NYSA TI Multipage 2
Offic2 of T_chnology Assessment Washington, DC 20510 John PL Gibbons
Abstract
The Staff Paper covers three, general areas:
Fields
- NYSA numbers
- 2142 B1793 03B
- Named Organization
- ACVA Atlantic (Predecessor of Healthy Buildings International, a PM front g)
- Agency for International Development
- Air Force
- American Cancer Society
- American Express
- American Health Association
- American Heart Association (Voluntary health organization that focuses on cardiac health)
Voluntary health organization that focuses on cardiac health and stroke. AHA occasionally teams with tobacco retailers to engage in promotions/fund-raisers (see http://www.smokefree.net/doc-alert/messages/247136.html and http://www.rawbw.com/~jpk/stand/Pictures.html).- American Journal of Public Health (periodical)
- American Lung Association
Voluntary health organization concerned with fighting lung disease, promoting lung health and advocating clean air, indoors and out.- Americans for Nonsmokers' Rights (Anti tobacco organization)
Concerned with clean indoor air.- Archives (National Archives and Records Administration)
- Army
- ASHRAE (Am Society of Heating, Refrig and AC)
American Society of Heating, Refrigeration and Air Conditioning- blood institute
- Boeing (Aircraft manufacturer)
- CIGNA (Health insurance provider)
- Congressional Budget Office (CBO)
- Control Data Corporation
- Defense Department (DOD)
- Department of Defense (DOD)
- *Department of Health and Human Services
- *Department of Health, Education, and Welfare (HEW) (use United States Departmen (use @hew_dept)
- Environmental Protection Agency (EPA)
- Fortune
- Gallup Organization (Polling firm)
formerly known as Gallup & Robinson, Inc. (1975)- General Electric Company (appliance company)
- General Motors Corporation
- General Services Administration (GSA)
- George Mason University
- Georgetown University
- Government Printing Office (GPO)
- Harvard University
- *Health and Human Services (HHS) (use United States Department of Health and Hum (US)
- International Agency for Research on Cancer (IARC) (WHO cancer research arm)
International Agency for Research on Cancer - The cancer research arm of the WHO. Conducted a multi-center epidemiology study on ETS, initiated in 1988, data collection completed in 1994 and results were published in 1998- Indian Health Service
- Institute of Medicine
- International Agency for Research on Cancer ("IARC") (International Agency for Research on Cancer ("IRAC"))
International Agency for Research on Cancer ("IARC")- International Journal of Cancer (scientific periodical)
- Johns-Manville Corporation
- Labor Management Committee (LMC) (of Tobacco Institute)
- Lancet
- Marine Corps
- National Academy of Sciences
- National Academy Press
- National Interagency Council on Smoking and Health
- National Research Council
- Navy
- New Jersey Dept. of Health
- Occupational Safety and Health Administration (Held hearings in 1994 to ban smoking in workplaces)
OSHA opened hearings in September 1994 on a proposal that amounts to a virtual ban on smoking in every workplace in the nation- Office of Personnel Management
- Office of Technology Assessment
- Office on Smoking and Health
Responsible for creating reports on the health effects of smoking. Created by the Public Health Service.- Postal Service (USPS)
- Preventive Medicine (periodical)
- Research Council
- Roper Organization (Consumer Research/Public Relations Org.)
Interested in finding out what drives consumer behavior; surveys consumers on their prime areas of concern; assists corporations with reputation-building and public image based on its findings.- Senate
- Seventh Day Adventists (religion that prohibits smoking. runs smoking cessation prog)
- Simon Fraser University (Burnaby, British Columbia, Canada)
- Texas School of Public Health
- Tobacco Institute (Industry Trade Association)
The purpose of the Institute was to defeat legislation unfavorable to the industry, put a positive spin on the tobacco industry, bolster the industry's credibility with legislators and the public, and help maintain the controversy over "the primary issue" (the health issue).- *University of California (use specific branch)
- University of Utah
- US Postal Service
- Veterans Administration
- Agency for International Development
- Named Person
- Alli, William
- Andrew, Duane
- Arnold, Susan
- Ballentine, Kit
- Banzhaf, John F., III (Exec. Dir. Action of Smoking & Health (ASH))
Executive Director of Action on Smoking and Health (ASH).Professor of Law at Georgetown. Banzhaf succeeded in using the Fairness Doctrine to get cigarette commercials off television in 1968. See Banzhaf FCC, 405 F, 2d 1082 (D.C. Cir. 1968) (affirming FCC ruling that radio and television stations must devote a significant amount of broadcast time to case against smoking). His telephone number is (202) 659-4310. The big focus in past years has been to force OSHA to enforce smoking bans, per Matt Bars. ASH publishes Smoking and Health Review bulletins. "A leading anti-smoking activist" (Chic. Sun-Times 6/23/93). Action on Smoking and Health is located at 2013 H Street, N.W., Washington, D.C. 20006. (Castano Expert List) See Action on Smoking a Health, TTLA Almanac - Names.- Behrens, Ruth
- Bennett, Glenn
- Boyd, Gayle
- Burns, David M.
- Cahn, Robert
- Carlson, Regina (GASP, Founder of NJ chapter)
- Chilcote, Samuel D., Jr. (TI President (1981-1997))
Chilcote has knowledge of The Tobacco Institute's and the tobacco industry's participation in public fraud and disinformation relative to health hazards of tobacco use, in the manipulation of nicotine in tobacco products and in marketing of tobacco products to children.- Cullen, Joseph
- Deluca, Gail
- Doyle, Nancy
- Erickson, Alan
- Fairbanks, Leland
- Fielder, Ron
- Friedman, Gary D., M.D. (CTR Grantee, Epidemiologist, Stanford U)
Defense- Garfinkel, Lawrence (Epidemiology & Statistics VP, ACS, Plaintiff's Expert)
Lawrence Garfinkel was an American Cancer Society official. He did a study which disputed a "Japanese Study" of early 1980s that concluded nonsmoking wives of smokers had a higher cancer rate than the smoking husbands (E. Whelan 1984). In an early 1980s ad, R.J. Reynolds Tobacco Company quoted Garfinkle, out of context, to attempt to prove that passive smoking is not an important health-policy issue. Garfinkle protested by letter to the N.Y. Times (L. White, Merchants 1988).- Gibbons, Jack
- Glantz, Stanton A.
- Goldbeck, Willis
- Gough, Michael
- Harmon, Dana
- Harris, Jeffrey Earl, M.D., Ph.D. (Associate Prof, Harvard Medical School)
Harris went through company documents and old medical-journal articles regarding the scope of the tobacco companies' early knowledge about the hazards of smoking. He testified regarding media and scientific state-of-the-art about smoking.- Hearn, James
- Hermann, Irvin F.
- Holbrook, John
- Ill, F. Banzhaf
- Jones, Jerry A.
- Katz, Lane
- Kong, Hung
- Larson, Brad
- Mah, Russell
- Maloney, Jeanine
- Marx, Dale
- Mcdonald, Douglas
- Melius, James
- *Meyers, Matt, Esq. (name is Myers)
- Mickel, Angela
- Morosco, Greg
- Nelson, Norton (NYU)
- Osier, Gerry
- Philippi, Terry
- Pike, M.C.
- Pinney, John Mercer (Policy Expert, Pinney Assoc., Inc., Anti-Tobacco Expert)
Plaintiff- Pollack, Earl
- Ramsey, Elizabeth
- Rice, Dorothy
- Robb, Walter
- Rosner, Robert (Smoking Policy Institute)
Smoking Policy Inst. Seattle Wash.- Seidman, Herbert
- Shopland, Donald R. (NCI Public Health Advisor)
Plaintiff- Siebert, George
- Sterling, Theodor D., PhD (Industry Consultant, Statistician Applied Mathematics)
Theodor Sterling was a statistician with Simon Fraser University, Canada. He is listed as a consulting scientist for the tobacco industry in 1988 memo PM 2023034933/4946 from Andrew Whist to R. Murray. Sterling presented the industry's poibnt of view at indoor air symposia in Tokyo, 1987 and in the U.K. in 1988. Industry Consultant and CTR Special Project recipient.- Stevens, Ted
- Thompson, M. J. (INFOTAB New Zealand)
- Thompson, Mary
- Topping, John
- Wasser, George
- Wiedemann, H.P. (researcher, ETS)
- Andrew, Duane
- Date Loaded
- 27 Jan 2005
- Box
- 0932. Sub. Files - N - Z
- Folder
- Passive Smoking
- Division
- Media Relations
Document Images
OFFIC2 OF T~CHNOLOGY ASSESSMENT
WASHINGTON, DC 20510
May 13, 1986
JOHN PL GIBBONS
TO:
F~OM:
SUBJECT:
TechnoloEy Asse~Board
John eibbo r
T~ansmittal of Staff Paper on Passive
Workplace
Smokin~ in the
The final version of
Workplace: Selected Issues,"
was prepared in response to a
Subcommittee on Civil Service,
GovernmenU Affairs Committee.
the Staff Paper, "Passive Smoking in the
is attached for your information. This Report
request from Senator Stevens, Chairman of =he
Post Office, and General Services of the Senate
The Staff Paper covers three, general areas: I) a review of the
literature abou= the health effects of.passive, or involuntary, smoking; 2) a
description of workplace smoking policies zn the Federal Government, at =he
State and local levels, and in the private sector; and 3) a discussion of
factors ~o be considered in evaluating ~he cost-effectiveness of smoking
policies in the workplace.
This Staff Paper has undergone extensive review by many people in
Federal, State, and local government offices, in industry, academia, special
in~eres~ groups, and medicine. I attach for your information a memo
summarizin~ ~he review process, major comments received, and lesponses made by
OTA.
We intend to deliver this Staff Paper to Senator Stevens on May 23.
Because of the sensitivity and importance of the issues discussed in ~h£s
document, I am tramsmit~ing copies to TAB for your information nine working
days before our intended release. However, unlike the procedure for OTA
~eports, I am no~ seeking formal TAB review and authorization ¢o release.
If you have any questions, please do not hesitate to call me or Hellen
Gelband, Project Director in the Heal~h Program, at 6-2070.
Enclosure
TI05870131
May 12, l~S6
3"0:
FROI~I
Jack Gibbons~ Director
Hellen Gelband, Project Director
Review of Staff Paper, "Passive ~moKing in the Workplace:
Selected Issues
Backqroun~
Senator Stevens~ in his role as Chairman of the Subcommittee
on Civil ~ervice~ Post 0ffice~ and General Services of the Senate
Sovernment Affairs C~i~tee~ wrote to you on October S, I~85,
requesting that 0TA examine several aspects of passive smoking:
...the nature of the phenomenon, the health risks it
poses~ and the policy implications of those risks...
The cost implications...and the possible cost benefits
of policies to restrict smoking in the workplace, would
also be important aspects of the study.
The letter also requested clarification on some definitions--
specifically, "sidestream smoke" and "environmental tobacco smokeI--
used in discussions of passive smoking. You replied on November 1,
saying that 0TA would take up these questions.
The first product delivered was a November 27 Staff
Memorandum~ "Clarification of Passive ~moking Terms," prepared by
Karl Kronebusch. The information in that Memo has also been
incorporated into the Staff Paper n~ being delivered to TAB.
Three major topics are included in the Staff Paper= l)a
review of the literature about the health effects of passive, or
involuntary~ smoking! 2) a description of workplace smoking policies
in the Federal Government~ at the State and local level¢, and in the
private sector; and 3) a discussion of factors to be considered in
evaluating the cost-effectiveness of smoking policies in the
workplace, Decisions about what to include were made after
consulting with members of~Senator Stevens staff, with the
understanding that we were~not undertaking a full assessment, and
could not court every aspect.~ We note that the National Academy of
Sciences has a major project under way that is examining this area
very thoroughly, Their report is expected in late 19S6,
I
TI05870132
The project was staffed by grad Larson, Karl Kronebusch, and
me. Host of the work occurred over a period of about two calendar
months. There ~s no advisory panel. Extensive contacts were made
with interested parties on all sides of the issue. Karl's Staff
Paper on the costs of smoking had a legacy of a very long contact and
mailing list, of which we made good use.
A draft of the Staff Paper was sent out to about
individuals and organizations on April 4, 1~86. We received about
responses. All individuals who either provided information during
the writing period, reviewed the draft, or did botht are listed in
the "Ackno~|edgments; at the back of the Staff Paper. The deadline
for c(:r~ents was April 23, since we had hoped to co~plete the
document by Hay I. Early in the co~nent period, we were asked by a
member of Congressman Sundquist's staff to contact three people who
had been supplied copies of the draft by The Tobacco Institute. I"
contacted these three and we received co~ents fror~ two of them.
The major=ty o~ commenter$, in particular, most of the
academic scientists, found the document to be a fair and objective
assessment of the issues.. Several people provided add|aloha|
references, inc|uding quite a few unpublished p~pers reviewing
different parts of the literature. A few reviewers also provided
updated information for the section on State and local laws
restricting smoking in the workplace. We used much of this
additional information in revising the draft. There were a few
requests for sofas
the epidemiologic
nonsmokers, and a
smoking policies.
45
sumary tables. We no~ have a table that lists all
studies of passive smoking and lung cancer in
table of all the State laws that set workplace
Host of the criticisms were about the health effects section,
though there was so~s dissatisfaction with the discussion of cost-
effectiveness. Several reviewers felt the latter ~ection should have
.~en more quan~.i~ative ~nd ~";'gorous~u~w,
be~lieve there are data adequate to support that t_~_pe
The appraisal of health effects was criticized frc~ two poles.
On one side, several reviewers believe that the data did not support
our conclusions that there did appear to be a relationship between
passive smoking and some health effects. On the other side, we were
¢riticized~ strongly by some, for tentative and weak conclusions
about these same health effects. In response to these critici sms~
all of the sutrcllary sections ~ePe rewritten incorporating the valid
criticisms from both sides, and ending with what I believe are
balanced views of the literature.
2
T105870133
Some specific c~ents and our responses are included belch.
These are representative of the most critical c~ents we received.
C~ents..on Health Effeqts Section
Two commenters suggested replacing the terms "passive smoking"
and "involuntary smoking' with "exposure to tobacco smoke by
nonsmokersI or "environmental tobacco smoke."
Me used these terms interchangetbly, since they all are in
comon use to describe the same phenomencm. We did not see
any PeRSon to eliminate the latter terms.
B
One c~Ttnenter found the information dealing with health
hazards to smokers irrelevant to this report.
Kn¢x,n, proven health effects o~ tobacco in s~ogers forms
basis for hypotheses of health effects in nonsmokers. It is
appropriate in judging the scientific literature to consider
this type of evidence. It is particularly relevant when
considering~hether a particular effect is "biologically
plausible.'
"Adding together equivoca} results and contradictory studies
cannot make the total any less equivocal or the whole more
meaningful scientifically."
This co~mnt refers to a sumaary of the results of lung cancer
studies end passive s~mking in nonsmokers. First, the Peso;as
o~ the studies ~,~e at not judged contradictory, and are not
described as contradictory in the draft. Several studies do
h~ue equiv~al results in that they are not conventionally
statistically signi~ic~t (s~e studies do have statistically
si~i~ic~t re~lts). This ~s only thtt~ even thigh the
re~tts~Pe positive~ it is possible that such re~lts ~ere •
ch~ce eQent, ~d not neces~ily truly ~ss~isted ~ith
passive moKin9. LooKing tt the ~ole ~y o~ literature
t~ther~ h~ver, there is t~ch str~r ~g~nt ~ ~
incr@tMd ri~ th~ ~ no incret~. A]th~gh ~e cannot add
t~t~r t~ re~lts ~ studies in ~ ~thmtic~} ~nse~
ts~ssin9 the 'weight o~ evidence" is the ~ the.
eptdemiol~ic literature is ~l~ys evaluated. ~ere ire
• l~st never single~ definitive studies. There ere literally
hun~eds ~ studies ~ut the e~ects ~ active ~ing~ end
it has ~en by ~s~ssin9 ill the studies together that
epidmioi~ists have pieced together the picture ~ n~ have
tb~t those e~ects.
3
Ti05870134
flaws and biases in the lung cancer studies,
~ have revised the ]ung cancer section to be more specific
about s¢me o~ the problems with the epidemiologic studies,
specifically the problem of classifying people'~ exposure to
environmental tobacco moKe. Table I also details the types
of exposure measures used in each study.
The draft made re~erence to "a half dozen or so" studies of
lung cancer in nonsmokers. C~ent: "Actually~ as of ~anuary
|~S6, there were fifteen such studies published....it is ha~d
.t~ understand ho~ ~ur study could have,missed so many of.the
~ti~|~,,,~u~l,ished in this field.'
This was a counting error, which ! heartily regret, Although
the draft r~entions half a dozen, ten studies ~ere actually.
cited in the fun0 cancer section~ which included all but ~ne
of the studies that we feel are adequate to evalu;te ~or this
question. All fifteen studies are listed in Table 1~ but O¢~ly
the ones that have adequate dat~ or are not irrevocably ~lawed
ape included in the text.
One co~menter mentioned that we had not included two as-yet
unpublished studies of lung cancer and passive moKing,
~le decided to include only published studies, given the
11mated staff time available and the general scope of this
review.
The draft was criticised for not mentioning that many
constituents of tobacco s~oke are carcinogenic.
This information is ncx~ included in two places.
The draft did not include studies of lung s~npto~s and disease
in children exposed to parents" tobacco mo~e.
Thiswas .brought up by several revie~rs. We initially made
the decision not to include this literature because the focus
of the report is on the office environment. Ho~ever, ! agree
that adding this literature would provide sc~e
infm'~tti.on~ as there is some evidence, thou~ not
to surest e4~ects in ~dults similar to tho~ s~en in
chiller, ~ did not 4eel this ~ could adequately
the primary literature ~ftlr the reviews h~ver.
inclu~d ~y statmnts fr~ ~ recent publi~ed
literature Ptview$ of the subject, The~ reviews dP~ faiPl~
$tr~g c~clusi~s.
4
T105870135
The draft failed to cite conclusions about the link between
passive moking and health effects fr(x~ testimony of the
American Cancer Societyj the American Health Association, and
the American Lung Association~ as well as sun~ary statements
made by public health leaders, etc,
The Subcmmittee that Senator Stevens chairs held a hearing on
this subject just before asking 0TA to revie~ the scientific
literature on the subject. The above-~entioned ~'oups
testifled~ as did many other people, ~m believe tht~
~nt~ Stevens is ~re ~ their vie~s, Particularly in
~eas~ere ~e did not rtuie~ a11 ~he primary liter~ure~ ~e
did cite s~ry tenements ;r~ s~e publi~ed sources thxt
~ere explicit literituPe reuie~s~ ~nd.th;se ~e indicated as
such. ~t does not seem appropriate to simply reiterate the
vies o~ other ~ps.
10.
11.
The draft did not include quantitative estimates of lung
cancer deaths in nonsmokers attributable to passive smoking
derived by Repace and Lo~rey.
The figures referred to a~e no~ includeds along with c~ments
on Repace ~nd Lo~,-ey'sm~thods.
Comments on Section About State,_Local, and Private Sector
Policies
"The draft report focuses entirely on those who have chosen to
restrict [s~oKing]...a truly balanced report would discuss the
experience of employers and public officials who have opted
against broad based and inflexible restrictions...' Examples:
Procter and Gamble, ~erican Sxpress~ Coca Colas and General
Motors,
Three of the four companies were contacted. Proctor and
Gamble is no~ developing a restrictive policy in response to a
local ordin~ncei American Express has never formally
considered (or opted against) a policYl General Motors" policy
restricts ~King in certain areas. The trend is t~d
increased restriction of smoking in the ~orkplace. While "thee
ma~.qlp_iJ~ business ha~e no~ormal mokinQ ~olicy~ it --
apples that f~ o~ these havo~sidere~ ~d opted ~_~
mgminst ~ch m pol~cY. ~ are not ~re o~ an ex~ple of
~siness that h~s thorn to re~ind ~ ~K~n9 pollc~ ~$ter
adopting
5
TI05870136
12.
The report is "so evenhanded so as not to present the
situation as it is--in a flux and increase."
The purpose ¢~f the State and local la~ section is to give
examples of components of l~vs. Data are included which shc~
an increase in State and local ~rkplace s~oKing restrictions
since 1983,
13.
The report ¢~its discussion of legal implications of workplace
• moKing policies.
The sections on workplace policies are meant to be
descriptlvel, motlvations and implications of policies are
outside the scope of the paper. & paragraph was added on
possible motivations fop policies, including legal
motivations.
14.
~qrnc~tpts on Co~-Effecti.~eness Section
~evePal ¢ .c~menters objected to the discussion of the possible
increases in the future costs of providing health care for
additional years of life gained as the result o4 pr,venting
mortality associated with passive moking.
Although ~r still point out the possibility that improvements
in longevity Bay lead to increases in future health cape
costst we have amended this discussion to indicate that
analysts disagree on whether these future ¢o$t increases
should be included in a cost-effectiveness analysis.
15.
Scx~e cctnmenters.also wanted the cost-effectiveness section to
be Bore conclusive about the cost-saving that they believe
will arise from reduced smoking and workplace smoking
policies, One cornmenter also wanted an explicit discussion of
the advantage? and disav~ntages of Senator.Stevens bill on
Federal policies concerning workplace smoking.
have added a pad'agP~ph describing the Stevens bill,
althou~ there is no detaile~ di.s~.ussion of its advantages and
di~vanta~ses. Bec~use,~e st~ll ~__ind the data on the
~its o~ w~kplace ~Kinq ~olicies t~e ver~ limited~
not connoted an~ qu~titative antly~i~ ~n~ing
"~strtt~" the alleged cost-stv;ngs of Peaced
Fop the purpose o; evaluating the benefits of reduced passive
mok~ing~ these studies are limited because they look only at
active smoking, fa!i to consider the possible increases in
future costs, and include heroic assu~ticms about possible
benefits.
6
TI05870137
16,
One ccr~aenter~ after concluding that the health effects
literature indicated that passiue smoking had not been shc~n
to be haPmful~ went on to argue that c~petitive markets would
lead businesses and employers to supply smoking policies in
response to the demands of consumers and workers. Thus he
concluded that there is no problem and no need for any
legislation.
In our discussion c~f alternatives to consider in a cost-
effectiveness analysis~ ~e no~ explict]y raise the possibility
of no •ctiont although we also point out that the assumptions
necessary to conclude that markets will lead to the best
possible result •re v~ry restrictive and unlikely to exist,
In addition, we point out that there still, however, n~y be •
need fop government action (legislation, regulation~ labor-
management negotiation) to set policies fop its c~m
worKpl•ces.
Several c¢na~enters pointed to survey research results that
indicate popular support for restrictions on smoking in the
workp]ace a~d around nonsntokers.
;n the discussio¢ c~f factors to include in a cost-
effectiveness an~lysis~ we h~ve included a reference to these
results and indicate that even though this expressed
preference ~ould be difficult to incorporate into in economic
analysis~ it is still an important consideration in •ny
decision concerning the creation o~ such policies,
18.
Several c~nraenters emphasized that an important benefit of
these policies is that they might induce smokers to quit or
reduce their tobacco c.onsumption.
Although we h•d previously mentioned this •s • possible
benefit~ ~e h•ve re~ritten that discussion •rid expanded it to
include ~cldition~l data fr~ one employer's survey indicatin9
that cre~tiort o~ •~xsrkp|tce making policy might le•d to
reductions in s~oRin9 man9 active s~oKers.
T105870138
.~ PASSIVE SMOKING IN THE WORKPLACE:
• -- SELECTED ISSUES
Staff Paper
prepared by the
Special Projects Office of the
Health Program
Office of Technology Assessment
U.S. Congress
May 1986
The views expressed in t'his Staff Paper do not
necessarily represent the views of the Technology
Assessment Board or its individual members.
T105870139
OTA PROJECT STAFF
Passive Smoking in the Workplace:
Selected Issues
Hellen Gelband, Project Director
Brad Larson, Research Analyst
Karl Kronebusch, Analyst
TI05870140
