May 15, 1978 PUBLIC S,'OKI?:G The tobacco industry acknowledges that there is controversy over many aspects of the general problem of smoking and health. There Is disagreement among medical experts as to whether the reported associations between smoking and various diseases are causal or not. Accordingly, there is a continuing need for further research into the causes of such diseases and it remains the.policy of the tobacco industry to support such research. "Public Smoking," to wit, smoking in the pres- ence. of another person, has become increasingly the subject of debate with mounting pressure for restriction. This Issue has also been variously referred to as "passive smok- Ing" or "involuntary smokIng"; however, in this paper these terms are intended to be subsumed under "Public Smoking." It is self-evident that, since there is disagree- ment among niedical experts as to whether the reported asso- ciations between smoking and various diseases are causal or not, there is no compelling evidence amounting to proof that there is any causal link between "Public Smoking" and various diseases. This paper will, therefore, address the issue according to the present state of scientific knowledgeN but will make no judgments on the varying vie-ws of the ex- perts which are quoted or referred to. *This paper will be updated periodically. Accordingly, before use it would be well to check to determine that t-he information to be used is up to date. NJ C> N) __J CN \0 CO BAT Industries document for Province of British Columbia 2 November 1999 I. Public Smoking as a Public Issue In the last few years, controversY has arisen about public smoking and health; claims and charges have escalated; campaigns to ban or restrict smoking in public have taken place and continue to increase. Thus, the public smoking issue has become a matter where the tobacco industry's position should be clear. There are three major points upon which to .focus. First, claims that tobacco smoke in the atmos- phere causes disease in nonsmokers are unsubstantiated; nevertheless, a large portion of the population--both smokers and nonsmokers--believe these claims. Second, leaders of the drive to prohibit smok- ing in public frequently resort to scare tactics to make nonsmokers believe their health is being harmed by tobacco smoke in the atmosphere. Third, igainst this background of misinformation public bodies are making rules about public smoking that intrude into personal liberty. Although the public smoking issue arose in the 1970's, it stemmed from the smoking and health controversy of the last 25 years. As a supplementary method to dis- suade people from smoking, the notion of a crusade to make smoking socially unacceptable was evolved. The mechanism to do this was to paint smoking as a health hazard to the -2- N) C) Ni LP4 N-) ___J BAT Industries document for Province of British Columbia 2 November 1999 nonsmoker. At the 3rd World Conference on Smoking and Health in New York in 19755, this was considered a viable plan for curtailing smoking. Since then, efforts along these lines have intensified. The problem that advocates of this tactic faced in 1975, and still face today, is-the fact that there is no proof that tobacco smoke in the atmosphere causes dis- ease in the nonsmoker. The most that can be said about atmospheric tobacco smoke is the possibility that there is a small group of exceedingly sensitive or otherwise ill people who have conditions which may be exacerbated by various environmental influences including environmental tobacco smoke. However, the contribution of tobacco smoke to atmospheric constituents is minimal. Even so, efforts were undertaken to make non- smokers-b elieve that their health was being adversely affected by atmospheric tobacco smoke. Thus, a small but determined corps of antismokers set out to get smoking banned in the work place, either by court or governmental regulation; to get laws passed regulating smoking in public places; and to get smoking restrictions on public transport. These forces are still at.work and today the public smoking issue is receiving widespread attention. In generating this public issue, the corps of antismokers -3- C:) r1 j Lt4 N) __4 BAT industries document for Province of British Columbia 2 November 1999 uses tactics based on misinformation and emotionalism not justified by facts. II. Atmospheric Tobacco Smoke and Health There is no scientific proof that tobacco smoke in the atmosphere causes disease in nonsmokers. Despite the contrary claims of a few, the view that atmospheric tobacco smoke does not present a health hazard to the non- smoker is supported by numerous reports of independent scientists and governmental bodies that have examined this issue. rtor ena plc, the 1973 rep-rt hy ite United K ng an expert group appointed by the in antism~okir 'p rt group ppoi e e ~a~ ed b he Un ~din 'It y t t; K organization known as Action oking and Health--concluded king and H-a ct ni -a ti on kn a- A i n ..m0 g that there is evidence" that smoking is "dangerous to t there is vide~n.e "tha k n da t v . ,.I, h__ thy nencmol-9-v h n In 1974, a workshop (organized, among others, by Dr. Rylander of the Universities of Geneva and Gothen- burg) was-attended by scientists from all over the world to consider the fiealth consequences of atmospheric tobacco smoke. These scientists were unable to conclude that cigarette smoking is a hazard to nonsmokers. Further., these scientists stated that: "For the majority of the population the average exposure burden due to environmental tobacco smoke is prob- ably much lower than that due to industrial air pollutants and in many cases also environmental air pollution or the lung burden due to dust clyuds or other indoor air pollutants." -4- CD NJ ~A BAT Industries document for Province of British Columbia 2 November 1999 In 1971, a joint study by the Federal Aviation Administration, the United States Department of Health, Education and Welfare and the National Institute of Occu- pational Safety and Health examined the health aspects of smoking on transport aircraft. Its conclusion was as follows: it is concluded that inhalation of the by-products from tobacco smoke generated as a result of passengers smoking aboard commercial aircrAft does not represent a significant health hazard to nonsmoking passengers.,, 3 This conclusion is supported by that of the U. S. Inter- state Commerce Commission's study of smoking on bLises: "We agree with the examiner's conclu- sions that petitioner has failed ade- quately to demonstrate the deleterious effects of second-hand smoke upon the health of motor bus passengers." 4 In 1977, a symposium on the topic of smoking in the work place sponsored by the Bavarian Academy of Industrial and Social Medicine was held in Munich, Germany and attended by eminent German scientists, lawyers, as well as government leaders.. The chairman of this symposium, Professor- Doctor H. Valentin of the University of "Erlangen- Nurenburg stated as follows: "In conclusion, with regard to medical and legal facts of passive smoking at the work place, the following must be considered. Under our present day work place conditions, no clear and signifi- cant untoward health effects from passive smoking have been shown. Therefore, we should, as in other everyday situations, observe the following rules: -5- r1 j CD rQ __j ON \0 -th., BAT Industries document for Province of British ColUrnbia 2 November 1999 . . . as much state intervention as necessary_- as much freedom as possible.'" :~ Quite recently (1978), the Ger-qa.n Society of Occupational Medicine --which includes approxinately 700 scientists and other persons interested in occupational health--examined the issue of smoking in the work place and found that "To date, according to our knowledge, scien- tifically unequivocal and objective proof of damage to health, as a result of passive smoking, has not be n established in any population group." 9 Accordingly, the Society concluded that a smoking ban in the work place cannot be justified on a scientific basis. In view of these conclusions by independent scientists. and governmental bodies, it is not surprising that some of the most avowed critics of tobacco have acknowledged that smoking has not been established as a cause of disease in nonsmokers. For exaTple, Dr.. Ernest L. Wynder of the Ameri- can Health Foundation admitted that he does not believe that "passive smoking really hurts the health of'somebody who sits next to you. Dr. Jonathan Rhoades, Chair- man of the National Cancer Advisory Board, admitted in commenting upon atmospheric tobacco smoke and health that to his knowledge "it is not, in fact, actually harmful.', 8 And on cancer, Dr. E. Cuyler Hammond of the American ' Cancer Society stated that there "was no shred of evidencell 0 \ `10 U1 BAT Industries document for Province of British Columbia 2 November 1999 that a nonsmoker can get cancer from "second hand" smoke and that there is a lot of evidence that he cannot. Dr. Hammond added that to suggest passive smoking could cause cancer is dishonest, and that he would be prepared to testify as much in a court.9 And even the then Surgeon General of the United States- Dr. Jesse Steinfeld--admitted after the 1.972 Public Health Service Report was issued that lie could not "say with certainty that exposure to tobacco snoke can cause serious illness in nonsmokers.1110 As further examples, the footnote lists a dozen others* who are usually critical of smoking and who have voiced the view that atmospheric tobacco smoke has not been established as being harmful to the health of nonsmokers. These opinions are supported by the findings of Hinds and First of the Harvard School of Public Health. Their study, which was financed by the Massachusetts Lung Association, measured tobacco smoke (by extrapolating from nicotine) in various public places such as restau- rants, cocktail lounges, bus and airline terminals and stu- *Wilb&rt C A--,, Richard Doll, Dean F. Davies, John R. Goldsmith, Gio Gori, Roy Korson, David Owen, Irwin Schnieltz, Dietrioli Reuel Stallones,1R. D. Stewart and 'r-rry.11 -7- C) QN %~D CN BAT Industries document for Province of British Columbia 2 November 1999 dent lounges, and found that the amounts were very small indeed.12 In editorial comment, appearing in the New England Journal of Medicine which reported this study, Dr. Gary Huber of the Harvard ,:edical School stated: "Under the most severe concentrations of exposure in their study, the non- smoker could consume an amount of tobacco so small that the risk of development of any adverse health effect would be non-existent, on the basis of any avail- able data In the literature today.,,13 Scientific facts notwithstandirfg, claims are sometimes made that smoking causes chronic degenerative diseases in nonsmokers. However, one recent study re- viewed the data from a number of other studies, includ- ing an American Cancer Society epidemiological study, and found no evidence that nonsmokers constantly exposed to tobacco smoke have an increased risk of lung cancer.14 It.is frequently asserted that atmospheric tobacco smoke causes or contributes to the development of atherosclerosis.in nonsmokers, as a result of carbon monoxide. Those that make this assertion point to studi.es by Astrup, et al., which reported a higher cholesterol content in animals chronically exposed to carbon monoxide compared with animals not so exposed. 15 While these studies also reported that the exposed animals had ar- terial changes indistinguishable. from early atherosclerosis, they ignored observations in humans (bridge and tunnel workers) indicating that persons chronically exposed to C:) N) LJ-4 O\ \0 __4 BAT Industries document for Province of British Columbia 2 November 1999 carbca monoxide do not have any increased incidence of atherzsclerosis.16 For those who advance the carbon monoxide- athemsclerosis theory, the Astrup work is conclusive; anyone suggesing a contrary view is discounted. Very recenzly, however, Astrup has admitted that he has been unable to reproduce his previous experiment, He stated that his "present study suggests that applying the gen- erally accepted criteria for intimal damage no direct IT toxic effect of CO can be demonstrated. A similar situation exists as to chronic ob- structfve pulmonary disease (COPD), principally bronchi- tis and enphysena. No one seriously claims that atmos- pheric tobacco smoke causes such diseases In nonsmokers. However, it is frequently claimed by some--usually the' same vcca:1 minority-who make assertions about cardiovas- cular disease and cancer--tbat parental smoking causes respiratory illness in children. Those making this claim point -to various questionnaire -type studies by Colley and others,18 which report that children of smoking parents have ar Increased incidence of respiratory illness compared to children of nonsmoking parents. They cite these studies -9- CD r\) (A CN %`0 00 BAT Industries document for Province of British Colurnbia 2 Novernber 1999 as p.roof of their theory, even though some of these studies also find a correlation between respiratory ill- ness in the parents and si,-,iilar such illnesses in the children, irrespective of smoking. Thus, the question recognized by Colley himself of whether the children's respi-ratory illness is caused by cross-infection from the parents or by a genetic predisposition to such illnesses in both parents and childrenP is simply ignored by those who argue that smoking'Is the established-cause of the. reported respiratory illness in these children. Likewise, they ignore other studies, including one by the Environ- mental Protection Agency, that do not find such an assoc- iation. 20 For them, the parts of the questionnaire-type studies that appear to support their position settle the issue. 21 Recently, a study by Bouhuys--an avowed critic of smoking--and coworkers reported data that parental smoking does not cause respiratory illness in children or other family members. These researchers studied respira- tory synptoms, diseases and lung function in 376 families with 816 children in three towns and "found no significant relation between parent smoking and respiratory symptoms or lung function in their children." They concluded "that exposure to low levels of smoke produced by cigarette smokers does not result in chronic respiratory symptoms or loss of lung function among children nor among adults." _10- ON BAT IndustrieS document for Province of BritiSh Columbia 2 November 1999 Another recently reported clinical study by Kerrebijn, et al., on chronic nonspecific respiratory diseases in children confirms the findings of Bouhuys, et al. Their study found that "Smoking and nonsmoking parents have about the same proportion of children with respiratory symptoms. The number of cigarettes smoked by the parents has no influence on resplratory symptoms in their children . . . if 2 Quite apart from disease causation, questions have been raised about whether there exists a small group of extremely sensitive or otherwise ill persons whose con- ditions might be exacerbated by atmospheric tobacco smoke'. For example, former Surgeon General Luther Terry, after discounting the causation of disease in nonsmokers, stated that "there are a few people who are genuinely sensitive, allergic to tobacco smoke and who can be made ill by being exposed to tobacco smoke.1123 Contrary to Dr. Terry's belief, the question whether digarette sinoke, or any of its constituents as found in smoke, Is alrespiratory tract allergen is unre- solved. Claims about tobacco allergy stem primarily from the many studies that have been done over a long period of time in which extract from tobacco leaf has been tested and found to cause allergic response usually in people-- both smokers and nonsmokers--who are otherwise allergic,24 NJ C:) N) (_q N) C) BAT Industries document for Province of British Colurnbia 2 NoveMber 1999 However, studies with tobacco lear extract do not resolve the issue or whether cigarette smoke or any or its constitu- ents is allergenick one recent study reported the isolation of a large molecular weight molecule from tobacco smoke, which the authors claim to be an allergen.25 However' Dr. Gerald Gleich of the Mayo Clinic reported to the American Academy of Allergy, as recently as 1976, that he and his colleagues had failed to rind any evidence of tobacco smoke allergens in their tests of 30 subjects wh6 reportedly ex- perienced.allergic type symptoms on exposure to tobacco or tobacco smoke.26 Dr. Gleich, as well as Dr. John Salvaggio and coworkers at Tulane University, are currently doing scientific research in this area. Their work to date has not found any4allergens in tobacco smoke. . Another group believed to be particularly vul- nerable-to various environmental impingements, including tobacco srmoke, are asthmatics. This belief is based on several subjective-reports that asthmatics are bothered by such smoke. However, there is no objective evidence to support these reports. And, one recent study by Pimm, et al.,-failed to find any significant changes in the lung function of asthmatics who had been exposed to cigarette smoke in a small test chamber.27 Further research is also needed in this area. Persons with severely compromised cardiovascular systems are another group believed to be adversely affected by environmental tobacco smoke, especially carbon monoxide _12- N) BAT Industries document for Province of British Columbia 2 November 1999 whatever its source. This belief stems largely from Aronow's studies of angina patients in which he used "pure" carbon monoxide, as %,ell as tobacco smoke, to ele- vate their COHb* levels. He found that a certain COHb level obtained by exposure to "pure" carbon monoxide caused certain changes in cardiac function, but that the same COHb level obtained from tobacco smoking did not result in such changes-28 The reason for these differ- ences in cardiovascular function are as yet unknown. Whatever the reason for these findings, this study raises a substantial question about the relevancy of "pure" carbon monoxide type studies to the nonsmokers situation. This is another area where further research is needed. Aside from matters of disease causation and persons who are either extremely sensitive or otherwise ill, there is a small group of nonsmokers who overreact strongly to the presence of tobacco smoke in the atmos- phere. Mere the question is whether there are sufficient amounts of atmospheric smoke to account for this phenomenon on a physiological basis, or,. whether the overreaction of this.small 'group of nonsmokers is better explained in psychological terms. The slightest smell of tobacco smoke causes them to overreact, even though the atmospheric levels . *COHb is the combination formed by carbon monoxide and red blood pigment. -13- N) C) N) BAT Industries document for Province of British Columbia 2 November 1999 of such smoke are generally "much lot-ter than assumed by convinced nonsmokers," as recently noted by Professor G. Wagner of the German Cancer Research Center?9 To support their claims, the overreactors cite d.-& "4- L-A..A:.hk, CDPUJ;~, laboratory studies treport Jag that/ high concentrations of tobacco smoke can be irritating and, therefore, produce various respiratory and other symptoms. ~these symptoms, however, are usually alleviated shortly after the smoke is removed. As a practical matter, however, it bas been observed that when the concentration of smoke sufficient to produce such symptoms is reached in real-life situations, persons respond appropriately, eog. they may either quit smoking or open a window.30 Studies have measured tobacco smoke constitu- ents in the atmosphere under realistic conditions; these have not found levels sufficiently high to account for the overreaction of this small group of nonsmokers. In- stead, these studiqs indicate that under realistic con- .ditions, indoor atmospheres do not nornally have high concentrations of tobacco smoke constituents. For example, there have been a considerable number of studies on carbon monoxide in the atmosphere from smoking. The combined results of these studies indicate that under realistic conditions carbon monoxide in the atmosphere from smoking will rarely exceed 10 parts per million (ppm).31 One exception was reported in a study of a -14- NO BAT Industries document for Province of British ColuMbia 2 Novernber 1999 sports arena which permitted smoking but was not air conditioned. There the carbon monoxide CCO) level reached 25 ppm.32 Another exception was the studies performed in taverns and night clubs where CO levels as high as 42 ppm were recorded.33 It should be noted, however, that these studies were performed with an instrument known to exaggerate the level of CO in the presence of alcohol vapors.34 Moreover, all of the values obtained in real- life situations a-re below 50 ppm, which ii the level set by.various health administrations (e.g. U. S. Occupational Safety and Health Administration) as the limit for indus- trial exposure over an 8-hour period. Many studies have measured COHb levels in smokers and in nonsmokers exposed to tobacco .smoke. Other studies have observed CORb levels in persons ex- posed to carbon monoxide not derived from cigarette 'smoke. The combined results of these studies indicate that under realistic conditions smokers wi'll rarely experience COHb levels greater than 10Z and that nonsmokers will not usually exceed 2 to 3%. And, even these relatively low levels of CORb will drop within a few hours after the cessation-of exposure to smoke. 35 The scientific studies notwithstanding, the antismokers continue to complain about the alleged build- up of carbon monoxide in offices and other places smoking is allcwed. One recent study showed that the -15- C) NJ N CD -th. BAT IndustrieS document for Province of BritiSh ColUrnbia 2 Novernber 1999 CoHb levels of office workers were higher when they came to work than when they left at the end of the day, even though they were exposed to cigarette smoke throughout the day.36 The results of this study indicate that the antismokers should be more concerned about the outdoor levels of CO from car exhaust and other sources that non- smokers are exposed to on their way to work than tobacco snoke in the office. It should be noted that no one has ever estab- lished that the health of nonsmokers is adversely affected by even the small amount of CO that might be in the at- mosphere as a result of cigarette smoke. CO is a natural body constituent which is even present in very small quantities in the blood without any exposure to CO in the atmosphere. The body can and does get rid of CO by vari- ous means. And, it should be noted, persons with COHb levels of 15% or less rarely even suffer any of the first symptoms of CO difficulties, such as headache, nausea, etc. 37 One claim that is frequently made about exposure to low levels of CO is that it affects certain performances, such as ability to distinguish between short intervals of time and to solve mathematical oroblems. There is still disagreement in the scientific literature, however, as to whether such performances are affected by COHb measurements in the neighborhood of 100. or less. Some studies indicate _16- Nj CD NJ (-P4 NJ C) Cn BAT Industries document for Province of British Columbia 2 November 1999 that these levels of GO will affect such performance,38 - while other studies do not so indicate.39 This is another area that requires additional research. In contrast to studies performed under realistic conditions, the overreactors frequently cite studies con- ducted under highly aritficial situations as evidence that high concentrations of GO from cigarette smoke can be at- tained. One such study by Srch placed two smokers and two nonsmokers in a small closed car in a..garage and had the smokers smoke ten cigarettes in one hour. 4o Another study by Harke placed a European car in a wind tunnel and then had nine cigarettes smoked inside the c -ar, one after another, without any ventilation in the car and no out- side wind movement. 41 Of course, in situations such as these, a rapid buildup of GO occurs; however, as Doctor Farke observed, these conditions do "not correspond to a normal traffic situation." And the subjective reactions of the test subjects to the Increased levels of smoke con- centration were revealing: a threshold is reached at roughly 20 ppm Cof CO] which normally prompts one to open a window or to turn on the ventil-' ation." Studies on nicotine indicate that atmospheric 42 levela are minimal. No one has suggested that the min- uscule amount of nicotine that might be absorbed by a , nonsmoker has anything to do with the production of human disease. Indeed one recent study that monitored heart -17- NJ CD NJ Q4 CD ()N BAT Industries document for Province of British Columbia 2 November 1999 rate in nonsmokers exposed to cigarette smoke under labor- atory conditions concluded that the amount of nicotine in- haled by nonsmokers under their rigorous test conditions was too small to alter heart rate.43 Studies of other tobacco smoke constituents indicate that smoke's contribution to atmospheric levels 44 of these compounds is minimal. Thesestudies are usually conducted in the context of an exaggerated claim about the danger of exposure to some compound attributable to tobacco smoke. One such study of "volatile" organic compounds recently concluded that the amount of such com- pounds added to the atmosphere as a result of cigarette smoking is "insignificant.,,45 The'laboratory measurement of smoke constitu- ents often is done as a purely analytic study without taking account of real life situations. A current example is Dr. Brunneman's recent report of nitrosamines in tobacco 46 b0L-eA)c--, KLS smokei , In prccc.nting and diccuccin.- hio findingg d,,r *47 n- study was intended as a model study and not as an imitation of reality. Because the overreaction of some nonsmokers to smoking cannot be explained on the basis of a physiologi- cal response to atmospheric tobacco smoke or any of Its constituents, the question arises whether this reaction can be explained on an emotional basis. While this auestion --4-19n on ucc in Footn,2te ?17 N) (-N N) BAT IndustrieS document for Province of BritiSh Columbia 2 November 1999 is far from settled, At least one researcher, Dr. Gary Huber, has suggested that this might be the case, noting that the odor of smoke comoonents "may trigger emotional 48 responses not yet well understood." This theory finds some support in a recent study by Rummel, et al., 49 in which college students, who were first characterized as to their attitudes.concerning tobacco smioke, were exposed to such smoke. The authors reported a significant differ- ence in heart rates of those who "disliked" smoke compared with those who were "indifferent-to smoke, with the higher rates among those who "disliked" the smoke. The authors could not determine from the data whether the "dislike" group had a true higher heart rate initially, or whether the anticipation of sitting and inhaling the "disliked" cigarette smoke caused an increased heart rate. This is not to say that perfectly normal people are not sometimes annoyed or irritated by atmospheric tobacco.smoke. Especially in places that are poorly ven- tilated, concentrations of atmospheric tobacco smoke may themselves or in combination with other environmental in- fluences give rise to eye or nasal irritation. Whatever the basis of the overreaction of some nonsmokers to smoking, one thing is clear: atri-iospheric, tobacco smoke has not been proven hazardous to the health of nonsmokers. Accordingly, as Dr. Pimm. noted in connec- tion with his research on asthmatics exposed to tobacco _19- N) CD N) C) 00 BAT Industries document for Province of British Columbia 2 November 1999 smoke, if smoking is to be restricted, it will have to be on the basis of annoyance and visual disturbance and not on health grounds.50 Ill. Government Rep:ulations and Individual Rights While common sense dictates no smoking for safety reasons In certain instances (e.g. near gasoline pumps), measures against public smoking, based upon un- founded claims that tobacco smoke causes disease in the nonsmoker, are unjustified. Beyond this, for government to regulate smoking in public or other places because it may annoy or irritate some nonsmokers constitutes an unwarranted Intrusion into.people's private lives. Contrary to the claims or the antismoking leaders, the vast majority of people--s.-nokers and nonsmokers--are not usually annoyed by public smoking. For example, a recent U. S. survey found that when people were asked about the kinds of things that annoyed or ir- ritated'them in their everyday lives, only about 2% of the annoyances mentioned were related to smoking. 51 Indeed 919 of those in the survey didn't even mention smoking.52 The American Express Company found little In- terest in nonsmoking tours that they sponsored. 53 Numer- ous surveys demonstrate that diners have little or no in- terest in the nonsmoking sections of restaurants. Por, example, one Seattle, Washington restaurant reported that in a 3-month period in which the restaurant had served -20- CD N) U4 CD %10 BAT Industries document for Province of British Columbia 2 November 1999 30,000 customers, there were only seven requests for seating in the nonsmoking area.54 Why then this outcry about public smoking by a small but vocal minority of anitsmoking leaders? They claim to seek protection for the nonsmoker, pCj,,jj ()_,c OLj.%,#cJ4A O.V +UL."_ but their e~~' ni~ i-, tn of mw&k==s*,c %rv,,akv\- As stated at the 3rd World Conference on Smok- ing and Health in response to a question:- and of even more consequence, is what nonsmokers' social action can contribute to the solution of the total smoking problem and its devastating effects on smokers."55 A campaign to harass and otherwise inhibit smokers is not' a legitimate concern of government. Public smoking policy should be set in light of the facts, not upon unfounded health claims that at- mospheric tobacco smoke is harmful to nonsmokers. In any event, the antismokers are sometimes successful. They get laws and other regulations to ban or limit the rights of smokers, but at a high cost to society. Thousands of hours of time are spent on an issue that is of little real consequence. Moreover, the end results of these costly proceedings are laws and regula- tions that are frequently impractical and unenforceable. Laws and other regulations that ban or limit -21- N) (-N N) CD BAT Industries document for Province of British Columbia 2 November `1999 smoking, whether aimed at the smoker or the nonsmoker, constitute an unwarranted intrusion into the lives and P rights of citizens. People in a free society should be allowed to make informed choices about smoking. Nor can these laws and other regulations be justified on the basis of annoyance to nonsmokers. If. the problem is one of annoyance, it can best be dealt with by mutual courtesy between smokers and nonsmokers rather than by governmental regulation or Ueprivation of individual freedom.. IV. Future Action by the Tobac'co' 'rndust'ry In order to understand why public smoking has developed into a publi c issue when there is no real basis for public actions, when there are not real public inter- ests invo~lved and when public actions infringe on private rights (freedom), the tobacco industry proposes the fol- lowing actions: 1. Social science research programs: What causes nonsmokers to accept unsubstantiated accusations about public smoking. (ii) What is the depth and extent of opinion and feel- ing about smoking as a public annoyance. (iii) is the public smoking issue part of a broader range of social issues of which cigarette smog_ ing is currently the most visible. -22- r1 j C) N BAT Industries document for Province of British Columbia 2 November 1999 2. Medical science research programs directed toward: (I) Determining .-thether or not there are any groups of extremely sensitive or otherwise ill people whose conditions nay be exacerbated by various environmental influences, including tobacco smoke. (ii) Investigating any evidence asserting that public smoking causes disease in these or any other -groups. (III) Determining why certain nonsmo kers overreact to even small amounts of tobacco smoke In the at- mosphere. 3. Public information programs: (I) To inform the smoking and nonsmoking public of the truth about tobacco smoke in the atmosphere and health. (ii) To urge smokers and nonsmokers to be mutually courteous. (III). To cooperate in public safety programs.that en- courage awareness of possible fire hazards. Beyond these research and information programs, the tobacco industry will strengthen Its activities In support of legislative freedom of smokers and nonsmokers alike. -23- BAT Industries document for Province of British Columbia 2 November 1999 REFERENCES 1. Action on Smoking and Health. "Pipe and cigar smoking: the report of an expert group appointed by 'Action on Smoking and Health'." The Practitioner 210 (1259): 645- 652; 1973. 2. Corn, M., et al. Workshop summary and recommendations. Report from a workshop on Environmental Tobacco Smoke Effects on the Non-Smoker, Bermuda, I-larch 27-29, 1974. Scand. J. Resn. Dis. Suppl. 91: 88-90; 1974. 3. U.S. Dept. of Transportation, Federal Aviation Adminis- tration, U.S. Dept. of Health, Education, and Welfare. National Institute for Occupational Safety and Health. Health aspects of smoking In transport aircraft. Rockville, Md. AD-736097, December 1971. 85 PP. 4. U.S. Interstate Commerce Commission. Smoking by passen- gers and operating personnel on interstate buses. Washington, D.C. No. mc-c-6748, motor Carrier Cases, 114: 256-278; November 17, 1971. 5. Valentin, H. In: Passive Smoking at the Workplace. Reports and discussions from a meeting of*the Bavarian Academy of Industrial and Social Medicine, March 31- April 1, 1977, p. 24. 6. Arbeitzmedicin; Social Medicine, Preventive Medicine 2/785. 39. 7. Wynder, E.L. Statement made on Barbara Walters' tele- vision program "Not for Women Only". WRC-TV, IIIBC Network, Washington, D.C. April 18, 1974, 9:00 A.M.- Radio TV Reports, Inc. Washington, D.C., p. 11. 8. Rhoades, Jonathan Jr., Comment during "A discussion of smoking and health", Newsprobe, WTAF-TV, Philadelphia, Pennsylvania, p. 9, July 16, 1975. 9. Hammond, E.C. "What.are the high risk groups for public education? How does epidemiology identify them?" In: Sumnary Proceedings of the International Conference on Public Education'About Cancer. 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