Smoking & Cancer (Contd.)

A last-minute added attraction staged by a performer who previously had been most unwilling to get into the act stole the show at the A.M.A. convention. The star: the American Cancer Society's Statistician Edward Cuyler Hammond. His show-stopping material: figures proving that heavy cigarette smokers die younger than non-smokers--mainly from heart disease and cancer, notably cancer of the lung.

Dr. (of Science) Hammond, Yale professor of biostatistics, was little moved when Drs. Evarts Graham and Ernest Wynder reported their conclusion that long-term cigarette smoking can cause lung cancer (TIME, March 7, 1949 et seq.). Nothing proved, he said shortly, and went on smoking cigarettes. So did his assistant, Dr. Daniel Horn. But all the while Hammond and Horn were gathering deadly data. They had taken careful smoking histories of 187,766 white men, aged 50 to 69, in 394 counties in nine states, and were keeping track of them to see what killed them. Hammond and Horn figured it would take three years or more to get worthwhile results, and wagged warning fingers at conclusion-jumpers.

But after only a year and a half, 4,854 men had died, and the causes noted on death certificates caught Hammond's eye. He asked A.M.A. to put him on its convention program. A.M.A. said no. So Hammond gave A.M.A. bigwigs a sneak preview of his figures; they promptly changed their minds and gave him a top billing for the opening day's scientific sessions.

Pack-a-Day Deal. Among the 4,854 deaths, Hammond told a packed house, were 745 men who daily smoked a pack of cigarettes or more. Their death rate was almost twice as high as that of the men who never smoked. There were 334 deaths from diseases of the coronary arteries, and this again represented a death rate almost double that of nonsmokers. There were 161 deaths from cancer, and this was 2 1/2 times the rate among nonsmokers.

On the question which had started the whole ruckus--"Does cigarette smoking eventually cause lung cancer?"--the statisticians had to hedge. They did not yet have enough cases to be certain. But on the basis of gleanings to date, they concluded that death from lung cancer is three to nine times as common among cigarette smokers as among nonsmokers, and five to 16 times as common among those who smoke a pack a day or more.

No less striking were the statisticians' findings that even the most moderate cigarette smokers (half a pack or less a day) also showed significantly higher death rates from both heart disease and cancer than nonsmokers, and that the increase includes all types of cancer, not only in the lung. Cigar and pipe smokers show no consistent increase in mortality. There is less chain-smoking of cigarettes in rural than urban areas, and the rural death rates from heart disease and cancer are lower.

"A Positive Theory." No one piece of evidence taken alone proves a cause-and-effect relationship between smoking and these higher death rates, said Dr. Hammond. But, he went on, every bit of evidence so far available fits the hypothesis that it is a case of cause and effect. Sallying from their statistical sanctuary, Hammond and Horn went out on a limb: "It is our opinion that regular cigarette smoking causes an increase in death rates from [heart disease and cancer]. We now advance this as a positive theory."

At least, they had convinced themselves: as the evidence flowed in, both Hammond and Horn gave up cigarettes and took to pipes. Their boss, Dr. Charles Sherwood Cameron, medical and scientific director of the A.C.S., quit his pack a day and switched to cigars. To those who want to stop smoking, his advice was: make a clean break, with no attempt at tapering off--"The best way to stop is to stop." But, said Cameron, he did not consider the Hammond-Horne theory entirely proved (neither do they). He added: "Personally, I believe that a life of outward productiveness and inward serenity is more important than how long life is." There were other skeptics. "If this were spinach instead of cigarettes, I think people would be easier to convince," Dr.

Graham told the American College of Chest Physicians. "More study is needed," protested a spokesman for the cigarette industry. But many lay men and women were quickly convinced. After the statistics hit Page One across the nation last week, common stocks of the big five cigarette manufacturers dropped as much as 4 points, preferred stocks even more, and buyers invaded pipe shops to buy experimental briars and fancy smoking mixtures. In Manhattan, Dunhill's expensive smoking emporium on Fifth Avenue reported that its stock of slim little ladies' pipes, enough to last several months at the old sales rate, was cleaned out in a couple of days.

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