[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:01.14,0:00:02.80,Default,,0000,0000,0000,,I'm going to tell you a story.
Dialogue: 0,0:00:04.05,0:00:05.44,Default,,0000,0000,0000,,I'm going to tell you a story
Dialogue: 0,0:00:05.46,0:00:08.64,Default,,0000,0000,0000,,about how the deadliest\Nconsumer product imaginable
Dialogue: 0,0:00:08.67,0:00:09.82,Default,,0000,0000,0000,,came to be.
Dialogue: 0,0:00:10.41,0:00:11.68,Default,,0000,0000,0000,,It's the cigarette.
Dialogue: 0,0:00:12.57,0:00:15.10,Default,,0000,0000,0000,,The cigarette is the only consumer product
Dialogue: 0,0:00:15.13,0:00:17.67,Default,,0000,0000,0000,,that, when used as intended,
Dialogue: 0,0:00:17.69,0:00:21.50,Default,,0000,0000,0000,,will kill half of all long-term users\Nprematurely, later in life.
Dialogue: 0,0:00:22.35,0:00:23.57,Default,,0000,0000,0000,,But this is also a story
Dialogue: 0,0:00:23.60,0:00:27.02,Default,,0000,0000,0000,,about the work that we're doing\Nat the Food and Drug Administration,
Dialogue: 0,0:00:27.05,0:00:29.45,Default,,0000,0000,0000,,and specifically,\Nthe work that we're doing
Dialogue: 0,0:00:29.47,0:00:32.62,Default,,0000,0000,0000,,to create the cigarette of the future,
Dialogue: 0,0:00:32.65,0:00:37.07,Default,,0000,0000,0000,,that is no longer capable\Nof creating or sustaining addiction.
Dialogue: 0,0:00:37.82,0:00:41.52,Default,,0000,0000,0000,,A lot of people think that\Nthe tobacco problem or the smoking problem
Dialogue: 0,0:00:41.55,0:00:43.28,Default,,0000,0000,0000,,has been solved in the United States
Dialogue: 0,0:00:43.31,0:00:45.47,Default,,0000,0000,0000,,because of the great progress\Nthat's been made
Dialogue: 0,0:00:45.50,0:00:47.39,Default,,0000,0000,0000,,over the last 40, 50 years,
Dialogue: 0,0:00:47.41,0:00:50.25,Default,,0000,0000,0000,,when it comes to both\Nconsumption and prevalence.
Dialogue: 0,0:00:50.28,0:00:51.44,Default,,0000,0000,0000,,And it's true;
Dialogue: 0,0:00:52.20,0:00:55.24,Default,,0000,0000,0000,,smoking rates are at historic lows.
Dialogue: 0,0:00:55.67,0:00:58.47,Default,,0000,0000,0000,,It's true for both adults and for kids.
Dialogue: 0,0:00:59.34,0:01:02.12,Default,,0000,0000,0000,,And it's true that those\Nwho continue to smoke
Dialogue: 0,0:01:02.15,0:01:04.78,Default,,0000,0000,0000,,are smoking far fewer cigarettes per day
Dialogue: 0,0:01:04.81,0:01:06.67,Default,,0000,0000,0000,,than at any time in history.
Dialogue: 0,0:01:08.04,0:01:11.94,Default,,0000,0000,0000,,But what if I told you\Nthat tobacco use,
Dialogue: 0,0:01:11.96,0:01:15.27,Default,,0000,0000,0000,,primarily because of firsthand\Nand secondhand exposure
Dialogue: 0,0:01:15.29,0:01:18.01,Default,,0000,0000,0000,,to the smoke in cigarettes,
Dialogue: 0,0:01:18.03,0:01:21.79,Default,,0000,0000,0000,,remains the leading cause of completely\Npreventable disease and death
Dialogue: 0,0:01:21.81,0:01:22.96,Default,,0000,0000,0000,,in this country?
Dialogue: 0,0:01:24.20,0:01:25.40,Default,,0000,0000,0000,,Well, that's true.
Dialogue: 0,0:01:26.99,0:01:30.95,Default,,0000,0000,0000,,And what if I told you\Nthat it's actually killing more people
Dialogue: 0,0:01:30.97,0:01:33.48,Default,,0000,0000,0000,,than we thought\Nto be the case ever before?
Dialogue: 0,0:01:33.96,0:01:35.23,Default,,0000,0000,0000,,That's true, too.
Dialogue: 0,0:01:36.90,0:01:40.99,Default,,0000,0000,0000,,Smoking kills more people each year\Nthan alcohol, AIDS, car accidents,
Dialogue: 0,0:01:41.01,0:01:44.20,Default,,0000,0000,0000,,illegal drugs, murders\Nand suicides combined.
Dialogue: 0,0:01:45.15,0:01:46.55,Default,,0000,0000,0000,,Year in and year out.
Dialogue: 0,0:01:47.98,0:01:49.87,Default,,0000,0000,0000,,In 2014,
Dialogue: 0,0:01:51.18,0:01:52.87,Default,,0000,0000,0000,,Dr. Adams's predecessor released
Dialogue: 0,0:01:52.90,0:01:55.32,Default,,0000,0000,0000,,the 50th anniversary\NSurgeon General's report
Dialogue: 0,0:01:55.34,0:01:56.81,Default,,0000,0000,0000,,on smoking and health.
Dialogue: 0,0:01:58.13,0:02:01.86,Default,,0000,0000,0000,,And that report upped the annual\Ndeath toll from smoking,
Dialogue: 0,0:02:01.89,0:02:04.54,Default,,0000,0000,0000,,because the list\Nof smoking-related illnesses
Dialogue: 0,0:02:04.56,0:02:06.04,Default,,0000,0000,0000,,got bigger.
Dialogue: 0,0:02:06.07,0:02:08.26,Default,,0000,0000,0000,,And so it is now conservatively estimated
Dialogue: 0,0:02:08.28,0:02:12.94,Default,,0000,0000,0000,,that smoking kills\N480,000 Americans every year.
Dialogue: 0,0:02:13.41,0:02:16.32,Default,,0000,0000,0000,,These are completely preventable deaths.
Dialogue: 0,0:02:16.81,0:02:20.03,Default,,0000,0000,0000,,How do we wrap our heads around\Na statistic like this?
Dialogue: 0,0:02:20.06,0:02:22.70,Default,,0000,0000,0000,,So much of what we've heard\Nat this conference
Dialogue: 0,0:02:22.72,0:02:27.09,Default,,0000,0000,0000,,is about individual experiences\Nand personal experiences.
Dialogue: 0,0:02:27.11,0:02:29.79,Default,,0000,0000,0000,,How do we deal with this\Nat a population level,
Dialogue: 0,0:02:29.81,0:02:32.78,Default,,0000,0000,0000,,when there are 480,000 moms,
Dialogue: 0,0:02:32.81,0:02:37.35,Default,,0000,0000,0000,,dads, sisters, brothers, aunts and uncles
Dialogue: 0,0:02:37.37,0:02:40.75,Default,,0000,0000,0000,,dying unnecessary deaths\Nevery year from tobacco?
Dialogue: 0,0:02:42.33,0:02:45.42,Default,,0000,0000,0000,,And then what happens\Nwhen you think about this trajectory
Dialogue: 0,0:02:45.45,0:02:46.71,Default,,0000,0000,0000,,for the future?
Dialogue: 0,0:02:47.27,0:02:49.14,Default,,0000,0000,0000,,And just do the simple math:
Dialogue: 0,0:02:49.83,0:02:54.50,Default,,0000,0000,0000,,from the time of the 50th anniversary\NSurgeon General's report five years ago,
Dialogue: 0,0:02:54.52,0:02:57.22,Default,,0000,0000,0000,,when this horrible statistic was raised,
Dialogue: 0,0:02:57.24,0:02:58.99,Default,,0000,0000,0000,,just through mid-century --
Dialogue: 0,0:02:59.86,0:03:05.35,Default,,0000,0000,0000,,that's more than 17 million\Navoidable deaths in the United States
Dialogue: 0,0:03:05.37,0:03:07.14,Default,,0000,0000,0000,,from tobacco use,
Dialogue: 0,0:03:07.17,0:03:09.16,Default,,0000,0000,0000,,primarily because of cigarettes.
Dialogue: 0,0:03:09.86,0:03:12.31,Default,,0000,0000,0000,,The Surgeon General concluded
Dialogue: 0,0:03:12.33,0:03:19.28,Default,,0000,0000,0000,,that 5.6 million children\Nalive in the United States in 2014
Dialogue: 0,0:03:19.31,0:03:23.74,Default,,0000,0000,0000,,will die prematurely later in life\Nbecause of cigarettes.
Dialogue: 0,0:03:24.30,0:03:26.46,Default,,0000,0000,0000,,Five point six million children.
Dialogue: 0,0:03:27.78,0:03:32.39,Default,,0000,0000,0000,,So this is an enormous\Npublic health problem for all of us
Dialogue: 0,0:03:32.41,0:03:34.71,Default,,0000,0000,0000,,but especially for us as regulators
Dialogue: 0,0:03:34.73,0:03:38.39,Default,,0000,0000,0000,,at the Food and Drug Administration\Nand the Center for Tobacco Products.
Dialogue: 0,0:03:38.41,0:03:40.01,Default,,0000,0000,0000,,What can we do about it?
Dialogue: 0,0:03:40.75,0:03:45.36,Default,,0000,0000,0000,,What can we do to reverse this trajectory\Nof disease and death?
Dialogue: 0,0:03:46.94,0:03:52.72,Default,,0000,0000,0000,,Well, we have an interesting guide\Nto help unravel issues
Dialogue: 0,0:03:52.74,0:03:56.56,Default,,0000,0000,0000,,like: How did the cigarette\Nas we know it come to be?
Dialogue: 0,0:03:56.94,0:04:01.02,Default,,0000,0000,0000,,What is the true nature\Nof the tobacco and cigarette business?
Dialogue: 0,0:04:01.65,0:04:02.96,Default,,0000,0000,0000,,How did the industry behave
Dialogue: 0,0:04:02.98,0:04:05.98,Default,,0000,0000,0000,,in the historically\Nunregulated marketplace?
Dialogue: 0,0:04:06.32,0:04:08.05,Default,,0000,0000,0000,,And our guide
Dialogue: 0,0:04:08.07,0:04:12.52,Default,,0000,0000,0000,,is previously secret internal documents\Nfrom the tobacco industry.
Dialogue: 0,0:04:13.02,0:04:14.87,Default,,0000,0000,0000,,Come with me
Dialogue: 0,0:04:14.90,0:04:17.70,Default,,0000,0000,0000,,in a tobacco industry\Ndocument time machine.
Dialogue: 0,0:04:19.15,0:04:20.60,Default,,0000,0000,0000,,Nineteen sixty-three
Dialogue: 0,0:04:21.61,0:04:27.26,Default,,0000,0000,0000,,was 25 years before the Surgeon General\Nwas finally able to conclude
Dialogue: 0,0:04:27.29,0:04:30.04,Default,,0000,0000,0000,,that the nicotine\Nand cigarettes was addictive.
Dialogue: 0,0:04:30.07,0:04:34.17,Default,,0000,0000,0000,,That did not happen until\Nthe Surgeon General's report in 1998.
Dialogue: 0,0:04:35.06,0:04:37.43,Default,,0000,0000,0000,,Nineteen sixty-three
Dialogue: 0,0:04:37.45,0:04:42.79,Default,,0000,0000,0000,,was one year before the first-ever\NSurgeon General's report in 1964.
Dialogue: 0,0:04:44.69,0:04:46.78,Default,,0000,0000,0000,,I remember 1964.
Dialogue: 0,0:04:46.81,0:04:48.97,Default,,0000,0000,0000,,I don't remember\Nthe Surgeon General's report,
Dialogue: 0,0:04:48.99,0:04:50.32,Default,,0000,0000,0000,,but I remember 1964.
Dialogue: 0,0:04:50.62,0:04:53.04,Default,,0000,0000,0000,,I was a kid growing up\Nin Brooklyn, New York.
Dialogue: 0,0:04:53.53,0:04:55.22,Default,,0000,0000,0000,,This was at a time
Dialogue: 0,0:04:55.25,0:04:59.29,Default,,0000,0000,0000,,when almost one in two adults\Nin the United States smoked.
Dialogue: 0,0:05:00.09,0:05:03.26,Default,,0000,0000,0000,,Both of my parents\Nwere heavy smokers at the time.
Dialogue: 0,0:05:04.18,0:05:07.37,Default,,0000,0000,0000,,Tobacco use was so incredibly normalized
Dialogue: 0,0:05:07.39,0:05:10.32,Default,,0000,0000,0000,,that -- and this wasn't North Carolina,\NVirginia or Kentucky,
Dialogue: 0,0:05:10.34,0:05:11.97,Default,,0000,0000,0000,,this was Brooklyn --
Dialogue: 0,0:05:12.83,0:05:16.38,Default,,0000,0000,0000,,we made ashtrays for our parents\Nin arts and crafts class.
Dialogue: 0,0:05:16.40,0:05:18.68,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:05:19.97,0:05:22.88,Default,,0000,0000,0000,,The ashtrays I made were pretty awful,\Nbut they were ashtrays.
Dialogue: 0,0:05:22.91,0:05:24.57,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:05:24.60,0:05:30.49,Default,,0000,0000,0000,,So normalized that I remember seeing\Na bowl of loose cigarettes in the foyer
Dialogue: 0,0:05:30.52,0:05:32.77,Default,,0000,0000,0000,,of our house and other houses
Dialogue: 0,0:05:32.79,0:05:36.76,Default,,0000,0000,0000,,as a welcoming gesture\Nwhen friends came over for a visit.
Dialogue: 0,0:05:37.61,0:05:40.70,Default,,0000,0000,0000,,OK, we're back in 1963.
Dialogue: 0,0:05:41.20,0:05:43.17,Default,,0000,0000,0000,,The top lawyer for Brown and Williamson,
Dialogue: 0,0:05:43.20,0:05:46.58,Default,,0000,0000,0000,,which was then the third-largest\Ncigarette company in the United States,
Dialogue: 0,0:05:46.58,0:05:47.79,Default,,0000,0000,0000,,wrote the following:
Dialogue: 0,0:05:47.81,0:05:49.00,Default,,0000,0000,0000,,"Nicotine is addictive.
Dialogue: 0,0:05:49.02,0:05:52.55,Default,,0000,0000,0000,,We are, then, in the business\Nof selling nicotine -- an addictive drug."
Dialogue: 0,0:05:53.18,0:05:54.52,Default,,0000,0000,0000,,It's a remarkable statement,
Dialogue: 0,0:05:54.55,0:05:57.17,Default,,0000,0000,0000,,as much for what it doesn't say\Nas for what it does say.
Dialogue: 0,0:05:57.20,0:05:59.56,Default,,0000,0000,0000,,He didn't say they were\Nin the cigarette business.
Dialogue: 0,0:05:59.58,0:06:01.88,Default,,0000,0000,0000,,He didn't say they were\Nin the tobacco business.
Dialogue: 0,0:06:01.90,0:06:04.54,Default,,0000,0000,0000,,He said they were in the business\Nof selling nicotine.
Dialogue: 0,0:06:05.27,0:06:07.12,Default,,0000,0000,0000,,Philip Morris in 1972:
Dialogue: 0,0:06:07.15,0:06:08.87,Default,,0000,0000,0000,,"The cigarette isn't a product,
Dialogue: 0,0:06:08.89,0:06:10.35,Default,,0000,0000,0000,,it's a package.
Dialogue: 0,0:06:10.71,0:06:12.31,Default,,0000,0000,0000,,The product is nicotine.
Dialogue: 0,0:06:12.77,0:06:16.86,Default,,0000,0000,0000,,The pack is a storage container\Nfor a day's supply of nicotine.
Dialogue: 0,0:06:16.88,0:06:21.38,Default,,0000,0000,0000,,The cigarette, a dispenser\Nfor a dose unit of nicotine."
Dialogue: 0,0:06:22.06,0:06:24.89,Default,,0000,0000,0000,,We'll come back to this\Ndose unit notion later.
Dialogue: 0,0:06:25.91,0:06:27.79,Default,,0000,0000,0000,,And R.J. Reynolds in 1972:
Dialogue: 0,0:06:27.81,0:06:31.35,Default,,0000,0000,0000,,"In a sense, the tobacco industry\Nmay be thought of as being a specialized,
Dialogue: 0,0:06:31.37,0:06:35.12,Default,,0000,0000,0000,,highly ritualized and stylized segment\Nof the pharmaceutical industry.
Dialogue: 0,0:06:35.14,0:06:38.00,Default,,0000,0000,0000,,Tobacco products uniquely\Ncontain and deliver nicotine,
Dialogue: 0,0:06:38.03,0:06:41.32,Default,,0000,0000,0000,,a potent drug with a variety\Nof physiological effects."
Dialogue: 0,0:06:41.76,0:06:44.87,Default,,0000,0000,0000,,At the time, and for many\Ndecades, publicly,
Dialogue: 0,0:06:44.89,0:06:47.52,Default,,0000,0000,0000,,the industry completely denied addiction
Dialogue: 0,0:06:47.55,0:06:49.68,Default,,0000,0000,0000,,and completely denied causality.
Dialogue: 0,0:06:50.16,0:06:52.74,Default,,0000,0000,0000,,But they knew the true nature\Nof their business.
Dialogue: 0,0:06:52.77,0:06:54.28,Default,,0000,0000,0000,,And from time to time,
Dialogue: 0,0:06:54.30,0:06:57.94,Default,,0000,0000,0000,,there have been health scares\Nmade public about cigarettes,
Dialogue: 0,0:06:57.96,0:06:59.56,Default,,0000,0000,0000,,going back many decades.
Dialogue: 0,0:06:59.99,0:07:01.92,Default,,0000,0000,0000,,How did the industry respond?
Dialogue: 0,0:07:02.33,0:07:03.53,Default,,0000,0000,0000,,And how did they respond
Dialogue: 0,0:07:03.55,0:07:06.63,Default,,0000,0000,0000,,in this historically\Nunregulated marketplace?
Dialogue: 0,0:07:06.66,0:07:08.89,Default,,0000,0000,0000,,Going back to the 1930s,
Dialogue: 0,0:07:08.91,0:07:13.99,Default,,0000,0000,0000,,it was with advertising\Nthat heavily featured imagery of doctors
Dialogue: 0,0:07:14.01,0:07:15.93,Default,,0000,0000,0000,,and other health care professionals
Dialogue: 0,0:07:15.95,0:07:18.08,Default,,0000,0000,0000,,sending messages of reassurance.
Dialogue: 0,0:07:18.62,0:07:20.25,Default,,0000,0000,0000,,This is an ad for Lucky Strikes,
Dialogue: 0,0:07:20.28,0:07:22.69,Default,,0000,0000,0000,,the popular cigarette\Nof the time in the '30s:
Dialogue: 0,0:07:22.71,0:07:27.01,Default,,0000,0000,0000,,[20,679 physicians\Nsay "Luckies are less irritating."
Dialogue: 0,0:07:27.32,0:07:31.52,Default,,0000,0000,0000,,Your throat protection\Nagainst irritation, against cough.]
Dialogue: 0,0:07:31.55,0:07:33.99,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:07:34.01,0:07:35.87,Default,,0000,0000,0000,,We laugh,
Dialogue: 0,0:07:35.90,0:07:37.64,Default,,0000,0000,0000,,but this was the kind of advertising
Dialogue: 0,0:07:37.66,0:07:40.66,Default,,0000,0000,0000,,that was there to send\Na health message of reassurance.
Dialogue: 0,0:07:40.68,0:07:44.20,Default,,0000,0000,0000,,Fast-forward to 1950s, '60s and '70s.
Dialogue: 0,0:07:44.22,0:07:47.17,Default,,0000,0000,0000,,And here, again,\Nin the absence of regulation,
Dialogue: 0,0:07:47.20,0:07:49.97,Default,,0000,0000,0000,,what we're going to see\Nis modifications to the product
Dialogue: 0,0:07:49.100,0:07:51.70,Default,,0000,0000,0000,,and product design
Dialogue: 0,0:07:51.72,0:07:54.40,Default,,0000,0000,0000,,to respond to the health\Nconcerns of the day.
Dialogue: 0,0:07:55.66,0:07:59.09,Default,,0000,0000,0000,,This is the Kent Micronite filter.
Dialogue: 0,0:07:59.12,0:08:03.66,Default,,0000,0000,0000,,And here, the innovation, if you will,\Nwas the filtered cigarette.
Dialogue: 0,0:08:04.40,0:08:06.08,Default,,0000,0000,0000,,[Full smoking pleasure ...
Dialogue: 0,0:08:06.10,0:08:09.01,Default,,0000,0000,0000,,plus proof of the greatest\Nhealth protection ever.]
Dialogue: 0,0:08:10.24,0:08:13.17,Default,,0000,0000,0000,,What the smoker\Nof this product didn't know,
Dialogue: 0,0:08:13.20,0:08:15.12,Default,,0000,0000,0000,,what their doctor didn't know,
Dialogue: 0,0:08:15.14,0:08:17.30,Default,,0000,0000,0000,,what the government didn't know,
Dialogue: 0,0:08:17.32,0:08:20.82,Default,,0000,0000,0000,,is that this was a filter\Nthat was lined with asbestos --
Dialogue: 0,0:08:20.84,0:08:21.90,Default,,0000,0000,0000,,(Gasps)
Dialogue: 0,0:08:21.92,0:08:24.64,Default,,0000,0000,0000,,so that when smokers\Nwere smoking this filtered cigarette
Dialogue: 0,0:08:24.66,0:08:27.18,Default,,0000,0000,0000,,and still inhaling the chemicals and smoke
Dialogue: 0,0:08:27.20,0:08:30.41,Default,,0000,0000,0000,,that we know are associated\Nwith cancer and lung disease
Dialogue: 0,0:08:30.43,0:08:31.64,Default,,0000,0000,0000,,and heart disease,
Dialogue: 0,0:08:31.66,0:08:34.10,Default,,0000,0000,0000,,they were also sucking down\Nasbestos fibers.
Dialogue: 0,0:08:34.11,0:08:35.11,Default,,0000,0000,0000,,(Gasps)
Dialogue: 0,0:08:36.24,0:08:38.79,Default,,0000,0000,0000,,In the 1960s and the 1970s,
Dialogue: 0,0:08:38.82,0:08:42.34,Default,,0000,0000,0000,,the so-called innovation\Nwas the light cigarette.
Dialogue: 0,0:08:43.49,0:08:46.97,Default,,0000,0000,0000,,This is a typical brand\Nof the day called True.
Dialogue: 0,0:08:47.48,0:08:50.91,Default,,0000,0000,0000,,And this is after the Surgeon General's\Nreports have started coming out.
Dialogue: 0,0:08:50.94,0:08:53.25,Default,,0000,0000,0000,,And you see the look\Nof concern on her face.
Dialogue: 0,0:08:53.27,0:08:54.58,Default,,0000,0000,0000,,[Considering all I'd heard,
Dialogue: 0,0:08:54.61,0:08:57.40,Default,,0000,0000,0000,,I decided to either quit\Nor smoke True.
Dialogue: 0,0:08:57.43,0:08:58.83,Default,,0000,0000,0000,,I smoke True.]
Dialogue: 0,0:08:58.86,0:09:00.40,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:09:00.42,0:09:03.36,Default,,0000,0000,0000,,[The low tar, low nicotine cigarette.]
Dialogue: 0,0:09:03.38,0:09:05.30,Default,,0000,0000,0000,,And then it says, "Think about it."
Dialogue: 0,0:09:05.32,0:09:08.60,Default,,0000,0000,0000,,And then even below that\Nin the small print
Dialogue: 0,0:09:08.63,0:09:11.51,Default,,0000,0000,0000,,are tar numbers and nicotine numbers.
Dialogue: 0,0:09:12.33,0:09:14.45,Default,,0000,0000,0000,,What was a light cigarette?
Dialogue: 0,0:09:15.47,0:09:16.94,Default,,0000,0000,0000,,How did it work?
Dialogue: 0,0:09:18.47,0:09:21.17,Default,,0000,0000,0000,,This is an illustration\Nof the product modification
Dialogue: 0,0:09:21.20,0:09:23.73,Default,,0000,0000,0000,,known as "filter ventilation."
Dialogue: 0,0:09:24.13,0:09:25.79,Default,,0000,0000,0000,,That's not a real filter blown up.
Dialogue: 0,0:09:25.81,0:09:27.00,Default,,0000,0000,0000,,That's just a picture
Dialogue: 0,0:09:27.02,0:09:30.23,Default,,0000,0000,0000,,so that you could see the rows\Nof laser-perforated ventilation holes
Dialogue: 0,0:09:30.26,0:09:31.61,Default,,0000,0000,0000,,that were put on the filter.
Dialogue: 0,0:09:31.64,0:09:33.27,Default,,0000,0000,0000,,When you look at a real cigarette,
Dialogue: 0,0:09:33.29,0:09:34.81,Default,,0000,0000,0000,,it's harder to see.
Dialogue: 0,0:09:34.83,0:09:36.94,Default,,0000,0000,0000,,Every patent for this product shows
Dialogue: 0,0:09:36.97,0:09:40.37,Default,,0000,0000,0000,,that the ventilation holes\Nshould be 12 millimeters
Dialogue: 0,0:09:40.40,0:09:42.16,Default,,0000,0000,0000,,from the lip end of the filter.
Dialogue: 0,0:09:42.19,0:09:43.50,Default,,0000,0000,0000,,How did it work?
Dialogue: 0,0:09:44.46,0:09:46.70,Default,,0000,0000,0000,,The cigarette got stuck into a machine.
Dialogue: 0,0:09:47.95,0:09:50.29,Default,,0000,0000,0000,,The machine started\Npuffing away on the cigarette
Dialogue: 0,0:09:50.32,0:09:52.75,Default,,0000,0000,0000,,and recording tar and nicotine levels.
Dialogue: 0,0:09:53.06,0:09:54.79,Default,,0000,0000,0000,,As the machine smoked,
Dialogue: 0,0:09:54.82,0:09:58.26,Default,,0000,0000,0000,,outside air came through\Nthose ventilation holes
Dialogue: 0,0:09:58.28,0:10:02.20,Default,,0000,0000,0000,,and diluted the amount of smoke\Nthat was coming through the cigarette.
Dialogue: 0,0:10:02.22,0:10:04.31,Default,,0000,0000,0000,,So as the machine smoked,
Dialogue: 0,0:10:04.33,0:10:06.87,Default,,0000,0000,0000,,there really was less tar\Nand nicotine being delivered
Dialogue: 0,0:10:06.90,0:10:08.74,Default,,0000,0000,0000,,compared to a regular cigarette.
Dialogue: 0,0:10:09.98,0:10:11.76,Default,,0000,0000,0000,,What the tobacco industry knew
Dialogue: 0,0:10:11.78,0:10:14.85,Default,,0000,0000,0000,,was that human beings\Ndon't smoke like machines.
Dialogue: 0,0:10:15.71,0:10:17.78,Default,,0000,0000,0000,,How do human beings smoke this?
Dialogue: 0,0:10:18.82,0:10:20.42,Default,,0000,0000,0000,,Where do the fingers go?
Dialogue: 0,0:10:20.44,0:10:21.68,Default,,0000,0000,0000,,(Murmurs)
Dialogue: 0,0:10:21.70,0:10:23.10,Default,,0000,0000,0000,,Where do the lips go?
Dialogue: 0,0:10:23.47,0:10:24.97,Default,,0000,0000,0000,,I told you that the patent said
Dialogue: 0,0:10:24.99,0:10:28.01,Default,,0000,0000,0000,,that the holes are 12 millimeters\Nfrom the lip end.
Dialogue: 0,0:10:28.04,0:10:30.28,Default,,0000,0000,0000,,The smoker didn't even know\Nthey were there,
Dialogue: 0,0:10:30.30,0:10:34.10,Default,,0000,0000,0000,,but between fingers and lips,\Nthe holes get blocked.
Dialogue: 0,0:10:34.50,0:10:38.22,Default,,0000,0000,0000,,And when the holes get blocked,\Nit's no longer a light cigarette.
Dialogue: 0,0:10:38.81,0:10:40.34,Default,,0000,0000,0000,,Turns out that there's actually
Dialogue: 0,0:10:40.36,0:10:43.07,Default,,0000,0000,0000,,basically as much nicotine\Ninside a light cigarette
Dialogue: 0,0:10:43.09,0:10:44.30,Default,,0000,0000,0000,,as a regular cigarette.
Dialogue: 0,0:10:44.32,0:10:46.29,Default,,0000,0000,0000,,The difference was what's on the outside.
Dialogue: 0,0:10:46.31,0:10:49.56,Default,,0000,0000,0000,,But once you block what's on the outside,
Dialogue: 0,0:10:49.58,0:10:51.13,Default,,0000,0000,0000,,it's a regular cigarette.
Dialogue: 0,0:10:52.82,0:10:55.83,Default,,0000,0000,0000,,Congress put FDA in the business\Nof regulating tobacco products
Dialogue: 0,0:10:55.86,0:10:57.33,Default,,0000,0000,0000,,10 years ago this June.
Dialogue: 0,0:10:57.36,0:10:59.68,Default,,0000,0000,0000,,So you heard the statistics\Nat the beginning
Dialogue: 0,0:10:59.70,0:11:04.36,Default,,0000,0000,0000,,about the extraordinary contribution\Nto disease and death that cigarettes make.
Dialogue: 0,0:11:04.75,0:11:06.78,Default,,0000,0000,0000,,We've also been paying a lot of attention
Dialogue: 0,0:11:06.81,0:11:10.67,Default,,0000,0000,0000,,to how the cigarette works\Nas a drug-delivery device
Dialogue: 0,0:11:10.69,0:11:14.25,Default,,0000,0000,0000,,and the remarkable efficiency\Nwith which it delivers nicotine.
Dialogue: 0,0:11:14.27,0:11:15.67,Default,,0000,0000,0000,,So let's take a look.
Dialogue: 0,0:11:16.84,0:11:19.60,Default,,0000,0000,0000,,When the smoker puffs on the cigarette,
Dialogue: 0,0:11:19.63,0:11:22.84,Default,,0000,0000,0000,,the nicotine from that puff\Ngets up into the brain
Dialogue: 0,0:11:22.86,0:11:24.67,Default,,0000,0000,0000,,in less than 10 seconds.
Dialogue: 0,0:11:25.25,0:11:26.73,Default,,0000,0000,0000,,Less than 10 seconds.
Dialogue: 0,0:11:27.30,0:11:29.03,Default,,0000,0000,0000,,Up in the brain,
Dialogue: 0,0:11:29.05,0:11:31.92,Default,,0000,0000,0000,,there are these things\Ncalled "nicotinic receptors."
Dialogue: 0,0:11:32.93,0:11:34.40,Default,,0000,0000,0000,,They're there ...
Dialogue: 0,0:11:34.43,0:11:35.59,Default,,0000,0000,0000,,waiting.
Dialogue: 0,0:11:35.94,0:11:39.21,Default,,0000,0000,0000,,They're waiting for, in the words\Nof that Philip Morris document,
Dialogue: 0,0:11:39.23,0:11:41.30,Default,,0000,0000,0000,,the next "dose unit of nicotine."
Dialogue: 0,0:11:43.25,0:11:45.92,Default,,0000,0000,0000,,The smoker that you see outside,
Dialogue: 0,0:11:45.94,0:11:47.83,Default,,0000,0000,0000,,huddled with other smokers,
Dialogue: 0,0:11:47.86,0:11:49.34,Default,,0000,0000,0000,,in the cold,
Dialogue: 0,0:11:49.36,0:11:50.62,Default,,0000,0000,0000,,in the wind,
Dialogue: 0,0:11:50.65,0:11:52.34,Default,,0000,0000,0000,,in the rain,
Dialogue: 0,0:11:52.37,0:11:54.62,Default,,0000,0000,0000,,is experiencing craving
Dialogue: 0,0:11:54.64,0:11:57.34,Default,,0000,0000,0000,,and may be experiencing\Nthe symptoms of withdrawal.
Dialogue: 0,0:11:58.56,0:12:02.12,Default,,0000,0000,0000,,Those symptoms of withdrawal\Nare a chemical message
Dialogue: 0,0:12:02.15,0:12:04.29,Default,,0000,0000,0000,,that these receptors\Nare sending to the body,
Dialogue: 0,0:12:04.31,0:12:05.87,Default,,0000,0000,0000,,saying, "Feed me!"
Dialogue: 0,0:12:08.49,0:12:14.34,Default,,0000,0000,0000,,And a product that can deliver the drug\Nin less than 10 seconds
Dialogue: 0,0:12:15.23,0:12:19.96,Default,,0000,0000,0000,,turns out to be an incredibly efficient\Nand incredibly addictive product.
Dialogue: 0,0:12:21.38,0:12:24.47,Default,,0000,0000,0000,,We've spoken to so many\Naddiction treatment experts
Dialogue: 0,0:12:24.49,0:12:25.64,Default,,0000,0000,0000,,over the years.
Dialogue: 0,0:12:26.05,0:12:29.36,Default,,0000,0000,0000,,And the story I hear is the same\Nover and over again:
Dialogue: 0,0:12:29.38,0:12:31.87,Default,,0000,0000,0000,,"Long after I was able\Nto get somebody off of heroin
Dialogue: 0,0:12:31.89,0:12:34.60,Default,,0000,0000,0000,,or cocaine or crack cocaine,
Dialogue: 0,0:12:34.63,0:12:36.68,Default,,0000,0000,0000,,I can't get them to quit cigarettes."
Dialogue: 0,0:12:37.14,0:12:40.33,Default,,0000,0000,0000,,A large part of the explanation\Nis the 10-second thing.
Dialogue: 0,0:12:42.08,0:12:45.84,Default,,0000,0000,0000,,FDA has it within its regulatory reach
Dialogue: 0,0:12:45.86,0:12:48.23,Default,,0000,0000,0000,,to use the tools of product regulation
Dialogue: 0,0:12:48.26,0:12:52.63,Default,,0000,0000,0000,,to render cigarettes as we know them\Nminimally or nonaddictive.
Dialogue: 0,0:12:54.03,0:12:55.50,Default,,0000,0000,0000,,We're working on this.
Dialogue: 0,0:12:56.05,0:13:00.09,Default,,0000,0000,0000,,And this could have a profound\Nimpact at a population level
Dialogue: 0,0:13:00.12,0:13:01.58,Default,,0000,0000,0000,,from this one policy.
Dialogue: 0,0:13:02.12,0:13:04.59,Default,,0000,0000,0000,,We did dynamic population-level\Nmodeling a year ago,
Dialogue: 0,0:13:04.61,0:13:07.34,Default,,0000,0000,0000,,and we published the results\Nin "The New England Journal."
Dialogue: 0,0:13:07.37,0:13:09.92,Default,,0000,0000,0000,,And because of the generational\Neffect of this policy,
Dialogue: 0,0:13:09.95,0:13:11.44,Default,,0000,0000,0000,,which I'll explain in a minute,
Dialogue: 0,0:13:11.46,0:13:14.27,Default,,0000,0000,0000,,here's what we project out\Nthrough the end of the century:
Dialogue: 0,0:13:14.29,0:13:15.97,Default,,0000,0000,0000,,more than 33 million people
Dialogue: 0,0:13:15.100,0:13:19.68,Default,,0000,0000,0000,,who would otherwise have gone on\Nto become regular smokers won't,
Dialogue: 0,0:13:19.70,0:13:22.34,Default,,0000,0000,0000,,because the cigarette\Nthat they'll be experimenting with
Dialogue: 0,0:13:22.37,0:13:24.11,Default,,0000,0000,0000,,can't create or sustain addiction.
Dialogue: 0,0:13:24.57,0:13:28.48,Default,,0000,0000,0000,,This would drive the adult smoking rate\Ndown to less than one and a half percent.
Dialogue: 0,0:13:29.45,0:13:31.33,Default,,0000,0000,0000,,And these two things combined
Dialogue: 0,0:13:32.11,0:13:37.59,Default,,0000,0000,0000,,would result in the saving of more than\Neight million cigarette-related deaths
Dialogue: 0,0:13:37.62,0:13:39.84,Default,,0000,0000,0000,,that would otherwise have occurred
Dialogue: 0,0:13:39.87,0:13:41.89,Default,,0000,0000,0000,,from the generational impact of this.
Dialogue: 0,0:13:41.92,0:13:44.18,Default,,0000,0000,0000,,Now, why am I saying "generational"?
Dialogue: 0,0:13:45.37,0:13:46.76,Default,,0000,0000,0000,,It's about kids.
Dialogue: 0,0:13:48.09,0:13:51.41,Default,,0000,0000,0000,,Ninety percent of adult smokers\Nstarted smoking when they were kids.
Dialogue: 0,0:13:52.12,0:13:54.22,Default,,0000,0000,0000,,Half of them became regular smokers
Dialogue: 0,0:13:54.25,0:13:57.66,Default,,0000,0000,0000,,before they were legally old enough\Nto buy a pack of cigarettes.
Dialogue: 0,0:13:58.29,0:14:01.47,Default,,0000,0000,0000,,Half of them became regular smokers\Nbefore they were 18 years old.
Dialogue: 0,0:14:01.49,0:14:02.64,Default,,0000,0000,0000,,Experimentation.
Dialogue: 0,0:14:03.21,0:14:04.36,Default,,0000,0000,0000,,Regular smoking.
Dialogue: 0,0:14:04.73,0:14:05.88,Default,,0000,0000,0000,,Addiction.
Dialogue: 0,0:14:06.52,0:14:07.86,Default,,0000,0000,0000,,Decades of smoking.
Dialogue: 0,0:14:07.89,0:14:09.49,Default,,0000,0000,0000,,And then the illness,
Dialogue: 0,0:14:09.51,0:14:11.66,Default,,0000,0000,0000,,and that's why we're talking\Nabout a product
Dialogue: 0,0:14:11.68,0:14:15.65,Default,,0000,0000,0000,,that will kill half of all long-term users\Nprematurely later in life.
Dialogue: 0,0:14:16.88,0:14:20.19,Default,,0000,0000,0000,,The generational impact\Nof this nicotine-reduction policy
Dialogue: 0,0:14:20.21,0:14:21.53,Default,,0000,0000,0000,,is profound.
Dialogue: 0,0:14:22.82,0:14:25.74,Default,,0000,0000,0000,,Those old industry documents\Nhad a word for young people.
Dialogue: 0,0:14:26.32,0:14:29.28,Default,,0000,0000,0000,,They were described as\N"the replacement smokers."
Dialogue: 0,0:14:30.58,0:14:32.94,Default,,0000,0000,0000,,The replacement smokers\Nfor addicted adult smokers
Dialogue: 0,0:14:32.97,0:14:34.12,Default,,0000,0000,0000,,who died or quit.
Dialogue: 0,0:14:34.53,0:14:38.30,Default,,0000,0000,0000,,Future generations of kids,\Nespecially teens,
Dialogue: 0,0:14:38.33,0:14:40.30,Default,,0000,0000,0000,,are going to engage in risky behavior.
Dialogue: 0,0:14:40.32,0:14:41.59,Default,,0000,0000,0000,,We can't stop that.
Dialogue: 0,0:14:42.01,0:14:46.01,Default,,0000,0000,0000,,But what if the only cigarette\Nthat they could get their hands on
Dialogue: 0,0:14:46.04,0:14:48.32,Default,,0000,0000,0000,,could no longer create\Nor sustain addiction?
Dialogue: 0,0:14:48.84,0:14:51.45,Default,,0000,0000,0000,,That's the public health\Nreturn on investment
Dialogue: 0,0:14:51.47,0:14:53.89,Default,,0000,0000,0000,,at a population level over time.
Dialogue: 0,0:14:55.13,0:14:57.20,Default,,0000,0000,0000,,Haven't said anything about e-cigarettes.
Dialogue: 0,0:14:57.52,0:14:59.73,Default,,0000,0000,0000,,But I have to say something\Nabout e-cigarettes.
Dialogue: 0,0:14:59.75,0:15:00.77,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:15:00.79,0:15:03.66,Default,,0000,0000,0000,,We are dealing with an epidemic\Nof kids' use of e-cigarettes.
Dialogue: 0,0:15:03.69,0:15:05.85,Default,,0000,0000,0000,,And what troubles us the most,
Dialogue: 0,0:15:05.87,0:15:10.25,Default,,0000,0000,0000,,in combination with the rising numbers\Nwhen it comes to prevalence,
Dialogue: 0,0:15:10.28,0:15:11.68,Default,,0000,0000,0000,,is frequency.
Dialogue: 0,0:15:11.70,0:15:14.03,Default,,0000,0000,0000,,Not only are more kids using e-cigarettes,
Dialogue: 0,0:15:14.06,0:15:18.14,Default,,0000,0000,0000,,but more kids are using e-cigarettes\N20 or more days in the past 30 days
Dialogue: 0,0:15:18.16,0:15:20.94,Default,,0000,0000,0000,,than at any time since e-cigarettes\Ncame onto the market.
Dialogue: 0,0:15:20.96,0:15:23.18,Default,,0000,0000,0000,,And at FDA, we're doing\Neverything that we can
Dialogue: 0,0:15:23.21,0:15:24.47,Default,,0000,0000,0000,,using program and policy,
Dialogue: 0,0:15:24.49,0:15:26.11,Default,,0000,0000,0000,,first to get the word out to kids
Dialogue: 0,0:15:26.13,0:15:28.20,Default,,0000,0000,0000,,that this is not a harmless product
Dialogue: 0,0:15:28.23,0:15:31.16,Default,,0000,0000,0000,,and to make sure that kids\Naren't initiating and experimenting
Dialogue: 0,0:15:31.19,0:15:32.35,Default,,0000,0000,0000,,on any tobacco product,
Dialogue: 0,0:15:32.37,0:15:34.25,Default,,0000,0000,0000,,whether combustion is present or not.
Dialogue: 0,0:15:34.57,0:15:37.69,Default,,0000,0000,0000,,But think about e-cigarettes\Nin a properly regulated marketplace
Dialogue: 0,0:15:37.71,0:15:39.64,Default,,0000,0000,0000,,as something that could be of benefit
Dialogue: 0,0:15:39.66,0:15:41.78,Default,,0000,0000,0000,,to addicted adult cigarette smokers
Dialogue: 0,0:15:41.80,0:15:44.16,Default,,0000,0000,0000,,who are trying to transition\Naway from cigarettes.
Dialogue: 0,0:15:44.18,0:15:47.72,Default,,0000,0000,0000,,So, I'll leave you with this vision:
Dialogue: 0,0:15:49.75,0:15:51.40,Default,,0000,0000,0000,,imagine a world
Dialogue: 0,0:15:52.08,0:15:54.75,Default,,0000,0000,0000,,where the only cigarette\Nthat future generations of kids
Dialogue: 0,0:15:54.77,0:15:55.93,Default,,0000,0000,0000,,could experiment with
Dialogue: 0,0:15:55.96,0:15:58.20,Default,,0000,0000,0000,,could no longer create\Nor sustain addiction
Dialogue: 0,0:15:58.22,0:15:59.96,Default,,0000,0000,0000,,because of a single policy.
Dialogue: 0,0:16:00.58,0:16:01.76,Default,,0000,0000,0000,,Imagine a world
Dialogue: 0,0:16:02.53,0:16:05.22,Default,,0000,0000,0000,,where health-concerned cigarette smokers,
Dialogue: 0,0:16:05.24,0:16:08.14,Default,,0000,0000,0000,,especially if a policy goes into effect
Dialogue: 0,0:16:08.16,0:16:11.77,Default,,0000,0000,0000,,that takes the nicotine levels down\Nto minimally or nonaddictive levels,
Dialogue: 0,0:16:11.79,0:16:14.33,Default,,0000,0000,0000,,could transition to alternative\Nand less harmful forms
Dialogue: 0,0:16:14.36,0:16:15.67,Default,,0000,0000,0000,,of nicotine delivery,
Dialogue: 0,0:16:15.70,0:16:17.95,Default,,0000,0000,0000,,starting with FDA-approved\Nnicotine medications,
Dialogue: 0,0:16:17.97,0:16:19.91,Default,,0000,0000,0000,,like the gum, patch and lozenge.
Dialogue: 0,0:16:20.70,0:16:21.90,Default,,0000,0000,0000,,And finally,
Dialogue: 0,0:16:21.92,0:16:24.77,Default,,0000,0000,0000,,imagine a world and a properly\Nregulated marketplace,
Dialogue: 0,0:16:24.79,0:16:28.01,Default,,0000,0000,0000,,whether it's e-cigarettes\Nor whatever the technology of the day,
Dialogue: 0,0:16:28.03,0:16:30.33,Default,,0000,0000,0000,,it's not the product developers\Nand the marketers
Dialogue: 0,0:16:30.36,0:16:32.30,Default,,0000,0000,0000,,who decide which products come to market
Dialogue: 0,0:16:32.32,0:16:34.13,Default,,0000,0000,0000,,and what claims get made for them,
Dialogue: 0,0:16:34.16,0:16:37.03,Default,,0000,0000,0000,,it's review scientists at FDA,
Dialogue: 0,0:16:37.05,0:16:38.63,Default,,0000,0000,0000,,who look at applications
Dialogue: 0,0:16:38.66,0:16:42.33,Default,,0000,0000,0000,,and decide, using the standard\Nthat Congress has entrusted us
Dialogue: 0,0:16:42.36,0:16:44.41,Default,,0000,0000,0000,,to implement and enforce,
Dialogue: 0,0:16:44.43,0:16:47.27,Default,,0000,0000,0000,,whether a particular product\Nshould come to market,
Dialogue: 0,0:16:47.29,0:16:50.53,Default,,0000,0000,0000,,because the marketing of that product\Nand the words of our law
Dialogue: 0,0:16:50.55,0:16:53.72,Default,,0000,0000,0000,,would be appropriate for the protection\Nof the public health.
Dialogue: 0,0:16:54.30,0:16:56.60,Default,,0000,0000,0000,,These are the kinds\Nof powerful regulatory tools
Dialogue: 0,0:16:56.63,0:16:59.61,Default,,0000,0000,0000,,that are within our reach
Dialogue: 0,0:16:59.64,0:17:01.01,Default,,0000,0000,0000,,to deal with what remains
Dialogue: 0,0:17:01.04,0:17:04.29,Default,,0000,0000,0000,,the leading cause of completely\Npreventable disease and death
Dialogue: 0,0:17:04.32,0:17:05.47,Default,,0000,0000,0000,,in the country.
Dialogue: 0,0:17:05.50,0:17:06.76,Default,,0000,0000,0000,,If we get this right,
Dialogue: 0,0:17:07.66,0:17:12.25,Default,,0000,0000,0000,,that trajectory,\Nthose 5.6 million kids,
Dialogue: 0,0:17:12.27,0:17:13.61,Default,,0000,0000,0000,,is breakable.
Dialogue: 0,0:17:13.64,0:17:14.79,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:17:14.81,0:17:17.52,Default,,0000,0000,0000,,(Applause)