WPC) ͗T -4!Jɲ`ը_ Yn3Xn;Y*\^"M@^%~Yf7ٮe$ 8[0OOTkc8VaK~kϹw/$74=3y ޳7>3Wˆ:]F6>J.$ZSu>vƭܗƒ~Kw$+ڍū߄9VbG (Prhe ׄ^. sوT`gnv(h֏[{aq5U2[^f;XUIrڧZ3WMJ+R Aԕخmg6l3wU/^0Ri/b)e`ϭBi~WѝMg==OjY)n+$I6"GJQ+=f$ZM[%9k7S(BH 7^nU**)5qǼ_n;>F3hEz%# UN %_ 0eUN[w@4  0: 0 D+ Jo  aaT3 Ka J  r"KI#$a6'( B( 0+L( )HP DeskJet 540 PrinterDESKJETC ,,,, 0 (hH  Z 6Times New Roman RegularX(%$UKUS.,..,,        TRW\6&A4W\6&A46&A46&A4T"UK  (9 Z 6Times New Roman Regular er er#e%3|x   $UKUS.,..,,        "UK      2    PM2028359843855,26May1993((3 $ %!UKUS.,..,,        TRWl6&A43' 6&A43'T"UK        0  (#$  0   @   $UKUS.,..,,        "UK      3    ݀"LungcancerbecametheleadingcauseofcancerdeathsamongJapanesemenin1993.  In1950theratewasabout4/100,000;in1990nearly50/100,000,andstillrising(alsoamongwomen).Smokingrates(cigarettesperadultperyear)19701990werecomparabletoUSAfigures.Datafrom Tobaccoorhealth:Aglobalstatusreport.Geneva:WHO,1997,pp.4512.  "$UKUS.,..,,        "UK      5    Thisisincorrect. W  "$UKUS.,..,,        "UK      4    HereMaglioneattacksthescientific,medicalandlegislativeestablishmentforhaving  strayedfromstandardsof goodscience. W  "$UKUS.,..,,        "UK      4    HereMaglioneattacksthescientific,medicalandlegislativeestablishmentforhaving  strayedfromstandardsof goodscience.    $UKUS.,..,,        "UK      1    Thepaperswereretrievedfrom,anindexedscanofmany  ofthe39,000attorneyclient privilegeddocumentsdumpedontoaUSCongresswebsite.ThenumbersgiveninthefootnotesrepresentthepagebypageserialBatesnumbers.   "$UKUS.,..,,        "UK      6    LetuscallthisthehijackingofPastorNiemollersfamousconcentrationcamp  soliloquy.Inthiscontextofthisindustrydocument,itisbreathtakinginarroganceandhypocrisy.  "$UKUS.,..,,        "UK      7    PM202622283438 A  "$UKUS.,..,,        "UK      8    ݀Itisdifficulttobelievethatsuchasimplisticnotionisduetolackofknowledgeonthe  partofthewriter.   "$UKUS.,..,,        "UK      9    ݀"Astatisticallysignificanttrend[increaseinthedeathrate]wasobservedwithrespect  tothenumberofcigarettessmokedintheagestandardizedincidenceofallfourmajorhistologicaltypes[oflungcancer],i.e.squamouscellcarcinoma,smallcellcarcinoma,adenocarcinomaandundifferentiatedcarcinoma(Doll&Peto,1978).IARCMonographsontheEvaluationoftheCarcinogenicRisksofChemicalstoHumans.TobaccoSmoking.Volume38,1985. W  "$UKUS.,..,,        "UK      10    Thefollowingparagraphseemsoutofsequencebutistranscribedasitappearedinthe  originaldocumentasscreenedonthewebsite.   "$UKUS.,..,,        "UK      1    Thepaperswereretrievedfrom,anindexedscanofmany  ofthe39,000attorneyclient privilegeddocumentsdumpedontoaUSCongresswebiste.ThenumbersgiveninthefootnotesrepresentthepagebypageserialBatesnumbers.  "$UKUS.,..,,        "UK      2    PM2028359843855,26May1993 @  "$UKUS.,..,,        "UK      3    ݀"LungcancerbecametheleadingcauseofcancerdeathsamongJapanesemenin1993.  In1950theratewasabout4/100,000;in1990nearly50/100,000,andstillrising(alsoamongwomen).Smokingrates(cigarettesperadultperyear)19701990werecomparabletoUSAfigures.Datafrom Tobaccoorhealth:Aglobalstatusreport.Geneva:WHO,1997,pp.4512.  "$UKUS.,..,,        "UK      5    Thisisincorrect.   "$UKUS.,..,,        "UK      6    LetuscallthisthehijackingofPastorNiemollersfamousconcentrationcamp  soliloquy.Inthiscontextofthisindustrydocument,itisbreathtakinginarroganceandhypocrisy.  "$UKUS.,..,,        "UK      7    PM202622283438 A  "$UKUS.,..,,        "UK      8    ݀Itisdifficulttobelievethatsuchasimplisticnotionisduetolackofknowledgeonthe  partofthewriter.   "$UKUS.,..,,        "UK      9    ݀"Astatisticallysignificanttrend[increaseinthedeathrate]wasobservedwithrespect  tothenumberofcigarettessmokedintheagestandardizedincidenceofallfourmajorhistolgicaltypes[oflungcancer],i.e.sqyamouscellcarcinoma,smallcellcarcinoma,adenocarcinomaandundifferentiatedcarcinoma(Doll&Peto,1978).IARCMonographsontheEvaluationoftheCarcinogenicRisksofChemicalstoHumans.TobaccoSmoking.Volume38,1985. W  "$UKUS.,..,,        "UK      10    Thefollowingparagraphseemsoutofsequencebutistranscribedasitappearedinthe  originaldocumentasscreenedonthewebsite. d>c$"Small Circle"0 H %!UKUS.,..,,        TRWl6&A43' 6&A43'T"UK     X6XXX76XXdd7  TRY 3' LetterWl6&A43' Letter 6&A4TTRWl6&A4Wl6&A4 6&A4 6&A4T@ aTOBACCOINDUSTRYDOCUMENTSINTHEMINNESOTADEPOSITORY:@@ a@@ a@ @ @@ a@@ a@ @ @@ a d    ` IMPLICATIONSFORGLOBALTOBACCOCONTROL  P  @aa)a@MM aBriefingPaperNo.10(December1998)byNorbertHirschhorn,MD #X6XXX6#@a  Intheirownwords:Thetobaccoindustrysnewlinesofdefense.      Thetobaccoindustry,facingsomuchlitigationinsomanypartsoftheworld,hashadtoresorttoincreasinglytendentious,howeversophisticated,linesofdefenseonthecrucialissuesofsmokingandhealth,addiction,environmentaltobaccosmoke,advertising,andthelike.Presentedhereintheirentiretyaretwo positionpaperswrittenandeditedbyPhilipMorrislawyersfromwhichlegaldefensesarebeingbuilt,andrepresentationsmadetothepublic,themedia,andtolegislativebodiesaroundtheworld.  #  1      ׀Acloseexaminationoftheirargumentsleads J onetobelievethattheindustrywilleventually,andnotlongfromnow,runoutofobfuscation,particularlyasmoreandmoreevidencefromgooodgoodresearchcomesalong.  Thefirstdocumentwaswrittenin1993byaPaulMaglione,andheavilyeditedinhandwrittennotesbycompanylawyerAnthonyAndrade.Itistitled, SmokerIssues.AnAnalyticalFramework. T`  #  2      ׀Belowisthetextwiththeeditsinitalics;whereanoriginalphrasewasstruck,it 4 isnotpresented.Anoccasionalfootnotebythisbriefingpapersauthorwillindicateawillfulmistatementmisstatementoffacts.*************************************************************************** ThePrimaryIssue   !$   Forover400years,singlemindedpeoplehavetriedtoconvinceotherpeopletostopsmokingtobacco.Byandlargethesepressureswerebasedontheperceptionofsmokingasanunhealthycustom,andthereforeanactivitywhichlikedrinking,drugabuseornonstandardsexualpracticeswasbadforboththeindividualand,morally,forthecommunity.  Bythelate1950'searly1960's,theaforementionedperceptionswerestrengthenedbymedicalopiniontotheeffectthatthesmokingoftobaccowascorrelatedstatisticallytoacertainnumberofhumandiseases.Reportspointedtosuccessivelystrongercorrelationsovertheyears *j$2 despiteanumberofinexplicableanomaliesandunansweredscientificquestionssuchas:Whydo d Japanesemenhavelowratesoflungcancerwhentheyareamongtheheaviestsmokers?   #  3      ׀Why b haveresearchersbeenunable(or failed)toreproducethesediseaseinlaboratoryanimals  8 viasmokeinhalationexperimentsdespitefrequentattemptswithmanydifferentspeciesand   strains?Why,despitethestrongstatisticalcorrelations,dothegreatmajorityofsmokersnever p   developlungcancer?[Paul,thisisasuggestion]Howcanconclusionsregardingcausationbedrawnwhenscientistsstilldonotunderstandtheunderlyingmechanismsbywhichcancerandheartdiseasedevelop?  Nevertheless,theallegedevidenceofadefinitivelinkbetweensmokingandillhealthwas   perceivedtobesostrongastoinfluencelargenumbersofsmokerstoquit,andtocreate x universalawarenessofthereportedrisksofsmoking.Thistrendstartedinthe1970'sintheUS x andacceleratedovertimesothatbytheendofthe1980'sandthebeginningofthe1990's,smokingincidenceintheUSwasdecliningbytwoormorepercentagepointsannually.OverallsmokingincidenceintheUSadultpopulationhaddroppedfromanalltimehighofXX%in196XtoXX%in1992.PP  -  4      ׀[Paul,afterfurtherreflectionIamnotsurewecansaythattheprimary  issuescience,especiallyepidemiology,isnot goodscienceorthatitstrayedfromformalstandards.Itismoreacaseofrelaxingwhatshouldberigorousstandardsofproofofcausationthatabettersciencedemands.]  Bytheearlytomid1980's,however,itbecameevidenttoantismokingcampaignersthat  !& themomentumoftheirmovementwasslowing.Infact,thepercentageofadultsmokersintheUnitedStatesactuallygrewmarginallyin1992.Clearly,beyondthefirstwavesofsmokerstogiveupsmoking,therewasasignificantgroupofdedicated(committed)smokersrepresenting X%,  approximatelyonethirdoftheadultpopulationwhoacceptedtheallegedriskstotheirpersonal &X . wellbeingandwhocontinuedtosmokedespiteanevergrowinglistofillnessesassociatedwiththeproduct,increasinglydramaticonpackwarnings,andmassivehealtheducationcampaigns. [suggestion]Antismokerssoughttoimpose healthpaternalismonsmokersbecausethey 8  wouldnotacceptthatmillionsofpeoplewouldfreelychoosetoenjoysmokinginthefaceofknownrisks.Theseantismokerssoughtnewapproachestoengineeringtheirgoalofasmokefreesociety.Anewformofpressurewasthusneededtorejuvenatethestagnatingantitobacco p   campaign. TheSecondaryIssue  @    [Paul,maybeatransitionparagraphstatingthattheantiswerefrustratedthatsmokers   didnotquitinlargeenoughnumbers.SotheantishadtofindanissueorsocialvehiclesocialvehicletopressuresmokerstoquitandthisgaverisetoETSandthethemeofsocialunacceptability;ifsmokerswouldnotquittoprotecttheirownhealththennonsmokersneededtobeconvincedtheirhealthwasindanger&theywouldsociallypressuresmokerstoquit.] H   Thisnewformofpressurewasfoundintheformofsocalled passivesmoking,i.e.thenotionthatthesmokingoftobaccoharmsnotonlythesmokersthemselvesbutalsothousethosearoundthem.Theeffectivenessofthisnotionisthatitcreatessocietalpressureonthesmokerbasedontheselfinterestofnonsmokers.Inotherwords,ittransformsthenonsmokerintoanantismoker.Consideringthatnonsmokersoutnumbersmokers3or4toone,thisisamostpowerfulelementintheantismokingcampaign.  Thepassivesmokingargument,called environmentaltobaccosmokebythetobaccoindustry,becamethemainthrustoftheantismokingmovementfromtheearly1980'stotheearly1990's.Nonsmokingbecamethenorminpublicplaces,withsomeexceptions;andsmokinggraduallybecameassimilatedwithinconsiderate, dirtyandirresponsiblebehavior.Tothesmokersownsenseofguiltaboutdamaginghishealthwasaddedtheguiltofharminghisneighbors.  Thenotionthat passivesmokingwaslinkedtoseveralhumandiseasesgraduallygainedcredibilityinthepublichealthcommunityandbecameabattlecryofthevarioushealthrelated `,%6 organizationsatworld,regionalandnationallevel[s](WHO,UICC,SurgeonGeneral,CenterforDiseaseControl,etc.).Smokingwaspositionednotonlyasaformofselabuse,butalsoasabehaviortobedistancedfromallformsofmainstreamsocialgathering. 00*<   Themedical/scientificbasisfortheSecondaryIssuewasgivencompellingcredibilityby h thescientific,mediaandpolicymakingcommunitiesdespitethelackofconvincingscientific h evidencetosupporttheclaimsbeingmade.Notably: 8  #c  #c#"0    Themajorityofepidemiologicalstudiesfailedtofindastatisticallysignificantassociation  8 betweenETSandhumandiseases.   -  5      ׀#c##݌ "" Ќ  #c  #cz%"0    Thefewstudieswhichdidfindanassociationwereseriouslyflawedwithselectionerrors, p   confoundingerrors;andotherexamplesofpoorresearchmethodology.#cz%%݌ "" Ќ  #c  #c&"0    Inseveralinstances,mostnotablyintheclassificationofETSbytheUSEnvironmental @  ProtectionAgencyasa ClassAcarcinogenstudieswhichdidnotfittheantishypothesiswereomittedfromresearchreviews;relativeriskratiosformerlycalled weakwereinappropriatelyreinterpretedas conclusive,andstandardconfidence x levelswereloweredspecificallytoaccomodate[sic]worksic]workwhichwouldfittheETS/carcinogenhypothesis.#c&&݌ "" Ќ    Therangeofscientific,legislative,mediaandsocialpressurewhichrevolvedaroundthecreationofthisSecondarysmokerissuecontributedtothesuccessinloweringsmokingincidenceintheUnitedStatesfromaboutXX%in1985toaboutXX%in1992.Thisoccurredatthecost  ofthescientificmedicalandlegislativeestablishmenthavingacceptedthedistortionofscience   toadvanceanactivistcause. P"   Buthere,onceagain,theantismokingcampaignhadreachedaplateau:onceallpublicplaceshadbeensegregatedintosmokingandnonsmokingareas;andoncethecampaignhadbeenevenmoresuccessfulineliminatingsmokingentirelyfromairlines,mostworkplaces,manyeatingandentertainingestablishments,andevenoutdoorstadiaanduniversitycampuses,thereseemedtobenobattlefieldleft.Andthefactremainedthatasignificantsegmentofthe X%, populationchosetocontinuetosmoke,althoughnowreducedfromonethirdtoonequarterof &X . thepopulation.Thestagewassetforanewphaseintheantismokingcampaign. TheTertiaryIssues  *$4   Thesecondaryissue,anditssuccessasanactivistplatform,hingedonthecondemnationas[sic]smokingasaharmful(andthereforehostile)formofsocialbehavior,i.e.behaviorin h socialsettings.   Fromanactiviststandpoint,however,thisargumenthadafundamentalweakness:itallowedsmokersanalmostfullrangeofactionintheprivatedomain(i.e.intheirownhomesandinthehomesoffellowsmokers);andindoingsoitconcededthe persoanlpersonalchoiceargumentwhichhadalwaysbeenthefundamentalideologicalrefugeoftheharriedsmoker.  Theactivistssolutiontothisstandoffwastodeviseanumberofwaysinwhichthesmokercouldbeharassedintheprivatedomain.Thejustificationoftheseinitiativeswasalmostalwayslinkedtotheconceptofthe socialcoststhatsmokersimposedontheeconomyoronsocietyingeneral.Formsoflegislatedorinanycaselegalharassmentinclude:#c  #ck2"0    Makingsmokers payfortheirsinsviaveryheavyexcisetaxesdespitethefactthat x thesetaxeswereseldomifeverearmarkedtofinancecancerresearchorhospitalcostsofdiseasesassociatedwithsmoking.#ck22݌ "" Ќ  #c  #c3"0    Publicinformationcampaignswhichportrayedsmokersasundereducated,bluecollar,  andinconsiderate(publicinformationcampaignshavealsoplayedonsmokersasbeingsexuallyunattractiveandhavetriedtopositionblacksmokersandwomenasnaivedupes   ofthetobaccoindustry).#c33݌ "" Ќ  #c  #c5"0    Thepositioningofsmokersas addictsofa drug,which,accordingtotheU.S. P$ SurgeonGeneralandotherhealthauthorities,is asaddictiveascocaineandheroin.#c55݌ "" Ќ  #c  #c6"0    Thepositioningofsmokinginthehomeasaformofchildabuse(duetothealleged " ( effectsofenvironmentaltobaccosmoke),andthesubsequentintroductionofacouplessmokingstatusasafactorinadoptionandchildcustodydecisions.#c67݌ "" Ќ  #c  #c8"0    Thenegationofsmokersrightstoevenapplyforjobswithalllevelsofgovernment,and &X . withagrowingnumberofprivateconcernsaswell(somegovernmentsandcompaniesalsohavefiredsmokers,followingtheanalysisofurinesamples,forsmokingathome).#c88݌ "" Ќ  #c  #c#:"0    Theintroductionofapersonssmokingstatusasafactorforcareeradvancementinmany *$4 publicandprivatesectorjobs.#c#:>:݌ "" Ќ  #c  #c6;"0    Theawardingofadditionalvacationdaystononsmokersinstateandprivatecompanies -`'8 asawayofpenalizingsmokersfortheir costtocompanyandgovernmenthealthinsuranceplans.#c6;Q;݌00*<"" Ќ  #c  #c<"0    Thedecisionbysomesurgeonstodenytreatmenttosmokerstosmokers(accordingtothesedoctors, h theapplicationoftheHippocratciHippocraticoathdoesnotapplytopeoplewithsocalledselfdestructivebehaviors).#c<<݌ "" Ќ  #c  #c->"0    Theremovalofcigarettesfromalltelevisiontalkshowsandtheeliminationofsmoking  8 scenesfromalltelevisionscriptsexceptforwhencigarettesmokingcanbeusedtopainanevendarkerpictureofatelefilmvillain(therehaveevenbeenseriousproposalstocensorsmokingscenesfromoldmoviesshownontelevision).#c->H>݌ "" Ќ    Theantismokingmovement,inaparallelfashion,hasbeenabletomarginalizetheeconomicimpactofthetobaccorelatedindustriesvia:#c  #c@"0    Theinternationaldrivetobancigaretteadvertising,sponsorshipandpromotionsatall   levels,nomatterwhattheimpactonmedia,sportsorculturalassociationswhichderivefinancingfromthistypeofmarketingexpenditure.#c@@݌ "" Ќ  #c  #cB"0    TheunprecedenteddecisionbytheWorldBankinWashingtonD.C.todenydevelopment H financingtoanyprojects,eventhoseintheThirdWorld,havingaconnectiontotobaccoharvestingorprocessingorthemanufactureoftobaccoproducts(despitetheroleoftobaccoleafasoneofthekeyexportandforeignexchangeearnersoftheworldspoorestcountries).#cB5B݌ "" Ќ    Itisstilltooearlytotellwhethertheimpactofthese tertiarymeasureswillresultinafurtheracccelerationaccelerationinthereductionofsmokingincidencefromthecurrent25percentoftheadultpopulation.Thepubliclystateaimofthevarioushealthauthoritiesisa SmokefreeSocietybytheYear2000.  Whatissignificantisthat,afterafirststageofactivisminwhichrigorousscientific #* standardswere relaxedsomewhattoaccomodate[sic]anideology;afterasecondstagein X%, whichsciencewasdistortedtofitpredeterminedconclusionsandtojustifyacrosstheboard &X . legislativeactiontoconstraintherightsofaminority;thisthirdstageischaracterizedbyawillingnesstocurtailorignoreawholeseriesofrightsorconceptswhichformtheverybasisofWesterndemocraticsociety.  Thetertiaryantismokingmeasuresoutlinedaboveareindirectconflictwithsuch `,%6 rtreauredtreasurednotionsasequalopportunityforall,particularlyinthjetheworkplace;freedomfromdiscriminationandpubliclyfinancedridiculebasedonalifestylechoice;thenotionoffreedomofchoice(the addicitonaddictioncahrgecharge);thesanctityoftheprivatehouseholdandlegallifestyle 00*< behaviorinthathousehold;theconceptofaresponsible,caringpersonalityastheprimefactorinchildadoptionorcustodyissues;freedomofcommercialspeechforalegalproduct;thenotionthatpublicfinancingshouldbenonregressive;therightofdevelopingcountriestoexport 8  earningsinexchangeforlegaleconomicactivity;theabrogationbysomedoctorsofthemostfundamentaloaththeywillevertake;andoutrightcensorshipofsmokinginthemedia,   particularlytelevision. p     Conclusion:thedrivetoeliminatesmokingmayindeedonedaysucceed.Butatwhatprice,whatrealprice,fordemocracyandsociety?Whatwillbethelegalprecedentsestablished?Andmostimportantly,whowillbenext?Smokersaremerelythelatestinalonglineofpersecutedminorities.Theyareamongthefirsttohavebeenharassedinsuchasystemic[sic]andmethodicalwaybasedonalifestyleratherthanonrace,religionorgender.Buttheywillalmostcertainlynotbethelast.Notif health,asdefinedbythepoliticallycorrectagendaofthedayandthepoliticallyinfluentialauthoritiesofthemoment,becomesthegatewaythroughwhichallpersecutionsmaypass,andallperversionsofdemocratic,civilizedprinciplesbejustified.  -  6        ****************************************************************************  TheseconddocumentwaswrittenbyAnthonyAndrade,inatelexmemotoPhilipMorrisexecutivesC.GagliardiandStephenParrishon30January1992.``  -  7      ׀Thetitlegiventhedocument P" bytheindustrylawyersistypicallygenericandunhelpfulinindicatingthesubjectmatter: TelexMemorandumFromCounseltoEmployeesandCounselDiscussingAdvisabilityofProposedHandoutsAtScienceAndTechnologyConferenceinNeuchatelRegardingEts.****************************************************************************  Cigarettesmokingandlungcancerhaveoften,andforalongtime,beendescribedascauseandeffect.Advocatesofthisviewhaveusedastheirmajorsourceofsupportthestatisticalcalculationsfromepidemiologicalorpopulationstudiesofsmokersandnonsmokers.Toamuchlesserextent,theyrelyonlaboratoryresearchonanimals,thechemicalanalysesofandtestsontobaccosmokeanditscondensate,andotherhumanevidencefromautopsystudiesandclinical *$4 impressions.Abriefoverviewofthenature%  ofepidemiologicalevidencebecauseofitsparamountroleintheissueofcausation,servestoplaceitinpropoerproperscientificperspective.Adiscussionoftheindustryspoistionpositiononthequestionofwhethercigarettesmokingcauseslungcanceralsofollows.  Epidemiologistsstudythepatternsofdiseaseoccurrenceordeathsinselectedgroupsofpeopleandthencalculatediseaseordeathratesbyreportedcausesusingmainlyhospitalrecordsanddeathcertificates.  -  8      ׀Withthisinformationtheyattempttoidentifyconditions,behaviors,or p  otherfactorsinthelivesofthesubjectswhichmayberelatedtothesediseaseoutcomes.Basically,epidemiologistsfocusondetectingstatisticalassociationsbetweenfactorsanddisease,andmeasuringthestrengthoftheseassociations.Tosaythatastatisticalassociationexistsbetweenafactorandadiseasemeansthatthediseaseandthefactoroccurfrequentlytogether,orchangetogether.Thereportofastatisticalassociationbetweenafactorandadiseasedoesnotmeanthatacauseandeffectrelationshiphasbeenestablished.  Infact,statisticscanneverestablishcausationawellrecognizedandacceptedscientificprinciple.However,statisticalassociationshavevalueinthathattheysuggestavenuesforfurtherresearchandtheyraisequestionsaboutdiseasecausationwhichcanbeansweredonlyonthebiologicalormechanisticlevel.  Epidemiologistsandotherscientistsusetheterm riskfactorforacondition,behaviororothervariablewhichhasbeenstatisticallyassociatedwithaspecificdisease;ariskfactormayormaynotbecausallyrelatedtothedisease.Inadditiontothismeaning,thetermriskfactorisoftenusedbyscientiststorefertoafactorwhichisbeinginvestigatedasapossiblecauseofthedisease.  Cigarettesmoking,alongwithotherconditionsorbehaviors,suchasdietaryinsufficiencies,familyhistoryoflunbglungcancer,age,occupation,placeofresidenceandgeneticmakeup,hasbeenstatisticallyassociatedwithsomekindsofhumanlungcancer.Itisworthnotingthatlungcancerisnotonediseasebutreferstothemanytypesofcancerofthelungwhich differin,amongotherthings,theiricroscopicmicroscopicappearances,growthrates,treatmentresponses, *$4 andlikelihoodofsurvivalorcures.Hence,cigarettesmokingisariskfactorforsometypesofhumanlungcancerbutisnotnecessarilyacause.  -  9       h    Todescribesmokingasariskfactorissupportedbythecurrentstateofscientificknowledge.Thisdescriptionacknowledgesthatthereissomeevidencefomfromepidemiologyandotherdisciplineswhichisconsistentwithacausalroleforsmokingintheproductionofsometypesofhumanlungcancer,butitalsorecognizesthelimitationsof,theinconsistenciesin,andthegapsinthisevidence.Consequently,theavailablescientificevidences[sic]doesnotrisetothelevelofestablishingscientificallyacausalrelationship.Threefactssupportingthisviewfollow.First,despiteyearsofeffortandconsiderableexpense,nohumantypelungcancerhasbeenproducedinanimalsasaresultofinhalationofwhole,freshtobaccosmoke.Second,noconstituentoftobaccosmokeasfoundinthesmokehasbeenshowntocauselungcancer.Third,nobiologicalmechanismbywhichtobaccosmokemightcauselungcancerhasbeenelucidatedbyscience.Thereareimportantunresolvedquestionsremainingbeforeacausalrelationshipcanbescientificallyprovenorrejected.  Whethercigarettesmokingcauseslungcancerornotisclearlyaquestionthatcanonlyberesolvedbyfurtherresearch.Afairstatementofthecurrentstateofscientificknowledgeisthatcigarettesmokingisariskfactorforsomekindsofhumanlungcancer.  0 0  -  10      ׀Twovariablesarestatisticallyassociatedwhentheyoccurfrequentlytogether,or P" changetogether.Scientistsiseusetheterm riskfactorforacondition,behaviororothervariablewhichhasbeenstatisticallyassociatedwithaspecificdisease;ariskfactormayormaynotbecausallyrelatedtothedisease.Afairstatementofthecurrentstateofscientificknowledgeisthatcigarettesmokingisariskfactorforsomekindsofhumanlungcancer. **************************************************************************** X%,   Inreadingthesedocuments,itisnecessarytounderstandthattheyarenotwritteninthe courseofscientificorintellectualdebate,butaredirectedtowardalegaldefenseagainsttortproceduresincourtsoflaw,aswellasmaterialforthepublicrelationseffortsoftheindustrytocreatcreate% $ itscasebeforethepublic,mediaandlegislativebodies.Therefore,eventheapparentadmissionthatsmokingisa riskfactorforsomekindsofhumanlungcancerisnomajorconcessiontotruthbutawayofestablishingasmokersfreechoiceinthefaceofarisk,whichinanycasefact,mayonlybeassociatedwithdiseasebutnotdirectlycausal.%