NYSA TI Single-Page 1
In fact, that's an area that has received a lot
Abstract
In fact, that's an area that has received a lot of attention from the NIH, and I think people are spending more effort on interracial and ethnic differences.
Fields
- Named Organization
- American Cancer Society
- American College of Cardiology
- 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)
- Americans for Nonsmokers' Rights (Anti tobacco organization)
Concerned with clean indoor air.- Beverly Hills Restaurant Association (Industry front group)
Set up c. 1988 by the Tobacco Institute to clandestinely fight a local smoking restriction (TI00380927-0949, Pag. -0946).- California Air Resources Board
- Californians for Nonsmokers' Rights (Americans for Nonsmokers rights precursor)
Precursor organization to Americans for Nonsmokers Rights- Center for Indoor Air Research (CIAR) (Industry formed/funded air research organization)
Nonprofit organization funded by the tobacco industry. CIAR was formed in March 1988 by tobacco companies "to sponsor "high-quality research on indoor air issues and to facilitate communication of research findings to the broad scientific community."- Congressional Research Service (Criticized 1993 EPA ETS report)
Criticized EPA's January 1993 report designating passive smoke as a carcinogen- Environmental Protection Agency (EPA)
- Federal Register (publication)
- McDonald's Corp.
- Ministry of Health and Welfare (Japan)
- National Institutes of Health (NIH)
- National Licensed Beverage Association
- National Research Council
- New England Journal of Medicine
- Nonsmokers Rights (California anti-smoking organization created by Stanton Glan)
- Occupational Safety and Health Administration (OSHA)
- Price Waterhouse (Accounting firm)
- R.J. Reynolds Corporation (second tier subsidiary of RJR Industries)
- 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 California San Francisco
- Washington Technical Information Group, Inc.
- World Conference on Smoking and Health
- World Health Organization (Concerned with global public health)
International organization concered with public health worldwide - American College of Cardiology
- Named Person
- Alsop, L. Susan
- Barr, Glen
- Bero, Lisa A., Ph.D. (Epidemiologist, UC San Francisco)
- Feinstein, Diane
- Garfinkle, Larry
- Glantz, Stanton
- Grossman, Ted
- Lee, Peter N. (TAC Biostatistician)
Frequently funded by the tobacco industry to criticize and discount published and epidemiological studies that linked between tobacco smoking and health damage.- *LeVois, Maurice (use LeVois, Maurice Emile, Ph.D.) (industry consultant)
1996 submitted comments to EPA, worked with PN Lee on IARC rebuttal.- Lowe, Michael
- Mahler, Sara
- Mayor, Francisco
- Michaels, Robert
- Parmley, Bill
- Penn, Arthur
- Pfeffer, William, Jr.
- Rossi, Bob
- Rossi, Robert
- Samet, Jonathan
- Siegel, Michael B., M.D. (Epidemiologist, Boston U, School of Public Health, Anti-Toba)
- Toon, Michael
- Wald, Nicholas J., Ph.D. (Colleague of Sir Richard Doll, coauthor with Law of secondha)
Professor of Preventive Medicine, Wolfson Institute of London, Colleague of Sir Richard Doll, coauthor with Law of secondhand smoke metaanalysis- Warner, Kenneth E., Ph.D (Plaintiff's expert, health care costs)
Plaintiff- Woods, Rosemarie
- Wynder, Ernest
- Barr, Glen
- Master ID
- TI10111465-1821
Related Documents: - Date Loaded
- 16 Mar 2005
- Box
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467
I know of ~wo independent scientists who have raised the
issue -- Nicholas Wald and Richard Pito from England. Pito,
I was very discouraged to hear, hadn't read our work when he
was making the criticisms, which I thought was pretty
irresponsible.
The issue does come up and it is addressed in my
testimony because the risks are higher than you would expect
if you assume a linear dose response relationship.
The risks for active smoking and heart disease
are about 2 to 4, depending on the presence of other risk
factors.
The passive smoking risk is about 1.3, so since
the dose that a non-smoker gets of ETS may be I percent of
what a smoker gets, it does seem that the risk is too big,
but that's the reason I presented the animal data that I did
and the platelet data because it appears to me that, first
of all, that nonsmokers responses to passive smoking are
qualitatively different than smokers' responses, and that
there's a very, very steep dose response relationship at low
doses, so there's no reason to assume a linear or a
sublinear curve, and I think that the animal and clinical
data supports a superlineal curve that the additional
effects at very high doses that a smoker gets produce
relatively small changes over the relatively low doses that
a nonsmoker gets.
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I think the experimental evidence, both the
animal data and also the clinical studies, supports that
view.
MR. SIRRIDGE: Your Honor, I'd like to take back
that estimate of 45 minutes, because I'm going slower than I
thought I might.
JUDGE VITTONE: Okay. You're coming up on 3:00,
and you started at 2:30.
MR. SIRRIDGE: And you recall I have 17 numbers
to examine under.
JUDGE VITTONE: I understand.
MR. SIRRIDGE: Thank you.
Let me ask --
JUDGE VITTONE: At this point, it may be
appropriate for me to ask, both the questions and the
answers, if we can tighten then up a little bit, it would be
appreciated.
MR. SIRRIDGE:
DR. GLANTZ:
it difficult but we'll try.
JUDGE VITTONE: Well, the longer we stay here,
maybe the tighter the answers will get.
MR. SIRRIDGE: That's usually what happens, Your
Honor.
I'll do my very best.
I think both of us are going to find
DR. GLANTZ: That's how I get papers out of my
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students, ~oo.
MR. SIRRIDGE: Dr. Glantz, let me add a third
dissenter to your view, 1.3 is the right risk and not too
high. It comes from an OSHA consultant who will be
testifying later this week, Dr. Jonathan Samet.
DR. GLANTZ: Yes.
MR. SIRRIDGE: Are you familiar with him?
DR. GLANTZ: I think I met him once, but I know
who he is.
MR. SIRRIDGE: He writes in a publication in
1992, entitled, "Environmental Tobacco Smoke":
"The extent of the excess risk associated with
passive smoking seems high in view of the relative risks
observed in active smokers, approximately twofold
increases," and he cites the Surgeon General for that.
DR. GLANTZ: Yes. So what's the question?
MR. SIRRIDGE: Would you agree that there is now"
a third dissenter? You knew of two and I'm adding one.
DR. GLANTZ: I would say that in 1991, when he
probably wrote that, that was probably an accurate
representation of his view. I don't know what his current
views on it are. You can ask him when he's here.
It's important that a lot of the evidence on
passive smoking and heart disease is relatively recent, and
when you quote from old documents, like the '86 Surgeon
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470
General's !eport or the National Research Council's report,
that said there's not enough evidence to say, those were
accurate statements when they were made because that was
before most of the evidence was published.
Most of it dates from the late '80s and into the
early '90s, so I don't know what Samet's view would be
today.
MR. SIRRIDGE: He certainly had the benefit of
your paper in 1991. Would that have been helpful to him?
DR. GLANTZ: Did he cite our paper?
MR. SIRRIDGE: Yes, he did.
DR. GLANTZ: Yes. Well, it was a new paper then,
and it takes a scientific community a while a to reach a
consensus.
MR. SIRRIDGE: Doctor, would you agree that
several risk factors, such as lack of exercise, diabetes and
Type A behavior pattern, were almost never controlled for in
the epidemiologic studies that you have referred to and
relied on for your views?
DR. GLANTZ:
MR. SIRRIDGE:
DR. GLANTZ:
I should just leave this one up.
I can move this along by just --
Well, you're asking questions, and
I'm trying to give you responsible answers.
MR. SIRRIDGE: Thank you very much.
DR. GLANTZ: I would say that, as direct
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471
covariates~ no; indirectly through controlling for
socioeconomic status, diet, and things like that, yes, to
some extent.
MR. SIRRIDGE: So socioeconomic status controls
for lack of exercise?
DR. GLANTZ: To some extent.
MR. SIRRIDGE: What study is that?
DR. GLANTZ: I would have to go get you the
references. That's some that's generally known. I mean,
it's something that's generally known among people who work
in this area.
Again, I think it's very important that, in
Wells' work, when he showed the better job you did of
controlling for the potential confounders, the higher the
risks attributed to ETS got. I think that's a very
important finding because it shows that these potential
confounders are not giving you an inaccurate view of what's
happening, but rather, if anything, obscuring the ETS
effect.
MR. SIRRIDGE: Dr. Glantz, do you know if any of
the studies controlled for coffee drinking?
DR. GLANTZ: Not to my knowledge.
MR. SIRRIDGE: Hasn't there been an association
reported in the range of 1.3 to 2.5 for heart disease --
DR. GLANTZ: I'm not familiar. I mean, other
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than heariHg things in the popular press from time to time
about coffee drinking, I'm not familiar with that data.
MR. SIRRIDGE: Would you be surprised if the OSHA
consultant, Neil Benowitz, published a study quoting the
fact that there's an association of 1.3 to 2.5 relative risk
for coffee drinking and heart disease?
DR. GLANTZ: Would I be surprised? I don't have
any reaction one way or the other to what Neil does. He was
an independent scientist.
published a study?
MR.. SIRRIDGE:
Why should I be surprised if he
Do you think controlling, or do
you think taking coffee into account, would have added
another risk factor to examine, to determine, whether the
risk of 1.3 is an accurate risk? Does socioeconomic status
take care of coffee drinking?
DR. GLANTZ: I'm not aware of any evidence that
coffee driniking is correlated with ETS exposure in a way
that could possibly influence the outcome of these studies,
so my answer is, I would be very surprised if that ended up
being an important factor.
MR. SIRRIDGE: Wouldn't the relationship be,
Doctor, whether cigarette smoking is correlated with coffee
drinking, and then, therefore, you have a coffee drinker in
the home, and isn't that the kind of dietary habits that
people cite when they write articles, saying that those
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habits ten~ to conglomerate in households? There is the
tie-in, Doctor.
DR. GLANTZ:
MR. SIRRIDGE:
473
I don't understand the question.
The question is, cigarette smoking
is related to coffee drinking.
on it?
on it?
Isn't that true?
DR. GLANTZ: I don't know that for a fact.
MR. SIRRIDGE: Would you like to see an article
DR. GLANTZ: Pardon me?
MR. SIRRIDGE: Would you like to see an article
DR. GLANTZ: Well, I can -- I mean, if you want -
- I mean, I'm not going to -- the CRS study I had read
before, I'm not going to speed read a scientific article and
give you a judgment on whether I think it's good or not. If
you want to give it to me, I'll be happy to read it later,
and I can respond in a post-hearing comment.
MR. SIRRIDGE: Let me ask, then: there are
cardiovascular studies, studies on cardiovascular disease,
which do control for coffee drinking as a potential risk
factor.
DR. GLANTZ: I'm not in the position to answer
that one way or another as an expert.
MR. SIRRIDGE: Doctor, you mentioned several
mechanisms, in your view, that ETS may be involved in the
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development of atherosclerosis. These are proposed
theories, or hypotheses, aren't they, Doctor?
DR. GLANTZ: The explanations of the mechanisms
of atherosclerosis that I discuss are current best
understanding of how atherosclerosis is initiated and
continues. This is an area which people have researched and
will research for years.
I would say they represent the current consensus
view of what happens which, in science, is instantly the
can't hypothesis and theory. So I would say that it is the
current hypothesis and theory, but that also means it's our
current state of knowledge.
MR. SIRRIDGE: Doctor, are you more careful when
you write in journals about things being theories and
proposed hypotheses than you were this morning?
DR. GLANTZ: Yes.
MR. SIRRIDGE: Are you more careful?
DR. GLANTZ: No, I've tried to be very careful
what I write. For one reason, I know you guys will take it
apart. I mean, I published a document with the restaurant
study, that I'm sure will get to you, that had an append±x
full of numbers, and found the one typographical error in it
for me.
MR. SIRRIDGE: I didn't see that study.
DR. GLANTZ: Well, you didn't, but the tobacco
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companies Bid. So I plan on all my things being very
carefully reviewed by them.
MR. SIRRIDGE: In fact, if you called them
proposed theories or research hypotheses in your articles,
you stand by that today?
DR. GLANTZ: Well, that's not the kind of
language I usually use when I'm writing, generally.
[Pause.]
JUDGE VITTONE:
MR. SIRRIDGE:
JUDGE VITTONE:
MR. SIRRIDGE:
Mr. Sirridge :-
I'll move off that.
Are you almost done?
I'm sorry. I'll move it "along.
Let me just finish that line, because it does take a while.
I'm sorry.
JUDGE VITTONE: Sure. That's all right. Go
ahead.
MR. SIRRIDGE: Your Honor -- or, actually, Dr.
Glantz -- I won't ask you a question.
DR. GLANTZ: You can.
[Laughter]
JUDGE VITTONE: I'm not sure how much value I'll
give.
MR. SIRRIDGE:
be very helpful.
JUDGE VITTONE:
As long as it's short, that would
You want yes and no answers?
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MR. SIRRIDGE: Yes. I like yes and no answers.
I like the courtroom.
Dr. Glantz, isn't it a fact the
pathophysiological data are too limited in scope to prove
any of your postulated mechanisms as to how ETS may cause
heart disease?
DR. GLANTZ: I would say that the mechanisms we
suggest are consistent with a large body of data that's
understood about the mechanisms of the induction and
promotion of heart disease.
MR. SIRRIDGE: I'm quoting Dr. Samet again from
that same publication:
"Pathophysiological mechanisms can be postulated
with the increased risk associated with passive smoking,
although the relevant experimental data are still limited in
scope. "
DR. GLANTZ: I would say that in 1991, when he
probably wrote that, that was an accurate statement. The
experimental data, the work that we've done, that I reported
here, work by Arthur Penn and others, has all been published
within the last couple of years, so it really post-dates
that article.
I think probably when he made that statement, it
was accurate. I mean, we would have -- and perhaps I did
say tentative hypothesis, or something in the paper Bill
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