Day 035 - 12 Oct 94 - Page 29


     
     1        health"?
     2        A.   To tell you the truth I would be very surprised if he
     3        would say that, even if the evidence were overwhelming,
     4        and the reason is -- well, one reason, aside from the fact
     5        that the limitations of the research we have discussed are
     6        that physicians, in general, do try to use very cautious
     7        and sometimes understated language, so they will use the
     8        words "may" and "might" to a tremendous degree.  You will
     9        see that also in the tobacco literature that stopping
    10        smoking may prevent cancer.
    11
    12        The other part of that is that even tobacco, the link
    13        between tobacco and lung cancer, tobacco sometimes causes
    14        lung cancer and some people will say tobacco causes
    15        cancer.  But the fact of the matter is stopping smoking
    16        might prevent lung cancer, but it does not always.
    17        Smoking may cause cancer, but it does not always, even
    18        though those links are quite well established.  So, one
    19        has to, I think, be very, very cautious.  Eating a
    20        high-fat diet does not always and predictably cause
    21        cancer.  There are some people in whom it will and others
    22        in whom it will not.
    23
    24        Smoking cigarettes does not cause cancer in a great many
    25        individuals.  So, it is perhaps quite reasonable to say it
    26        might and it may cause cancer and that these links are
    27        there.  I regret to say that combined with, perhaps, the
    28        natural conservative nature that physicians have it is
    29        going to lead to the over-use of words like "may" and
    30        "might" when one might like a much stronger phrase that
    31        fat causes cancer.
    32
    33        The fact of the matter is that some people will eat a
    34        high-fat/low-fibre diet and not develop cancer.
    35
    36   MR. JUSTICE BELL:  This is my last interruption of your
    37        cross-examination at this stage, but I would see the point
    38        of that were it not that the Surgeon General uses the word
    39        "risk"?
    40        A.  Yes, I agree.
    41
    42   Q.   If you bring "risk" into the equation, he would certainly
    43        be saying that stopping smoking would reduce the risk of
    44        lung cancer, would he not?
    45        A.  Yes, quite correct.
    46
    47   Q.   And over the page he would say "would decrease the risk
    48        of", "would decrease the risk of lung cancer"?
    49        A.  Probably so, yes.
    50 
    51   MR. JUSTICE BELL:  I have interrupted more than enough. 
    52 
    53   MR. RAMPTON:  I was not going to add anything, save perhaps
    54        this:  Dr. Barnard, if the Surgeon General thought in 1988
    55        that substantial numbers of Americans were going to
    56        contract these various forms of cancer, or that there was
    57        a serious risk that they were going to contract these
    58        forms of cancer unless they reduced their fat intake and
    59        or increased their fibre intake, he would say so; he would
    60        have to.  It is his business to say:  "Look, watch out!

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