RUSH-PRESBYTERIAN-ST. LUKE'S MEDICAL CENTER DEPARTMENT OF PREVENTIVE MEDICINE JAMES A. SCHOENBERGER. M.D., CHAIRMAN March 19, 1982 The Honorable Ronald Reagan The White House Washington, D.C. 20500 Dear Mr. President: I have just learned about the recent reversal of supportby the Administration for the stronger, rotational cigarette warning labels proposed in the Comprehensive Smoking Prevention Education Act (S. 1929) now before the Senate. I am quite concerned and puzzled by this news, particularly since Assistant Secretary Brandt and Surgeon General Koop supported this same provision in testimony on H.R. 5653 before the House Sub- committee on Health and the Environment on March 5, 1982. Much of my professional career has been devoted to medical practice in cardiology and to teaching and research in the fields of pre- ventive medicine and epidemiology. I am convinced that there is no single act that would do more to reduce illness, premature deaths and the imrmnse costs of health care and lost productivity in our nation than would preventing the smoking of cigarettes. As was emphasized in the 1982 Report of the Surgeon General on "The Health Consequences of Smoking", cigarette smoking is a deadly and costly behavior for Americans: more than 300,000 premature deaths, another 10 million afflicted with debilitating illness, more than $41 billion dollars in health care, lost productivity and Medicare/ Medicaid costs! Since the publication of the first Surgeon General's Report in 1964 by Dr. Luther Terry thousands of my colleagues and millions of other Americans have succeeded in their efforts to stop smoking. I believe the clear statements of the mounting scientific evidence on the health effects of smoking played a large- part in this decision. However, 54 million Americans still have not been able to stop smoking, and children and young persons continue to start smoking in alarming numbers. 10th Floor Schweppe-Sprague 1743 W. Harrson Street Chicago, lllinos 60612 Telephone: (312) 942.5910 The Honorable Ronald Reagan March 19, 1982 L2- According to the Federal Trade Commission's Staff Report on Cigarette Adver- tising, the current cigarette warning label has become so familiar to consumers that it is no longer effective as a health warning. Although recent studies indicate that most people may be generally aware that smoking is a health hazard, others clearly indicate that most consumers are not awre of the specific health consequences -- such as cardiovascular and pulmonary diseases -- nor do they know the extent to which smoking endangers their health. The FTC strongly recommended the use of a number of warning labels, each of which states a specific health consequence, and that the labels be used,in rotation on cigarette packages and in advertisements. Not only do consumers not have this important health information, but they also do not have adequate safeguards under federal consumer protection measures. Tobacco and tobacco products are not classified as a food, a drug, a toxic substance or even a consumer product. Our consumer protection laws carefully and deliberately exempt tobacco and the dangerous toxins it produces tihen smoked. I beli.eve that American consumers -- most particulary children and young persons -- have a right to know exactly what health dangers they face if they start to smoke or fail to stop. They also have a-right to know how serious these dangers really are. I believe that the federal government has an.important obligation to provide this information by means of clear and unambigious warnings on cigarette packages and in advertisements. This is especially necessary in view of the unusual exemption tobacco and tobacco products enjoy from consumer protection laws. There is no other agency in our society to meet this obligation. The system of rotational labels proposed in the health legislation now before Congress (H.R. 5653 and S. 1929) would be responsive to this obligation and would serve immensely to advance this important educational effort. These measures will not prohibit Americans from their free exercise of choice in deciding whether to smoke or not, but they would help to ensure that it was an informal choice. The cost to industry to rotate the warning labels would be minimal, especially in view of the rapid and frequent changes in advertising messages and in cigarette package designs. Any effort by any person or group of persons -- regardless of their position or power -- to deny Americans the right to know the health hazards of cigarette smoking:is simply not in our nation's public health interest and must be resisted. The Honorable Ronald Reagan March 19, 1982 -3- 1 therefore urge you to hold firm against the forces of opposition on this issue and to reinstate your support for stronger rotational warnings on cigarette packages and in advertising. We look to your leadership in protecting the health, the well-being and the very lives of all Americans, especially our children and youth. Sincerely, James A. Schoenberger, M.D. JAS:hmh cc: The Honorable Richard S. Schweiker The Honorable Edward N. Brandt, Jr., M.D. The Honorable C. Everett Koop, M.D. Mrs. Virginia H. Knauer