666 L jjjdV 9 L eiqwnloo t19111.18 10 GOUIAOJd jo; juewnoop oo.LVS
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N
The Tobacco indu-stry acknowle-Iges --ac
is ccntroversy Over man,,, aS=ettS Of' 6he general prabje=- o-
s = c 'I%- -1 n Sand heal th. There is disagreement a=ng medlcaj
exzerts as to whether the reoorted associations between
smoking and various diseases are causal or nct. Accordingly,
the=e is a continuing need for -further rese&rch. into the
causes of su@h diseases and it remains thle polic7 of the
tobacc_- _4M.-du3try to support such -research.
"?ub-1-4c S=Qkinv, +-a w4@, s-, king -zr. , .6, .-6 e zres-
ence cf fanc--ter person has become Lncreasfngly t.he s u e c t
i
of debate wfth --o-untIng pressu,re rest-:-_-'ct_-cn. Tha I-I S
also teen va:-Icus_'.y referred as "=assive smck-
In, t2h a
C_- however, is = @er Q
te:=s are in-.ended to be subsumed under "?,_,'=1_,C
It I-s self-evidenz th.-at, sfn..-e ttere is disag-_ee-
ment azcn-z =eA__'c_=I ex,--erts as to whether :,ep-crted- assc-
c:@ztlons between s=ckfnz And va_-ious diseases are caus-al
cz, nct, the=e is no comnell.-Ing evidence to zr--cf
that there 13'any causal llinkc between I_'F'ub7Ic Sim-oking" and
Various diseases. This paper will, -Wherefcre, address the
issue az_-ording to the presents state of sclentific knorile4ge*
but will r,,aA'.C a- no Judgments on the vaz-y4-.-.g views of the ex- U4
-erts ...,h"ch are quoted or referred to. CD
CD
h4s paper will be'updated per"od"call-r. Aczor@!-,,Sly,
before use it"would be to check, tz determine that the N-0
inI:-o:-:rzt-_'cn to be used is up to date. CY%
BATCo document for province of British Columbia 16 April '1999

T' 'Du'r, 1 q C
=okins as a ?-ublic issue
Tn the lest -ew years, controve.-sy has arisen
@abcut public s,,.,__-k'Ing and he-alth; claims and changes have
escalated; ca=pa.Igns to bar. or restrict smosking 'Ln publ,,-
have token place and continue 'to increase. Thus, the
public @smoking issue has be-.o,-,.e a matter where the tobacco
industry's position sh-culd be clear.
There are three =ajor points upon ehich to
100cus.
First, cla-4?"m that, tobacco smoxke 14-72 the atlmcs-
phere causes disease in norI_j,-yokers are umsubstan,11.1sted;
never-.1--eless, r- 1-=-se portlon of the pcpLvIa-"-_cn--bcth
smokers and -nons=ckers--be.1-4--ve these s
S e -_ _=&d I-elders of the drive to s-.-ok-
-Ing :Ln izubl_`c frequent"y resort. '%-.c scare tactics to =ake
nc.-is-mckers lwe:Lave the-r health is being ha=ed by t-Obaccc
smoke in the at-::csphIe_-e_.
Th4rd, aza-ns. this backgrcund of
pubj:L-_ bodies a=e =akcing rules, abooutt public smok-Ing that
in-'C.rude into personal liberty.
Although the public szmoking issue arose in the
1970's, it ste=-ned 06ro= the s-moking and health cont-=oversy
of the last. 25 Years. As a supplementary methad to dis- U4
suade zeoole from, smnoking, the notion of a crusade to make
C)
smoking so.-4ally unacceptable was evolved4. The mtechanisz: z
--4
to do this was to pa-Int smmoktng as a health hazard to the -.-O
U14
BATCO document for Province of British Columbia 16 April `1999

n@or z r
the -7--d World Conference on Cmoklng and
.Hea".'- in Nle-..., York in 7_975, this was consf A ered a-viabje
plan fcr curtailing smoking. Since then, efforts along
these lines have inte.nsified.
the problem. that advocates cf this tactic faced
-in 1975, and still face today, is the fact that "'Anere is
no pr--of tcbacco s.-..oke in the atmosphere cases d4s-
ease In the nonst-cok-e-r.
M-_ most "hal- can be said about atmospheric
1he
A.'Obacco S=oke is the poss-'101-11ty 4%-.,u.ere is a sr-all
group cf exceed-Ing'-I sens"tive =ecp'.
ha-,-e c@=.dltions be exacerbated by various
envircr:--ental in."'luences includ_4ng env'_'_--_n=ent6a'I tobacco
Smcks. the Contr11--uticn of to'bac-co S,-,IC'r.,e -tc
Lis C.Z..'.!stlituents is 'min4mal .
,men so, ef_P:r-.s -..;e:-e under-6pl- to zake n=-
smckers belie7e that was being adversely
a I'-" e c t ed '--.v a=_os=h=_ric t--bacco smoke. 11"Inus, a S==-'! but
deter '.aed ccrps of azit-Ismokers set out to get smakfng
banned L- the -.-rork ;Iace, either by court or sovernmental
regulaticn; tc get I-ews passed regulating smoking in
public places; and to get s=okIng restrict4ons on public
trans-ort. I-I"hese fcrzes aze still at. work, ant4 today the
public s.-ackinz Issue Is receiving ifidespread atte-ItIcn.
In gener-ating this issue, the corps of antism-okers
X.Ia.
BATCO document for Province of BritiSh Columbia 16 April 1999

sea t6 -a c t. ics b-ased on mi-s i- fz-rmation and emotional _4s7,
n c tu z t -1 f --' c C1. b Y f,,,- c @.- s
!I. Atmoszheric TobaCc-o S='SCe and Fealth
There is no scientific proof" that tobaccc SMOILI-e
in the 'atmosahere causes disease in nonsmokers- Des-p-Ite
-ra--y cla-ims of a 'e-..t, the view that at=os_pher_IC
t2he c ont
tobacco smnoke does not nresent a health hazard L.0 A
nonsmoxker is su-morCed by nume_?,ous reports of indemender,@_
scien-tist's and governmaen'Wal bodies that have examined
this issue Fc- e-arm-'e, ir, 1.01T4, a urcrics-cp (oz-
a M. Cn& o t, 'M ers, by Dr. 'FI%Y-!En-%'_-__- of the Univers.'Ll'.1es of'
oA-' -A-ended by sc4entfss rnzrz
Geneva. U.. 4.1- 6
all crrez- 0-,crld to ccnside:- `Che health conse-uences of
a6..,,CSMhe_-_IC @OCPCCO Smoke. These scien-tists were unacle
to concede cisarett_= smok-in- is a h?-za=,-' -A@.o r-z?--
!--r"hez, these Sc4en'S's s ;.Zf- at;
64.e of the po,,.--," -Pt-f-cm.
')he averaGe e,;-csure burden due t1lo
envi-ronmental ".4cloacco smaoice is prob-
ably nuch 1 mier %Than z6ha-6 due to
industrial a4r pcllutan@s and in
many cases also envirzonmtental a _4
pollution or -6.he lung burden due
to dust clouds cr other Indoor air
pollutan'vs.112
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C)
LS
BATCo document for Province of British Columbia 16 April 1999

1." a Vio-int. stud.v by t'-o Federal Aviation
Ad=tnistraticn, '%'.-.e United States Department oP Health,
EducatIcn a:-d ',-,"elrare and the National- inst-itute-of Occu-
pationaZ Safety and Healt, i examined t.ie hea'th aspects of
.smoking on transp.crt aircraft. TtS concluslon was as
follows:
it is concluded that inhalation
of lc-'-Products 06--nom" tobacco S=Cke
generzte@ a result of Passengers
as .6
S=cjd.::g aboard aircr-*ft does
nc,: represent a sign-4-ficant. hea'th h-azard
to nons-mcking passengers." 3
ThIs ccaclusicr- -'s suppo--ted 16-,,y that cf the U. S. Inter-
state Co=erze C=-..LssIonI_%--stIu,_-y o-f s-,--k-Ing on -buses:
STWe agree wlth. exa=Lner's c--nc-;.u-
sicns th.at Petitioner h.as fafled adje_-
cua:e_-y tc demonstrate the deleter4-us
effects of seco.-U4-hand smacke -,=or. zne
4
hel:th @-f -aoc-- bus passenze-s.
977, a sympos- = cr. the tcpic cf s=ok:Lng
n -, . ... - 6 ..; - ;.
in the work =:=--e s=cnscred by t%he
1--idustrIal a:,.--' S:cL_=_- Me-d-Ic-Ine was !Ield In Germany
and atten'ded '-_Y e-lne.nt Ge:-=an szierz,;@sts, la-aryers, as
well as loaders. ""se chafr=&r. C-f This Sy-.posium'
Sovern=en.
Fro_I'esscr Dcczcr H. Volent-1-n. of the Ur,:Lversity oA"' Erl ange"_
Nurenburg stated as follows:
"Ir. concluslor., with resard to medical
and legal facts o-!' -assive s-.ck,-',-ig at
the work place, the following =used. It e
consLdered. Under cuZ, present day %rcrk
place acndltions, no clear and sign!f-1- C)
can". untoward health effects Pass-_!ve C@
s=cI'I,.:Lng have been sh.ovrn. Theref-cre, ure
s'ou:d, as -In other everyday situations,
:1 -o S
ooser,re S.-O
C71%
0%
BATCo document for Province of British Columbia 16 April 1999

2
as s a@e in@erver.`-f-n
as necessary - as =uch freedom as
Possible.
':78), the German Soc4ety of
QuIte recently
Occupational Medicine-whch includes approximatelY 700
scien@'Isl's and other persons Interested in occupational
healt,"i-examined. the issue cf smok-ing in the work place
and found that
"To date, accordln; '66c our knowledge, sclen-
tifical"ry uneq!i1vccal and objective proof of
damage to health, as a mesa!-. of passive
s=ck-Ing, has rc. Iceen, estatlished :Ln any
population groun
Acccrdi n g ly he Society c=c:uded that P s=ckinx- ban in
.,-.e work place cannot @,us:4-fled on a sc."6ent"fla basis.
Tn view of these ccncluslrons by _Jnde.-enC1_._.
sclenzists and Scvern-mental tc,_;Les, it is rose s,-,-;r'Ls-'ng
th.at sc=e of %the --ast avower zritics c-f tobacco h. E-, e
acknowledged that s=cklng no". been esta6-2.'s.h, ed a s a
cat,se ol' disease :Ln
F
X-or ex=zle, :):-. ---:-sees-. L. Wynder of the
c an H. a I -@.&h -7 o, un d a : i cn a d= -I t z e' ..i ae d o e so t b e !i e v e
at p a
zsive szck.Lng _-e2!!y '--.==s the health of somebody
who sits ex- to you. .,T Dr. Jonathan Rhoads Chair-
n
=an of the Nat:@onp_! Cancer Ad7:@Sory Board, adz:itted in
cc=enting upon atmospheric tCtacco smoke and health that
la his knc-al ful
6 edge "it is not, :@n fact, actually ha=-
CD
And on cancer, Dr. B. Cuyler c!' t'he AnerLcan
Cancer. Society stated that "was na shred of evidence"
BATCo document for Province of British Columbia 16 April 1999

that a nc.-.s=cke:t can get eancer -frcm "second hand" s=cke
and tha'. %',fee is a lot of e,,,'Lden-^e that he cannot.
Dr. Ea=-mcnd added that to suggest passive
S=Oking could cause cancer is dlsh.onest-, and th.at he
would be prepared to testify as much in a court.9 And
even the ithen Surgeon General ol' the United States-
Dr. Jesse Steinfeld--ad=itted after the 11972 Public
.Health Ser,7tze Rezor-. was -4-esued -.hat he could not 11 say
with certainty that. exposure to tcl-Wac-co s=oke can cause
serious 411-ness in ncrst-m-kers.11C As further examines,
the foc-.-.c:e -1-4sts -d-..o are critical-
ol' smoking who have voted the view :.t=t,, at=osphertc
tobacco S=ZA,,e lips nc--'- been estab---'shed As bel..g ha--=-
to W.- 6, A.. 1. r.
.6 u, e of no-s=o'-e:-s.
These opim-cr-8 are su-z.=::,-.eA- the flnd-lngs
of !---Hands and 2FIrst cf the -vard Schcol of Putt-14c Health.
stu4-7 was financed '--.7 the Massachusetts Lung
Assoclazlzn, =easured- -.crack smo."Ce ('--y
frc= njc@tine) :L-: various ;';.-aces such as restau-
rants, c--ckta4-1 lounges, bus and afrllne termij-nals and stu-
*Rich-ard Doll, Dean john R. Golds=ith,
GIC Go-"is Roy Korson, David C-...,en, :rwin Schmeltz, Reuel
Stallones-and R. B.
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ON
co
-7-
7--
BATCo document for Province of British Columbia 16 April `1999

den.t !sizes, and -found that t"he anounts are very s."Iall
j._:.4eed. 1-2 71 edltor4al cczament, appear4r:g in -he New
61
England journal of Med-Ici.ne which rencrted thIs study, Dr.
Gary Huber of the Harvard Medical Schoc-I
"Under the most severe concentrations
of exposure In their study, the non-
smoker could corsume ar, amount of toba----o
so small that the risk of develop-ment
of any adverse health effect would be
non-existent, on the basis of any ay
able data in the literature today.11-T-
Sc:@ent!""c "acts notwIt.n.stand"ng, cIaLms are
sc.meti:,aes made that, smoking causes chronic degenerative
diseases in nonsmokers. However, one recent st@;dy re-
-h
viewed the data Zf'rcm a n=be:- a' -ner s@ud4-s, 1 -lud-
I_g A-erL'
Cancer Society epIde- clczfca' study,
A".1 Ca.. .4
and -Gould rc ev:@dence 16-hat nonsmokers ccnstar...17 exMosed
to tobaccO smoke have an _,@ncreAsed 7 4-sk of 1,-ing cancer.I4
Ili., is :'requently asserted th.at
tcbacco sm..Cke causes or contributes to the devel==ment
aZ' at.heros_-Iercs:@s in nons-mokers, as a result off carbor.
=en a XL d aMhose that =ak,e this assertion r"cl_nt- to Studies
by ASr
et a!., whIc.h. reported a choleas--ero"
conten: in azi=als chrCaLcally exposed to carbon- -monoxide
%, h' I 5
ccrma_-ed wit' arnimal s not so exposed. While these
studies also reported IChat the exposed an_'mals had ar-
terial changes ind-'stinguishable :"rom early atherosclerosis,
-'Ase an,4 el
6.4.
'hey igno-ed observatIons in humans
CD
workers) indicating that persons ch.-C.-feally exposed to
C)
BATCo document for province of British Columbia i6 April `1999

carbon Monoxide do no-. hal.-e any increased. i:::fden-_e c.P
atheros-cleros"S.15
Fcr those %,hc advance the carbon =:noxide-
atherosclerosLs theory, the As"6-.u.z work Is c--nclusive;
anyone suggesnS a contrary view is discounted. Very
6 . 6,
recently, howeier, Astrup has ad_-.4tted that '-e has been
unable to repr--duce his previous expe-riment. stated
that h_'Is "present study suggests -what applying 'Che Sen-
erally accepted crlteria for intiz-al damage ::: direct
toxic effect of CO can be de=onst:-P_ted."17
A situ,,ton exists as t'a cb-
Structive pul=cna:-Y disease (CO?:)), nrl@ncimz::Y 4
6' 16s and e=physe=a. No cme seriously clai_ms t1nat atmos-
-he:,!= tobacco s:rc,.-
..e causes such dise-ases i.-. ncns-,.oke_-s.
=cwever, frequently claimed by
sa=e vocal r._'nz:-fty who -"fare assertfons atou- Cardfovas-
"ar d1sesse and -a:-ce:--t'-aI.- PAren-al ca-;ses
c,;
resp'lratcry _'!','".ess ir. c.hild@-_-. '..c s e =akfn rt. "-. is car---:
-c4 to vartcus questicnnalre-ty=e stv-d4es u7 Col' ay and
offers, whlch. -rencrt, that children o'67 smokni pa=ents
have an increa sed incidence of respiratory illness coaimared
-7
to children of n.cns.-.ok4_n& parents. They cite -..',.ese studes
CD
-9-
BATCo document for Province of BritiSh Columbia 16 April 1999

. ................
as proc-" of %their theory, even thoug.h some of th-ese
sz-_,dles also find a cor--elation between res.-Iratc--y -'II-
ness in t?-_ parents and si.-,;lar such illnesses in th_-
children, irrespective of sr-oking. Thus, the question
recognized by Colley hi=self of %--r.'acther the children's
respiratory illness is caused by cross-infection ft-a= the
parents or by a genetic predisposition to sucn illnesses
19 Is simply ign-red by those
in bot-h parents and ch4ldren,
,,.also argue that s-mokins is 16: e established cause of
re.ported respiratory illness in these children. Likewise,
they igncre other studies, IncludIng one by the Znvircn-
mental ?rotecticn Agency, that do not f.1nd such an assoc-
20
i a: --' on. For them, the parts of the t7pe
"a
stuA-les t-'-at a=,oez:, &to sunno:-. t.he4- -os4t4cn se@,
f5sue.
Recent!,..y, a st-i;dy by
of co-wrcrkers reporzed dat-a that parental
smokl-Ing does not, cause resp"ratory illness in chId-ren or
th. e Th.ese research.ers 51.1u,
tlorv sy=zto=s, diseases and luzig function in 375 --a-mi S
.6
c ca.,
-owns and ",pound no--s"gn", n16
0-0 hildren in three
=elatllon between parent smnoking and resp-l-ratory sympto=s
or luns function in their child=en.11 They concluded
exposure to low levels of smoke produced by cigarette
smnokers does not re.-ul"11 in chronic resPi-ratory symptor"s or CD
loss of lung -6,.m c t i o n amo n g c h d r e n n o r a--..c n S a d u It s C)
BATCo document for Province of BritlSh Columbia 16 April 1999

ox
Anothe@- recently repo.rzed clinicaj StUdY by KerrebiJns
et a!., on ch=2nf.,_-- r-.onsoe--'-f"c..resz:Lral;.-o.-y dise-as-es -In
c.nildren conf-'r-as -..,.e findings of Bouhuys, et aI. Their
sI.1-Idy 06ound %"-.at
IISEcklng and nonsmoking parents have
about. Lee same proportion of children
wit.h respiratory symptoms. The
of c'&a_-_&t-.es smcked by the parents has
no inf-1---ence on respiratory Symptcmas tn
the':, c.-_@._Idren. tr;)2
Qu-1,:e a_=art. -from d -'sease causaticn, q,.:estions
have been rai-ced atout whet.--er there exists a mail grou;
of ex-;re=e_IY sz-::sf:fve -or c,:h,erwIse ill zerscrs whose con-
diticns "-_'ght ':e ex-cerbatet', by atmospheric tot-a:ao smoke.
For Surzeo:.! Generpl 7-uther after
disccunt'ng tht causat-f--n cf disease In ncr-smckers, stated
t1hat are a few -_eople who are Senu"nely sensitive,
allerg:Lc -.2 s=ka amd` whn ca:-. be =ade il' being
ex;csed tc
canzza--v
Y S belie--r" @UA C.
clgaze::e or amy of its ccnstituenzs as
Zpound In smokb, -Is a. hu=an respiratory tracz- a!,.-'--:-Zen is
unresolved. C_I&_I=s abcut'., t_-bacco allergy stem Prt=arily
.6.60M the many S:udles that have been done over a long period
of time in wItich extract frcm, tobacco leaf has been tested
and found' tc_ cause &'Iergic response usually in ;ecp_'7e--
CD
bcth smokers an! n-_ns-okers--w-o are otherwise a:Iergic.2j.,
C:>
NJ
BATCo document for Province of British Columbia 16 April 1999

However, s-tudles wi:-'- tcbacco leaf extract do nct resolve
the issue of whe:her cigarette smoke cr any of its constitu-
ents is allersenic tc% h=az,_s. One recent study nepcrted the
.Lsclat._fcn of a lazge molecular weight molecue from tobacco
smoke, which the au-;..-.o--s cla-'= to be an allergen.25 However,
Dr. Gerald Gleich of the Mayo Clinic reported to the American
Academy of Allerz_y, as recently as 1976, that he a-id his
colleagues had failed to find any evidence of tobacco sm.oke
6ests of 3' sub4ects who re=orteA--Iy ex-
a lerse=s In their
Perienced allerStc ",.7;e sy=-.c.-,s on ex-Pcsure 16.o tobacco or
tobacco smcke.26 Dr. Gleich, as well as Dr. Salvagglo
and coworkezs at Tulare University, are currently %doing
sclentif-" -_ r -_se=-_-=h 'In area. "Mine-'r work %to C-4pte has
no-. found any allergens 'n tobaccc s=cke.26a.
Ancth.er tc be vul-
nera' le to vaz'ous env!:-on--e::-.a]6 :@ncludln-
Wobacco $=-,Caere, are Mals bel-lef -is '--ased an
several suble-c-.17e re=C:`.S asthrat'zs az-e lzcthered by
sucl- s=ke. '-rcwe-;el;.
.,-.ere Is no cbjectl7e ev. t. _4ence to
support, these repcrts. AnC!, one recent study by I.-Fiz-m, et"
al., failed to A"'Ind any signiffican-1. changes in -6.ae lung
-o c'garette
function o," asthmatfcs whc had been exposed 16
smoke in a small test char.'--e:,.27 I'lurther -esearch is also
needed in are=
Persc.ns with severely co=romised cardicvascular
C'-
systems are ancth.er Srcup be'-le,,red to be adverse'"y affected
by environmental, tc'-_ac.-: s.--_I%,e, eszec-la'@._',- ca:-',-,cn =.-oxide
'@O
U4
BATCo document for Province of British Columbia 16 April 1999

4. 61 s e... y fro=
vl-A@ever its source. ':his -s large-
Arono-e-I's studies of ang4na =atients in which he used
pure" ca--bc:-. monox'_@A_ e, as ..-ell as ;tobacco smoke, to e-l-
,6 in
vate their CC':.rD* levels. found thot a cerl.,a - CCHb
level obtatned by exzosure to "Pure" carbon monoxide
caused certaLn changesr in card '-fac funct-Ion, but, that the
same CO'.-.b le,.,el obtained f:---= tobacco smoking cud no,,C.,
result." in suc-'- chanses.28 The reasc.n. for these
.6 @. er-
ye,6 U
ences in ca_-,_-_'ovascula_- function are as
What-ever the reason for Jose t'.1,_,'Is study aises.
a substant'I'al cuestIc". about the relevancy of 'pure"
ca--bon =cnoxide t yp e s tud i _- s t c t Ia e noms=olkers' s' Ituat"Icn.
This is another area in',,Iere --'-.he:- reseexch :ts r. e e d ed .
e frc.: =at'ters :-r dIse=se causation and
persons axe eit.--er extre=ely sensL-._!-_- o.- o-4.herwize
th o v e rr e a ct.
ere :Le a s-u7a-!: grcuz @,-f nons.-a-kers Vhc
S@rCr
.g.y 1._ 6'-e DreSenCe C
f :CbaC_-O 3=01ke :@n the atmcs-
r), a-'a. =O-a quest4cn fs -'-ether there az-e sufficient
a7I o un t sof a".=cs=he_-i: s.-nok-z tc pcccunt this ;.hencmencn
or. a bas's, or, whet.he-r the cve:-reac tion of
this s.-,.a-Tl Srcwup of ncris=okers is better expla.4-ned in
Psychological terms. The smell of tobacco smoke
causes the= to overreach, even-though tire atmospheric levels
U4
*co,-:,z is the formed by ca-.bcr. CD
monoxide and red bloo4- parent.
CD
%lo
BATCo document for Province of BritiSh Columbia 16 April 1999

-au c' ha
of such s,-,cke are generally ", .". lower t. -11 assumed by
convinced ncns=ckers,II as recently noted by Professor 'V.
Wagner of the Ger=an Cancer Rese-zr:h Cen-er.2c
To suzoort their cialas, the cverreactors cite
labcratory stud-'es done u-nder unrealistic conditions,
which report that very high concentraticns of tobacco smoke
car. be irritat:Lng and, therefore, p.roduce various respi
ra
tory and other symptoms. Even these sy--ptotzs, hcwever, are
usually allevtated shortly a-,"ter t,he s=-o.k--- is removed. As
a practical- mat-zer, however, it has been obser-ted that when
the concentrat'-4cm of smoke su-"L-4---fent 16@: produze such sy=p-
toms is reached in real-1-117-e situ-atcns, pperscns respond
appro;:,'ata:y, e.g. %they may eitner quft- s=ok-jng oz, o.pen a
Act
Studies have =easured tabacc= s=cke ecnstLtu-
en:s the z-t.-"csp-he---e under real-'stic Ccnd.'t!:ns; these
.-.a-7e nct fcund le--,els suff-Iciently ----fgh. tc acc:,--nt for
t.he cve:-reac:t--n of th-4s szall gr@:u= of
stead, t.hese studies indicate t6h.-at under rea" cc=-
elltfcns, indocz, at=cspheres do noz nor=allly ha-de
concentration's of tobacco smoke ccnstituents. To.- exampla,
J
there h - of s@udias on carbon
ave been a considerable number - I.- --
monoxide in the atomsophere from s=ck-4=&. The combIned
results of these stud4es indicate that trader realistic
ccnd,It-'Icns carbon mcnoxide i.r. 'the atmos.mhe--e frcm smokin-
will rarely exceed 10 parts per =i!1ion (pp-,a)._,- C)
One exception was reported in a study of a
-4
4
BATCO document for Province of British Columbia 16 April 1999

spcr--s arena whfcn- ze=Lzzed SMck-4ng 'U"Ut was nct air
cond-4-6-ioned. Vnere t)-..-- c=-r'----n monoxide (CO) level --re-ached
25 =z-, 32
Anot,@.,er excep:fc;n -.,-,s tne s'@udies merfor=ed
in taverns and cluts I.-Ihe.re CO level's as hi&li as
42 ppm were re-orded.33 It should be noted, !,.clever,
that these studies were -_erformed with an Lnstrument k-no,.-.-.
to exaggerate the level c--" CO in the Presence of &I c o.)-,.o 1
vapars.34 . Vioreover, all of the values In real-
fe situat_,@ons are belou, 50 ppm, which -s t.ne level set
by various 1,.ealth ad-n4nistrations Ce.g. U. S. Occupaticnal
Safety and H_ -_ a " t h as the _'Im"". -for :Lndus-
tri'al, ex.zcsure, over azt peri"zd.
Many s@u,"as hz-,,e neas,, e-2 C^Fb levels :L-1
_r
smokes a:,.--2 _fn ncr=ckers exposed 6wo tobacco sncke.
Other stud"I'es @_,_=-,re observed CO-H-b 7e7els L-- perscns ex-
Posed to carb-on, =c-.cx.I_`e -ot derfved f'rom clxazette 's=--ke
J_
The cc-r-bined _results r-f thase stud'es f-c"cate a
_-ea'Us-.'c c-_nd-.Lcns s-mokers will razely experfence =F,
levels gz-e-=-.e:, t.=n ':Cf% t!,.at nC.-_S:,ok=-s "OA-
usually exceed 2 '60 3%. A.1d, even t;he-se, relat-ively. ic-d
.1evels of COHb will drop a fe,..r afte_r the.
35
cessation of exposure to smoke.
Tl,.e scienti c studies notwit:hstanding, tlze
an. -6 ismckers continue to =-plain abov-t '%..%e alleged build-
up of carbon monoxide Jn. offices and o'@her %.fine
C)
s--oking is allowed. One recent studY showed that the C:>
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BATCo document for Province of BritiSh Columbia 16 April 1999

levels of off4ce workers were i--,".en they camne
to urork than they left at', the end of '.!.,.a daY, even
though. tl-,.ey were exposed to c4earette s=oke
4.he day.36
I- zesu7ts of this study indIcate z'-P* the
'a.ntismckers should be more concerned about outdoor
'levels o!' CO ;"re,-,, car exhaust'. and other sour.-es that. non-
smokers are exposed to on their way to work than tobaczo
smoke Ln th.-- cfflce.
--t could be noted that no one 2-has ever estab-
lished -%ha-. '..-.-a healtk-, of Nonsmokers -is Adversely affected
by even th.e s7ra-1-1 amount of CO that be --7n t.te at-
=o s a r a a s r- r a s -., I t c-,?' c 4 & ar e t t e sc'.,. aCi S a. n aa 1
body cc.--st,-Ituent. whic.1a Is even ;--esent- Ln very
quar.--it-'es, tn the blood wft.hout any exnasure t1- --O ,,'-a
body can and does. get rld of C-' vari-
c,-,s raises. It sahould be noted, perscns o-rith COEb
"areas cf 15,1 cr 'less rare-Tr even suffer any cf :;"-.e
of CO d I -" ff a u I t -I a ss u ca s. h a acn E 1-1 s a a
etc. J7
Cna c'a-,'-, that is frequently 'made alzcut exmos,--:,e
lto low levels of CO is that it affects certain. performances
such as abil-lty' to distinguish between short -'ntervals of
time and to solve mathematical problems. There Is st-4111
disagreement in the scientific 1-4,terature, hct-.Pever, as to
whether such oerfcrmances are affected by- CO!-.b measurementos
CD
in the neis'-.1--orhcod of 10% or less. Some studies -!"eicatle
-.0
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BATCo document for Province of BritiSh Columbia 16 April 1999

38
t ha t, these leire"s el-" CO ..,111 af-rect such performance,
%hile other stud'-fe-S do not so :@ndicate_.39 This is aznother
area that requires ad al _'? t- --lonal research.
in co-zrast to st-udlies perfor.-ned under realistic
conCitions, the overreactors 'Vrequently c-Ite studles car.-
ducted under y artf ficia-I s-f tuaticns as evidence that
high concentratIcns of CO f",or., cigarette smoke car. be at-
tained. Ore such study by S.-ch. -placed t6wo smtokers 2-nd
$two nonsmokers _4=. a small closed car in a ga-rage and had
40
the smokers smo'Ace tan cigarettes. in cne hour. An 0 44-21'._ r
study by Harks plazed a European car Ln a -Blind tu.-_nel and,
then had c.-fgazet"tes inslde "-..%a car, one after
anot.her, any vertf'lat:@t:n in the car ard no out-
J
sIde winA. =--vement."-L Z course, :Li zituaticns such Ps
these, a rapi-A buildup cf CO cccurs; 'Forever-, as Doctc_-
=a='-%-e cbse=ved, t,'--e-se c-=Utions, dc "not carrespcnfl tC 2.
Incrnal t1ra-f f_' JLnd the sub"ecl.:1-ve react-rc-11's
of the tlest sub",ects -.0 the increased !ava's c-?' severe cc.-
centrat4an ..race
a thzes,'-,oI_d is reached at roughly
20-ppm [cf CO., which nor=ally rprorapts one
to open a .,.indctq or to turn on the ventil-
ation."
Studies on nicotine in,4icat-e A., ha, I.- at-mosmheric
42
levels are minimal. No one Inas suggested t, ha t, t,4-,&e Min-
Uscule' ai-,.ount of nicotine -.hat" misht be . absorbers' by a. U4
nons-Woker has anything to do wtth -the production of hu=wn C)
disease. Z.ndeed one recent stud Y that Monitored hear.
co
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BATCo document for Province of British Columbia 16 April 1999

rate nonsmokers exposed to cigarette smcke under labor-
a-.--:,y cc-ndit-Ions concluded ;-..,:at the ar.-ount, of n-11,55ctine in-
haled by nonsmokers under t.hei_- rigorous test-, ccnditions
was too small to alter heart rate.43
Studies of other. tobacco smoz6e constituents
indicate t1hat sm-oke's contribu-t-ior. to at=cs-aheric levels
of t.hese compounds is zLn!_m.*j.44 These studies are
usually ccnduct-ed in the cqntext o--:' an exaggerated clai=-
about twhe danger of exposure to some compound attributable
to tobaczo s=oke. One suC.a study of I'volatfle" organic
co--,.cunds :recently concluded -..hat azount of such. com-
zcun:is Pdded to the atmosphere as a results of cigarette
s @ "ll. n s _4 gni f i c an t4:@
The laborszory Measurement of s=oke itu-
cfzen is done as a purel.7 analyt -1c study wit.=_u 1.
taking acccunt of rea: llfe sltuatfsns- A current. exa=-Ple
is Brunnemann's recent renc_r, of nitrcsam.@.nes in tobacco
s = o.?--. ehe -, r e r , tlh i s s z 1--d 7 w a sr. t en d e A- a sc d e I s "L u d
an d n oa s a n t a, t, o n C f r eiy
Because the cverreaction of some nonsmokers to
smoking can=t be exzlalned on the basis of a physiologic
cal reszonse to atmospheric tolcacco s=oke or any of' i t s
cc.-st.1tuents, the question arlses whet her this reaction can
be explained on an e:-actio.n.al b-asis. W"hile this cuestion C)
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BATCO document for Province of British Columbia 16 April 1999

is 'A"ar settled, at leest- cne reseprchar, Dr. Gary
Fluber, has suggested thar. t@,- S might be the case, notfng
treat the cdor of Smoke "may trigger e=141,ional
responses r.:zt yet well unc'srstcod.1118 This t"heory finds
in 49
Some Sucoor, recent s,-Lidy by Rummel, e, 01., in
4
which col2ege students, vt',-,o were first characterized as
rn', aere exposed
to their atti'udes conce. nS tobacco smoke,
,f P, Ca."116 diIIjI___
to sucI., smoke. V-4e authoZ-s reDcrted a-sign,
ence in heart, rates of %'.'.Jose who "disliked" smoke co=pz-ed
with these who were frind-1-f-fe-rent" to smoke, w 'it In the
bIgher :rates =ong Close wh.o "d's'l-ked' the smoke . T'h a
authors CCU-1-A not deter-.tne from the data whether tLe
I'dislllkel' gzsup had a tr-,:.e h-'g.her nearly', rate initially,
or w.ne-th.ear anti-Afs.-paticn cl, S`tt'lng a:-d inhaling the
J S., J 1 -M,4 !I
c1sare-4te s_-ncIj,6e caused a:,. Increased haart rat-A-
Th-'s is not. to say t.hat perfectly no-a! peop'Le
are not scmetf-es alloyed cr lrr-ated by atmospheri
C
tobac--,,; E-Espec"aLly 'In places th.at are --carry van-
.t ted, ccncentratfcns or at-mcspheric tobacco smoke ma-
tih.emselves or in ccma@!-Inatlcrz with other &nvLrcn,-.,entIa1 I,-,-
fluences give rise to eye or nasa-I _!_":Iita6-- ion.
Whatever the basis of IZhe ove--reaction of Some
nonsmokers to smokling, one Allen& is c:eaz,: atmospheric
tobacco smcke has not been proven ba=ardous -to -he health.
of nonsmokers. Accord,ngly, as Dr. Pi== noted in connec-
tion with his research on Ist.L-nat-Ics exposed to tobacco
C)
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cr,
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of British Columbia 16 April `1999
BATCo doCUM8nt for ProvinCO

smxlk-e, if snc'-,_4ng 'Is be restricted, it -wil-7 have to2
be on the basis c--:' anncyance and visual disturbance and
not on health rrounds.50
&S
111. Government Rez-,;I_=t!_cns and Individual Rlxhl.
While common sense dictates no smacking for
safety re 'asons in certain instances (e.g. near gascline
pumps), measures against public smoking, based upon un-
founded claims that tcbaccc smnoke' causes d--'sease in the
nonsmoker, are Beyond this, Afor government
to regulate in zublic-or other pl_=2es because
it zray annoy or irritate zone nonsmokers ccnstitut-es an
unwarranted into peoples's private lives.
ContrEry 16.c the cl-aims of the an-t-Ismalm:Lng
leaders, the majorfzy of people--sr:ckers and
mons-Okers--aze not usu_='@@.ly annoyed by publIc 5-mck.Ing.
For example, a recent U. S. survey found that when zecple
4
were asked a`oo-_-: the c _' 6' h.-Ings that. annoyed c-
ritated them in their e-.reryC!ay lives, only abc,---- 2.01 of
the a-nnoye-naes =ent'_@cned` -related to smcking- :,n de e d
9109' of those in :'ne survey didn'"k even ment-I'cn, s,-..or-_'ng.52
The'America.- Express Commany found little in-
ored. 53
terest in nonsrack"ng tours that they spons Nume.--'
ous surveys demonstrate that diners leave little or no in-
6erest in the ncnsmokinz sections of restaurants. For
LJ_J'
examine, one Seattle Was.hington. restaurant reported that CD
C)
in a 3-month period in which the restaurant had served,
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BATCo document for Province of British Columbia 16 April 1999

30,000 custo-Mers, there were cniy seven requests for
seating in the nonsm-okIng artz.54
krhy then this o,-,*.,C:,y abcut public smoking by
a small but vocal a nc:--'-.y of antism--k-Ing leaders?
They claim to seek protection for -he nonsmoker,
but their proposals are d4-rected at .-a-strictIng the
freedom of the smoker.
As stated a,: the World Conference or. Smok-
!ng and Health in response -,o a ques-.L2,i:
11 . . . and of -even =cre ccrsequence,
is what, -accia-I action. can
contribute to sclu:ion of the total
sm,okIns ;roble_?, a-nd -I`.,,s devastating
effects or. sz:ckers.
A campa_zgn to harass az,.4- in.-_@b-It szokers is not
a 1eg'_ItI=zte concern of
Pub!_4c s=116-Ing -ol-Icy- be set in IiSh"I.:
J
of the ,F'acts, not u=on un.6cund ea:th cle-4--.3 t6hat. at-
mbspheri: tobacco smro'Ke @s tc nznsmckers-
P_ny eren-@, *_==fs-_-_kers are scmet-1-mes,
successor. They ge-. laws and other regulat-4--ns &to ban
or hill i 46: the rings of but at a high cost". to
.society. I'housands of hours of tilte are spent on an issue
that is of little real ccnsecuence. Moreover, the end
.-esults. of these costly proceed-Ings: are la-es and regula- L4
CD
tIons that are frequently _!=nractical amd unenforceable.
C)
Laws and other regul-al.-Ions t::-=t ban Or lim-14t 4
%.0
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BATCO doCUment for Province of British Colurnbla 16 April '1999

smoking, aimed at the smck'er cr. t--- ncrsmollcer,
coast' tute an unwarranted inrusion Into the lives and
rights of citizens. People 'n a _f:--e__e society should be
allowed to naj'--e ch-._-'-_es about-
Nor can these laws and other regulations be
Justified on the basis of anncyAnce to nonsmokers if
the problem is one of annoyance, it. can best be deall.
.6
with by mutual courtesy bet-wreen smokers and nonsmokers
-a-her than by governmental regulation or deprivaticn
o" Individual freedom.
:,VV. Future Act'-on by the Tobacco' Trdt;st`_y
in order to understand way Publ_fc. s.---!okng has
developed' into a public issue where there is mc real basis
-for pub' 'Ic -act"ons, there are not re--ml inter-
eats ard oublic actIons 'nf_-_,'nze on rrTval.---
I-oba=., I-dus-ry =rc-czez @'-e fal-
low,-,.g actic-ns
1. Social science researc.1--l p--ogra.-s:
I-rhat causes ncrasmo'e,.ers to accemt. unsut-sta.nt'ated
accusations about pub-1-4C s,-.,okfrg.
(11) What is -he depth and extent. c'L opinicn. and feel-
ing about s-woking as a public annoyance
(ii!) is the public smoking issue part of a broader
.range of social issues of whIch cigarette ammok-
L-4
ing is currently-the most visible.. CD
CD
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BATCo document for Province of British Columbia 16 April 1999

2 IMed"cal science research prog:,a:.-.s r1frected ttovard:
W
(i) Determining %hether or not there are any grou.-s
040 e;@tre-iely se,nsitive or ot!"Ier'.4,ise ill people
whose conditions -,toy be exacerbates by various
environmental influences including tobacco
(ii) Lnvestigating any evidence asserting that public
smoking causes disease in these c.- any othe.-
groups.
(iii) Deterr-4ning why certain ncrsmokers overreac,"." to
even small xmcunts of tobacco =ck,e in the a@._
mosphere.
Public :Lnforziation programs:
(i) To infor-m the s moking' amid nc.-Mmc' public of
the t--u-th about tobacco smoke I= the atrosphere
and health.
(ti) To urge smokers and nc-nsmokers tc be ziutuall-r
courteous.
To cooperate -'.n public safety p--.=S:--=-s that. en-
courage awareness cf Possible f-fre h-azards.
Beyond these research and inforMat-Ion progrpurzis,
the tobacco industry will strengthen its act-ivities in
support of legislative freedom of s,-,,okers and nonsmokers
alike.
LN
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"I.
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BATCo document for Province of British Columbia 1166 April 1999

1. Ac,@4on on Sr:_-king and Fealt."..
"Pipe and cigar smak4ng:
the reDort or an expert grcup appointed "My 'Actlo-., or,
SmokIng and Healthl.ll The Practitioner 210 (12531): 645-
652; 1973.
2. Corn, M., et al. W=rkshop summary and recc:mmendatl ons.
Report-from a wo-rkshop on Environmental mc-acco S"..ke
---Acres on -th.-_ Non-Sroker, Ber-muda, rlarc@, 27-20, 107.
Sca:,d. j. Resn. Dis. Su I
@T 91: 88-90; 7574.
3. U.S. Dept. of Transportaticn, :-Iederal Avlaticn Ad=_Inis-
6-a-4on, U.S. Demt. or ':eal'.h, Zduca"i-n, and Welfare.
Na"6Lona" InstIture _'Por Occupational Safet,.y and _'Eellth.
Health aspects of smaking t_-ansnort a.-Lraraft .
Md. A-0-73050,97, Dece=ber 19711. 85 PP.
4. U.S. T----S-6a:e Co=erce Cor-alss4cr.. Smcklng by passen-
ger sand oper-at.-I-ng personnel on interstate buses.
.6
'Wash.ington, D.C. No. MC-C-01,41 jMctor Carr:@er Casess
25'-27--; November 17, '071.
Ta lentin, H. Zn ?assive S,-,ok_Inz at
=-_;C:--,s and dLSc,4SSI_-ns f:,:::, a-meezing of Bava-z-far-
of IndustrIal wd Scci_2_1 Medic, e,
V..
A I 3 I 0977, D. 21-1.
-te'-=:ed4ci=; Social MeA4clne, ?reven"',- iMe'"cIne
7. WYn d -_ r ,E - LStateme .!t :;-.ade on Baztara Wa:ters'
VISIc.r. Prog-rar. "Not -far Women. Or.1711- lu-IRC-77, NBC
N twork, I-T shlngtcn, D.C. April 18, ig-4, c:oo i,_x.
I et .,a A.- . I
Radj--- TV Repc_-ts, inc. Wash.:Lngtcn, D.C., p. !I.
R.Io A,-; sjanat'han Jr., Comment during "A dLs-.-_,ss'lcn of
smokfng and ',real th", Nevsprcbe . W'7AF-TV, ?'.-..:I.I_adeIph_4a,
Pennsylvania, p. 9, JuIY 16, 1 75.
9. Ha==..cnd, E.C. "What are the high risk grouz.s-for pubiic
education? How does epidemiology identify them?" in:
Suz!z.-.ary ?roceedlngs of -he international C-neerenc e on
? u IV, 11 -V Educatl;n Xzout c6ancer6. UICC "I'sch-lzal 'Re-@Ort
Series, Vol. 1.2. Geneva, 11975, P. 13.
10. Slezrl'eld, responsfb-414ty: a b-1`1 L-4
j.T. :T. The pub"ic's . -- C)
o!" for the ncn-s-.:-.cker. Rhode i3land "ed. 7. 515
(i): let-126, 138; 19712. CD
%.O
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BATCo document for Province of British Columbia 16 April 1999

!I. a) Doll, ?. "Ciga-rette Smok'lng"., Ilewsbeazt, B_5C ?ad-ro,
pp. !-4, Deceriber-23, 4,976.
b)Davies, D.?. "Cancer, Cigarette Smoking as a Cause".
Amner:Lcan W"ournal of I-Tursing 61 M : 6:D:-66, April, 1c.6.1.
c)Goldsm-Ith, j.R. Statement before 'Che National Commis-
54 on on S=oklng and Public Policy, The American Cancer
S;ciety "'For=", Los Angeles, March 22, 1977. As
cited !.CS LA
d)Gori, G. "Nine in the Morning", 'WTOF-TV, CEES, Wash-
ingtcn, E.C., January t, 1-977.
e)Xorscn, F. Statement before 'le National Co=ission
on Smckl::g and Public '-Follcy, Ameznican Cancer Scc!.ety
3--ston, v!-::ss . , june 2, 11077. Tape SlIde 2
Rev. a"12.
fOwen, D. "Simoki.ng in ?,_,b_1_jc`., Med. J. 2: 395-
400; May :173 100T5.
g)Stallcnes, R. Quoted' In "Old ?et'a: He Smokes and
Hts Bus_4.-ess", leading T:@=-es, Fe-ad-Ing, Pa., Septemb-ter
7, I 517 16
h)Stewaz-., "The Effeats of Low Concenz.-attons of
Carbcn 'Acncxl A--e in Man" Report fror. A Wczrkshcp cn
Tobacco Smoke or the 111.on-Smcker:
B e r = uz; z-:- 2 7 - 2 10 ; I 9 Scand. j. D's.
Su=zl. cl: @'-`2; 119T4.
71--st, M.W. "Concenzrazions of Nicc--'ne
..-nds, W. C.., -
Tobacco _,'@-_cke fn ?ub-1-4c 1"laces." 'Crew Enz. .7. Med. 292 (1,6,'
844-8450; 1975.
13.'Huber, G.' - "Emoke and heat", Letter to -he E'ditor,
Va 293 (1): 1-48-40; 1975v
New Eng. j . .1-d.
14.Garfinkel-, L. "Questions and ans,.-sers on cancer: bron-
chial ca in acn-smokers. CA - A Cancer Journal for
-0ans 40 7-
Clini (3): 181-12.2; 97b.
C:)
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BATCo document for Province of British Columbia 16 April 1999

15 - a -'.S truP, P., K.;' e !dse n , K., Tvianstrup , j "Enh-anc-Ing
Influence of carbon "-onoxide on the de-,rejc,z_je,-,-6 of
athe--c.-atosis in choleste--ol-fed rabbits.11 J @.L- t@'-
sclar. Res. 7: 3"3-354; 1967.
b) 'r-anst-rup, j. , Kjelrlsep, K. , kstlrup, P. -I'Acceler-=
of s.-;cntanecus inti.-nal-subintizz-al chantges in rabl_-,t
aorta by a proonged moderate carbon mzono_x4de ezzosure
Acta. Path. 14-icrobiol. Scand. 75: 353-3052; 19050
c) K'eldsen, K., Astrup P., Wanstrup, J- I'Ultrastruc-
,J - 2 6 -
'tura" -4:,.-6"=al changes in the rabbit aorta after a
moderate carbcn monoxide exposure.11 Atherosclez-osis
!5 (1): 67-82; 1072.
d) Kfeldsen, K., Tho-msen, H.K., Astrup, P. ".Effects of
carbon =On@xide on myocarCaium. Ult'rastructural C'hanze.
.4
I= rabbits after moderate, chronic exposure." - Circu-
lation Res_&a_--_.h.34(3): 339-348., Fiarch 1974.
e) Thorsen-, E.-K., Kjeldsen, K. "ThreshcId limit for ca:-tc
=cno_xIde-ind,_,ced rayocard-laZ damage. An e-l-ectran
J%@ -_ - - - @_ -
in rabbits.n 'Fea-"-
29 (,:,5: '7378, August 1,974.
f) Mhomsen, H.K., K'jeldsen, E. IlAortic
in rabblits: an e v a lu a c n o f a t1h r e sh C e 1 i
E
nv4 -n- fealth 30 (" 2) -607; 19T, 5.
15
0. F_ A@-_es, S.M., 7,!,rans, R., Ucht, D. , e 4-1 al al, 'th
e f fe c -_ s -_ f --xmcs,-,:-e to high concentratIcns of aut-o-
=ct ive e_- _4ss'_cns- Studies tzi bridge a.-.d tI.,anne-l-wrorik-ers
'i
in New 'YcrIe. y." Arch. Environ. F-'ealt-h 27 (3):
17--_; 1,973.
b) Se-ie:-s, F.F.; Ed -aard s ' T.L., Murra A . L S c I= e -.-.: jk
117ffec-s or' exposure tc ccrcentratjons of
Assoc. 123: 585-588; 192"2.
CO. Am. Med
t) Jonesy j. G., Sinclair, A. Axt a r 1 a 1 'C' 1-1 s e a s e amaon g s t
blast =a c e wc=kers. Ann . 0 c a u o . Fy z . 1 8 : 1 5 - 2 0 ; 1,53 7
17. a) Hugcd, C., Fawkins, L., Kjeldsen, K., Th.o=sern, K."K.,
As-ruo, ?. "The .-If-luence of carbon moncx-lde on-intImall
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60 - its." At'-ercscl a
aub erosis 2S: 357-367; 1977-
C@I
c) Hugod, C., Hawk-s, L., Astrup, "Ezmcsu-.e of
passive smoker c -obacco smnolce cors`uen@s-tl
i. 3 k, s. @.L. - %I
Manuscript suIz.-Itted for publicat I C n
Co
BATCo document for Province of BritiSh Columbia `16 April 1999

13 - a) COlle.7, j-@!-T- Ln- children
and parental Snck.119 an.; phies-_ production." BrL@@-
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ance- 1.@
2 (788-5): , 103'-'034; "Z7,".
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Colley, J..R.T. 11--infIt.-ence of t'a=illy factors In the'.
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b) Leeder, S.R., C-ciley, j.R.T., Corkh4ll, P., Folland,
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ILM. J. 1-05 (6): 530-25-13; 19T7.
20, Environmental Protection Asenc7_ '2--a-Ith Con3equences of.
su"I'l-Ir oxides: A ReTc--. frcm CEMS. 1c70-1977. (=-?A
-1 Development.
4-004). W"ice of 2eseara@, ar.
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21. Schill!mg, R.S.F., :;e-af, ;:L:-,, S.Z., Beck, G.J.,
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7
24. a) Farkavy, .0. "T;c'--acco a::ergy in card"zvascula=
't I em P, '447 1 0.
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it,
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.iVe Sy=;,.O=5. " A.-CU. 7-
alth 16 (3):
443-4-'O'; 19,68.
-27-
-j
BATCO doeUment for Province of British ColUrnbla 16 April 1999

25. -a a c lr:_r@r n , IL . I-,rie-zl ems nn , 1! .
se n s i Y o s ob z -_ o ant i& en . P-:::!. 'Nat. Aca._'.
U.S. 73 (54) 1712-17, 6 17 5.
b- Bec'er, D-.@b4n, T., Wiedemann, F.?. %:zo
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cutaneous hypers-_rsit!,:.,!t- :;c
11
cured tobacco and present :Ln
0 - O.
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d Becker, C,G., Levi, R., Zavecz, J.E., Holland, B.
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24W. L%IcDougall, J.C., Gle-Ich, G.J. "T"obacco alle-rgy-fact c:
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27. P.E., Slhephard, R..J., Silvermnan, P. "."11hysiologica
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28. a Ar V. S . , C a S S --d" Y V ar gr 0 tf , 7 S . , M ar C -h 31
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Vawter, M. ,---,-Vale---; of c-1ga-rette sm-oking a.-d !:reason-'-:,
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C-
A -noW, T
b) G c I d In j' R - I. S. "Carbor. -.,-cx-!A= an
E
Ccrc-
na:-y g,.aase: a revieur. -nT, -or:. Res.
29. Wa-ner, G. Ref erc-EMed. 29, 1975
30. a ark, e .-F . , L _-1 Zed-` ,W. Denker, O'. Mrc@_,_Iem of
.-Sations of CO Zere' 4-
passive smnck-lng. I nvms Z
af-er cigarette snmal,@._,!ng.ll Tnt. -Ch.
te.
-tsred. -13 (3) 207-220; 1974.
b) Weber, A.. , F-F scher, T., Scancin, E., Grandjean, E..
Air Pollutic:& Suez -,C cigarette smokc-a: ph.-O s i o -1 c St c a 1
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13C-132; 1970'.
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passage smokinz." Lakartidn. 70: 2833-20,-jO5;-10473-
C:@
-22- 00
ument for Province of BritlSh Columbia 1 6 APril I 999
BATCO doC

rn to the@ assess-
b) Sridoc-e 0 - ?
Me.,A 0 .6 .6
expcs-..:re of ncn-smokers to air c:
cizarette and C 1:-:ar sm--ke in occupied spa-es.11
Environne,-tal Fes. 5 (2): 1012-209 1972
C) Cole, ?.V. effect's of a'6,mos=.-Ie_-_-Ic
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d) U.S. Dept. or Transportation, Fede:,p 1 A
^viation
tration, U.S. Best. of Health, Education, and Welfarz
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a - - W 1. I
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inn. Med- 3 (6) 310-3-1-1; 19TOS.
g) YagIcu, C.?. recuire=ents 1"Or cigarette
sz-,cke. :A C = %.I I T
I-ans cticnz 6I: 25-32; 1955.
32. Ellictt, L.?., D.F. 11.1% ir quallty durzing puciic
ga t her 4.-. gs . %7 . A 1. :,- ? * I I u, -C a -_ t A s s C c . 2 5 C 6 5 -
635; 1075.
33. a) Cuddeba=k, Z.E., :Ocnovan, Z.R., Bu:-&, W.R. IOCCu_
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in encicse-d =ub-!-. facilit-les-ff Eryi--p-n. Woolf-
32 (2): 53-5:_-'; :,@377-
.6 6
3" Flz-s-, M.W., @-C- 'I,'%' bient tobacco Gore 7.easu:rem
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C) Ha-ke, H.F. "The problem of 'passive sraoicing'
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C)
CD
.10
-No
CD
BATCO document for Province of British Columbia 16 April 1999

nes, -an, in non-
d) Jo. i.M. , Fa: E.
smo.-Cers : a mat%her.S:2.c_z!_ r.--del.11 Arch. Z-1--fran.
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S) Ste,.-rart, R.D., Peterson, J.E., Bazre6.4.a, E.D.,, el., 'a'
lilt
Ex --ental, humar. e-^zosure to caxboa =onoxide.
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36. Sza-_%owsk.:@, D., Harke, 'Body burder, of
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M ZA
3 (6): 310-313; I
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C\ xensl er, -.,T. "Co=c-e-ts of z.h_-.=azc'_?z ic Interest
C21
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e.
tazacco@ sMaks Ann. ) f. 6.
43-417; Septe=iber 15050.
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exha 6 - %.- 1. -
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i64; 1970.
LIM
C)
N.0
BATCo document for Province of British Columbia 16 April 1999

a) =ear,; V`er: A vi ora 1
assoC12t-__-; t 1,
. sma.@_ dzses 016 ca:100.i Monoxide;.11
V-
AM- L tj 57: 2032-22222; 1-1'7.
b) Beard G.A."E-ehavioral ma-rife5,a-o,-js
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r 0r
c) Bender, W., Goethert, G. "Effe
J L
low carocn monoxide concentraticns on =s,rc.-jojo,..-c I
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nal
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de Groot, T.
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and Weifa:-a. Public 'R.'ealt-h Serv,:@-_e. - Natloral Institute
for Occupat!.onal Safety and Healt.h., 1.51T4. pp,. 2q2-'z05-!
e) Grcll-Kna=-j Z., Wagner, RE., Hat:ckc, H. , HaIder, 1,11
..:1
'Effects of low carton =onoxide ccncentrations on
vigilance and computer-analyzed IC-ralin pot"e.ntials."
Staub. Re:@n_halt. Lul"t. 32 (4): 6--68; -11*72.
f) Halperin, R.A., 'Delivery., T.!., Rc-ughtcn'
J
P. J. T.I. I'V; Iime-ccurse olL e_f_r-e-_:s of carbon mnonoxide
+0 _,0
on v4sual j'. LIYsicl. 1-1 ': 583-5153; 19.5.9-
Horvath, S.M., Damr-w' 017 n7on, Z.F. "CO a"-
-.a C
huram. A--ch. Envircn. Healti 23: 143- 347;
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h) Ray A.Ml. , "An e:t-,!_0ra-_Cry study Of
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Sci. 174: 334-E-4103; I
W hi
irl ght, G. , Randel R. , Shep. ard. R. "CO and dZ-_- ns
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39. a) Beard; R.R. First Annual Confe:-enca on E.M.-vironmental
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the audience of scie-tis-%3 durins the discussion ol-
his paper; 1,970.
b) '@eard, R.R. , Grandsta.ff, N.W. Carton co-noxide and
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E . , Lat i e s V. G . E A-1 3FT Plenum ?rass, New York,
1975. pp. 1-27.
Lk
C)
%.D
-Ti
rQ
BATCo document for Province of BritiSh Columbia 16 April `1999

c Ettema, R.L. "Z*'fect's cf
carbon anom:vide ar:@:' ex;=sure on
rn,e.nt,al cap-acity. -n-.. Arch. Occun. Health
35 (2): 111.7-132; 19715.
d) Fodor, G.G., 'Hinne@-.@e, G . "Effect of concen-
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e) Hanaks, T.G., Hackney, J., Farquhaz, R ".Susan perfor-
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to carbon monoxide." Ann. N.Y. Acad. Si:!
1T4: 421
424; 1970.
f) Milval ka, P., OID-nnell, R., Heinig, P., Theodore, J.
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Ann. N.Y. Atad. Sdi. !T4 (1): 409-420; 13-10.
?all
J. ITRU=
-;rkos, P.K., Th
.nell,' R.D. , Ch X.
O'Dar ecdcre:
sleep patterns and Msychomotor perfo=:,P_r._-e du=img
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Proc. Ann. Envi-_Or.. Toxic., -P. 7:-_-; 1970.
h) O'Donnell, -.R.D., et a". "Low CO expcz,_:,e and h-u-nan
psychomator Toxic. A;nl-.
18: 553-602; 197
i) O'Donne"', F.D., MaIrk-os, P. and Theodcre IT. ft-.-.r,6ec-6
of' CO exposure or. h.:-=an sleep and -er-
fo C e . AvDI. ?hysiol. 31
S tew ar,66 , R. N e -u t. cP . E . , Hlosk@., ?et_-rS=I
"El'-fect cf cart-or, monox4de or. "6 1--e
ArCh. Ervircn- 'H.-galth. 2'T (3): 153-760; 1-3-73.
k) Stle,.-iart, Newtcn, ?.E., Hosko, M.J.,
Mellende=, "The el"Lect o--:' carb=_ =zn=xide on
time perCep-.4-a.-, manual coord.-Inat ir.S=ectica, and
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1) Weber, A., :ervtini, C., Grandjean, E. B _' fe c t s o f . a
low concen"=ation o-- carbon monoxide an ==-.F.." Soz.
Praeventivred- 20(5'): 21S; 1975.
CD
CD
NO
%-0
BATCo document for Province of BritlSh Columbia 16 April 1999

Id_`nnelce G. "Ear-1.y dete-c-t--ton of occ-pational haza-4--
behavloral effects :f rnethylene chioZide and car-bcn
'de as assesse-I by senscry and psychcmotcr per-
r,-.cnox
..P I Tn: Be'-7i3ral Tox-coicgy,Xintaras, C.,
i a:-,,_=nce.
Jo.'--Lnscn, B.L. de Groc: , 1 ;-'does U.S. Dept. of
Health, _--ducption a.-:d Welfare. Public Health Serv-_:e.
Narional institute 61'ar Occu;atiorzal Safety and -E-ealth;
la -P
974, PIP. 130-144.
40. Srah, M. "Or, the Importance of ca:-bc.-, :,oncxide due to
r
ci ga-- e t. e smo k,1 r. g in c ar s. r? Dw ec u 1". s c lie Z . Ge r i z h t 1 . M- e d.
6
0: 80-810; 19057.
4I. Harke, E.?.,, Lied!, W., Denker, D. '11--he zroble-" of pass!,Ta
smoking. 17. Tnvest-igat"cons of CO level in t1ae a,_,tc:-.oZ::Ue a
cizarett,e s.-.ick.:.ng.;II Int. Arcn. Arteits::ed- 33(3): 207-2_w:)0;
42. a) -'Indersscn, G., Dalharn., T.' risks due to
passive seeking. 70: 2833-28-J-6; 19T3.
Du.-..as, C.., Via'=
e
b Can c_ Ca talln , Bad:-
R. "Deter=-InA'.-_-_n o--:' n.-;.co-.-::e by
gas-hase chromatograpnY. 17. AaoljCp@janS.11
jk,
u,"cues '-ncaises 28 (11): '33-640,; lC70.
ace C
c) Harke, 11111he problem of I.ppassive'-s-mcklngl."
Munchen. Med. I.-#-s cn r .22 I 232 3-2 3 3 4 ; _15 70.
d) A'Eazk aF. . ? 11?assive s.-...-k,.-z czncentrmtlon oZ' smcke
const.-ftuents in the air of large and small --ccr.-,s as
-a j"unctior, cf number of cigarettes 5-moked and tire."
international A:-_@.-.1yes o--:' Occu=aticnal Fealth -c (41:
323-339; 110T2.
e) Hinds, W.C., Fizst, MJI'. "Concentraticns cf n:Lco'w--?-e
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mass spect-rometric evaluator of exhailed tobacco smoke.lr
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Z) K-losterkotter, W., Gono, E. 10n the prob--e:r cif
It-As. Zbl. 1. !kbt. Orir-,. 162: 51-6.9; 197 U14
43. 'Harke, H.?., Blelchert, A. "On the przoblem of passive
szmoking- int. Arch. Arbeitsmed. 2c.: 312-322; 11072.
-4
BATCo document for Province of BritiSh Columbia 16 April 1999

-44'. a) Antarsscn, 0. J Dalhann, T i e Z I t ". r I s II: s0
!_rS. it
70: 2@.$33-23#34_; I9173.
b) Bin:@er, Mitchell, C.A., Hoseln, H.R., B-ztthuys, A..
of the indoor environm.-ent in p,@Iluzt@ an
ex;@su-"- Arch. Environ. Health II'- (;')): 2TIF-2TS; 1576.
e) Bri-d9e, D.?-, Corn, M. "Contribution to t2he assess-
-ment of exposure of non-s-mokez-s to air fZ-o=
cigarette and cigar s-,;ol--.e in occupi-ed spaces."
mental Pesearch 5 (2): 192-209.1- 19072.
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ft A
e) i a t. t , L. ? . , Row e , D . R. A%__ qualiltly d,_-_4ng pub-lic,
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63,=-053;';' ISIT5.
f) U.S'. Dect. of Transportation, .7 e d e r a 2. JIL v _4 a, t 4-
tration, 7.S. Dept. of Educat-ion, and Welfa,re.
Znstftute -for Cccupational Sz-,.fat-Y a.
Hea'Ith as=ec--s of 57-okIzZ tn trarlszor-_ ZircrEft.
RC ' 10 @ -I 8 5
c X d AD-73609,, December 1971.
GaluskLnz---a, V.' ff3,4-:,:enzy=yrene n t h
-.e-L, -6 Z"COMS and restau-
or s0cfa
C -,O U: -n. t h er 0 em O
norLcus-
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46. z-'68; 1954.
O
'-' S -Z ,J. . Bcrkc,-,rnJka, Mzzia:-ka, S. "TICICE:CC SM.O.ke
i.?-- the a-:, of Warsa-.-, cCffee rco.-.-@s-` -ocz.
Za'kll Hf.
23 (2); 1 9-2.35; 2.972.
IOq the of assume
Hyz- I. Abt. C@Ix. '164 : 5-
Le_fcoe., N.'r-T., inculet, in dcm-estic
Premises: !I. Am"oient levels and indooz-out-co:
sh:@Ps.ll Arch. Environ. 30 (12): 565-570; 1975.
k) a!" , ?E "F=actical methods of =educ.'I.-.g afrhorne
ccntaminants in interiar spaces-" Arch. Environ.
Health 30 (11): 552-556; 1975.
U4
-34-
-,4
:77 - @7 @7
BATCO document for Province of British Columbia 16 April 1999

F
"Fasten your sea- --e,*c:
no smo,"ng. Br-"@;. Cclumb-4-g. '!red. J. 15 (1-0): 3!"I!
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C:)
BATCo document for Province of British Columbia 16 April 1999

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CD
C)
BATCo document for Province of British Columbia 16 April 1999