Tobacco Documents Online

(s As of \iav 18, nothing hadbeen filed in the docket on behaif.of defendant Shaw Industries, Inc. to extend the time for responding to the complaint, nor had Shaw vet filed its answer. For a discussion of the plaintiffs' allega- tions. see issue 46 of this Report, April 30, 1993. WORI:PL-~CE: HARASSME!vT [ 17] Srotko v. Dakota County (Dakota County, Minnesota) (decided May 7, 1993) A jury has reportedlyv awarded $117;000 in damages and S33,000 in lost wages to a county employee who claimed she had been harassed after complaining that co-workers .vere ignoring a smoking ban. Man, Stotko, a county dispatcher, evidently told her supervisors on January6, 1991, that employees were continuing to smoke in spite of a building-wide ban that had gone into effect on January 1. According to her attorney. Stotko s co-workers then ceased passing essential -. information to her, left her alone in the office during busy times, and would not speak to her when she greeted them. Stotko eventuallyy quit working as a dispatcher. According to a press report, this case is the first to be decided by a jury for harassment over enforcement of the State Clean Indoor Air Act. In a related develop- ment, legislative employees have apparently been told to stop harassing an employee who complained that the no-smoking law is not being enforced in the Capitol. See Star Tribune. May 9, 1993. PRISONER CASE [18]' Stanfield v. Hay, 1992 Ky. App. LEXIS 228 (Supreme Court, Kentucky) (discretionary review denied April 14, 1993) The Supreme Court of Kentucky has denied an application for discretionary review filed by a county jail inmate who alleged that his constitutional and civil rights were being violated by a prison smoking ban. In so ruling, the Supreme Court upheld a Courrof Appeals decision which found no violations of peti- tioner David Stanfield's rights. See issue 36 of this Report. December 4, 1993. L•TS1dAQ REPORT. ISSUE 48 LEGAL ISSUES AND DEVELOPMLNTS [19] Television Broadcast Addresses Child Custodv Cases and Smoking During a May 18, 1993, broadcast of NBC Nightly News, the issue of children being removed from the custody of smoking parents in divorce actions was addressed. The report featured the cases of Timothy Badao and K.C. Mitchell. Badao's visitation rights with his son were reportedly cut to four days a month by a judge who agreed with the boy's mother that smoking was aggravating the boy's asthmatic condition. Mitchell evidentlyy losr custody of her som solely because she smoked. During the report, a pediatrician was quoted as saying "it's welP known that it doubles the incidence of SIDS, which is Suddem Infant Death Syndrome, if one of the parents smokes." See.ti'BC Nightly News, May 18, 1993. [20] ASH Creates Form Letter for ADA Complaints to Restaurants In its most recent publicatiom ASH has includ'ed a form letter for those who are "so sensitive to tobacco smoke that exposure in a public place causes them difficulties with breathing or eating." The letter, according to ASH, will make it possible at a later time to file "a more formal'complaint" with the Department of )ustice under the Americans with Disabilities Act (ADA) against proprietors of public places such as restaurants who refuse to impose smoking bans. The form letter warns its recipient that "persons sensitive to tobacco smoke are entitled to protection under disability laws. Please understand that if you do nothing to remedy the problem, I may be forced to take legal action." The letter further discusses the litigation pending against fast-food restaurants in UIS. District Court in Connecticut, and advises the recipi- ent to contact ASH for "further information concern- ing your possible legal liabilities for refusing to curtail smoking." See ASH Smoking and Health Review; March-April 1993: [21]' New Jersey Magazine for Trial Lawyers Issues 'Call to Arms' for ETS Litigation Claiming "the tobacco lobby is no better than a ~ common criminal," the May 1993 issue of Nrw firse1

MAY _'R; 1!993 Tzial Lneverexhorts its readers to initiate ETS litiga- tion against cigarette manufacturers and other defen- d'ants. "Trial lawyer associations and every public interest law firm should use their contacts around the country to find plaintiffs who are harmed by second- hand smoke and get their claims before the judiciarv," the magazine asserts in an editorial. The editorial relies heavily on the EPA Risk Assessment on ETS and claims that ETS exposure "causes 30 times as many lung cancer deaths as all other cancer causing air pollutants regulated by the EPA." Including the editorial„the issue contains three articles related to tobacco litigation. In the second article, which deals with parental smoking, the author advances this hypothetical situation: A nonsmoking, divorced mother, who has custody of her five-year old daughter, files a motion with the New Jersey Family Court to enjoin the child's father from smoking in his daughter's presence. According to the hypothetical, "[t]he child is in good health, but returns home to her mother even' Sunday night [after weekend'visitation with the father] with her clothes smelling slightly from cigarette smoke." The author says sucLa case is unprecedented in reported New Jersey decisions but that he feels the injunction may properly be granted. "[A]ny constitu- tional' right a parent has with regard to his or her children is subject to the best interest of the children," he asserts. "Any inconvenience caused by a court- ordered smoking ban is, by any reasonable stretch of the imagination, more than outweighed by the benefits which accrue to a child through clean air in a smoke- free environment." To support his daim that ETS exposure increases a child's risk of illness, the author cites a 1991 report from the Department of Health and Human Services, a 1992 statement from the American Cancer Society and the EPA risk assessment. The third article focuses not on ETS issues, but on preemption and the Cipollone decision by the U'.S. Supreme Court. "[T]he court has finally removed the preemption shield that has given cigarette manufactur- ers unparalleled success in defending against claims based on state law,"'the author contends. The New Jerrey Trial Lawyer is the second legal publication in as many months to attempt to foster ETS litigation. The April 1993 issue of the I»door Pollution Law Report was devoted primarily to ETS litigation. See issue 47 of this Report, May 14, 1993. [22] Smoker Is Assaulted in Restaurant A woman sitting in the smoking section of a Man= land restaurant was reportedly struck several times by a man when she refused to put out her cigarette at his request. The alleged assailant, a 47-year-old attorney. has been charged with criminal assault„witka trial date set for June 9, 1993. See Baltimore Sun, May 21, 1993. [231 "Resurrecting an Old Cause of Action for a New Wrong: Battery as a Toxic Tort," C.J. McAuliffe (Student Author), 20 Environmental Affairs 265 (1993) This article addresses the difficulties plaintiffs face in proving causation in toxic tort litigation. The author suggests that actions in battervwould overcome this hurdle for plaintiffs because plaintiffs do not have to prove physical injury to satisfy the harmful contact element of a battery cause of action, i.e., the body's contact with certain substances can by itself constitute the injury. The author cites a student law review article about "Smoker Batterv'" and asserts that the intent element of battery is satisfied where the smoker continues to smoke after being told to stop. [24] U.S. Supreme Court Decision Expected Soon in Case Involving the Admissibility of Scientific Evidence A decision by the U.S. Supreme Court is expected before the end of June in a products liabilin• case in w•hi&the parties have asked the Court to decide the appropriate standard for the admissibility of scientific evidence. Daubert v. Merrell Dow Pharmaceuticals, lnc., No. 92-102 (U.S. Supreme Court) (review granted 10/ 13/92). The petitioners in the case are two minors born with limb reduction birth defects, who allege that a prescrip- tion drug taken by their mothers during pregnanc.•, Bendectin, caused their birth defects. Bendectin is an anti-nausea medication. At the trial court level, plaintiffs"causation evidence consisted primarily of expert testimony based upon in vitro studies, in vivo (animal) studies, chemical struc- ture analysis. and a reanalysis of existing epidemiologic

8 studies. Defendant offered affidavit testimom• to establish that, based upon the available literature of more than 30 published studies involving more than 130,000 patients, no published epidemiologic study demonstrated a statistically-significant association bern•een Bendectin and birth defects. The district court granted a motion for summary judgment filed bv Merrell Dow. holding that plaintiffs must provide statisticalh•-significant epidemiologic evidence of causation in order to meet their burden of proof and that an unpublished reanalysis offered by one of plaintiffs' experts was inadmissible. The U.S. Court of Appeals for the Ninth Circuit affirmed, stating that the reanalysis did not meet the requirements of general acceptance in the scientific communirv: To the Supreme Court, petitioners argued that the Federal Rules of Evidence eliminate any, n-pe of "general acceptance rest" for excluding'scientific evidence. Respondent Merrell Dow contended that the Federal Rules of Evidence require the specific testi- monv of each expert witness to have an adequate foundation, judged by the accepted standards of the expert's field. Briefing is complete, and oral argument was held on March 30, 1993: One of the amici curiae who filed a brief supporting the pharmaceutical company was Alvan Feinstein,, professor of medicine and epidemiology at Yale University and the author of "Justice, Science and the 'Bad Guvs,"' an editorial about ETS andscience. In his brief, Dr. Feinstein argued that significance testing and confidence intervals are necessary tools for evaluating the stability of the numbers being examined in epidemiologic data. He stated: "I can think of no better sav to allow `junk science' into the courtroom than to remove the constraints that demand numerical stability for data. If researchers can choose confidence intervals in an ad hoc manner, without justifying their selection of appropriate boundary values according to accepted scientific standards, the result will'be confidence games, not confidence intervals." Professor Feinstein also stated that reanalysis of epidemiological data may be an accept- able scientific method if subjected to established scientific standards and the rigors of peer review. ETS/IAQ REPORT. ISSUE 48 OTH ER D EVELOPIMENTS [25) Polls in Virginia and Kentucky Cover Work- place Smoking Issues According to a survey conducted by Mason-Dixon Political-Media Research Inc., 66 percent of Virginians favor laws banning smoking,in indoor places. Sixry-one percent also favored laws protecting the rights of smokers, requiring employers to provide smoking areas for employ - ees and barring discrimination against employees who smoke. See [Y/rrshington Times, May 10, 1993. According to a poll of 801 adults conducted by a newspaper in l:entucky, 50 percent said smoking should be banned at indoor workplaces. Some 22 percent of respondents reportedly stated'that there were no smoking restrictions in their places of emplo.-- ment, down from 33 percent in 1990. According to the survev, attitudes about smoking prohibitions did not van' between tobacco-growing counties and other counties. See The Courier JournaL April 25; 1993. [26] Restaurants Study Ban on Smoking A number of restaurant operators in Spokane are considering joining together to ban smoking in their establishments. Consideration of a ban is due in part to recent reports of the alleged effects of exposure to ETS. Vocal nonsmokers are also a motivating force. The restaurant's employees reportedly have conducted surveys and found that most customers would not be bothered by a smoking ban. See Journal of &usirress- Spokane, April 15, 1993. [27] Insurance Industry Views IAQ Complaints as Psychosocial Phenomenon At a recent meeting of an insurance industrv trade association, a risk manager from Oregon reportedly told emplovers that workers' compensation is a"tailed social policy that does more harm than good." The risk manager blamed the media for creating illnesses that do not really exist and'declared that the issue of indoor air quality "has been put to bed as largelv a psychosocial phenomenon." He added that employers should'get tough with employees who are out sick and that workers too often~blame the workplace for illnessess they would have had anyway. See Narimra! Llnder-

:%L-kY 28. 1993 writer, hroperry GCasualty/Risk & Benefits Management Edirro,t. Mav 3. 1993. [28] Doctor Who Bans Smoking Turns Away Patients Who Smoke Dr. Mark Jameson of Hagerstown, Maryland, reportedly opened his private practice in March and not only banned smoking in his office, but decided to limit his practice to nonsmokers. Jameson, who is a former director of health services for the Washington County Health Department, apparently believes that he has no duty to take care of patients who are suffer- ing from "their deliberate act." See Associated Press, May 13, 1993. MEDIA COVERAGE [29] "Carpet Industry Facing Toxic Concerns: at Least 500 People Say New Carpeting Has Made Them Sick," J. Fried, The I'hiladtlphia Inquirer, May 9, 1993 This article highlights current developments in~the controversy over the alleged health effects of new carpeting. Recent events mentioned in the article include the release of the results of Anderson Laborato- ries mice experiments, the EPA's decision to investigate carpet emissions, and the filing of a lawsuit in Philadel- phia against three major carpet makers. The article asserts that at least 500 people have complained to the Consumer Product Safety Commission that new wall,- to-wall carpeting has made them sick. [30] "Smoking Shifts to Front Burner of Property Issues," T.J. Howard, The Chicago Tribune, May 16, 1993 This article examines how the public pressure for stricter smoking policies affects building owners and' operators in the Chicago area, who must try to keep both tenants and employees happy. According to the artide, 52 office buildings inside the Chicago Loop, or about 20 percent of the total, prohibit smoking entirely. Another 112 buildings, or 42 percent, prohibit smoking in the lobbies and corridors. , 9 The owners and operators say their decisions about smoking polices are influenced by BOMA's recommenda- tiomof a ban on smoking in~the workplace, the EPA Risk Assessment on ETS, and the perceived threats of lawsuits by persons alleging injury from ETS exposure. As employers curtail smoking, the article states, building owners and managers are often charged with policing the issue and providing alternatives for smokers, such as outside smoking areas or separately-ventilated lounges. A relatively new alternative discussed in the artide is a smoking trailer. The Williams Scotsman Group. a Baltimore-based manufacturer of portable office space. plans to market designated smoking facilities - trailers with enhanced ventilation svstems. [31] "Workplace Issues: Smoking in the Workplace," Fair Employment Practices Guidelines (April 25, 1993) This article discusses a number of workplace smoking issues including the alleged costs to employers of emplo.-- ing smokers, the respective rights that both smokers and nonsmokers may have under the Americans with Disabili- ties Act. discrimination against smokers in hiring prac- tices, and adoption of.vorkplace smoking policies. The article includes a summary of the EPA Risk .+lssessmenr on ETS and discusses the wavs in which some states are responding to the risk assessment. [32] "Les Miserable ... The Wretched, the Doomed, the Hard-core Smokers," J. Adams, The Courier- Journar; April 25, 1993 This artide presents, in a playscript format. information about smoking policies that are being adopted by Louis- ville, Kentucky, businesses and the effect those policies are having upon smokers who are being forced to smoke out of doors. The writer has one of the characters observe that he or she "can't stand the smoke even on the sidewalks" and that perhaps smoking should'be banned everywhere except on a particular bridge.

10 SCIENTIFIC/TECHNICAL. ITEMS UPCO\MING IM4 EETINGS [33] "Twenty-sixth Annual Meeting for the Society for Epidemiologic Research (SER)," Keystone, Colorado, June 16-18, 1993 According to the preliminarv program, this meeting will include presentations entitled "Influence of Maternal Smoking. Paternal Smoking, and Involuntary Maternal' Smoking Exposures on Oral Cleft Defects," by G.M. Shaw: "Previous Reproductive Cancer as a Risk Factor for Lung Cancer in Lifetime Nonsmoking Women," by G. Kalsat; "Dietary B-Carotene and Lung Cancer Risk in Nonsmokers," by S.T. Mayne; "A Case-control Study of Childhood and Adolescent Household Passive Smoking and the Risk of Female Lung Cancer," bv F. Wang; and "Effects of Maternal Smoking and Childhood Respiratory Illness on Pulmonary Function in Young Adults: the CARDIA Study," by J. Dunn. One symposium will include three papers on meta-analysis. [34] "Third International Conference on Preventive Cardiology," Oslo, Norway, June 27-July 1, 1993 According to the program for this conference, it will include an entire session on ETS and cardiovascular disease. Lars Wilhelmsen will present "Is There a Threshold Valve?"; Robert Beaglehole will present "Updating Epidemiological Evidence"; Stanton Glantz will present "Updating Experimental Evidence"; and Richard Peto will present "How Many Victims?" RESPIRATORY DISEASE AND CONDITIONS - ADULTS [35] "Long-Term Ambient Concentrations of Total Suspended Particulates, Ozone, and Sulfur Dioxide and Respiratory Symptoms in a Nonsmoking Population," D.E. Abbey, F. Petersen, P.K Mills, and W.L. Beeson, Archives ofEnvironmental Health 48(1): 33-46, 1993 [See Appendix A] This study discusses long-term follow-up of a non- smoking cohort of Seventh-Day Adventists in Califor- ETS/IAQ REPORT, ISSUE 48 nia. ETS is not mentioned. The authors report statisti- cally significant increased risks of certain respiratory conditions associated with outdoor air pollutant levels. RESPIRATORY DISEASES AND CONDITIONS - CHILDREN. [36] "Childhood Asthma and Indoor Environmental Risk Factors," C. Infante-Rivard, American Journal of Epidemiology 137(8): 834-844, 1993 [See Appendix A] Based on a case-control study of children in Montreal, Canada, this author reports a statisticallv significant risk of asthma associated with "mother's heavv smoking." A number of potential risk factors for asthma were also identified. [37]' "Indoor Nitrogen Dioxide and Childhood Respiratory Illness," L.S. Pilotto and R.M. Douglas, Australian Journal of Public Health 16(3): 245-2 50, 1992 [See Appendix A] In this review article, the authors discuss epidemiologic data on nitrogen dioxide, which the.• describe as an emission from gas-fired appliances and a component of tobacco smoke, and childhood respira- tory illness. Thev conclude that additional research is needed to "determine if there is a health risk" associ- ated with exposure to nitrogen dioxide. [38] "The Relationship of RSV-Specific Immuno- globulin E Antibody Responses in Infancy, Recurrent Wheezing, and Pulmonary Function at Age 7-8 Years," R.C. Welliver and L. Du1R,, Pediatric Pulmonology 15: 19-27, 1993 [See Appendix A] Respiratory syncytial virus (RSV) has been related to childhood respiratory infections. In this paper, the authors investigate pulmonary function in children who had had bronchiolitis attributable to RSV: Thev conclude that "passive smoking" may be more impor- tant in determining the outcome of bronchiolitis than the severity of the RSV infection itself.

NLM`'_8', 1993 OTHER HEALTH ISSUES [39] "Protracted Secretory Otitis Media. The Impact of Familial Factors and Day-Care Center Atten- dance," F. Rasmussen, International fournal of Pediatric Otorhinolaryngology, 26: 29-37, 1993 [See Appendix A] This article reports on a Swedish cohort study assessing possible risk factors for otitis media (requiring t.Tttpanotomy tube insertion). The authors suggests that attendance at a day-care center or having a sibling with the condition were associated with an increased risk of otitis media. Parental smoking was reportedly not associated with the incidence of otitis media. INDOOR AI R QUALITY [40] "Measurement of Cabin Air Quality Aboard Commercial Airliners," N.L. Nagda, M.D. Koontz, A.G. Konheim, and S.K. Hammond, Atmospheric Environment 26A(12): 2203-2210, 1992 ['See Appendix A] This study reports data on levels of ETS and other substances in airliners, collected as part of the 1989 Department of Transportation study on airliner cabin air qualiry. The authors suggest that ETS "migrated" into nonsmoking areas, and report that CO, and humidity could "pose potential comfort problems" for occupants. [41] "Effects of Ventilation on Smoking Lounge Air Quality," P.R. Nelson, R.B. Hege, J.M. Conner, G.B Oldaker, and H.E. Straub. In: Measurement of Toxic and Rrlated Air Pollutants, Proceedings of the 1992 U.S. EPA/A&WMA International Symposium. Pittsburgh, Air & Waste Manage- ment Association, 89-94, 1993 [See Appendix A] Researchers from RJ. Reynolds report on a "test" smoking lounge in which various ventilation configura- tions were evaluated. Acceptable air quality was reportedly achieved at ventilation rates suggested by ASHRAE. [421 "Ventilation and Indoor Air Quality in Finnish Daycare Centers," R. Ruotsalainen, N. Jaakkola, and J.J.K. Jaakkola, Environment International 19: 109-119, 1993 [See Appendix A] This Finnish study presents data collected on ventila- tion rates, temperature, humidity, indoor air constitu- II ents, and perceptions of indoor air quality: The authors conclude that, in generai, indoor air quality in Finnish daycare centers could be improved, citing inadequate ventilation as one of the major problems. [43] Indoor Allergens: Assessing and Controlling Adverse Health Effects, Committee on the Health Effects of Indoor Allergens, Institute of Medicine, A.M. Pope, R. Patterson, and H. Burge (eds.), Washington, National Academy Press, 1993 "Indoor allergens constitute a substantial public health problem„" according to this recendy-released report. Moreover, "[t]he economic and social impacts of allergic disease in the United States are significant," and include absenteeism from work and school. The Institute of Medicine prepared this "assessment of the public health significance of indoor allergens" in response to a request from "several agencies of the federal government." Identified sponsoring agencies were EPA; the National Institute on Allergy and Infectious Disease; the National Heart. Lung, and Blood Institute; the National Institute of Environmen- tal Health Sciences; and the Agency for Toxic Sub- stances and Disease Registrv. The committee that prepared the report included engineers, aerobiolo,ists. epidemiologists, psychologists and physicians. ~ The primary objectives of the study were "to identih- airborne biological and chemicall agents found indoors that caa be directly linked to allergic diseases.° "to assess the health impacts of these allergens," and'"to determine the adequacy of the knowledge base thar is currently available on this topic." The report includes a summary of available data, a list of consensus recom- mendations designed to improve awareness and education, and a research agenda describing long-term research needs. Using currently available data, the committee esti- mates that "one out of five Americans will experience allergy-related illness at some point during their lives and that indoor allergens will be responsible for a significant share of these cases." They estimate that 50 million Americans experience hay fever and other allergic diseases, and that 20-30 million have asthma. Related to the latter estimate, the report indicates that the estimated cost of illness related! to asthma was $6.2 billion in 1990.

12 The committee lists the following "major sources" of indoor allergens: house dust mires, fungi and'other microorganisms, domestic pets (cats and dogs), cock- roaches, and "reactive allergenic chemicals" contained in some household' produas. ETS is discussed in the committee's description of the process of developing :illeroic disease. Wliile some persons have claimed to experience "tobacco smoke allergy," the committee classes ETS among "nonallergenic agents." Nevertheless, they suggest that nonallergens can interact with allergens in the development of sensitization in an~ individual. In particu- lar, the report states: "Exposure to nonallergens that irritate the respiratory tract (e.g., environmental tobacco smoke) can promote the development of allergic reactions and disease." With regard to control of alkrgen-caused disease, the committee advocates avoidance of exposure. They state: "The reduction andlor elimination of human exposure is probably best achieved by simultaneouslv controlling allergen sources and improving building ventilation, i.e., the design, operation, and mainte- nance of heating, ventilation, and air-conditioning (HVAC) systems." IN, EUROPE & r'1ROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS AuSTRALIA [44] Rebel MPs Stall Plan to Implement Parliament Smoking Restrictions According to a press report, plans to impose a partial smoking ban in the New South Wales Parliament have been set back six months following stiff opposition from "rebel" MPs. The restrictions will now go into effect on January 1, 1994. See Daily Telegraph Mirror,. Ntay 19, 1993. In a related story, control of the New South Wales Parliament was apparently taken from its two presiding officers and given to a new MP-run committee in the wake of contention over issues such as smoking. See Srdney Morning Herald, May 17, 1993. ETS/IAQ REPORT: ISSUE 48 Meanwhile, MPs in South Australia are apparently defying a ban on smoking that was imposed in Parlia- ment offices during its last session. See Adelaide Advertiser, May 12, 1993. AUSTRIA [45]' Coalition Reaches Compromise on Tobacco Law According to a press report, the parties of Austria's ruling coalition have reached a compromise on a new tobacco law. Among other matters, there will appar- ently be no provision in the measure imposing the originally-planned smoking ban in official buildings. schools, universities and on public transport. See Der Standard May 14, 1993. CANADA [46] Smoking Restrictions Considered in East York The East York Council was reportedly scheduled to consider a smoking restriction by-law at its May 17 meeting. Some three vears of community consultation apparently preceded development of the by-law which would require the designation of smoking areas or the creation of completely smoke-free environments in all East York workplaces. The measure, if adopted, will go into effect on May 31. World No-Tobacco Day: Workplaces and public places will reportedly have one year to make the transition. See Caitarda Newsu%'ire. May 13, 1993. [47] Scarborough Approves in Principle Total Smoking Ban According to a press report, Scarborough has become the first municipality in Canada to call for a total smoking ban in all enclosed public places induding bars, restau- rants, pool halls, bingo parlors and meeting places. Council reportedly voted to approve the ban in principle, but it will not go into effect until a bvlaw• laying out the terms is approved by Queen's Park later this vear. The mayor urged Council to approve the policy and reportedly said it would be good for the city's image. Opposition to the policy reportedly came from representatives of bingo halls who said it would put them out of business. See The Toronto Star. May 20, 1993.

\LA1•.,.'_8. 1993. SWEDE^: [;48] Debate Over Health Effects of ETS Heats Up On the eve of the May 27, 1993, parliamentary vote on the New Tobacco Act,,the press reported findings from the United States that traces of nicotine were found' in 99 percent of 5,000 individuals tested by the Centers for Disease Control and Prevention (CDC). Apparently, Sveyzska Dagbladet was the first newspaper to have seen preliminary results at this stage of the CDC study, which will eventuallv anahze blood tests from 23;000 people. Head of the stud.•• Dr. James Pirkle• evidently admitted that cotinine traces originating from foods such as instant tea could have been picked up by the sensitive instruments that are being used to anahze blood'1 samples. "Traces are very small in these foods, and diet could very well be an insignificant factor," he said; "but we must make sure that there are no ques- tion marks whatsoever hanging over this survey." The press also reported the findings of the EPA Risk Assessment on ETS. According to Margaretha Haglund of the Medical Research Council, the CDC survey and the EPA report demonstrate that "passive smoking is much more widespread than we had thought" and that "passive smoking produces much the same damage as active smoking." See Svenska Dagbladet, May 1993. It is unknown what impact this information will have on the vote in Parliament. The New Tobacco Act would not require the imposition of total smoking bans in public places or restaurants and would permit employees and their employers to develop mutually agreeable smoking policies. See issue 45 of this Report, April 16, 1993. KINGDOM OF TONGA [49] Government Considers Smoking Ban The King and Legislative Assembly are considering legislation that would ban smoking in enclosed public places, government buildings, workplaces, shopping centers, restaurants and'on public transport. Also being considered are cigarette package warnings that would change every six months and that would include the statements "Protect children: don't make them breathe 13 your smoke" and "Smoking damages the health of those around you." UNITED KINGDONf [50] Southend Debates Smoking Policy Proposals to ban smoking in various authority-run buildings in Southend were reportedly defeated after heated debate. Supporters of the measure cited the 1974 Health and Safety Act which purportedly imposes a duty upon the council for the health and safety of its employees. Opponents apparently resisted the proposals by arguing that Council should not be dictating to others about the issue. See Southend Evening Echo, April 28, 1993. [51 ] Barrow Councillors Disobey Ban They Adopted According to a press report, the personnel committee in Barrow was told that the only individuals breaking, the ban on smoking that was adopted in March are the councillors who voted to adopt it. A representative of FOREST is quoted as saying, "It is what you.t•ould expect from these sort of people - on the one hand they behave like prudish health fascists and on the other hand they ignore the rules anyway." See Xortb Western Evening 1L1arG April 16, 1993. [52] Health Board Adopts Smoking Restrictions The Borders Health Board has reportedly approved' a policy that will restrict smoking by emplovees too designated breaks in special areas. Visitors and contrac- tors will not be permitted to smoke in any health board premises, but patients can continue to smoke if they are long-term residents or if thev are short-term patients who are unable to stop smoking. Staff will have discretion to permit smoking by those patients and relatives who find themselves in "ven• stressful situations." The policy will apparently be implemented in stages, and employees will have until October 31', 1993, to adjust to the restrictions. See Berkwicksliire News, April 15, 1993. [53] Antismoking Campaign for Children Launched Health chiefs in Gloucestershire have reportedlv backed a campaign created by the Royal College of Physicians which, among other matters, says children

ETS/IAQ REPORT, ISSUE 48 have a right (i) to schools, youth clubs and public places that are smoke free; (ii) to be brought up in a home that is smoke free; and (iii) to be free from the effects of tobacco in the womb. Children are appao- enthy being encouraged to join a "Smokebusters" club and will work to persuade others to stop smoking. See Gloucester Crtizxn, April 30, 1993. LEGAL ISSUES AND DEVELOPMENTS UNITED KINGDOM REPUBLIC OF IRELAND [55] Tobacco Companies Make Legal Aid Submissions On May 24, 1993, several U.K. cigarette manufacturers made submissions to the Northern Ireland Legal Aid Department stating their opposition to granting such aid. The submissions were made in response to reports that some lawyers were preparing legal aid applications on behalf of employees who claim their employers failed to protect them from the alleged health effects of ETS exposure in the workplace. (54]' "Tobacco Firms Aim to 'Stifle' Legal Actions," R.. Ta},lor, Yorkahire Post - Leeds, April 21, 1993; "MP on `Disgraceful' Cigarette Companies," R Taylor, and "Cigarette Ash in the Works," Editorial Yorkshire Post - Leeds, April 22, 1993 These press items discuss the significance of the action taken by tobacco companies in the United Kingdom to forestall the granting of legal aid to employees who are seeking to recover damages for workplace exposure to ETS. The tobacco companies have filed documents with the legal aid board, urging it not to grant assistance in these cases. See issue 42 of this Report, March 5, 1993. A spokesperson for ASH is quoted as saying that the measures taken by the tobacco companies "show the desperate lengths they will go to. Thev re saying they are prepared to interfere in every passive smoking case against an employer and attempt to strangle them at birth." Conservative MP Jerry Haves is evidently .vriting to the Lord Chancellor's office to protest the industry action. He argues that the tobacco companies should not "blatantly interfere in the process of justice," and is calling for a thorough investigation. Haves has also served as a spokesperson for ASH. Although recognizing that the tobacco companies have a legitimate right to intervene with the legal aid board, the editorial characterizes the action taken by the industry as "naked bullying by the rich and power- ful," and questions "how their shareholders feel about being associated with such a crew." The writer evi- dendy believes that the fairest way to deal with the issues is for a test case to proceed in court. OTHER DEVELOPIMENTS AL'STRALIA [56] Council Requests Comments on ETS Publication The National Health and Medical Research Council has published a notice indicating it is establishing a working partv to update its 1986 publication, "Effects of Passive Smoking on Health." In the notice, which was published in a newspaper ad, individuals interested in the topic are invited to submit comments by June 22. 1993. Comments should be directed to: Health Care Com- mittee, National Health and Medical Research Council, GPO Box 9848, Canberra ACT 2601. See Ik%ekend Australian. Mav 22-23, 1993. [57] Business Makes Smoking Condition of Employment It has been reported that one Ipswich business is requiring its employees to accept ETS exposure as part of their employment conditions. Evidently, a doctor..•ho was treating a nonsmoking patient for a chest condition learned of the requirement. The patient reportedly worked in an office where 25 of 30 employees were smokers. See Quen:sland Times, May 11, 1993. [58] Doctor Links Parental Smoking to Development of Childhood Asthma According to a press report, Dr. David Hill, writing in the Medical Journal of Australia, has purportedly found evidence in worldwide studies for a link between parental smoking and the development of asthma in children. See Gladstone Observer, Mav 12, 1993.

MAl' '_8. 1993 [59] Smoke-free Restaurants to Be Identified With New Logo According to a press report, those restaurants that have adopted smoking bans or have set aside nonsmok- ing areas will be identified byy a logo which features the combination of symbols for eating utensils with the international nonsmoking symbol on the plate. See Daily Telegraph Alirror, IVfay 19, 11993. [60] Perfume May Join ETS as Public Health Concern According to a press report, perfumes may follow ETS as the next alleged public health hazard in Austra- lia. Publicity is being given to a 575,000 damage payment that was made by Bloomingdale's in the U'.S& to a woman who claimed she had been hospitalized'w•ith an asthmatic attack after being sprayed with perfume. The press is also discussing the San Francisco ban on perfumed products at public meetings and a church that has apparently set aside four odorless pews. See SrandaY Telegraph, May 23, 1993. SNVITZERLAti D [61] International Union Releases Fact Sheet on ETS The Geneva-based International Union Against Cancer has released a series of fact sheets on tobacco. Among the "fact sheets"' is a document entitled Policies to protect the rights of non-smokers. Each "fact sheer" develops a specific theme, provides practical advice to implement a strategy relevant to the theme's goal and concludes with a recommendation. The "fact sheets" were evidently prepared with the support of ASH-UK, the American Cancer Society and the Anti-Cancer Council of Victoria, Australia: UNITED KINGDOM [62] FOREST Publishes Artide by Economic Analyst The smokers' rights organization FOREST has recentlyy published an article entitled "No Problem' An Economic Perspective on Smoking" by Dr. Kevin Dowd, an economic analyst. The article, concluding that claims by antismoking activists regarding smoking as an economic burden are specious, contains a brief 15 mention of ETS issues. Dowd cautions that those studying the issue of ETS must distinguish between ETS and the smoke that a smoker inhales before trying to establish whether there are any adverse effects due to ETS exposure. He also states "there is still no convinc- ing evidence in favour of the adverse health effects of passive smoking." An introduction to the article by Lord Harris of High Cross notes that the trend of general intolerance that has been directed at smokers is part of "the widespread tendency to identify such private behaviour as a public problem' for which the `solution '. is to 'summon up Leviathan to stamp it out'." Lord Harris: new slogan is "Anti-smokers can damage }our freedom - and their own." [63] Tobacco "Freedom Fighters" Defy Train Smoking Ban On Mav 1:7, 1993, members of PUFFS (Passengers Uhired for Freedom to Smoke): reportedly took over the rear carriage of a commuter train and lit pipes and cigarettes to protest a smoking ban introduced on Network SouthEast's Great Eastern division. Accord- ing to Network SouthEast, anyone who continues to deh• the ban will face f nes of up to 400 pounds. See The Times, May 18, 1993, In a related storv, a rail users' H•atchdoggroup has reportedly criticized British Rail's decision to ban smoking on most Nkrwork SouthEast routes. Accord- ing to the group. railway managers are ignoring the demands of a "significant minoritv° of commuters. See Daily Telegraph, itilay' 20, 1993. [64] Leading Bridge Club Bans Smoking The ACOL Bridge Club in Hampstead has report- edly introduced a smoking ban which has provoked a number of resignations. The club has placed its future in the hands of a world and European bridge cham- pion who: according to press reports, "has a virulent dislike of the weed." The manager of the London School of Bridge who is quoted in the article observed that bridge players tend to smoke a lot, but that students at the school are not allowed to smoke "in. the hope that they won't develop the habit of pufting while they play." See The Daily Telegraph, May 22, 1993.