REPORT OF THE ADVISORY COMMITTEE TO THE SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE U-23 DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Public Health Service Publication No. 1103 For sale by the Suprrintendent of Documents, U.S. Government Printing Office U~ashingmn. D.C., 20402 - Price $1.25 THE SURGEON GENERAL'S ADVISORY COMMITTEE ON SMOKING AND HEALTH Stanhope Bayne-Jones, M.D., LL.D. Walter J. Burdette, M.D., Ph. D. William G. Cochran, M.A. Emmanuel Farber, M.D., Ph. D. Louis F. Fieser, Ph. D. Jacob Furth, M.D. John B. Hickam, M.D. Charles LeMaistre, M.D. Leonard M. Schuman, M.D. Maurice H. Seevers, M.D., Ph. D. . . . 111 COMMITTEE STAFF Professional Staff Eugene H. Guthrie, M.D., M.P.H. Peter V. V. Hamill, M.D., M.P.H. Staff Director Medical Coordinator Alexander Stavrides, M.D. Jack Walden Special Assistant to the Director Information Officer Mort Gilbert Jane Stafford Editorial Consultant Editorial Consultant Helen A. Johnson Benjamin E. Carroll Administrative Oficer Biostatistical Consultant Secretarial and Technical Staff Helen Bednarek Alphonzo Jackson Mildred Bull Jennie Jennings Grace Cassidy Martha King Rose Comer Sue Myers Jacqueline Copp Irene Orkin Adele Rosen Margaret Shanley Don R. Shopland Elizabeth Welty Edith Waupoose iv Foreword Since the turn of the century, scientists have become increasingly inter- ested in the effects of tobacco on health. Only within the past few decades, however, has a broad experimental and clinical approach to the subject been manifest; within this period the most extensive and definitive studies have been undertaken since 1950. Few medical questions have stirred such public interest or created more scientific debate than the tobacco-health controversy. The interrelationships of smoking and health undoubtedly are complex. The subject does not lend itself to easy answers. Nevertheless, it has been increasingly apparent that answers must be found. As the principal Federal agency concerned broadly with the health of the American people, the Public Health Service has been conscious of its deep responsibility for seeking these answers. As steps in that direction it has seemed necessary to determine, as precisely as possible, the direction of scientific evidence and to act in accordance with that evidence for the benefit of the people of the United States. In 1959, the Public Health Service assessed the then available evidence linking smoking with health and made its findings known to the professions and the public. The Service's review of the evidence and its statement at that time was largely focussed on the relationship of cigarette smoking to lung cancer. Since 1959 much addi- tional data has accumulated on the whole subject. Accordingly, I appointed a committee, drawn from all the pertinent scientific disciplines, to review and evaluate both -this new and older data and, if possible, to reach some definitive conclusions on the relationship be- tween smoking and health in general. The results of the Committee's study and evaluation are contained in this Report. I pledge that the Public Health Service will undertake a prompt and thorough review of the Report to determine what action may be appropriate and necessary. I am confident that other Federal agencies and nonofficial agencies will do the same. The Committee's assignment has been most difficult. The subject is com- plicated and the pressures of time on eminent men busy with many other duties has been great. I am aware of the difficulty in writing an involved technical report requiring evaluations and judgments from many different professional and technical points of view. The completion of the Com- mittee's task has required the exercise of great professional skill and dedica- tion of the highest order. I acknowledge a profound debt of gratitude to the Committee, the many consultants who have given their assistance, and the members of the staff. In doing SO, I extend thanks not only for the Service hut for the Nation as a whole. SURGEON GENERAL " Table of Contents FOREWORD . . . . . . . . . . . . . . . . . . ACKNOWLEDGMENTS . . . . . . . . . . . . . PART I INTRODUCTION, SUMMARIES AND CONCLUSIONS Chapter 1 Introduction . . . . . . . . . . . . Chapter 2 Conduct of the Study . . . . . . . . Chapter 3 Criteria for Judgment . . . . . . . . Chapter 4 Summaries and Conclusions . . . . . PART II EVIDENCE OF THE RELATIONSHIP OF SMOKING TO HEALTH Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Consumption of Tobacco Products in the United States . . . . . . . . . . . . Chemical and Physical Characteristics of Tobacco and Tobacco Smoke . . . . Pharmacology and Toxicology of Nico- tine . . . . . . . . . . . . . . . . Mortality . , . . . . . . . . . . . . Cancer . . . . . . . . . . . . . . . Non-Neoplastic Respiratory Diseases, Particularly Chronic Bronchitis and Pul- monary Emphysema . . . . . . . . . Cardiovascular Diseases . . . . . . . Other Conditions . . . . . . . . . . Characterization of the Tobacco Habit and Beneficial Effects of Tobacco . . . Psycho-Social Aspects of Smoking . . . Morphological Constitution of Smokers. Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Page V ix 3 11 17 23 43 47 67 77 121 259 315 335 347 359 381 vii ACKNOWLEDGMENTS During this study the -4dvisory Committee on Smoking and Health has had the constant support of individual s. groups and institutions throughout a broad range of professional and technical occupations. In many cases the contributions of these individuals involved considerable personal. pro- fessional or financial sacrifice. In every case the contributions lessened the burden of the Committee and increased the authorit>- and completeness of the Report. In this space it is impossible to assign priorities or special emphasis to individual contributions or contributors. The Committee. however, does acknowledge with gratitude and deep appreciation-and with sincere apologies to any individual inadvertently omitted--the substantial coopera- tion and assistance of the follo\ving: ACKERMAN, LAUREN, \I.D.-Professor of Pathology, Washington University School of Medicine, St. Louis, MO. ALBERT, ROY E., M.D.--Associate Professor, Department of Industrial Medi- cine, New York University Jledical Center, New York, N.Y. ALLEN, GEORGE V.-President and Executive Director, The Tobacco Insti- tut3, Inc., Washington, D.C. ALLING, D. W., M.D.-Statistician, National InsGtute of Allergy and Infec- tious Diseases, U.S. Public Health Service, Bethesda, Md. AMERICAN CANCER SOCIETY, New York, N.Y. AMERICAN TOBACCO Co., lYew York,N.Y. AXDERSON, AUGUSTUS E., Jr., M.D.--Senior Attending Internist, Research Laboratory, Baptist Memorial Hospital, Jacksonville, Fla. ANDERVONT, HOWARD B., SC. D.-Chief, Laboratory of Biology, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. ARTHUR D. LITTLE, INC., Cambridge, Mass. ASCARI, WILLIAM, M.D.-Pathologist, Presbyterian Hospital, New York, N.Y. AsHFoRD, THOMAS-P., M.D.-Instructor in Surgery, College of Medicine, University of Utah. Salt Lake City, 1.tah. ASTIN, ALEXANDER W., Ph. D.-Research Associate, National Merit Scholar- ship Corporation, Evanston, Ill. ?I~ERB.~CH, OSCAR, M.D.-Senior Medical Investigator, Veterans Adminis- tration Hospital, East Orange, N.J. ljAIL&R, JOHN C. III: &M.D.-Head, Demopraphv Section, Biometry Branch, National Cancer Institute, U.S. Public Healih Service. Bethesda, Md. NhTTIST~, S. P.-Pharmacologist, Arthur D. Little, Inc., Cambridge, Mass. AEARMAK, JACOB E., Ph. D.-Professor of BioFtatistics. L'nirersit! of >lin- nesota School of Public Health, Minneapolis, Mimi. REERE, GILBERT W., Ph. D.-Statistician, National Academv of S(+nres. Rja- tional Research Council. Washinpton, D.C. ix BELL, FRANK A., Jr.,-Program Director for the Engineer Career Develop- ment Committee, Office of the Chief Engineer, U.S. Public Health Service, Washington, D.C. BERKSON, JOSEPH, M.D.-Head, Division of Biometry and Medical Statistics, Mayo Clinic, Rochester, Minn. BEST, E. W. R., M.D., D.P.H.-Chief, Epidemiology Division, Department of National Health and Welfare, Ottawa, Canada. BLUMBERG, J., Brig. Gen.-Director, Armed Forces Institute of Pathology, Washington, D.C. BOCKER, DOROTHY, M.D.-Bibliographer, Reference Section, National Li- brary of Medicine, U.S. Public Health Service, Bethesda, Md. BRAUNWALD, EUGENE, M.D.-Chief, Cardiology Branch, National Heart Institute, U.S. Public Health Service, Bethesda, Md. BRESLOW, LESTER, M.D.-Chief, Division of Preventive Medical Services, California Department of Public Health, Berkeley, Calif. BROWN AND WILLIAMSON TOBACCO CORP., Louisville, Ky. BROWN, BYRON WM., Jr., Ph. D.-Associate Professor, Biostatistiea Division, School of Public Health, University of Minnesota, Minneapolis, Minn. BUTLER, WILLIAM T., M.D.-Clinical Investigator, Laboratory of Clinical Investigations, National Institute of Allergy and Infectious Diseases, U.S. Public Health Service, Bethesda, Md. CANADIAN DEPARTMENT OF NATIONAL HEALTH AND WELFARE, Ottawa, Canada. CANADIAN DEPARTMENT OF VETERANS AFFAIRS, Ottawa, Canada. CARON, Herbert S., Ph. D.-Cleveland Veterans Administration Hospital. Cleveland, Ohio CARNES, W. H., M.D.-Professor and Head of Department of Pathology, College of Medicine, University of Utah, Salt Lake City, Utah. CARRESE, LOUIS M.-Program Planning Officer, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. CASTLEMAN, BENJ.4MIN, M.D.-Department of Pathology, Massachusetts General Hospital, Boston, Mass. CHADWICK, DONAI.D R., M.D.-Chief, Division of Radiological Health, U.S. Public Health Service, Washington, D.C. CLARK, KESNETH, Ph. D.-Consultant, Office of Science and Technology. Executive Office of the President, Washington, D.C. COBB, SIDNEY, M.D.-Program Director, Survey Research Center, University- of Michigan, Ann Arbor. Mich. COMROE, JULIUS H., M.D.-Professor of Physiology and Director of the Cardiovascular Research Institute, University of California, San Francisco. Calif. COONS CARLETON S., Ph. D.-Curator of Ethnology, University of Pennsyl- vania Museum, Philadelphia, Pa. COOPER, W. CURK, M.D.-Professor, Occupational Medicine, School of Public Health, Berkeley, Calif. CORNFIELD: JEROME-Acting Chief, Biometrics Research Branch, National Heart Institute, U.S. Public Health Service, Bethesda, Md. DAMON, ALBERT, M.D.-Associate Professor, Department of Epidemiology, Harvard University School of Public Health, Cambridge, Mass. X DAWSON, JOHN M.-Statistician, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. DIPAOLO, JOSEPH A., Ph. D.-Senior Cancer Research Scientist, Rowe11 Park Memorial Institute, Buffalo, N.Y. DOBBS, GEORGE, M.D.-Associate Chief, Division of Scientific Opinions, Federal Trade Commission, Washington, D.C. DOLL, RICHARD, M.D.-Director, Medical Research Council's Statistical Research Unit, University College Hospital Medical School, London, England o DORN, HAROLD F.-Chief, Biometrics Research Branch, National Heart Institute, U.S. Public Health Service, Bethesda, Md. DOYLE, JOSEPH T., M.D.-Direotor, Cardiovascular Health Center, Albany- Medical College, Union University, Albany, N.Y. DUNHAM, LUCIA J., M.D.-Medical Officer, Laboratory of Pathology. Na- tional Cancer Institute, U.S. Public Health Service, Bethesda, Md. EBERT, RICHARD V., M.D.-Professor and Head, Department of Medicine, University of ,irkansas Medical Center, Little Rock, Ark. EDDY, NATHAN B., M.D.-Executive Secretary, Committee on Drug Addic- tion and Narcotics, National Academy of Sciences, National Research Council, Washington, D.C. EISENBERG, HENRY, M.D.-Director of Chronic Diseases, Connecticut State Department of Health, Hartford, Conn. ELLIOTT, JAMES LLOYD, M.D.-Assistant Chief, Bureau of Medical Services, U.S. Public Health Service, Silver Spring, Md. ENDICOTT, KENNETH M., M.D.-Director, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. FALK, HANS L., Ph. D.-Acting Chief, Carcinogenesis Studies Branch, Na- tional Cancer Institute, U.S. Public Health Service, Bethesda, Md. FILLEY, GILES F., M.D.-Associate Professor of Medicine, University of Colorado Medical Center, Denver, Colo. FISHER, RUSSELL SYLVESTER, M.D.-Chief Medical Examiner, State of Maryland, Baltimore, Md. FORAKER, ALVAN G., M.D.-Pathologist, Baptist Memorial Hospital, Jack- sonville, Fla. FOX, BERNARD H., Ph. D.-Research Psychologist, Division of Accident Pre- vention, U.S. Public Health Service, Washington, D.C. FRAZIER, TODD M., SC. M.-Director, Bureau of Biostatistics. Baltimore City Health Department, Baltimore, Md. GARFINKEL, LAWRENCE, M.A.-Chief, Field and Special Projects, Statistical Research Section, Medical Affairs Department, ijmerican Cancer Society, Inc., New York, N.Y. %LIAM, ALEXANDER, M.D.-Professor of Epidemiology. The Johns Hop- kins University, Baltimore, Md. GOLDBERG, IRVING D., M.P.H.-Assistant Chief, Biometrics Branch. National Institute of Neurological Diseases and Blindness, U.S. Public Health Service, Bethesda, Md. GOLDSMITH, JOHI\`. M.D.-Head. Air Pollution Medical Studies, California Department of Public Health, Berkeley, Calif. `Deceased. xi ~OI.DSTEIY, HYMEN, Ph. D.-Chief, Biometrics Branch, National Institute of Neurological Diseases and Blindness, U.S. Public Health Service, Bethesda, Md. GRAH.431, SAXON. M.D.-Associate Cancer Research Scientist, Roswell Park Memorial Institute, Buffalo, N.Y. GREENBERG, BERUARD G., Ph. D.-Professor of Biostatistics. School of Public Health. University of North Carolina, Chapel Hill, N.C. GROSS. PAUL, M.D.-Research Pathologist. Industrial Hygiene Foundation, Mellon Institute. Pittsburgh, Pa. HAENSZEL, WrLrr.AM-Chief, Biometrv Branch, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. HAINER, RAYMOND M., Ph. D.-Research Physical Chemist, A. D. Little Inc.. Cambridge, Mass. HALL, ROBERT L.. Ph. D.-Program Director, Sociology and Social Psy- chology, National Science Foundation, Washington, D.C. HAIXSTAIL D.kvtD-Actuary, The National Center for Health Statistics, U.S. Public Health Service, Washington, D.C. HAMMOND, E. CUYLER, SC. D.-Director, Statistical Research Section, Medi- cal Affairs Department, American Cancer Society, Inc., New York, N.Y. HAMPERL, H.. M.D.-Director of the Pathology Institute, University of Bonn, Bonn, Germany. HARTWELL, JON.4TH.4N L., Ph. D.-Chief, R esearch Communications Branch, National Cancer Institute, U.S. Public Health Service, Silver Spring, Md. HAYDEK. ROBERT G.. Ph. D.-Research Psychologist, Behavioral Sciences Section, Division of Community Health Services, U.S. Public Health Service, Washington, D.C. HEIMANN. HARRY, M.D.-Chief, Division of Occupational Health, U.S. Public Health Service, Washington, D.C. HEINZELMJNN, FRED. Ph. D.-Assistant Chief, Behavioral Sciences Section, Division of Community Health Services, U.S. Public Health Service, Washington, D.C. HELLER, JOHN R., Jr.. M.D.-President and Chief Executive Officer, Sloan- Kettering Institute for Cancer Research, New York, N.Y. HERMAN, DORIS L., M.D.-Pathologist, Tumor Tissue Registry, Cancer Com- mission, California Medical Association, Los Angeles, Calif. HERROLD: K.~THERISE, M.D.-Medical Director, Laboratory of Pathology. National Cancer Institute. I.S. Public Health Service, Bethesda, Md. HESTON, WALTER E.: M.D.. Ph. D.-Chief, Laboratory of Biology, National Cancer Institute, T7.S. Public Health Service, Bethesda, Md. HIGGINS, 1.t~ T. T.. M.D.-Professor of Epidemiology and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa. HOCHRC->I> GODFREY, Ph. D.-Chief, Behavioral Sciences Section, Division of Community Health Services: U.S. Public Health Service, Washington. D.C. HOCKETT. ROBERT C.: Ph. D.--Associate Scientific Director, Tobacco Indus- try Research Committee: New York, N.Y. HORN, DASIEL: Ph. D.-Assistant Chief for Research, Cancer Control Pro- gram, Division of Chronic Diseases, U.S. Public Health Service, Washing- ton, D.C. xii HORTON, ROBERT, J. M.: M.D.-Chief, Field Studie: Branch, Dix-ision of Air Pollution, U.S. Public Health Service, Cincinnati. Ohio. HUEPER, WILHELM C., M.D.-Chief, I? nvironmental Cancer Section. Sa- tional Cancer Institute, U.S. Public Health Service, Bethesda, Told. IPSEN, JOHANI~ES, Ph. D.-Professor of Medical Statistics Henry Phipps ln- stitute, University of Pennsylvania. Philadelphia, Pa. ISBELL, HARRIS, M.D.-Professor of Clinical PharmacoloF)-. I'niversity of Kentucky Medical School. Lexington, KY. ISKRANT, ALBERT P.-Chief, Developmental Research Yecticjrl. Division of Accident Prevention, U.S. Public Health Service, Washington. D.C. JANUS, ZELDA-Statistician, National Cancer Institute, 1..S. Public Health Service, Bethesda, Md. JOSIE, G. H., SC. D., M.P.H.-Chief, Epidemiolo=)- Divi.;iotr. Department of National Health and Welfare. Ottawa, Canada. KAHN, HAROLD A.-Statistician, Biometrics Research Branch. National Heart Institute, U.S. Public Health Service. Bethesda. Md. CANNEL, W. B., M.D.-Associate Director, Heart Disease Epidemiology Study, National Heart Institute. U.S. Public Health Service. Framingham. Mass. KELEMEN, GEORGE, M.D.-Research Associate, hlassachusetts Eye and Ear Infirmary, Harvard University Medical School. Boston, 3iass. KELLEY, HAROLD H., Ph. D.-Professor, Department of Psychology, Uni- versity of California, Los Angeles, Calif. KENSLER, CHARLES J., Ph. D.-Senior Vice President, Life Sciences Division, Arthur D. Little, Inc., Cambridge, Mass. KESSELMAN, AvIva-Statistician, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. KLEINERMAN, JEROME, M.D.-Associate Director, Medical Research Depart- ment, St. Luke's Hospital, Cleveland, Ohio KNIGHT, VERNON, M.D.-Clinical Director, National Institute of Allergy and Infectious Diseases, U.S. Public Health Service, Bethesda, Md. KNUTTI, RALPH E., M.D.-Director, National Heart Institute. U.S. Public Health Service, Bethesda, Md. KOTIN, PAUL, M.D.-Associate Director of Field Studies, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. KREYBERG, LEIV, M.D.-Director of Institute for General and Experimental Pathology, University of Oslo, Oslo, Norway KRUEGER, DEAN E.--Statistician, Biometrics Research Branch, National Heart Institute, U.S. Public Health Service, Bethesda, Md. KUSCHNER, MARVIN, M.D.-Professor of Pathology and Director of Labora- tories, Bellevue Hospital Center. New York University Medical Center, New York, N.Y. LARSON, PAUL S., Ph. D.-Professor and Chairman of Department of Phar- macology, Medical College of Virginia, Richmond, Va. LEITER, JOSEPH, Ph. D.-Chief, Cancer Chemotherapy National Service Center, U.S. Public Health Service, Silver Spring, Md. rdEUCHTE~~~~~~~, CECILIE, M.D., Ph. D.-P f ro essor, EidgenGssische Tech- nische Hochschule, Institut fiir Allgemeine Botanik, Zurich, Switzerland . . . XIII LEUCHTENBERGER, RUDOLF, M.D.-Professor Eidgeniissische Technische Hochschule, Institut fiir Allgemeine Botanik, Zurich, Switzerland LEVIN, MORTON L.. M.D.-Professor of Epidemiology, Roswell Park Me- morial Institute, Buffalo, N.Y. LIEBOW, AVERILL A., M.D.-Professor of Pathology, Yale University School of Medicine, New Haven, Conn. LIGGETT & MYERS, INC., New York, N.Y. LILIENFELD, ABRAHAM, M.D.-Professor of Chronic Diseases, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md. LISCO, HERMAN, M.D.-Cancer Research Institute, New England Deaconess Hospital, Boston, Mass. LITTLE, CLARENCE COOK, M.D.-Scientific Director, Tobacco Institute Re- search Committee, New York, N.Y. LOUDON, R. G., M.B.-Assistant Professor of Internal Medicine, The Uni- versity of Texas Southwestern Medical School, Dallas, Tex. MAR'OS, NICHOLAS E.-Statistician, Division of Occupational Health, U.S. Public Health Service, Washington, DC. MARDER, MARTIN, Ph. D.-Research Psychologist, Behavioral Sciences Sec- tion, Division of Community Health Services, U.S. Public Health Service, Washington, D.C. MATARAZZO, J. D., Ph. D.-Professor of Medical Psychology, Department of Medical Psychology, University of Oregon Medical School, Portland, Oreg. MCFARLAND, JAMES J., M.D.-Professor of Otolaryngology, School of Medi- cine, George Washington University Hospital, Washington, D.C. MCGILL, HENRY C., M.D.-Professor of Pathology, Louisiana State Uni: versity School of Medicine, New Orleans, La. MCHUGH, RICHARD B., Ph. D.-Associate Professor of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minn. MCKENNIS, HERBERT, Jr.-Professor of Pharmacology, Medical College of Virginia, Richmond, Va. MEDALIA, NAHUM Z., Ph. D.-Executive Secretary, Mental Health Small Grants Committee, National Institute of Mental Health, U.S. Public Health Service, Bethesda, Md. MEHLER, MRS. ANN-Research Assistant, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. MILLER, JACK, M.D.-Research Fellow in Medicine, The University of Texas Southwestern Medical School, Dallas, Tex. MILLER, ROBERT W., M.D.-Chief, Epidemiology Section, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. MILLER, WILLIAM F., M.D.-Associate Professor of Internal Medicine, The University of Texas Southwestern Medical School, Dallas, Tex. MITCHELL, ROGER S., M.D.-Associate Professor, University of Colorado School of Medicine, Denver, Colo. MURPHY, EDMOND A., M.D.-Attending Physician, The Moore Clinic, The Johns Hopkins University Hospital, Baltimore, Md. NASH, HARVEY. Ph. D.-Illinois State Psychiatric Institute, Northwestern University Medical School, Chicago, Ill. xiv NELSON, NORTON, Ph. D.-Professor and Chairman, Department of Indus- trial Medicine, New York University Medical Center, New York, N.Y. ORCHIN, MILTON, Ph. D.-Professor of Chemistry, University of Cincinnati, Cincinnati, Ohio. P. LORILLARD Co., New York, N.Y. PAFFENBARGER, RALPH S., Jr., M.D.-Medical Director, Field Epidemiology Research Section, National Heart Institute, U.S. Public Health Service, Framingham, Mass. PAUL, OGLESBY, M.D.-Chairman, Committee on Epidemiological Studies, Passavant Memorial Hospital, Chicago, Ill. PFAELZER, ANNE I.-Concord, Mass. PHILLIP MORRIS, INC., New York, N.Y. PICKREN, JOHN W., M.D.-Chief, Department of Pathology, Roswell Park Memorial Institute, Buffalo, N.Y. PIERCE, JOHN -4., M.D.-Associate Professor, Department of Medicine, Uni- versity of Arkansas Medical Center, Little Rock, Ark. POTTS, ALBERT M., M.D.-Professor of Ophthalmology, University of Chi- cago School of Medicine, Chicago, Ill. PRINDLE, RICHARD A., M.D.--Chief, Division of Public Health Methods, U.S. Public Health Service, Washington, D.C. R. J. REYNOLDS TOBACCO Co., Winston-Salem, N.C. REED, SHELDON C., Ph. D.-Professor of Zoology, Department of Zoology, University of Minnesota, Minneapolis, Minn. REMINGTON RAND, LTD. (Ottawa) ROOS, CHARLES A.-Head, Reference Services Section, National Library of Medicine, U.S. Public Health Service, Bethesda, Md. ROSEN, SAMUEL, M.D.-Chief, Pulmonary Mediastinal and ENT Pathology Branch, Armed Forces Institute of Pathology, Washington, D.C. ROSENBLATT, MILTON B., M.D.-Associate Clinical Professor of Medicine, New York Medical C 11 g o e e, and Visiting Physician, Metropolitan Hospital, New York, N.Y. Ross, JOSEPH, M.D.-Associate Professor of Medicine, University of Indiana School of Medicine and Head of Chest Division, Robert Long Hospital, Indianapolis, Ind. SANFORD, J. P., M.D.-Associate Professor of Internal Medicine, The Uni- versity of Texas Southwestern Medical School, Dallas, Tex. SAVAGE, I. RICHARD, Ph. D.-Professor of Statistics, Florida State University. Tallahassee, Fla. SCHIFFMAN, ZELDA-$Ckd Assistant to Executive Officer, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. SCHNEIDERMAN, MARVIN. A-Associate Chief, Biometry Branch, National Cancer Institute, U.S. Public Health Service, Bethesda, Md. SCHWARTZ, JOHN THEODORE, M.D.-Head, Ophthalmology Project, Na- tional Institute of Neurological Diseases and Blindness, U.S. Public Health Service, Bethesda, Md. SCOTT, OWEN-Executive Officer, National Institute of General Medical Sci- ences, U.S. Public Health Service, Bethesda, Md. SELICMAN, ARNOLD M., M.D.-Chairman, Department of Surgery, Sinai Hos- pital, Baltimore, Md. SELTSER, RAYMOND, M.D.-The Johns Hopkins IJniversity School of Public Health, Baltimore, Md. SELTZER, C~RI. C., Ph. D.-Research Associate in Physical Anthropology, Peabody Museum, Harvard University, Cambridge, Mass. SHAPIRO, HARRY, M.D.-Curator of Anthropology, American Museum of Natural History, New York: N.Y. SHUBIK, PHILLIPE, M.D.-Professor of Oncology, Chicago Medical School, Chicago, Ill. SILVETTE, HERBERT, Ph. D.-Visiting Professor of Pharmacology, Medical College of Virginia, Richmond, Va. SIRKEN, MONROE, Ph. D.-Acting Chief, Division of Health Records, The National Center for Health Statistics, U.S. Public Health Service, Wash- ington, D.C. SLOAN, &RGARET H.. M.D.-Special Assistant to Director, National Cancer Institute, IT.S. Public Health Service, Bethesda, Md. SPIEGELMAN, MoR'rrMER-Associate Statistician, Metropolitan Life Insurance Company, New York, N.Y. STALLOKES, REUEL, M.D.-University of California School of Public Health, Berkeley, Calif. STEINBERG, ARTHUR, Ph. D.-Biologist, Professor in Department of Biology, Western Reserve University, Cleveland, Ohio STEWART, HAROLD L.: M.D.-Chief, Laboratory of Pathology, National Can- cer Institute, U.S. Public Health Service, Bethesda, Md. STOCKS, PERCY, M.D.-World Health Organization Consultant, Former Chief Medical Statistician in the Office of the General Registrar (1933-50), London, England STOUT, ARTHUR P., M.D.-Professor Emeritus of Surgery, Laboratory of Sur- gical Pathology, College of Physicians and Surgeons, Columbia University. New York, N.Y. STOWELL, ROBERT, M.D., Ph. D.-Scientific Director, Armed Forces Institute of Pathology, Washington, D.C. SYME: SHERM.~N LEOYARD-SOciOIOgiSt, San Francisco Field and Training Station, I'.S. Public Health Service Hospital, San Francisco, Calif. TAEUBER, K. E.-Research Associate, Population Research and Training Center, University of Chicago, Chicago, Ill. TOBACCO IXSTITI-TE, INC.. Washington, D.C. TOB.~CCO INSTITUTE RESEARCH COMMITTEE, New York, N.Y. TOICL-HATA: GEORGE, Ph. D., D.P.H.-Chief of Epidemiology, St. Jude Re- search Hospital, Institute of Biology and Pediatrics, Memphis, Term., and Assistant Professor of Preventive Medicine, University of Tennessee, Col- lege of Rledicine. Memphis, Tenn. TOMPSETT, RALPH, M.D.-Professor of Internal Medicine, The University of Texas Southwestern Medical School, Dallas, Tex., and Director of Medical Education. Baylor University Medical Center, Dallas, Tex. TOTTEN, ROBERT S.. M.D.-Associate Professor of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pa. TURNER, CI.ACDE G.-Director, Tobacco Policy Staff, Agriculture Stabiliza- tion and Conservation Service. United States Department of Agriculture. Washington. D.C. xvi VINCENT, WILLIAM J.-Student, University of California, Los Angeles, Calif. VON SALLMANN, LUDWIG, M.D.-Chief, Ophthalmology Branch, National In- stitute of Neurological Diseases and Blindness, U.S. Public Health Service, Bethesda, Md. VORWALD, ARTHUR, M.D.-Chairman, Department of Industrial Medicine and Hygiene, Wayne University College of Medicine, Detroit, Mich. WALKER, C. B., B.h.-Biostatistics Section, Research and Statistics Division, Department of National Health and Welfare, Ottawa, Canada WALLENSTEIN, MERRILL, Ph. D.-Chief, Physical Chemistry Division, Na- tional Bureau of Standards, Washington, D.C. WEBB, BLAIR M.: M.D.-Otolaryngologist and ENT Consultant at the National Institutes of Health, U.S. Public Health Service, Bethesda, Md. WEINSTEIN, HOWARD I., M.D.-Director, Division of Medical Review, Food and Drug Administration, Washington. D.C. WOOLSEY, THEODORE D.-Assistant Director, National Center for Health Statistics, U.S. Public Health Service, Washington, D.C. WYATT, JOHN P.: M.D.-Professor of Pathology, St. Louis University School of Medicine, St. Louis, MO. ZERZm4\`Y, FRED M., M.D.-Department of Maternal and Child Health. The Johns Hopkins School of Public Health, Baltimore, Md. ZUKEL, WILLIAM, M.D.-Associate Director, Collaborative Studies, National Cancer Institute. U.S. Public Health Service, Bethesda, Md. 114-422 o-64-2 xvii