Tobacco Documents Online

6 union] has failed to demonstrate a need to change the current ventilation rate of 5 CFM." Because there was a nonsmoking policy in the office, the employer was complying with the "minimum Federal rate," and no one had yet complained about the air quality, the panel did not believe it was necessary for the employer to spend $12,500 to raise the ventilation rate. OTHER DEVELOPMENTS [ 12] "It's Ronald McDonald vs. Joe Camel in the Smoking Debate," BA. Epstein, St. Petersburg Times, April 12, 1993 Dr. Bruce Epstein, a St. Petersburg pediatrician, urges parents to force restaurant owners to ban smoking in their facilities for the sake of the health of children. Epstein cites the EPA Risk Assessment on ETS to bolster his argument about the alleged health effects of ETS exposure. He concludes, "We can no longer allow eating, which is life-sustaining, and smoking, which is life-destroying, to co-exist in the same room." [13] SEC Approves Omission of McDonald's Share- holder Proposal About Smoking Policy According to a press report, McDonald's Corp. won permission from the Securities and Exchange Commis- sion (SEC) to omit from its proxy statement a share- holder proposal that the board adopt a smoke-free policy at corporate headquarters and smoke-free policies for all new franchisees by 1995. Apparently, the SEC agreed with McDonald's assertion that the shareholder proposal dealt with matters relating to the corporation's ordinary business operations. Under SEC rules, such matters need not be included in the issuer's proxy materials. See BNA Pensions d Benefits Daily, April 22, 1993. McDonald's and two other fast-food chains have been sued in U.S. District Court in Connecticut under the Americans with Disabilities Act (ADA) to force the adoption of smoking bans as a reasonable accommodation of persons allegedly disabled by asthma and lupus. Staron v. McDonald's Corp., Staron v.Burgrr IGng Corp., Staron v. Wendy ~ Old Fashioned Hamburgers of Nrw York, Inc., see issue 45 of this Report, April 16, 1993. ETSIIAQ REPORT, ISSUE 46 [14] Restaurant Chain Operators Keep Eye On McDonald's Experiment According to a trade publication, the operators of fase-food restaurants are waiting to see what McDonald's will decide to do about smoking following its test of a smoke-free policy in some 40 of its restau- rants. The director of marketing for the Atlanta-based chain, Chick-fil-A, is quoted in the article as saying, "Someone as big as McDonald's creates the standards." The National Council of Chain Restaurants was reportedly scheduled to consider the issue of smoking at a March 31, 1993, meeting. Reports suggest that concern about potential lawsuits by employees and customers may be fueling consideration of smoking policies by restaurant operators. The executive vice president of operations for Hardee's Food Systems, Inc., however, observed that this is not a priority issue because customers have not been complaining about smoking in its restaurants. See Nation 's Restaurant News Newspaper, March 15, 1993. According to other reports, approximately 50 of the 3,700 Wendy's fast-food restaurants went smoke free last year; Wendy's official policy is to provide separate smoking and nonsmoking areas, according to a com- pany spokesperson. See New York Times, April 3, 1993. At Indoor Environment '93, held last week in Balti- more, John Banzhaf claimed the Chuck E. Cheese fast- food chain has instituted a smoking ban. [15] MCS Sufferers Want Perfumes Banned under ADA According to an article appearing in a recent issue of The Philadelphia lnquirer, a number of communities may soon follow the lead of San Francisco and Oak- land in adopting policies to ban perfumes and other fragrances from government public meetings. Santa Clara and Santa Cruz officials are also reportedly considering such a ban in order to comply with what are deemed vague requirements under the Americans with Disabilities Act (ADA), which are intended to protect the disabled from discrimination. The movement in San Francisco to ban fragrances was apparently spearheaded by John Cailleau who suffers from AIDS and claims he developed MCS following years of exposure to solvents and new carpet fumes and a violent reaction when he was exposed to

APRIL30, 1993 an overbearing perfume in 1990. Cailleau believes that the ADA should apply to those with MCS. He has joined with like-minded individuals in a group known as the Environmental Health Network and hopes to take his campaign nationwide. The group has reportedly received inquiries from Arizona, Hawaii, Oregon and Minnesota. See The Philadttlphia Inquirer, April 12, 1993. [16] Shopping Mall Goes Smoke Free A shopping mall in Connecticut is reported to be the first there to adopt a total smoking ban. According to press reports, Westfarms mall in Farmington intro- duced its ban gradually and, until this month, permit- ted smoking in customer lounges. A spokesperson for the International Council for Shopping Centers was reported to say that smoke-free malls are a national trend in response to consumer concerns about ETS. See The Hartford Courant, April 15, 1993. [17] Survey on Corporate Health Practices Released According to a survey recently released by the U.S. Public Health Service, some 59 percent of 1,507 workplaces with 50 or more employees prohibit or severely restrict smoking. Apparently, this represents a doubling of the number of workplaces imposing smoking restrictions since 1985. Twelve percent of those businesses surveyed reportedly adjust health insurance rates based upon whether an employee smokes. The survey reportedly focused upon a variety of healch-promoting issues and found that self-insured companies and those with 750 or more employees were the most likely to offer wellness programs. See UPI, April 13, 1993. A survey released by the Bureau of National Affairs in 1991 reported that total bans on smoking had been established by 34 percent of compa- nies in the survey, compared with seven percent of firms in 1987 and two percent in 1986. See issue 7 of this Report, September 13, 1991. (18] Hotel Space for Nonsmokers Some hotels in the United States are reportedly setting aside more nonsmoking rooms. According to a press report, Marriott has converted 60 percent of its rooms into nonsmoking rooms, which is up from 22 percent in 1990. Hilton has 50 percent nonsmoking rooms, up from 10 percent in 1987. Most hotels, however, still maintain more smoking rooms than nonsmoking rooms, reportedly on account of foreign travelers who smoke at higher rates than Americans. See USA Today, April 13, 1993. [ 19] Smoking Rights Advocates Decry Use of To- bacco Tax Funds Californians for Smokers' Rights, a Sacramento-based smoking advocacy group, reportedly complained to the governor of California that tobacco tax funds are being misspent on baby showers, pool parties, parade floats and racing cars. Defenders of the programs say that they are public outreach programs that bring messages about the purported dangers of ETS exposure, among other matters, to teenagers and low income women who are pregnant. According to a health official quoted in a press report, "We aren't doing a lot of traditional, ho-hum stuff (with the cigarette tax money), and the tobacco companies are going nuts." See The San Francisco Chroniclr, Apri123, 1993. SCIENTIFIC/TECHNICAL ITEMS RECENT/UPCOMING MEETINGS [20] "Indoor Environment '93: Defining Strategies for Effective Indoor Air Management," Balti- more, Maryland, April 21-23, 1993 Although several sessions of this conference were devoted exclusively to ETS, many other IAQ issues were dealt with during sessions that were divided into five tracks. The estimated 600 participants, who induded environmental lawyers, building managers and owners, IAQ consultants, government officials, and industrial hygienists, could choose among tracks designated as Programs & Policy, Issues in Evaluation & Mitigation, Building Management, Safety & Health, and Litigation & Liability. The opening session featured an address by Bob Axelrad, Director of the Indoor Air Division of the EPA. His remarks included reference to the EPA Risk Assessment on ETS, and he particularly focused upon the alleged health effects for children. A session entitled "ETS: Recent Health Effects Research" was led by Steve Bayard, Project Manager of the ETS risk assessment and'John Banzhaf, executive

8 director of ASH. During this poorly attended session, Bayard defended the purported validity of the risk assessment, and Banzhafs presentation stressed antismoking monologue, which included an assertion that the greatest risk to smokers comes from their exposure to ETS and not from their inhalation of mainstream smoke. The handout provided to conkr- ence participants by Banzhaf is attached as Appendix C. It includes information about the ETS risk assess- ment and cases which ASH asserts put those permit- ting smoking on their premises at risk of incurring liability for ETS-related injury. Officials of state and federal agencies discussed the programs and studies they are currently conducting with regard to IAQ issues, and attorneys who are litigating SBS cases gave practical information about avoiding such lawsuits. Helen Eisenstein Zukin, who has litigated such cases for a number of years, predicted that an "explosion" of SBS litigation was unlikely because the cases are burdensome and expensive for the plaintiffs who file such daims. Victor Schwartz, an attorney specializing in products liability issues, and Banzhaf addressed issues during a session designated simply as "Environmental Tobacco Smoke." Schwartz rebutted Banzhaf s assertions about the coming tide of ETS litigation by challenging the ETS risk assessment for its "pages and pages of assumptions" and by noting the difficulties plaintiffs claiming injuries based on ETS exposure would have in proving causation. ASH attorney Kathleen Scheg shared a podium with a representative of the Building Owners and Managers Association (BOMA) to address "IAQ and the Americans with Disabilities Act" (ADA). Scheg concentrated on ETS and the ADA and declared that a complete ban on smoking is the only reasonable accommodation that can be made under that Act to protect the rights of the alleged 100 million impaired Americans for whom ETS poses a significant health threat. The speaker from BOMA discussed the difficulties building owners face in resolving all IAQ problems for purposes of removing barriers to entry for the disabled, but echoed Scheg in denouncing ETS and in recommending total smoking bans. Susan Rosmarin, representing the IAQ Model Law Task Force, was supposed to present to conference participants a completed "conceptual outline" which ETS/IAQ REPORT, ISSUE 46 would form the basis for the draft of a model law on IAQ that will eventually be made available to state and local governments. See issue 44 of this Report, April 2, 1993. However, Rosmarin indicated that difficulty has been encountered in the drafting process due to an attempt to accommodate the interests of a range of business, health and consumer groups. She did discuss the broad param- aers being considered by the subpand drafting the model law. There was no mention of source control. Additional sessions considered issues related to multiple chemical sensitivity, IAQ and worker productivity, microbial contamination, and IAQ and psychological factors. During the session on worker productivity, the results of two studies were reported which indicated, to the researchers' surprise, that there was no observ- able correlation between poor IAQ and productivity. These studies were presented by Dr. Jan Stolwick and Edward Chu. [21] Indoor Air Quality Congress '93, Boston, Massachusetts, June 15-16, 1993 According to advance materials, the 1993 IAQ Congress will address solutions for IAQ improvement. Topics indude minimizing legal risks, applying new methods and discovering new systems for improving IAQ. Health aspects, problem diagnosis and problem mitigation will also be covered. The conference is sponsored by the Environmental Engineers and Managers Institute, The Demand-Side Management Society and the Association of Energy Engineers. LUNG CANCER [22] Letter to the Editor Regarding "Commentary: Environmental Tobacco Smoke and Lung Can- cer," C.W. Heath, The IQncet 341: 526,1993 The Lancet has published a response by Gio Gori to this editorial. As discussed in Issue 43 of this Report, March 19, 1993, the author said that the EPA Risk Assessment on ETS provided a "firm regulatory basis for increased societal action to eliminate ETS." Gori s response appears in The Lancrt 341: 965, 1993. Gori proposes that Heath's editorial is not "well informed," and suggests that the editors consider the ETS risk assessment itself. He then criticiaes a number of the positions detailed in the risk assessment.

APRIL 30, 1993 Gori writes that EPA's claim that ETS is equivalent to the smoke inhaled by smokers "falls short of objective verification," and suggests that EPA "categorically exdudes" the possibility of a threshold. He also calls the reported ETS exposures "vanishing" and the epidemiology "incondusive." Moreover, Gori calls the EPA's use of 90% confi- dence intervals and "one-tailed" statistical tests a "questionable gambit." He also criticizes EPA's use of meta-analysis, its decision rcgarding confounders, and its failure to include two recent epidemiologic studies, which, he proposes, "invalidate the Agency's condu- sions even by inflated statistical standards." Gori concludes by stating that "Clark Heath's attributions of robust science are perplexing," and criticizes some of Heath's particular statements, including one concerning the possibility of OSHA regulation. Gori calls for attention to scientific credibil- iry, and proposes that "[a]lthough the EPA report may yet prove an effective policy instrument, the Agency's claim of scientific support seems ill-founded." RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [23] "Chronic Sidestream Smoke (SS) EEhects on Airway and Pulmonary Artery Reactivity to Serotonin in Developing Rats," J.M. Bric, KE. Pinkerton, and J.P. Joad, Journal ofAllergy and ClinicalImmunol- ogy 91 (1 Part 2), 1993 [See Appendix A] This abstract reports on an experiment in which young rats were exposed to sidestream smoke and tested for airway reactivity. The authors propose this system as an animal model for increased airway reactivity and asthma prevalence reported in children who live with smokers. Their data, however, suggest statistically significantly decreased airway reactivity in rats exposed to sidestream smoke. [24] "Risk Factors for Acute Wheezing," A.L. Duff, E. Pomeranz, G.W. Price, L.E. Gelber, A.H. Farris, F.G. Hayden, A.E. Platts-Mills, and P.W. Heymann, AnnaG ofAlkrgy70: 47, 1993 [See Appendix A] In this abstract, the authors report on an investigation of the prevalence of three purported risk factors (viral 9 infection, ETS exposure, and allergy) in acutely wheezing children. They report a higher prevalence of smoke exposure in study subjects under the age of two. OTHER HEALTH ISSUES [25] "Evaluation of Individuals Attributing Hyper- sensitivity Symptoms (HS) to Indoor Air Pollution (IAP)," P. Kuhnl, G. Golling, B. Eberlein-Konig, and B. Przybilla, Journal of Allergy and ClinicalImrnunology 910 Part 2), 1993 [See Appendix A] This abstract reports on an investigation of persons with a self-reported hypersensitivity to "indoor air pollution." The authors report that "common" allergic diseases alone; psychosomatic effects alone; and a combination of the two contributed to the claimed hypersensitivity in different segments of the sample studied. [26] "Spontaneous Resolution of Severe Chronic Glue Ear in Children and the Effect of Adenoidectomy, Tonsillectomy, and Insertion of Ventilation Tubes (Grommets)," R. Maw and R. Bawden, British Medical Journal306: 756-760, 1993 [See Appendix A] This paper is another report from a large study on chronic otitis media with effusion ("glue ear"), con- ducted in Great Britain. The authors report that long- term resolution of glue ear was best with combined removal of the adenoids and tube insertion. However. they also claim a longer time to resolution in children whose parents smoked. [27] "Social Differences in Swedish Infant Mortality by Cause of Death, 1983 to 1986," M.L. Nordstrom, S. Cnattingius, and B. Haglund, American Journal of Public Health 83: 26-30, 1993 [See Appendix A] The authors of this study investigated mortality in more than 355,000 infants born in Sweden between 1983 and 1986. They report statistically significantly elevated risk estimates for sudden infant death syn- drome in infants whose mothers smoked.

10 ETS ExPOSURE AND MONITORING [28] "Development of Pulmonary Cytochrome P450 (CP-450) Isoenzymes: Protein Expression, Activity and Response to Environmental Tobacco Smoke (ETS) in Postnatal Rats," A. Gebremicbad, C.G. Plopper, A.R. Budcpitt, and K.E Pinkerton, Toxicologist 13: 49, 1993 [See Appendix A] This abstract reports on the experimental exposure of rats to sidestream smoke, and on data collected con- cerning enzyme activity. The authors report "signifi- cantly higher" activity in exposed rats of one of the two enzymes measured. [291 "A Time Series Modd for Cigarette Smoking Activity Patterns: Modd Validation for Carbon Monoxide and Respirable Particles in a Chamber and an Automobile," W. Ott, L. Langan, and P. Switzer, Journal of Exposure Analysis and Environmental Epidtmiologgy 2(Suppl. 2): 175- 200, 1992 [See Appendix A] The authors present a detailed mathematical model for calculating "pollutant" levels over time in the presence of smoking. They also apply the model to a "microenviron- ment," that of an er.ciosed automobile, in which they report that ETS levels can become "relatively high." INDOOR AIR QUALfIY [30] "Air Movement, Comfort and Ventilation in Partitioned Workstations," F.S. Bauman, R.S. Helm, D. Faulker, EA. Arens, and W J. Fisk, ASHRAEJournal (March): 42-50,1993 [See Appendix A] Based on experiments conducted in an environmental chamber, the authors of this study report that office partitions do not always present a barrier to effective air circulation or ventilation eflicienry. [311 "W'ill the Mouse Bioassay for Estimating Sensory Irritancy of Airborne Chemicals (ASTM E 981-84) Be Useful for Evaluation of Indoor Air Contami- nants?" J.S. Tepper and D.L Costa, Indoor Environmens 1: 367-372, 1992 [See Append'a A] This "Opinion" article reviews information on a mouse bioassay, which is intended to indicate the ETS/IAQ REPORT, ISSUE 46 irritancy of an airborne substance by a change in the animal's breathing pattern. The authors review the applicability of the assay with respect to human exposures, such as sick building syndrome. SMOKING POLICIES AND RELATED ISSUES [32] Letters to the Editor Regarding "Issues and Answers Concerning Passive Smoking in the Workplace: Rebutting Tobacco Industry Argu- ments," J.L. Repace and A.H. Lowrey, Tobacco Control 1: 208-219, 1992 The journal Tobacco Control recently published two letters concerning this article. As discussed in Issue 35 of this Report, November 20, 1992, the authors purport to present a summary of tobacco industry positions on ETS. They then present rebuttals to each claimed position, for "regulatory officials and employers unfamiliar with advances in ETS research." The authors, James Repace, an EPA employee, and Alfred Lowrey, have published several articles relating to the alleged health effects of ETS exposure. The first letter in the current correspondence is from Sharon Boyse, a scientist with the British-American Tobacco Company, the second letter is a response from Repace and Lowrey. The letters appear in Tobacco Control 2: 56, 1993. Boyse refers to Repace and Lowrey's claim that the tobacco industry takes scientific data out of context. She "would argue that the industry does not do so," and suggests that Repace and Lowrey "could be accused of doing so in this article, in the enthusiasm of their attempt to discredit the scientific acumen of the tobacco industry." Boyse characterizes the Repace and Lowrey paper as "riddled with statements that simply cannot be justified by the current scientific data." Boyse discusses in some detail three of the largest studies of spousal smoking and lung cancer in non- smoking women, describing their reported results as a "situation of conflicting data ... typical of the ETS story." She then inquires: "Why do Repace and Lowrey fail to disclose these facts, unless it is because they can be accused of exactly the same bias that they assign to the tobacco industry?" Noting that approximately 80% of the spousal smoking studies and 80% of the studies including estimates of workplace exposure do not report statisti-

APRIL 30, 1993 cally significant increases in lung cancer risk, Boyse questions "how the authors can criticise either the tobacco industry - or ... independent scientists ... - for holding to the opinion that the case has not been proven." She concludes with the suggestion that "[i]f this evidence applied to anything other than tobacco smoke, it would never have become a major public issue." In their reply, Replace and Lowrey claim that Boyse's letter provided "several textbook illustrations of how the tobacco industry quotes scientific studies and methods out of context and ignores contradictory studies" concern- ing ETS. They claim that the tobacco industry puts undue emphasis on statistical significance, which they suggest reflects a "cavalier attitude toward public health." Repace and Lowrey advocate the "total weight of evi- dence" approach, and invoke the argument of "biological plausibility." Moreover, they daim that, if the data from the "highest" exposure categories reported in 17 of the spousal smoking studies are considered, statistical signifi- cance is achieved. Repace and Lowrey further accuse Boyse of a "shame- less quote-out-of-context" concerning the Wu-Wil- liams, et al., (1990) study of spousal smoking in China. They refer to the authors' condusion that an"efl•ect" of ETS was "obscured" in their study because of high indoor air pollution; however, as Boyse had pointed out, Wu-Williams, et al., reported a statistically significantly negative risk estimate for spousal smoking. In conclusion, Repace and Lowrey claim that "even while vehemently denying the practice of the selective citation and the out-of-context quote, the tobacco industry cannot refrain from their use." They write: "Perhaps for those who market tobacco, such practices have become as addictive as nicotine." STATISTICS AND RISK ASSESSMENT [33] "An Individual Decision Model For Environ- mental Exposure Reduction," N. Duan and W. Ott, Journau of Exposure Analysis and Environ- mental Epidemiology 2(Suppl. 2): 155-174, 1992 [See Appendix A] This paper presents a detailed mathematical model to illustrate ways that an individual can reduce personal exposure to a given substance. The authors use benzene, 11 purportedly from ETS and active smoking, as an example in their discussion. They call for increased availability of exposure and cost data for the general public. IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS AtJSTRALIA [34] Parliament House Smoking Policy Debated in New South Wales According to a press report, the members of State Parliament plan to debate the issue of banning smok- ing in the New South Wales Parliament House on April 27, 1993. Ser Sunday Telegraph, April 25, 1993. [35] Smoking Bans Adopted in Railway Stations and on Trains According to Transport Minister David Hamill, Brisbane's major railway stations will become smoke free beginning on July 1, 1993. The ban will'report- edly apply to platforms and subways at Central, Roma St., Brunswick St., Toowong and Ipswich. Ser Courier Mais: April 15, 1993. In a related story, Hamill also reportedly announced that smoking will be banned on long-distance Qld trains from July 1. The decision to adopt the ban was apparently a result of Qld Rail's concern for the health of staff and passengers and concerns about liability following recent ETS cases. See TownsvilLe Bulktin, Apri18, 1993. Meanwhile, CityRail staff reportedly planned to conduct a three-day campaign to crack down on passengers violating smoking and other regulations in the Sydney, Newcastle and Wollongong areas. See Sydney Morning Heralca; April 23, 1993. [36] Local Council Adopts Smoking Ban Beaudesert Shire Council has reportedly banned smoking in its buildings as part of a move to curb

12 compensation and injury payouts. See Gold Coast Bulletin, April 28, 1993. CANADA [37] North York Considers Tougher Smoking Restrictions The North York Council has reportedly endorsed a new Board of Health report on ETS. According to a press report, the endorsement will likely lead to a board request that the council adopt a stronger smoking bylaw which will further restrict smoking in public and workplaces. See The Toronto Star, April 15, 1993. PHILIPPINES [38] Manila Adopts Street Corner Jails to Enforce Smoking Laws Manila City has reportedly begun to jail persons caught violating tough nonsmoking and other laws in street-corner jails where they can be seen by passersby. Street jails can apparently be found in the Sampalic district and on Malate, Tondo and Magsaysay Streets. According to police, the concept appears to be working as smoking in public places has been reduced. Since a government crackdown began in January on the orders of Manila's mayor, over 11,500 people have been arrested for violating smoking, prostitution, jaywalking and littering ordinances. See Xinhua, April 23, 1993. TAIVe/AN [39] Legislature Considers Tobacco Hazards Control Act The legislature has reportedly begun to deliberate the merits of a proposed "Tobacco Hazards Control Act,' which would, among other matters, restrict tobacco smoking. See BNA Inttrnational Trade Reporter, April 7, 1993. UNITED KINGDOM [40] More Action Considered by Local Governments on Smoking Issue South Derbyshire Council is reportedly considering segregating smokers from nonsmokers at its offices in ETS/IAQ REPORT, ISSUE 46 Swadlincotc. A committee will apparently seek a report and recommendations on the matter. See Burron Dailjr MaiL March 27, 1993. Numerous changes to the smok- ing policy already in effect at Argents Mead Council offices were reportedly considered at a recent meeting of the Health and Leisure Committee. And after a lengthy discussion, committee members decided to keep the present system which permits smoking in specially designated rooms. See Hincklry Trsnrs; April 1, 1993. Meanwhile, a total ban on smoking has evidently been adopted in Croydon Council's Taberner House offices. According to press reports, the ban may be extended to more than 10,000 other council staff in other locations such as schools, senior citizen homes and works depots. See Crwydon Advertiser, April 2, 1993. ETS-RELATED LITIGATION INVOLVING CIGARETTE MANUFACTURERS AUSTRALIA [41] Tobacco Institute ofAustralia Ltd v. Australian Federation of Consumer Organisations Inc. (Australian High Court) (appeal filed April 1, 1993) AFCO has filed an application for special leave to appeal from the March 11, 1993, decision of the full federal court. The application for leave to appeal challenges the award of costs and "such other parts of the judgment as senior counsel may advise should be induded in the Application for Special Leave." In support of its challenge, AFCO asserts that the case involves a substantial public interest, that the proceed- ings were brought solely in the public interest, and that TIA refused AFCO's offers of settlement and compro- mise. TIA has entered an appearance in the case. The March 11 decision: (i) declared language in a 1986 TIA advertisement misleading and deceptive; (ii) denied AFCO's request for injunctive relief; (iii)) refused AFCO leave to introduce new evidence; (iv) refused TIA leave to argue a constitutional free speech issue; and (v) awarded AFCO fewer costs than origi- nally awarded by the trial judge in the case.

APRIL 30, 1993 OTHER DEVELOPMENTS AUSTRALIA [42] Restaurant Smoking Policies Stir Debate Eleven clubs reportedly answered a Canberra Times survey on smoking bans recently and most expressed concern about such policies unless all clubs and pubs are required to abide by the same rules. According to a paper presented at a Licensed Club Association direc- tors' seminar, however, the industry should adopt smoking bans to fulfill legal obligations in light of recent court cases showing that the courts are finding a legal link between ETS exposure and ill health. See Canberra Tirnrs, April 11, 1993. Meanwhile, a new dub, called Smoko, which is just for smokers and their friends, has reportedly formed in the southern suburbs. See Brisbane Sunday Mai,: April 18, 1993. In Sydney, however, the Galileo restaurant in the Observatory Hotel has reportedly just become the first top dining room to ban smoking completely. See Sydney Morning Hrrald April 4, 1993. [431 Landmark Shopping Complex to Ban Smoking According to a press report, Sydnry's landmark MLC Centre is the latest commercial and shopping complex to adopt a smoking ban. The policy will reportedly com- mence on May 31 to coincide with "World No Tobacco Day." Sce Sydney Morning Herald April 4, 1993. [44] Chinatown Restaurants Experiment With Smoking Restrictions According to press reports, seven of the most popular restaurants in Sydney's Chinatown area will offer smoke- free zones for an 8-week trial period. The experiment is reportedly part of the state's campaign to minimize ETS exposure in a particular ethnic community. Sydnry's smokers will also be asked to refrain from smoking in nondesignated areas in the Queen Victoria Building public eating areas or toilets. The move is apparently part of a long term plan to gradually ban smoking in the building. See Daily Tilrgraph Mirror, April 15, 1993; Sydney Morning Htralc4 April 16, 1993. 13 BELGIUM [45] Tobacco Information Centre Begins Courtesy Campaign on Smoking The Belgian Centre for Information and Documenta- tion on Tobacco has reportedly started a courtesy campaign which includes in its materials the blue and green, smoking and nonsmoking elephants, which were used recently in a campaign by French hoteliers. See Le Sois, April 23, 1993. CANADA [461 IAQ Becomes Marketing Tool for Commercial Building Managers According to press reports, high vacancy rates in commercial office buildings are forcing landlords to pay attention to IAQ issues which are of concern to their tenants. Some building managers have hired environmental consultants to conduct regular IAQ tests in their properties. Test results are being used as a promotional device that is apparently being noticed by prospective tenants when the results are positive. According to the president of Purdy's Wharf Develop- ment Ltd., a twin-tower complex in Halifax, more new tenants have been signed in the first quarter of 1993, than in all of 1992, since the company began promot- ing its superior IAQ during the last six months. See Mackan i April 19, 1993. [471 Train Smoking Bans Announced VIA Rail has reportedly announced that smoking will be banned on trains traveling in the Quebec Ciry-Ot- tawa-Windsor corridor beginning on June 1, 1993. Apparently, bans will not be imposed on other VIA routes because some of those trips take longer than four hours to complete. See The Citizen, April 15, 1993. INDIA [48] Doctors Call for Declaration About ETS During a public conference recently held in New Delhi, doctors called for the designation of ETS as a carcinogen. K.L Chopra, chairman of the Heart Care Foundation of India, reportedly stated that ETS, to which nonsmokers are exposed, has higher concentra-

14 ETS/IAQ RE['ORT, ISSUE 46 cions of toxic substances than the mainstream smoke inhaled by smokers. The vice chairman of the founda- tion called for smoking to be banned in government offices. Ser Xinhua, April 11, 1993. JAPAN [49] Nonsmoking Businessman Fined for Assault on Airline Cabin Crew A nonsmoking Japanese businessman was reportedly fined $12,000 for attacking three Qantas cabin crew members after he was forced to sit in a smoking section. According to a federal prosecutor, the man did not speak English and became frustrated when the crew could not understand his demands to have his airline seat changed. See Herald Sun, April 17, 1993. UNITED KINGDOM [50] Antismoking Activists Seek ETS Legislation According to a press report, the Association for Nonsmokers' Rights stated at a recent Glasgow symposium on national health that education about ETS is a waste of time unless it is accompanied by legislation offering protection to nonsmokers from ETS exposure. The association is apparently calling for the adoption of new laws to address the issue. Ser Edinburgh Evening News, April 3, 1993. [51] Unusual Coalition Seeks to Overturn Railway Smoking Ban Lord Harris of High Cross has reportedly been joined by Cockney comedian Chubby Oates and FOREST in a fight to reverse the British Rail decision to close the smoking compartment on commuter trains to London. Apparently, Lord Harris recently participated in a "smoke-in" on the 8:24 Tonbridge to London train and regularly protests the ban in the House of Lords. FOREST reportedly presented a Chubby Oates cabaret on Apri129, in London's West End, evidently in recognition of Oates' lobbying activities on behalf of smokers' rights. See Sunday Telegraph, April 4, 1993.

APRIL 30, 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. RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [23] "ChronirSidestream Smoke (SS) Effects on Airway and Pulmonary Artery Reactivity to Serotonin in Developing Rats," J.M. Bric, K.E. Pinkerton, and J.P. Joad, Journal ofAllcrgy and Clinical Immunology 91 (1 Part 2), 1993 "Since children raised in the homes of smokers exhibit increased airway reactivity and a higher inci- dence of asthma, we previously exposed developing rats to SS in an attempt to establish an animal model for this effect. However, the SS-exposed rats did not become hyperresponsive to methacholine. This study was designed to determine if SS-exposed rats develop increased reactivity to another bronchoconstrictor, serotonin.... [R] ats were exposed to filtered air (FA) or to SS for 6 hr/day, 5 days/wk from 2 days of life to I 1 wks of life. Then, their lungs were removed and studied in an isolated, buffer perfused system where lung resistance (RL) and pulmonary artery pressure (Pr,,) were measured while increasing doses of seroto- nin were injected into the pulmonary artery. In contrast to our expectations, airway reactivity to seroconin was markedly decreased in SS-exposed rats. However, the serotonin-induced increase in PPA was not altered by previous SS exposure. After serotonin, lung weight/body weight ratio in the SS-exposed group did not differ form that in the SS-exposed group did not differ from that in the FA-exposed group. We conclude that serotonin may play a role in environ- mental tobacco smoke-induced airway problems." [24] "Risk Factors for Acute Wheezing," A.L Duff, E. Pomeranz, G.W. Price, LE. Gelber, A.H. Farris, F.G. Hayden, A.E. Platts-Mills, and P.W. Heymann, Annals of Allagy 70: 47, 1993 "A cross-sectional analysis was performed on 100 acutely wheezing children (WH)...and 58 controls (CON) to evaluate multiple risk factors for wheezing. Patients were evaluated for inhalant allergy...for A-1 tobacco smoke exposure...and for viruses. Some risk factors appear to be more prevalent in different age groups of wheezers. Viral pathogens were more preva- lent in WH <2 when compared to WH >2 and to CON <2. Smoketxposure was found in 79% WH <2 compared to 21% WH >2. Inhalant allergen sesitization was more significant in WH >2 yrs than in WH <2. Sixty-six percent of all WH were exposed to two or more risk factors. Multiple risk factors may be associated with an individual's acute wheezing episode, but based on the age of the patient, some risk factors may be more contributory." OTHER HEALTH ISSUES [25] "Evaluation of Individuals Attributing Hyper- sensitivity Symptoms (HS) to Indoor Air Pollution (IAP)," P. Kuhnl, G. Golling, B. Eberlein-Konig, and B. Przybilla, Journal ofAllergy and ClinicalImmunology91 (1 Part 2), 1993 "Air pollution as well as allergy have found much interest in the general public, and there are increasing numbers of patients attributing HS to IAP, especially to 'chemicals'. Frequently, in dinical practice such an interpretation of symptoms can neither be proven nor rejected, although the complaints appear bizarre not rarely. To approach this issue, we... recruited individu- als complaining of HS attributed to IAP...71 patients were investigated in detail by a thorough allergological examination. In addition, a structured psychological evaluation was performed by a trained psychologist.....Among the 65 patients...different groups took shape: 17 (26%) had 'common' allergic (or other hypersensitivity) diseases (CAD) not yet treated adequately, e.g. allergic rhinoconjunctivitis or asthma. In 19 (29%) there were CAD superimposed by strong psychosomatic effects. An exclusive psychoso- matic cause of the complaints was found in 19 (29%). Imonly 10 (16%) there were indications of actual HS to indoor pollutants other than allergens from biologic sources; all these patients were also suffering from CAD. So, patients presenting with HS related to IAP by themselves are a heterogenous group. If a conclusive diagnosis of CAD cannot be made or seems insufficient with regard to the complaints, an additional psycho- logical evaluation is indispensable. The role of indoor pollutants for the development of symptoms in some patients with CAD is being further evaluated."