Topics:

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

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

The magnitude of the cancer problem directly caused by tobacco use underscores the urgent need for accelerating our knowledge and understanding of lung and other smoking-related cancers through research. New studies into the long-term adverse effects of tobacco carcinogens on the human genome must be conducted to counteract the pathological impact of tobacco products. Therefore, the American Association for Cancer Research takes the position that the proposed tobacco settlement must include support for federally funded cancer research in proportion to the devastation caused by tobacco-induced cancers on our public health.

The American Association for Cancer Research (AACR), comprised of over 13,000 member scientists, is the world's largest and oldest organization of laboratory and clinical cancer researchers. Many of our members have conducted the critical research studies providing definitive evidence linking smoking to lung cancer. For decades, the tobacco industry has denied that smoking is the major causative factor in lung and numerous other cancers. Researchers have now demonstrated this fact unequivocally. Active tobacco smokers have over a 15-fold increase in their risk for lung cancer as compared with nonsmokers. Smoking is the cause of more than 160,000 cancer deaths each year in the United States, and smoking is responsible for about 30% of all cancer deaths annually. In addition, smoking has been determined to 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 continue to be at high risk for lung cancer for many years after smoking cessation because they carry long-term DNA damage in their lungs. It has been found that these DNA changes are associated with the development of cancer, the changes persist for many years after smoking cessation, and the lung tissue may never return to its normal state. Since DNA damage is absent from the lungs of lifetime nonsmokers, this confirms that the changes observed in former smokers are directly related to their previous smoking. Those who have stopped smoking can remain from 1.5 to 4 times more likely than nonsmokers to develop lung cancer. In fact, over half of all lung cancers in the US occur in former smokers. These new findings have alarming public health consequences for current and former smokers. Clearly the tobacco industry is culpable for the death and suffering from these cancers.

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

  1. markedly increase the research budget of the NCI;
  2. underwrite the cost of participation in clinical research trials on tobacco-related cancers that will contribute to curative or preventive new therapies; and
  3. supplement, not supplant, current resources provided to the NIH and NCI. This must be done by including a trigger mechanism to maintain the integrity of the baseline budget that is provided through direct appropriations.

Immediate Action Needed

The shocking incidence, morbidity, and mortality rates of tobacco-related cancers mandate that immediate steps be taken to eradicate this ghastly human affliction. To accomplish this, more research is desperately needed. Scientists need to identify the specific DNA alterations associated with smoking and their role in lung cancer. New molecular probes are now becoming available that will make it possible for the first time to identify the specific DNA changes that cause lung cancer and their biological effects. Further investigations must be conducted to unravel the pathways and the timing of events leading to cancer. It is important to increase our understanding of the carcinogenic effects of tobacco, of how these malignant lesions can be treated most effectively after diagnosis, and of how these cancers can be prevented. In order to launch a responsive research program against smoking-related cancers, epidemiologic studies are required to increase our knowledge base of statistical trends in cancer; such studies will assist in early detection efforts and facilitate the control of cancer. Also, educational programs should be implemented to inform the lay public, health-care professionals, and our youth about the serious, long-term health hazards of tobacco use. In short, the commitment of the tobacco industry to provide additional resources for research in this unique period in the evolution of 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 the related legislation being considered by Congress will have only a limited effect on tobacco use outside of the United States. There is a major increase in smoking in Asia and other countries throughout the world, which is a direct result of the promotion of tobacco subsidized in part by US funds. The United States represents only 5% of the world's population. Recent epidemiologic studies have shown that lung cancer will soon become epidemic around the world. Indeed, studies of the global impact of disease show that, within only a few decades, lung cancer due to smoking will increase exponentially in its cost, morbidity, and the loss of lives. As a US-based scientific society devoted to the conquest of cancer around the world, the AACR finds these adverse trends of grave concern and urges Congress to do all within its means, through legislation and other measures, to decrease the number of tobacco-related cancers worldwide.

The AACR strongly favors including within the tobacco settlement and any accompanying legislation the full authorization for the Food and Drug Administration (FDA) to regulate any substances found in tobacco products that 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 of the Food, Drug, and Cosmetic Act, we are aware that the negotiations with the tobacco industry have focused on the potential regulation of substances in tobacco. We urge that FDA's authorities in this matter be confirmed beyond any question and that no restrictions or unusual conditions be placed on the FDA in its promulgation and enforcement of such regulations to protect public health.

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

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

 
Loading comments...
Please Wait 20 seconds or click here to close