Tobacco Documents Online

6 ETS/IAQLITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS GRADUATE SCHOOL EXPOSURE [12] Beckman v. Neuw York City Sc/iool of V'uaalAm (U.S. District Court, New York) (filed January 16, 1992) On January 22, 1993, the mediator filed a report stating that court-ordered mediation had been unsuccessful in resolving any issue in the case and that the unresolved issues should be treated as if thry had not been sent to mediation. In this case, Melissa Beckman alleges that she had to take a medical leave of absence from the graduate school because ETS cxposure allegedly caused her to suffer "repeated blackouts, frequent vomiting, high fevers, infections, weight gain, mood swings and other physical and emotional trauma." Beckman has requested $5 million in actual damages, $5 million in punitive dam- ages, and an injunction to eliminate smoke in the school. PRISONER CASES [13] Hemphill v. Gomes, 1992 U.S. Dist. LEXIS 20031 (U:S. District Court, Northern District, California) (decided December 8, 1992) A U.S. District Court judge has dismissed the claims made by nonsmoking state prison inmates who alleged violations of constitutional rights after prison officials failed to honor their cell change requests. The inmates had styled their action as a"class action" suit and had sought damages of $175,000. The court, however, issued an order dismissing the action without prejudice to an amendment of the oom- plaint for plaintiffs to allege that the "defendants as supervisors failed to properly train or supervise pessonnel, resulting in the harm to plaintiH"x; or that defendants had an official policy or custom which resulted in the harm; or that defendants knew of the alleged misconduct and failed to act to prevent the misconduct." The plaintifl's were given 30 days in which to amend their complaint. [14] Cookisls v. Commaissiorur, New Harnpsfiirr D~epart- mcnt of Corncctions (District Court, District of New Hampshire) (filed January 1, 1988) On January 6, 1993, the U.S. District Court dis- missed this action stating the plaintiff had `voluntarily ETS/IAQ REPORT, ISSUE 40 escaped" from prison and had therefore abandoned the opportunity to prosecute his civil daims. Plaintifl's current whereabouts arc apparently unknown and he had missed several court filing.deadlines. Cookish brought his daim against prison officials based on allegations that ETS exposure subjected him to cruel and unusual punishment and deprived him of his liberty interest without due process. LEGAL ISSUES AND DEVELOPMENTS [15] •"Children are Focus in a War to Snuff Secondhand Smoke," C. Scanlan, The Philadel- phia Inquirer, January 24, 1993 Discussing the EPA Risk Assessment on ETS, this article focuses on alleged health effects of ETS exposure on children. John Banzhaf, director ofASH, and Joseph LaMacchia, founder of Parents Against Second- hand Smoke (PASS), are quoted in the article for their views on protecting children from ETS in the home and in public places. According to LaMacchia, who last year fought a court battle to prevent his ex-wife from smoking in the presence of their son, his goal is "to dog the court system with these cases. All the informa- tion is in, but because of neglectfW, incompetent parents these kids have to suffer in smoke when they don't want to." The views of the tobacco industry are also included in the artide, and information is provided to readers to contact agencies and organizations offering brochures and packets of material on ETS. SCIENTIFIC/TECHNICAL ITEMS UPCOMING MEE'I'INGS [16] "Indoor Environment'93: Defining Strategies for Effective Indoor Air Management," Balti- more, Maryland, April 21-23, 1993 Sponsored by five indoor air quality publications, the conference invites IAQ professionals, building manag- ers, scientists and environmental lawyers to participate in discussions covering the "entire spectrum of indoor

FEBRUARY 5, 1993 air quality related issues." Sessions will include public programs and policy, building management, issues in detection and mitigation, safety and health, and litigation and liability. The safety and health session indudes presentations on "ETS: Health Effects and Recent Research," "Sick Building Syndrome: Prece- dents, Current Litigation, and Predictions," and "Workers Compensation and IAQ." [17] The Sixth Annual National Conference on Indoor Air Pollution, Tulsa, Oklahoma, March 29- 31,1993 The University of Tulsa will host this tonference, which will focus on IAQ issues such as indoor air diagnosticx, federal IAQ policie.c and research, and legal implications of sick building syndrome. Scheduled speakers include Robert Axelrad, Helen Eisenstein, Mark Mason and Harriet Burge. LUNG CANCER [ 18] Letters to the Editor Regarding "Environmental Tobacco Smoke-. The Price of Scientific Cer- tainty," D.M. Burns, Journal ofthe National Cancer Institute 84: 1387-1388, 1992 The Jouraal of tlx National Cancer Institute recently published two letters concerning this editorial, pub- lished at the same time as the Stockwell, et al., case- control study on ETS exposure and lung cancer in nonsmoking women. As discussed in Issue 31 of this Report, September 25, 1992, the author, David M. Burns, called for the development of public policies based on his belief that a causal relationship between ETS exposure and lung cancer has been "clearly established." Dr. Bums is an antismoking activist and a member of the EPA's Science Advisory Board commit- tee that reviewed the Draft Risk Assessments on ETS. The first letter in the current correspondence is from Gio B. Gori, and is followed by a reply from Burns. The letters appear in Journal of the National Cancer Insritutu85(1):66-67, 1993. Gori comments that Burns' original artide suggests that `either the editorialist [Burns] did not read the report carefully or his perception of certainty is a 7 curious one." Gori writes that Stockwell, et al., referred to suggestion, rather than certainty, in their article. He also points out "incongruities" of ETS cpidemiologic studies. In particular, Gori states that the odds ratios reported by Stockwell, et al., "vary from apparent protection to apparent risk," and that the reported results on adenocarcinoma "conflict with the much quoted and larger study of Fontham et al." Gori continues with a reference to potential confounding variables, biases, uncertainties in exposure estimates, and other problems, which he characterizes as "weak- nesses of epidemiologic data." Gori suggests that epidemiology should not be "interpreted in an equivo- cal dialectic context," calling the certainty referred to by Burns "an assertive policy proposition." In his response, Bums describes Gori's letter as °a fine example of the 'reasoning' used by the tobacco industry to delay and confiue the development of scientific certainty." Burns writes that neither the Stockwell, et al., study nor his own editorial implied that the Stockwell, et al., study provided sufficient data to reach scientific certainty. He calls for using "multiple lines of evidence and all of the data available" in judging causality. Burns also accuses Gori of an`ad hominem atrack suggesting that, because I [Bums] agree with the condusion of evey comprehensive scientific review of these data that has been conducted in the last 7 yeus, my position must be based on advocary and cannot be sdentific.'° CARDIOVASCULAR ISSUES [19] "Reduced Plasma Ascorbic Acid Concentrations in Women Regularly Exposed to Environmental Tobacco Smoke (ETS)," D.L Tribble and S.P. Foranann, Circuktion 86(4): Supplement, 1992 [See Appendix A] The authors of this abstract propose that a reduction in levels of the vitamin ascorbic acid may be related to the pathogenesis of heart disease. Based on measurements of plasma ascorbic acid concentrations and diecary ascorbic acid intake in nonsmoking women, the authors report that "passive smokers" had lower plasma ascorbic acid levels, which they suggest "may contribute to increased heart disease risk associated with ETS ecposure."

8 RESPIRATORY DISEASES AND CONDITIONS - ADULTS [20] "Pulmonary Effects of Environmental Tobacco Smoke Exposure on Asthmatic Subjects," S.B. Lehrer, CL4R Currents 2(2): 1, 4, 1992 [See Appendix A] This anicle reports on a test chamber developed by a research team at Tulane University, in which asthmat- ics claiming smoke-sensitivity were txposed to sidestrcam smoke as a surrogate for ETS. The author reports that only 10 percent (17 out of 163 subjects) `reaaed" to side- stream smoke at high smoke levels, corresponding to ETS concentrations that "would be extreme and rarely encoun- tered" in actual environments. RESPIRATORY DISEASFS AND CONDITIONS - CHILDREN [21] "Maternal Age as a Risk Factor for Wheezing Lower Respiratory Illnesses in tbe First Year of Life," F.D. Martinez, A.L Wright, C.J. Holberg, W J. Morgan, and LM. Taussig, American Joxrnal ofEpidimiology 136(10): 1258-1268, 1992 [See Appendix A] This report, part of the Tucson Children's Respira tory Study, reports that maternal age is related to the incidence rate of wheezing lower respiratory infections. Namely, such infections are reportedly more frequent in the offipring of younger mothers. The authors also report a statistically significant odds ratio for maternal smoking as an independent risk factor for wheezing lower respiratory infections. The lead author of the study, Fernando D. Martinez, was a major contributor to the EPA Risk Assessment's section on childhood respiratory diseases and conditions. OTHER HEALTH ISSUES [22] "Clinical Ecology," Council on Scientific Affairs, American Medical Association, Journal of ths American MedicalAssociation 268(24): 3465- 3467, 1992 [See Appendix A] This Council Report, by the American Medical Association, discusses multiple chemical sensitivity ETS/IAQ REPORT, ISSUE 40 syndrome (MCSS), chronic fatigue syndrome, and sick building syndrome, as well as the branch of treatment called clinical ecology. The authors conclude that no studies have established a mechanism or cause for MCSS or have confirmed the efficacy of methods advocated by clinical ecologists. They also recommend that the literature on these topics should be monitored and call on practitioners of clinical ecology to prove the effectiveness of new treatments by controlled dinical trials. ETS ExPOSURE AND MONITORING [23] * "Preliminary Data: Exposure of Persons Aged 2:4 Years to Tobacco Smoke - United States, 1988-1991," Centers for Disease Control, Morbidity and Mortalit.y Weekly Report 42(2): 37-38, 1993 [See Appendix A] This preliminary report by researchers at the Centers for Disease Control (CDC) has received extensive press coverage. It reports on initial results of assays for blood serum levels of cotinine, a metabolite of nicotine, in 800 individuals. The study subjects are a subset of a larger group of 23,000 persons being surveyed as part of the Third National Health and Nutrition Examina- tion Survey (NHANES III). A very sensitive assay methodology was employed, and cotinine was report- edly detected in all individuals tested. The artide implies that all low levels of cotinine are due to ETS exposum Apparently, the CDCs new methodology allows detection of levels of cocinine previously undetectable in many studies. However, the authors do not discuss the possible contribution of diet to cainine levels. Nicotine is found in small amounts in such vegetables as tomatoes and eggplant, and also in oettain forms of tea. In press reports, Dr. James Pirkle of CDC was quoted as saying about the 100 percent detection level, "we really weren't expecting that '" Pirldc also reportedly stated'that the CDC research would address criticisms leveled against the EPA Risk Assessment on ETS concerning doatmentation of numbers of exposed persons and levels of exposure. Pirkle reportedly said that the new methodology "will allow us to figure out the extent of the problem using an objective measure.'" See The New York 7ime.% January 22, 1993.

FEBRUARY 5, 1993 OTHER DEVELOPMENTS [24] Restaurant Customer Faces Murder Charges Following Dispute Over Cigarette Smoldng Toby Titus Wade of Sacramento, California, reportedly faoess a murder charge after he allegedly stabbed a waiter to death in an argument over smoking. According to police, Wade and the waiter began shouting at each other after Wade lit a cigarette and the waiter told him to stop. A dry ordinance reportedly prohibits smoking in restau rants. The confrontation allegedly escalated in a back oflice and the waiter was found stabbed to death after Wade left the restaurant. See Los Angcla Tima, January 13, 1993. [25] • California Mall Bans Smoldng According to press reports, the South Coast Plaza became one of the first indoor shopping malls in the nation to ban smoking in common areas as of February 1, 1993. Restaurants in the Plaza and food court will evidently keep designated smoking areas open. The impetus for the rule, according to a mall spokeswoman, was the EPA Risk Assessment on ETS. See Los Angrrles Tsmet; January 26, 1993. [26] • EPA Risk Assessment on ETS Spurs Anti- Smoking Activists in Illinois A health group coalition, lawmakers and state officials reportedly planned to meet in late January to take steps to strengthen Illinois' public smoking law. The current law, which was enacted in 1989, requires restaurants, hotels and other public places to provide nonsmoking areas. Thosccities, induding Chicago, which passed stricter ordinances before the state law went into eBect in 1990, are exempt from the law. Antismoking activists are reportedly seeking a bill that would give municipalities the right to decide where people can smoke in public, if at all, and they will reportedly use the EPA Risk Assessment on ETS as their `main wexpon" in an `expocted battle" with the tobacco lobby. See Cbicago Tri6une, January 19, 1993; GreenurirK January 20, 1993. MEDIA COVERAGE [27] "When Your Office Calls in Sick," K GaRtt, Health, January/February 1993 In this article, stafl'writer Katherine Griffin discusses 9 sick building syndrome, its probable causes and health consequences, and possible remcdiation measures. Focusing on inadequate ventilation, improper mainte- nance of HVAC systems, and the presence of toxic chemicals and biological contaminants as sources of poor IAQ the article provides specific recommenda- tions for office workers to document sick building problems and find ways to resolve them. Induded are references to EPA publications and a NIOSH hotlinc. The author notes that the EPA will be publishing a list of private IAQ consultants within the next few months, and observes that such businesses are prolifer- ating "like algae in a drain pan." [28] "The Architecture of Illness," D. Steinman, Vegetarian Tima, January 1993 This article profiles the IAQ problems the EPA had with its Waterside Mall headquarters and discusses sick building syndrome issues. Thcauthor addresses causes and effects of poor IAQ and observes that basic HVAC systems maintenance might be the most effeccivc way to reduce exposures to indoor air pollutants. Some of the steps recommended for improving a"sick work space" indude bringing in house plants, improving air circulation and ventilation, using nontoxic deaning products, using a high-efficiency particulate air filter for personal work spaces, organizing other workers and tenants, quitting your job, and filing a lawsuit. The artide condudes by reviewing actions that are being taken on the federal and state levels to improve IAQ. IN' EUROPE & AROUND THE WORLD ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS AUSTRn1.lA [29] • Tobacco bvtttute ofAwnwAa Ltd v. Australian Fideration of Consumer Orgamisatiorss Inc. (Full Federal Court, New South Wales District Registry, Australia) (decided December 17, 1992) During a post-decision hearing conducted before the full Federal Court on February 3, 1993, the court

10 considered, among other matters, whether it would rely upon the EPA Risk Assessment on ETS in deciding AFCO's request to grant an injunction against public statements by TIA about ETS. The court also heard argument addressing the injunctions imposed by Justice Morling, the appropriateness of the declaratory relief sought by AFCO, the question of costs, and TIA's request for leave to rely on a new submission based on the Australian High Court decisions in cases involving free speech rights. A special report on the AFCO decision appears in issue 37 of this Report, December 18, 1992. The court apparently did not issue a ruling at the condusion of the hearing. It did, however, take under advisement (i) whether to grant leave to TIA to argue the free speech issue, and (ii) whether to grant leave to AFCO to put on funher evidence. The court indicated that it would either relist the matter for further consideration or deal with the issue in its reasons for judgment. ETS/IAQ LITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS UNITED KINGDOM [30] Ytronica Blmtd v. Stockport Mesropolitan Borough Council (Manchesoer) (writ issued June 14, 1991; settlement entered January 27, 1993) A 36-year-old nonsmoker has reportedly agreed to settle her ETS workplace exposure daim against her employer, the Stockport (UK) Metropolitan Borough Council, for the sum of £15,000 (U.S. $21,600). The settlement was made out of court without an admission of liability. The claimant, Veronica Bland, alleged that she had been exposed to ETS from 1979 until a no-smoking policy was implemented in 1990. Bland daimed that she had been forced to share an office with co-workers who smoked up to 150 cigarettes a day and that this caused her to suffer sneezing, coughing, streaming eyes, and ultimately chronic bronchitis. During a press conference held to announce the setdement, Bland reportedly barely raised her voice above a whisper and claimed her once beautiful soprano singing voice was no longer what it had been. ETSIIAQ REPORT, ISSUE 40 Bland's union, NALGO (National and Local Gov- ernment Officers' Association), brought the suit on her behalf. Although representatives of NALGO reportedly lauded the settlement and predicted that it would force employers to impose workplace smoking bans to avoid future liability, press reports observed that NALGO does not impose a smoking ban in its own offices. Media coverage of the settlement has been extensive, with articles appearing in many U.K publications, and in Australia, the United States and France. Most of the articles acknowledge that the settlement does not create legal precedent, but they suggest that employers will hasten to impose smoking bans to avoid similar litigation. According to ASH, there will be an explo- sion of such lawsuits in the near future. See The Indeprndcnt, January 28, 1993; Daily Tekgrapb, January 28, 1993; The Tinus, January 28, 1993; Sunday Telrgraph, January 31, 1993. It has been reported'that members of Parliament arc calling for the government to impose workplace smoking bans. Secretary of State for Health Virginia Bottomley, however, has ruled out any legislation before 1995, when voluntary smoking policies are expected to be in place in the majority of workplaces. According to ASH, some 80 percent of large compa- nies currently have a workplace smoking policy. See The Irldepcndent, January 28, 1993; Reuter Library Report, January 27, 1993. . Legal Aid GsmUed to Nonsrtnker Sung Ertpbyer, ltem 33. LEGAL ISSUES AND DEVELOPMENTS AusrRAl.tA [31] "Australian Court Decision on Passive Smoking Upheld on Appeal," S. Chapman & S. Woodward, British MedscalJourna4 January 9, 1993 Stephen Woodward, executive director of Australia's Action on Smoking and Health (ASH), and Simon Chapman, a lecturer in community medicine at the University of Sydney, submitted this article following the 77A v. AFCO decision on December 17, 1992. In it, Woodward and Chapman claim the appeal court found the "critical sentence" in the TIA ad, "And yet there is little evidence and nothing which proves

FEBRUARY 5. 1993 scientifically that cigarette smoke causes disease in non- smokers,° was misleading and deceptive. Further, they allege that each of the appeal judges were'emphatic" in their ruling, and that Justice Shepherd "vehemently rejected" TIA's claim in the'critical sentence." Even so, the authors assert, the tobacco industry was handed a`symbolic but fairly meaninglessviccory in having two orders varied. These concerned matters that were a pure technicality ... and a virtual truism." Further they stated, 'the tobacco industry is unrivalled at making silk purses from sows' ears. It still maintains with blithe equanimity its opinion that active smoking, let alone passive smoking, does not cause disease - it has been shown only to have a 'statistical association,' much in the same way that sexual intercourse might be denied to 'cause' pregnancy." The authors note that the 148-page opinion of the Federal Court gives "quite priceless advice to the industry about how it might become more clever in the same ambitions that gave birth to this dumsily worded advertisement. Each judge offers advice, often explicit, on how the offending sentence could have been published without falling prey to a misleading and deceptive charge." Research assistance for the artide was provided by the barrister who appeared for AFCO before Justice Morling and for the full Federal Court appeal. [32] Tobacco Companies Submit Memorandum to Legal Aid Board On January 14, 1993, Philip Morris, Rothmans, and WD & HO Wills reportedly submitted to every state and federal legal aid body a memorandum which attempts to oppose the grant of legal aid in cases which might be brought against cigarette manufacturers by smokers or by those exposed to ETS. Although these "prospeaive defendants" acknowledge that it is unusual to oppose a grant of legal aid before proceed- ings have been commenced, they observe that some solicitors have been advertising to recruit claimants for tobacco litigation and that it seemed appropriate to outline relevant issues for legal aid authorities. One of those advertisements appears in issue 25 of this Report, July 7, 1992. The memorandum makes rekrence to a newspaper article which refers to a possible common law claim by 11 West Australia's 120,000 asthmatics with respect to ETS exposure. For a summary of this article, see issue 34 of this Report, November 6, 1992. Various argu- ments are advanced explaining why a"dass action" of this sort would not succeed. UNITED KINGDOM [331 Legal Aid Granted to Nonsmoker Suing Em- ployer A Midlands office worker who is planning to sue her employer for damages allegedly caused by ETS expo- sure has reportedly been granted assistance from the Legal Aid Board. The claimant, a woman in her fifties, apparently claims she developed asthma and bronchitis after working for five years in an office in which smoking was permitted. Lawyers arc reportedly predicting that there will be a flood of legal claims against employers and parents for ETS exposure in the wake of the Veronica Bland settlement. A barrister with Leigh Day and Company said he has had several preliminary inquiries from people who want to sue their parents. See The lndepcn- dtnt, January 31, 1993. Applications for legal aid submitted by smokers wishing to sue dgarrtte manufacturrrs have been denied . veronica Bland'Setdement, Item 30. SCIENTIFIC/TECHNICAL ITEMS RESPIRATORY DISFASFS AND CONDITIONS - CHILDREN [34] "Prevalence of Asthma in Swiss Children," F.H. Sennhauser and B.H. Guentert, European RespiratoryJourrnal5: Supplement, 1992 [See Appendix A] This absttact, presented at the European Respiratory Society meeting in 1994 nreports on a study to determine the prevalence of childhood asthma in Switzerland. Reportedly, the prevalence of nighttime symptoms, such as cough, chest tightness, and wheeiing, was significantly higher in children of families with smokers.

12 [35] "Effect of Age on Urinary Cotinine Level in Young Children," P.N. LeSouef, A.C. Reese, LI. Landau, and I.R. Jatnes, European Respiratory Journal5: Supplement, 1992 [See Appendix A] These Australian researchers investigate the hypoth- esis that the reported association between parental smoking and respiratory illness in infants is due to increased exposure rather than to claimed increased lung sensitivity. They daim to have found an inverse relationship between urinary cotinine levels and age; that is, younger children (0-2 years) reportedly had cotinine levels strongly associated with the number of cigarettes smoked by their parents. (36] "Passive Smoking and Children's Diseases," K Pisiewicz and C. Macura, European Respiratory Journal5: Supplement, 1992 [See Appendix A] This meeting abstract reports on a study comparing the prevalence of respiratory diseases and symptoms in children living with smokers and nonsmokers in relation to family history of disease. The authors report that "the influence of family history was stronger than that of passive smoking," and attribute this to parents with allergic diseases smoking significantly less. [37] "Urinary Cotinine Levels in Primary School Children: Evidence of Exposure to Environmen- tal Tobacco Smoke," E. Dagli, N. Cakan, and A. Araman, European RespiratoryJournal5: Supplement, 1992 [See Appendix A] These Turkish researchers use questionnaire data and urinary cotinine measurements to examine ETS exposure in school children. Theycondude that'the dose of nicotine received by Istanbul school children from ETS was estimated to be equivalent to I to 5 cigarettes per day." [38] "The Prevalence of Inherited and Environmen- tal Factors in Patients with Asduna," R. Lyons, S. Sreenan, C.K Power, and C.M. Burke, European RespiratoryJournal5: Supplement, 1992 [See Appendix A] Based on questionnaire responses, these researchers in Ireland report that, in their study population, childhood asthma is associated with a family history of asthma or eczema, suggesting an inherited aspect. However, the ETS/IAQ REPORT, ISSUE 40 authors also suggest that environmental factors are related to asthma, based on reports of atisociations between asthma and damp housing or ETS exposure. UNITED KINGDOM [39] "Passive Smoking Exposure and Urinary Cotinine in Relation to Respiratory Health and Bronchial Responsiveness in Adolescents," F. Forasdere, N. Agabiti, V. Dell'Orco, R Piscelli, G.M. Corbo, G. Brancaco, R. Pacifici, P. Zucarro, and CA. Perucci, Exmpean Re.rpiratory Journal5: Supplement, 1992 [See Appendix A] The authors of this study, conducted in Italy, com- pare urinary cotinine measures with questionnaire responses concerning several indices of respiratory health. They condude that urinary cotinine does not provide additional information beyond data produced by questionnaire responses. ETS EXPOSURE AND MONITORING [40] "Biological Evidence of Significant Exposure to Tobacco Smoke in Children of Smoking Par- ents," LM. Galanti and V.M. Godding, Circula- tion 86(4): Supplement, 1992 [See Appendix A] This abstract, prepared by Belgian researchers, reports that urinary eotinine levels in children are correlated with pan:nts' eotinine levels and with the number of cigarettes reportedly smoked per day. The authors daim to find urinary cotinine levels four times higher in children with smoking parents than in non-smoking adults. OTHER DEVELOPMENTS CANADA [41] Montreal Restaurants Ignore No-smoking Law According to press reports, nearly 90 percent of Montreal restaurants do not have the number of nonsmoking seats required by law. Since August 1992, restaurants have been required to set aside half of their seats for nonsmokers or risk fines ranging from $300 to $1,000. The survey, which also revealed that fully one-

FEBRUARY 5, 1993 third of restaurants failed to establish any nonsmoking section, was conducted by a city councillor who reported that his researchers found most restaurant owners were unaware of the bylaw requirements. According to city officials, they have done enough to publicize the bylaw by sending inspectors to al14,000 restaurants in the city and distributing pamphlets and no-smoking signs. Sff The Gazrttc (Montrnal), Janu- ary 23, 1993. CZECHOSLOVAIQA [42] Cigarette Executed in Wenceslas Square Animal S.O.S., an organization with animal rights and environmental concerns, reportedly staged the execution of a cigarette on old town square in Prague on January 17, 1993. The purpose of the event was apparently to bring attention to the interests of non- smokers, animals and nature. Animal S.O.S. reportedly advocates smoke-free workplaces. Su CTKNational Nnus Wire, January 18, 1993. UNITED KINGDOM [43] "Passive Smoking" Exhibition Opens at Science Museum On January 14, 1993, the Science Museum in London held a formal opening of its "passive smoking" exhibition. The assistant director described the exhibi- tion as one in a series intended to cover topical issues of scientific debate which are of interest to the public. A stated aim is to provide a "candid assessment'° of the evidence. The exhibition was reportedly produced with the assistance of three 'independent' experts, Martin Jarvis, Sir Richard Doll and Professor Nicholas Wald. The exhibition consists of display stands, wall charts and a device that permits visitors to test the alleged effects of ETS by measuring the amount of carbon monoxide in their breath. Interactive computer terminals provide visitors with an opportunity to take part in an opinion poll on ETS and to get furrher information from scientific papers. A running display of the average number of people who allegedly die from smoking-related diseases during the course of the exhibition will reportedly be given. 13 On March 10, 1993, National No Smoking Day, the Museum will have special presentations, a dramatic performance for children, and a"table-top" science day where people can take part in experiments to attempt to show whether they have been affected by cigarette smoke. A sampling of the handouts available at the exhibition are attached as Appendix D. [44] Nicotine Sensor Badge Developed for Non- smokers Bedfont Scientific Limited, a company in Kent, is reportedly developing a lapel badge which changes color when it is impregnated with airborne nicotine. The purported purpose of the badge is to measure the cumulative effect of ETS exposure. According to the company's sales and marketing manager, the badges will be sold within the next few months if tests prove successful. They will be marketed under the name Smoke Check and will cost 84 pounds for a packet of 30. See The Indepardcnt, January 31, 1993. [45] Smokers Ignore British Rail's Smoking Ban British Rail passengers who smoke are reportedly defying a smoking ban that was imposed on most South of England lines. Some are tearing down penalty notices as soon as they are posted. Others are lighting cigarettes in spite of the ban. On January 22, 1993, a smoker was stabbed and badly wounded when he lit a cigarette in a nonsmoking compartment to the evident chagrin of his nonsmoking assailant. According to Conservative peer Lord Aldington, who reportedly smokes a pipe and rides the train into London from Kent, the ban is a violation of human rights and he is calling upon the government to intervene. See The Sxrrday Tilegrapk January 24, 1993. [46] BAT Publishes Workplace Smoking Guide and Smoking Fact Sheet BAT has published a workplace smoking guide that emphasizes a fair and cooperative approach to the devel- opment ofsmoking policies in the workplace. Noting that a total smoking ban may be detrimental to office morale and productivity, the guide urges employers to "handle individual complaints as they occur and at the lowest level of supervision. ... Simple modifications to the immediate environment ... might be all that is required. A mutually worked out agreement is the ideal solution."

14 Snrokingg Rrskr asd liroritier is the title of BAT's smok ing fact sheet. This document challenges scientific findings on the health risks associated with cigarette smoke by showing how various studies on all health risk faaors can be contradictory. ETS studies are critidzed as failing to adequately account for other risk factors, and the document condudes by stating that people should be left alone to make their own choices about what they eat, drink or smoke. WoRLD AIRLINE NEws [47] Ausrralia Qantas is reported to be considering a smoking ban on all its flights worldwide. Bans on selected routes will apparently be introduced gradually as the effects on customers are studied. See Sydney Morning Herald January 27, 1993. [48] China China Airlines has reportedly indefinitely postponed its plan to ban smoking on its Taipei-Los Angeles and Taipei-New York routes. The ban was scheduled to go into effect on January 1, 1993. See Indu.rhy Sourrr.r, December 17, 1992. [49] Finland A Finnair spokesman reportedly announced the airline will not consider instituting a smoking ban on international flights. Reasons cited include fear of fires, as smoking passengers might throw cigarette ends into lavatory waste baskets. The spokesman reportedly said an alternative to a total ban would be to allow smoking at certain controlled intervals. See Savon Sanomat, October 15, 1992. [50] Iran Iran Air has reportedly announced it will ban smok ing on international flights less than 150 minutes long. The airline has already banned smoking on all domes- tic flights. See Reutcrr, December 16, 1992. UNTTED KINGDOM [51] Airplane IAQ to be Investigated A British Euro MP has reportedly called for an investigation into the safety and quality of the air ETS/IAQ REPORT, ISSUE 40 inside airplanes following the publication of a newspa per story regarding "sick aircraft syndrome" and the businessman who is threatening to sue a U.S. airline for a virulent form of pneumonia he allegedly con- tracted in-flight. See issue 39 of this Report, January 22, 1993. In his written question, tabled in the Euro- pean Parliament, Edward McMillan-Scott, Conserva tive MEP for York, discusses alleged problems with ozone levels and ETS in cabin air and asks if the Commission is aware thac circulation rates in some aircraft cabins arc below the levels recommended to maintain the health of occupants in buildings. See Sunday Tekgraphs January 17, 1993. [52] WHO Releases Report on Tobacco or Health Prognmme According to the WHO report on its Tobacco or Health Programme, WHO and the International Civil Aviation Organization (ICAO) have begun preparing guidelines for smoke-free travel. ICAO reportedly adopted a resolution in October 1992, "to take necessary measures as soon as possible to restrict smoking progressively on all international passenger flights with the objective of implementing complete smoking bans by 1 July 1996." These agencies are also charged by the World Health Assembly to promote smoke-free travel in all means of public transport. According to the report, lack of financial resources will preclude a meeting of officials responsible for surface transport policies to obtain international consensus on guidelines for smoking control in surface transport, but officials from a few selected national transport agencies will be asked in the coming months to offer their comments on WHO's draft guidelines to ensure their accuracy.

FEBRUARY 5, 1993 APPENDIX A The numbers assigned to the following article summaries correspond with the numbers assigned to the synopses of the articles in the text of this Report. IN THE UNITED STATES SCIENTIFIC/TECHNICAL ITEMS CARDIOVASCULAR ISSUES [ 19] "Reduced Plasma Ascorbic Acid Concentrations in Women Regularly Exposed to Environmental Tobacco Smoke (ETS)," D.L. Tribble and S.P. Fortmann, Circulation 86(4): Supplement, 1992 "Oxidative processes have been implicated in the pathogenesis of heart disease, offering a potential explanation for the high risk attributable to smoking. Cigarette smoke contains numerous oxidants, and smokers exhibit reduced circulating concentrations of the antioxidant vitamin ascorbic acid (AA) ... We measured plasma AA concentrations and dietary AA intake in nonsmoking women exposed to 220 hr/wk ETS, i.e., passive smokers (PS), as compared with nonsmokers with 22 hrs ETS cxposure/wk (NS) and active smokers (AS), to assess whether PS also may exhibit suboptimal AA nutriture.... Both PS and AS exhibited reduced plasma AA relative to NS. Reduced plasma AA in PS may be partially due to reduced dietary AA. These results suggest that suboptimal AA nutriture may contribute to increased heart disease risk associated with ETS exposure." RESPIRATORY DISFASES AND CONDITIONS - ADULTS [20] "Pulmonary Effects of Environmental Tobacco Smoke Exposure on Asthmatic Subjects," S.B. Lehrer, CIAR Curr=ts 2(2): 1, 4, 1992 "Our studies have focused on the incidence and characterization of asthmatic responses to environmen- tal tobacco smoke." "[A] dynamic test chamber was developed in which sidestream smoke (SS) test atmospheres, used as a surrogate for ETS, can be precisely controlled for any A-1 desired duration by varying the number of machine- smoked cigarettes and adjusting the air flow. ... The exposure environment within the chamber is composed of the diluted SS from machine-smoked IR4F research cigarettes and is characterized and monitored by concentration measurements of nicotine, respirable suspended partides, and carbon monoocida" "In our study, 163 asthmatics claiming smoke- sensitivity were challenged with SS-ETS for up to 240 minutes. Total suspended particle (TSP) levels ranged 750-2000 uglms and nicotine ranged 250-450 ug/ms. Twenty-eight (28)/163 asthmatics (17%) demon- strated a significant decline in lung function (decrease in FEV, greater than or equal to 20%) after 90 to 240 minutes of exposure. While intermittent exposure to this ETS level is possible in an environment such as a very smoky bar, ETS partide concentrations greater than 300 ug/m3 would be extreme and rarely encoun- tered. A typical indoor level is about 120 ug/m3 or less in smoking environments." "all reactors were sham (SS-ETS absent) challenged in the chamber. Eleven (11)/28 (39%) reactors had a positive sham challenge, were non-specific reactors, and were removed from the group. Thus 17/163 (10%) asthmatics reacted to SS-ETS." "Seven (7) of the 17 SS-ETS reactors were selected for dose-response challenge with decreasing levels of SS-ETS up to 360 minutes at 4 week intervals. No subjects reacted to any SS-ETS levels before 90 min- utes, and 3/7 did not react to levels less than the highest.... No participants demonstrated a significant drop in peak flow rate when monitored overnight." "Our studies showed that about 10% of asthmatics daiming to be smoke sensitive actually demonstrated objective changes in their pulmonary function from high level SS-ETS exposure. These responses do not appear to be related to IgE antibody reactivity to tobacco allergens. Almost 40% of all reactors also exhibited a significant drop in their FEV, in the absence of tobacco smoke which suggests that the nature of some forms of asthma are unstable and that controls are needed when evaluating cigarette smoke- induced responses. Future studies are directed at assessing the role of mediators in ETS-induced asth- matic and extrapulmonary responses, identification of the ETS components that might provoke asthmatic