Sickened by secondhand smoke

By Robert McAfee
Copyright 1998 Bangor Daily News
October 2, 1998


Late on Friday, July 17, U.S. District Court Judge William Osteen, of the Middle District of North Carolina, issued a ruling in the 5-year-old lawsuit brought by the tobacco industry against the Evironmental Protection Agency (Flue-Cured Tobacco vs.  EPA).  In the suit, tobacco companies charged that EPA violated procedural requirements and used bad science in classifyingenvironmental tobacco smoke (ETS) as a Class A carcinogen (i.e. produces cancer in humans).

The 1993 EPA report at issue was a scientific report produced by a panel of experts convened to review all the available evidence on the health effects of secondhand smoke.  Because the report did not constitute any "final agency action" and had no legal ramifications, it should never have been reviewed in a court of law.

It is most unusual that a judge chose to review the epidemiology, statistical analysis and other scientifc work that went into the EPA report.  This is simply not the pureview of the federal courts.  The decision asks us to accept the judge's interpretation of scientific evidence over the conclusions of the experts convened by the EPA.  Judge Osteen's conclusions on the science seem to have been informed solely by the tobacco companies' briefs.

According to Steven Bayard, co-author of the EPA report, "EPA's 530 page health risk assessment, which took nearly four years to complete is an extensive review and evaluation of several hundred scientific studies on ETS.  Two separate drafts were reviewed externally and public comments obtained.  Two public review meetings were held by an EPA Science Advisory Board (SAB) committee of 18 independent experts in the field.  No other report in recent memory has received a stronger SAB endorsement" (Bayard S. and Jinot J., "Environmental tobacco smoke: Industry's suit studies focus on epidemiological studies," July 1998).

Despite the judge's ruling the harmful effects of secondhand smoke are scientifically and medically known.  EPA was not the first, nor the only scientific body to conclude that secondhand smoke is injurious to health: An early Report of the Surgeon General (U.S. DHEW,  1979) noted several adverse respiratory outcomes in children and adults, as well as some acute cardiovascular effects associated with involuntary exposure to tobacco smoke.

The 1982 Report of the Surgeon General     (U.S. DHHS, 1982), which focused on the carcinogenic effects of active smoking, raised concern that involuntary smoking may cause lung cancer.

The 1996 review by the National Research Council (NRC, 1986) as well as the 1986 Report of the Surgeon General, based on reviews of all available evidence, concludedthat: "Involuntary smoking is a cause of disease, including lung cancer, in healthy non-smokers" (U.S. DHHS, 1986).

The state of California undertook a broad review of ETS and issued a Final Report in Sept. 1997 that concluded "ETS exposure is causally associated with a number of health effects" including "developmental, respiratory, carcinogenic and cardiovascular effects     including fatal outcomes such as sudden infant death syndrome and heart disease mortality, as well as serious chronic diseases such as childhood asthma" (California EPA, 1997).

More than 100 major studies in the past 13 years have examined health of passive smoking, and most, about 63 percent found evidence of harm, from respiratory problems to cancer (JAMA, May 1998).

Of the reports that were inconclusive or found no health effects, nearly 75 percent were written by scientists funded by tobacco companies.  The evidence "suggests that the tobacco industry may be attempting to influence scientific opinion by flooding the scientific literature with large numbers of review articles supporting its position" (JAMA, May 1998).

By the tobacco industry's own admission, the dangers of secondhand smoke present the greatest challenges to the continued viability of tobacco companies:

According to the Roper Report of 1978, commissioned by the Tobacco Institute, all previous "attacks," including Surgeon Generals' Reports on the health hazards of smoking, warning labels, broadcast ad bans and required warning on cigarette advertisements, were "blows the cigarette industry could successfully weather because they were all directed against the smoker himself. " Roper warned however, that "What the smoker does to himself may be his business, but what the smoker does to the nonsmoker is quite a different matter. " The report concluded that the issue of passive smoking was "the most dangerous development to the viability of the tobacco industry that has yet occurred" (Roper, 1978).

Tobacco companies have long known of the toxicity of passive smoking.  According to Dr. William Farone, who served as Director of Applied Research for Philip Morris from 1976 to 1984, "In the 1970s research paid for by the Cigarette Manufacturing Industry uncovered the fact that tobacco specificnitrosamines were the most significant risk of lung cancer both among smokers and in non-smokers subjected to sidestream smoke.      The fact that this powerful carcinogen NNK increases over time in a smoke filled room to add to the risk from the many other carcinogens was withheld, not only from the public, but also from other researchers within the Industry and even within the company that obtained the results" (Farone W., "Toxic Gas for the Masses," July 13,1998).

An internal Philip Morris memo dated Feb. 19,1993, declares that "The RD's, in addition to fighting taxes, will make fighting smoking bad legislation their top priority.  Where appropriate, we will proactively push for accomodation with preemption legislation in all cases.     " The document outlines a comprehensive strategy, including communications, public relations and legal strategies.

Its "Objectives" include: Associate EPA study with broader questions about agency research and government regulation.

Link issue with more "politically correct" products.

Have nonindustry messengers provide reason for legislators, business executives and media to view EPA study with extreme caution. (www.philipmorris.com/getalling.asp/DOCID(equal sign)2021252097/2110)

The scientific and public health effects of involuntary exposure to secondhand smoke are clear -- environmental tobacco smoke causes cancer, heart disease, lung disease, and death.  We can't turn back the clock on this public health issue, we must protect the public from involuntary exposure to this toxic substance despite the best efforts of the tobacco industry to have us to otherwise.

Dr. Robert McAfee is a retired surgeon from South Portland.  He is a past president of the American Medical Association and serves as chair of the Tobacco Prevention and Control Advisory Council of the Partnership for a Tobacco-Free Maine.

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