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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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Suggested Citation:"C Time Line of Tobacco Events." Institute of Medicine. 2001. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington, DC: The National Academies Press. doi: 10.17226/10029.
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C Time Line of Tobacco Events Science Products Policies or Regulation 1700s • Cigarettes are first made from scraps of cigars 1761 • Dr. John Hill reports in Cautions Against the Immoderate Use of Snuff on two case histories and observed that (“snuff is able to produce swellings and excrescences”) in the nose, and he believed these to be cancerous 1807 • Cerioli isolates the “essential oil” or “essence of tobacco” 1828 • Posselt and Reimann isolate nicotine from tobacco 1843 • Melsens describes nicotine’s chemical empirical formula 593

594 APPENDIX C Science Products Policies or Regulation 1854-1856 • Cigarette popularity grows between 1854 and 1856 during the Crimean War 1881 • James Bonsack of Virginia patents the first cigarette-making machine. 1893 • Pictet and Crepieux synthesize nicotine 1900 • Brosch appears to be the first investigator involved in experimental tobacco carcinogenesis. He applies tobacco (“juices”) to guinea pigs, observing epithelial proliferation 1913 • Camel brand is produced by R.J. Reynolds in 1913 1928 • Lombard and Doerring find an association between heavy smoking and buccal cancer 1938 • Pearl, a statistician and biometrician at Johns Hopkins, publishes the first statistical analysis comparing the health of smokers and nonsmokers and finds that individuals who smoked could expect shorter lives 1950 1950 • Epidemiological studies • Filters introduced report that lung cancer is particularly prevalent among cigarette smokers

APPENDIX C 595 Science Products Policies or Regulation 1954 1954 1954 • Doll and Hill publish • Winston by RJR features • Industry faces first The Mortality of Doctors a filter (cellulose acetate) liability lawsuit by lung and Their Smoking and reconstituted sheet cancer victim claiming Habits in the BMJ tobacco negligence and breach of • Tobacco Industry warranty. Suit is Research Committee is dropped 13 years later formed 1956 • RJR introduces Salem as its first filter-tipped menthol cigarette Early 1960s • More porous cigarette paper is introduced 1960 • Ban on advertising tar and nicotine levels as less harmful 1960-1966 1962 • Royal College of Physicians reports that lung cancer is prevalent among smokers in Smoking and Health 1964 1964 • Surgeon General’s report • Public Health Service concludes that smoking establishes the National causes cancer and other Clearinghouse for serious diseases Smoking and Health (NCSH), later to become the Office on Smoking and Health 1965 • Federal Cigarette Labeling and Advertising Act is passed requiring warning labels on all cigarette packs but not on advertisements. The act also requires the Secretary of Health, Education, and Welfare to issue annual reports to congress on the health consequences of smoking

596 APPENDIX C Science Products Policies or Regulation • Federal excise tax on smokeless tobacco products is repealed. 1966 • The Cambridge Filter method is ultimately adopted by the Federal Trade Commission 1967 • Surgeon General’s report concludes, “Cigarette smoking is the most important of the causes Late 1960s of chronic non- • Expanded or “puffed” neoplastic tobacco appears in bronchiopulmonary cigarettes diseases in the United States.” The report also identifies measures of morbidity associated with smoking 1968 • National Cancer Institute begins work on a safer cigarette by establishing the Less Hazardous Cigarette Working Group 1969 • Surgeon General’s report makes solid conclusions regarding the relationship between maternal smoking and infant low birthweight. It also defines evidence of increased incidence of prematurity, spontaneous abortion, stillbirth, and neonatal death • Use of chlorinated pesticides begins to be faded out

APPENDIX C 597 Science Products Policies or Regulation Early 1970s • Ventilated filter tips are 1971 used and modified to be 1971 • Surgeon General’s report longer with increased • Broadcast ads for finds smoking associated efficiency cigarettes banned with cancers of the oral • Introduction of puffed, cavity and esophagus expanded, and freeze- 1972 dried tobaccos 1972 • Surgeon General’s report • Officials declare that studies immunological airlines must create effects of tobacco and nonsmoking sections tobacco smoke, and identifies carbon monoxide, nicotine, and tar as smoke constituents the most likely to produce health hazards from smoking 1973 • Surgeon General’s report presents evidence on the health effects of smoking pipes, cigars, and “little cigars” 1975 1975 • Surgeon General’s report • RJR introduces NOW issues further evidence with lower-tar and regarding health effects nicotine while from involuntary preserving tobacco taste (passive) smoking, especially the relationship between parental smoking and rates of bronchitis and pneumonia in children’s first year of life 1977–1978 • Surgeon General’s report focuses on health effects of smoking on women, noting in particular the effects of oral contraceptives and smoking on the cardiovascular system

598 APPENDIX C Science Products Policies or Regulation 1979 • Surgeon General’s report addresses the role of adult and youth education in preventing smoking habits. Report also reviews health effects of smokeless tobacco • Bandury conference and report 1980 • Surgeon General’s report projects that lung cancer in women will surpass breast cancer as the leading cause of cancer mortality in women. Report also notes prevalence of smoking by adolescent females 1981 1981 • Surgeon General’s report • Insurers offer discounts examines the health on life insurance consequences of lower- premiums to tar and nicotine nonsmokers cigarettes. Concludes that lower-yield cigarettes decrease the risk of lung cancer, but have little effect on rates of cardiovascular disease, chronic obstructive pulmonary disease, and fetal damage. The report also reviews risks related to various additives and their combustion. The Surgeon General reinforces the fact that there is no safe cigarette

APPENDIX C 599 Science Products Policies or Regulation 1982 • Surgeon General’s report releases epidemiological evidence from a study of nonsmoking wives and their smoking husbands, finding that the risk of lung cancer in wives was not causal, but a possible serious public health problem. Report notes possible low-cost smoking cessation interventions 1983 • Surgeon General’s report evaluates health consequences of smoking for cardiovascular disease, declaring cigarette smoking as one of the three primary causes of coronary heart disease 1984 1984 1984 • Surgeon General’s report • Nicotine-based chewing • Warnings strengthened examines health effects gum approved as an aid on cigarette packages of smoking on chronic to quitting and ads obstructive lung disease • San Francisco requires (COLD). Smoking business to accounts for 80-90% of accommodate COLD deaths in the nonsmokers United States 1985 • Surgeon General’s report focuses on smoking and hazardous substances in the workplace. Smoking alone is found to be a greater risk than the average workplace environment. Workplace exposure to asbestos and other such substances is found to compound health risks

600 APPENDIX C Science Products Policies or Regulation 1986 • Surgeon General’s report states that “Involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers.” Report further notes the health of children of smokers and nonsmokers, as well as the exposure to smoke of passengers in smoking and nonsmoking sections of airplanes • A special report of the advisory committee appointed by the Surgeon General examines the health effects of smokeless tobacco, concluding that it too leads to nicotine addiction and can cause cancer 1987 • Tobacco Institute Testing Laboratory (TITL) assumes cigarette-testing responsibilities from the Federal Trade Commission Test Center using its approved methodology 1988 1988 • Surgeon General Koop’s • Government bans report states that smoking on short nicotine (cigarettes and domestic airline flights other forms of tobacco) are addicting 1989 Late 1980s • Surgeon General’s report • RJR Premier is reports that cigarette developed and smoking is a major cause introduced to the public of cerebrovascular disease (stroke). Report also addresses the future of nicotine addiction in light of new nicotine delivery systems test marketed in 1988

APPENDIX C 601 Science Products Policies or Regulation 1990 1990 • Surgeon General’s report • Smoking banned on identifies the health interstate buses and benefits of smoking domestic airline flights cessation: “Smoking of six hours or less cessation has major and immediate health benefits for men and women of all ages.” Report examines life expectancy, smoking- related diseases, and reproductive health issues of smokers and former smokers 1992 • Nicotine patches introduced • 97.5% of cigarettes in the U.S. have filters 1993 • Vermont bans smoking in all indoor public places 1994 1994 1994 • Surgeon General’s report • Major U.S. cigarette • Executives of seven looks at “preventing companies release a list largest U.S. tobacco tobacco use among of 599 additives used in companies swear in young people.” Report the manufacture of congressional testimony examines and discusses cigarettes that nicotine is not an age at first initiation, addictive and deny issues or problems manipulating nicotine encountered with youth levels in cigarettes cessation, tobacco as a • Amtrak bans smoking “gate-way drug,” effect on short-and medium- of advertising, and distance trips school-based tobacco use • Brown and Williamson prevention programs documents provide evidence that tobacco executives discovered smoking risks before the surgeon general made declaration • Mississippi files first of 24 state lawsuits seeking to recoup millions from tobacco companies for smokers’ Medicaid bills

602 APPENDIX C Science Products Policies or Regulation 1996 1996 • RJR Eclipse test • Liggett Group settles marketed in United claims with five state States, Germany, and attorneys-general and Sweden promises to help them against other companies 1997 • Federal judges rules that government can regulate tobacco as a drug, but industry is allowed to continue advertising • Landmark settlement, subject to congressional approval, calls for restrictions on cigarettes and on tobacco maker’s liability in lawsuits. Industry is required to spend $368 billion over 25 years, run antismoking campaigns, issue bold health warnings on packs, decrease advertising, and pay fines if youth smoking doesn’t drop significantly • Mississippi is first state to settle, agreeing to $3.6 billion deal with tobacco companies • Florida settles at $11.3 billion

APPENDIX C 603 Science Products Policies or Regulation 1998 1998 1998 • Surgeon General’s report • Phillip Morris Accord • Texas settles with examines tobacco use presented at a poster industry at $15.3 billion among U.S. racial and presentation at the over 25 years ethnic minority groups: Society of Toxicology in • Tobacco executives African Americans, Seattle testify before Congress American Indians and that nicotine is addictive Alaska Natives, Asian under current Americans and Pacific definitions of the word Islanders, and Hispanics. and smoking may cause Concludes that cigarette cancer smoking is one of the • Minnesota and Blue major health hazards Cross/Blue Shield of among different racial Minnesota settle at $6.6 and ethnic groups. billion with the tobacco Tobacco use and industry patterns of use vary • Senate vetoes a proposal among these groups as of $1.50 tax increase per well pack on cigarettes • McCain Universal Tobacco Settlement Bill dies in congressional filibuster. Bill addressed tobacco product regulation of ingredients, sales, and advertising. It also addresses education and nicotine addiction prevention • 46 states welcome a $206 billion settlement with the tobacco industry over health care costs for treating sick smokers 1999 1999 • Star Tobacco introduces • Justice Department sues new cigarettes with low- the tobacco industry to nitrosamine tobacco and recover billions of activated-charcoal filter, government dollars but is unable to make spent on smoking- health claims related health care, accusing cigarette makers of a “coordinated campaign of fraud and deceit”

604 APPENDIX C Science Products Policies or Regulation • Government and tobacco industry lawyers present oral argument to the Supreme Court over whether the Food and Drug Administration (FDA) can regulate tobacco as a drug and crack down on cigarette sales to minors 2000 2000 2000 • National Institute for • Phillip Morris • Tobacco farmers sue Environmental Health introduces cigarettes cigarette makers for $69 Sciences publishes ninth with “safer” paper billion, claiming they report on Carcinogens • Star Tobacco—new conspired to undo the including ETS as one of cigarettes produced in federal system that the known human Virginia and Kentucky regulates tobacco prices carcinogens with low-nitrosamine • Supreme Court rules, • Surgeon General’s tobacco, but without 5-4, that FDA lacks Report, Reducing Tobacco health claims authority to regulate Use, published tobacco as an addictive drug • New York state imposes fire-safety standards on cigarettes

APPENDIX C 605 REFERENCES Associated Press. 2000. Major events in fight vs. tobacco. The New York Times, March 21. 2000. Feder BJ. 1996. A safer smoke or just another smokescreen? Reynolds courts support for a new product. The New York Times. April 12, 1996:(Business Day);D1. Gorrod JW, Jacob P III. 1999. Analytical Determination of Nicotine and Related Compounds and Their Metabolites. PAF2. Amsterland, Netherlands: Elsevier Science B.V. Hoffmann D, Hoffmann I. 1997. The changing cigarette, 1950-1995. J Toxicol Environ Health 50(4):307-364. NIH (National Institute of Health). 1996. The FTC Cigarette Test Method for Determining Tar, Nicotine, and Carbon Monoxide Yields of U.S. Cigarettes. Monograph 7. NCI Smoking and Tobacco Control. Bethesda, MD: National Institutes of Health, National Cancer Insti- tute. R.J. Reynolds Tobacco Company. 1988. Chemical and Biological Studies: New Cigarette Proto- types That Heat Instead of Burn. Winston-Salem, NC: R.J. Reynolds Tobacco Company. U.S. DHHS (U.S. Department of Health and Human Services). 1964. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. At- lanta, GA: U.S. Public Health Service. U.S. DHHS (U.S. Department of Health and Human Services). 1973. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services. U.S. DHHS (U.S. Department of Health and Human Services). 1982. The Health Consequences of Smoking: Cancer; A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. U.S. DHHS (U.S. Department of Health and Human Services). 1986. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Wynder EL, Hoffman D. 1979. Tobacco and health: a societal change. NEJM 300(16):894-903.

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Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction Get This Book
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Despite overwhelming evidence of tobacco's harmful effects and pressure from anti-smoking advocates, current surveys show that about one-quarter of all adults in the United States are smokers. This audience is the target for a wave of tobacco products and pharmaceuticals that claim to preserve tobacco pleasure while reducing its toxic effects.

Clearing the Smoke addresses the problems in evaluating whether such products actually do reduce the health risks of tobacco use. Within the context of regulating such products, the committee explores key questions:

  • Does the use of such products decrease exposure to harmful substances in tobacco?
  • Is decreased exposure associated with decreased harm to health?
  • Are there surrogate indicators of harm that could be measured quickly enough for regulation of these products?
  • What are the public health implications?

This book looks at the types of products that could reduce harm and reviews the available evidence for their impact on various forms of cancer and other major ailments. It also recommends approaches to governing these products and tracking their public health effects.

With an attitude of healthy skepticism, Clearing the Smoke will be important to health policy makers, public health officials, medical practitioners, manufacturers and marketers of "reduced-harm" tobacco products, and anyone trying to sort through product claims.

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