BATCo document for Province of British Columbia 1 November 1999 I T BATCo document for Province of British Columbia 1 November 1999 41 CONTENTS Introcuctior. 1 . Coes Sr-.ckinc Ca~.;z-=- -as=-ase? 2. S,Mokirc ana Pregna7.6,. E-ivircr-irnergal Toz-a-_= Z71,1011S 4. How the ComPar... ria-z .=es;--nded 5. Use of lrgredien:s 6. Is Smckno Addic-:ve~ 7. Warnincs 8. Smokinc !s fo, Ac,;I:z- 9. Acveris'.-:: 10. Sponsorsnip 11. Should there be S!r,-.Kin-- bars? 12. Social Ccs*.s 13. Animal 7es!inc I A Con,-Iusi--.n ApnI 199-3 Page 9 10 11 12 13 Jl 15 16 CD U-4 CD BATCo document for Province of British Columbia 1 November 1999 INTRODUCTION Tobacco a~:: smokonc arc- cc-.-.'_~versial s~.=:~-:s. Pecole hold strong views on tre :ssues a.52d. As z-77 employe-e -_f E totaccc company it is inevitable !,-.E: you be as~=_:: about me :ss,.:es. either at work o, socially, bo,r7 :n the LIK and a_t-:ad. so it is irn-corzant that you should know where =- s',anc The purpose :;' this ',Cokle! is T- summarise ocsition or some of tre more impor:anz queszions in a s;mple anc no.-I-tecnnical manner. It is -L;! hoped tha, :r,,,z- bookle: will give- vcu enough, information c deal with. the czmmem_z which mav be falsed t'v.'peo le:V L;, mee!. questions o, P not provide sufficient detail to e.pabli you to respond to questions.- P from the media: their questions must always'-be referred. to your Public Affairs Depa~tment. THIS BOOKLET HAS BEEN PRODUCED FOR THE COMPANY~S EMPLOYEES. IT IS FOR INTERNAL COMPANY USE ONLY AND SHOULD NOT BE COPIED OR SUPPLIED TO THIRD PARTIES. CD Q~ C__ BATCo document for Province of British Columbia I November 1999 1. OOES SMOKING CAUSF OISEASE? claim :hat smoking ::sease -s :;ase,.:argely or. -re of nave ecorec s;ads*z:c=i zsscciaticn --.demiolccicai s-,ua!ec te-7,veen smc~king:ancl ~c :::seases. E,:4perniology involves m-i_ :-_ilec-i,-n.and analysis of statistical imorrn~ii .!~,jjejaijhg to -.~a :c~-;,.:,,r9nc5 otclfsease and of whtr factors. . ircl(iJ supt~',z ings -=s ~o-ecorcr~fc szAlus and environmental -~~Szs s- exposUrII-I Thus. emcemic:- the pattern of ciseases'in :ccOlations: of,pecole arc :~=_ '-=c*ors hici:.rnay influence this. pattern, 14 a statistical asscc;aticn tS -:served bemeen a factor anc a disease, :~e factor uncer :nvesuga-icn s said 'o. be a 'risk factor' for that disease. Risk', in this context. ar7c s:_=:is*,ical association', are not synonymous 'cause'. Risk faccrs mt~., -ave nothing to ~Io with causes. They are oth v .,e=lly risk markers: thev arz --=:~her suff;aenr nor necessary to explain rne risk. Risk factors a~e 2_z_z_-c'aiec ith an altered probability of the cccurrence OT a disease. a7E., man being causaily related to it. ~maving a driving licerc-a :s _= -:sk marKer for car amdents. because pcssession of a driving `ce~cz s star'szically associated with having an ' ' :_,,-_ver. acz;dent while drving a :a.7 - 3 cssess;ng a dnving ;icence does n~t of itself cause =_::::enrL. Sc-entis*,s agree thaz statistical j. a-zsoc;ation alone :snor =_~c_:- 7c crove :aL;sa,icr.. :Mg S a rISK fac:or for cer:ain diseases. f~e statistics !nc;ca!e :ra: I -cst notabiv iur,.c ca~cs- -c%vever. it !s :r1portant !c place the eczemiologyinto a ana prccer sc:entific, contex,. -.e origins of ::!sz= :-z t -:ate:^ 3zazis"c-nily vjith SMCKing are ::-nolex. Nuir-rcus -ac-._-. -:;-_c:nc died. vress. cccucaticn. li~esZyle arri zonci,tions may contribute to their cevelopment. E--ch of '11-as-_ :-se2ses bias been associated nor only with z7 oking. but i:h mar,. 'accrs. For examoie. hear, disease is aSsociated 'Nith over 22CO ;-=ccs. sorne of whicn have a suonger s:a:!sical assoc:anon -,:" :~-a ::.Sease :rian smoking. Mos-, of 'he people 4 4 %~io suffer rcrn a dise-mSe s-:-z: S::cally assocatea 'Nittl smoking will have zsen exposea -c mary ns..( faccrs mth which T-e disease is =zsomaied. AL., CD BATCo document for Province of British Columbia 1 November 1999 'V., Tne eP,ce-,icJoc:::ai daza conrair many anomalies. For exarnpie SMCKIng wa-re a caise of iunc cance-. the incidence of lung cancer srno~(ers sn:uld be similar irrespec:ive of residence or ethnic group. In 'ac:. the s--=:jstics snow considerable vanaiion in cancer rates becwei~. are-as anc :-cups: for ins-ance. the Percentage of JaPanese men v.:-: s.---w.e is :.,.-,ce tha' o' Brish men. but Janianese men have a lov.-s- inctence c' !ung cancer and of hea:i disease. The staustics aIsc ira: me ~Ps: majoriTy of smokers do not get Jung cancer. OespT!e more than 40 years,of,,intensilite. rese#qp'. no-one has yet 'n b6 iiri able to deirnonstratea. bas .j~~Oor lung cancer e e ic causal mecha. o r,fde--~Jear- disease., Therefore. it has not been scientifically proV6nq-hbt smoking causes disease. More research is necessary to establish the causes of the diseases for which smoking is a risk marker and to investigate the mechanisms by which such diseases arise. 2 BATCo document for Province of BritiSh Columbia I November 1999 x. 2. SMOKING AND PREGNANCY There are a nu-nber of s*,L;aies -Nhicn -ave exar-.-sc S:7'.Ck;rg and pregnancy. Mos: of these studies have :nCicatec .Others who smoke.tend zc c,ve bir-." :c 'viter babie--. 'n additic.- ::a!r.,.s nave ceen avade that mazernai S,,c-ng iowers 'r- growth -=-:= n cnilcren and re,4rds oocess n eac:ng. r[Ting ana n-,:-r'earnirc..Ne n ncr-e!ie ve that these szucies esta .c:,sr, :,hat smoking -uses any --nese. h h cevel6aiad- coumc-s s abo' grarris (71.0s e tinl;v wezm ir y ?..,-This to be r6diuked by =t:~at.200-.^:Q!Warns in ~.)abies ' within1hE . ~ 6i t_irth -eights whose' mojl~ers smoke. .'rich ;s. '1orm4Kttr- = in infants. There 's no ccrvincing evid-enc~ :hat such =_.':~~e~ucljon in birth edit r,'al -C weight has any :7edical sicriificance. A L2':7-_e. c sta'as"that the obseriation. *hat babies bom to mothers who srrc#:-- are smaller those bom to ncn-smokirg mothers 'seerrs oi little ir-:-_rzarce since the difference is generally less 'than 10% _f expecle: ::ir-.h wetgnt.' In addition. suc" cifferences disappear durr:: --hildhooc. At least SIXTV fac*crs have. been linkec .-o:h chancez- n birth weight. including low wegra gair. ;n pregnancy. c, pre-pre,_7a:rcy weigm. low social class. low edLcaticrai status. and a:czhol and ccnsurnction. Any analysis of ne claimec affect Of SMCK:ng on birr,. eigr, vhicn does not adequateiv contrci for such confcu:~ding fac::-s -11 result in a misleadinc cver--Bstima:e _-i any ellec:. s ackric., _=Ccec by many s u'. -Piderr:c-cc,cal studies oregnar:.. r4;c~Jarly authcrit;e a clitficuit to ;nter::. -2!. There are .3;ri:ar oifficu;'~--_s sith ;he szuc:eS zf reaair,- anc 3,her learning abilities. Otner -ac:z:.-s. sucn as -:: ai c!ass soc:a: ciass, at 16. arc rncr~,.ers age _=7 --ir77 ot 'he cmic -ave a s,,. :-:ef ~_7 .ac:. The Lancat editorial said. ;n its COnCiLs,on: "It is -'sincrest to say there is serious evidence that her fetus :s at risk if sne (the mother) does not give up smoking'. 3 A A CD BATCo document for Province of British Columbia 1 November 1999 3. ENVIRONMENTAL TOBACCO SMOKE Eackground Newspan-er repo-3 :3nvey 'he ir-noressic.- -har :-,erE- can be !i-.:e dou::-. B-nout t~e ill eTec,.s eXPCSLre !o envicnMenta! zooaccc smc-~=- (ETS.. scie,~:Jic s?u:%. .7,-=Tcan De ccrs:ruc--. u,)reasc:7-=: as o; E7-z in-.,analciv a7ra-zz prez-z- ::verage. MeanWhii s uc -nich firc no asso--:-=--ion. or ever. a ne=ive association. be-.-;e-2r, E7-z a.-c norsmoker rea-.7;-, problems are large!~.. ;qnored. What is E7S? =:Z; Is-COM-PoSe-C. c.-Astiv diiuzed- anc (!re ' ' t b 57,CKe emitied the u ni c end o; crcaret el ant the sm-oke e r ng. ex,~aiec by sm-ok.'s.-s. The maior corn:cr~,edis of ETS arc vazer an't `oon o .ioxide. kl-cs', other substances 'ound ir, ETS arc- a- rmnuscule eveis. :-7S is "a, from the xedominant source 'cr.-ncsz c* the subs*,ances found !n indOO7 air. Incee-C. smoking does no! s;cn;ficantly affec+ the ;eve!s of -cs, corstituerim in zme air..Aimcst all c~ SUDS-,ances founc in E'S rtave a variezy of c;-:=__, sources inaoors. Tne major claims made against E7S are ma? it, causes lung cancer arc near-, disease in nonsmokers. and res:--aorv disorders ana other c:~nditions in children who are exposed tc Lung Cance!- ne claim is base:: on two types of evicance. First, it relies on a:1 a7 alysis of the ava:'.able eo.idemioiogical c-aza. Second. it is s--,-,ges-.ec !.-,a, because is known to contair subs:ances that have been --:~ortec !c, be ca-c:nocens. and because :: nas Zeen assumea '.nat !he,=- :s no safs leve'; of exposure to carcinoce-!s. it is claimeo tha: inhaiing SMOKErt -:neone eise s tc-cco smckE rrav cause !un- cancer in nc- ~:na 'ric -.".,asncic -=-z:-,jment)- ne epidE-.rnioicc:c-=. evidence relating Tc exocsure to ETS and lunc cancer nas beer -.,idely criticise'- by inae:~ercenz scientis-zs. It reiiez- ennrelv on stuciving the health problerr-s of nonsmokers married smokers and it of:eri fails to taKe aaec-.;a*e account of a number of Potentia; biasing fac".:)rs. 4 '7, BATCo document for Province of BritiSh Columbia 1 November 1999 .V, k, W.. A -.~ese inc:Lde. -Nrongly diacrosing 'Te :-sease: --aSirg exposure cn cuec--- _-,-.najrE-S~ -7 ailing -c con-,rcl 4cr oc-z-z-:: s ds.< -=---:cs iucn ---- -.4iec or .-.;:!cr.. -miszakeniy c:assiNing -zz,---Kers z:,- ix-smckerz ~s ncnsmc,=:z-. Excertmen- al errors. suc" ES over~c:w ng syste7=:;c differe, z- env e a n a-ric contrcis, m swclies,, he use c'. --equate jt'&Ci'ejs. and the .;,3cc, :i :,i ~kaia--Ivsjs (a .5- '6v s.ir-.. riv. have u Re d n atiszic,al averaging ixaggeratep and misleacir: 1,esul!z, than 30 studic-s- --r lung c 41, a rn o n g i r.. total. mcre -cnsmokers married o z7o,~,ers ".=,e been c--c.ished. Cf 7, 4 s e. over :10". recor no szaristicafl- c;znific-=~,. associatic:- :erveen to a ~,-.oker and the developrr=-~- of IL-r,: -ancer. F--:7-rer. of the a-zzirnaies szucies :nvestigating -.7=-:ner zx::-ure to E7S at worK With it -m:-. inc-eased r;sk of lu:-: :anc=-- :ver 8-7~: -epcr-, nc z-:-=-.:sacalIy S.gr.lflcant assoc:aticn. -A~ for 'he 'no 'nreshclo' 2-::~;mer.:. -.:--=re ;s ce::-z-.-3 about !here sai; levels cf exoosL;.,=- carc::-::ens. par-.----,arly in Zh=- v new -sicnis into the mecriar=s of c7s-ical carc:r~cenesis. - a--:ncgens M--e uticuitcus ~r, :he hL7-=:7 envv:-erit. Vir--1:v all of rarmcals -.,esenz in rcoacco s,-.c,z- Bre :resent :r -:- - ourccc, -1-:: -r-cccr -vTrcnrr.en:s. !~.e fcoc -,e arc 7--3 waier -.-ie :."MK. In cd a icn scurc= of carc;rc---~.s. cc--- -c oca c--=:-=s ever .---= ;Lrher. -s ac=.: ::,,ial :z--.,nogers --.d rnuza~z- curing tcdy pr:d-icc - Z- - - --is s--. ve in a --onc;: ;--nc 7 e. a:: : e s a r cv. , If au s;= c c s a .urai de~encas. Respiratory Ccriditions in Children -ec=.-i- -ev,ev., of szucies --; -axccs-:=- :o E-S -es ra: .,;ors Pre-scrccl cnildren n:-.---z prc: ---rs inc!-~: -.g 'he ur-a- -=--:iitv of z:-;esz~cnnaires. a lailure -.-- ac--:-7z of the of c.-:ss,nfec:!cn. anc a 'o for scc z--aconcrr.--- z-:-=:,-,s and -ate,~ fa=rs. Evidenc= - a:irc schcol --ca anj olce, :-;.cren is !,cons;stzert. and 'he s,uz::=-z- sz~;ffer zhe sa-- ;iaws as --e~lina .,:r, ycunCer Cr~;icrer. C D C_- BATCo document for Province of BritiSh Columbia 1 November 1999 heV.: Disease evice~c= exocs----e to E7E and he=r disease is S for -.:!SrrOK=-rS mamed 'o smokers. Again. the results are nave a7EC::E:: :)'.' S:a`E-1'ca! bias. -ano esPecially by the af --1 risk '-=::o.,s fc.- near dise-=Ss :,n=- T, KnC ... nit- ::.occ: presst~re ana hic, cnoiesz=- eve's =csess;-,=:-,zs of -,h!s evidence bE-:7 prepared under the ria au --c,*:i=--, ric, ;-, s --r~ re Qt whicr ~s. corOjded'tha, E be, e=- E T S e. x p0 s u r e a A"~ ~Ii d.1 s e g s e i n 'i a-5 -z:-7z aoth -7.-- VS Su~,esr Gene,.--! and th e US Nazi aq~l-, Acade rn v E shave c~nci---dea :ria: :nerc is :nsuffin-en, evicierice'of a causal ETS an: hear: disease- This condusion has been au* c ~v na:1 I hor;:; -s in The Netherlancs. Norway, Australia an: Na:!onal autho.;-zies have thereio,-= not concluded tha: ET-C "as beer, snown zo cause hear: c~sease. Sue~:~.,7 Infant Death Syndrome (SIDS or 'Cot Death') iumer::---s riSK fac-Lors for SIDS have :)een suggested, the :r c-auses a-=- not presently known. The epicemioicoical evidence. ccn-z as a wr-,31e. does ncz demons,,rate tha: childhooo exposure to E~-z S -m :ause -- SIDS (co! ceath). The cause or causes of cot death bL~: we note tha: Ine number of sL;c-, deaths ir. the UK anc Ne, has oeen more man halven since mothers were advisea nc- -: :.-: :aOies ::: sieec in me Prone PCS;110rl. Corz.L,sion 77,e- -=--= verv rr.-=:,!% rncre constituems ir. cur air nan c:care!',e smoke. a.n: 3-::w:z--s snc~:;:: nc: ce sri.-;ed out s;7-,oiv beca--,se the result of thel- .-,,.=-.s-vie ;s vis;me. Ooures~ anc oz)rnmon-sense have permitTec B.-C nc:i5.-)OKerS tc live ano work tooe'.her in harmony. The s::=--:-= 7S c-:,.,j,.4es ne!;!7er reason ncr Justification to acandon these prin=,es. The scientific evidence. considered as a whole, does not dern:nslrate that ETS causes lung cancer, heart disease, or any other Zisease in nonsmokers. 6 U-. BATCO document for Province of BritiSh Columbia I November 1999 4. HOW THE COMPANY HAS RESPONDED :.na! more research is necas-zarv :c, determine wils: :-tuses :.zs-2-zs-z assmaiec: Nittl smokirg-ana he par, it any. by T~-e Con- :---v,oing pary has ccntribu:-?--' *c SUC~' research b, ;rca;penaent organisarions -.-.`c,'iaje determined the --z-=-arcr ar1c. by using the mone-.. prcv:ded by us. su.-::--.ed or -~7ax~~r. irelevant researcn. -e Unrit6d.Kingdcrn as:r-., e: in 195 the -:-~:any. bf'rhe :ndUs-,rZ Medicai :--zz-ar provided f:narice for the ch se, :n e Tobacn Manu;=::--,rers -0. h, the inclustry . -z*_=.---',ng Ccmrnitzee (T?vlSC). TMSC. -:~n the recommenda,:-- of its and scenfific advisers, financ-=c research directly in *.,-z- ':eia of -7 C g z: health. Up to 1963 totai excenciture on direc:l~.- '-7arced -;as over Ell millicn. ",E ;'rdus,,;y formed the Tc-n-=.--:::: zese-=rccri Council 72--a. The S,w -~,-7 : i : h e T R C, s e x'oenditure Snd ---cr, was devoted ':: :-=-r-,icai a-a biological testing.on nicn were carr z: :)ut at -::.C s aCCiatories in Harrogate. The TF:0 also supported 're --icrK Of researchers. BevNeen 1G-53 191-1. the TRC over Z.-. researc". In 19'78. a --r~anisaricn Was 'crr-,=-: -.allec -c~-:z Acviscry Ccuncd (T,-: Continued -z: c-cocr: :7 =- agreed zo orovice -: :c il milion per 'c a the Tocac.-.- :-'esearch Tus~ ,he :e-s .'.e lrce!~endert Sc:e-::~;: C,~mm,ttee on Sr-:- 3rc 'cr ressarc~ inzo =,~ez:s oT mccinec. Ev *he ame these fur-~:z a.re exiaus*Led. a c-.-m 2-1-8 -.=-.,e teen .3;:ent. of ISCSH. wrce~ :-v ~tlhe UK mduszr,'~ had c:--ir=d some E6 millic- :;-.(er ar~j acove their 7--:~-,sa q and D. arc _7 a .=7,1 IGnc wav. ~he :aroes*, z----sz:rs of research ir,:-- ----Klrg *he LIK.' BATCo document for Province of BritiSh Columbia I November 1999 Wn:;s: :S no, ac::ep,, tha: it fnaS beer. scien*ifically estabiis"ed that simokinc -----.-,ses d.!sease. we.nave- responc:ed positively to suggestions as !c ho, :-,r produc:s might be modified and have (with the rest of the UK ind---s.*-...) acreed and implemented a produc* modification programme -;,-,/ern,,nen,, an d the ISCSH. As ::ar*, oi that prograr-m-ne, we na-je inve-::icated wavs of reoucinc the 'tar. nicc*,ine. carbon monoxide ano o1her -zrnci