Tobacco Documents Online

-I- Visit to New York Author: P.N.Lee Date : 7.11.88 I started my recent US trip by visiting Dr. Nancy Haley (NH) of the American Health Foundation in New York on October 30th. I had met her a number of times previously at conferences and she had visited me at my office last year when in England. She met me from the airport and I had lunch at her home where we discussed a wide range of issues. Points found of interest are noted below. I asked her what the current situation was in regard to the IARC urinary continue study. In this study, as I understand it, urine was collected from 200 self-reported non-smoking women in some 10-15 centres worldwide. The American Health Foundation had completed the chemical analyses well over a year ago, but no paper had emerged yet describing the results. NH had written to Riboli, the project organiser at Lyon, threatening to publish herself if he did not pull his finger out. She was over in Brussels in February for the passive smoking conference and was thinking of going to Lyon then to sort out what was going on. She said that the studies had shown evidence of denial of smoking, despite being conducted in a manner likely to minimize it. She said the Japanese sample had shown 3% of true smokers among the sample. This is equivalen~ to about 15% of smokers denying smoking, given the small proportion of

Japanese women who smoke. She noted that there was a tendency for denial rates to be higher in countries where smoking was less socially accepted. She also noted that median cotinine levels resulting from passive smoke exposure tended to be highest in countries where people spent more time indoors and lived in smaller rooms. She did not give me sight of any data. NH told me that the American Health Foundation were conducting a study in which they had cholesterol levels and a range of other risk factors on a large sample. She noted a highly significant, though small, positive trend in cholesterol level in relation to number of cigarettes smoked. This trend may reflect differences in diet of smokers and non-smokers. She mentioned that Judson Wells is continuing his work at estimating the number of deaths due to passive smoking. Apparently a paper is due to appear in Environment International shortly claiming tens of thousands of deaths a year from all causes - no doubt the figure includes large and totally unreliable contributions from heart disease and cancer other than the lung. DiN had a poor opinion of Barbara Hulka, who was chairman of the group producing the National Research Council report on passive smoking and had chaired sessions in Tokyo and at Imperial College. On the morning of November Ist, I called in briefly at the American Health Foundation's headquarters in the impressive Ford Foundation building in New York. I Ealked to Ernest Wynder and to Geoffrey Kabat. Although Wynder felt the issue of misclassification of active smoking was important, he also stressed the importance, in case-control studies, of misclassification of passive smoke exposure. Non-smokers with lung

-3- cancer were likely to overstate their passive smoking exposure, in an attempt to explain their disease, relative to non-smokers with a disemse not associated with smoking. He said that he and Kahat were going to update their 1984 paper with substantially more cases and controls. Their analyses so far had confirmed their earlier finding relationship of passive smoking to lung cancer. I was provided with recent versions of the questionnaires they use and of a very recent paper on the effect of low-yield cigarette smoking on lung cancer risk. They are attached as Appendices. I will review the paper in the near future.