sample="quota" bates="501477276" isource="rjr" decade="1970" class="ni" date="19770716" ti SPECIAL REPORT SMOKING AND THE PUBLIC Published by the staff of The Tobacco Institute, 1776 K Street, Northwest, Washington, D.C. 20006 The Question of 'Public Smoking' This special issue focuses on a subject that has become increasingly familiar to many - "public smoking" and the campaign to limit or prohibit smoking in public places. The crucial question is whether the exposure of nonsmokers to tobacco smoke is normal, everyday situations actually creates a health hazard. The answer, arrived at after a careful examination of the scientific literature is unequivocally "No." Indeed, many scientists who believe smoking is harmful to smokers have publicly stated there is no evidence that public smoking is harmful to nonsmokers. Why, then, is so much emphasis being placed on the subject? A simple answer is difficult, but it seems reasonable to conclude that the failure of the campaign aimed at making smokers stop smoking has resulted in a compensatory effort to make smoking "socially unacceptable." The campaign for outright bans or restrictions of smoking in public places is noteworthy for its lack of supporting scientific findings. However, it is causing unpleasant and potentially dangerous events. Smokers and nonsmokers, friends and neighbours, are being set against each other. Social friction has arisen in many instances. Violence and militancy have been kindled in some cases. And, most serious of all, personal freedom in democratic societies are being attacked and eroded. There is no need to demand restrictive legislation to infringe on freedom of choice. Common sense, courtesy and tolerance for the preferences of others are all that is needed to enable smokers and nonsmokers each to enjoy their preferences and to respect those of others. Society is ill-served when its members are subjected to any kind of campaign based on fear or misinformation. No goal can be justified by the use of any expedient or contrivance used in an effect to attain it. Emotional rhetoric is not a substitute for scientific fact. The Editors Summary No Scientific Proof for 'Public Smoking' Theory (Page 1) Meeting Discusses 'Passive Smoking' At Places of Work (Page 2) Cancer Chain Is 'Dishonest' (Page 3) Tobacco Allergy: Myth or Truth? (Page 5) Scientists Comment On Public Smoking (Page 6) The Solution Is Courtesy (Page 6) No Scientific Proof for 'Public Smoking' Theory To some it's "public smoking." Others call it "passive smoking" or "involuntary smoking," and it is also frequently referred to as "second-hand smoke" or "environmental smoke." No matter what phrase is used, it means only one thing: the inhalation of tobacco smoke in the ambient air by nonsmokers who are in the vicinity of smokers. Behind this phrase is the allegation that such inhalation constitutes a health risk for the nonsmoker. Those who make this allegation are seeking to have governments - national, regional and local - enact legislation or issue rulings to restrict or prohibit smoking in public places and transportation facilities. They have been successful in certain instances to date. Supporting or corroborative scientific data for the theory that public smoking is harmful do not exist. On the contrary, there is a considerable amount of research findings which show that normally encountered environmental tobacco smoke is not a health hazard to nonsmokers. It is significant that many scientists who have claimed smoking is a health hazard for smokers (especially smokers of cigarettes), have also expressed their belief that public smoking does not represent such a hazard for those who do not smoke. How It Began The public smoking theme appears to have been promoted for the first time by Dr. Jesse L. Steinfeld during his 1968-1973 term as Surgeon General of the U.S. Public Health Service. This is a major division of the Department of Health, Education and Welfare (DHEW). In a 1971 speech he said: "Evidence is accumulating that the nonsmoker may have untoward effects from the pollution his smoking neighbour forces upon him...It is high time to ban smoking from all confined public places such as restaurants, theatres, airplanes, trains, and buses..." Dr. Steinfeld did not cite any evidence, nor did he give any scientific references that would support a ban. He did not mention a booklet, "Smoking, Health, and You," which had been published several years earlier by DHEW. Cancer Claim is 'Dishonest' Dr. E. Cuyler Hammond, chief statistician of the American Cancer Society, has often said that smoking is dangerous for smokers. In 1974 he participated in an international conference on public education in cancer sponsored by the International Union Against Cancer. In 1975 the Union published a report on the conference that included the following: "Dr. Hammond stated that there 'was no shred of evidence' that a nonsmoker can get cancer from 'second-hand' smoke and there is a lot of evidence that he cannot. For instance, one doesn't find in the tracheobronchial trees of nonsmokers those atypical cells which are so characteristic of even light cigarette smokers. He added that to suggest passive smoking could cause cancer is dishonest, and that he would be prepared to testify as much in a court." Bartenders at Risk In May 1976, three scientists at the University of Cincinnati, Ohio (USA) reported a study which they said, showed that bartenders in smoke-filled taverns could suffer a health risk from the CO and other substances produced by the cigarettes of their customers. the report was carefully analyzed by two researchers at the Harvard School of Public Health, Boston (USA). In a later issue of the same journal in which the report had appeared, they pointed out it had "certain errors" which made the conclusions doubtful. "Because of the strong public sentiment on the subject of passive smoking," warned Drs. Melvin W. First and William C. Hinds, "it is imperative that investigators in this field do careful and responsible work to avoid sensational claims on one side or the other of this issue." These two investigators had earlier published results of their own study of tobacco smoke concentration sin a variety of public places. Their findings did not suggest any health hazard to non-smokers, they said. Research in Sweden Two Swedish scientists, Drs. Gunnar Anderson and Tore Dalhamn, conducted an experiment in which 7 smokers and 5 nonsmokers were exposed in a ventilated but closed room for 2 hours to smoke from cigarette, pipes and cigarillos (cigarettes made from pipe tobacco). There was no significant increase in COHb levels in the nonsmokers, they reported, and the CO concentration in the room, which rose to a mean value of 4.5 ppm, "cannot be assumed to constitute any health risk to nonsmokers." (Before smoking, the room CO concentration was 2 ppm.) Long-Term CO Exposure Well-conducted research does not support any claim that long-term exposure to CO might be hazardous to non-smokers. In a study of guards who worked in a motor vehicle tunnel in New York City it was reported that they were healthy and their work performance did not seem to be affected even though they were regularly exposed to CO concentrations averaging 70 ppm. Some exposure rose as high as 200-300 ppm. Commenting later on this study, Dr. T. J. Curphey wrote in a medical journal "What appears to be the most significant observation of this study of traffic officers in the Holland Tunnel is that the blood CO levels of nonsmokers in the tunnel on the average exceeded those of smokers in an environment free from any occupational exposure to CO. Since these men remained healthy after being consistently exposed for 13 years to CO levels appreciably higher than those found in tobacco smoke, the conclusion then is inescapable that smokers with CO levels that lie well within the same ranges are similarly unaffected by CO." In another project, Dr. Frank Stern of Cincinnati, Ohio (USA) examined the causes of death of men employed as motor vehicle examiners by the state of New Jersey. Few deaths than had been expected were found, and of these fewer than expected were from heart disease. The workers generally were exposed to CO concentrations below 35 ppm, but at times the level reached 200 ppm, Dr. Stern said. Smoking histories were not available, but it seemed likely that workers' smoking experience was similar to that of the general white male population in the U.S. CO and Heart Disease There have been some reports claiming that exposure to CO, especially in cigarette smokers, can contribute to the development of artherosclerosis, or hardening of the arteries. Several studies on pigeons, rabbits, dogs, primates, and humans have not shown any harmful effects at blood COHb levels of 15%, a high level rarely found in humans and then only transiently. "There is no evidence to date that passive smoking leads in the long run to typical smokers' diseases or to an increased health risk in an average healthy person. There are no plausible reasons to justify the assumption that such disturbances develop in passive smokers in the short term"- Prof. Dr. W. Klösterkotter and E. Gono, Essen University, Germany. "Potential health effects of tobacco on the nonsmoker have recently been reviewed...No data are available to demonstrate health effects of physiologic response to nicotine levels reached in adult nonsmokers and carbon monoxide concentrations in nonsmokers are far below levels that are known health hazards" - Dr. Gary L. Huber, Harvard University, Boston (USA). "A number of research papers have been published on this subject. I am advised that they provide no clear evidence to show that tobacco smoke is harmful to normally healthy nonsmokers or that a heavily tobacco smoke laden atmosphere has other than transient effect..." _ Dr. David Owen, Minister of State (for health) in England in 1975. "I do not have any had evidence in that direction (that passive smoking harms the nonsmoker). To my knowledge, it is not in fact, actually harmful" - Dr. Jonathan E. Rhoads, chairman of the U.S. National Cancer Advisory Board and former president of the American Cancer Society. "Passive smoking can provoke tears or can be otherwise disagreeable, but it has no influence on health. In this case, the doses are too small"- Dr. Ernst L. Wynder, president of the American Health Foundation, New York City, who has long proclaimed the hazards of tobacco for smokers. "In very direct terms there is no medical proof that nonsmokers exposed to cigarette smoking in ordinary relations with smokers suffer any damage" - Dr. Reul Stallones, University of Texas and an advisor to the 1964 U.S. Surgeon General's Advisory Committee on Smoking and Health. "The present evidence indicates that there is virtually no risk to the healthy nonsmokers..." - Sir Charles Fletcher, chairman of an Expert Group appointed by the British organization, Action on Smoking and Health, which was established by the Royal College of Physicians of London. (The above is from the group's report on pipe and cigar smoking published in a British medical journal.) "As is always the case in any group that becomes anti of any situation or circumstance, there are always loud voices and much flag-waving. So it is in the anti-smoking group... Smoking may be offensive to certain people but so is an alcoholic breath, a sweaty body, an unkempt figure, a crying baby, or an undisciplined child...if you ban smoking then will you ban these other annoyances and inconveniences?"- Dr. Paul B. McCleave, while serving as director of the department of medicine and religion of the American Medical Association. "If we want to remain with facts and not with fiction, there is little danger of disease to people that stay in a room where people smoke" - Dr. Gio Gori, U.S. National Cancer Institute (1976). Editor's Comment: The Solution is Courtesy Courtesy is the solution to any problem, whether real or imaginary, that may exist between smokers and nonsmokers. Add to this understanding and consideration, and there will not be situations of smokers vs nonsmokers, but rather one where each respects the other's preferences. Everyone is occasionally subjected to annoyances and irritations from many sources, including those that result from the personal characteristics or customs of others. Such situations can be handled sensibly if one maintains tolerance for the preferences of others. Nobody wants a government to intrude in such matters, for then there arises the spectre of legislative restrictions seeking to control many aspects of life. Smokers who are reasonable in the enjoyment of their custom will not let it be an annoyance to others. A courteous approach will do much to lessen any friction that may arise and will increase mutual respect and understanding. The Tobacco Institute recognizes that there are differences of opinion concerning smoking and health. This folder is presented in the belief that full, free and informed discussion of the smoking and health controversy is in the public interest, and in the conviction that the controversy must be resolved by scientific research. The Tobacco Institute, 1776 K Street, Northwest, Washington, D.C. 20006 A question in this booklet asked: "Can it harm you to breathe the smoke from other people's cigarettes?" The answer was "No, It may make your eyes tear or make you cough, but it cannot harm you..." Three months after the 1971 speech, Dr. Steinfeld was called to testify before a committee of the U.S. Congress. Questioned about the booklet, he responded: "I think we just do not have enough information to make any categorical statement other than it (public smoking) is unpleasant." Regardless of the disavowal, a new campaign theme had been created for anti-smoking groups in the USA and Europe. The 1972 U.S. Surgeon General's report on smoking and health to Congress apparently was the first major document to claim public smoking might be harmful to nonsmokers. The Carbon Monoxide Claim The major argument for the alleged dangers from "passive smoking" rests on the claim that the carbon monoxide (CO) produced by a burning cigarette causes health damage to nonsmokers. The emphasis remains on CO, though other substances, nicotine among them, occasionally have been cited as suspect agents.