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BATCo document for Province of British Columbia 28
October 1999


CLAIMS ABOUT
ACTIVE SMOKING
PAGE
I Smoking has been proven to cause disease. 1
2 It is not credible simply to state that smoking
does not cause 3
these diseases.
3 Smoking causes lung cancer. 4
4 90 F. of all lung cancer patients are smokers;
surely this 8
indicates that smoking causes lung cancer.
5 Smoking causes heart disease. 9
6 Smoking causes emphysema and other chronic lung
diseases. 11
7 Thousands of deaths every year are caused in
this country by 13
tobacco.
8 If smoking has not been proven to cabse disease,
why do 14
doctors advise people to give up smoking?
9 Smokers die younger. 15
10 You say you spend a lot of money on scientific
and medical 16
research; however, this is small compared to your
advertising
budeet.
11 Do you think that people should practice
moderation in 17
smoking?
12 The tobacco industry could have produced a
safer cigarette 18
years ago, but did not do so because it would have
shown that
existing cigarettes were unsafe.
13 People who give up smoking have reduced risks
for certain 19
diseases compared to continuing smokers.
14 Heavier smokers are more likely to develop some
diseases than 20
light smokers (i.e., there are close-response
relationships).
15 The tobacco industry does little to rewive
health questions 21
about smoking, except to deny that smoldng is
harmful.
16 Would you like your children to become smokers
when they 22
grow up?
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CLAIMS ABOUT
ACTIVE SMOKING
17 Smoking is dangerous for pregnant women. 23
18 Would you advise a prcgnant smoker to give up
or continue? 25
19 Smoking is dangerous for women using oral
contraceptives. 26
20 You are working for a company that is selling a
product that is 27
claimed to kill peopie.
21 When government or other groups claim that
smoking is 28
harmful. they take ev;dence from scientific and
medical experts
into account.
22 Some life insurance companies charge higher
premiums to 29
smokers because they die younger. Does BAT agree
with this.
23 If pregnant women smoke, will they harm the
baby7 30
24 If smoking hasn't been proven to cause
diseases, why do 31
doctors tell us to give up?
25 Smokers should pay more for health services
because they make 32
more use of them.
SMOKING ISSUES - Claims and Responses 07,
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October 1999


CLAM 1
Smoking has been proven to cause disease.
RESPONSE
There is still a cor::--oversv about smoking and
health.
Althou-eh there is a 'statistical association'
between smoking and certain
diseases. which r-.=s that smokers are more likely
to develop lung cancer
than non-smokers. smoking has not be proven to
actually cause the diseases.
The cause could ec-~ally be one of the many other
things that smokers do that
makes them different from non-smokers.
Smokers have been reported to have quite different
lifestyles from non-
smokers. For exampie, smokers have poorer,
high-fat diets than non-smokers.
It has also been s-..;zgested that this may
explain the elevated risk of heart
disease in smokers. I
Smoking might cause diseam. or it might not.
SUPPLErVIENTARY INFORMATION
There are a number of'anomalies' in the evidence
that do not sit comfortably
with the simple theory that smoking causes
disease.
1. For examp.e. Japanese men have one of the
lowest rates of heart
disease. and also of lunz cancer, in the world.
And yet around 60 per
cent of Japanese men smoke: one of the highest
incidences in the
world.
2. Conversely. Chinese women have one of the
highest rates of lung Cri
cancer in d~e world - and yet very few of them
smoke. (Cooldng C:)
practices have been considered to be a major
influence on lung cancer
rates here.)
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BATCO document for Province of BritiSh Columbia 28
October 1999


REFERENCES
Fulton, M et al. "Cigarette smoking. social class
and nutrient intake:
reievance to coronary heart dise=". Fur J Clin
Nutr 42(9): 797-
803, 1988.
Koo., L C et al. "Active and passive smoking among
female lung
cancer patients and controls in Hong Kong". I Exo
Clin Cancer Res
367-375, 1983.
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October 1999


CLAIM 2
It is not credible simplv to state that smoking
does not cause these
diseases.
RESPONSE
We are not saying that smoking does or does not
cause these diseases: we are
saying we do not know. (See also previous
response.)
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BATCo document for Province of British Columbia 28
October 1999


CLAM 3
Smoking causes lung cancer.
RESPONSE
There is still a controversy about smoking and
health.
Although there is a 'statistical association'
between smoking and lun; cancer.
which means that smokers are more likely to
develop the disease than non-
smokers. smokine has not been proven to actually
cause lung cancer.
The cause could equally be one of the many other
things that smokers do that
ma.kes them different from non-smokers.
Smokers have been reported to have quite different
lifestyles from non
smokers. For example. smokers have poorer,
high-fat diets than non-smokers.
It has been suggested that this may explain the
elevated risk of h= disease in
smokers. It has also been suggested that this
difference in diet might affect
smokers' risk of developing lung cancer.
SUPPLEMENTARY INFOILMATION
We do not know how lung cancer develops, and so we
can't be sure
what causes it.
2. Moreover. eminent scientists have questioned
the evidence on smoking
and lune cancer because of its mary
inconsistencies and its failure to
answer such basic questions as:
Why do the great majority of "heavy smokers" never
develop
lung cancer?3 On the other hand. why do a
significant
percentage of non-smokers develop lung cancer?4
LTI
Whv don't lung cancer rates in countries such as
Japan parallel CD
cizarerte consumption? For example. in lapan
around 6076 of
men smoke but lung cancer rates are extremely low.
(N.B. C)
this is not, as frequently suggested. because
Japanese men 111J
began to smoke later than western men - Hirayarna,
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- 5 -
Lifestyle and Mortality, Karger Press 1990, noics
that the
history of smoking in Japan is a long one).
C-z!nverselv,
Chinese women in China and Hong Kong have ar.
extremely
low incidence of smoking, yet their lung cancer
-,=:! is very
hizO
Whv. after more than 40 years of research, have
scientists
failed to produce lung cancer (of the type that is
;:acistically
associated with smoking) in laboratory anim-l-'s
through
inhalation of tobacco smoke?6 They have been
su:zessful. in
producing such lung cancer using other agents.
suc:- as diesel
exhaust fumes.7
3. Cancer is a very complex disease. Many factors
have been associated
with this disease besides smoking, including
occupa"onal and
environmental exposures. diet, viruses, heredity
and stress.3 Clearly.
there are many gaps in knowledge about lung cancer
that c-ly furtzher
research will resolve.
REFERENCES
1. Fisher. R A. "Smoking. The Cancer Controversy".
Oliver and Boyde,
1959.
2. Fulton. M et al. " Cigarette Smoking, social
class and nutrient intake:
relevance to coronary heart disease". 'Fur J Clin
Nutr 42(9):797-803.
1988.
3. Herroid. K. "Survey of Histologic Types of
Primary Lung Cancer in
US Veterans". Patholoey Annu;tl 7: 45-79, 1972.
Miller. A. "Epidemiology: Problems in the Study of
Canct-s of Low
Incidence and the Need for Collaboration". I Nad
C2nce:- !nst 54(21):
299-301. 1975.
Hehlmann. R. 'Psychosomadk und Krebs
(Psychosomatics and
Cancer)". Much med Wschr
124(38):829-830,Septembe-.24. 1982. Ln
C:)
4. Enstrom, J. "Rising Lung Cancer Mortality Among
Nons.-mokers". k.,4
Nad Cincer Irist 62 (4): 755-760, April 1979.
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-6 -
5. Burci. P. "The Surgeon General's 'Epidemiologic
Criteria for
CausLity'. A Critique". j Chron Dis 36 (12):
821-836, 1983.
US P--biic Health Seryl cc, Office on Smoking and
Health, The Health
Cons11C---en----s of SmokinL,: Cancer. A Reoort of
the Surzeon Gene-,,:
1 ~IE. De-:artrnent of Health and Human Services.
DHHS (PHS) 82-
50179. 19s:. P.-U.
Segi. NI. e, al. (eds.) Cancer Mort,lity and
Morbiditv Sintistics: JaDnn
?nd World. Japanese Cancer Association, GANN
Monograph on
Cancer Rcsearch No. 26 (Tokyo: Japanese Scientific
Societies Press.
1981).
Lee. P. (ed.) Tobacco Consumotion in Various
Countries, Tobacco
Resezc~ Council. Research Paper No. 6 (4th ed.:
Edinburgh: T and A
Conszzbie Lrd. 1975).
6. Hockatt. R. Statement, United States House
Committee on Energy
and Commerce. Subcommittee on Health and the
Environment,
Sm6jn2 Prevention Education Act, Hearings, 98th
Congress, First
Session, March 9 and 17, 1983 (Washington:
Government Printing
Office. 1983), pp.841-851.
US Public Health Service, Office on Smoking and
Health, The H~nlth
Conseauences of Smokini!-. Cancer, A Rewrt of the
Surzeon Gene-71:
198'-. Devartment of Health and Human Services,
DHHS Publication
(PHS) L--!0179, 1982, p.218.
7. Mauderly. 1. 'Diesel Exhaust is a Pulmonary
Carcinogen in Rats
Exposed Chronically by Inhalation". Fundam ADiDl
Toxicol 9: 208-
221. 1987.
National Institute for Occupational Safety and
Health. Carcinogenic
effec,,s of exposure to diesel exhaust. August
1988.
8. Sterlinz. T. *Does Smoking Kill Workers or
Working Kill smokers?
or The )Mutual Relationship between Smoking,
Occupation. and
ResviraEory Disease". international Journal of
H,-.nlth Services
8(3):437,52.197/8. Ln
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7-
Macdonald, E. "Air Pollution, Demography, Cancer:
Houston,
Texas". Journ;11 of the Amerimn Medic;fl Women's
Association 31
(10): 37/9-395, October, 1976.
Kissen. D. *Possible Concenmation of the
Psychosomatic Approach to
Prevention of Lung Cancer'. Medivil Officer.
pp.343-345, December
24. 1965.
Schratizer, G. Statement, US Congress, House
Committee on Energy
and Commerce. Subcommittee on Health in the
Environmeit,
Comorehensive Smokinz Prevention Education Ac, -
Anuendix,
Hearings, 97th Congress, 114arch 5, 11, 12, 1982,
p-747.
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October 1999


CLAIM 4
90 Fe of all lung cancer patients are smokers:
surely this indicates that
smoking causes lung cancer.
RESPONSE
You have to ask yourself he converse question
here: if smoking causes lung
cancer. why do the vast rraioritv of smokers not
develop lung cancerl. and
why do non-smokers deve;op it?2 These are
questions to which science has not
provided answers.
It has not been shown that the reason why smokers
have a statistically higher
risk of developin- certain diseases is because
they smoke. Smokers have been
reported to difier from non-smokers in a variety
of ways - in their diet,
occupations. average weight, etc.3 A number of
these smoker/ non-smoker
lifestyle differences. in addition to smoking
itself, are statistically associated
with lung cancer.
REFERENCES
Miller. A. "Epidemiology" problems in the study of
cancers of low
incidence and the need for collaboration". I Nad.
Oricer Inst 54 (2):
299-301, 1975.
2. Enstrom, 1. *Rising lung cancer mortality among
non-smokers'.
Nad Cancer Inst 62 (4): ;55-760, April 1979.
3. Seltzer, C. 'Constitution and heredity in
relation to tobacco smoking".
Mn NY Acad Sci 142: 322-330, March 15, 1967.
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CLAIM 5
Smoking causes heart disea-w.
RESPONSE
'nere is still a controversy about smoking and
health.
Although there is a small 'stzdsfical association'
betweei smoking and heart
disease. which means that smokers are more likely
to deve:oo the disease than
non-smokers. smoking has not been proven to
actually cause heart disease.
The cause could equally be one of the many other
things tl~aE smokers do that
makes them different from non-smokers.
Smokers have been reported to have quite different
fliestyles from non
smokers. For example, smokers have poorer,
high-fat diets :han non-smokers.
It has been suggested that this may explain the
elevated risk of heart disewe in
smokers.
SUPPLEMENTARY INFORNIATION
1. Scientists do not really know what causes heart
disease and smoking is
only one of many possible "risk factors" that have
been associated with
it. In fact, as of 1981. nearly 250 factors other
than smoking had been
identified as statis6cally associated with heart
disease.1 These include
age, heredity, diet, cholesterol, stress and
obesity.
2. Indeed. intervendon trials which have attempted
to rest the theory that
reductions in cigarette smoking (as well as other
risk factors) will lead
to reductions in the risk of dying from coronary
heart disease have
generally failed to support the claim that smoking
is a causal factor.
For example, in the United States, the Multivie
Risk Factor
Intervention Trial (NfRFM was designed to emamine,
whether
reductions in cigarette smoking, high blood
pressure and elevated Lrl
serum cholesterol would reduce the risk of dying
from coronary heart C:)
disease.3 Although some of the participants in the
study were
successful in reducine the levels of these risk
factors. the study itself C)
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failed to demonstrace that reducing these 'risk
factors" significantly
reduces the chances of dviniz from coronarv heart
disease.4
REFERENCES
Hopkins, P and R Williams 'A Survey of 246
Suggested Coronary
Risk Factors". Atherosclerosis 40: 1-52, 198 1.
"Cigarette smoking, social class and nutrient
intake:
Fulton, M.
relevance to coronary heart disease." Fur I Clin
Nutr 42 (9): 797-
803. 1988.
Multiple Risk Factor Intervention Trial Research
Group "Multiple Risk
Factor Intervention Trial: Risk Factor changes and
Mortality Results".
1 AMA 248 (12): 14654477, 1982.
A "NIRFIT and the Goals of the Journal". JAMA 248
Lundber.-. G.
(12): 1501. September 24, 1982.
Kolata, G. "Heart Study Produces a Surprise
Result". Scienc 218:
31-32, October 1, 1982.
Oliver, M. *Does Control of Risk Factors Prevent
Coronary Hear-,
Disease?". 3r Nfed 111: 1065-1066, October 16,
1982.
Editorial, "Trials of Coronary Heart Disease
Prevention". T -ncet TI:
803-804, October 9, 1982.
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October 1999


CLAIM 6
5 moking causes emphysema and other chronic lung
diseases.
RESPONSE
7 ie origin and development of emphysema and other
chronic lun - diseases
a7 e poorly understood.1 Researchers have studied
the possible role of many
s-~.spected factors in addition to smoking,
including air polludon, occupational
e7 posures. childhood diseases, adult infections
and genedc disorders.2 But
,_~:!y have yet to find what actually causes these
diseases.
I-. their efforts to determine the cause of these
diseases. scientists have
e!---,osed experimemal animals to various
substances, including tobacco smoke.
1,-.~-_restingly, such experiments have failed to
produce emphysema in animals
ex-cosed to tobacco smoke while air pollutant
eWsure has resulted in this
d:
;,WC. 3
UFERENCES
Burrows, B. and M. Lebowitz "Characteristics of
Chronic Bronchitis
in a Warm, Dry Region% Amer Rev Resoir Dis 112
(3): 365-370,
1975.
Kilburn, K. "New Clues for the Emphysemas*. Amer
JNfed 58 (5):
591-600, May 1975.
2. Burrows, B. et al "The Relationship of
Childhood Respiratory Illness
to Adult Obstructive Airway Disease". Am Rev
Respir Dis 115 (5):
751-760, May. 1977.
Quanjer, P et al. "Epidemiological Follow-Up
Investigations of Lung
Function. SEPCR Worldng Group Meeting'. Scnnd J
Respir Dis 57: Ln
CD
Sterling. T. *Does Smoking Kill Workers or Workinz
Kill Smokers? L-4
Or The Mutual Relationship Between Smoking.
Occupation, and
Respiratory Disease". Int. J HP11th Serv 8 (3):
437452. 1978. CD
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3. Aviado, D. Statement, United States, House
Committee on Eiergy
and Commerce, Subcommittee on Health and the
Environment,
Smokine Prevention Education Act, Hearing, 98th
Congress. First
Session, March 9 and 17, 1983 (Washington:
Govemment Pmriting
Office, 1983), pp.810-831.
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CLAIM 7
Thousands of deaths every year are caused in this
country by tobacco.
RESPONSE
The kind of numbers games that result in such
numbers have no root in
scientific or medical fact: they are merely
statistical extrapolations. I and
indicate the extent to which the smoking and
health issue has become
politicised.
SUPPLEPMENTARY INFORMAMN
The simple fact is that we do not understand the
mechanisms of the
diseases that have been associated with smoking.
Until we know the
mechanisms, we cannot fully understand the causes.
It is therefore not
feasible to attribute specific deaths to tobacco.
2. There are various discrepancies even amongst
the health authorities
who quote these figures about deaths from
cigarette smoking. In
Australia, for example, figures varying from
23,500 per year down to
16.000 per year are quoted by various individual
health authorities.
3. If you take any one individual who has been
claimed to have died as a
result of smoking, and look at his lifestyle, it
is usually found that not
only was he a smoker., he was also exposed to
diesel exhaust and other
environmenud pollution-, he may have been exposed
to toxic chemicals
as a result of his occupation etc. No-one can tell
which of the factors,
if any, caused his particular dis
REFERENCES
I . Burch, P R 1. "Can Epidemiology become a
vigorous science? How LF1
big is The Big Kill?". IRCS Med Sci 14: 956-961.
1986. CD
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CLAIM 8
If smoking has not been proven to cause fisease,
why do doctors advise
people to give up smoking?
RESPONSE
Doctors are in the business of giving advice, and
that advice is usually
conservative. The conventional wisdom is to
counsel patients against
smoldne, and this is certainlv what doctors are
taught in medical school.
Doctors have to give advice to their patients,
even when the available
scientific evidence is not conclusive.
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CLAM 9
Smokers die younger.
RESPONSE
Smokers reportedly differ from non-smokers in many
ways that may affect
how lonz they live. quite regardless of whether or
not they smoke, For
example:
Smokers are more enerzetic and restless than
non-smokers
Smokers tend to marrv and divorce more often than
non-smokers
Smokers tend to change their jobs and move more
often.
Scientists do not really know why smokers'
mortality rates differ from those
of non-smokers, but some have suz-ested that the
prime determinant may be
the behavioural arid genetic nature 07the smoker
as opposed to smoking itself.
SUPPLEMENTARY INFORMATION
CWms that smokin. a cigarette shortens a smoker's
life by so many minutes
Z
or hours should be viewed with considerable
scepticism. Statements like this
have been described by some scientists as
"fanciful extrapolations". 2
REFERENCES
Seltzer. C. *Constitution and Heredity in Relation
to Tobacco
Smoking". ~.nn NY Acad Sci 42: 322-330, March 15,
1967.
2. Rosenblatt. M. Statement. United States
Congress, House Committee
on Interstate and Foreign Commerce, Cigarette
Labelling and Ln
Advertisin? - 1969, Hearing. 91st Congress, First
Session, April 15-30
and Mav 1. 1969 OVashington: Government Printing
Office, 1969),
pp. 1255-1271.
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CLAIM 10
You say you spend a lot of money on scientific and
medical research:
however, this is small compared to your
advertising budget.
RESPONSE
This is comparing chalk and che--se. We provide
funds for research that we
believe will help provide answers to some of the
questions about smoking that
still exist and the tobacco industry has spent
over US S200 million on such
research. Any sound research project carried out
in a bona fide research or
medical institution that would help us to answer
some of these questions
would have a high chance of receiving support.
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CLAM 11
Do you think that people should practice
moderation in smoking?
RESPONSE
This is a matter for individual judgement. Unlike
our opponents. we do not
presume to tell people how much or how little of
anything they should
consume or practice.
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October 1999


CLAIM 12
The tobacco industry could have produced a safer
cigarette years ago. but
did not do so because it would have shown that
existing cigarettes were
unsafe.
RESPONSE
This is pure mythology. Even those scientists who
claim that the present
product is unsafe cannot tell us why they think
so. If and when they can tell
us on sound scientific grounds that a certain
modification will enhanc-. the
safeEy of our product, then of course we would
give it very serious
consideration.
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CLAIM 13
People who give up smoking have reduced risks for
certain diseases
compared to continuing smokers.
RESPONSE
When people give up smoking, this frequently goes
hand-in-hand with other
changes to their lifestyle. They may begin to
exercise more or change their
eating habits. However, major studies have not
found that when people give
up smoking they have a reduced risk of heart
disease.
REFERENCES
I Oliver. M F. "Does control of risk factors
prevent coronary heart
disease". Br Med T 285:1065, 1982.
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CLAIM 14
Heavier smokers are more likely to develop some
diseases than light
smokers (i.e. the re are dose-response
relationsbips).
RESPONSE
Heavy smokers are likely to have other aspects of
their behaviour or li--stvle
that are different from fight smokers. Also, why
is it that many heavy
smokers don't have any problems? Again, we're into
an arm where knence
has not provided definitive answers.
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October 1999


CLADI 15
The tobacco industry does little to resolve health
questions about smoking
except to deny that smoking is har7nful.
RESPONSE
We do riot deny that smoking is harmful; we simply
believe that science has
lot yet proven whether it is or not. In fact, we
are committed to resolving the
smoldne and health controversy. We believe this
will only be accomphshed
bv solid scientific research. So far. the tobacco
industry has committed more
US S200 million world-wide for independent
research on smoking and
health questions.
SUPPLEMENTARY INFORMAUGIN
1. In fact. in the United States. in many years
the industry's funding of
smokin,, and health research has surpassed funding
by any government
department as well as the combined grants of the
major voluntary
health organisations. The industry is proud to
supply grants for
worthv research and this is done on a "no-strings"
basis. Grantees
have the complete freedom to publish, whatever the
results.
2. Through such research, valuable data concerning
lung cancer. heart
disease. chronic obstructive respir-atory diseases
and other diseases
have already been gathered. But more remains to be
learned, and the
industry's commitment will continue.
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CLAIM 16
Would you like your children to become s7nokers
when they grow up7
RESPONSE
If smoking is the worst issue that I have to
address with my children. I would
be ve-y relieved. I would like to think that my
children are able to grow up
in a society where they can make their own choice.
Smoking is an adult
choice: when they arc adults they are entitled to
make their own minds up
about smokinz as well as other aspects of their
lifestyle.
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CLADJ 17
Smoking is dangerous for pregnant women.
RESPONSE
The evidence here is incorclusi,e, and many of the
medical studies have
provided conflicting results. To date, the most
consistent information relates
to low birth rate. whe-e researchers stated that.
stafistically, some women are
more likely to deliver lower weight infants if
they smoke.
However. this claim doe5n't take into account the
fact that women who smoke
durins pregnancy also do other things that have
been associated with low birth
w6 ght. For example. women who smoke during
pregnancy may also be more
likely to drink more alcohol, caffeine, and eat a
poorer diet than women who
do not smoke. It is also important to note that
the claimed reductions in birth
weight are exuremely small (the US Surgeon General
in 1979 quoted an
average of 200 grammes) and in fact within the
normal range of birth weights
in infants: they are simply at the smaller end of
the scale. There is no
convincing evidence to suggest that infants who
are bom slightly underweight
suffer any major adverse consequences in terms of
physical or psychological
development as they become older. I
SUPPLEMIENTARY INFORMATION
L.Irnitations of child's growth and learning
ability. Limited research
has been conducted and the findings are
inconsistent.2
2. Congenital ma4rormadon. An association between
congenital
malformations and smoldng has not been confirmed
in several major
studies. Even the US Surgeon General's 1989 Report
stated that
"...maternal smoking has not been demonstrated to
be a major risk
factor for the development of congenital
malformations. "3
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REFERENCES
1. Yershalmy, 1. "Infants with low birth weight
born before their
mothers started to smoke cigareEtes-, Am I Obstet
GvnecoI 1-12 (2):
277, 284. 1972.
Bjerre, I & Varendh, G. *A studv of some
biological and socio-
economic factors in low birth wei2h[" Act- Paediat
Scnnd 61: 605-
612, 1975.
Brooke, 0. SLatement, US Congress, House Committee
on Energy &
Commerce, Subcommittee on Health and the
Environment,
"Comprehensive Smokinz Prevention Education Act",
Hearines. 97th
Congress, Appendix pp 586-590, March 5, 11 & 12,
1982.
2. Lebowitz, M. "Smoking During Pregnancy:
Long-term eff ", on
Offspring". Develop Psychol 17 (2): 192-194, 1981.
Fogelman, K. "Smoking in Pregnancy and Subsequent
Development
of the Child". Child: C-e. Hf-Ith -nd Develooment
6: 2-13-249,
1980.
3. Evans, D et al. 'Maternal smoking habits and
congenital
malformations: a population study". Dr Med J 11
(6183): 171-1-73, July
2-1, 1979.
Underwood, P B et al. "The relationship of smoking
to the outcome
of pregnancy*. Am J Obstet Gvnecol 91: 270, ]an
15, 1965.
McDonald, A D et al. *Congenital defects and work
in pregnancy'. BE
J Industr Med 45: 581-588, September 1988.
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CLAIM 18
Would you advise a pregnant smoker to give up or
continue?
RESPONSE
It would not be appropriate for us to provide
medical advice to individuals.
Smokers should consult their doctors about these
issues, and then decide on
the most appropriate course of action.
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CLAM 19
Smoking is dangerous for women using or2l
contraceptives.
RESPONSE
The data that led to the claim that women who both
smoke and use cral
contraceotives have a hip-her risk of heart
disease or other diseases such as
thrombosis have been criticised as being
statistically and scientifically
inadequate. I Taken as a whole.. the evidence on
this issue is conflicting.
R~EFERENCES
Statements by Cox, G; Dickinson Gibbons, J;
Kastenbaun, M; Budne.
T: US Congress, House Committee on Govemment
Operations,
Subcc)mmittee, Quality of Scientific Evidence in
FDA Regulatory
Decisions (The Adoption of an Anti smoking Warning
in Oral
Contraceptive Pill Labelling), Hearing, 95th
Congress, 2nd Session.
Washington DC, US Government Printing Office,
October 4 1978.
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CLAEq20
You are working ror a company that is selling a
product that is claimed to
kill people.
RESPONSE
Smoking has not been proven to kill people. We are
providing a product that
people want to buy in full knowledge of the
controversy surrounding it.
There are few industries whose products or
processes have not been criticised
for public health reasons.
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CLAal 21
When government or other groups claim that smoking
is harTnful. they
take evidence from scientiric and medical experts
into account.
RESPONSE
It is important to understand that this whole
issue is a matter of continuing
controversy.
There art eminent scientists around the world who
believe that there are a
number of unanswered ques6ons in the area of
smoking and health and would
reeard the current evidence as inadequate to
establish that smoking is a cause
of disease. Many such scientists have published
their views over the years,
and many more have testified at US Congressional
Hearings to this effect. I
We frequently find that claims made against
smoking do not accurately reflect
the results of the scientific studies and reports
upon which they are apparently
based.
RESPONSE
See Appendix 1.
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CLAIM 22
Some lire insurance companies charge higher
premiurns to smokers
because they die younger. Does BAT agree with
this?
RESPONSE
We agree as long as they are not claiming that
smokers die younger becaus
they smoke! In fact, the reduction in premiums for
non-smokers is based on
the staristical observa6on that smokers are more
likeiv to die slightly earlier
than non-smokers. However, it is important to
understand that this is a
purely statistical observation and does not lead
to the conclusion that smokers
die younger because they smoked. Smokers and
non-smokers differ in many
ways, including their lifestyle and diet. and it
would not be possible to
determine whether smoking or any of these other
factors was the most
important.
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CLAIM 23
ir pregnant -omen smoke. will they h2rm the baby7
RESPONSE
The medical evidence on smoking during pregnancy
is conflicdng, and
confused by the fact that women who smoke during
pregnancy usually
continue with other behaviours that have been
considered to be 'risk fictors'
for complicaticns during pregnancy e.g. drinking
coffee and alcohol, having a
less 'healthy' diet.
In the case of pregnancy. however, it is
recognised that many pregnant
women choose to avoid certain publicised risk
factors, even if those risk
factors have not been proven to be harmful. For
that reason, therefore, many
women choose not to smoke during pregnancy.
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CLAIM 24
If smoking hasn't been proven to cause diseases,
why do doctors tell us to
give up?
RESPONSE
Doctors are in the business of giving advice, even
when the available
scientific evidence on an issue is not conclusive.
For that reason. many
doctors choose to err on the side of caution, not
just with smoking, but with
other claimed risk factors for disease e.g.
cholesterol, alcohol.
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CLAIM 25
Smokers should pay more for health services becauw
they make more use
'If them.
RESPONSE
7.-.is claim is based on the belief that smoking
has been proven to be a cause
c-' disease. This is not the case and there is
still a controversy about smokinz
z:.d health. Ultimately, both smokers and
non-smokers die. and many of both
amups will require hospital treatment. For all the
diseases that are claimed to
te associated with smoking, there are many factors
other than smoking that
".,e been considered to be risk factors. It is
simply not possible to apportion
a specific percentage of these deaths to smoking
or any other factor.
Rcial services such as medical care are set up to
provide the greatest benefit
= the total population, not on a 'pay as you use'
basis or for selected groups.
Ctherwise, all persons known to require more
medical attention, such as
t_:abetics. obese people or sportsmen, would be
required to pay more.
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USEFUL QUOTAMNS 0,NACTrVE SMOKING
"... Statistical methods cannot establish proof of
a causal relationship
in art association. The causal significance qt -an
assocz .an.on is a
matter ofjudzemenr which goes beyotid any
statement of statistical
probability. '
US DHEW
Criteria for jud :gement: Smoldng and Health:
report of the
advisory committee to the Surgeon General of the
Public
Health Service. PHS publication no.1103. chapter
3, 17-21,
1964.
'It is often suggested that the incidence ofcancer
and coronary heart
disease (CHD) could be much reduced or even
eliminated ~f only
people ceased to smoke cigarettes and reduced
their cholesterol level
through appropriate eating.
The evidence suggests that such views are sim
,olistic and unrealistic
and that cancer and CHD are the product of many
risk factors acting
synergistically.
Professor Hans Eysenck
Smoking, Personality and Stress: Psychosocial
Factors in the
Prevention of Cancer and Coronary Heart Disease.
New York, Springer Vcrlag (1992) p. vii.
... an e-Tplanarion ofhealth problems in terms
ofsimple causation by
smoking is no longer plausible. Other
alternatives. including
personality, stress, genetic factors, and general
lifestyle as leading to
health problems... must now be considered more
plausible than
smoking. *
J. Wakefield
Results and methodological quality of smoking and
health
studies.
Personality and Individual Differences (1988) 9 p
465-477. Un
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'As ue are all it-ell aivare, many eminenr
persons, committees and
commissions have unanimously concluded thar lung
cancer 'is cimost
entirei.y due to cigarette smoking'. I once shared
that view, but having
now snidied the evidence in more derail and from
new angles I feel
unable to reach a definitive conclusion,
apariftorn rejecting the
causal rheorv. '
Professor Philip Burch
Smoking and Lung Cancer: the Problem of Inferring
Cause~
I R Statist. Soc A (1978) 141, Part 4, pp437-477.
'In our need to understand, to explain, and to
treat, the remptaron to
impute causality to association is pervasive and
hard to resist. It 's the
most i.rnporrant reasonfor error in medicine.
P. Skrabanek, J. McCormick. Follies and Fallac'es
in
Medicine. Pergamon Press, 1989.
'It is the infimation by epidemiologists that they
hold the key to the
causes of diseases and their prevention which
makes them overstep
their briefandjoin the moralists in their
preaching how to avoid death
by being good, clean-living citizens. '
P. Skrabanek, in: Health, Lifestyle and the
Environment,
Counterinz the Panic. The Social Affairs Unit/
Manhattan
Institute, 199 1.
... diseases such as lung cancer, chronic
bronchitis, and ischaemic
heart disease, which have been linked
epidemiologically with smoking,
develop over a long period as a result of the
comple-r intertwining of
internal factors, such as ageing and heredity
predisposition. vvith
external factors arising from an individual's
lifestyle, occupation and
residential environment... Thus, while a possible
risk of smoking to
the pkysical health cannot be denied, at the
present stage it Is difficult
to single out smoking or any other occurrence as a
specific riskfactor
and establish direct causaliryfrom it.
Kasuga H. et al
Smoking and Health: a review prepared by the
Smoking and
Health Subcommittee of the Tobacco Industries
Council, a
Council formed by the Minister of Finance of
Japan.
Int. J. Addictions (1991) 26 (4) pp 423-440.
SMOKING ISSUES - Claims and Responses
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'Post-morTem studies ofthefrequency oflung cancer
show that the
most imporronrfacror in the increase ofrecorded
lung cancer has been
clinical diagnostic error. Severe under-diagnosis
during the earlier
part ofthe cenrurv was eventuallyfollowed, in the
past decade or so,
by over diagnosis. ,
Professor Philip Burch
Smoking and Health
British Medical Journal (Ian 15 1977) 1 p 16-5.
'It has been Droven beyond any shadow ofdoubt that
smoking is a
preferred cause ofsrarisrics'.
Anon. in T. Voss: Smoking & Common Sense.
Peter Owen. 199 1.
'Although there is an immense amount of
literature. reliable
researchers are always coming to the conclusion
that we know too little
to be able to givefinal, categorical statements
about the effects of
smoking, and ofpassive smoking. F-stimares,
suppositions and
unproven theories dominate the debate - they are
the result ofbelief
rather than science. *
T. Voss. Smoking and Common Sense.
Peter Owen, 1991
'Riskfacrors have nothing to do with causes. 77iev
are risk markers,
but they are neither sufficient nor necessary to
erplain the risk. 7-1?us,
for example, the possession of a driving license
is a risk marker for
death in a car accident, marshes are a risk
markerfor malaria, and
homose-rualir'v a risk markerfor AIDS. 77ze
knowledge of risk markers
rarely, ifever, contributes to the elucidation
ofcausal mechanisms. '
P. Skrabanek. in: Health, Lifestyle and the
Environment,
Countering the Panic. The Social Affairs Unit/
Manhattan
Institute, 1991.
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M-- TCo document for Province of British Columbia
28 October 1M-**


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CLAMS ABOUT ADDICTION
PAGE
I Smoking is addictive; smokers can't quit because
thev're I
addicted to nicotine.
2 Smoking is an addiction comparable to heroin and
cocaine 3
addiction.
3 Smoking must be addictive because people carry
on smolcing 5
even when they're told it may be harmful.
4 Tobacco industry employees are no better than
drug-pushers. 6
5 Tobacco smoking leads to illicit drug use. 7
6 It has been claimed that the tobacco industry is
adding nicotine 8
to its cigarettes to keep smokers addicted. What
do you think
of the proposal that cigarettes should be
classified as drugs and
be regulated by organisations such as the FDA in
the USA!
(JI
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October 1999


CLAIM I
Smoking is addictive: smokers can't quit
because they're addicted to
nicotine.
RESPONSE
Millions of smokers all around the world have
given up smoking. ~ichout any
difficulty or specialised help. I
You on1v have to look at the difference between
smokers and Ehe avenze
heroin or cocai.ne addict to realise how
ridiculous it is to compa:.- smoking
with hard drugs.
SUPPLEMENTARY INFORMATION
1. Smokers do not experience most of the symptoms
of 'addiction': there
is no standard withdrawal syndrome or physical
dependence, and
unlike all other 'addictive' substances smo;dng
does not lead to
intoxication or euphoria. Smoking does not lead to
any kind of
deterioration in social or occupational
functioning, as happens with
addiction to alcohol or heroin.
2. To claim that smoking is like hard drug use
trivialises the real problem
of drug addiction by putting such a large
percentage of the population
in that category.
3. The term 'addiction' has been used in so many
different ways that it
has become meaningless. For example, people say
that they are
addicted to chocolate, or to soap operas,or video
games.
Even the US Surgeon General, who claimed in 1988
that smoking was
addictive, had previously claimed that children
were addicted to video
games.
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2-
REFERENCES
I US Department of Health and Human Services
(1989), Reducing the
Health Consequences of Smoking: 25 Years of
progress. A Report of
the Surgeon General. DHHS Publication No. (CDC)
89-8411. US
Government Printing Office, Washington, DC, p 4.
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3 -
CLAEVI 2
Smoking is an addiction comparable to heroin and
Cocaine addiction.
RESPONSE
T"his cWm received a great deal of publicity -hen
it appeared in the 1988 US
Surgeon General's Report. 1 Howe,,er. this example
of anti-sm&"ne e--cess
was quickly challenged by scientific and medical
experts both in Cht US and
Europe.
You only have to look at the difference between
smokers and u~a averaze
heroin or cocaine addict to realise how ridiculous
it is to compa7! smoking
with hard drugs.
SUPPLEMENTARY INFORMATION
Smokers do not experience most of the symptoms of
'addiction': there
is no standard withdrawal syndrome or physical
depend.-:,cc, and
unlike all other 'addicfive' substances smoking
does not lead to
intoxication or euphoria. Smoking does not lead to
any kind of
deterioration in social or occupational
ftincdoning, as har;ens with
addiction to alcohol or heroin.
About 2 months after the 1988 US Surgeon General's
Report
appeared, its conclusions were sharply crificised
d,-,-4ng US
Congressional Hearings. Both a psychiatrist and a
psycholopt argued
that the Report used an overly broad definition of
addic-ion and
narrowly focused on selected and flawed studies.
In addidon. they
noted that the Report ignored. the clinical
perspective. which =ognises
fundamental differences between smoking behaviours
and drug
addictions.
3. A British psychologist at the University of
Reading provided a more
detailed analysis of the Report's claim. He
concluded that the Surgeon
General "ignored the discrepancies in his
enthusiasm to find criteria to
compare nicotine use with heroin and cocaine use.*
In summairising his ~_n
position regarding the Surgeon General's attempt
to equate smoking CD
with heroin addiction. he stated that *the most
important measure for a
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scientific claim is experimental verification, not
political
pronouncements. however masterful."2
4. The Report's conclusicns were also attacked by
other experts in the
area. Professor Albert Hirsch of the University of
Paris, a well-known
anti-smoker, argued that tobacco cannot be
compared to drugs.
especially hard drugs like heroin or other
narcotics. He cautioned
against using "misstatements or distortions of the
truth" and urged
resisting "the kind of discrimination and
witch-hunt that can be
observed in some of the excesses of the
anti-tobacco campaign in the
United States. "
REFERENCES
US Department of Health and Human Services, Public
Health Servicc,
Office on Smoidng and Health. "The Health
Consequences of
Smoking: Nicotine Addiction. A report of the
Surgeon General";
1988, Public no DHHS (CDC) 88-8406, Washington DC,
US
Government Printing Office, 1988.
2. Warburton. D M. "Is Nicotine Use an Addiction?*
The Psvcholozist
4 : 166-170, 1989.
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5 -
CLAIM 3
Smoking must be addicti,;e because people carry on
smoking even when
they're told it may be har7nful.
RESPONSE
People smoke primarily because they enjoy it.
People are constantly receiving information in the
press and from their doctors
that certain types of behaviour may have a risk
associated with them. It is
then their individual decision whether to accept
the claimed risk. if they
choose to do so it does not m= they are addicted.
SUPPLEIMENTARY INFORMATION
Many people consume butter and dairy products even
though they have
been claimed to cause heart disease; people still
buy food with
additives that they have been told may be harmful,
they still ride
motorbikes. fly Ln planes and go hang-gliding even
though they have
been told these acdvities are risky. It is their
individual choice. It
does not follow that they are addicted to these
activities; they simply
enjoy them.
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6-
CLAIM 4
Tobacco industry employees are no better than
drug-pushers.
RESPONSE
This suggestion is offensive. Cigarettes are legal
products purchased by
millions of law-abiding people. The industry's
legitimacy is endorsed by
governments who gather a considerable amount in
revenue from taxes on the
product. Similarly, governments in many countries
around the world,
including much of Europe (Spain. Italy, France.
Portugal) are themselves in
the tobacco business through state-owned
monopolies. Hard drugs are illegal
and those involved in their sale are involved in
an illegal act.
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CLAIM 5
Tobacco smoking leads to illicit drug use.
RESPONSE
This is pure misinformation and. moreover,
illogical - why, then. are so few
tobacco smokers also drug users? Most smokers do
not go on to use illicit
drugs.
In many studies, cigarette smolcing has not been
reported to be a useful
predictor of later illicit drug use.
REFERENCES
O'Donnell, I A. *Cigarette smoking as a precursor
of illicit drug use".
In: Cigarette Smoking as a Dependence Process, N A
Krasnegor (ed),
National Institute on Drug Abuse, Research
Monograph 23,
Publication no. DHEW (ADM) 79-800, Washington DC,
US
Government Printing Office, Chapter 4, 30-43,
1979.
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CLAIM 6
it has been claimed that the tobacco industry is
adding nicotine to its
cignrettes to keep smokers addicted. What do you
think of the proposal
thnt cigarettes should be classified as drugs and
be regulated bv
organisations such as the FDA in the USA?
USPONSE
So outrageous are these claims that one US tobacco
company (Philip Nto M.'s)
filed a S 10 billion libel suit against ABC who
broadcast the TV programme
which originally carried the claim.
BAT does not believe that smoking is addicdve.
Nfilfions of smokers have
given up smoking without the need for specialised
help.
The cWm that we increase the nicotine levels in
our cigarettes is also untrue.
Nicotine occurs naturally in tobacco and some is
actually lost during the
manufacture of cigarettes. It is also the case
that the nicotine content of
cigarettes in the US and some other markets has
declined considerably over
the past 40 years, primarily due to consumer
preferences.
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USEFUL QUOTATIONS ONADDICTION
'The data supporting the proposition [that
cigarette smoking is
addictivel are not parricularly good; in fact,
looked at with a ruthless
eye, they are rorherflimsy.
S. Schachter. NIDA Research Monograph 23,123,
1979.
7 t is tacirN assumed.. that smoking is basically
a fonn of nicotine
dependence. There is verv little hard evidence to
support such an
hypothesis. '
R. Kumar. Electrophysiological Effects of
Nicotine. :15
(Remond & Izard. Elsevier), 1979.
Wicotine is not like other so called 'addictive'
substances and h--s 2ow
abuse potential. '
D. M. Warburton Nicotine and the Smoking Habit.
l9S:.
'The e-Tperimerual evidencefor rite development
ofnicotine dependewe
in human smokers is not good. '
D. J. K. Balfour. International Encyclopedia of
PharmacDiogy
& Therapeutics Section 114, pl01 Nicotine and the
Srnoidng
Habit, t984.
'One of the most owsranding researchers in
tobacco. Dr. St=L-,v
Schachter.. said, and I quote from a government
publication. ,Most
of us who do research on smoking have at some time
championed ile
hypothesis that cigarette smoking with nicotine as
the active ag--.-i is
an addiction... when scientists are asked to wigh
the evidence --*h
care in terms of the long term implications, they
generalky agree that
we have a long way to go before we can give
sciendflc support :0 *e
statement, cigarette smoking is addictive. -
*Cigarette smokers are very attached to their
smoking behaviour.. I
have also noted people have equally strong
attachments to m-ids,
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:ogging, =74v, rock music, Coca-cola, members of
the opposite ser,
bind har;&urgers... one sees very strong
attachments to playmates,
.:srents. certain articles ofclothing, TV,
blankets, and teddy bears. *
T. H. Blau. 1982 Waxman Hearings, pp 487-494.
(Hearings
before the House Committee on Energy and Commerce,
Subcommittee on Health and the Environment.
Regarding the
"Comprehensive Smolcing Prevention Act").
7.:bacco does nor induce the acute behavioural
toxicity that is seen
alcohol. opiates, amphetamines, cocaine. and
hallucinogens...
are no reports of acute faral tobacco overdosage
as a result of
-,-Taking or induced aberrant behaviour. '
J. H. Jaffe, NI. KanzIer. NIDA Research Monograph
23,12
(19-19).
7 ze presence of an abstinence syndrome is cruciai
to the definition of
i-lug dependence... reluctance to label tobacco as
a dependence-
'--roducing substance rests on doubts concerning
the existence of a
:obacco withdrawal syndrome. '
S. M. Schiffman, NIDA Research Monograph 23, 159.
1979.
7,nere is no evidence from human studies to
support the notion that a
consistent characteristic withdrawal syndrome
occurs in all. or even
wsr individuals who discontinue smoking.
P. S. Larsson. H. Silvette
Tobacco Experimental and Clinical Studies Suppi 3
(Baltimore
Williams & Williams), 1975.
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BATCo document for Province of British Columbia 28
October 1999


CLAIMS ABOUT SOCIAL
COSTS
PAGE
Smoking causcs social costs.
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SMOKING ISSUES - Claims and Responses
BATCo document for Province of British Columbia 28
October 1999


CLAIM 1
Smoking causes social costs.
USPONSE
These claims are based on the belief that smoking
has been proven to cause
specific diseases. However, there is still a
controversy about smo;~ng and
healthcare. It is simply not possible to state
with certainty that a given
perceitage of healthcare costs, for example, can
be attributed to smoking.
because no one can be sure what exactly causes the
diseases in question. For
all those diseases, there are many factors apart
from smoking that have been
statiWcally associated with them.
(A social cost results when an individual's
actions or behaviour
imposes a cost on society as a whole. The "social
costs" alle edly attributable
to tobacco use are said to include, among other
things, lost producdon
because smokers produce less than non-smokers and
health care expenses
because smokers have higher medical bills than
non-smokeTs].
SUPPLEMENTARY INFORMATION
Smokers contribute a considerable amount to the
revenue of most
countries around the world through taxation of
tobacco products.
Without this revenue, it could be argued that the
burden of health care
costs would be greater.
2. Some researchers who have analysed such claims
contend that blaming
smoking is an oversimplified attempt to resolve an
extremely complex
situation. They point out that the body of
literature used to support
such claims is inconclusive, contains
inaccuracies, and relies on
incorrect assumptions. I For example, these
studies fail to take into
account other considerations, such as occupation,
income. educational
levels, and geographic data, all of which may
affect the validity of the
conclusions.
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3. These problems are illustrated by analysing the
claim that smokers am C)
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less productive at the workplace than non-smokers.
A U.S. study
which examined' productivity in the workplace
reported that smoking
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BATCO doCUrnent for Province of BritiSh COIUMbia
28 October 1999


was seldom mentioned as a factor when productive
and unproductive
employees were compared. Smoking or not smoking
was not among
the traits listed.2 In fact, researchers at one
university reluctantly
reported that among the professional workers thev
studied, the
smoking workers tended to be more productive than
the non-smoking
workers.3
4. Such inconsistencies also appear in analysing
the claims that smokers
miss more work than non-smokers. This claim
overlooks a number of
outside factors in assessing the rates and causes
of absenteeism ranging
from job satisfaction to commuting problems.
Indeed, a recent study
udlising US health statistics concluded that usage
of tobacco had no
si2nificant effect on absentecism.4
5. Attempts to regulate a person's decision
whether to smoke based on
another person's concept of that habit's cost to
society is simply a
method of using public policy to enforce one's
personal preference on
others. Such a philosophy will not create a better
society but will
diminish each citizen's right of free choice.
6. Many people have suggested that smokers should
pay more in taxes
and insurance to offset the cWmed increase in
health costs they incur.
However:
(i) social services such as medical care are set
up to provide the
greatest benefit to the total population, not on a
"pay as you
use" basis or for selected groups. Otherwise, all
persons
known to require more medical attention. such as
diabetics or
sportsmen, would be =ed more heavily.
(ii) studies have equally suggested that smokers
incur fewer health
costs than non-smokers over a lifedme.5
REFERENCES
Tollison, R and Wagner, R. Smokinir ;%nd the
Stnte: Soci;;l Costs.
Re-it Seekine. ;1nd Public Policv (Lexington, MA:
Lexington Books.
D C Heath and Co. 1988).
SIMOKING ISSUES - Chtirns and Responses
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2. Response Analysis, Over;,11 Ret)ort: Smokine
and Productivitv in the
Workolace, Conducted by Response Analysis
Corporation, Princeton,
New Jersey, June 1984.
3. Slovut, G. "Study Finds Productivity Is Helped
By Smoking'.
Minnewolis Sf.r;ind Tribune, Tuesday, October 23,
1984.
4. Bonilla, C. Determivrice of Employee
Absenteeism (Washington:
The National Chamber Foundation, 1989).
5. Woodfield, A. *Cost Benefit Analysis of
Consumer Policy:
Framework and Critique'. 6n;dvsis of Consumer
Policy, University
of Pennsylvania, Philadelphia. Wharton applied
Research Center, 29-
26. 1981.
Kramer, W. 'A Bonus for Smokers?" Per Spiezel 17:
213-215, Apr~!
25. 1983.
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October 1999


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CLAIMS ABOUT
CONSTITUENTS
PAGE
The 'tar", nicotine, and carbon monoxide in
tobacco smoke are
dangerous.
Cigarettes with low 'tar" and nicotine are safer.
Tobacco smoke contains toxic and cancer-causing
chemicals.
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October 1999


CLAIM 1
The "tar", nicotine. and carbon monoxide in
tobacco smoke are
dangerous.
RESPONSE
Tobacco smoke constituents may be among the most
heavily researched
substances in the world. Despite this, no
constituent. at the levels found in
tobacco smoke, has been scientifically proven to
cause human disease.
SLTPLENIENTARY WFORNIATION
"Tar's- Concern about "tar" is primarily due to
early experiments in
which this artificial substance was painted on the
shaved backs or ears
of experimental animals. These so-called
skin-painting experiments
prompted a great deal of interest, as the tumours
which appeared after
the painting have been said to be evidence that
turnours might develop
in the lungs of smokers. However, the scientific
value of these
experiments has been seriously questioned for many
reasons, including
the fact that the skin and ears of laboratory
animals are not similar to
human lung tissue and because extremely high
concentrations of *tar" -
equivalent to smoking over 100,000 cigarettes a
day - were used.2 The
more relevant experiments with animals exposed to
tobacco smoke
through inhalation have not produced human-type
lung cancer. 3
[Actually, there is no such thing as "tar" in
tobacco smoke. *Tar" is a
laboratory product obtained by collecting the
particulate matter in
tobacco smoke, either by passing cigarette smoke
through a cold trap
at extremely low temperatures or by using filters
in a drawing process.
Obviouslv. material collected in this way hardly
duplicates what people
are exposed to when they smoke.4] U-1
2. Nicotine: Nicotine and its by-products are
rapidly eliminated from the C:)
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body.5 Consequently, it is not surprising that
nicotine has been
described as having no known chronic or cumulative
effects.6
r1 i
Despite this. claims are still made that nicotine
causm heart disease.
However. no-one has demonstrated a biological
mechanism by which
SMOKING ISSUES - Claims and Responses
BATCo document for Province of BritiSh Columbia 28
October 1999


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nicotine is involved in heart disease.' Moreover,
animal and human
studies have fadled to scientifically establish
that nicodne causes
cardiovascular disease.8
3. Carbon monoxide: CO is a tasteless, odourless,
colourless gas found
in cigarete smoke as well as in many natural and
manmade sources.
including automobile exhaust and industrial
emissions.9 Consequently.
CO has received a lot of attention in the
scientific literature,
particularly with regard to heart disease.
However, the levels of CO
in tobacco smoke are reported to be relatively
insignificant when
compared with amounts generated by other sources.
A number of
specialists who have reviewed the large amount of
literature available
have concluded that the relationship between CO
from cigarette smoke
and human heart disease, if any, remains
undetermined. 10
REFERENCES
Okun, R. Statement, United States Senate Committee
on Labor and
Public Welfare, Subcommittee on Health, CiVrette
Smoldne and
Nsease. 1976, Hearings, 94th Congress, 2nd
Session, February 19,
March 24, and May 27, 1976 (Washington: Government
Printing
Office, 1976), pp.152-167.
Macdonald, 1. Statement, United States House
Committee on
Government Operations, Legal and Monetary Affairs
Subcommittee,
False and Nfisleadine Advertisinz (Filter-Tio
Ciff;lmttes), Hearings,
85 th Congress, First Session, July 18, 19, 23,
24, 25 and 26, 1957
(Washington: Government Printing Office, 1957),
pp.224-240.
Hockett, R. Statement, United States House
Committee on Energy
and Commerce, Subcommittee on Health and the
Environment,
SmokinL, Prevention Education Act, Hearings, 98th
Congress, First
Session, March 9 and 17, 1983 (Washington:
Government Printing
Office. 1983), pp.841-851.
US Public Health Service, Office on Smoking and
Health, The H-alth
Consecuencesof5moldnFuCancer.
ARewrtoftheSurveonGeneral- UI
IM. Department of Health and Human Services, DHHS
Publication CD
(PHS) 82-50179, 1982 p.218.
NJ
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4. US Pubi': *-lealth Service, The H-11th
Consecuences of Smoking. A
Ret>orT c-' The Sur2eon Genern): 1972, Department
of Health,
Educaticn, and Welfare, Washington, DHEW
Publication No. (HSM)
71-7516. P.141.
5. Schie%-e:*-.!-.n. H. "Nicofine, Rmrption and
Fate". Ph,-macol Exq
18 (2): 1982.
Benowitz. .1; et a]. "Inter- individual
Variability in the Metabolism and
Card iovasc-.;1ar Effects of Nicotine in Man". I
Ph:;rmacol Exo Ther
221 (2): 34-8-372, 1982.
Jacob. P e: al. "Recent Studies of Nicotine
Metabolism in Humans".
Pharmacc; Biochem Behav 30 (1): 249-253, 1988.
6. Hockeu. R. Statement. United States Senate
Committee on Labor and
Public Wtifare, Subcommittee on Health, CiLnrette
SmoldnLz :'rid
Dise-3-;e. i?76, Hearines, 94th Congress, 2nd
Session. February 19,
March ';-!. and May 27, 1976 (Washington-
Government Printing
Office. 19-:6), pp.146-151.
Hine, C. Statement, United States Senate Committee
on Labor and
Public W!ifare, Subcommittee on Health, Cienrette
SmokinL7 :%nd
Disease. 1976, Hearings, 94th Congress, 2nd
Session, February 19,
March 7-4. and May 27, 1976 (Washington:
Government Printing
Office. 1976), pp.127-145.
7. US Public Health Service, Office on Smolcing
and Health. The H-1th
Conseviencts of Smo)dnL,: Cardiowltrular Dispn-;c.
A Renort of the
Surzeon Cenernl: 1983, Department of Health and
Human Services,
Washinemn DHHS Publication No. (PHS) 84-50204,
1983, pp.50,
229, 2-3-0.
US Pubiic Health Service, Centers for Disease
Control. Center for
Chronic Disease Prevention and Health Promotion,
Office on Smoldng
and Hea~-tln. Feducinz the H-Ith Conseauences of
Smoldne: 25 Y-r3
9 f Proirress. A Report of the Surs!eon Generni:
1989, Department of LF1
Health ird Human Services, DHHS Publication No.
(CDC) 89-8411, CD
Prepublication Version. January 11, 1989, pp.60.
61.
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8. Schievelbein, H and Heinemann G. "Nicotine and
Atherosclerosis*.
Lktherosclerosis VI: Proceedings of the Sixth
Inwrnationpi Sym sium,
I p0
ed. F Schettler et a] (Berlin: Springer-Verlag,
1983), pp.899-9Cr,,.
Fisher, E. Statement, United States House
Committee on Energy and
Commerce, Subcommittee on Health and the
Environment, Smoking
Prevention Education Act, Hearings, 98th Congress,
Ist Session.
March 9 and 17, 1983 (Washington: Government
Printing Office.
1983), pp.406-423.
9. Wakeham, H. "Environmental Carbon Monoxide from
Cigarette
Smoking - A Critique". Prev Med 6: 526-534, 1977.
10. Weir, F. and Fabiano, V. 'Re-Evaluation of the
Role of Carbon
Monoxide in Production or Aggravation of
Cardiovascular Disease
Processes". J Occqp Med 24 (~: 519-525, 1982.
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October 1999


CLAIM 2
Cigarettes with low "tar" and nicotine are safer.
RESPONSE
Many varieties of low %ar' cizart-tes are now on
the market. This is in
response to increased consumer demand for this
type of cigarette which
probably developed from media at!2ndon given to
these products and from the
public's growing preference for 'lighter' products
including low calorie foods
and beverages.
Numerous governments. anti smokers and and smoldng
groups, and health
associations may have led smokers 0 believe that
smoking low "tar* cigarettes
is preferable to smoking higher 'tar" cigarettes.
Indeed, several of these
organisations have at times publicly encouraged
smokers to switch to low
delivery cigarettes. They claim that such
proposals are based on scientific
studies but these studies have reported widely
different conclusions.1 It should
be remembered that no type of cigarette, no matter
what levels of "tar* and
nicotine, has been scientifically established as
harmful or harmless.2
REFERENCES
US Public Health Service. Office on Smoking and
Health, The Hf-;,Ith
Consecuences of Smoldne: C;;rdiovit-ul;-,- Dis--.
A Re0ort of the
Surzeon Gener;%I: 1983, Department of Health and
Human Services,
Washington, DHHS Publication No. (PHS) 84-50204,
1983, p.43.
US Public Health Service. Office on Smoking and
Health, The H-Ith
Consequences of Smoldne: Chronic Obstructive Lunt
Dis--. A
Reoort of the SurLeon Geie-il: 1984, Department of
Health and
Human Smices. Washinaton. DHHS Publication No.
(PHS) 84-
50205, 1.984, P. 12.
SMOKING ISSUES - Claims and Responses
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US Public Health Service, Centers for Disem
Control, Center for
Chronic Disease Prevention and Health promotion,
Office on Smoking
and Health, ReducinL, the H-1th Consequences of
Smokinz- 25 Y--,rs
of Prozi-ess. A Renort of the Surgeon Genevil:
1989, Department of
Health and Human Services, D14HS Publication No.
(CDC) 89-8411,
Prepublication version, January 11, 1989, p.486.
Okun, R. Statement, United States Senate Committee
on Labor and
Public Welfare, Subcommittee on Health, Cignrette
SmokinE -id
r)isease. 1976, Hearings, 94th Congress, 2nd
Session, Febnjary 19,
March 24, and May 27, 1976 (Washington: Government
Printing
Office, 1976), pp.152-167.
Worden, A. 'Tobacco and Smoking Products*. ne
Fjture of
Predictive Safe~v Ewduation, Volume 2, eds. A
Worden et al.
(Lancaster: MTP Press Ltd, 1987), pp.283-295.
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CLAIM 3
Tobacco smoke contains toxic and cancer-causing
chemicals.
RESPONSE
Virtually ail of the chemicals in tobacco are
present in the air we breathe. or
in water or the diet from other sources. They are
unavoidabie. whedier or not
you smoke.
Even nicotine, commonly thought by people to be
unique in tobacco smoke, is
present in many vegetables (e.g., tomatoes,
aubergines) and so people will
take in nicotine from their diet.
It is often said that individual chemicals in
tobacco smoke are toxic or are able
to cause cancer. However, when laboratory animals
are exposed to whole
cigarette smoke by inhalation, studies have not
generally found that it causes
cancer.
Most of the chemicals claimed to cause cancer have
been classiried as toxic or
cancer causing on the basis of studies in
laboratory animals, not on the basis
of studies in humans. In most of these experiments
animals are given doses
tens or hundreds of times higher than the level in
cigarette smoke. and usually
the animals do not inhale it - it may be injected
into the stomach or skin. or
painted onto the backs of mice. This is hardly a
suitable model for human
smoking.
REFERENCES
TARC Monographs on the Evaluation of the
Carcinogenic Risk of
Chemicals to Humans. No. 38. IARC. 1986.
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October 1999


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October 1999


CLAIM I
%N'h,v do vou add chemicals to the tobacco?
RESPONSE
The distinct blend of each tobacco product has
been developed over many
years in response to consumer tastes and demands.
To achieve the desired
characteristics. the blender selects from a range
of ingredients, which are
gene-ally approved by the authorities in various
European countries for use in
manufactured foods and tobacco. Flavours, such as
menthol, contribute to the
ovemll impression of the product through their
effect on the taste of the
smoke and the aroma. Sugars and honey can be added
to smooth the taste,
whfle substances called hurrectants help to keep
the tobacco moist.
REFERENCES
Samfield. M. 'The Casing and Flavouring of
Cigarettes". TabAlr I Tnt
15 :380-384, 1984,
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BATCo document for Province of British Columbia 28
October 1999


CLAIM 2
How can you justify the use of harmful chemicals
in your products?
RESPONSE
The ingre!~:.-rits which are added to our tobacco
products are generally
approved by the authorides in various European
countries for use in
manufacn;-_-~ foods and tobacco. A range of these
ingredients can be used in
the rrianuf~z-uring process to enhance flavour and
to differentiate our product
blends. Ar:-; non-tobacco ingredients which are
added in substantial amounts
usually are. or are identical to, naturally
occurring compounds such as sugar,
honey, and :ocoa. Many ingredients which are used
in tobacco products are
also curre:-.:Iv being used in a variety of
consumer products, including foods
and beverzzts.
REFERENCES
FOOD
UK
M FF. Food Additives and Contaminants Committee.
Report on the
Re%~ew of Flavourings in Food. (FAC/REP/22)
H.M.S.O. 1976.
EUROPE
Co=cil of Europe. (The Blue Book') Flavourine
Substances and
Nam.r-,1 Sources of Flavourine%. 3rd ed. 198 1.
Flavouring Substances and Natural Sources of
Flavourings. 4th ed.
19 c0. Vol. 1. Chemicafly defined substances.
(Only draft copy
av-0able at present).
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October 1999


3 -
TOBACCO
BELGIUM
13/8/1990. Royal Decree relating to the
manufacture and marketing of
tobacco-based products and similar products.
Moniteur Belge
5.1.1991 pp. 117 et seq.
FRANCE
Decree of 16th July 1984 relating to additives
authorised in the
manufacture of tobacco products and tobacco
substitutes. Journel
Officiell de la Republique Francaise 9.9.1984.
S%I,TrZERLAND
Order Re!adng to Foodstuffs 817-02. Dated 26th May
1936 - State Ist
January 1988. - Section 33 Tobacco and Tobacco
Articles.
GERMANY
Verordnung uber Tabakerzeugnisse (rabakverordnung)
20.12.77.
UK
Frogsatt. P. Fourth Report of the Independerit
Scientific Cornmittee on
Smolcing and Health. Dept of Health and Social
Security. 1988.
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CLAIM 3
A list of tobacco ingredients released recently in
Australia includes
chemicals which are said to cause cancer. How can
you say these are not
harmful to health?
RESPONSE
Ingredients used i;-i tobacco products have been
independently evaluated and
they are generally ap roved by the authorities in
various European countries
p
for use in manuramred foods and tobacco. There is
a misperception that all
of the substances which appear on the list are in
all tobacco products. In fact.
in deve!oping a prcduct, the blender will
generally select only a proportion of
the approved che--;cals.
REFERENCES
See Claim 2.
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October 1999


CLAIM 4
Why do tobacco products contain so many different
chemicals?
RESPONSE
It is merely an assumpcion that tobacco products
conWn many ingredients. In
general. only a proportion of the total number of
approved ingredients is used
in any particular product. The blend of each
product has been developed over
many years in response to consumer tastes and
demand, and the blender
sel" from a range of ingredients, which are
generally approved by the
authorities in various European countries for use
in manufactured foods and
tobacco.
REFERENCES
See Claim 2.
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October 1999


6 -
CLAIM 5
Why do tobacco products contain such a large
quantity of added
chemicals?
RESPONSE
The use of total weiLht of ingredients is
meaningless. This total includes
substances added to the tobacco which are lost
during manufacture, such as
volatile compounds. which remain only in trace
quantities in the finished
product. Many of the same ingredients are used in
the processed food
industry and are agreed as ingredients for tobacco
by the authorities in various
European countries.
REFERENCES
See Claim 2.
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October 1999


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CLALM 6
%'.'h,. do cigarette and pipe tobaccos contain
such large quantities or
ingredients compared to cigarettes?
RESPONSE
Ingredients are used in the manufacture of
cigarettes and tobacco to improve
taste and flavour, and provide the characteristics
of the product which the
consumer desires. The amount used will therefore
vary between products and
will depend also on the particular blend of
tobacco. For instance. the
traditional Virginia cigarette may contain only
minimal amounts of flavouring
ingredients or no ingredients at all. while pipe
tobaccos generally have more
distinctive flavours and aromas.
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BATCO document for Province of BritiSh Columbia 28
October 1999


CLAIM 7
What are the chemicals you put in your tobacco
products?
RESPONSE
Over 99% by weight of the ingredients added to
tobacco are made up of
casings such as sugar and honey, and substances
called humectants which keep
the tobacco moist. Flavouring ingredients are
added to tobacco only in small
amounts. We are of course unable to disclose
exactly which ingredients are
used in our products because these recipes are
closely guarded trade-secrets.
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CLAIM 8
Why don't you want sTnokers to know about the
chemicals that are added
to cigarettes?
RESPONSE
We are not trying to hide anything from smokers -
this is a question of
commercial confidence. The specific blend of each
brand of cizarene is
unique and, in the hands of our competitors, this
information could be
commercially damaging to our company. We aim
simply to prese.-,-e the
commercial confideitiality of product formulae and
recipes, as would for
instance Coca Cola. which seeks to preserve the
confidentiality of the recipe
for its soft drinks. There is nothing underhand or
sinister in the fact that the
list is not publicly available.
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CLAIM 9
Other products, such as certain foods. provide
Usts of their ingredients on
the packaging. %Vby should tobacco be different?
RESPONSE
Some products carry lists of general ingredient
categories on their packages.
However, this use of general terms. such as
flavourings or permitted
colou--:ngs, does not reveal the individual
ingredients and so does not disclose
the re:-pe of the product. No manufacturer would
be willing to reveal to their
compe2fors the specific ingredients used in their
products. This is why we
only r~:pply such information to governments on
the understanding that it will
be trm---d in commercial confidence.
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SMOPUNG ISSUES Claims and Responses
BATCO document for Province of British Columbia 28
October 1999


CLAIM 10
IN'liv don't all governments require companies to
declare their
ingredients?
RESPONSE
You would need to put that question to the
relevant government. Only a
minority of countries, such as New Zealand and the
United States. require
disclosure of ingredient information. In fact,
when the issue was considered a
few years ago by the US Congress, the position
taken by the pertinent US
government health official was that the whole
ingredients issue was
'peripheral' or 'inconsequential'. Nevertheless,
BAT reviews evaluations in
other countries regarding tobacco ingredients and
makes every effort to
comply with international guidelines in all its
markets.
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SMOKING ISSUES - CWms and Responses
BATCo document for Province of British Columbia 28
October 1999


- 12-
CLAIM 11
Surely, if governments were aware or what tobacco
manufacturers were
putting into their products. they would ban the
use of these ingredients?
RESPONSE
Several governments have, in confidence,
considered the lists of ingredients
which are approved for use in the manufacture of
tobacco products. None,
including in the recent case of a submission to
the New Zealand government.
have acted to restrict the list of possible
ingredients over and above what is
considered generally acceptable.
SMOKING ISSUES - Claims and Responses
BATCO doCUrnent for Province of BritiSh C01UMbia
28 October 1999


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CLAIMS ABOUT HEALTH
WARNINGS
PAGE
I If smoking did not cause disease, there would be
no healLh I
warnings on cigarette packs.
2 Stronger (or rotational) health warnings are
needed on tobacco 2
products and in advertising since people are not
aware of the
health risks of smoking.
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BATCo document for Province of BritiSh Columbia 28
October 1999


CLAM 1
If smoking did not cause disease, there would be
no health warnings on
cigarette packs.
RESPONSE
There is a community expectation that cigarettes
should con:zjn health
warnings. As responsible manufacturers we respond
to that expectation by
placing health warnings on packs of cigarettes
that -A.- produce. fn most
countries the warning is required by government
and its contents determined
by government. This in no way indica!es that the
company accepts that
smoking has proven to be a cause of disease.
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SMOKING ISSUES - Claims and Responses
BATCO document for Province of BritiSh COIUMbia 28
October 1999


CLAM 2
Stronger (or rotational) health warnings are
needed on tobacco products
and in advertising since people are not aware of
the he.21th risks of
smoking.
RESPONSE
Further legislation is unnecessary and
unwarranted. V-~espread a-areness
about smoking and health cWms suggesis that
pecp:.- are already well
informed. and suggests that existing labels fulfil
the info-,ational purpose
The fact that millions of people continue to smoke
is mereiv an indication that
they have exercised their freedom of informed
choice on te matter. not that
they are unaware of the specific health claims
about smo.'-~::g.
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SMOKING ISSUES - CWms and Responses
BATCo document for Province of BritiSh Columbia 28
October 1999


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BATCo document for Province of British Columbia 28
October 1999


CLAIMS ABOUT TAXATION
PAGE
I Taxes should be used to get consumers to stop
smoking or to 1
reduce the amount they smoke.
2 Tobacco taxes are an effective and efficient
means of collecting 2
governmenE revenue.
3 E-cise wes on tobacco are an equitable wky of
raising revenue. 3
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SMOT(ING ISSUES - CWms and Responses
BATCO document for Province of BritiSh COlUmbia 28
October 1999


CLAM I
Taxes should be used to get consumers to stop
smoking or to reduce the
amount they smoke.
RESPONSE
Expericice shows that excessive taxation can lead
consumers to seek
cheaper sources of supply, rather than reduce
consumption. This can
either be from down trading to cheaper products or
smuggling from
lower taxed countnes.
2. The imposition of higher cigarette taxes as a
means to reduce
consumption is socially unfair as it impacts far
harder on those with
low disposable incomes.
3. Using mx increases as a means of social
engineering is discriminating
to all smokers since they are forced to pay more
without receiving any
reciprocal increase in benefits or services.
Trying to force people to
stop using a legal product in this way is not a
proper function of
taxation.
REFERENCES
Shroeter, W. 'Cigarette tax and health policy"
7-itschrift fur Zolle und
Verbrauchssteuren April 4. 1976, translation.
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BATCo document for Province of British Columbia 28
October 1999


CLALVI 2
Tobacco ta-xes are an effective and efficient
means of collecting
government revenue.
RESPONSE
1. In economics. a tax must meet several criteria
to be considered a zood
tax, including being effective and efficient. To
be effective, a tax
should produce a reliable stream of income. to be
efficient, it should
raise revenue with the least amount of unintended
side effects on other
areas of the economy.
2. Continually increasing cigarette taxes is not
effective because at a
certain point resulting revenue will decrease
rather than increase
because of either a drop in demand. a move to
lower taxed products or
an increase in smuggled products upon which no tax
has been paid.
3. Continually increasing cigarette taxes is not
efficient because at some
point increases will have an impact on other
economic factors such as
output. employment, trade balances, purchasing
patterns, etc.
Excessive taxes could ultimately result in plant
closings and lay-offs,
which would have implications for the economy's
output.
unemployment level, investment rate, technology
and productivity
levels, human resource deployment, etc. The impact
will be both
direct on the cigarette industry and indirect on
suppliers and
downstream activities such as retailers and
distributors.
4. Cigarette tax increases are highly
inflationary.
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October 1999


CLAIM 3
F_xcise taxes on tobacco are an equitable -sy of
raising revenue.
RESPONSE
As tobacco excise taxes are levied on a mduct at a
flat rate, the tax is
charged accordingly to an individual's consumption
rather than his
ability to pay the tax. This means that the tax is
highly *regressive* as
compared to an income tax which is paid on a
"progressive" basis
according to an individual's we-,ith.
Consequently, tobacco excise
taxes hit hardest at the poor. For example. a
study in the United States
calculated that low income individuals pay 27
times more of their
income in federal excise taxes than high income
individuals. I When
state and local excise taxes are added, the
discrepancy is even greater.
Similar conclusions were reached by a US
governmental study which
examined the distributional effects of increasing
excise taxes on
tobacco, beer, wine, liquor, perrol, airline
tickets, and telephone
service. According to that repori, an increase in
the excise tax on
tobacco would be the most regressive of all. 2
The burden of excise taxes extends from
individuals to business,
industry and the nation-wide economy. According to
economists and
business organisations, excise taxes weaken
business competitiveness
and hinder economic growth.
REFERENCES
1. Citizens for Tax Justice. Weedne the Revenue
Targets in the 1988
Budget: W-ill Tax Reform Be Extended or
Undermined?". Washington
DC, May 1987.
2. Congressional Budget Office, *The
Distributional Effects of an
Increase in Selected Federal F_xcisc Taxes'. Staff
Working Paper US
Congress, Washington DC. January 1987.
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October 1999


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BATCo document for Province of British Columbia 28
October 1999


CLALNIS ABOUT
ENVIRONMENTAL
TOBACCO SMOKE
PAGE
I Exposure to environmental tobacco smoke is
harmful to the I
health of non-sinokers.
2 If we accept the claims that have been made
against acti%e 3
smokinE. are we not forced to conclude that
"passive smoking"
must be harmful to health - albeit perhaps to a
lesser extent?
3 It has been proven that non-smokers can develop
lung cancer as 5
a result of exposure to environmental tobacco
smoke.
4 It has been proven that non-smokers can develop
heart disease 7
as a result of exposure to environmental tobacco
smoke.
i It has been proven that adult non-smokers can
develop lung 9
disease or dysfunction as a result of exposure to
environmental
tobacco smoke.
6 1E has been proven that exposure to
environmental tobacco I I
smoke can impair the respiratory health of
children.
7 Exposure to tobacco smoke at work is harmful to
non-smokers. 14
8 Scientists have shown that thousands of
non-smokers die each 16
year from exposure to environmental tobacco smoke.
9 Some people are aller.gic to tobacco smoke in
the air. 17
10 Sidestrearn smoke contains higher
concentrations of toxic and 18
cancer-causing chemicals than mainstream smoke.
I I Environmental tobacco smoke contains
cancer-causing 20
substances. How can you cWm that it is not
harmful?
12 If non-smokers. even children, have components
of ETS such as 22
nicotine in the;r blood. how can you say that they
are not
exposed to significant levels of ETS?
13 Tobacco smoke is a health risk for non-smokers
already 24
sufferinz from heart and lung diseases, such as
asthma.
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SMOKING ISSUES - Claims and Responses
BATCo document for Province of BritiSh Columbia 28
October 1999


CLAIMS ABOUT
ENVERONMEENTAL
TOBACCO SMOKE
I- Why should we accept your word about the health
effects of 25
environmental tobacco smoke over that of
disinterested and
objective medical authorities such as the US
Surgeon General.
15 Even if, as you say, environmental tobacco
smoke is not 27
harmful to non-smokers. you cannot deny that it
can be
irritatine and annoying,
16 People who work in offices where smoking is
permitted require 28
more time off because of their exposure to
co-worker smoking.
17 Non-smokers have a right to smoke-free air. 29
tS Environmental tobacco smoke is a major source
of indoor air 31
pollution.
19 Smoking on board commercial aircraft should be
banned. 33
20 The United States Environmental Protection
Agency has 35
reponed that environmental tobacw smoke is a
"known human
carcinogen". Surely this is proof that passive
smoking is
dangerous?
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October 1999


CLAIM I
Exposure to eii%ironinental tobacco sTnoke s;
harmful to the health of
non-sinokers.
RESPONSE
Scientists do not agree that environmenta.1
toba.-:o smoke (ETS) has been
proven to be a cause of disease. and the
scient;-"c evideice. considered as a
whole. does not justify this conclusion.
For example. more than 30 statistical studies of
lung cancer among non-
smokers married co smokers have been publishe-C'.
Of these over 80 per cent
report no statistically significant association
be,-.t-;!.-.n ETS exposure and lung
cancer.
Even in the minority of studies that report a
significant result. the risk is so
z
low as to be virtuafly unmeasurable by normal
epidemiological standards.
Most of the studies have been severely criticised
for poor methodology and
for failing to take into account other factors
that could influence the results,
e.g. evidence suggesting that smoking households
have different diets and
lifestyles from non-smokina households. which
could affect their risk of
diseases like lung cancer.2
People often say that smoking should be banned in
the workplace because it is
a risk to the health of non-smokers. However.
again. 85 per cent of the
studies investigating whether exposure to ETS in
the workplace carries with it
an increased risk of lung cancer, report no
statiSriC311V significant association.
REFERENCES
I Lee. P. Environmental Tobacco Smoke nnd
Nfortnlitv. Karger. 1992.
C:)
2. DeSerres. F 1. and Matsushima. T. "Niecting
Report: kfutagenesis
and Carcinozenesis by Niiropyrenes and Cancer
Chemotherapeu tics".
Nfutir Res 164: 4. 1986. CD
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28 October 1999


- 2
Anonymous. "Lung Cancer in South China". Oncolopy
Timm. Vill
(6): 33. 1986.
Mumford. J N et al. "Lun2 Cancer and Indoor Air
Pollution :n Xuan
Wei, China". Scienc 235: 217-220. 19137.
Gao. Y T et ad. "Lung Cancer Among Chinese Women".
Int I Cpncer.
40 : 604-609, 1987.
Koo, L. et al. "Life-History Correlates of
Environmental Tobacco
Smoke: A Study of Nonsmoking Hong Kong Chinese
Wi%es with
Smoking Versus Nonsmoking Husbands*. Soc Sci Med
26,7):751-
760, 1988.
Koo. L. "Dietary Habits and Lung Cancer Risk Among
Chinese
Females in Hong Kong Who Never Smoked". Nutr
Cancer. 11: 155-
172. 1988.
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October 1999


Anonymous. "Lune Cancer in South China". Oncoloev
Times. VIIr
(6): 33, 1986.
Mumford. J N et al. "Lung Cancer and Indoor Air
Pollution in Xuan
Wei. China". Scienc 235: 217-220, 1987.
Gao. Y T et al. "Lung Cancer Among Chinese Women".
Int J Cancer,
40 : 604-609. 1987.
Koo, L, et al. "Life-History Correlates of
Environmental Tobacco
Smoke: A Study of Nonsmoking Hong Kong Chinese
Wives with
Smokin2 Versus Nonsmoking Husbands'. Soc Sci Med
26(7):751-
760. 1988.
Koo. L. "Dietary Habits and Lung Cancer Risk Among
Chinese
Females in Hong Kong Who Never Smoked". r4utr
Cancer. IT: 155-
172. 1988.
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BATCO document for Province of BritiSh COIUMbia 28
October 1999


CLAITNI 2
Ir we accept the claims that have been made
against active ;moking. are
we not forced to conclude that "passive smoking"
must be harmful to
he3l1h - albeit perhaps to a lesser extent?
RESPONSE
W'!-a;ever one's views of the claimed health
effects of active it does
no- ;`61low that non-smoker exposure to
environmenLal tobacco smoke (ETS)
in%olves a health risk. There are differences in
physical ar." chemical
prc:erties of the smoke, and in the route of
exposure. apart from :;-e fact that
cor~:entrafions of ETS in the air are so low as to
be virtuallv unmt-15urable.
SLTIPLETNIENTARY INFOBAIATION
The-e are clear differences in chemical and
physical properties
between the mainstream smoke to which an active
smoker is exposed
and the ETS to which the non-smoker is exposed.
ETS is a
combination of side stream smoke (i.e. the smoke
coming off the
burnine end of the cigarette) and exhaled
mainstream smoke. But
before the non-smoker is exposed to that mixture,
ageirz and. even
more significantly, very substantial dilution with
the sur70unding air
occurs. As a consequence, non-smokers are exposed
at most to trace
amounts of smoke. and the smoke is not even
iden:~cal to the
mainstream smoke to which the active smoker is
exposed 1.
2. Extrapolation is also inappropriate because of
the differences in routes
of exposure. The active smoker holds the cigarette
in his or her mouth
and breathes deeply before exhaling. The
non-smoker's exposure to
ETS, by contrast. is primarily through the nose,
with its natural
filterine mechanism, and is not followed by the
tak~ing of a deep
breath. These differences are of such significance
that most scientific
research on ETS. as well as analyses of the ETS
scientific literature.
have recognised that conclusions concerning the
possible health effects
of ETS must be based on research focusing solely
on ETS - not by
attempts to extrapolate from active smoking daEa2.
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3. For the reasons just described. the phrase
"passive smoking" is a
misnomer. The phrase is used by anti smokers.
despite its
inappropriateness from a scientific standpoint.
for its political
implications - in much the same way that the
equally inappropriate
phrase "involuntary smoking" has been used.
Phrases like "passive"
or "in%olunury* could equally be applied to
exposure to the smoke
produced by barbecue grills, motor vehicle
exhausts. cooking fumes or
fireplace smoke. Their use reveals the extent to
which. in the case of
ETS. members of the anti-smoking community are
prepared to
sacrifice science on the altar of their political
agenda.
REFERENCES
Ba.ker, R R. and Proctor, C J. *The origins and
properties of
environmental tobacco smoke". Environ Int
16:231-245, 1990.
2. See e.g. Wu. 1. *Summarv and Concluding
Remarks". Environmental
Tobacco Smoke: Proceedings of the International
Symposium at
McGill University, 1989. D Ecobichon and J Wu
(eds.) (Lexington:
D. C. Heath & Co.) pp. 367-375.
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CLAIM 3
It has been pro, en that non-5mokers can develop
lung cancer as a result
or exposure to en, ironmental tobacco smoke.
RESPONSE
In fact. of more :-an 30 epidemiological studies
(hat have investigated a
possible association *xrweeri E75 and lung cancer
in non-smokers, the vaz~
majority (over 80:7~j ha,.;! reported no
statistically significant association
be:ween exposure :c ETS or. more precisely, mamage
to a smoker) and the
incidence of lung c-z-zer a:-nong rion-smokers.
Supplementary Information
None or the ;-ew positive studies have been able
to rule out the ve.-v
high probabi:;ty that the smaH increased risk
being reported was due to
factors or c;,-.umsmnces having nothing to do with
ETS per se. but
perhaps having something to do with marriage to a
smoker- These so-
called 'confoundine fac-ors' include diet.
occupational exposures.
heatine and _-cokinr sources. radon, motor vehicle
exhaust exposure as
well as nurnemus oiher Favors.
At an inte7natiomi sc;entific symposium at McGill
University.
Canada. in ia:-- 1990. that was attended by more
than 80 investigators.
not a single _;c;Cnd5E voiced an objection to the
unanimous conclusion
of the ETS,' 'uns! cancer panel participants that
science has been unable
to establish ---,iv re!ationship between ETS and
lung cancer in non-
smokersl. Indeed. a number of researchers
expressed the view at the
symposium zz~at suO a re!ationship was so
improbable that devoting,
additional resources to the issue could not
bejustified 2.
3. At an internzJonal workshop held in Tokyo in
1993 3. sponsored by Lri
the Japan Indoor Air Research Society. there was
general consensus by
a group of distinguished scientists that the
database of studies did not
support an as,-ociation between ETS exposure and
lung cancer.
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-6
REFERENCES
See Wu. J. "Summary and Concluding Remarks".
Environmental
Tobacco Smoke: Proceedings of the International
Symposium at
McGill Universm- 1989. D Ecobichon and I Wu (eds.)
(LcxinE-on:
D.C. Heath & Co. 1990) pp. 367-375.
2. See jtW at p128-132 (comments of Dr F J C Roe).
3. See Kasuza. H. 'Discussion on ETS Exposure and
Lung Cancer
Risk*. Environmental Tobacco Smoke. H Kasuga (Ed.)
(Sprirzer-
Verlae. 1993) pp. 71 - 84.
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October 1999


7
CLAIM 4
It has been pro, en that non-smokers can develop
heart disease as a result
of exporure to environmental tobacco smoke.
RESPONSE
This c;aim has been rejected repeatedly by
scientific reviewing bodies
throus",out the %%orld. including the United
States Surgeon General. US
National Academy of Sciences and the Independent
Scientific Committee on
Smok,~!z and Heaith in the United Kingdom. 1 No
studies have appeared since
those .-e-wris thaz .could warrant a chan2e in
their conclusions.
SUPPLEINIENTARY LNFORIMATION
Of the eleven epidemiological or statistical
studies that have been
conducted on the ETSY' heart disease issue. 5 have
reported a small,
but statistically significant increased incidence
of heart disease in non-
smokers married to smokers as compared with
non-smokers married Eo
non-smokers ( I of these 5 studies generated both
significant (in
women) and non significant (in men) results); and
the remainins!
studies reported no significant difference in
risk.
2. After reviewin2 Elie science. and taking into
account the amounts of
ETS to which non-smokers are exposed. a number of
investigators
have emphasised the biological implausibility of
any link between ET S
and hear, disease
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REFERENCES
See U.S. Department of Health and Human Se:-;;ces,
The Fealth
Conseauences of In,oluntarv Smokinz: A Recor.. of
the Surscon
General (Washington: US DHHS 1986).
Committee on Passive Smoking. Board on
Environmental Studies and
Toxicology, National Research Council.
Frivironnientni Tobacco
S moke: Measuriniz Exoosures and Assessinv Health
Effects
(Washington: National Academy Press 1986).
Department of Hea1zh and Social Security, Fourzzh
Rer>ort of the
Indeuendent Scientific Committee on Smokine And
H-Ith. (London:
Her Majesty's Stationery Office 1988).
2. See. e.z., Schievelbe;n. H and Richter F. "The
Influence of Passive
Smoking on the Cardiovascular System". P-ev Med
13(6): 6Z6-6,19.
1984.
Rylander, R. "Workshop Perspectives".
FTS-Environment:11 Tobacco
Smoke: ReDort from a Workshoo on Effects and
F-vasure Leve!s. R.
Rylander et al. (eds.) Eur J Rest)ir Dis Suppl.
133(65): 143-145.
1 ~84.
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CLAIM 5
It has been proven that adult non-mokers can
de%-elop lung dissease as a
result of exposure to environmental tobacco smoke.
RESPONSE
The 1986 reports of the US Surgeon Geneml and the
US National Academy of
Sciences concluded that this claim has not been
supported 1. Epidemiological
(statistica!) studies have reported. at worst. a
very small effect while an equal
number oC other studies have repor-ted no effect
at all.
SUPPLEMENTARY LNTORNIATION
These results prompted panel members at a recent
international
symposium at McGill University in Canada to agree,
in the words of
one of the symposium co-organisers. that:
"...the data are extremely weak in this area and
no relationship has
been convincingly demonstrated. At most, ETS
exposure may cause
transitory irritation or annoyance in adults. This
kind of irritation,
however, is not specific to tobacco 2.,
2. At an international workshop held in Tokyo in
1993 3. Dr [an Gross of
the Medical University of South Carolina stated
that *Reviews of the
studies focusinz on healthy adult subjects
generally have concluded
that there is little or no association between
exposure to ETS and
decreased lune function or adverse respiratory
symptoms".
REFERENCES
See. US Department of Health and Human Services,
The H-1th
Consectuences of lnvoluntniZ; Smokine: A Revort of
thd Sur2eon
General (Washington: US DHHS 1986). Lrl
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- 10
Committee on Passive Smoking, Board on
Environmental Studies and
Toxicology. National Research Council,
Environmentnl Tobacco
Smoke: kleasurine Exi)osures and Assessine Henith
Effecs.
(Washineton: National Academy Press 1986).
Wu. J. "Summary and Concluding Remarks".
Environmenmi Tobacco
Smoke: Proceedines of the Internatiowd Svmr>osium
at McGill
Uni,ersitv 1989. D Ecobichon and I Wu (eds.)
(Lexington: D.C.
Heath & Co. 1990) pp. 367-375. See also Witorsch,
P.. pp. 169-
186.
3. Gross. A 1. in Fnvironmcntal Tobacco Smoke, H.
Kasu-za (ed.)
(Suringer - Verlag 1993) pp. 85.
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October 1999


CLAIMT 6
It has been proven that exposure to environznental
tobacco smoke can
impair the respiratory health or children.
RESPONSE
A number of epidemiological (statistical) studies
have repxorted an association
between having a parent who smokes and an
increased incidence of
respirator; symptoms (e.g. Coughing and phlegm
production) and illness (e.g.
cold and flu-like symptoms. and reduced lung
functioni among pre- school
aze chiidren. The symptoms in question are in no
way life-threatening and
they appezx to be self-limiting, the association
being no longer identifiable in
school-azt children.
It is not aE all clear that the associations
described above are caused by
exposure to ETS. Factors other than ETS may well
account for the
associations. such as socio-economic status,
dampness in the homel-3,
infections transmitted during day-care
attendanCe4-8, proximity of the home to
industrial and other outdoor pollution9-10,
inherited SUSCeptibiliEV to childhood
respiratory illnesstl, inadequate pre-natal care,
and cooking with gas in the
homel'. The failure of the studies to account for
these other important
factors. as well as inconsistencies in study
design and execution. prevent any
definitive Conclusions.13
SUPPLEMENTARY UqFORNIATION
1. Still. it would appear prudent for parents to
avoid smoking around
new-borns - just as it is prudent to keep infants
away from people
suffering from colds or flu-like symptoms. dusty
conditions or
extremes of temperature. Common sense simply
suggests that parents
may wish to avoid many behaviours around their
children: these are
the kinds of personal decisions that parents alone
arc in the best
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The science reia--ina to the respiratory health of
children and ETS
provides no basis for he public and workplace
smoking laws that have
been enacted or -jropcsed in a number of places.
Infants are se!dom
seen in the wo:k-pIac:-. and public place smoking
restrictions affect
adults almost e-:7usi,-e:-.-.
REFERENCES
Martin. C et al. 'Housing Conditions and III
Health". Br ~Med J 294:
IIZ5-1127. 1987
Strachan. D. *Darnp Housing and Childhood Asthma:
Validazion of
Reporting ol'Symptoms". Br Nied J 297: 1223-12M,
1989.
Strachan. D and E'..- n. R. "Relationship between
Respiratory
'o
Morbidity in Ch;idren and the Home Environment".
Familv P-acrice 3
(3): 137- 142, 1936.
Anderson. L, e, al. 'Dav Care Center Attendance
and HospiWization
for Lower Respiratory Tract Illness". Paediatrics
82 (3): 300-308,
1988.
5. Colley. J. "Respiratory Symptoms in Children
and Parental Smoking
and Phleem Prod-.iction". Br ~Med 1 11: 201-204,
1974.
6. Fleming. J., "Childhood Upper Respiratory Tract
Infections: To What
Degree is Incidence Affected by Day Care
Attendance?". Paediatrics
79 (1): 55-60, 1937.
7. Gardner. G et al. "Effects of Social and Family
Factors on Viral
Respiratory Infec-.ion and Illness in the First
Year of Life". I
Fr)idemiol Communitv H--nith. 38: 42-48, 1984.
S. Koo. L C. et al. "A Compajison of the
Prevalence of Respiratory
Illnesses among Nonsmoking Mothers and their
Children in Japan and
Hong Kong*. Am Re, Resvir Dis 138: 290-295. 1988.
Ln
9. Harrington. W and Krupnick, A. "Short-Term
Nitrogen Dioxide
Exposure and Acute Respiratory Disease in
Children". J&UA 35:
1061-1067. 1985.
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10. Kerigan, A. et al. "A Three Year Cohort Study
of the Role of
Environmental Factors in the Respiratory Health of
Children in
Hamilton, Ontario: Epiderniologic Survey. Design.
Methods. and
Description of Cohort'. Am Rev ReSDir Dis 133:
987-993, 1986.
1. Lebowitz. M. et al. "The Effect of Passive
Smokinst on Pulmonary
Function in Children". Environ Int 8: 371-373.
1982.
12. Melia. R, et al. *The Relation Between
Respiratory Illness in Primary
Schoolchildren and the Use of Gas for Cooking. 1.
- Results from a
National Survey*. Int J Eoidemiol 8 (4): 333-338,
1979.
13, Hood. R D, et al. "Environmental Tobacco Smoke
Exposure and
Respiratory Health in Children: an Updated
Critical Review and
Analysis of the Epiderniologic Literature". Indoor
Environment 1: 19-
35. 1992.
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CLAIM 7
Exposure to tobacco smoke at work is barmful to
non-smokers.
RESPONSE
People often say that smoking should be banned in
the workplace because it is
a risk to the health of non-smokers. However, 85F.
of the studies
investigating whether exposure to ETS in the
workplace carries with it an
increased risk of lune cancer, report no
statistically significaric association.
Measurements taken in off-ices and work-places
indicate that he contribution of
ETS to the air we breathe is minimal. 1 -1 For
example, a non-smoker would
have to spend from 100 to 1000 hours in an office
to be exposed to the
equivalent nicotine from just one cigarete.3
REFERENCES
Kirk, et al. "Environmental tobacco smoke in
indoor air" in Indoo
and Ambient Air Oualitv R Perry and P W Kirk
(eds.) (London,
Selper Ltd): 99-112. 1988.
2. EatouRh. D, et ai. "Assessing exposure to
environmental tobacco
smoke" in Indoor ;%nd Ambient Air Ou-litv R Perrv
and P W Kirk
(eds.) (London. Selper Ltd.): 131-140. 1988.
3. Badre et al. "Pollution atmospherique par ]a
fumee de tabac". Ann
Phirm Fr 36 (9-10): 443-452. 1978.
Carson. J R and Erikson. C A. "Results from a
survey of
environmental tobacco smoke in offices in Ottawa.
Ontario". Environ
Technol Letters 9:501-508. 1988.
Hinds and First. "Concentrations of nicotine and
tobacco smoke in
public places". New Enel J Nfed 292 (16): 844-845.
1975. Ln
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Jenk;ns et al. "Development and application of a
thermal desorption-
based inethod for the determination of nicotine in
indoor
environments". in: Indoor ;,nd Ambient Air
Ou;;Iitv eds. R Perry and
P W Kirk (London: Selper Ltd): 557-566, 1988-
NlurarnaLSU et al. "Estimation of personal
exposure to ambient nicotine
in dailv en,-ironment'. Arch Occuo Environ Health
59: 545-550,
1987.
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CLAIM 8
Scientists have sho,~,n that thousands or
non-smokers die each ye3r rrom
exposure to environmental tobacco smoke.
RESPONSE
All of the ETS risk assessments that have been
undertaken suffer from a
common threshold problem: they assume that ETS has
been shown zo harm
the health of non-smokers. (See also claim I )
Supplementary Information
The claim is based on a series of risk assessments
that have been
undertaken. particularly in the US, by a few
individuals for the
avowed purpose of supporting the enactment of
legisladon resricting
smoking in public places and the workplace. The
assessments have
been based on a series of unsubstantiated and, in
some cases. even
demonstrably incorrect assumptionst.
Unfortunately. an uncritical press has chosen to
publicise the results of
the risk assessments that have been undertaken.
When that sort of
thing happens. of course, everyone loses: science.
whose credibiiity is
undermined. public policy makers. whose actions
are demonstrably ill-
founded: smokers. who face an unjustified loss of
personal freedom:
and non-smoke-s. who carry the burden of fear and
uncertainty that
has been engendered.
REFERENCES
1. Arundel. A et al. "Exposure and risk-based
estimates of never smoker
lung cancer deaths in the US in 1989 from exposure
to ETS". L&M
and Ambient Air Oualitv R Perry and P W Kirk
(eds.), Selper Ltd.
1988.
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17
CLAIM 9
Some people are allergic to tobacco smoke in the
air.
RESPONSE
Viis is one of the most common complaints about
ETS. Despite repeated
efforts. however. scientists have been unable to
identify specific allergens in
tobacco smokel. Thus. while some people may react
to the sight or smell of
ETS. that does not mean that they are experiencing
an "allergic" reaction.
UFERENCES
See Lehrer. S et al. "Tobacco Smoke Sensitivity: A
Result of
Allergy?". Ann Allerzy 56: 1-10, 1986
Tavlor. G. "Tobacco Smoke Allergy - Does it
Exist?". Fri,ironment-1
Tobacco Smoke Effects on the Non-smoker: ReDort
from a WorkshOD
R Rylander (ed.), Scnnd J Resoir Dis Suppl. 91:
50-55. 1974.
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CLAM 10
Sidestrearn smoke contains higher concentrations
of toxic and cancer-
causing chemicals than mainstream smoke.
RESPONSE
This claim is based on a fundamental misconception
of what environmental
tobacco smoke ;s. Sidestream smoke is what comes
off the burning end of [he
ciz arette between puffs. with measurements being
taken in the laboratory only
a tew milIiMetre5 from the end of a burning
cigarettel. A non-smoker would
bum his or her nose if placed at that distance
from a lit cigarette. The ETIS to
~Oich the non-moker is exposed is composed of aged
side stream and
exhaled mainstream smoke thai is verv
suhsrairrial1v diluted bi. the
surrounding air.
As a consequence of this dilution. non-smokers -
even in the "smokiest'
environments such as a crowded pub or bar - are
exposed at most to virtually
unmeasurable arnounts of chemicals that can be
attributed to tobacco smokine.
Indeed. a series of studies has shown that a
non-smoker would have to spend
more than one hundred hours in a smoky bar, and
even longer in the ovoical
office or restaurant environment. to be exposed to
the nicotine equivalent of a
sinele cigaretle2.
REFERENCES
1, Reasor. M. "Scientific Issues Re2arding
Exposure to Environmental
Tobacco Smoke and Human Health'. Cle-ine the Air:
Pcrsxctives on
Environment-il Tobacco Smoke R D Tollison (ed.)
(Lexington: D.C.
Heath & Co.. 1988): 7-14.
2. See e.g. Hinds. W and First. Xf.
"Concentrations of Nicotine and
Tobacco Smoke in Public Places". New EnRI J Nfed
292 (16): 8--
8-15. 1975
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Press Release, "Study of Air Quality in 100 N.Y.C.
Reszaurants.
Offices Shows Tobacco Smoke is Insignificant
Factor". T1he (US)
Tobacco Institute. Dec. 10, 1986.
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CLAIM 11
Environmental tobacco smoke contains
cancer-causing substances. How
can you claim that it is not har-mrur
RESPONSE
A number of chemicals in tobacco smoke have been
classified as actual or
pe,erid-L carcinogens (cancer-causing chemicals)
in animal studies. But the
results ,:-' such studies are. at best. of
uncertain relevance to humans.
In add--on, the chemicals so classified are truly
ubiquitous: they occur
nazur-_:':.- in the environment. both outdoors and
indoors, and are also present
in nan-. foods and bevera!zes. Althou2h some of
these chemicals can be
found -.:: ETS in tiny amounts, the ETS levels in
the environment are dwarfed
by he contributions from these Other sourcesi.
SUPPLEMENTARY INFORMATION
Besides, epidemiological (statistical) studies
have been unable to
zonfirm a consistent statistically significant
association between ETS
and any type of cancer'-.
REFERENCES
See. e.g. Schievelbein H. *Are There Really
Important New Findings
A~out Passive Smoking?". Oeff Gesundheitswes 44
(0): 454-456,
1
1982 (nitrosamincs).
~:oilo%vell, C and Miksch. R. *Sources and
Concentrations of Organic
Compounds in Indoor Environments". Bull N.Y. Acad
Nled 57 (D): LTI
96-2-977. 1982 (volatile organic compounds). CD
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See. e.g. Layard, M. 'Environmental Tobacco Smoke
and Cancer:
The Epidemiologic Evidence". Fnvironmentnl Tobacco
Smoke:
Proceedinzs of the Internation;1I Svmt)osium at
McGill Universitv 1989
D Echobichon and J Wu (eds.) Lexington: D.C. Heath
& Co. 1990:
99- 115.
"Panel Discussion on Lung and Other Cancers',
itidat 117-136.
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CLAIM 12
If non-smokers. even children. have components of
ETS such as nicotine
in their blood. how can you say that they are not
exposed to signiricant
levels of ETS?
RESPONSE
The presence of nicotine in the blood. urine or
saliva may or may not mean
that the person has been --Kncosed to ETS in the
past. It is well known that
nicotine can also be obtained from certain
ve.,,etables (e.z. tomatoes,
aubereines) and it has been reported that
non-smokers would be able to
achieve measurable amounts of nicotine or its
metabolites in body fluids from
this source. I
A number of studies, ha,e re,ealed that a
non-smoker would have to spend
more than one hundred hours in a typical workplace
setting or restaurant to be
exposed to the nicotine equivalent of a single
cigarette.?
SUPPLEMENTARY ESiFORINIATION
The presence of trace amounts of nicotine in body
fluids certainly does
not mean. in and of itself, that the person is at
nsk of adverse health
effects. If anything. the ability to detect
nicotine or nicotine
metabolites in the body fluids of non-smokers
represents more a
triumph of analytic chemistry than anything
relating to human health.
REFERENCES
See e..-. I:nvironmenrnl Tobacco Smoke:
Proceedines of the
Internationq] Svmwsium at McGill Universitv 1989 D
Ecobichon and
J Wu (eds.) (Lexinvon: D.C. Heath & Co. 1990):
41-42 (comments (_n
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of Dr. G. Feuer). 42-4.1 (comments of Dr. 1.
Gorrod). LA
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2. See e.g. Hinds, W and First. M. 'Concentrations
of Nicotine and
Tobacco Smoke in Public Places'. New EnLl J Med
292 (16): 844-
8-15, 1975
Press Re!ease, "Study of Air Quality in 100 N.Y.C.
Restaurants.
Offices Shows Tobacco Smoke is Insignificant
Factor'. The (US)
Tobacco Institute. Dec. 10, 1986.
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CLAIM 13
Tobacco smoke is a health risk for nonsmokers
already suffering from
heart and lung diseases. such as aghma.
RESPONSE
'Vie available data simpiv does not support that
claim.
SUPPLEINEENTARY INFORMATION
Most of the studies that have focused on ETS and
pre-existing heart
disease have reporTed no significant statistical
association between the
t,,o. The few studies that have reported a
positive association have
ignored many of the heart disease risk factors
known to be associated
%ith the development of that condition.
2. A number of scientists have questioned the
plausibility of an
association between adverse reactions in heart
patients and exposure to
ETS. given the extremely low levels of ETS
encountered in everyday
life.
Similariv. studies that have assessed the
influence of tobacco smoke
exposure on asthmatics are not conclusive. as the
results of the
different studies are inconsistent. Even in those
studies that suggest a
relationship. investigators were unable to rule
out the influence of
emotional factors and psychological stress.2
REFERENCES
Armitage. A. "Environmental tobacco smoke and
coronary heart
disease". in: Other Peoule's Tobacco Smoke Galen
Press. pp. 109-
116. 1991.
Witorsch, P. "Effects of ETS exposure on pulmonary
function and
respiratory health in adults". in: Fnvironmentni
Tobacco Smoke:
Proceedin'es of the International SvmDosium at
McGill Universitv.
jM Lexington Books. pp. 169-186, 1990.
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CLAM 14
NVhv should ~e accept your word about the health
effects or
environmental tobacco smoke over that of
disinterested and objective
medicnl authorities such as the US Surgeon
General.
RESPONSE
I am no~ suezestin-a that you do so. Indeed. most
of the poir.:z *.hat I have
made about iTS is reflect'ed in the scientific
portion of the 1986 7!pOr- of the
US Surceon General on ETS. Unfortunately. these
points were omitted from
the executive summary and press materials that
accDmDanied the =_-ort.
When one thinks about it, such omissions are not
terribly surprising. The US
Surgeon General is a political appointee, and the
Surgeon General at the time
of that report. Everett C Koop. had an announced
commitment to doing
everything oc.
, in his power to move the US toward a smoke-free
s ietv by the
year 2000. While the Surgeon General's apparent
motivation for adopfing
that goal was his views on the health effects of
smoking on the smoker, he
acknowledged seizing on the ETS issue to achieve
his goal. Simiiar criticisms
can be levied apainst other bodies. I
SUPPLEMENTARY EWORMATIONN
Whatever one's views about active smoking, one has
to question
whether the means the Surgeon General has adopted
- the scientifically
unwarranted. politically-based claims about the
health eff!c:s of ETS -
are appropriate. Over the moderate to longer term,
what of the impact
on the credibility of science? The distortion of
public policies
concerning indoor air?
2. The Hon. Walter B. Jones of North Carolina.
House of
Representatives, is quoted in the Congressional
Record. February 18
1987, saying:
Surgeon General. like myself. is a politician. I
ha, e. ',earned that
when dealing with politicians it is better to
watch what they do as
opposed to listening to what they say. This is as
true for -,he Surgeon C:)
General as it is for me. The simple fact of the
matte: is that the (_~J
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conclusions in the Surgeon Gener-al's Report are
not supported by the
research in his own Report.*
REFERENCES
See US Department of Health and Human Services,
The H-11th
Consecuences of lnvolunt:-rv Smokine: A Renort of
the Summon-
Qeneral. (Washington: US DHHS 1986).
Scientific Advisory Board of the US Environmental
Protection
Agency. "Safeguarding the Future: Credible
Science. Credible
Decisions". US EPA, 1992.
Carlo. G eE al. 'The interplay of science, values
and experiences
among scientists asked to evaluate the hazard of
dioxin, radon and
ETS". Risk AnnLysis 12: 37-43, 1992.
SMOKING ISSUES - CWms and Responses
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CLABI 15
Even if. as you say. environmental tobacco smoke
is not harmful to non-
smokers. you cannot denv that it On be i"h2ting
and annoving.
RESPONSE
Obviously, if ETS is permitted to accumulate in
occupied spaces. it can be
irritating and annoying - to smokers and
non-smokers alike. But the solution
to that problem is not a smoking ban but improved
ventilation and, on
occasion, the moving of people to different
workstations.
In addition to dealing with ETS. of course,
improved ventilation will reduce
the many indoor pollutants that cannot be seen or
smelled but that have been
found, on invesfization, to be the real cause of
the overwhelming majority of
indoor air-related compWnts in both workplaces and
public placesi.
REFERENCES
See Melius. J et al. "Indoor Air Quality - the
NIOSH Experience".
Ann Am Conf Gov Ind Hv2 10: 3-7, 1984
Robertson. G. *Source. Nature and Symptomology on
Indoor Air
Pollutants'. Indoor ;%nd Ambient Air Oualitv R
Perrv and P Kirk
(eds.) (London: Selper Ltd. 1998); 311-319.
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CLAIM 16
People who work in offices where smoking is
permitted require more time
orr because of their exposure to co-worker
smoking.
RESPONSE
No conclusive support for this claim exists. In
fact. the claim runs counter to
the we;zht of research results that are available.
SLTPLENIENTARY INFORMATION
The primary factors affecting absenteeism are job
satisfaction. job
level and educational and socio-economic status.
Whether or not an
employee. smokes is entirely irrelevant to e;ther
absenteeism or
productivity. Far from reducing costs and
improving producti,ity, the
imposition of smoking bans and restrictions can be
disruptive and may
effect employee morale and productivity adversely.
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CLAIM 17
Non-smokers have a right to smoke-free air.
RESPONSE
This claim is rooted in emotion rather than logic
or common sense. It is true
that some non-smokers sav that thev want to avoid
all exposure to ETS. BLE
how thei are we to deal with at least equally
legitimate claims to zhe "right."
to be free of exposure to overpowering perfumes?
There is currently a
movement in California to ban the use of certain
perfumes in pubiic piaces:
this is another example of the extremes that
people can reach in their aztempts
to impose their own preferences on other peoples'
behaviour.
SUPPLEMENTARY INFORINIAUON
Courts in the United States have consistently
rejected claims of a
natural or constitutional "right" to a smoke-free
environment.
recognising the implications that such a "right"
would have. Instead.
they have required employers and proprieors of
public places to
accommodate the interests of both smokers and
non-smoke-s - in other
words. to balance the wishes of all invoked while
appeaiing to
common sense and courtesyl.
2. Since the health claims that have been made
about ETS have not been
supported by the weight of scientific research.
the real issue raised by
claims to a "right" to a smoke-free environment is
whether smoking
should be prohibited because some people rind it
annoving or a
nuisance. Many things that people do are an
annoyance to some other
people. But for government to be regarded as
having the responsibility
for dealing with such issues is to call for
government regulation of
everything".
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REFERENCES
Fox. J and Davison. B. "Smoking in the Workplace:
Accommodating
Diversity". Califomia West Law R 25(2): 215-237.
1988-1989~
Williams, W. "Cigarettes and Property Rights".
Cl,-nrine the Air:
Per,r,ectives on EivironmentA Tobacco Smoke R D
Tollison (ed.).
(Lexington: D.C. Heath and Company, 1988): 39-62.
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CLAIM 18
Environmental tobacco smoke is a major source or
indoor air pollution.
RESPONSE
A build tip of ETS in the air may be a symptom of
poor ventilation. Adequate
ventilation will not onlv -et rid f ETS
, , 0 . which of course may be annoying to
some people. but will also ge, rid of other
subsmnces that are present in far
Feater quantities.
Smokine bans will not result in 'clean air'. They
will fail to solve the problem
of poor ventilation and may make it Hess likely
that more effective efforts will
be made to address the situation.
Many issues surrounding smoking in the workplace
and public places can be
addressed by common sense. co-operation and
courtesy on the part of both
smokers and non-smokers.
SUPPLEMENTARY INFORMATION
1. ETS has become an easy target for those who
want a quick, simple
solution to the problem of indoor air quality,
probably because it can
be seen and smelled quite easily. Because ETS is
visible and easy to
identify, it is often blamed for poor air quality
in public places and
work places.
2. However. a number of studies have shown that
ETS contributes little
to the overall quantity of chemicals in the air.
The substances present
in ETS are present in the air anyway, from other
sources. eg.
buildings, furnishings. office materials etc. They
are not unique to
ETS. Banning smoking in public places and offices
would not.
therefore. significantly reduc: people's overall
level of exposure to
these airborne substances.
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3. Govemment and private -zudies of -sick
buildings" in the United States
and Canada report. ho,eer. that ETS was a factor
in only 2-5 % of
. v
the buildings investigazed for cornplainEs about
air qualit. 1. Tnis
suggests that even a to,.L smokine ban is not
likely to affect comfort
problems in 95-98 % of "sick buildings"2.
REFERENCES
Kirkbride, J. "Sick Bui:dim, Svnd.-ome: Causes and
Effects". Health
and Welfare Canada (Ouawa. Canada: 1985).
Melius. I et al. "Indoor Air Quali:y - the NTOSH
Experience". Ann
Am Conf Go, Ind Gviz 10: 1-7. 1