166 



Johnson had always been reluctant to move aggressively on ciga- 

 rettes and often remarked how hard he had found it to quit smok- 

 ing after his heart attack in 1954. Perpetually at odds with the 

 south because of desegregation, he didn't want to make his political 

 life any more difficult in tobacco-growing States. 



As I pressed my case, I lit a cigarette from one of the two to four 

 packs I smoked each day. Johnson pointed his finger at me and 

 chuckled confidently, "The day you quit smoking those things, I'll 

 send your bill to Congress." I didn't quit smoking until October 

 1975, and Johnson never sent the bill to the Congress. 



The suppression of scientific knowledge that cigarettes were ad- 

 dictive had its most profound effect on Government public health 

 policy during the Carter administration when I was Secretary of 

 Health, Education, and Welfare. 



Mr. Chairman and members of the committee, I have over the 

 weekend discussed the following testimony with President Jimmy 

 Carter and with Dr. Julius Richmond who was Surgeon General of 

 the United States when I was Secretary of HEW. 



President Carter had instructed me, as Secretary, that he wished 

 to mount a major public health promotion and disease prevention 

 campaign. Every physician and public health official whom I con- 

 sulted said that any serious health promotion effort had to target 

 smoking. I decided that the time had come for a second Surgeon 

 General's report to assemble all the research of the intervening 

 years and lay it out before the American people and the Congress. 



On January 11, 1979, the 15th anniversary of Dr. Terry's first 

 report, we issued ours. Dr. Richmond and I were able to state that 

 the evidence that cigarette smoking caused lung cancer, heart dis- 

 ease, and numerous respiratory ailments like emphysema was — 

 and I quote — overwhelming. This changed the nature of the dia- 

 logue on cigarette smoking and eventually led to strengthening la- 

 bels on cigarette packaging and advertising. 



What has never been revealed is the debate we had in 1978 and 

 1979 over whether cigarettes were addictive. Dr. William Pollin 

 whom I had appointed as director of the National Institute of Drug 

 Abuse, had urged the Surgeon General to declare cigarettes addict- 

 ive. I also wanted Dr. Richmond to do so, but Dr. Richmond felt 

 that we did not have sufficient data to make that finding. Since we 

 knew that the tobacco interests would attack any report we issued, 

 we believed it was imperative that we be on unimpeachable ground 

 in all we said. I therefore agreed with Dr. Richmond, and we de- 

 cided not to declare that cigarettes were addictive. 



In discussions this weekend with President Carter and Dr. Rich- 

 mond, we all agreed to this. Had we known what the tobacco com- 

 panies knew and had we been privy to their research on the addict- 

 ive nature of nicotine and their ability to manipulate the amount 

 of nicotine in cigarettes, the 1979 Surgeon General's report would 

 have found cigarettes addictive and we would have moved to regu- 

 late them. Unfortunately, the President of the United States, the 

 Secretary of Health, Education, and Welfare, and the Surgeon Gen- 

 eral of the United States were all victims of the concealment and 

 disinformation campaign of the tobacco companies. 



It was not until May 16, 1988, almost 10 years later, that Sur- 

 geon General C. Everett Koop was able to state unequivocally that 



