ETS

There may be many things that people will accept secondhand -- but smoke is NOT one of them. Tobacco Smoke is so dangerous, it can even kill secondhand.

Tobacco companies do not allow smoking around tobacco seedlings -- because it kills them -- tobacco mosaic virus. Tomato plants are also susceptible to this. People are also hurt and killed by secondhand smoke.

CINCINNATI – A new Cincinnati Children's Hospital Medical Center study shows that exposure to environmental tobacco smoke, even at extremely low levels, is associated with decreases in certain cognitive skills, including reading, math, and logic and reasoning, in children and adolescents.

The study is the largest ever to look at the effects of environmental tobacco smoke on children's health. It is published in the January issue of Environmental Health Perspectives.

"This study provides further incentive for states to set public health standards to protect children from exposure to environmental tobacco smoke," says Kimberly Yolton, PhD, a researcher at the Children's Environmental Health Center at Cincinnati Children's and the study's main author. "We estimate that more than 33 million children in the United States are exposed to levels consistent with the adverse effects seen in this study."

The study's findings translate into nearly a three-point decline in a standardized reading test and nearly a two-point decline in a standardized math test, given an average score of 100 and a modest increase in exposure to environmental tobacco smoke.

Logic and reasoning skills were tested in a task that involved the assembly of blocks. This task evaluated a child's ability to visually organize and reason in constructing a design quickly and accurately. The study found a .55 decline in block-design scores, given an average score of 10 and a modest increase in exposure.

"These declines may not be clinically meaningful for an individual child, but they have huge implications for our society because millions of children are exposed to environmental tobacco smoke in the United States," says Dr. Yolton.

The study is based on data gathered from 1988-94 for the third National Health and Nutrition Examination Survey (NHANES-III), conducted by the National Center for Health Statistics at the Centers for Disease Control and Prevention. NHANES is designed to collect information about the health and diet of people in the United States.

To measure exposure to environmental tobacco smoke, researchers measured levels of cotinine, a substance produced when nicotine is broken down by the body. Cotinine can be measured in blood, urine, saliva and hair. It is considered the best marker of environmental tobacco smoke exposure.

For this study, cotinine was measured in the blood of 4,399 children between 6 and 16 years old. Children were only included in the analysis if their serum (blood) cotinine levels were at or below 15 ng/ml, a level consistent with environmental tobacco smoke exposure, and if they denied using any tobacco products in the previous five days.

Cognitive and academic abilities were assessed using portions of standardized intelligence and achievement tests. Reading, math and reasoning scores were highly related to environmental tobacco smoke exposure: The greater the levels of exposure as measured by cotinine levels, the greater the decline in reading and reasoning ability, even at extremely low levels of exposure, according to Dr. Yolton.

Surprisingly, Dr. Yolton and colleagues at Cincinnati Children's also found greater decreases in cognitive skills at lower levels of exposure. While there was, on average, a one-point decline in reading scores for each unit increase in cotinine at levels above 1 ng/ml, there was a five-point decline for each unit increase in cotinine at levels below 1 ng/ml. In the United States, 43 percent of children are exposed to environmental tobacco smoke in their own homes, and 85 percent of children have detectable levels of cotinine in their blood.

Cincinnati Children's Hospital Medical Center is a 423-bed institution devoted to bringing the world the joy of healthier kids. Cincinnati Children's is dedicated to transforming the way health care is delivered by providing care that is timely, efficient, effective, family-centered, equitable and safe. It ranks third nationally among all pediatric centers in research grants from the National Institutes of Health. The Cincinnati Children's vision is to be the leader in improving child health. Additional information can be found at www.cincinnatichildrens.org.

1Cincinnati Children's Environmental Health Center, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; 2Department of Pediatrics and 3Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; 4Department of Pediatrics, University of Rochester School of Medicine and the American Academy of Pediatrics Center for Child Health Research, Rochester, New York, USA; 5Institute for Health Policy and Health Services Research, University of Cincinnati, Cincinnati, Ohio, USA

We used the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to investigate the relationship between environmental tobacco smoke (ETS) exposure and cognitive abilities among U.S. children and adolescents 6-16 years of age. Serum cotinine was used as a biomarker of ETS exposure. Children were included in the sample if their serum cotinine levels were 15 ng/mL, a level consistent with ETS exposure, and if they denied using any tobacco products in the previous 5 days. Cognitive and academic abilities were assessed using the reading and math subtests of the Wide Range Achievement Test-Revised and the block design and digit span subtests of the Wechsler Intelligence Scale for Children-III. Analyses were conducted using SUDAAN software. Of the 5,365 6- to 16-year-olds included in NHANES III, 4,399 (82%) were included in this analysis. The geometric mean serum cotinine level was 0.23 ng/mL (range, 0.035-15 ng/mL); 80% of subjects had levels < 1 ng/mL. After adjustment for sex, race, region, poverty, parent education and marital status, ferritin, and blood lead concentration, there was a significant inverse relationship between serum cotinine and scores on reading (ß = -2.69, p = 0.001), math (ß = -1.93, p = 0.01), and block design (ß = -0.55, p < 0.001) but not digit span (ß = -0.08, p = 0.52). The estimated ETS-associated decrement in cognitive test scores was greater at lower cotinine levels. A log-linear analysis was selected as the best fit to characterize the increased slope in cognitive deficits at lower levels of exposure. These data, which indicate an inverse association between ETS exposure and cognitive deficits among children even at extremely low levels of exposure, support policy to further restrict children's exposure. Key words: children, cognition, environment, environmental tobacco smoke, epidemiology. Environ Health Perspect 113:98-103 (2005). doi:10.1289/ehp.7210 available via http://dx.doi.org/ [Online 7 October 2004]

This paper was presented in part at the annual meeting of the Pediatric Academic Society, May 2002.

British Medical Association condemns tobacco industry ventilation claims
EXCERPTS from: BMA condemns tobacco industry ventilation claims - News-Medical.Net January 13, 2005

Following a conference held this morning by the Scottish Licensed Trade Association, the BMA stressed that ventilation does not protect employees or customers from the deadly effects of passive smoke and condemned arguments otherwise as untrue and based on flawed science.

Research in America found that there was 50 times more air pollution in a smoky bar than in New York's Holland tunnel at rush hour, and studies have found that ventilation in bars does not reduce the risk to the health of customers or staff.

The tobacco industry has proposed that ventilation is the solution to the problem of passive smoke, however, scientific evidence proves that conventional ventilation and air-cleaning systems do not provide effective protection against the health hazards of second hand smoke.

Ventilation systems use a filtration method to re-circulate air. However, while this method can clear the smoky atmosphere, the toxins present in the gas of second hand smoke remains.

Dr Peter Terry, Chairman of BMA Scotland said: "Passive smoke kills. Businesses installing expensive ventilation systems will do so in the belief that they are protecting staff and the public from the ill-effects of second hand smoke. The sad truth is that they are mistaken.

"Although good ventilation can help reduce the irritability of smoke, it does not eliminate its poisonous components. Tobacco smoke contains 4,000 toxins and more than 50 cancer-causing substances. Many of these are odourless, invisible gasses, which are not removed by ventilation systems.

"Partial bans on smoking in enclosed public places would not protect people from the harmful health effects of exposure to passive smoke, and voluntary measures have failed.

"Smoke free enclosed public places are what Scotland wants and needs. Our only hope now is that our MSPs are not wavered by misleading claims fuelled by the tobacco industry. The only way to protect the significant majority of the population who do not smoke is to legislate for smoke free enclosed public places."

http://www.bma.org.uk

http://www.news-medical.net/?idr90

Secondhand Smoke, or Environmental Tobacco Smoke [ETS], has been labeled
a Class A carcinogen by the U.S. Environmental Protection Agency. Carcinogens are cancer producing substances.

ETS is a known human carcinogen, according to the Report on Carcinogens, 2000, of the National Toxicology Program of the U.S. Department of Health and Human Services, Public Health Service.

ETS kills through:
     Several types of cancers
     Cardiovascular disease (atherosclerosis, heart disease, stroke)
     Respiratory diseases
     Perinatal death, miscarriage, low birth weight
     Sudden Infant Death Syndrome (SIDS)

ETS increases the risk of illness including:
     Atherosclerosis (hardening of the arteries)
     Respiratory infections -- pneumonia, bronchitis, bronchiolitis, colds, sore throats
     Asthma
     Middle ear infections
     Dental caries

There is no doubt that giving up smoking can be extremely difficult – like any addiction kicking the habit is no easy task. When smokers decide to quit they are often advised to set a date, bin the fags and then just do it. Support from a doctor or health professional during this time can be invaluable. I am going to give the same advice to John Reid.

In the forthcoming White Paper for England, he should set a date for banning smoking in all enclosed public places, this will give the bars and restaurants time to bin their ash-trays and then these workplaces will just have to abide by the law. John Reid already has the support of the medical profession.

EXCERPTS from The Toledo Blade, March 8, 2004, Letters to the Editor, headlined, Danger of secondhand smoke is real

Lung cancer victim, Alice K. Helm, spoke out in testimony shortly before her death in June, 2003. Helm, a courageous fighter for the right to breathe smoke free air, gave testimony to Maryland's Montgomery County Council (USA), June 12, 2003:

Excerpts from Canadian Press, March 7, 2003, headlined, Second-hand-smoke fosters sore throats, colds, no writer noted.

WINNIPEG - The Manitoba Medical Association says second-hand smoke not only kills - it makes restaurant and bar workers more susceptible to colds and other annoying symptoms.

The association released a study Friday of short-term effects on 45 workers at both smoking and non-smoking bars and restaurants in Winnipeg and Brandon.

Dr. Mark Taylor said there are plenty of studies proving the long-term effects. But he said he hoped this one on the short-term impact would help spur city and provincial officials to implement an all-out ban on smoking in public places.

Kristina Hunter of the University of Manitoba's environmental health sciences faculty worked on the report.

She said hospitality workers are among the few exposed to such a hazardous work environment without any regulations regarding levels of exposure to a proven carcinogen.

"It tends to employ a lot of young people, a lot of females, people that are nearing their reproductive age, so they are at a very vulnerable time in their lives."

One Ottawa woman dying of cancer has already won workers' compensation benefits for her exposure to second-hand smoke. Heather Crowe, 57, has become an advocate for tougher smoking bans after 40 years as a waitress.

Non-smoking bar and restaurant workers also are many times more likely to have sore throats, coughs, teary eyes and colds if they work in places where smoking is allowed, the Manitoba study found.

Both the city of Winnipeg and the province are considering an all-out ban, and an all-party committee of the Manitoba legislature is going to review the issue later this year.

Coun. Mark Lubosch said he believes a bare majority of Winnipeg city councillors are ready to go for an all-out ban, but he wishes provincial politicians would have a little more courage.

"I don't know how much more evidence we need, whether it's the 250 people that are reportedly dying every year from second-hand smoke in this province or whether it's the $250 million that we're spending on additional health-care costs to treat people with preventable smoking-related illnesses," he said.

Brandon now has the toughest anti-smoking bylaw in the province, but the study was conducted both before and after its all-out ban was implemented.

The study was released at an Applebee's restaurant in Winnipeg. Janet Harder, who runs the chain's outlets in Alberta and Manitoba, said it's time for provinces to face facts and do the right thing.

A smoker herself, Harder said business at Applebee's fell off initially when they went smoke-free but they attracted new customers and their staff are happier and more productive.

Manitoba isn't the only province looking a breaking new ground with an all-out ban on smoking in public places.

Ontario Health Minister Tony Clement has also said his province will consider a provincewide ban as part of its review of Ontario's anti-smoking strategy.

The Ontario Medical Association is also applying pressure for an all-out ban, saying 2,600 people a year die in the province as a result of second-hand smoke.

Taylor admitted their sample in the Manitoba study was small and they hope to expand it in the future. They had trouble finding non-smoking employees working where smoking was allowed who would participate.

"We have no proof, but our suspicion is they're being discouraged from participating by their employers," he said.

C. Andrew Aligne, MD, MPH; Mark E. Moss, DDS, PhD; Peggy Auinger, MS; Michael Weitzman, MD

Context: Dental decay is the most common chronic disease of children, and it disproportionately affects those living in poverty, but the reasons for this are not clear. Passive smoking may be a modifiable risk factor for dental caries.

Objective: To examine the relationship between dental caries and serum cotinine levels.

Design, Setting, and Participants: Cross-sectional data from the Third National Health and Nutrition Examination Survey (1988-1994) of 3531 children aged 4 to 11 years, who had had both dental examinations and a serum cotinine level measurement.

Main Outcome Measures: Passive smoking defined as serum cotinine levels of
0.2 to 10 ng/mL and caries defined as decayed (unfilled) or filled tooth
surfaces.

Results: Twenty-five percent of the children had at least 1 unfilled decayed tooth surface and 33% had at least 1 filled surface. Fifty-three percent had cotinine levels consistent with passive smoking. Elevated cotinine level was significantly associated with both decayed (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9) and filled (OR, 1.4; 95% CI, 1.1-1.8) tooth surfaces in deciduous but not in permanent teeth. This relationship persisted after adjusting for age, sex, race, family income, geographic region, frequency of dental visits, and blood lead level. For dental caries in deciduous teeth, the adjusted OR was 1.8 (95% CI, 1.2-2.7) for the risk of decayed surfaces and 1.4 (95% CI, 1.1-2.0) for filled surfaces. We estimated the population attributable risk from passive smoking to be 27% for decayed and 14% for filled tooth surfaces.

Author/Article Information:
Author Affiliations: Pediathink, Rochester, NY (Dr Aligne); Eastman School of Dentistry, Rochester, NY (Dr Moss); and Center for Child Health Research of the American Academy of Pediatrics (Ms Auinger and Dr Weitzman) and Departments of Community and Preventive Medicine (Dr Moss) and Pediatrics (Ms Auinger and Dr Weitzman), University of Rochester School of Medicine, Rochester, NY.

Corresponding Author and Reprints: C. Andrew Aligne, MD, MPH, 620 Park Ave,
Box 135, Rochester, NY 14607 (e-mail: andy@pediathink.com ).

Funding/Support: This research was partially supported by a Special Projects grant from the Agency for Healthcare Research and Quality and the Ambulatory Pediatric Association, and by the Monroe County Smoking and Health Action Coalition of the New York State Department of Health.

EXCERPTS from Minnesota's newspaper, The Duluth News-Tribune, May 3, 2000, writer Melanie Evans; headlined: The power of second-hand smoke, Research suggests inhaling smoke has similar health effects as smoking, More on Duluth's proposed smoking ban

It is a truism that emerged unscathed after more than a half-century of legal
challenges and medical scrutiny: Smoking kills.

But what about that lazy trail of smoke that lilts from a lit cigarette into the
open air?

                      Scientists agree it contains the same cocktail of harmful compounds that
                      smokers inhale, more than 55 cancer-causing chemicals including
                      formaldehyde, arsenic and the powerful toxin benzoapyrene.

                      They also agree that nonsmokers inhale and digest the toxic smoke just as
                      their smoking counterparts do, albeit in smaller quantities. Traces of
                      chemicals found only in tobacco turn up in biological studies of nonsmokers
                      frequently exposed to cigarette smoke.

                      Tobacco causes increasingly stiff and narrow arteries that precipitate a heart
                      attack. Its chemicals create long-lasting genetic mutations that blossom into
                      lung cancer.

                      But how much damage does so-called passive smoking cause? Can
                      involuntary exposure, over time, wreak similar damage on the heart and
                      lungs of someone who has never lit up?

                      During the past, biologists and courts have wrestled with the question,
                      occasionally arriving at different answers. Fueled by regulators' zeal to hold
                      the tobacco industry accountable for America's epidemic of
                      smoking-related illness, the legal and scientific debate has intensified during
                      the last five years.

And geneticists, epidemiologists and molecular and cellular biologists point
to a growing body of research on secondhand smoke.

                      Large research studies single out environmental tobacco smoke as the
                      culprit for a number of childhood ailments and chronic diseases: asthma, ear
                      infections, eye irritation and low birth weight babies.

                      A 1998 study, published in the Journal of the American Medical
                      Association, found secondhand smoke increased the rate at which
                      nonsmokers' arteries clog or harden by 20 percent.

                      Reports like these worry Bridgeman's waitress Carrie Newberg. Her father,
                      grandfather and grandmother all died of heart disease at early ages, 53, 56
                      and 38, respectively. Newberg turned 36 Tuesday.

                      Three of her four weekly shifts landed her in the Duluth restaurant's smoking
                      section, where the fumes aggravated her allergies. ``By the time I would get
                      home, I would have such a headache,'' she said.

                      Newberg and several Bridgeman's employees approached the restaurant's
                      operations manager, Warren Nelson, about eliminating the smoking section.
                      ``I just felt like it was a major factor for my health,'' she said.

                      Newberg is thrilled. The irritation, sneezing and sinus trouble that plagued
                      her at the end of each eight-hour shift have subsided. The air is clean, she
                      said.

                      The amount of secondhand smoke circulating in the air of restaurants and
                      bars can vary, according to recent medical studies. In some research,
                      investigators found the presence of smoke is no more than levels found in
                      the home of a smoker.

                      In other reports, the amount of smoke recorded in air samples was six times
                      that found in other workplaces and four times that found in the home of a
                      smoker, leading researchers to estimate that some hospitality industry
                      employees face as much as a 50 percent increased risk of developing lung
                      cancer.

                      The most clear-cut example of secondhand smoke's effects surface in
                      studies of lung cancer, where a unique trail of chemical footprints left by
                      harmful tobacco compounds has linked all cigarette smoke -- including
                      secondhand -- to the development of tumors.

                      Each time a person breathes in tobacco smoke, it triggers the body's
                      intricate genetic survival plan against cancer -- one that doesn't always
                      succeed.

                      Once inhaled, the smoke's cancerous chemicals come under attack as the
                      body tries to break down the toxic material into less harmful elements that it
                      can digest and reject.

                      This first line of defense can fail. More virulent chemicals can turn the tables.
                      Instead of falling prey to the body's foot soldiers -- proteins called enzymes
                      -- the cancer-causing agents take root and form a powerful, and potentially
                      unshakable, bond with DNA.

This tight link can mutate DNA, the genetic code found in each of the
body's 100 trillion cells. Genes carry instructions that guide cell growth.

Altering those instructions can produce fatal consequences: In cases of lung
cancer, scientists worry in particular about tampering with two genes.

One promotes the growth of tumors; the other suppresses them. Altering
either can make conditions ripe for cancerous tumors to flourish.

                      Desperate to shake loose from this destructive bond before it causes
                      damage to the genetic code, the body dispatches enzymes to repair cells'
                      DNA.

                      This second line of defense can fail too, triggering a last-ditch effort to rid
                      the body of the cell entirely, a sort of hari-kari of the cell, by which it
                      commits a programmed suicide.

Not all of the cells follow the body's survival code: Too many such rouges,
and a colony of mutated cells develops into a cancerous tumor.

                      Why do genetic defenses fail in some cases and succeed in others? What
                      makes some people more susceptible to developing lung cancer and others
                      seemingly immune?

Researchers aren't sure. That's because a number of factors, such as family
history and diet, can affect somebody's susceptibility.

                      But one thing is very clear for Dr. Stephen Hecht, Wallin Professor of
                      Cancer Prevention at the University of Minnesota-Twin Cities Cancer
                      Center.

                      ``Everything you see in smokers,'' he continued -- listing the complex
                      biological struggle to rid cells of smoke's toxic chemicals -- ``the same is
                      true for people exposed to secondhand smoke.

                      And dosage matters, he said. Nonsmokers have a lower risk for developing
                      lung cancer than smokers because they are less frequently exposed to
                      smoke, he said. And their bodies don't have to fend off smoke's toxic
                      chemicals as often.

                      All Hecht needs to illustrate his point are studies of nonsmokers' urine that
                      contain the same chemical residue from cigarettes that smokers' urine
                      carries.

Assessing that risk is more difficult, though, largely because there are fewer
lung-cancer patients who never smoked available to study.

                      Science and public awareness still fail to fully comprehend risks associated
                      with secondhand smoke, said Dr. Richard Hurt, a physician from the Mayo
                      Clinic in Rochester, Minn., and the director of its nicotine dependence
                      center.

In time, the scientific condemnation of secondhand smoke will equal medical
distaste for smoking cigarettes, he said.

``We're now to the point with ETS that we were at in 1964 with cigarettes,''
said Hurt, who testified before the Duluth City Council Monday evening.

                      The Surgeon General's landmark report on secondhand smoke, released in
                      1986, wasn't published until 22 years after the office's first study on
                      cigarette smoking among U.S. adults.

The fledgling field is subject to the same political crossfire earlier debates
over smoking, Hurt added.

                      He should know. Hurt testified on behalf of Minnesota in the state's
                      landmark lawsuit against the tobacco industry. He was among the first to sift
                      through internal documents revealing the industry's public relations campaign
                      against smoking research.

Not all are as convinced as Hurt. The debate over secondhand smoke's
liability remains an undecided one in the nation's courtrooms.

                      In 1998, a federal judge found the Environmental Protection Agency made
                      scientific mistakes when drafting a 1992 report that declared as many as
                      3,000 lung cancer deaths each year resulted from secondhand smoke.

``In this case, the EPA publicly committed to a conclusion before research
had begun,'' wrote Federal District Court Judge William Osteen.

                      And in June 1999, for the second time in as many years, a jury refused to
                      find the tobacco industry liable for the cancer death of a nonsmoker
                      frequently exposed to secondhand smoke.

                      Hurt, a former smoker (two packs a day for 12 years), dismisses lingering
                      questions about the harmful nature of secondhand smoke. The current
                      growing body of research provides a powerful argument against exposing
                      the unwilling to the cigarette gases.

As proof, he cites new studies that link sudden infant death syndrome to
postnatal exposure to cigarette smoke.

EXCERPTS from BBC News World Edition, March 12, 2004, online, headlined Public Smoking 'Banned' in Uganda

Remember, the tobacco industry savagely fights all efforts at reducing or eliminating smoking in public places, including the workplace.

Massachusetts data reveals a decline in youth smoking due to clean indoor air, as well as other factors to "denormalize smoking."

Testimony presented by Virginia GASP to those working with tobacco settlement money in Virginia, including recommendations re. workplace smoking, and on-screen smoking.

Excerpted from EurekAlert, November 1, 2001, Contact: Wallace Ravven, wravven@pubaff.ucsf.edu, 415-476-2557, University of California - San Francisco

Philip Morris tobacco company launched a hidden campaign in the 1990s to change the standards of scientific proof needed to demonstrate that secondhand smoke was dangerous, according to an analysis of internal tobacco industry documents by researchers at the University of California, San Francisco (UCSF). The "sound science" standards they promoted through a variety of industry groups would have made proving the hazards of secondhand smoke virtually impossible, according to the study.

The tobacco industry strategy involved a seemingly noble calling for "sound science", while rejecting so-called "junk science" on secondhand smoke that actually threatened the industry's business interests.

Working through lawyers and public relations firms, Philip Morris sought to organize other industries to participate in the "sound science" movement, masking its own involvement. It also hired public relations and marketing firms to help form The Advancement for Sound Science Coalition (TASSC), developed to look like a grassroots organization of scientists and policymakers. Phillip Morris hoped TASSC would seem like an independent body rejecting evidence that secondhand smoke caused significant lung cancer and heart disease risk, according to the analysis of the documents.

In Europe, where secondhand smoke restrictions had not yet been put in place, Philip Morris promoted a set of standards originally proposed by the Chemical Manufacturers Association called "Good Epidemiology Practices." By modifying the proposal and developing new opportunities to introduce it, Philip Morris sought to establish an arbitrary threshold for identifying health risk from secondhand smoke - a threshold higher than what scientists had found for secondhand smoke.

The proposal would have revoked conclusions that an environmental toxin such as secondhand smoke was a public health problem. This effort was particularly focused on undermining a large European epidemiologic study of passive smoking and lung cancer being conducted by the International Agency for Research on Cancer at the time, the researchers found.

The analysis appears in the November issue of The American Journal of Public Health.

First author is Elisa K. Ong, MD, a medical resident at Santa Clara Valley Medical Center who conducted the research while a medical student working in the Institute for Health Policy Studies at UCSF. Her co-author is Stanton Glantz, PhD, a core faculty member of the Institute and a professor of medicine at UCSF.

Between 1994 and 2000, seemingly independent seminars involving other industries and issues on the so-called "Good Epidemiology Practices" (GEP) were conducted in the United States, United Kingdom, European Union and China, yet in all cases Philip Morris was connected to these events, the documents show.

Essentially, Philip Morris appropriated the "sound science" concept to shape the standards of epidemiology and to prevent increased smoking restrictions, the authors state.

"Phillip Morris has gone beyond 'creating doubt' and 'controversy' about the scientific evidence, to attempting to change the scientific standards of proof," they write.

The approach, the report states, ignores the fact that a comprehensive assessment of risk involves considering all the evidence related to a toxin, not just the epidemiology.

"While every practicing scientist agrees that scientific work should be rigorously done, the scientific, public health and regulatory community need to be more aware that the 'sound science' and 'GEP' movement is not simply an indigenous effort from within the profession, but also reflects sophisticated public relations campaigns controlled by industry executives and lawyers to manipulate the scientific standards of proof for the corporate interests of their clients," the authors conclude.

The research was supported by the National Cancer Institute and the Richard and Rhoda Goldman Fund.

                    Being exposed to second-hand smoke in the
                    workplace doubles a non-smoker's risk of
                    developing asthma, according to a new study.

                    For non-smokers who also live with a smoker,
                    the risk of developing the breathing disorder
                    jumps almost fivefold, Finnish researchers have
                    found.

                    "Our results demonstrate conclusively that
                    passive smoking plays a role in the development
                    of adult asthma," said Maritta Jaakkola of the
                    Finnish Institute of Occupational Health in
                    Helsinki.

                    The researchers studied 718 subjects in southern
                    Finland, 231 of whom had been diagnosed with
                    asthma as adults. None of them had ever
                    smoked.

                    Those exposed to second-hand smoke at work
                    were twice as likely to develop asthma as those
                    who were not. Those who lived with a smoker,
                    but were not exposed to smoke on the job, were
                    at a slightly lower risk.

                    Subjects exposed to smoking at work and at
                    home were close to five times more at risk than
                    those who had a smoke-free household and
                    workplace.

                    Characterized by an inflammation or swelling of
                    airways in the lungs, asthma can cause wheezing,
                    coughing and gasping for breath. It can, in the
                    extreme, lead to suffocation. About 2.7 million
                    Canadians have asthma.

                    The findings were presented yesterday in Berlin
                    at the European Congress on Lung Disease and
                    Respiratory Medicine.

                    Other research presented at the conference
                    showed that, even as smoking rates decline,
                    women are routinely exposed to cigarette smoke.

                    Italian researchers found that 47 per cent of
                    women had been exposed to "acute passive
                    smoke" in the past week. More than 63 per cent
                    of the exposure was at home.

                    Sandra Baldacci of the Institute of Clinical
                    Physiology in Pisa, Italy, found that non-smoking
                    women exposed routinely to second-hand smoke
                    in the workplace saw their risk of developing
                    conditions, such as shortness of breath at rest and
                    obstructive lung disease, grow by 2.1 and 2.3
                    times, respectively. If they were also exposed to
                    smoke at home, those risks were 2.8 and 4.2
                    times greater than among those living and
                    working in smoke-free environments.

                    Second-hand smoke kills about eight Canadians
                    daily. According to Health Canada, there are
                    about 12.6 million Canadians in the labour force,
                    of whom 4.1 million smoke. About 60 per cent of
                    employees work where there is little or no
                    regulation of smoking.

                    It is estimated that for every eight people who die
                    from smoking-related causes, one non-smoker
                    dies from the effects of second-hand smoke.

                    Research by Health Canada has shown that
                    workers in the hospitality industry are at the
                    greatest risk of the effects of second-hand
                    smoke. Working in an environment like a bar can
                    triple a non-smoker's risk of developing lung
                    cancer.

EXCERPTS from BBC News Online, September 25, 2001, headlined, Passive smoking 'causes asthma'

People whose partners smoke are nearly five times more likely to develop
asthma in adulthood than those who are not exposed to passive smoking,
according to new research. And those who are exposed to second hand smoke at work are more than twice as likely to develop respiratory problems.

The risks of exposing children to passive smoking are already well-documented but until now, a direct link between passive smoking and
asthma in adults has not been proven.

Now a team of scientists, led by Maritta Jaakkola, from the Finnish
Institute of Occupational Health in Helsinki, has produced the first hard
evidence to prove that passive smoking does play a role in the development of adult asthma.

The scientists studied a total of 718 people, none of whom had ever smoked, from a region in southern Finland.

A total of 231 had been diagnosed with asthma in the previous
two-and-a-half years - the remaining 487 represented the control group.

The team compared the amount of exposure the two groups had had to passive smoking over a 12-month period and found that the development of adult asthma was more prevalent in those who had had the most exposure.

Maritta Jaakkola, who presented her findings at the 11th European Congress on Lung Disease and Respiratory Medicine in Berlin this week, said: "Our results demonstrate conclusively that passive smoking plays a role in the development of adult asthma."

Clive Bates, from the(London-based) anti-smoking group Action on Smoking and Health (ASH), believes the study will have enormous implications for
employers who have not introduced anti-smoking regulations in the work-place.

He said: "This is a ground-breaking study which proves that passive smoking more than doubles the risk of developing asthma in adulthood.

"So, if employers have been negligent in reducing smoking in the work
place, employees who develop asthma will have a fair chance of proving it
was caused by passive smoking.

"And they will be able to claim thousands of pounds in compensation through the courts."

Mr Bates called on the government to introduce passive smoking legislation
to reduce the risk of law suits to employers.

A German study, the results of which were also presented at the conference, linked passive smoking to lung cancer in women who had never smoked.

Meanwhile a study carried out in Italy reinforced the Finnish findings and
also found that women were more likely to be exposed to passive smoking
than men.

Lawsuit over secondhand smoke - Victim wins

Eliminating smoking from the workplace does not eliminate the smokers - only the smoke. The purpose is to create a work environment that is safe and healthy for all workers.

This merely affirms that there are many things that one is not permitted to do in the workplace, and smoking is one of them.

Ventilation is not the answer, as one would need a hurricane to blow away the cancer causing chemicals, particulate matter, and radioactive particles.

There is no reason why smokers cannot be required to smoke outside the workplace. They can use various nicotine alternatives to satisfy their nicotine addiction if necessary. Many smokers welcome a smoke-free environment as more healthy for themselves, and as an incentive to quit smoking.

No-Smoking in the workplace, which includes many public places, not only saves lives, it also saves money for businesses, by decreasing days lost from illness, increasing productivity and morale, decreasing maintenance costs. Furthermore, it sets a good example for the young, by showing them that smoking is so dangerous, it can even hurt you secondhand.

There is a great problem with "double speak" - when we tell young people that tobacco use is bad for them, but then allow others to blow smoke in their faces.

                   Smoking among Massachusetts adolescents
                   has dropped faster since 1996 than at any other time in
                   state history, public health officials reported Wednesday,
                   led by sixth graders who had a 70 percent drop in their
                   use of cigarettes.

                   The 24 percent overall decline in cigarette use among
                   youth in grades seven through 12 is especially impressive,
                   said Public Health Commissioner Howard Koh, because it
             came at a time when tobacco companies are spending
                   more to attract young smokers.

                   "This is definitive evidence that we are inoculating the
                   next generation against cigarette addiction,'' Koh said.
                   "Not only have we seen a substantial decline in youth
                   smoking, but we lead the nation in cigarette smoking
                   reductions by both youth and adults.''

                   The study, based on a survey of 6,892 students in 106
                   communities, found that cigarette use among 8th graders
                   declined 40 percent while, among 10th graders, the drop
                   was 27 percent. Public health officials said the results
                   prove that the Massachusetts tobacco control program is
                   having a big impact.

                   The program, one of the nation's biggest state efforts to
                   counter tobacco advertising, funds 44 youth programs
                   across the state and 273 local boards of health that
             promote clean indoor air and put pressure on tobacco
                   retailers not to sell cigarettes to minors. The percentage of
                   retailers illegally selling to minors decreased from 42
                   percent in 1994 to 9 percent in 1999.

                   Since 1993, $250 million, most from tobacco settlements,
                   has been spent on antismoking campaigns and
                   workshops in Massachusetts.

                   Gregory Connolly, director of the tobacco control program,
                   said Massachusetts is the first state to show a decline in
                   both youth and adult smoking. The state also boasts the
                   fourth-lowest adult smoking rate in the nation, according
                   to the Centers for Disease Control behavioral risk factor
                   survey.

       "If you want to reduce youth smoking, you have to
                   denormalize smoking,'' said Connolly. "Kids benefitted
                   from higher prices, clean indoor air, an aggressive media
                   campaign and advertising restrictions.''

EXCERPTS from Independent News, June 12, 2000, writer Amanda Kelly, headlined: Smokers' children run meningitis risk

                               Babies who live in a smoky environment are more likely to
                               harbour the deadly meningitis bacteria and go on to contract
                               the illness than those living in a cigarette-free household,
                               scientists at Edinburgh University said. Tobacco smoke
                               appears to help the meningococcal bacteria (Neisseria
                               meningitidis) adhere to the tissues lining the throat, and the
                               more smoke a baby comes into contact with, the more bacteria
                               they will have. A child with parents who smoke is also more
                               likely to catch colds and flu, which can trigger the disease.

                               Caroline Blackwell, one of the study team from the university's
                               department of medical microbiology, believes the findings
                               could also have implications for research into cot death and
                               chest infections among babies.

                               "It has been known for some years that smokers are much
                               more likely to be carriers of bacteria," she said. "What we
                               found was an important association. If a mother smoked, we
                               were more likely to find the bacteria in her children. The greater
                               the number of bacteria present, the greater the risk that they
                               will develop the disease."

                               Dr Blackwell and her team studied more than 250 babies in
                               Greece and found that those who had the bacteria all had
                               mothers who smoked.

                               The research was carried out in Greece because equal
                               numbers of women in the country across the social spectrum
                               smoke, whereas in Britain smoking is more common among
                               people from poorer backgrounds.

                               Meningitis is more common among poorer people in Britain, a
                               fact that may be explained, at least in part, by the newly
                               discovered link with smoking.

                               The researchers also found that passive smokers suffered the
                               same effects as smokers on the tissue in their throats and
                               nasal passages.

ETS Increases Risk of Strokes

                  LONDON (AP) -- Breathing in other people's cigarette smoke makes
                  nonsmokers 82 percent more likely to suffer a stroke, a new study
                  suggested Tuesday -- indicating the dangers of so-called passive smoking
                  are much worse than originally believed.

                  The study by researchers at the University of Auckland in New Zealand is
                  the largest and most rigorous to date, and gives more ammunition to those
                  campaigning to have smoking banned in all workplaces and public areas.

                  Current estimates of how smoking increases the risk of various diseases
                  are dramatically underestimated because the ill effects of secondhand
                  smoke inhalation are not taken into account, say the researchers, whose
                  work is published in the British medical journal Tobacco Control.

                  Because New Zealand's anti-passive-smoking legislation is among the
                  most progressive in the world, it is easier to separate out people who have
                  been exposed to secondhand smoke, he said.

                  Two previous studies have linked stroke with secondhand smoke. Studies
                  also show passive smoking increases the risk of heart disease, heart
                  attack, lung and breast cancer, and breathing-related diseases.

                  The suggestion that studies into the dangers of smoking underestimate the
                  real risk is "an important point that has not been well appreciated,'' said
                  Stanton A. Glantz, a secondhand smoke expert at the University of
                  California-San Francisco who was not connected with the study.

                  The study examined 521 stroke patients in Auckland and compared them
                  with 1,851 randomly selected healthy people matched by sex and age to
                  see the effect of smoking and secondhand smoke on the chances of
                  suffering a stroke. None of the subjects was older than 74.

                  "Half the people who have strokes are 75 or older, so these are
                  premature strokes that should not be happening,'' said Ruth Bonita, the
                  lead author of the study, who now runs the non-communicable disease
                  section at the World Health Organization.

                  People were classed as having been exposed to secondhand smoke if
                  they lived with or worked in the same room as someone who regularly
                  smoked in front of them for more than one year during the past 10 years.

                  Overall, smokers were four times more likely to suffer a stroke than
                  nonsmokers. But when the nonsmokers exposed to secondhand smoke
                  were excluded from the equation, smokers were six times more likely to
                 have a stroke. That's a difference of about 50 percent.

                  Again in the basic investigation, people who had quit smoking more than
                  two years before were no more likely to suffer a stroke than those who
                  had never smoked. But once the passive smoking factor was removed,
                  those people still had nearly double the chance of suffering a stroke.

                  Lifetime nonsmokers and those who had quit smoking more than a decade
                  earlier were 82 percent more likely to have a stroke if they were breathing
                  secondhand smoke.

June 6, 2000, Public Comment Time, Virginia Tobacco Settlement Foundation
Anne Morrow Donley, Co-Founder and Issues Coordinator, Virginia GASP^®

FIRST: The victims of tobacco have been forgotten. Where is the apology from the tobacco industry to the families of those who died from using tobacco products? Industry documents have proven that the industry knew their products would addict and kill. Most settlements require the defendants to cease and desist their actions. But here, the settlement money only flows if the tobacco companies are permitted to continue to market an addictive and lethal drug.

SECOND: It follows that the only way these death merchants can stay in business is by marketing to children and teenagers.

THIRD: By becoming dependent upon tobacco money, this state has joined a partnership with the merchants of death. So you will have to take bold steps to show you are serious.

FOURTH: If you are quite serious in eliminating child and teen tobacco use, there is one single step you can take that is the most important one, the cheapest one, and the most effective one of all.

This foundation can recommend increasing protections afforded under the Virginia Indoor Clean Air Act by requiring that all workplaces ban smoking on the workplace site.

This would help children, teenagers, adults, and the fetus, because it would immediately provide:

Secondhand smoke, or Environmental Tobacco Smoke, kills more than 60,000 people, including young people, every year nationwide [USA].

Innumerable reports have stated the lethal nature of secondhand smoke. Most recently there is the Report on Carcinogens, 2000, of the National Toxicology Program of the U.S. Department of Health and Human Services, Public Health Service, which stated that Environmental tobacco smoke (ETS) is known to be a human carcinogen.

Actions speak louder than words. While on the one hand, this foundation, the tobacco industry, and the public, say that they tell young people: "Don't Smoke!", they turn around and blow smoke into the airspace of teenagers and children, hurting them and eventually killing them by predisposing them to several cancers, heart disease, and other diseases.

FIFTH: Eliminating smoking at the workplace is the single most important step you can take. Philip Morris has a new website and propaganda trying to convince businesses to allow smoking in the workplace. But it is a civil rights issue as well as a health issue. When smoking is allowed in the workplace, the nonsmoker's right to a healthy environment is violated.

Smokers can remain smokers while postponing their smoking behavior until they are outside the building. They can use nicotine addiction alternatives. Smoking is not necessary for life or work. But breathing is necessary for both life and work. And breathing is still a very popular thing to do. There are many things one is not permitted to do at the workplace, and smoking should be one of them.

SIXTH: GASP's Recommendations:
1. Governor James Gilmore should issue an executive order prohibiting smoking in all buildings owned, operated, and/or leased by the Commonwealth of Virginia. GASP would then happily revoke the name we have given him of "Nicotine Jim."

2. Attorney General Mark Earley, who has aggressively fought to preserve the life of the fetus should prove his commitment to this by backing legislation prohibiting smoking in the workplace. We do not offer businesses a choice or let the marketplace decide on issues of the public health and safety.

3. Incentives, such as tax credits, should be offered to businesses which have eliminated workplace smoking by the end of this year.

4. Free "No-Smoking" signs and free "Welcome to a Smoke-Free Environment" signs should be provided to businesses and government agencies.

5. A resolution should be sent to the other states involved in the tobacco settlement, asking them to support a letter to the movie and television industry, requesting an end to the extravagant use of smoking in films, cartoons, and shows. Smoking onscreen is a deadly advertisement for the industry. This is not about product placement. This is about smoking itself onscreen, even in places where smoking in not permitted in most states.

Eliminating smoking in the workplace and stopping the onscreen smoking will be the most effective efforts you can ever take to stop tobacco use among children and teenagers. It's time to put your money where your mouth is.

Editor's Note: As of 2004, even with a new administration in place, the Virginia Tobacco Settlement Foundation has worked more to assist tobacco farmers/workers than to protect children and adults from secondhand smoke.

SECONDHAND SMOKE - HAZARD TO LIFE