sample="supplemental" bates="TIMN_256918" isource="ti" decade="Bliley" class="ue" date="19790101" PRIVILEGED AND CONFIDENTIAL Produced as required by the Court's March 7, 1998 Order State of Minnesota, et al. v. Philip Morris, et al. Court File No.: C1-94-8565 1 Public Smoking This could have been the shortest chapter in this book collection, considering the first item to be presented below. But it won't be, because the myths which have grown up around the whole subject of so called public smoking (sometimes called "passive smoking" ) must be discussed. Despite what is written and declaimed those myths, the recent words testimony of the man who has directed the government's smoking and health research program for more than 10 years tell the whole story may well summarize the situation. NCI's Dr. Gio B. Gori of the National Cancer Institute was asked by a Congressional committee in last October, 1978 "Is there evidence to suggest that there may be an increase in risk of heart and lung disease s to a nonsmoker by being in the presence of smokers?" Replied Gori: Well, this is a difficult question to answer, Mr. Chairman, because the answer that I have to give as a scientist may not please always the anti-smoking forces. But the fact remains that we really do not have conclusive scientific evidence about the adverse health effects of passive smoking on the bystander ((and)) in the usual conditions under which smoking is practiced, the evidence does not indicate that the casual bystander is seriously harmed by smoking (1). Very recent research -- two papers published in the second half of 1978 confirms these this appraisal s in one, which appeared in the American Medical Association's Archives of Environmental Health, a Canadian team found that physiological responses to smoke exposure in normal adults could only be called be described only as "minimal" and said "arguments concerning effects rest on symptomatology"--in other words, on how the subjects said they felt , a highly unreliable standard (2) (Dimm et al 1978). In the second, Danish and British scientists wrote in International Archives of Occupational and Environmental Health that they found "transitory discomfort" but that constituents of neither the gas phase nor the particulate phase of ambient cigarette smoke ha s ve " a lasting adverse health a effect in otherwise healthy , individuals" (Huged et al 1978) (3) Like the Canadians, the researchers said their test situations were realistic and typical of rooms heavily polluted with tobacco smoke in which smokers gather. Carcinogenic effects have not been demonstrated in humans. Nor do any studies to date establish that breathing others' tobacco smoke either causes lung disease or worsens the status of patients with existing lung disease (Moore 1978) (5) What evidence there is that ambient cigarette smoke may affect CHD sufferers has been called deficient (see below). Nitrosamines A recent gimmick technique of other some researchers has been to the measure ment of the levels of specific cigarette co n mponents in various public places and then the announce ment that the nonsmoker , by merely being present, would inhale would smoke the equivalent of so many cigarettes in so many hours . Obviously the larger the estimates are, the more they are quoted by anti-smokers. One such experiment in New York was described in 1977 at a joint conference of the American Chemical Society and the Chemical Institute of Canada (Brumremann and Hoffmann 1977) (6) One of the researchers told how they had isolated tiny amounts of nitrosamines in cigarette smoke from laboratory smoking machines. So they designed an apparatus to measure the compounds also in the smoke produced between the machine's puffs (the sidestream smoke, in effect). Then they fitted the apparatus, consisting of two glass jars full of "trapping solution", some tubing and a battery-operated vacuum pump, into an attache case. And they headed, attache case in hand, first for a smoke laden smoky New York commuter train bar car and then for a small polluted metropolitan bar in the metropolitan area " frequented primarily by cigarette-smoking clientle." The amounts of nitrosamines they trapped in their glass bottles, they told their fellow chemists, indicated that customers in the bar which registered higher than the bar car in their glass bottles could have inhaled in an hour the same amount of nitrosamines as a smoker of 9 to 16 nonfilter cigarettes. Studies have measured CO in the atmosphere under more realistic conditions. Combined results of these studies indicate that CO from smoke measured in normal daily situations smoking can rarely exceed 10 parts per million (21-26) (Szadkowski et al 1976, Cole 1975, Anderson and Dalham 1973, Bridge and Corn 1972, DOT 1971, Marke et al 1974 -- all from PM white paper. pp. 13 and The maximum established by the Environmental Protection Agency in 1971 for CO in the ambient air is 9 ppm (EPA 1971). Cigarette smoke is, of course, not the only source of CO in the atmosphere. The most predominant modern source is exhaust from the internal-combustion engine (Eisenbud 1972) (27) It CO is also a natural body constituent created by normal metabolism. 1970 from SH&B 12/7/77 paper) Recently a Canadian researcher reported that high levels of CO are generated when pots and pans are placed over otherwise clean burning gas flames during the cooking of a meal (Sterling 1978) (28). Nicotine The question of nicotine absorption by nonsmokers has been investigated by some scientists. These studies, in both experimental and real-life situations, have shown that nonsmokers are exposed to insignificant amounts of tobacco smoke. In fact, when a German researcher found Klosterkotter reports that the nonsmoker takes up just only a small fraction of the nicotine, absorbed by the smoker H he concluded that "when speculating on possible health hazards by passive smoking, one may ignore nicotine ." (Klosterkotter 1977). (29). In order to discover the possible physiological effects of exposure to nicotine other researchers Hark and Bicichort (1972) recorded heart rate, blood pressure, electrocardiogram readings and skin temperature in nonsmokers in experimental present in rooms with heavy concentrations of tobacco smoke. None of these parameters was measurably affected . (30) Work Performance Any claims that tobacco smoke, or the CO in tobacco smoke, adversely affects work performance are not warranted by the evidence. The HEW 1975 report to Congress said that what evidence there is in that area is conflicting and any "psychomotor" effect of CO exposure ( one gathers the authors meant CO from all sources, not just from cigarette smoke) "remains unclear " (USPHS 1975, p. 99) (19). The Federal Aviation Administration addressed the point recently in its denial of a petition that smoking be banned in the cockpit (DOT 1977) (31). In its denial, the FAA cited conclusions of Air Force scientists on effects of abnormally high levels of (this?) CO on performance. The petition denial written by attorneys, was simplified excedingly in t The FAA news release that accompanied it. That said: occur person denial said: FAA said the information submitted by the petitioners to support their contention that smoking impairs performance "is too inconclusive to warrant the issuance of the requested rule"...FAA conceded that smoking can reduce the blood's oxygen-carrying capability capacity but said there is not evidence at present that this has any deleterious effect on performance. In fact, the agency noted that there is evidence that the body adapts to the effects of small amounts of carbon monoxide by increasing its red blood cell mass and, thus, its oxygen-carrying capability. It called the petitioners' failure to address this point a major deficiency in their argument. (DOT 1977a) (32). A National Institute s of Health panel of scientists also considered the question of cockpit smoking early in 1978 last year at the request of the Surgeon General, perhaps as the result of the FAA turndown and the FAA's view feeling that the original petition was deficient. Parent/Child Effects A favorite slogan recently of those urging legislation to restrict public smoking has been "parents" that cigarette smoke can cause respiratory disease in a child ; (Terry et al 1978). Or if they want to be more dramatic, anti-public-smokers say something catchy, like "The largest area of child abuse is parental smoking" (Kice 1977) (48). That smokers' children have more respiratory ailments because their parents smoke is strictly conjecture. Much epidemiological research has been done on the question here and abroad, but no investigatory has been able to demonstrate that cigarette smoke in the home is responsible for a child's picking up a germ or cough. Some have claimed they've proved reported that cigarette smoke may be responsible for adverse effects causes disease, in youngsters (Cameron et al 1969, Luquette et al 1970, Cameron and Robertson 1973, Colley 1974, Harlap and Davies 1974). (49-53). But their work has been questioned because of faulty study design or suspect conclusions (HSPHS 1972, 1975 1970). (19,54). Epidemiologists whose own research in smoking and nonsmoking homes in three American cities was published in 1977 (55) (Schilling et al 1977) one of them was a longtime foe of smoking wrote on the subject again in 1978 in British Medical Journal (Schilling and Bouhoys 1978). (56) Conclusions First they summarized their earlier conclusions that neither lung function nor respiratory symptoms of a nonsmoking husband or wife were affected by a smoking spouse and that parental smoking appeared to have "had" no effect on children's respiratory symptoms "or" and lug function." Then they suggested that "the only definite evidence" that parental smoking may affect children's respiratory systems was a British study (57) indicating that the infants of smoking parents have more respiratory illness during the first years of life than infants of nonsmoking parents (Colley et al 1974) (Leeder et al 1976). But, they pointed out that in the same population that this was not true in children aged 1-5 years. And they concluded that " at present there is no firm evidence that these illnesses in children under one year have a serious and lasting effect , as no excess of respiratory illness or diminish ing ed lung function has been found in the older children of smoking parents." At least four other studies have failed to demonstrate adverse effect s on children of smoking parents (58-61) (Shy et al 1970, Hammer et al 1975, Lebowitz and Burrows 1976, Kerri h bijn et al 1977). Other environmental and socioeconomic factors that have been associated with respiratory symptoms and diseases include a "cooking effect" identified in a four-year study of 5,700 youngsters in England and Scotland (Melia, et al, 1977) (62) Boys No and girls from homes in which gas was used for cooking had more coughs, "colds going into the chest" and bronchitis than children whose homes had electric stoves. The researchers concluded that products of fuel combustion might be the cause of the increased respiratory illness. PRIVILEGED AND CONFIDENTIAL Produced as required by the Court's March 7, 1998 Order State of Minnesota, et al. v. Philip Morris, et al. Court File No.: C1-94-8565 Conclusion Public smoking has not been proven to cause disease in nonsmokers. As a past president of the American Association for Thoracic Surgery As a thoracic surgeon recently testified in Illinois: An assertion that tobacco smoke is a health hazard to the normal nonsmoker is untenable. The weight of evidence as it exists in the world literature does not support a claim of adverse health effects for those exposed to "passive smoking" (Langston 1979) (63) It has been Speculat ed ing that reaction to public smoking may have psychological or emotional origin is worth considering. A medical columnist noted recently that " symptoms may come from anger rather than from the smoke itself ." (64) (Halberstam 1978). He added that: ". . . what is irritating or annoying has not yet in any scientific study been shown to be dangerous to the nonsmoker." CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION PRIVILEGED AND CONFIDENTIAL Produced as required by the Court's March 7, 1998 Order State of Minnesota, et al. v. Philip Morris, et al. Court File No.: C1-94-8565 16 References for Public Smoking