November 15, 1963

If This Is Peace,
What Would War Be Like?

Suppose I began this report by revealing a secret plot to undermine the United States and take the lives of 100,000 or more Americans in the next 12 months -- as many persons as were killed in the atom-bombing of Hiroshima. Suppose I said that this was actually a conservative estimate, that in fact the number of fatalities resulting from this evil plan next year might exceed a quarter of a million -- say roughly the total number of Americans killed in battle in World War II. Would you be shocked? Would you want to know who had hatched this terrible scheme? I'm confident you would.

But let's go a little further. Suppose I told you that persons in the highest places knew about this plot but had done nothing about it. Suppose I said that many of your fellow Americans were not only aware of these facts but were co-conspirators in the plot. Suppose I told you that, not just a few, but most of your fellow Americans were already aware of this evil design, and they didn't really care. Suppose I said that many of your own neighbors, and perhaps members of your own household, would help contribute more than $7 billion in the same 12-month period to carry out this mass murder. Would you wonder about the sanity of the American people?

In truth, there is such a plan. It may not be formulated in specific terms and written in disappearing ink on old gum wrappers. But I'll tell you this: formulated or not, conscious or not, deliberate or not, a program is going forward that will take 100,000 or more lives this coming year, and every succeeding year, and up to this point nobody is doing much about it. If Nikita Khrushchev had hatched the scheme, it couldn't be more effective. If Americans had been brain-washed by the Communists, they couldn't care less.

By this time I'm sure you know I'm not talking about some Soviet plot, or even some plan of those lunatics in Arlington, Virginia, the members of the American Nazi Party. I'm talking about the plan of the American tobacco industry to lure more and more young people to smoke cigarettes, to stimulate more and more adults to smoke more and more packs a day, all in the face of mounting scientific evidence showing that the end result of this massive sales effort will be casualties in the next 3 to 10 years exceeding the total battle deaths in all the wars we have fought since 1776.

Speaking as a parent, as well as a congressman, I might express my reaction to these facts in some such manner as this: Who needs enemies when we have friends like the "Marlboro Man"?


In years past people who campaigned against smoking could be classed either as 1) health faddists, or 2) members of certain religious groups which discourage smoking. Most people are neither, and thus appeals to young people to avoid the habit have fallen largely on deaf ears. All that is changing with the accumulation of massive scientific evidence linking smoking with lung cancer, emphysema, cardiovascular disorders and other diseases. The campaign against smoking has moved from the pulpit to the laboratory to the halls of Congress.

Let's look at some recently-published facts:

** In 1920 consumption of cigarettes in the United States was 750 for each adult, or about three-quarters of a pack a week. By 1961 this had increased to 4,000 per adult, an average of about four packs a week for our entire adult population.

** Medical researchers say that three-fourths of all lung cancer cases are caused by cigarette smoking. Among men who smoke two packs a day, more than 25 will die for every non-smoker who dies of the disease. Deaths attributable to lung cancer now total over 36,000 a year in the United States.

** A study by the U. S. Public Health Service last year revealed a relationship between smoking during pregnancy and the occurrence of premature births. Birth weight was found to vary inversely with the amount of smoking done by the mother during pregnancy. More startling rela-

tionships, such as infant breathing difficulties and other abnormalities, are likely to show up in future studies.

** The same U. S. Public Health Service reports that the death rate for regular smokers is 32 percent greater than for non-smokers. Among persons who smoke regularly the ratio of deaths from cancer is approximately 10 times that of non-smokers.

** The Surgeon General of the United States Air Force said last year there is an ever-increasing link between cigarette smoking and cancer, pulmonary diseases, cardiovascular diseases, etc. Because of these facts he announced the Air Force no longer will permit cigarette companies to make free distribution of their products in Air Force hospitals and flight lunches.

** A study published by the Scientific American last year revealed that out of 3,361 deaths among cigarette smokers felled by coronary artery disease, only 1,973 would have died had they been non-smokers. That meant that more than 40 percent of the deaths in this group were attributable to cigarette smoking. Note that heart disease is our No. 1 killer, taking around 1 million lives a year.

These are just a few of the facts that are accumulating on the effects of cigarette smoking. What began as a popular theme for "odd balls, kooks and religious fanatics" is becoming something more. As a nation can we ignore facts like these? Where there's this much smoke, there has to be some fire. If we can't put it out, we certainly ought to keep it from spreading.


We began hearing about the lung cancer threat several years ago, but what was the reaction of the tobacco companies? Why, they turned to Madison Avenue, stepped up their advertising campaigns and began an all-out effort to depict smoking as synonymous with virility and sex appeal, using pictures of pretty girls no red-blooded American boy could possibly resist, and handsome boys no girl could possibly ignore.

Because of this massive appeal to youth the American Public Health Association predicts more than 1 million present school-age children will die of lung cancer before they reach the age of 70. And this says nothing about the deaths that will come from cigarette-caused heart disease and lung ailments.

Several years ago the American Journal of Public Health reported a major study which found that among high school students in Portland, Oregon, only 19 percent of the boys and 32 percent of the girls got to their senior years without having smoked experimentally or otherwise. Among the boys it was discovered that 15 percent were regular smokers in their freshman year, 25 percent in their sophomore year, 31 percent in their junior year, and 35 percent in their senior year. Figures on the girls were somewhat lower but, even so, by the time they reached their senior year 26 percent of the girls were, not occasional, but regular smokers. I find these figures shocking when viewed in the light of recent scientific evidence on the likely result of this smoking pattern.

Since I first took an interest in this problem about a year ago I have had hundreds of letters from all over the country and a most interesting exchange of correspondence with leading medical researchers. One is Dr. Charles F. Tate of the University of Miami. Dr. Tate tells me that increased consumption of cigarettes by school children will likely result in a tremendous increase in disabling emphysema in the years ahead. He points out that chest specialists now believe emphysema is caused principally by smoking. And emphysema now ranks as the second highest cause of total physical disability in this country.


The college campus has been perhaps the No. 1 target of the cigarette industry for years. Students are usually introduced to their first free cigarettes as they complete registration as freshmen. There at the end of the line is the friendly "campus representative" of some cigarette company, handing out free packs to one and all. He also shows up for other events and has supplies of free cigarettes for all kinds of campus affairs. The school newspaper also feels the impact of the cigarette industry, which has accounted for 40 percent of all campus advertising in recent years.

There are all sorts of promotions employed by cigarette companies, but I think one of the worst is the campaign which offers premiums to college fraternities which collect Marlboro wrappers. I am told that many fraternities assign quotas to their pledges, generally freshmen newly arrived from the innocence of hearth and home.

Why all the emphasis on young people? Well, the college sales director of one cigarette company put it quite bluntly when he said: "Students are tremendously loyal. If you catch them, they'll stick with you like glue because your brand reminds them of their happy college days."

If that's true for a particular brand, how much more true is it for smoking itself?


Another reaction of the tobacco industry has been the formation of a so-called Tobacco Industry Research Committee, ostensibly to determine and publish factual reports on the hazards of smoking. In fact, the purpose has been to minimize the importance of legitimate scientific findings and to question the truth of unbiased research. The committee's main theme is: "but that facts aren't all in." In the world of science the facts are never all in; Galileo or Newton or Einstein may ultimately be proved wrong on some theory as new facts turn up. However, we built modern science on the discoveries of Galileo and Newton, and we built an atomic bomb with Einstein's theories. Surely the causal relationship between smoking and lung cancer (or heart disease) requires no greater order of proof. In truth, nearly all medical scientists agree that the case has been made.

Here are some other interesting arguments used to counter scientific findings:

1. People who are going to get lung cancer have an increased desire to smoke throughout their adult lives. Thus the correlation of high mortality with high cigarette consumption is not significant and can be ignored.

2. Smoking produces cancer only in the lungs of people who are going to get cancer somewhere anyway, and smoking simply determines it will be in the lungs instead of, say, the left ear lobe or third right toe.

3. Lung cancer affects people who would have died of tuberculosis in former times but who have now survived with lungs susceptible to cancer.

4. Smokers inherit their desire to smoke and with it inherit a susceptibility to some other undiscovered agent that causes lung cancer.

5. Smokers are by their nature more liable to many diseases, including lung cancer, than the "self-protective" minority of non-smokers.

6. Smokers tend to drink more alcohol than non-smokers, and it's the booze, and not the tobacco, that does them in.

Such explanations are ludicrous, of course, but they're understandable when one considers this important fact: the tobacco industry is a $7 billion industry. It pays $3 billion in taxes to various levels of government. It is one of the major users of advertising in all media, adding heavily to the earnings of Madison Avenue agencies, television networks, newspapers, magazines, and thousands of local radio and television stations. We live today in a sea of cigarette advertising.


I know something about the power of the tobacco dollar because I had a little run-in with it last winter. It seems I sent out a questionnaire in which I asked constituents (maybe you were one of them) whether they thought advertising of beer, wine and tobacco products should be confined to hours after children go to bed (as is done in England). Fifty-six percent of my respondents said, "yes," and I reported this fact. That's all I did. I didn't introduce a bill or even indicate a willingness to do so. But you should have seen the flood of mail and angry telegrams my little question produced.

"Udall, are you out of your cotton-picking mind?" That's the way one radio man addressed me in a hot letter. One advertising man on the West Coast even went so far as to say, in print, that the children of American were more in need of protection from congressmen like Morris K. Udall than they were from the effects of advertising.

To be sure a lot is at stake when we talk about doing something to reduce the hazards of smoking. However, a lot is at stake when we talk about winning the space race, or building anti-missile missiles, or probing toward some kind of disarmament. Imagine what would happen to Tucson and Phoenix if this country suddenly stopped building missiles or maintaining bomber and missile squadrons. The economic effect would be tremendous, but I don't think anyone would suggest that we maintain a military machine just to keep dollars flowing into these cities. The same is true of the prosperity of the tobacco industry.

I don't have any ill will for my friends in North Carolina and Kentucky. I want them to have all the prosperity possible. But I don't want them enjoying that prosperity at the expense of the American people, and that is what they are doing now. If a way can be devised to take all the harm out of tobacco, and I hope it can, I will bless their efforts at expanding their industry, and they can run all the romantic ads they want. Until that happy day I think the American people had better do something about the menace in their midst.



Because of the enormous accumulation of scientific evidence indicating serious effects from cigarette smoking I wondered what my responsibilities might be as a Member of Congress. I don't believe you can outlaw smoking or legislate habits, and I don't ever intend to try. But we can legislate against misleading advertising and see that people get the truth about products like cigarettes. In the course of my study I came across this startling fact:

The Food and Drug Administration controls the nicotine content of foods sold to the public, permitting nicotine to be present as a residue only to the extent of 2 parts of nicotine to 1 million parts of food. There is no such regulation for tobacco products, even though the nicotine content of the average cigarette is 12,000 parts in a million, or 6,000 times as much nicotine as FDA permits in food.

When I discovered this fact, I decided the time had come for one concrete step by the Congress, and that was legislation to bring smoking products under the federal Food and Drug laws. I prepared such a bill and introduced it last April. Since then companion bills have been introduced on the Senate side by Senator Joseph S. Clark of Pennsylvania and Senator Frank E. Moss of Utah. Another colleague interested in the problem and preparing legislation of her own is Senator Maurine Neuberger of Oregon. I don't expect to see any progress on our bills this year but hope for hearings next year.


Although leading authorities say the Food and Drug approach holds the most promise, legislation may take some other form. The one thing I know is that we're headed for some kind of legislation on the tobacco problem. Nearly all medical researchers, nearly all practicing physicians, nearly all health organizations and many other leading individuals and groups have come to the conclusion that something has to be done. No matter what weapons the tobacco industry may use to block effective action it is obvious to me that "something's got to give." Overwhelming scientific evidence and mounting public opinion will demand it.

Already the pendulum has started to swing. Athletes are now giving testimonials against smoking. Advertising copy is being toned down, with less appeal to young people, and cigarette ads have been dropped from college newspapers. Only Philip Morris Inc., with its Marlboro leading the pack among college smokers, has refused to withdraw from the campus.

The most important development, however, is a study now nearing completion by the Surgeon General's Advisory Committee on Smoking and Health. The committee, composed of seven doctors, a chemist and a statistician, has been working steadily for the past year and expects to have its report ready for publication next month. I predict the report will be a real "blockbuster" and the trigger of a drive that will end in national legislation.


The variety of hemp known as marijuana is smoked by perhaps a few thousand people in this country. Aside from possibly being habit-forming, marijuana is not known to have any other harmful effects. But the mere possession of it can bring a fine and imprisonment. Tobacco is equally, or more, habit-forming. It has proven harmful effects and is probably much more lethal. But it is not only legal to produce, sell and use; we are told hundreds of times daily that it is a prerequisite of the full and rewarding life.

How long can this obvious inconsistency go on? I am told that without prompt action we can expect one of the worst medical catastrophes in history in the next 25 to 30 years. Surely we have a responsibility to ourselves and coming generations to head off such an unfortunate event.

Already casualties are running in excess of 100,000 a year. If this is peace, what would war be like?

Previous Report: October 14, 1963 -- The Great Numbers Game, or The Case of the Missing Factor: People
Next Report: December 1963 -- "Come, Let Us Reason Together"

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