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.For this reason, more and more workplaces are going smoke-free around the world.
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.
The authors declare they have no competing financial interests.
Received 27 April 2004; accepted 7 October 2004 .
Medical Association condemns tobacco industry ventilation claims
EXCERPTS from: BMA condemns tobacco industry ventilation claims - News-Medical.Net January 13, 2005
ENVIRONMENTAL TOBACCO SMOKE KILLS.
Secondhand Smoke, or
Tobacco Smoke [ETS], has been labeled
a Class A carcinogen by the U.S. Environmental Protection Agency. Carcinogens are cancer producing substances.
ETS is the single most important source of harmful indoor air pollution.
Several types of cancers
Cardiovascular disease (atherosclerosis, heart disease, stroke)
Perinatal death, miscarriage, low birth weight
Sudden Infant Death Syndrome (SIDS)
increases the risk of illness including:
Atherosclerosis (hardening of the arteries)
Respiratory infections -- pneumonia, bronchitis, bronchiolitis, colds, sore throats
Middle ear infections
EXCERPTS from The Toledo Blade, March 8, 2004, Letters to the Editor, headlined, Danger of secondhand smoke is real
William Delaney, owner of Delaney's Lounge, was quoted ... as saying "secondhand smoke will not kill anyone." I invite Mr. Delaney to tell that to the family of Dr. Abid M. Hanson.
A nonsmoker who suffered from asthma, Dr. Hanson was a passenger aboard an Olympic Airways international flight in 1998 and was seated near the smoking section. After he began suffering major breathing distress, Dr. Hanson and his wife made repeated requests of the flight crew to have him moved away from the smoke. The flight crew refused to move him. Dr. Hanson later died on that smoke-filled flight at the age of 52.
The family sued Olympic Airways for negligence; the court awarded damages in the amount of $1.4 million. That award was upheld by the Ninth Circuit Court of Appeals in December 2002.
On Feb. 24 the United States Supreme Court upheld the award for Dr. Hanson's family. I hope that Dr. Hanson's tragic and unnecessary death will help destroy the myth that secondhand smoke has never killed anyone.
EDWARD L. SWEDA, JR.
Editor's note: Mr. Sweda is senior attorney for the Tobacco Control Resource Center at the Northeastern University School of Law.
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:
This is Alice K. Helm. Most of you know me. This testimony is in the form of an open letter to Mark Doherty, General Manager of the Anchor Inn restaurant, since it probably will be my last public comments about smoke filled restaurants. There are several points I want to make before I die to Mr. Doherty, other owners of smoke-filled restaurants and bars, non-supportive Council members, and County Executive Duncan.
This is an issue of killing people, not whether the Anchor Inn may lose some business.
I never smoked. However, for many of my 75 years I inhaled the carcinogens borne by second hand smoke in restaurants such as the Anchor Inn, in elevators, at meetings, on airplanes, in stores. Health experts say that's probably why I now have fourth-stage lung cancer that also has spread elsewhere in my body.
Since Mr. Duncan vetoed the smoking ban in restaurants a few years ago, progressive states and local jurisdictions have enacted smoke free legislation such as the bill we passed then in Montgomery County. Those jurisdictions did not see patron flight from their restaurants. Instead, what they did see was a reduced number of health problems that were due to the inhalation of carcinogens that previously permeated their smoke-filled restaurants.
Ventilation does not work. Council members, Mr. Duncan and tobacco companies know this. It is not a compromise. It is a death sentence. It is not Mr. Doherty's right to poison the air others must breath in order to make a dollar. It is the government's mandate to protect the public's health. That's why they inspect restaurants for rats, contaminated food and certainly the most important should be to prevent death from the carcinogens in second hand smoke.
I probably won't be here to enjoy Montgomery County's smoke free restaurants and bars. But you will have the chance to see the lives of workers and patrons last longer. And remember. I'll be watching!
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
suspicion is they're being discouraged from participating by their
JAMA, Journal of
American Medical Association. 2003;289:1258-1264
Vol. 289 No. 10, March 12, 2003 http://jama.ama-assn.org/cgi/content/short/289/10/1258
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.
Passive smoking defined as serum cotinine levels of
0.2 to 10 ng/mL and caries defined as decayed (unfilled) or filled tooth
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 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.
Reprints: C. Andrew Aligne, MD, MPH, 620 Park Ave,
Box 135, Rochester, NY 14607 (e-mail: email@example.com ).
Author Contributions: Study concept and design: Aligne, Weitzman.
research was partially supported by a Special Projects grant from the
for Healthcare Research and Quality and the Ambulatory Pediatric
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
challenges and medical scrutiny: Smoking kills.
But what about that lazy trail of smoke that lilts from a lit cigarette
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
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
attack. Its chemicals create long-lasting genetic mutations that blossom into
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
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
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
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.
The restaurant went smoke-free April 24.
Newberg is thrilled. The irritation, sneezing and sinus trouble that
her at the end of each eight-hour shift have subsided. The air is clean, she
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
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
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
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
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
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'
This second line of defense can fail too, triggering a last-ditch
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
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
Researchers aren't sure. That's because a number of factors, such as
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
``It's established, rock solid: Smoking causes cancer,'' Hecht said.
``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.
``It's just a matter of dosage.''
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.
But the risk is still there.
All Hecht needs to illustrate his point are studies of nonsmokers'
contain the same chemical residue from cigarettes that smokers' urine
Assessing that risk is more difficult, though, largely because there
lung-cancer patients who never smoked available to study.
Science and public awareness still fail to fully comprehend risks
with secondhand smoke, said Dr. Richard Hurt, a physician from the Mayo
Clinic in Rochester, Minn., and the director of its nicotine dependence
In time, the scientific condemnation of secondhand smoke will equal
distaste for smoking cigarettes, he said.
``We're now to the point with ETS that we were at in 1964 with
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
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
had begun,'' wrote Federal District Court Judge William Osteen.
And in June 1999, for the second time in as many years, a jury refused
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
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
Uganda has imposed a smoking ban in all public places, the environment minister has said.
Kahinda Otafiire said smoking in restaurants, educational institutions and bars would now be an offence.
Offenders will be fined between $10 and $50 if arrested by policemen who have been instructed to enforce the law.
But the BBC correspondent in Kampala says the smoking ban has not been gazetted so it remains unclear quite how rigourously it will be enforced.
Mr Otafiire said the cabinet and parliament are backing the ban.
A spokesman of Environmental action network, (Tean) which works for tobacco control, Philip Karugaba said the minister was simply implementing a court decision passed in December 2002.
Mr Karugaba said the ministry was instructed to prohibit smoking in public places after a court ruled that the habit was dangerous to the health of Ugandans.
VIRGINIA - Smoking in State Capitol hurts people & art
in the USA) Indoor Clean Air Act
Remember, the tobacco industry savagely fights all efforts at reducing or eliminating smoking in public places, including the workplace.
- The tobacco industry does not want young people to see that smoking is so dangerous, it can even kill you through breathing someone else's smoke.
- The tobacco industry does not want young people to think that it is "normal" to have NO SMOKING in the workplace, in restaurants, and so on.
- The tobacco industry is responsible for many deaths - of consumers - such as George Harrison, and of those who have breathed someone else's smoke, and of those who have died in fires started by cigarettes.
Manslaughter charges are being considered against smokers.
Excerpted from EurekAlert, November 1, 2001, Contact: Wallace Ravven, firstname.lastname@example.org, 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.
The full text of the article is available online at the American Journal of Public Health web site http://www.ajph.org/cgi/content/abstract/91/11/1749
on the significance of this work are also in the journal: http://www.ajph.org/cgi/content/abstract/91/11/1742
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
"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
The researchers studied 718 subjects in southern
Finland, 231 of whom had been diagnosed with
asthma as adults. None of them had ever
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
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
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
EXCERPTS from BBC News Online, September 25, 2001, headlined, Passive smoking 'causes asthma'
People whose partners
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
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
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
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
anti-smoking group Action on Smoking and Health (ASH), believes the
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
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
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
out in Italy reinforced the Finnish findings and
also found that women were more likely to be exposed to passive smoking
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
"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.''
A Milan prosecutor has begun investigating whether an asthma sufferer died from passive smoking, with a view to charging her employers and colleagues with manslaughter.
The victim, identified by Italian newspapers as Stefania C, 25, collapsed at her desk in a Milan bank 10 months ago and died of an acute asthma attack.
Employers have in the past been ordered to pay compensation for the effects on health of passive smoking, but this would be the first time in Italian legal history that anyone had been charged with culpable homicide in such a case.
The woman, who suffered from chronic bronchial asthma, had been hired under a scheme that gives tax incentives to employers who take on staff with physical handicaps. But her family say she was forced to work in a small, windowless room, surrounded by habitual smokers.
Her repeated written requests to be transferred to a healthier environment were allegedly ignored by her employers.
The prosecutor, Luca Poniz, is investigating whether those who continued to smoke around her and those who ignored her pleas for help should be charged with manslaughter.
She returned from work every day with her clothes reeking of smoke and feeling humiliated by the insensitivity of her colleagues, her husband told the prosecutor.
Her anxiety at having to work in an airless, smoke-filled room often caused her to break down in tears, he said.
According to Francesco Bacchini, a researcher on labour rights at the University of Modena, the entire bank hierarchy could be liable to prosecution.
"There is still no law against passive smoking in Italy, but using an extensive interpretation of other laws on safety in the workplace, there is no doubt that this case has serious penal implications," he said.
Mr Poniz will decide if he should go ahead with charges against the bank staff after questioning all those involved in Mrs C's case. His decision is expected by the end of the month.
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
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
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
June 6, 2000, Public Comment Time, Virginia Tobacco Settlement
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:
According to the U.S. Centers for Disease Control and Prevention, approximately 70% of teenagers who work at paid jobs do so in a smoky environment.
- a healthier work environment;
- protect the civil rights of the nonsmoker;
- promote a positive image that not-smoking is the example to follow;
- teens who smoke would be encouraged to quit smoking;
- exemplify the policy that one should not hurt another person; and
- break the vicious, undermining, "double-speak" cycle.
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.
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.
Note: As of 2004, even with a new administration in place, the
Tobacco Settlement Foundation has worked more to assist tobacco
than to protect children and adults from secondhand smoke.
Updated 28 January 2006