NOW, LET’S TALK SPECIFICALLY ABOUT WHAT WE CAN DO.

IF YOU HAVE A BUSINESS, SIT DOWN WITH YOUR EMPLOYEES
NOW, AND SET A TIME-TABLE TO MAKE YOUR WORKSITE SMOKE-
FREE. DON’T WORRY ABOUT THE IMPACT ON YOUR BUSINESS.

ONLY GOOD THINGS WILL HAPPEN.

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ABOUT TEN YEARS AGO MR. WILBUR MCPHERSON, THE OWNER
OF. RADAR ELECTRIC CO. OF SEATTLE DECIDED TO RID HIS
BUSINESS OF SMOKERS. HE KNEW THAT SMOKERS WERE LESS
EFFICIENT, LOST MORE TIME IN ABSENTEEISM, COST MORE IN
HEALTH BENEFITS.

SO HE SIMPLY SAID, "NO SMOKING".

MOST OF HIS SMOKING EMPLOYEES QUIT SMOKING.
ABSENTEEISM DROPPED, MAINTENANCE COSTS DROPPED,

PRODUCTIVITY WENT UP.

52
YOU ALL PROBABLY KNOW THE SUCCESS STORY OF THE NON-
SMOKERS INN, LOCATED IN DALLAS, ON THE WAY INTO TOWN
FROM THE DALLAS-FORT WORTH AIRPORT.

ALTHOUGH SCOFFERS PREDICTED BANKRUPTCY FOR A NON-
SMOKERS INN, WITHIN SIX WEEKS THE OWNER USED ONLY
BLACK INK.

THE SUPPORTING FIGURES SHOW WHY.

BUSINESS ECONOMISTS HAVE CALCULATED THAT A SMOKING
EMPLOYEE COSTS A FIRM ABOUT $4,600 PER YEAR MORE THAN A
NON-SMOKING WORKER.

- AND THE SAVINGS ON MAINTENANCE, CLEANING, ETC. CAN

AMOUNT TO 41 PERCENT A YEAR.

53
DOCTORS HAVE AN ESPECIALLY IMPORTANT, PIVOTAL ROLE TO

PLAY IN THE FIGHT AGAINST SMOKING IN THIS COUNTRY.

AND IT IS A PROFESSIONAL RESPONSIBILITY DEMANDING A

PERSONAL COMMITMENT AND A PERSONAL APPROACH.
THOSE OF US IN THE ANTI-SMOKING MOVEMENT, THOSE WHO

ARE DOING ALL THEY CAN IN CESSATION PROGRAMS SEE THE

YEAR 2000 AS A GOAL FOR MANY OF US.

54
MY CALL FOR A SMOKE-FREE SOCIETY BY THE YEAR 2000 HAS

BEEN MATCHED BY THE NATIONAL CANCER INSTITUTE’S CALL

FOR A 50 PERCENT REDUCTION IN CANCER MORTALITY RATES BY

THE TURN OF THE CENTURY.

WE ARE ALREADY IN THE 1990s, SO WE HAVE A LOT TO DO, FAST.

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NOW FOR SOME GOOD NEWS.

THE AIM OF OUR EDUCATIONAL EFFORTS HAS CHANGED

RECENTLY.

FOR THE LAST 25 YEARS WE HAVE TRIED TO CONVINCE

AMERICANS TO STOP SMOKING --AND NEVER TO START.

NOW WE KNOW THAT MOST SMOKERS --PERHAPS AS HIGH AS 90

PERCENT-- WANT TO STOP.

 

THEY DON’T NEED CONVINCING.

THEY NEED HELP IN SMOKING CESSATION.

56
SINCE 1982 THE NATIONAL CANCER INSTITUTE’S SMOKING,
TOBACCO, AND CANCER PROGRAM HAS FOCUSED ITS RESEARCH

ON METHODS OF INTERVENTION:

AMONG THEM ARE:
-SCHOOL-BASED PREVENTION:

WE KNOW THAT THE AVERAGE AGE FOR THE INITIAL
SMOKING EXPERIENCE GETS LOWER EACH YEAR. ANTI-

SMOKING EDUCATION MUST BEGIN IN THE ELEMENTARY

GRADES.

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-SELF-HELP METHODS:

SEVERAL NATIONAL MAGAZINES RECENTLY HAVE
HIGHLIGHTED THESE UNIQUELY AMERICAN INSTITUTIONS.
THE ADDICTED SMOKERS NEED TO QUIT THEMSELVES.

BUT IT CAN TAKE ABOUT 5 TIMES TO QUIT, SO THEY NEED

HELP.

58
THEY CAN GET IT IN
-COMMUNITY INTERVENTIONS:

AMONG THE MOST PROMISING ARE THOSE OF COMMIT

(COMMUNITY INTERVENTION TRIAL FOR SMOKING CESSATION).

THIS IS A MULTI-FACETED EFFORT BASED ON 11
COMMUNITIES IN THE USA AND CANADA, USING EXISTING
COMMUNITY ORGANIZATIONS LIKE WORKSITE GROUPS,
HEALTHCARE FACILITIES, CIVIC GROUPS, LOCAL MEDIA, AND

SCHOOLS.

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ALL THESE GROUPS COOPERATE IN CESSATION EFFORTS

AIMED ESPECIALLY AT PEOPLE WHO SMOKE 25 OR MORE

CIGARETTES A DAY, THOSE WITH THE GREATEST CANCER RISK,

THOSE WHO HAVE THE TOUGHEST TIME QUITTING.

THE IDEA IS TO SURROUND THEM, EVERYWHERE THEY GO,

WITH REMINDERS --AND ASSISTANCE-- TO TAKE CHARGE OF

THEIR LIVES BY CEASING TO SMOKE.

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COMMIT ALSO URGES PHYSICIANS TO ASSUME THEIR NATURAL
ROLE AS COMMUNITY LEADERS BY BECOMING PART OF THE
LOCAL MEDIA.

COMMIT CALLS PHYSICIANS TO BECOME "SMOKING CONTROL
MEDIA ADVOCATES".

COMMIT SPOKESMEN ASSERT THAT DOCTORS NEED TO APPEAR
ON TV, ESPECIALLY LOCAL TV, TO CARRY THE ANTI-SMOKING

MESSAGE, TO URGE PEOPLE TO QUIT.

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PEOPLE BELIEVE DOCS ON TV.

(REMEMBER HOW WHEN ROBERT YOUNG TOOK THE JOB OF
PLUGGING SANKA, MOST AMERICANS THOUGHT IT WAS DR.
WELBY, AND THEY PAID ATTENTION.)

TELEVISION AND RADIO ARE WHAT SHAPE THE AMERICAN MIND.
SMOKING ADS MAY HAVE LEFT THE AIRWAYS, BUT AGGRESSIVE
ANTI-SMOKING MESSAGES NEED TO TAKE THEIR PLACE.

MEDIA ADVOCACY IS ACTIVIST, SURMOUNTING THE THRESHOLD
OF MEDIA RESISTANCE OR INDIFFERENCE, SURMOUNTING THE

OBSTACLES OF PHYSICIAN RELUCTANCE OR INDIFFERENCE.

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THE NATIONAL CANCER INSTITUTE ASSIST PROGRAM --
AMERICAN STOP SMOKING INTERVENTION DY FOR CANCER
PREVENTION-- FOCUSES ON COMMUNITY-BASED COALITIONS
DEALING WITH ENTIRE STATES OR LARGE METROPOLITAN
AREAS.

THESE CENTERS ARE FUNDED IN EXCESS OF $100 MILLION TO
ENSURE A SUSTAINED IMPACT ON THE LIVES OF MORE THAN 50
MILLION AMERICANS.

ASSIST AMOUNTS TO THE LARGEST INTERVENTION EFFORT EVER
UNDERTAKEN BY AN AGENCY OF THE US PUBLIC HEALTH
SERVICE.

THERE IS HELP OUT THERE FOR THE SMOKER WHO WANTS TO

STOP.

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AND FINALLY,

-PHYSICIAN/DENTIST INTERVENTIONS.

THAT LAST-MENTIONED METHOD SHOULD BE OF SPECIAL
INTEREST TO ALL THE PHYSICIANS HERE THIS MORNING.

WE KNOW THAT NOTHING IS AS EFFECTIVE IN STOPPING
SMOKING AS WHEN A DOCTOR LOOKS A PATIENT STRAIGHT IN

THE EYE AND SAYS,

"IF YOU CONTINUE TO SMOKE, YOU’RE GOING TO KILL

YOURSELF. YOU NEED TO STOP....NOW."

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THAT CAN WORK WHEN ALL ELSE SEEMS TO FAIL.

THERE ARE NEW METHODS TO ASSIST QUITTERS, RANGING FROM
AVERSION THERAPY USING ELECTRIC SHOCKS TO
EXPERIMENTAL PHARMACEUTICAL AGENTS.

BUT, STILL, 85 PERCENT OF THOSE WHO QUIT. . .JUST DO IT!

I CALL UPON THE PHYSICIANS WHO ARE HERE TODAY TO CARRY

THAT MESSAGE TO EACH OF YOUR PATIENTS WHO STILL SMOKE.

65
FINALLY, THERE ARE A NUMBER OF PUBLIC POLICY ISSUES THAT

DEMAND OUR RESOLUTE ATTENTION AND ACTION.

ONE OF THEM IS CIGARETTE ADVERTISING.

THE ADS HAVE GONE FROM TELEVISION, THANK GOD, --
ALTHOUGH THEY ARE SNEAKING BACK THROUGH VIDEOS-- BUT
CIGARETTE ADVERTISING STILL ASSAULTS OUR SOCIETY IN

PRINT AND BILLBOARDS.

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THE TOBACCO INDUSTRY SPENDS $4,000 PER MINUTE ON

PROMOTION ($2.5 BILLION A YEAR)

ONLY THE GROTESQUE ECONOMIC POWER OF THE
INTERNATIONAL TOBACCO COMPANIES CAN SUSTAIN THIS
OUTRAGE, AS THEY USE ECONOMIC BLACKMAIL TO INTIMIDATE

PUBLISHERS AND GOVERNMENTS.

67
I AM PARTICULARLY DISTURBED BY CIGARETTE ADVERTISING
THAT TARGETS VULNERABLE GROUPS WITHIN OUR POPULATION:

YOUNG PEOPLE, WOMEN, AND MINORITIES.

CIGARETTE FIRMS MANIPULATE MINORITIES, WOMEN, AND

YOUNG PEOPLE BECAUSE THESE PEOPLE HAVE THE STRONGEST

ASPIRATIONS TO CHANGE THEIR STATUS.

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SO THESE ADS ASSOCIATE SMOKING WITH MAKING IT...

IN THE WHITE, OR ANGLO, OR MALE, OR ADULT WORLD.

THEY ASSOCIATE SMOKING WITH A HIGHER ECONOMIC STATUS

(WHEN REALLY HIGHER INCOME GROUPS ARE NOW SMOKING

LESS).

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WE KNOW THAT THOSE WITH MORE EDUCATION TEND TO QUIT
MORE READILY. "THE MORE YOU KNOW, THE LESS YOU SMOKE."
BUT TOBACCO ADVERTISERS ASSOCIATE SMOKING --CONTRARY
TO ALL EVIDENCE-- WITH ROBUST ACTIVITY, ATHLETICS, SOCIAL
ACCEPTABILITY, SUCCESS, OUTDOOR LEISURE, AND EVEN GOOD

HEALTH.

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ONE OF THE MORE OUTRAGEOUS ADVERTISING GIMMICKS IS
ONE CIGARETTE COMPANY’S "ALIVE WITH PLEASURE" THEME.
THIS IS CLEARLY AN EFFORT TO UNDERMINE THE SURGEON
GENERAL’S WARNING ON EACH PACK.

TRUTH IN ADVERTISING SHOULD REQUIRE, NOT "ALIVE WITH

PLEASURE", BUT "DYING IN AGONY".

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IN THE ADVERTISING WARS YOU HEAR A LOT ABOUT PROOF.

THE TOBACCO COMPANIES SAY THAT IT HAS NOT BEEN PROVEN
THAT ADVERTISING INCREASES CIGARETTE SMOKING.

OF COURSE, THE COMPLEXITY OF THIS ISSUE OF HUMAN
BEHAVIOR WILL PROBABLY PRECLUDE THE ESTABLISHMENT OF A
SCIENTIFIC PROOF OF A CAUSAL LINK.

BUT TO MY MIND THE BURDEN OF PROOF SHOULD BE ON THE
TOBACCO INDUSTRY TO SHOW THAT ADVERTISING DOES NOT
INCREASE CONSUMPTION OF A PRODUCT THAT WE KNOW LEADS

TO DEATH WHEN USED AS INTENDED.

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IN THE 1850s JOHN SNOW ENDED THE CHOLERA EPIDEMIC IN
LONDON BY REMOVING THE HANDLE OF THE BROAD STREET
WATER PUMP, 30 YEARS BEFORE THE BACTERIUM CAUSING

CHOLERA WAS DISCOVERED.

FORTUNATELY HE DID NOT NEED TO CONTEND WITH A CHOLERA
INSTITUTE THAT DEMANDED THE PUMP KEEP WORKING UNTIL IT
WAS PROVED THAT WATER FROM THE PUMP WAS CAUSING THE

CHOLERA.

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AT THIS POINT THE CIGARETTE COMPANIES TROT OUT THE OLD
LINE THAT THEIR ADVERTISING IS INTENDED ONLY TO ENFORCE
BRAND LOYALTY, AND TO GET CONSUMERS TO SWITCH TO THEIR
BRAND.

NO ONE REALLY BELIEVES THAT.

BRAND CHANGERS FORM ONLY A TINY FRACTION OF THE
MARKET.

THE REAL PURPOSE OF CIGARETTE ADVERTISING TO IS HOLD ON
TO THOSE SMOKERS ALREADY HOOKED --ADDICTED-- AND TO

ATTRACT NEW ONES.

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IT WORKS.

RECENT STUDIES CONFIRM THAT INCREASED ADVERTISING
BRINGS ABOUT A HIGHER DEMAND FOR CIGARETTES IN

GENERAL, NOT JUST FOR THE BRANDS ADVERTISED.

WE KNOW ADVERTISING IS EFFECTIVE, AND THEY KNOW IT IS

EFFECTIVE, BECAUSE OF THE BRIEF EXPERIENCE WITH COUNTER-

ADVERTISING IN THE 1960s.

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