Tobacco Documents Online

6 consideration in the Senate that would replace local smoking ordinances enacted after April 1 with a single standard (AB. 996). See The New York Times and USA Today, June 24, 1993. •Connecticut On June 7, 1993, the Senate reportedly approved 29-7 a bill that restricts smoking to designated areas in the State Capitol. The bill also prohibits smoking in all public 'elementary and high schools and in any place where the public conducts business. Governor Lowell P. Weicker, Jr. (ACP) has indicated he will sign the bill if there is "noth- ing untoward in it," reports a spokeswoman. The bill's author had introduced antismoking bills previously without success; however, the turning point reportedly came this year with the release of the EPA Risk Assess- ment on ETS and its claim that an alleged 3,000 non- smokers die each year from exposure to ETS. See The Hartford Courant, June 8, 1993, and May 25, 1993, and The New York Tima, June 6, 1993. •Louisiana Governor Edwin Edwards (D) has reportedly signed into law a bill that prevents municipal and parish governments from enacting legislation more restrictive than the state's on smoking in public buildings. The law requires state, parish and municipal governments to designate a smoking room or area in government buildings. Local antismoking laws enacted before September 1, 1993, will not be affected. Ste The AcsocYated Prru, June 9, 1993, and The Times Picayunr, June 16, 1993. •hocal Governments in Maryland The Howard County Executive vetoed a bill that would have prohibited smoking in most public places, including office common areas, child care centers, beauty shops and stores, according to news reports. Smoking in restaurants would have been eliminated by 1996. The county executive was reported to say that he sympathized with the intent of the bill, but a ban might put restaurants at an economic disadvantage with competitors in neighboring counties. He also allegedly objected to the bill's provisions exempting bars and making it illegal for employers to fire or refuse to hire a person who smokes outside the workplace. See The Washington Post, June 19, 1993, and The Washing- ton Times, June 20, 1993. In Anne Arundel County, the County Council enacted a smoking prohibition that will affect banks, classrooms, auditoriums, health care ficilities, public meeting rooms, ETS/IAQ REPORT, ISSUE 50 museums, libraries, restrooms, and other areas. See The Balt imore Sun, June 8, 1993. •Midugan The Michigan Department of Public Health, in a report released on June 2, has apparently found a high level of voluntary compliance with the state's Clean Indoor Air Act, which restricts smoking in public places and govern- ment workplaces. According to the report, the department has received more than 3,000 calls for information since the statute took effect in 1987. Formal complaints were evidently filed against facilities covered by the law in 163 cases, and of those complaints 93 percent were resolved. The Department has apparently recommended amend- ing the law to place restrictions or complete bans on smoking in additional locations, including private workplaces and restaurants. The report indicates that the most common problems under the current law involve smoking in nondesignated areas, designation of smoking in inappropriate areas, lack of adequate ventilation and failure to adequately consider those who are purportedly hypersensitive to ETS. See Toxic Chemicals Litigation Report, June 10, 1993. •New Hampshire Town councilors of Bedford, New Hampshire, have reportedly voted 5-2 to defy the state's Indoor Smoking Act which calls, among other matters, for segregated smoking areas in publicly owned buildings. Uhdu the Act, physical barriers must separate smokers from non- smokers, and designated smoking areas should be con- sttucted near exhaust vents. Persons in charge of public buildings who violate the Aa face fines of up to $100. Bedford officials reportedly said that they are "tired of government telling us what to do and legislating common sense and morality," and that they are making "a stxte- menr." They call the law an "unfunded mandate" which requires that a community spend money without the state providing the funds. See Bonon Gbby June 15, 1993. ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS [14] Blanchard Hearing on Venue Motions to be Held on July 1 The court will hear argument on defendants' motions to transfer venue and motions to strike on July 1, 1993.

JUNE 25,,1993 In broad terms, the motions contend that the current venue of Galveston County, Texas, is improper because (i) plaiintiffs' causes of action did not accrue there; (ii) that the claims asserted on behalf of the various plaintiffs did not arise out of the same transac- tions or occurrences; (iii) that plaintiAs did not seek leave of the court before filing their supplemental and amended petitions, that added new parties to the case; and (iv) that the petitions are improper attempts at forum-shopping. Three of the 14 plaintiffs in this case presently allege injury from exposure to ETS. Raye Blanchard and Tamara Reed, mother and daughter, both claim damages for unspecified "illness and disease" allegedly resulting from exposure to the ETS from cigarettes smoked by Raye's deceased husband, Thomas, and by Raye herself, who daims she smoked "for about ten years." The third ETS plaintiff, Pamela Kastrin Stephens, claims unspecified "lung and respiratory diseases" allegedly caused by exposure to the ETS from the cigarettes smoked by her deceased father. The named defendants are purported to be the six major U.S. cigarette manufacturers, The Tobacco Institute, the Council for Tobacco Research, and a number of wholesalers and retailers. Blanchard, etat, v. RJ. Rrynolds Tobacco Company, et at (District Court, Galveston County, Texas) (filed July 31, 1992). (15] Broin: Rehearing Petition Filed; Depositions of Executives Stayed On June 11, 1993, defendants: • Filed a motion for rehearing and for certification with the Third District Court of Appeal from that court's May 27 ruling denying defendants' petition for writ of certiorari; • Sought from the trial court and were denied a motion for protective order regarding depositions noticed of senior tobacco company executives that were to be taken from June 14-22; and • Sought from the Court of Appeal and received an emergency motion for a stay of the depositions of the company executives. The stay will remain in effect pending further order of the appellate court. Plaintiffs fil~ ed a motion to vacate the stay on June 14, but the Court of Appeal 7 denied it on June 18 before defendants submitted their response. In the trial court order that preceded the stay from the appeals court, Judge Robert Kaye had di- rected that the depositions go forward on June 14 despite the pendency of the motion for rehearing. At issue in this case are the claims of 28 flight atten- dants allcgedly injured by occupational exposure to ETS. In addition, the husband of one of the flight attendants claims loss of consortium. The attendants purport to represent a class of approximately 60,000 other attendants. Injuries alleged by the putative class representatives include lung cancer, breast cancer and unspecified respiratory ailments. Plaintiffs further allege that occupational exposure to ETS on board aircraft causes at least 22 diseases and a reasonable fear of contracting such diseases. The defendants are purported to be the six major U.S. cigarette manufacturers (plus related entities), UST, Inc., United States Tobacco Company, Dosal Tobacco Corp., the Council for Tobacco Research, The Tobacco Institute, and three trade associations. Broin, etaL, v. I'hilipMorris, etaf. (Circuit Court, Dade County, Florida) (filed October 31, 1991). [16] Butla: Trial Date Set for September 5, 1994 On June 8, 1993, Judge Gibbs entered a scheduling order setting a trial date of September 5, 1994. The scheduling order directs plaintiffs to designate their expert witnesses on September 24, 1993; for defen- dants to designate their experts on October 22, 1993; for all motions, except dispositive motions and evidentiary in limine motions, to be filed on December 31, 1993; for discovery to be completed by January 30, 1994; for all dispositivc motions to be filed by May 27, 1994; and for the final' pre-trial conference to be held on August 13, 1994. Plaintiffs contend that Burl Butler, a barber in Laurel, Mississippi, developed lung cancer as a result of his occupational exposure to environmental tobacco smoke. The defendants in this case consist of the six major U.S. cigarette manufacturers and several local retailers. Butlcr v. RJ. Rrynolds Tobacco Company, et a1 (Circuit Court, Hinds County, Mississippi) (filed Oaober 21, 1992).

8 [17] Dunn: Defendants Granted Extensions to Respond to the Complaint Plaintiffs' attorneys have extended the date for defendants to respond to the complaint. Responses are now due August 12, 1993. Plaintiffs in this case contend that Mildred Wiley was a nonsmoker who died of lung cancer as a result of her exposure to environmental tobacco smoke at her place of employment (a Veteran's Administration hospital) for seventeen years. Her husband, Philip Wiley, is also asserting a loss of consortium daim. Defendants in the case are purported to be each of the six major U.S. cigarette manufacturers, parent companies of three of the manufacturers, The Tobacco Institute, and the Council for Tobacco Research. Dunn, et at v. RJR Nabisco Holdings Corporation, ct aL (Superior Court, Delaware County, Indiana) (filed May 28, 1993). [18] Vorh: Motion to Dismiss Filed On June 14, 1993, Brown & Williamson filed a motion to dismiss the complaint based on plaintiffs failure to state a claim. On June 11, R.J. Reynolds and Forsyth Tobacco Products filed a joint answer to the complaint. Frank Voth, who is incarcerated in the Oregon State Penitentiary, alleges that his civil rights have been violated as a result of his exposure to ETS. He daims he has "incurred permanent health damage and is at risk of death" as a result of such exposure. Defendants in Uoth are Forsyth Tobacco Products, R.J. Reynolds and Brown & Williamson. Voth v. Forsyth Tobacco Products, et at (U.S. District Court, Oregon) (filed April 27, 1993). ETS/IAQ LITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS PRISONER CASE [19] Special Report: HeUing v. McKrnne, 1993 WL 209628 (U.S. Supreme Court) (decided June 18, 1993) In a 7-2 opinion, the U.S. Supreme Court gave inmate William MclGnney an opportunity to try to prove that ETS/IAQ REPORT, ISSUE 50 Nevada prison authorities have violated the Eighth Amendment to the U.S. Constitution by exposing him to levels of ETS that pose an unreasonable risk to his future health, but the Court made it clear that his burden of proof will be extremely heavy. Further, the Court recog- nized the official position of the United States Govern- ment, as reflected in the amicus currae arguments of the Solicitor General, (i) "that the harm to any particular individual from exposure to ETS is speculative° and (ii) "that exposure to ETS is not contrary to current standards of deoenry." The Court expressed no opinion on whether ETS exposure in fact poses a risk of harm. In the end, the Court simply ruled that McKinney's lawsuit could not be summarily dismissed at a preliminary stage with no chance to prove his daim. "We cannot rule at this juncture that it will be impossible" for McKinney to make his claim, the Court said. On remand, McKinney must prove not onlythe objective and subjective elements necessary to find an Eighth Amendment violation, but he also must prove that he is entitled to the specific remedy of an injunction. In order to prevail, McKinney must show four things. First, that he is currently being exposed to "unreasonably high levels of ETS." Second, that the exposure subjects him to "unreasonable risk with respect to his future health." Third, that the risk he complains of is "so grave that it violates contemporary standards of decency to expose anyone unwillingly to such a risk" And fourth; that the prison authorities' current attitudes and conduct amount to deliberate indifference to the risk The Court said "the realities of prison administration" can be taken into account in determining whether prison officials are acting with deliberate indifl'erenoe toward McKinney. The Supreme Court emphasized that a forrnal smoking poliry is now in effect in the Nevada State Prisons and noted that the policy may make it impossible for McKinney to prove at least two of the required elements of his case: (1) that he is now being exposed to an unrea- sonable risk to his future health; and (2) that prison authorities are acting with deliberate indifference to the alleged health effects of ETS. "In this respect we note that at oral argument McKinney s counsel was of the view that depending on how the new policy was administered, it could be very difficult to demonstrate that prison authori- ties are ignoring the possible dangers posed by exposure to ETS," the Court said.

JUNE 25, 1993 Justice White delivered the Court's opinion, which was joined by Juscices Rehnquist, Blackmun, Stevens, O'Connor, Kennedy and Souter. Justice Thomas wrote a dissenting opinion, which was joined by Justice Scalia. Justice Thomas said he would dismiss McKinney's claims as a matter of law and would "reject the claim that exposure to the risk of injury can violate the Eighth Amendment." The Office of the Solicitor General submitted a brief and participated in oral argument in this case as amuur curiae supporting the Nevada prison officials. In characterizing the position taken by the U.S. Government in its argu- ments, Justice White used these words: "[T]he United States submits that the harm to any particular individual from exposure to ETS is speculative, that the risk is not sufficiently grave to implicate a`serious medical nee[d],' and that exposure to ETS is not contrary to current standards of decency." WORKPIACE: COLLECTIVE BARGAINING [20] In tbe matter of Tyndall Air Force Base, Florida and Loca13240, American Federal of Governme nr Employees, AFL-C7O,1993 WL 184118 (Federal Service Impasses Panel) (decided May 25, 1993) A federal arbitration panel has determined that an employer may impose a smoking ban at its Main Ex- change facilities as long as it offeis smoking cessation classes to its employees and designates an outdoor smok- ing area that is reasonably accessible to employees and provides a degree of protection from the dements. The matter came before the panel due to a negotiation impasse, and the panel decided to resolve the issue on the basis of written submissions from the parties. The union had asked for employee polling and designated indoor smoking areas. The panel approved a modified version of the employer's proposal on the basis of "the overwhelming scientific evidence concerning the adverse impact of exposure to second-hand smoke." The panel further asserted, "a ban on indoor smoking is neoessary to enhance the health of all individuals at the Main Exchange." 9 WORKPIhCE: LAQI SICK BUILDING SYNDROME [21] A'/eeklt,y v. Industrial Commission, 1993 III. App. LEXIS 866 (Second District Appeliate Court, Illinois, Industrial Commission Division) (decided June 9, 1993) The Appellate Court of Illinois has denied workers' compensation benefits to a woman who daimed that an office remodeling project caused her to suffer hypersensitivity to fumes and odors. After reviewing the evidence presented in the case, the court deter- mined that the claimant, an executive secretary, had failed to establish (i) any connection between her symptomatology and the materials used in the remod- ding project; (ii) any type of risk in her work environ- ment greater than that to which the general public is exposed; or (iii) that her condition resulted either from the remodeling project or the general office environ- ment. According to the court, medical records showed that many of the daimant's complaints predated her employment. The court also rejected the claimant's argument that the Industrial Commission improperly excluded from evidence publications about sick building syndrome. LEGAL ISSUES AND DEVELOPMENTS [22] Special Report: Washington Court Denies Reimbursement of Former Smoker's Alleged Quitting Expenses On June 22, 1993, a small claims court in Seattle denied a former smoker's daim for reimbursement of the expenses he allegedly incurred in quitting smoking. The court ruled that the statute of limitations for the case expired before the claim was filed. The plaintiff, Alfred J. Deskiewicz, Jr., filed the case in December 1992 against Philip Morris Incorporated. Deskiewicz claimed he began smoking Marlboro in 1959 at age 17 because he was enticed by Philip Morris' advertisements. He sought recovery of approxi- mately $1,153 to enable him to stop smoking due to his alleged addiction to Marlboro. He sought $343.50 to compensate him for the cost of doctor's visits to help him quit, $271.95 for the cost of nicotine patches,

10 $189.99 to reimburse him for the money he spent on cigarettes from the time he began trying to quit smoking until he finally stopped, and $349.00 for a fifteen-month health club membership, which he contended he needed after quitting. The case was tried to Judge Linda Jacke earlier this month. Judge Jacke held that the statute of limitations for Deskiewicz's daim had expired because he had known as early as the 1970s that he had a potential claim against Philip Morris. That was when he tried twice, unsuccessfully, to stop smoking. Losing parties in Washington small claims court cases who file a timely request are entitled to a new trial in the Circuit Court, Washington's court of general jurisdiction. [23] "Smoke Alarm," E Hopkins, Mirabella, July 1993 This article, written by an alleged asthmatic with an acknowledged antismoking bias, examines a number of ETS-related issues including workplace smoking policies, smoking disputes in child custody cases, and antismoking legislation. The author characterizes ETS as "extremely hazardous° and cites the EPA Risk Assessment on ETS to support her claims. According to this artide, divorce lawyers believe that the ETS risk assessment will "substantially influence the outcome of many future custody suits." Richard Daynard of the Tobacco Products Liability Project and John Banzhaf of ASH are quoted in the article which condudes that "the days of smoking rights are numbered ...[as] nonsmoking activists are getting mad and even." OTHER DEVELOPMENTS [24] Michigan Malls Rely Upon EPA Risk Assess- ment to Support Smoking Ban According to a press report, five shopping centers in Southwest Michigan have adopted a smoking ban in all public and common areas, effective September 1, 1993. A spokesperson for Shopping Centers of South- west Michigan reportedly cited the EPA Risk Assess- ment on ETS to support the ban. The new policy will apparently not affect the interior of individual stores and restaurants. See PR Newswire, June 15, 1993. ETS/IAQ REPORT, ISSUE 50 [25] Kansas City Area Joins Debate Over Smoking in Public Places A citizens advisory council has reportedly asked Overland Park, Kansas, officials to consider making the city the first in the metropolitan Kansas City area to ban smoking in all public places including restaurants and hotels. The matter will apparently be discussed during a public meeting on July 7. Tourism officials and the Missouri RestaurantAssocia- tion in Kansas City are already reportedly opposed to the idea, and a local restaurant which tried to adopt a smoking ban in April was forced to rescind the ban following a "vicious backlash" from smoking customers. According to hotel and restaurant members of Overland Park's Cham- ber of Commerce, local businesses already set aside space for nonsmokers based on market demand. See Kanun City Stnr, June 17, 1993. [26] Smoking Cessation Program Aims to Create Smoke-free Environment Lederle Laboratories is reportedly providing 250 adult smokers in Paterson, New Jersey, with its ProStep nicotine transdermal system free of charge as part of a program to eliminate purported smoking-related health hazards for smokers and their families. Counseling and behavioral modification will also be made available as part of the program. A professor of clinical psychiaay at a local medical university which is running the program cited the EPA Risk Assessment on ETS as "condusive evidence of the harmful effeccs of both active and passive cigarette smoking." See PR Nnrmwire, June 8, 1993. [27] World Bank Employees Vote to Ban Smoking According to a press report, the 6,000 employees at the World Bank's headquarters in Washington, D.C., have voted to ban smoking in the building. The vote has apparently caused consternation among some of the bank's directors who smoke. See The Guardian, June 9, 1993. [28] Los Angeles County High School Speech Contest Asks "Should Smoking be Banned in Public Places?" In response to the EPA Risk Assessment on ETS, the Los Angeles County Tobacco Control Program, in conjunction with the Los Angeles Unified School

JUNE 25, 1993 District sponsored a high school speech contest. The topic, "Should Smoking be Banned in Public Places?", was chosen to encourage students to learn more about public health issues. Most participants conduded that smoking should be banned in public places, citing the findings of the ETS risk assessment. See PR Newswire, June 7, 1993. [29] AMA Supports Legislation Banning Tobacco The American Medical Association (AMA), at its annual meeting, adopted a resolution to support legislation that would prohibit smoking in prisons and jails. The 435 delegates also approved measures supporting federal legislation for smoke-free schools and reaffirmed its opposition to tobacco sales from vending machines. Also formalized was a policy to reject revenue form tobacco companies, but not necessarily from the companies' non- tobacco subsidiaries. SeeAssociaud Prus, June 17, 1993. MEDIA COVERAGE [301 "Magic Carpets," T.W. Orme, Ph.D., Priorities, Winter 1993 This article discusses the attention that carpet emissions have been getting from the press and Congress, and dismisses the Anderson study as "junk science at its worst." The author, a representative of the American Council on Science and Health, observes that Anderson does not follow the government's Good Laboratory Practices Guidelines and has not published in peer reviewed journals. Dr. Orme expresses his concern that the Senate committee considering Anderson's testimony in October 1992, "preempted the role of scientists in scientific review [and] was unqualified to ask the appropri- ate questions." The article also disco.sscs the controversy surrounding claims of "multiple chemical sensitivity" and states, "A conscientious scientist reading the current literature on MCS comes away more oonfusod than enlightened by it. Is MCS a political movement, a religion or a disease?" Apparently, a woman from Vermont who claims that she and her family coneractad MCS from new carpeting has received treatment that has been suggested as a means of spiritual renewal but is not standard medical procedure. > EPA fais to duplikate Anderson's findings, item 2. 11' [31] "Times Just Says No to Tobacco Advertising - Evidence of Danger `Overwhelming,'" S. Wieland Nogaki and H. Gupta, The Seatxle Times, June 14, 1993 Citing recent evidence regarding the purported dangers of ETS exposure, as well u"growing medical evidence on the dangers of smoking," the publisher of The Seatnlc Times has reportedly decidedto cease accepting advertise- ments for tobacco products. The ban will take effect when existing contracts expire by the end of the year and will apparently result in lost revenues of at least $120,000 to $150,000. The Tobacco Institute (TI) reportedly eriu- dzod the decision as an attack on the FirstAmendment. According to a TI spokesperson who is quoted in the artide, "I'm astonished that a newspaper that I imagine would embrace the First Amendment would selectively deny space to an advertiser for a legal product just on the basis that a certain segment of the community disagrees with the message. It sets a disturbing trend." [32] "Health Agency Investigates Airplanes and TB Infections," M. Tolchin, The New York Times, June 21, 1993 This article discusses Federal health officials concerns that airplane passengers with tuberculosis may be infecting fellow passengers on long flights. Officials seek to determine whether the recirculation of air in planes would allow the transmission of tuberculosis, a bacterial disease that is spread through the air. Officials say data is still being collected and they declined to disclose any preliminary findings. SCIENTIFIC/TECHNICAL ITEMS LUNG CANCER [33] "Meta-aaalysis of Epidemiological Studies of Carcirtogeaesis," J. Peto. In: Mechanimu of Carcinogcnesi.r in Risk Ident#rcatron. H. Vainio, P.N. Magee, D.B. McGregor, and A.J. McMichael (eds.). Lyon, International Agency for Research on Cancer, 571-577, 1992 [See Appendiz A] This article discusses characteristics of epidemiologic studies with respect to the validity of meta-analysis in

12 assessing those studies. The author uses as an example the meta-analyses that have been conducted on the epidemiologic studies of spousal smoking and lung cancer. The author notes that "there are valid grounds for suspecting that the observed effects of passive smoking on lung cancer may be partly, or even entirely, due to bias." RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [34] "Snoring, Sleep Disturbance, and Behaviour in 4- 5 Year Olds" N.J. Ali, D.J. Pitson, and J.R Stradling, Archives of Drseau in Childhood 68: 360-366, 1993 [See Appendix A] The authors of this paper studied children deemed to be at high risk for sleep and breathing disorders. They report that maternal but not paternal smoking was associated with the high risk group, and that those children were thought to be more hyperactive and inattentive by both their parents and their teachers. [35] "The Relationship of Nasal Disorders to Lower Respiratory Tract Symptoms and Illness in a Random Sample of Children," M.B. Barr, S.T. Weiss, M.R Segal, I.B. Tager, and F.E. Speizer, Pediatric 1'ulmonology 14: 91-94, 1992 [See ApPendnc A] This study examined maternal smoking with respect to children's nasal symptoms, and also studied the possible relationship between nasal disorders and c}u+onic lower respiratory symptoms. The authors report that frequent colds and sinus trouble were "highly associated with chronic lower respiratory symptoms." Statistically signifi- cant odds ratios for both colds and sinus trouble are reported for maternal smoking, which is also described as a "significant predictor" of lower respiratory symptoms. [36] "Increased Influence of Passive Smoking on Hospitalization for Respiratory Disease in Low Birthweight Infants," Y. Chen, S.L Home, and JA Dosman, American Review ofRespiratory Disease 147(4 Part 2): A213, 1993 [See Appendix A] This abstract reports on a comparison of the "risk and incidence" of hospitalization for respiratory disease ETS/IAQ REPORT, ISSUE 50 among infants of low and normal birthweight report- edly exposed to ETS in the home. The authors con- dude that low birthweight infants from households where there was smoking were more likely to be hospitalized for respiratory illness than were those of normal birthweight. [37] "Effects of Early Vs. Iate Environmental To- bacco Smoke Exposure on Pulmonary Function in Children," J. Cunningham, D.W. Dockery, and F.E. Speiur, American Review of Respirarory Diaeare 147(4 Pan 2): A213, 1993 [See Appen- dix A] Based on data from a cohort of 8,970 children in North America, the authors report that maternal smoking during pregnancy was significantly associated with measures of reduced lung function in children. They suggest that this exposure "may explain a signifi- cant part of the association of ETS exposure and reduced pulmonary function in later childhood." [38] "Parental Smoking and Respiratory Problems in Childhood," ].-A. Evans and J. Golding. In: Effects of Smoking on the Fetus, Neonate and Child D. Poswillo and E. Alberman (eds.). Oxford, Oxford University Press, 121-137, 1992 [Sec Appendix A] The authors of this chapter report on new analyses of data from the 1970 British Births Cohort. These analyses investigate maternal smoking during pregnancy and after the child's birth with respect to several respiratory end- points. The authors claim that maternal smoking during pregnancy is associated with wheezing, bronchitis and pneumonia in the child, and that maternal smoking during childhood is associated with snoring/mouth breathing, ear discharge and possibly chronic cough. [39] "Eight-months Incidence of Acute Respiratory Infections and Involuntary Smoking in Adoles- ~ cents," D.B. Teculescu, E. Rebstock, Q T. Pham, A.D. Corlan, and J: P. Deschamps, American Review of Respiratory Disease 147(4 endix A] Part 2): A134 1993 [See A O U' ~ , pp ~ French researchers report in this abstract on a study on the incidence of acute respiratory infections (e.g., bronchitis, common cold) in adolescents aged ten to 16. The authors report statistically significant elevated

JUNE 25, 1993 risks for acute respiratory infections when either one parent or both parents were smokers. RESPIRATORY DISEASES AND CONDITIONS - ADULTS [40] "Sidestream Tobacco Smoke (SS) Alters Re- gional Nasal Mucociliary Clearance: Compari- son of Sensitive and Nonsensitive Subjects," J. Nadarajah, R Bascom, T.K Fitzgerald, M. Bickert, K. Cheng, T. Permutt, and D. Swift, American Review of Respiratory Disease 147(4 Part 2): A216, 1993 [See Appendix A] In this experiment, "ETS-sensitive" and "nonsensitive" subjects were exposed to sidestream smoke followed by challenge with an aerosol. Nasal dearance was measured in both groups; 50 percent of the "sensitive" subjects reportedly exhibited an inhibi- tion of clearance after smoke exposure. OTHER HEALTH ISSUES [41] "Antenatal Smoking, Postnatal Passive Smok: ing, and the Sudden Infant Death Syndrome," J. Nicholl and A. O'Cathain. In: Effects of Smoking on the Fetus, Neonate and Cbild D. Poswillo and E. Alberman (eds.). Oxford, Oxford Univer- sity Press, 138-149, 1992 ['See Appendiz A] Using data collected in the United Kingdom, the authors of this study attempt "to uncavel the roles of maternal smoking during pregnancy and postnatal passive smoking in SIDS deaths." They report sratistically significant risk estimates for maternal smoking and for partner's smoking (a surrogate for ETS exposure). ETS EXPOSURE AND MONITORING [42] "Passive Smoke Exposure During Pregnanry: A Rodent Model," D.M. Schilling, M.R Reed, RM. Booze, and C.F. Mactutus, Teratology 47: 462, 1993 [See Appendix A] This abstract describes the experimental exposure of female rats to sidestream and mainstream smoke, 13 beginning before pregnancy and continuing until litters were born. The authors claim that the offspring of rats exposed to sidestream smoke as a surrogate for ETS exhibited decreased birthweight, slower growth, and pathologic changes in the brain. These endpoints were attributed by the authors to decreased oxygen levels during the prenatal period. INDOOR AIR QUALITY [43] "Indoor Air Quality and Environmental To- bacco Smoke: Concentration and Exposure," LC. Holcomb, Environment International 19: 9-40, 1993 [See Appendix A] Based on a review of literature on IAQ and ETS published since 1980, the author of this study suggests that "ETS has only a minor impact on IAQ ° More- over, he presents estimates of retained doses of ETS particles that range from 3 to 40 milligrams per year, a range which he suggests "does not seem to support" the summary relative risks calculated using meta-analysis. SMOKING POLICIES AND RELATED ISSUES [44] "Restrictions on Smoking: Changes in Knowl- edge, Attitudes and Predicted Behaviour in Metropolitan Toronto from 1983 to 1988," LL Pederson, S.B. Bull, M.J. Ashley, and D. Kozma, Canadian Journal of Public Hcalth 83(6): 408-412, 1992 [See Appendix A] Based on the results of two surveys, the authors of this artide claim that residents of Metropolitan Toronto showed marked changes in their attitudes about smoking. For instance, the authors report that between 1983 and 1988, Toronto residents began to more strongly favor restrictions on smoking (induding complete prohibitions). They also claim that, over the five-year span, residents became "no more knowledge- able about the health effects of smoking and ETS."

14 ETS/IAQ REPORT, ISSUE 50 SiNGAPORE IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS AUSTRIA [45] Agreement Reached by Government Officials on Tobacco Legislation According to a press report, the health and finance ministers, the chancellor and the director-general of Austria Tabak have reached an agreement on amend- ments to proposed tobacco legislation. Provisions banning public smoking are reportedly unchanged, but no fines will be imposed for contravening the ban. Sct Die Tabak Zeitung, June 18, 1993. [48] Health Warnings to Change As of January 1, 1994, labels on cigarette packs will' reportedly be required to carry a warning in English stating that "Smoking harms your family." Evidently, the packages will no longer carry the phrase "Govern- ment Warning." According to a press report, this will be changed to "Health Warning." See The Smoking Regulations, May 29, 1993. OTHER DEVELOPMENTS AUSTRALLA [49] Woodward Predicts Widespread Smoking Bans Within Five Years EUROPEAN COMMUNITY (EC) [461 EC Commissioner Endorses Workplace Smok- ing Ban According to EC Commissioner Vasso Papandreou, the EC is considering "specific measures to limit or to ban smoking at the workplace." Papandreou's remarks reportedly were made in response to a written question to the commission. The workplace directive would apparently require, at a minimum, adequate ventilation and smoke-free restrooms for nonsmokers. See Safety Managemrnt, May 21, 1993. HONG KONG [47] Hong Kong Government Examines Indoor Air Quality The Hong Kong Government has brought in a team of specialists to dean office air ducts in its 1,208 government buildings. A contractor hired to do the deaning estimates that up to 20 percent of the 187,000 government workers may be suffering symptoms related to indoor air constituents. A government spokesperson denied that any of the buildings were suffering from sick building syndrome saying, "The deaning of air ducts is simply part of our scheduled work." See South China Morning Pott, June 13, 1993. Stephen Woodward, spokesperson for the New South Wales Cancer Council, has reportedly predicted that smoking will be banned in almost all indoor public places including bars and restaurants within the next five years. According to Woodward, smoking has already been banned in all commonwealth public service departments, in most hospitals and State health departments, and in businesses such as Telecom, Aust Post, Shell, ICI, CSIRO, BHP, AMP, Westpac, 3M, Price Waterhouse, and IBM. See Daily Tilegraph Mirror, June 15,1993. Woodward is also executive director of Australia Action on Smoking and Health (ASH). . EGY1rT [50] Physician Calls for Smoking Ban A physician has reporoedly called on his Arab colleagues to ban smoking in front of patients. According to Dr. Mohammed Basheer Shreim, more than half ofArab physicians smoke at work. SrrAl Hayas; June 4, 1993. ITALY [51] Oncology Institute Official Calls for More Research According to a press report, an official with the European Institute of Oncology in Milan claims that

JUNE 25, 1993 there is still a need to quantify the alleged risks of low- level exposure to ETS. He reportedly suggests, how- ever, that there is no need for new evidence to justify the adoption of measures to restrict smoking. Srt The Lancet; June 10, 1993. SWITZERLAND [52] Tobacco Industry Launches Press Campaign The Swiss tobacco industry has launched a press campaign calling for more tolerance and understanding between smokers and nonsmokers. The campaign apparently consists of a series of seven advertisements which will be run in 25 daily and weekly journals covering three linguistic regions of the country. The campaign's slogan is "Better to discuss than to fight." The first advertisement appeared on June 13, 1993, and will run for three weeks. UNITED KINGDOM [53] Health Education Authority Targets Workplace Smoking The Health Education Authority has recently pub- lished its strategy for the next five years. Among the Authority's goals is "to create a healthy working environment, including freedom from environmental tobacco smoke." Other targets include reducing purported risks associated with tobacco consumption. See Safety Management, May 1993. [54] Smoking Ban Takes Effect in NHS Facilities According to press reports, a ban on smoking in all NHS hospitals, offices and canteens, which will apparently affect one million employees, went into efffecc at the end of May. Evidently, smoking by long- term patients and patients in psychiatric wards may be permitted in limited areas. The director of.ASH has been quoted as saying that the rule may be flouted due to the decentralization of authority over individual trust hospitals. Health Minister Dr. Brian Mawhinney reportedly lauded the progress that had been made by NHS in adopting smoking policies "to protect patients, visitors and staff from the health risks of smoking." See Daily Telcgraph, May 31, 1993. 15 MEDIA COVERAGE UNITED KINGDOM [55] "By Order: No Smoking In Furness," D. Kermode, North Western EveningMaA May 20, 1993 This artide discusses the smoking bans and restric- tions that have been adopted by businesses and govern- ment entities in Furness. Barrow Town Hall has apparently restricted smoking to a temporary room, and workers at Tesco can only smoke in the restaurant. The British Gas terminal in Barrow will reportedly implement a total ban beginning in January 1994. Penalties for noncompliance, in some cases, include termination from employment. The author notes that some Furness firms have tried to accommodate smok- ers by creating smoking rooms.