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REMARKS BY:    LOUIS W. SULLIVAN, M.D., SECRETARY OF HEALTH AND
                   HUMAN SERVICES
PLACE:         First International Conference on Smokeless Tobacco
               Columbus, Ohio
DATE:          April 10, 1991

Good evening, ladies and gentlemen.

I am pleased to have this opportunity to address the First International Conference on Smokeless Tobacco. I would like to congratulate Dr. Schroeder and all Planning Committee and Advisory members for their success in making this landmark conference a reality. And to those of you visiting from abroad -- I extend the warmest of welcomes.

Your efforts here are timely. Smokeless tobacco use appears to be increasing rapidly throughout the United States, especially among the most vulnerable of our citizens -- our children.

With over 30,000 new cases of oral cancer reported in the United States alone last year, it is time that use of smokeless tobacco takes its rightful place next to cigarette smoking, in national and world consciousness, as a serious health risk which must be stopped.

As many of you will recall, smokeless tobacco use as a health issue first became a subject of focus in the United States about six years ago. The media reported extensively at that time on the tragic consequences of smokeless tobacco use -- particularly on cases of oral cancer among young men.

In 1986, the Surgeon General released a report, "The Health Consequences of Using Smokeless Tobacco," which concluded that oral use of smokeless tobacco represents a significant health risk, is not a safe substitute for smoking cigarettes, can cause cancer and a number of noncancerous oral conditions, and can lead to nicotine addiction and dependence.

Also, Congress passed the Comprehensive Smokeless Tobacco Act of 1986, which banned smokeless tobacco advertising on television and radio, and required three health warnings to be rotated on smokeless tobacco packages and in advertisements.

Regrettably, an initial downturn in sales of smokeless tobacco products was not sustained. Statistics from the recently released 1991 Federal Trade Commission Report to Congress on Smokeless Tobacco Sales and Advertising Expenditures paint a grim picture.

Sales of smokeless tobacco products overall rose by over 2 million pounds in 1989, to 116.4 million pounds, following a three-year decline. Revenues from these sales were over a quarter of a billion dollars higher in 1989 than in 1985 -- $981.6 million versus $730.6 million. And expenditures to promote smokeless tobacco sales rose sharply in 1989, to $81.2 million -- up from $68.2 million in 1988. Three companies -- U.S. Tobacco, Conwood, and Pinkerton -- together control over 80 percent of the market share of smokeless tobacco in the United States.

The most disturbing trend is in the sales of moist snuff, now the most popular -- and the most dangerous -- form of smokeless tobacco. While oral cancer has been shown to occur several times more frequently among smokeless tobacco users than among nonusers, it may occur, in some sites in the mouth, as much as 50 times more frequently among long-term moist snuff users.

Sales of moist snuff have risen steadily in recent years, while sales of other forms of smokeless tobacco have fluctuated or have declined. Sales of moist snuff climbed to 41 million pounds in 1989, a 14 percent increase over the 35.9 million pounds sold in 1986. Revenues from these sales rose to $602.1 million in 1989, a 38 percent increase from $435.7 million in 1986. The U.S. Distribution Journal reported that the volume of moist snuff sales has risen 70 percent in the last ten years.

Our most recent surveys of smokeless tobacco use found that, in 1988 nationally, 25.8 percent of males between the ages of 12 through 17 had tried some form of smokeless tobacco and 6.6 percent had used smokeless tobacco in the past month.

Newer evidence suggests the problem is becoming much more serious. For example, according to a recent survey by the Illinois Department of Public Health, nearly half of all high school-age males across the state have tried smokeless tobacco in some form. About 16 percent of Illinois high school juniors are regular users, and in rural communities, the figure rises to 28 percent. Some begin use of smokeless tobacco as early as the second, third, or fourth grades!

The culture of smokeless tobacco use in the United States has to a large extent centered around sports, particularly baseball. When impressionable youngsters see their heros openly using smokeless tobacco on the playing field, it creates a powerful incentive to try it. These young people also begin to correlate smokeless tobacco use with athletic excellence.

When I addressed the Major League Baseball Team Physicians and Trainers last December, I suggested that no effort aimed at ending the use of smokeless tobacco in America would succeed without the support of the Major League Baseball community. I called upon baseball officials to develop a program with the goal of the eventual elimination of smokeless tobacco use in professional baseball and in America as a whole.

I am pleased to report that the baseball community has responded positively and boldly. On March 7, as a first step in an effort to disassociate professional baseball from smokeless tobacco use, Baseball Commissioner Fay Vincent announced that the use of smokeless tobacco will be forbidden in four "rookie" and class "A" minor leagues -- the levels at which most young men enter professional baseball.

The Commissioner also announced stepped-up efforts to educate players to the health risks of smokeless tobacco use and to help users quit. I commend Commissioner Vincent for his action and will be following the progress of his efforts with great interest.

Now we must urge officials and coaches at the college, high school, and youth league levels to ban the use of smokeless tobacco in baseball and in other sports activities under their jurisdictions.

This brings us to another significant element which serves to encourage young people to begin using smokeless tobacco -- promotion and advertising by the tobacco companies.

I have noted already that expenditures by the tobacco companies to promote and advertise smokeless tobacco use rose sharply -- by over 19 percent -- in 1989, according to the Federal Trade Commission.

The largest single category of expenditure -- nearly a quarter of total promotion and advertising expenditures for smokeless tobacco -- was devoted to sports and sporting events. Another 18.5 percent was devoted to expenses involving the insidious practice of distributing free samples.

The tobacco companies, indeed, play a major role in the promotion of sporting events. Philip Morris, known for its "Virginia Slims" tennis tournaments, is now the number one event sponsor in sports, according to the publication, The Sporting News -- spending about $100 million annually. RJR Nabisco spends about $40 million. The tobacco product these two companies promote, of course, is cigarettes.

It is not surprising, therefore, that when The Sporting News recently compiled a list of who they believe to be the 100 most powerful people in sports in the United States, the marketing vice presidents of Philip Morris and RJR Nabisco were ranked, respectively, 29th and 49th.

This represents a sad commentary on the state of sports in America. Without question, by sponsoring sporting events, the tobacco companies are trading on the prestige and image of the athletes to barter their deadly products. They are using the vigor and energy of these athletes as a subtle -- but incorrect and dishonest -- message that tobacco use is compatible with good health. And, all too often, that message is targeted to young people, women, minorities, and blue-collar workers.

We must question seriously values which allow activities that ostensibly represent the essence of fun, fitness, and health -- to be exploited to such a large degree by the merchants of suffering, disease, and death.

The time has come to end the association of tobacco and sports in this country and around the world.

The time has come for promoters of and participants in sporting events to be held accountable for the fact that when they accept money from the tobacco companies, they are promoting not only fun and games -- they are also promoting disease and death.

Ladies and gentlemen, it is immoral for civilized societies to condone the promotion and advertising of products which, when used as intended, cause disability and death.

I am all too aware that such activities are allowed under current law in the United States and elsewhere. And I am, quite frankly, disgusted that this remains the case. We react with horror and outrage when we hear of suffering and death overseas. Yet, at the same time, we not only allow our citizens to suffer and die from the poisonous chemicals contained in tobacco -- we condone expenditures of vast amounts of money by the tobacco companies to encourage it!

A little over a year ago, I urged the tobacco industry to voluntarily withdraw from direct sponsorship of sporting events. Obviously, my plea fell on indifferent ears.

If the tobacco companies will not adhere to this country's strong philosophy of voluntary corporate responsibility, then it is up to our citizens to provide the incentive.

As individuals, Americans can send a message to the tobacco companies in the only language they appear to understand -- the language of money. The message is that we will no longer financially support promotors of sporting events and others who would encourage our children to use addictive substances which will ruin their health and send them to an early grave.

And I urge public and private institutions to refrain from allowing their facilities to be used for tobacco company-sponsored sporting events.

The disgraceful trade-off in America between profits and good health must stop! But it will stop only when our citizens rise up and say "enough -- no more!"

I urge you and other individuals and organizations throughout the nation and the world to join me in the expression of anger and resolve. Let this be the beginning of an all-out effort.

Again, I applaud your dedication and I wish you the best of success. Make no mistake, the continuing battle against tobacco use will be long and difficult. But it is a battle that can be won, must be won, and will be won. Together, we will win it.

Thank you.

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