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The New Problem. Said Dr. Cornelius P. Rhoads. research director of Manhattan's Memorial Center for Cancer and Allied Diseases, after study of the Graham-Wynder findings: "The underlying medical question is settled. But as so often happens, we now have a new problem with social implications—how to organize and pay for the research which will show us how to remove the mouse-cancer agent from tobacco, or render it inert, and also to track down the many other factors which may be contributing to the increase in lung cancer."
There are many puzzling questions in the case against cigarette smoking as a cause of lung cancer. With answers based on the best medical opinion today, some of these are:
¶ Why indict cigarette smoking, and acquit the smoking of pipes and cigars? Because the cancer-causing factor apparently must be retained deep in the lungs, a condition usually found in cigarette smokers, who inhale deeply, not in pipe and cigar smokers, who seldom inhale. ¶ Why does lung cancer concentrate on men in middle life? Because the cancer-causing factor seems to be a slow-acting agent, which may need half an individual's normal life span to do its deadly work. ¶ If cigarette tar contains a cancer-causing agent, why don't all cigarette smokers get lung cancer? Some do not live long enough to get the cancer; many more would never get it anyhow because of the element of susceptibility, which leaves some individuals liable while the majority escape, as is true of all cancers.
Two things are certain: there is more than one type of lung cancer in humans, and there is more than one cause. Says Dr. Graham:"There are different varieties which are due to different causes. However, by far the most common variety, which makes up approximately 95% of all lung cancer, is the one that seems to be due largely to cigarette smoking."
Nicotine Acquitted. What to do? One obvious answer is to isolate and purify whatever it is in cigarette tar that causes cancer. Then, perhaps, experimental cancers can be produced faster. But no less than 45 different substances have been identified (and many more are suspected) in the tar; 15 of these, including nicotine, have been tested for cancer-causing powers and acquitted, and most of the other 30 seem unlikely culprits. At New York University's Institute of Industrial Medicine, Chemist Alvin Kosak and Physician William E. Smith are breaking down tobacco tar into several fractions and testing each on mice. Parallel work to that at N.Y.U. is going on at two or three other laboratories in the U.S. and half a dozen in Britain. Dr. Wynder himself, now working with Rhoads at Memorial, is digging into the relationship between cigarettes and cancer of the larynx.
There is no reason why research of this type should not pay off quickly if there is enough money for an all-out effort. There is a perfect textbook example: in 1945 the Standard Oil Co. of New Jersey sent a cancer-causing oil to Memorial and later to N.Y.U.'s Institute. The cancer-causing factor was identified and measures were perfected to limit the use of the oil and keep workers from being exposed to it. In the case of cigarettes, researchers are confident that the cancer-causing factor can be 1) identified and 2) removed from the tobacco in manufacture.