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"Betrayal: How Political Pressure Almost Destroyed the 1964 Surgeon General's Report on Smoking and Health": Home

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Interview Information:

Total approximate duration: 1 hour 1 minute and 59 seconds

 

Interview Abstract:

Dr. LeMaistre begins by discussing the massive spread of disease and cancer which was occurring at the time the Advisory Committee to Surgeon’s General on Smoking and Health was formed. Dr. LeMaistre then talks about the events that led to the creation of the Advisory Committee on June 19, 1962. Dr. LeMaistre explains that this committee was formed to assess the evidence of the causal connection between health and smoking. Surgeon General Terry served as chairman with 10 other members. Next, Dr. LeMaistre discusses how the committee realized there must be new approach to the evaluation of existing scientific evidence to determine causation or the study would fail. Then Dr. LeMaistre talks about how the new criteria revolutionized epidemiology, and discusses the results of the report as well as the effects.

 

Major Topics Covered:

Cigarette Smoking
Tobacco Smoking
Tobacco Use
Health Behavior
Health Risk Behaviors
Lung Neoplasms
Mouth Neoplasms
Emphysema
Cardiovascular Diseases


 

Table of Contents

 

Interview Session One: 16 November 2007

 

The Birth of the Public Health Service and the Worldwide Spread of Tobacco

Segment 01 / Professional Service beyond MD Anderson


The Advisory Committee to the Surgeon General on Smoking and Health

Segment 02 / Professional Service beyond MD Anderson


The Interworking’s of The Advisory Committee

Segment 03 / Obstacles, Challenges, Barriers


Betrayal at the May 4th Meeting
Segment 04 / Obstacles, Challenges,
Barriers


Significance of the Criteria
Segment 05 / Contributions


Final Conclusions of the Advisory Committee
Segment 06 / Contributions


 


 

 

 

Chapter Summaries

Interview Session One: 16 November 2007

Segment 01 (Professional Service beyond MD Anderson)
The Birth of the Public Health Service and the Worldwide Spread of Tobacco (listen/read)

Topics Covered

  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • Cultural/Social Influences
  • Global Issues -Cancer, Health, Medicine

Dr. LeMaistre is introduced then he begins by talking about the differences between the Public Health Service in 1964 from present day. He then discusses the “medical disaster” the U.S. was then experiencing due to tobacco. Dr. LeMaistre gives a history and timeline of events regarding tobacco from the Elizabethan Era - WWII. (A slide of the “Worldwide Spread” of tobacco timeline is shown). Dr. LeMaistre discusses he massive spread of disease and cancer aided by the free distribution of cigarettes as well as the addicting quality of nicotine. Dr. LeMaistre then touches on the Royal College of Physicians of London evaluation and its effects.

Segment 02 (Professional Service beyond MD Anderson)
The Advisory Committee to the Surgeon General on Smoking and Health (listen/read)

Topics Covered

  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • Cultural/Social Influences
  • On Research and Researchers

Dr. LeMaistre discusses the events that led to the creation of the Advisory Committee to Surgeon’s General on June 19, 1962 to assess the evidence of the connection between health and smoking. Dr LMaistre talks about how it was born amongst controversy since the Tobacco industry stated there was simply a “statistical association” which did not mean causation. Dr. LeMaistre then discusses the factors which caused few additional studies and research to be done as well as explaining the nominees’ reluctance to join the committee due to several factors.

             

Segment 03 (Obstacles, Challenges, Barriers)
The Interworking’s of The Advisory Committee (listen/read)

Topics Covered

  • Portraits
  • Obstacles, Challenges
  • Collaborations
  • Controversies
  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • Cultural/Social Influences
  • On Research and Researchers

The 1964 Surgeon Generals Advisory Committee on Smoking and Health was formed with Surgeon General Terry as chairman. (Slideshow of each 10 members, their credentials, and whether or not they were smokers). The 10 members were doctors Stanhope Bayne-Jones, Walter J. Burdette, William G. Cochran, Emmanuel Farber, Louis F. Fieser, Jacob Furth, John B. Hickam, Charles LeMaistre, Leonard M. Schuman, and Maurice H. Seevers. Dr. LeMaistre then describes the difficulties Dr. Terry experienced on this committee such as convincing members that they would be supported and not receive interference from outside parties.

Segment 04 (Obstacles, Challenges, Barriers)
Betrayal at the May 4th Meeting (listen/read)

Topics Covered

  • Obstacles, Challenges
  • Collaborations
  • Controversies
  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • Cultural/Social Influences
  • Global Issues -Cancer, Health, Medicine
  • On Research and Researchers

Dr. LeMaistre discusses the events of the meeting on May 4, 1963 when the committee was meant to review 9 volumes of evidence on carcinogenicity and smoking including all the evidence from the smoking industry. Dr. LeMaistre explains how Dr. Hundley issued a directive to expedite the report of the committee which was contradictory to the assurances Surgeon General Terry had given them originally, and how the committee reacted. Dr. LeMaistre then talks about the possible influences and reasons for Dr. Hundley’s interference.

Segment 05 (Contributions)
Significance of the Criteria (listen/read)

Topics Covered

  • Discovery, Creativity, Innovation
  • Obstacles, Challenges
  • Collaborations
  • Controversies
  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • On Research and Researchers

Dr. LeMaistre discusses how the committee realized there must be new approach to the evaluation of existing scientific evidence to determine causation or the study would fail. Dr. LeMaistre describes how during a meeting the establish criteria for causation Dr. Stallone created 5 criteria for causation.  Dr. LeMaistre then talks about how the new criteria revolutionized epidemiology despite there being several contentious discussions among committee members over topics ranging from causation to epidemiological data.

Segment 06 (Contributions)
Final Conclusions of the Advisory Committee (listen/read)


 

Topics Covered

  • Discovery, Creativity, Innovation
  • Obstacles, Challenges
  • Collaborations
  • Controversies
  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Politics and Cancer/Science/Care
  • On Research and Researchers
  • Cultural/Social Influences

Dr. LeMaistre discusses the meeting of the Subcommittee on Lung Cancer and Carcinogenesis which discussed the confusion over certain terminology. It was chaired by Dr. Walter Burdette and attended by Dr. Emmanuel Farber, Dr. Jacob Furth and Dr. Peter V.V. Hamill and 9 other experts. Next, Dr. LeMaistre talks about how this subcommittee showed causality between smoking and lung cancer. Dr. LeMaistre then delves into details and events surrounding the 6th meeting of the advisory committee. Lastly, Dr. LeMaistre discusses the assassination of President Kennedy and how this impacted the study, and shares how on January 11, 1964 the conclusions of the report were announced.