Statement of the American Association for Cancer Research on the Proposed Tobacco Settlement

The magnitude of the cancer problem directly caused by tobacco use underscoresthe urgent need for accelerating our knowledge and understanding of lungand other smoking-related cancers through research. New studies into thelong-term adverse effects of tobacco carcinogens on the human genome mustbe conducted to counteract the pathological impact of tobacco products.Therefore, the American Association for Cancer Research takes the positionthat the proposed tobacco settlement must include support for federallyfunded cancer research in proportion to the devastation caused by tobacco-inducedcancers on our public health.

The American Association for Cancer Research (AACR), comprised of over13,000 member scientists, is the world's largest and oldest organizationof laboratory and clinical cancer researchers. Many of our members haveconducted the critical research studies providing definitive evidence linkingsmoking to lung cancer. For decades, the tobacco industry has denied thatsmoking is the major causative factor in lung and numerous other cancers.Researchers have now demonstrated this fact unequivocally. Active tobaccosmokers have over a 15-fold increase in their risk for lung cancer as comparedwith nonsmokers. Smoking is the cause of more than 160,000 cancer deathseach year in the United States, and smoking is responsible for about 30%of all cancer deaths annually. In addition, smoking has been determinedto be a major cause of many other serious illnesses and deaths each year,most notably from cancers of the pharynx, larynx, esophagus, oral cavity,pancreas, bladder, and other organ sites.

What has not been known until very recently is that former smokers continueto be at high risk for lung cancer for many years after smoking cessationbecause they carry long-term DNA damage in their lungs. It has been foundthat these DNA changes are associated with the development of cancer, thechanges persist for many years after smoking cessation, and the lung tissuemay never return to its normal state. Since DNA damage is absent from thelungs of lifetime nonsmokers, this confirms that the changes observed informer smokers are directly related to their previous smoking. Those whohave stopped smoking can remain from 1.5 to 4 times more likely than nonsmokersto develop lung cancer. In fact, over half of all lung cancers in the USoccur in former smokers. These new findings have alarming public healthconsequences for current and former smokers. Clearly the tobacco industryis culpable for the death and suffering from these cancers.

Therefore, the AACR respectfully urges Congress to ensure that publichealth funds obtained from the tobacco settlement are provided to the NationalInstitutes of Health (NIH) for additional peer-reviewed, national cancerresearch programs of the highest standard. It is highly appropriate thatfunds be provided from the tobacco settlement for research and it is essentialthat the amount be consistent with the scope and gravity of this epidemic.Specifically, these new resources should be directed to the National CancerInstitute (NCI) in support of important priorities in basic, clinical,and translational cancer research. We ask Congress to ensure that the resourcesprovided through the tobacco settlement will:

• markedly increase the research budget of the NCI;
• underwrite the cost of participation in clinical research trials ontobacco-related cancers that will contribute to curative or preventivenew therapies; and
• supplement, not supplant, current resources provided to the NIH andNCI. This must be done by including a trigger mechanism to maintain theintegrity of the baseline budget that is provided through direct appropriations.

Immediate Action Needed

The shocking incidence, morbidity, and mortality rates of tobacco-relatedcancers mandate that immediate steps be taken to eradicate this ghastlyhuman affliction. To accomplish this, more research is desperately needed.Scientists need to identify the specific DNA alterations associated withsmoking and their role in lung cancer. New molecular probes are now becomingavailable that will make it possible for the first time to identify thespecific DNA changes that cause lung cancer and their biological effects.Further investigations must be conducted to unravel the pathways and thetiming of events leading to cancer. It is important to increase our understandingof the carcinogenic effects of tobacco, of how these malignant lesionscan be treated most effectively after diagnosis, and of how these cancerscan be prevented. In order to launch a responsive research program againstsmoking-related cancers, epidemiologic studies are required to increaseour knowledge base of statistical trends in cancer; such studies will assistin early detection efforts and facilitate the control of cancer. Also,educational programs should be implemented to inform the lay public, health-careprofessionals, and our youth about the serious, long-term health hazardsof tobacco use. In short, the commitment of the tobacco industry to provideadditional resources for research in this unique period in the evolutionof science will offer new opportunities for discoveries in cancer causation,development and progression, treatment, early detection, epidemiology,and prevention of cancers directly related to tobacco use.

Further, the AACR notes that, unfortunately, the settlement and therelated legislation being considered by Congress will have only a limitedeffect on tobacco use outside of the United States. There is a major increasein smoking in Asia and other countries throughout the world, which is adirect result of the promotion of tobacco subsidized in part by US funds.The United States represents only 5% of the world's population. Recentepidemiologic studies have shown that lung cancer will soon become epidemicaround the world. Indeed, studies of the global impact of disease showthat, within only a few decades, lung cancer due to smoking will increaseexponentially in its cost, morbidity, and the loss of lives. As a US-basedscientific society devoted to the conquest of cancer around the world,the AACR finds these adverse trends of grave concern and urges Congressto do all within its means, through legislation and other measures, todecrease the number of tobacco-related cancers worldwide.

The AACR strongly favors including within the tobacco settlement andany accompanying legislation the full authorization for the Food and DrugAdministration (FDA) to regulate any substances found in tobacco productsthat are known or later discovered to be addictive and/or to act as drugs,carcinogens, mutagens, or teratogens. Although in our considered view,the FDA already holds such authorities under the general provisions ofthe Food, Drug, and Cosmetic Act, we are aware that the negotiations withthe tobacco industry have focused on the potential regulation of substancesin tobacco. We urge that FDA's authorities in this matter be confirmedbeyond any question and that no restrictions or unusual conditions be placedon the FDA in its promulgation and enforcement of such regulations to protectpublic health.

In conclusion, the high cost of the research needed to combat the serioushealth consequences of smoking, especially lung and other smoking-relatedcancers, must be borne by the tobacco industry. The tobacco industry hasa moral obligation to support cancer research because of the morbid impactof its products on the people of the world. The taxpayers should not berequired to shoulder the burden of this research and the enormous health-carecosts associated with the overall burden of lung and other tobacco-relatedcancers. Providing new research funds through the tobacco settlement forearly detection, treatment, and prevention will offer the hundreds of thousandsof Americans afflicted with tobacco-related cancers a better health outcome.The AACR takes the position that Congress has the clear mandate to ensurethat our national investment in cancer research is intensified in proportionto the devastating effects of tobacco on public health.

In conclusion, the high cost of the research needed to combat the serioushealth consequences of smoking, especially lung and other smoking-relatedcancers, must be borne by the tobacco industry. The tobacco industry hasa moral obligation to support cancer research because of the morbid impactof its products on the people of the world. The taxpayers should not berequired to shoulder the burden of this research and the enormous health-carecosts associated with the overall burden of lung and other tobacco-relatedcancers. Providing new research funds through the tobacco settlement forearly detection, treatment, and prevention will offer the hundreds of thousandsof Americans afflicted with tobacco-related cancers a better health outcome.The AACR takes the position that Congress has the clear mandate to ensurethat our national investment in cancer research is intensified in proportionto the devastating effects of tobacco on public health.