggests that share- to an acceptable agreement. If resolution of the public holders of tobacco companies would be better served by a health issues surrounding continued sale of tobacco prod- continuation of the "scorched earth" slow retreat that has ucts can be reached in the United States, it may provide a been the tobacco industry's practice for the past 40 years. model for similar resolution in other countries. Editorial

Mr Shopland contributed to this work in his private capacity. The views KENNETH E WARNER Tob Control: first published as 10.1136/tc.6.1.1 on 1 March 1997. Downloaded from expressed here are his own and no official support or endorsement by the School of Public Health, University of Michigan, National Cancer Institute or the Departmeni of Health and Human Services is intended or implied. Ann Arbor, Michigan, USA; email: [email protected] Dr Connolly contributed to this work in his private capacity. The views expressed here are his own and no official support or endorsement by the Mas- sachusetts Department of Public Health is intended or implied. 1 Cigarette smoking among American teens rises again in 1995 (press release). Ann Arbor, Michigan: University of Michigan Stuvey Research We are grateful to Richard Daynard, Matthew Myers, and Charles L Gruder, Center, 15 December 1995. who provided critical comments on earlier versions of this editorial. 2 US Food and Drug Administration. Regulations restricting the sale and dis- tribution of cigarettes and smokeless tobacco to protect children and DAVID BURNS adolescents; final rule. Federal Register I9963<51:44395-638. UCSD Medical Center, 200 West Arbor Drive, 3 France M3 Bongiorno L. Big tobacco may be ready to deal? Business Week 1996 Oct 7. San Diego, California 92103, USA; 4 Ingersol B, Frisby M. Smoke signals: Omens of tobacco truce are in the air. email; [email protected] Wall Street Journal 1996 Dec 19:A16. NEAL BENOWITZ 5 Warner KB. Dealing with tobacco (editorial). Am J Public Health 1997. In University of California at San Francisco, press. San Francisco, California, USA; 6 Glantz SA, Fox BJ, Ughtwood JM. Tobacco litigation: Issues for public health and public policy. JAMA 1997;277:751~3. email; nbeno@hsa. ucsf. edu 7 US Occupational Safety and Health Administration. Notice of proposed J 8 US1i Departmend/^l9295968t of Agriculture. Tobacco6 outlook and situation report. GREGORY N CONNOLLY Washington, DC: US Department of Agriculture, April 1996. Massachusetts Tobacco Control Program, 9 US Centers for Disease Control, Medical care expenditures attributable to Massachusetts Department of Public Health, smoking—United States. MMWR l993;43:469-72. Boston, Massachusetts, USA; 10 US Centers for Disease Control. Cigarette smoking—attributable mortality and years of potential life \ost~-United States 1990. MMWR 1993; email; gr£[email protected]. com 42:645-9. 11 Harris J. American cigarette manufacturers' ability to pay damages: K MICHAEL CUMMINGS overview and a rough calculation. Tobacco Control I996;5:292-4. Roswell Park Cancer Institute, 12 Gorodetzky CW. Implications of alternative treatment goals: product impli- Buffalo, New York, USA; cations. Tobacco Control 1995;4 Suppl 2:S57-9. email: [email protected] 13 Sutherland G, Stapleton JA, Russell MA, et al. Randomized controlled trial of nasal nicotine spray in smoking cessation. Lancet 1992;340; 324-9, RONALD M DAVIS 14 Tonnenesen P, Norregaard J, jVlikkelsen K, Jorgensen S, Nilsson F. A double-biind trial of a nicotine inhaler for smoking cessation. JAMA 1993; Editor 269:1268-71. 15 Hughes JR. Applying harm reduction to smoking. Tobacco Control 1995;4 JACK E HENNINGFIELD Swppl 2;S33~8. Johns Hopkins University, 16 US Federal Trade Commission. Report to Congress for 1993. Pursuant to the Baltimore, Maryland, USA; Federal Cigarette Labeling and Advertising Act. Washington, DC; Federal email: fhenning@ckarm. net Trade Commission, 1995. I? US Federal Trade Commission, Report to Congress for 1994. Pursuant to the DONALD R SHOPLAND Federal Cigarette Labeling and Advertising Act. Washington, DC: Federal Trade Commission, 1996. National Cancer Institute, 18 France M. Is Big Tobacco ready to deal? Business Week 1996 Dec 23.

Rockville, Maryland, USA; 19 Broder JM. Cigarette maker concedes smoking can cause cancer. New Vork http://tobaccocontrol.bmj.com/ email: [email protected] Times 1997 Mar 21: Al, A12. on September 23, 2021 by guest. Protected copyright. - fOTH; WORLD CONFERENCE ON TOBACCO OR HEALTH

Beijing, 24-28 August (997

The conference will be a worid-wide forum to share the. Venue: Beijing fnternationaf Convention Centre latest scientific advances in the whole field of tobacco For more information contact; . - : issues, which include health effaces of: Secretariat. !Och WCTOH, •smoking as well as:. Chinese Association on Smoking & j^ealt . * passive smoking • tobacco smuggling Building 12, Dist. I, Anhuaxili, j • smokeless tobacco use • tobacco marketing Beijing !0 001 f, CHINA. 0\ •_ ._ • hcalift promotion * cobaceo advertising Ttsiephone/Fix: (84 10) 426 0?^;-^* • tobacco legislation • economics • smoking cessation * taxation etc • tobacco control advocacy.