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Legislative Approaehes to a S'moke Free Society Appendix }:, Peter Hanauer Glenn Barr Stanton A. Glantz AMERICAN NONSMOKER:S' RIGHTS FOL?NDs1'T'IONI Berkeley, California

u C Cbpyriglnt @1I9ss; by American Nonsmokers' Rights Foundation 2054 University Ave., Suite 500, Berkeley,, Cal;fornfia 94704 All rights reserved. No part of'this publication may be reproduced or transmitted' in any form or by any means, electronic or mechanical, including photocopy. recording, or any information storage and retrieval system, without permission in writing from the publisher. ISBN 0-9616473-0-2

V List of Appendices A. "A Study of'Public Attitudes Toward Cigarette Smoking and the Tobacco Itidkistry in, 1978."' The Roper Organization„ May, 1978;, prepared for the Tobacco ~ Institute B. "Proposition P: Anatomy of' a Nonsmokers' Rights Ordinance," Peter Hanauer. 1New York State Journat of Medicine, July, 1985 C': Charts of'Cali'fornia and national~ nonsmokers' rights laws D: "Bibliography on Involuntary Smoking," compiled by Stanton A. Glantz and Lydia Jensen E. 1986 Letter fiom Siargeon Generali C. Everett Koop to Americans for Nonsrnokers' Rights summarizing the health e$'ects ~ of second-hand smoke F. "Tobacco Smoke and the Nonsmoker" brochure G. Testimony in support of n+onsmokers''rights legislationi before the tJnited'. States Senate Siab• cmmmittee on Civil Serviee, Post Office and~ General Services of the Committee on Govern- mental Affalas,, September 30, 1985 • James L. Repace • Joseph A. Califano, Jr. • Alfred Munzer, M.D. • Stanton A. Glantz, Ph.D. • Bill Ross H. Indoor air pollution studies • Excerpts from "C1ean Your Room!! A Compendium on Indoor Pollution." California Department of Consumer Affairs, February, 1982 • Exeerpts from Indoor Polfutants,,National Academy Press; 1981 I. Letter of support for a nonsmokers' rights ordinance from the Greater Riverside (California) Chambers of Commerce J. Celebrities who have supported nonsmokers' rights 10' ~ 0 ~ co

vivi1 . Sacramento, 1984 • San,Francisco. 1982 V. Tobacco1 Institute legal opinion on constitutionality of nonsmokers' rights legislation W. "Smoking a the Workplace: Legal' Issues," Timothy J. Lowenburg. American Lung Associa tion; 1983 X. "Addiction Mortality in the United States, 1980: Tobacco; Alcohol, and Other Substances." R.T. Ravenholt,, Population and'Developrnent Review, December, 1984 . Y: "Economic Costs of Smoking: An Analysis of Data for the United States," Dorothy Rice. December 28, 1983 Z: Questions and Answers on Proposed lYonsmokers" Rights Legislation AA. "A Quantitative Estimate of Nonsmokers' Lung Cancer Risk from Passive Smking,"' Repace and Lowrey,, Environment Internataonal; April, 1985 BB. Brochures explaining how smoking pollution contro]' laws work • Oregon • San Jose • San Di+ego : . Fort Coll2ns CC. Sample brochure for businesses explaining, a voluntary workplace smoking program, and in- cluding a survey measuring the success of the program DD: Legal opinion on the right of'an employer to hire only nonsmokers, Tom Downs, September. 11, 1985. EE. Model Smoking, Pollution Control Ordinance FF. Sample smoking pollution control i ordinances • Los i Angeles • San Diego • San Francisco • Sacramento • Palo Alto: • Mountaih, View GG. Legal opinion on validity of clause in workplace smoking ordinance prohibiting ret!aliatib.n by employer against emplioyee for asserting rights under the law, Paul N. Dubrasich, October 18. 1984

C VOLIIlC I Psapsr.d, for WE 'lOBA'CC0 IZ:STZ'TtJTL lsay 1978, T.k RCPMt G'R'G`,KITA:'i0N Iz_. a-z

IM r'tODUC';'_O't2 This is the aixth bi'ennial nationa2 opir.ion su-vey we have condti:eted for The Tobacco Institute. Like all its predecessors it deals with public atti- tndies towards tl'u smokirag and health~ issue and attitudes towards both the to2iacco industry and government regulation of'it. Ia the more recent surveys in the series, a secoad focus of'the studies has beem oA the passive smokinq/non-=oke='s rights issues lhis survey updates all sajjor, tren& areas &,nd: breaks significant newgroun3 in the passive smok!ingi/r.on-smoker•s rights area. A complete description of the survey, aethodology, sample size, i.nter- vie+.*ing, dates, etc., as well as copies of the questionnaires used, may be found in the •Metho3ology~' section following: this~ •Itisalysis' section.

ix HH. Newspaper articles on success of nonsmokers' rights laws • Wall Street Journal, August 15, 1984 • Saeramento Bee, April 3, 1984 • Los Angeles Timies; May 13; 1'985 • Contra Costa Times, November 1'7, 1985 II. Letters~and testimony of enforcement officials and'channber of commerce officials attesting to the success of snnoking, pollution control ordinances • Cupertino • East Lansing, Michigan. • Minnesota • Pasadiena • 'Poway •: San Diegp • San Francisco • San Jose • Santee • West Hollywood (letter from City Councilinember quoting, chamber of commerce offi- cials) JJ. List of officials in California responsible for administering smoking pollution control laws. KK. Sample petition seeking passage of a nonslnokers" rights ~ law LL. Tobacco Institute testimony before the jJnited'~ States Senate Subcommittee on Civil Service. Post Office and' General Services of the Committee on~ Governmental Affairs, September 30. 1985 MM: Sample action letters to grass roots supporters • Pleasant Hill • San Francisco • Los Angeles (postcard) NN. Case study of Los Angeles workplace smoking ordinance, as reported by the Los Angeles press •"T..A. Councilman to Propose Anti-Smoking Ordinance," Los Angeles Times. July 8. 1983 ~ •"L.A.'s Gravy Train," Los Angeles Herald; Feb. 3, 1984 ~ • "City Panel' Studies No-Smoking Proposal,"' Los Angeles Daily Journal: Feb 16': 1984 Q 0 ~

; i k- A STUDY OF PU'BI-1iC ATTlTUDES TOWARD CIGARETTE SMOKING AND THE TOBACCO, INDUSTRY IN 1978 VOLUME' I MAY 1978 • 0 X oph Q ?*~IwS -RE Cfl''7 8U406 QR 6 A a_1

( vi' K. Data on smoking and fires • Known Causes of Residentiali Fires: National Figures for 1981. California, Fire Incident Reporting System • Known Causes of Residential Fires: California, Figures for 1981. California Fire Incident Reporting System L. "Tobacco Industry Conglomerates," Smoking and Health Reporter. July. 1984 M. Cost of smoking to lbusiness • Testimony of Professor Marvin Kristein before the United States Senate Subcommittee on Civil' Service„ Post Office and General Services of the Committee on Governmental Affairs, September 30, 1985 •"'hTiow Much Can Business Expect to: Profit From Smoking Cessation?" M. Kristein. Preventive Medicine, 1983 •"Wamted: Smoking Policies for the Work Place;" ML Kristein, Business and Health. I+dovember, 1984 • "A Smokefree WorkpIace,"' California Nonsmokers' Rights Foundation, 198'5. N'. Public opinion surveys on smoking restrictions • 1984 Cali'fornia Poll . 1983 National Gallup Polll • 1984 Galdup ;Monthly Report on Eating Out • 1985 Harris Poll • 1984 Michigan Survey • Summary of 1980 Minnesota Poll O. Editorials supporting nonsmokers' rights • Los Angeles Times, February 10~ 1985' • New York Times, April12„ 1980. • New York Times, January 2'1, 1981 • New York Times, February 11, 198G • Oakland Trib'une, September 20„ 1985. • San Jose Mercury; May 20, 1983 • Washington Post, November 22, 1985 P. Columnists supporting nonsmokers' rights • Ellen Goodman. August 6, 1985 (

n. 8 ob j'.ctivi in otlz opinion ia tu develop aut~ositativ+e ;nd credible eviGlence with - s.spect to the effecu of passive smc4cinq on the nor.-smcker "s heal th. The issue, •s' re sse it, is t#o lznqer' vhat the smoksz does to hi!mstlf, but vhat he dbes ta~ others. I

x • "Watered Down No-Smoking Law Gets Preliminary OK," Los Angeles Douminurn News. Feb 28, 1984' • "L.A. Council Acts To Limit Srnoking At Pliaces of Work: 10-1 Vote for Measure," Los. Angeles Dazly Journal; Oct. 10, 1984 • "Council Adopts Tough Law on, Smoking on, Job," Los Angeles. Times, Oct. 110. 1984 • "Conflicts Mostly Soived: Few Fired Up OverL.A. Smoking Law," Los Angeles Times, Oct. 11, 1984' • "L.A. Council Acts To Ease. Curbs on Smoking at Work: Victory for Business," Los. Aingeles ! Daily Journal; Oct. 17, 1984 •"Tobacco Firms Act to Snuff Out Smoking, Law:, View Weakening of L.A. Plan as Just a, First! Step,"' Loa Angeles TiTnes,, Oct. 18, 1984' •"No-Smoking Law Opponent Hosting Council at Resort," Los Angeles Times,, Oct. 1'9, 1984 •"I..A. Strengthens Draft Ordinance To Curb Smoking: Penalty for Retaliation,"' Los Angeles Daily Journal,' , Oct. 24, 1984' •"Council Puts Some Muscle Back in L.A. Smoking Law," Los, Angeles Times, Oct 24', 1984 •"L.A. Approves Strict On-Job Smoking Law," Los AngelesTirnes, Oct. 31, 1984 "Bradley to Sip No-Smoking Ordinance, Press Aide Says;" Los Angeles Times, Nov. 1, ' 1984 •"Law's Opposition Doused," Los , Angeles Times, Nov. 9, 1984 •"C1ock Running for No-Smoking Plans," Los Angeles Daily News, Dec. 14, 1984. •"Smoking on Job: No More Ifs, Ands, Butts - It's Law,"' Los Angeles Times, April 14. 1'985 •"A Month: With! S;mokzng Law: Probieffis.Resoived Smoothly," Los Angeles Times, May 13, 1985 00. Sample press releases • Press release announcing a press conference • Press release announcing the support of a nonsmokers' rights ordinance by a prominent physician PP. Transcript of'a debate between a nonsmokers' rights activist and & tobacco industry repre- sentative

• Don Graffy July 25, 1982. • Bob Greene, December, 1985 • Ann Scott, October 23, 1985' • Carl Roxvany November, 1983 Q. Cartoons on smoking • Abbett, June 8„ 1983 • : Auth, July 25„ 1982 •' Auth, 1982 • Stein, Apri120, 1984 R. Correspondence showing misuse of medical evidence by opponents of nonsmokers' rights leg- islation • Correspondence between Dr. Paul~ &iagnus and Dr. Claude Lenfant • Letter from Dr. Jonathon Rhoads to Mr. Jack Mcdowell and copy pf quote out of context in initiative campaign ballot pamphlet S. Tobacco Institute analyses of health effects of passive smoking and rebuttals thereto • "Cigarette Smoke and the Nonsmoker," The Tobacco Institute, 1984 • "A Rebuttal to the Tdbacco Industry's Paper, 'Cigarette Sffioke! and the Nmnsmoker,'" Ftnster and Burns, Journal of Public Health Policy, September, 1!984 •"Response to'American Lung Association of'Superior; California Document "The Need for Smoking, Control Legislation in Butte County: A Case Statement,' " Center for Environmentall Healith' and Human T1'oxicolmgy • Letter from Robert Hutchings of the Office oni Smoking and Health to Mark Pertschuk. January 24, 1986 T. Tobacco industry polls on smoking restriictions andI related newspaper articles. • Los Angeles, 1984 • Analysis of Los Angeles poll by Californians for Nonsmokers' Rights • Michigan, 1985 : • ?"he Coloradoan, November 13, 1'984 • Los Alamos Monitor, December 15, 1982' U Letters from Califorsua city, attorneys concerning the constitutionality of nonsmokers' rights legislation N • Los AnQeles. 1983' N

.I .:::-:~.~.:~~-, 22 t3al*ctad qovar^-zont ccntrols (l2;,13) '!'he kiads of drugs a p.raoa. lUr ym'a3,ght talte Tbe kinp of birth control drvi'ces a p.rsoa like you aigfit nse Z'he amcunt a person 1Lkr yoa iight sacke Zhe amouat a p.rsoc if,7ee you a3ght dri;atit The aacont o!I sleep~ a peaoa 1'ike you aight g.t 8mculd _ control 83sould aot _o1 eo^ t tto o .inion _ 29 6b 5 38' 76 6. 13 83 •' 13 83 4 . 2' .95 3' There is certsi3a.Ly' ao overvhelm3:ng sardste here for gaver=nent eoatrols.

T The only category that decliaes over the four year period' is 'doesn't macter.' One imoker is f'igh!eing back. He has coined t~.>e +rprd •fL=ptaobe • (t"C0ort-ah-T0BE)I and persu.dledns tntest whether this, tan= canbe associated in t.l:e ptia25lic s2nd with an irrational aaiti-=okincp zealot. We asked respondents to choose one of the follow'd~.nq rtat=meots to descri'be whaz they thougkit a fvaaphome i:s. a fumap2aabe is . . .. (Question 31Y A person who doesn't partinilarly like eigarette :moke 7s' X person who :irsds cigarette smoke unpleasant A prss©a who has al medical allergy'to cigasette saoke: a person .rhs thinks cigarette smoke ia bad for people's bealt2a Xpezsoa who has an extr eme feas of' eigaretta s;aoke Doa't )aaw/ao aasawaz 9. 10 40 23 We met,ed'. earli's Nuestion 21) that 58s of' the public t'il.zlcs ssnki.-~, is 'probably' Sazardous to rma-smoke:s' healtb; nndoubt=dly some of tbes are not esrtaia of this a7ad are, tMerefore, emowe3ble.' ftreower, tbeze is amothe= 33% vrbo say that saokiag , doesn't have any real effect on non-smoke_s' health. Based on tae rationale of the ficdieoqs, both groups (the percentage of 'aoveables' along , .r+ t2s t: e group of' disbelievers)' sight be persuaded ta! regard some zealous anti-sanoke_ s as being, perhaps, unbalanced on the subj~ectof cigarette fwaes;, in eff~ect, as 'f=+aptoobes.' A-1!5

Saai'cer reaetion to restrictioav (Questioa SG ) Mre careful,, sesLsitive: 19'% Mora aarncyed, aqig,ressi've 10 Dat'h (volunt~ersed!) 5 1 lio affect ' 65 Dba" t Jabw/ro sa..~we,r 1. itmen were acre serssitixe. than aost to others' feeLing,s, as were colleqe educated people aasd' tbose vhu, bes.d' professional or aanagerial jobs. lbre men, an& younq people than average said that all the restrictiorss haven't a;ffected theo at a11.. We possd the same qgaestioa to non-smokers', askirrg, whether they t4-wnght smokers r+iouldi be =ore careful or aore unmoyed. The noa-soo3ce_-s expected a stroaqer, reaction from amkers,, aad they th~ught it +rould be more acgqressiv+e.than it_turns out to be. 3bn-smoker expectations of smoker rsacti oas to restrictiostis (!Question 613) Ibre careful, semsitive 21% lbre asuncYed,, aggressive 25 moth (v+o luntetired ) 11. l1o effect 35 DDa't k=ow/m, amsver 8 Indeed, smo3cers have beeom. a great d+aal aore narc:nmfoztatble abo+att other people. seckinq around Qbco.fort.able smokers (Question i9) 1978 19'76' Tte+querstly 13 9. Occasioasally 40 39 N Sa ldom 29 . 34, Q. Jis'ver (volunteered) 17 16 ~ Doa't kncw/rn ansver 1 2' ~ Aoajozity of sooke.s is.eithes frequently or occasionally unrac,iarcible about O. smcki:q in any. The •freqasezstly' eategpry has gone up ala,csst ha, s wh-1e ~ A-13

•1e ao graat claocs tcr Whe osa.=e. t5e askad 2mw eacasr:rned paop3e were about ciq;arette baotlegg'i.aq'. Coaasra aboot bootl.qqinq (Questioa 34) Oery, cozseun,ed' 12 % Scrae.rhat, eaacs,.-aed'22; 8ot ' too ooacstmed 26 Ibtatalli concs.-sud 35 Doa' L 3=N,/= a:asr++er 4 ~ Zbo-t,t+sirds of the natioa, is sat eoncerned or bas no opinion. Asked if they tbought sakityq, bootlegging a federal c.iae wouU Yaducee baotleqging, apbuaiaca was quite evea,ly, divided and, nocysmetrss^vsemerqed. Lff*ctiveness oi t+ederal Iavs aqai'rsst boo tlegg,iaq (Qulstion 35) lsduee bootlegai'r.g ~ - anea2l.y 15% fiam.,rrhat 28 c3s,iy a lit tIe 26, Ibt at all 24 IDom "t ]mcW/ao aaswes 8

-1 . XMZI'G7':= OF' THE STVD'Y 7lpprosimate3'y forty percent of'this six:h study of public attitudes tarrard cigarette saoking consists of' new questions rhich have never before been asked for The Tobacoo Institute. !or this reason alone, a+any of the research ., `L hkB II. I".' I?'s'' findings coataiaed in tMSs report are of special interest. The study also coco-- taias a systesstic revi'aw of trend data for questions which have beem asked in the past. Zak'em together, the large body of new matarial and' the eomprehesssive view of changing attitudes over the last ten years highlight results that we con- sider to be of extraordinary iarportance, to t2ne industry. D)ot all of these findings are encouraging. In fact, the ma jor high- lights of this report divide thesaselves into results vhich are sometiaes proris- , img but nostly foreboding as regards the very future of' the tobacco industry. C!b put it another way there are a certain nirmber of •si!Z'ves liaing,s" to thee uany •elouds.") For this reason, we have decided to present the highlights of this report in the form of a balance sheet, measuring the optimistic and pessi- aistic entr'ies., as it were, oa opposite sides o1 the ledger. These balaoce sheet 'eatries' are presented vithout do,-%=entatioa in the interest of conciseness. ZSty are, mowever, •audited"' in the "Detaile3 analysis• that follows. •7L55gZ5" l. the overall saSiency of' the 'eigaretts issue' is low. Coaspared tm crime, drugs, pollution, and a half a dozen otfies itams, smoking is at the bottom of the list of personal ooncerns. 2. There is little aentis+ent for a total b+an on cig,rrette smokimg in public places (but see 13 under •S.iabilities") .. 3. There is overwhelsi'ng approval of placing aotices outside places that restrict cigarette mokitvc. 1. lsore t2sa:e nine out o:f eve-ry t=Americuas bel i eve that smo);iag is hazardous to a saoker's baalth. 2.. A majprity of Jkmeri'cans be:ieves that'it is probabl'y hazardous to be arvszrsd' Qeopl'e .r3'~o smoke evr.z 3 N ~ ~ if they' are not smoking ther.selves. krA 3. Zhere is aajority sent~.ment for separate smoking sect:ons in al: public places we askd3 about. 0 9 A-4

4 •'7LS5M;• (conti'nued'). 4. Tev people favor job discrimination based on cigarette svckis„q. S. The percentage of'smckerx in the 17 to 24' year oIIid age group is up, and tse amouaat smoked per day per young saoker is also up ftt see f5 ander 'Liabilitiese) . 6. Tbere is broad support for FZ+C regu- lation, of 'public service' adver- tising saon.sored by noc-profi't groups like the Cancer Society an6 Ral'ph Rader. 7. Yhe_•e is less than majority senti- ment in favor of'a gradaated tar cigarette tax. S •LIAB II.IT:'€S" (eont f na ed) 4. There is majority acceptance ' of the idea that the cigarette varning label' should be made stronger an3 more sseti`ic. t. S. The percentage of people vho smoke cigarettes is at the lov- .st level, measzared in the pas t. tan years. 6. A steadily incseasing' majority of Americans believes~ t2ut whe tabacco indust_y knows that the case against eigarettes is true. 7. Favorable attitudes trward the tobacco industry are at their lowest ebb. 8:4 There is widespread support for anti-mokirg education in the schools-and at the very early pears. 9. Tvo-t:fiizds of smokers r.cucd like, to give up smokin5. 10. Nearly half the public thiir_ks that smoking is an addic_on.. 12', ricre people say they would vote for than against a political- caar didate who takes a position, favoring a ban on s*okir.g in pub~- lic places. N

'!wv aatof three aoa-smo3cp-ss pseties stififer wAr~ ~n:n+g, 1sbels on c3ga.: ettes and even smo3cass are svenly divided oa the subjact. :

s • 23i°3~.TGK2'I'O2+S 0~~.' T: ,i'i PIND3NG5 ) Shs original Surgeon Geneaal's report, followed by the f'i.r'st. `h,azard' varn- 1 iaq oa cigarette packages, the, v4bsequent 'dasoger• varning on packages, the removal of cigarette advartisirsg from televisioa a;nd the isaclusioa of the danger va_-ning i,a • tiga'rette, advertising were all 'blows• of sorts for the tobacco' industry. They . C were, bowevar, blovs that the cigarette industry c+ould successfully weather because (' they were all directed against the amokes hisiself. whi!le the overvhelrninq ssajority of the public' has been convinced by the anti-smraking forces that smoking is darqerous to tbe sacker's health, this has aot persuadied'very saoy smokers to give up smokittg. C1 Mie anti-smokimg forces' litest' tack, bo+rever--o'n the passive smo0cing issue+--is another ma'tter. What the smoker does to b.d:mself may be his business, but vhat the smoker does to the aon-smoker is quitea different matter. The anti-smokinq C formes~ b3ve~~ aot Yet~ convinced anything l'ikeas'~ sany people that~ smo'3tinq~ haxmsthe Dailth of the non-moker as they have coervinced people that smokinqi harms the health of the smoker. Hut this study shows that they ase well on the vagy to making the same sale about the effects o?' smoking' on the aoa-smoke, as they have already madee vrith rsspect to the effects' on the smoker. pearly six out of tyer. believe t.`sat saok- lbQ is ha.xardous to the nonTsa+oker's healthy up s}narply over the last four years. Ibre than two-thirds of non-smokers belie4e it, nearly hal,' of' all sackers believe it. Shis we see as the most dangerous dev+elopmesst to the viability of the tobacco industry that has yet occsrred. 1h:ile there is little sentiment for an out- riot ban on smokinq in public gatherisog places, there is already majority sentiment for providing separate facilities for smokers and noee-smokers. As the amti-smok:.nq forces succeed in their efforts to convince non-smokess that their bea/t.5 is at N . 0. ~ •take too, the pressure for segregated facilities will change from a ripple to a t;:de~1 as we see it. Zt is, of cou.rse, possible t3iat' once smokers and rmon-smokexs alike ex- perience all' the inconveniences of separate facilities, people will recca+e fed up A-6

0 17I average rise. Shis is undoubtedly so bscau!se of' the high suppost for •'gpvem-eent is saking about the right sffort' ncnr. One iight speculate that without the public sxo)Cinq~ segregation alts.-aative, har'sher, restrictions ssight be more popular. She crsax of the control eysasstion still' remsins whether or not cigarettes can be con'sidiesed haTSfull to others. U long as smoking is thought of as a possible baza,rd to the smoker h3mself or perhaps srerely annoying to others, the case can be &,zgued for a sccial soiution. sut if smoking is regarded as dangerous to others, Lhen 1!sqal restraints =me into question. Zver simce 1974„vhea ve began a!ski.ng about arguments in favor of laws to prohibit smoki:og, the two most isaportant reasons had to do rit.'~ dangers to others: as a lire hazard in public places and' as a danger to the health of non- smokers. In this study, for the first*time, possible barm to the health of others is' the reason sost often elaosen. JlrTumee~ts in favor of' public aoti-smoki!ng laws (Q.30X) Zhs health of aon-smoJters is harz.d by ot2isr psopl'e smoking in their presence Smokinq;tends to be a firs hazard in public places s,ist-smokers are entitl'ed to br.athe air, lr.e of tobacco smoke some aon-smoksrs are allsrgic to tobacco socks tvess if there is no health hazard to them, aany people are annoyed by •oc.her people smoking in their presence The goveraaent should protect people who d©n't want othez peopl'e to smcke around tDem in public places St viw1Z nc: be a hardship on smokers to stop smoking in public places lion-smoker's are a s1a jori'ty and so their rights ccoe before the rights of' sackers 1978 1976 1974 • 33 25 29 26 28 23 24, 20 -22 2'3' 23 2V 21 21 24' ~ 10, 10 N C!t ~ ~ 9 8 7 N 0 ~ b 7 5 r C` C=; A-l~

We thank the following for permission to use their copyrigtited material included in~t'his Appendix: "Proposiition P: Anatomy of a Nonsmokers' Rights Ordinance;"' New ~ York State Journal o/'1Vledicinm. Qc 1985: "Tobacco Industry Congiomerates," Smoking and'Health Reporter, cQ 1984; "How Much Can Business Expect to Profit From Smoking Cessation?"' Preventive Medicine, eQ 1983; "Wantedt Smoking, Policies for the Work Place." Business and' HealtJt, ® 1984; 1'984 California Poll, ©c ~ 1984; 1'983 National Gallup Poll. cQ 1983: 1984 Gallup Monthly Report on Eating, O>Ilt„ cQ 1984; "Good Idea Defies Smoke Screen." Los Angeles Tivnes, Q 1985; "Thy Neighbor's Lungs," New York Times, Q 1980; "Smoking Your Wife to Death.' New York Times, cQ 198L "O'h, To Breathe in Nassau County:. " New York Times. © 1986: "Contra Cost& packs it in," Oakland ?~iburse, © 1 1'985; "Clearing the air," San Jose Mercury, cQ 1983: "Secondhand Smoke," The Washington Pvst, Q 1985; "Tobacco Company Crusaders Try Weapon of 'Cotartesy.'- Ellen Goodman, © 1985; "Cigarette makers set greed record,"' Don Gkaff; QQ 1982; "Why Does Anyone In This Nation Still Smoke Cigaret'tes?"' Bob Greene, cQ~ 1985; "Good Neighbor," Ann Scott, ©c 1985: "Frisco votes an antidote to smoking poison," Carl Rowan, © 1983; "Thank you for Smoking" (Cartoon). Auth. © 1982; "Dept of'Health/Dept of Agzicultur" (Cartoon), Auth„©1982; "News Iteffi:' San Francisco~Passes. Toughest Anti-smoking law in U!S." (Cartoon), Abbett, ©c 1983; "Do you mind if'P burn a hole in your shirt:. "' (Cartoon), Stein, © 1984: "A Rebuttal to the Tobacco Industry's Paper, 'Cigarette Smoke and the Nonsmoker,'" Journal of Public Health Policy, Q 1984; "Addiction Mortality in the United States. 1'980:" Population and Develapment'Review, c© 1'984; "A Quantitative Estimate of'Nonsmokers"Lung Cancer Risk from Passive Smoking," Environment lnternationa @ 1985; "Reporter finds tobacco types behind survey; ?7xe Coloradoan, Q ~ 1984; "Tobacco Institute Raising, eyebrows here,"' Los Alamos Monitor. Q 1982. "San Francisco Anti-Smoking, Law & Success," Tla'e Wall Street Journal, Q 1984;, "Smokers Survive Their New Habit,"' The Sacramento Bee, Qc . ~ 1984; "County close to being smoke free," Contra Costa Times. Q 1985. "L.A. Councilman to Propose Anti-Smnking,Ordinance," Los Angeles Timea; ®4983, "L.A.'s Graay Train.' Los Angeles Herald, © 1'984', "City Panel Studies No-Smoking Proposal," Los Angeles Daily Journal. cQ L984. "Watered Down No-Smoking, Law Gets Preliminary OK,"' Loe Angeles Dovnt,oun News, c© 1984. -L. a. Council Acts To Limit Smoking At Places of Work: 10--1 Vote for' Measure," Los A ngeles Daily Journ al: cQ 1984, "CounciliAdopts Tough Law on Smoking on Job." Los Angeles, Times. cQ 1984! "Confiicts Mostly Solved: Few Fired' Up Over L.A. Sm'oking, Law,"' Los Angeles Times, ~¢Q 1984, "L.A. Council Acts To Ease Curbs on Smoking at Work: Victory for Btasiness." Los Angeles Daily Journal. Qc 1984. '"Tooacco Fir--Act. to Snuff Out Smoking Law: View Weakening of L.A. Plan as Just a First Step." Los Angeles Tirnes. Q 1'96-1, "No-Smoking Law Opponent Hosting Council at Resort," Los Angeles Timea, cQ 1984, "L.A. Strengthens Draft Ordinance To Curb Smoking: Penalty for Retaliation," Los Angeles Daily Journal, c© 1984. -Council Puts Some Muscle Back in L.A, Smoking Law," Los Angeles TimeJ, cQ1 1!984, "L.A. Approves Strict On-Job Smoking Law," Los Angeles Times, cQ 1984, "Bradley to Sign No»Sffioking Ordinance, Press Aide Sati-s:" Los Angelea, Time3, cQ 1984, "Law's Opposition Doused." Los Angeles Times, ® 1984. "Clock Running for No-Smoking P1ans,"' Los Angeles Daily Newa, © 1984. "Sffioking on Job: No More Ifs. Ands. Butts - It's Law," Loe Angeles Times, Qc 1'985, "A Month With Smoking Law: Problems Resolved Smoothl.•.' Lon Angeles Times, QQ 1985.

29 , ' 3e4reg,atiom, Prohibition knd' warmisnc ` Aublic ssntis+ent for prohibiting cigarette smoking in public places has. aofi risen significantly in th. past two years. If anything, 2t has declined some- Mhat. Cu the otiaer landl, there has been an appreciable rise in the n=ber of peoFle tibo favor segregation of public smokers to~separate sections or facilities. We think . the ty+o: tremds are conmected. We think the absence of any rise in sentiieent to out- 1ati smoking is d9:rsctly correlated with the fact that there exists an acceptable oltssnative in segreg,ated' public smoking areas. Shere is apajority approval' for segregating smokers in every one of the pwblic places we tested, and enrery, case represents a rise of sent3aent ove: two ?4:ars ago. (Question 26Y) _ 5mo'kiag~~ should be n_ ermj tted', .. In separate. section5 14nyvhere 1978 1976 1978 •1976' • s s • s Isn traLns, ai.-planes and buses 91 81 7' 16 Ia tbsaters 831 a1 11 15 ia saticq places 73 57' 25 39 at iadoor spor.inq events 73 67 22 28 At public s.etings 67 62 26 33 Ia train, plane, bus stati.orss 62' S4 34 42 In vcrk pl'aces or offices 61 52' 34 42 Ia barber oi beauty sbops 53 43 511 After asking about segregated facilities for pablic s=3ce;s, we asked N ~ ' ~ .::ely :rom a slig*stl'y long,er trfiether people thoughC amoking' should be banned snt~ ~ list that cozatainedl these same placts, as wel'1 as ot.5e:s. ~ ~. C C C A-10

?ON 1'3 the •zaldc=' rat=yory is down s'ignificantly. Incidkn2ally, people wtio aoke low tar cigazettes are sore uncomfortable about smobcing aroumd other people, w2uiSe more tvgulas cigarette smokers tha:o the average say they are seldom or never samcomfortable.. C oaLis a,ddiedi sensitivity of smokezs-one si'ght almost say 'isferiority ~lez of saoOcess'--i!s demonstrated by their actions when they ase indoors with other pecple and want a cig,arette. We askeA! 'Do you light up a cigarette without really thi,nking about it, oz do you look around and then decide whether it's okay, or do you ask i: others would mincii, or db you just not smoke?' When smo3cing indoors, do yvo.... (Qae,stioa 41) ~ 1976' 1976 1974 Light up 32' 29 36' c" Irao,k a+rouad' and then decide 27 27 29 Ask ot2sers 26 23' 199 ibt mokr 4. S S' Ix dspends 11 13 9 Doa 't ksoow/no azsswes e 2 1 •Ask ottoers' is the only eategoty with a significant iarrease over tMe past fo= years. Blacks, people aged 17 to 20 and'people wbo make less th,an, 57,000 a yearr all l'ight up mcre than tbe average without really thinking about it. womea do so less than the average. , In the same )iciad of situation, what does the non-smoker do? When scmemne is smoking iiodoors, do y,ou.... (Qaest,iasa 62) 1976 ' 1'9'7'6 1974 •' • • Ask aim to stop 5 5 4 Indicate disapp_oval without sayiaq so 10 9 8 N C N, to nove awa Zr 42 39' 41 ~ y y Doesn't matter 33 36' 40 La3oy it It depemds S 7 4 MIL~ (0 00' Don't ksaow/nc answer 4 3 2 A-14 -

1'6 Zt i& perhaps aotawortlay that, despite steadily incrsasing restrictions irposed by qowermment on ciqaretta emokinq, roughly twice as aany .timericans continue to call for more rathes than less controls--& ratio that bas- changed little over the p+ast tan years. Zbis clamor for stricter goverssmental controls is, of course, part ofa I larger movement involving the public's changing attitudies and expectations with respect to government and is r.at focused! exclusively on 11-~e cigarette iadustrf. As a satter of fact, controls related to cigarettes remain at the bottom of the list we have tested (although ci'garettes have for the first ti'ae drawn even with alcoriolic beserages). S'Me qoverxsnent should take more steps aqsinst (Q.7) 19781 1976 1974 1972 V % a _ i Gr,ime in the streets 82' 67 70 65 Narcotics addiction 76 63' 66 72 Water pollution S& 45 48' SI Erposure to :umes and ds}st on the job 53 36 35 sX' ?ood' additives 33 44 42 37 Xiz pollution 33 42 <Z 47 Use of Mari'juana 69~ 43 47 SO Aresariptioa drugs and sedicines 49i 39 35 36 Autooomile safe--Y 44 34 35 37 Alcoholic beverages _ 34 31 28 25 Cigarette smoking 34~ 29 24' 20 aeinq around people vhc are aaoking 2'S 22 17 7GC Ttse averag,e acceptance of these qoverraer.t controls over twelve selected 2iaz__--3s ~ is 511 and has risen 10 percentage points over the past two years. But the in- Mp in favor of governaent cont_-^ols over ciaarette smakir+g is only halr the crease • 3x ind'icates that question vas not asked in the study, in qtaesticn. ,-

t: ert5y ra~.'alesdi. To test reaction to such a proposal, we posed tw+o versions of aa question, about x4niform taacss to different halves of' ou: sanple. One-haL' was asktd their opiiuion of' a f sderal tax whieh wouldi raise the price of a pack of cigarettes throughout the nation to the level of tiew Yor3t State,, which is L"ie high- est in the nation. The olhez ha1f' of the sarspl'e was asked' their opinion of a tax arangement rrlaereby the cost of a, pack of cigarettes vculd me rediaced to the level of lbrth Grolin&, the lorrest in the nation. (Question 36) Cost of eicarettes brought. ~ Up to A1ew York Lbwsi to D+'ort1h Carolina To~_l ibn- bbn- Smok:e_-s smokers Total Smobce,s sacke.rs lavor 42 22 51 48 65 38 oppose 42 66 29 34 22 41 Donlt l=w,/no answer 2'6 12' 18 18 13 21 . Jk un.d,for.n cigarette tax to discourage boqtleggin3 is fsvored if the tax is lowered to the level of liorr~.~.2r Carolina. Opinion is divided ov+ez ra:isinq the tax to the level of Diew York. The lotives of smo,kess are aot hard to fatboa. They are opposed' to raisinq csgarette taxes and' in favor of lowering thca--by a:isost the same propor- tiomnc in reverse. Dtyn-smoDcers, on the other hamd, favor rai_- sing cigarette taxes and are of tr+o sSS.rsds about 1owerinq t2xm. Since they youl& pres=ably not pay cigarette taxes, one mrast assnme that their amtives involve t'he conviction that taxes will force smokers to quit. Interestingly, there is a hirst of the same eonwiction on the part of' smokezs wbo are thessselves trying to quit. They seem more disposed toward mi'gher taxes and mare opposed to lower taxes than are smke=s who hsve never tried to qudt--as much as to suggest that they secretly ?aope higher cigarette taxes will help them give up smo `1.izg.. llthaagh An+ericans as a.rhol'e (bat not smokers in partic,:la: ) are disposed to accept the i,dea of unifarm ci'qaretts taxes to discourage bootleggi:x,, there is A-28

r iobstassces vhicb pradiaces systiptrss li!ke a rasb, nausea, 2readaches, etc.' Tt,en vf asked a31 our rsspor.dents, •llrs you allergic to cigarette sunke or do you just fir.;:! It UnpltasaAt?' aoughly •ti of the mon-smokers in each half of the saaple said tha:t they rere auerqic.. Wett3r or ac+t these smokezs actually have am aSlergy to cigarette saobee is, of ea»se, a sedieas q4*stiom. Dut it seems elear that they truly believe: tbemse lves to have sucm a medical' oonditioa, for the same proport3on of them con- tiiaoe to describ their prflble3 as an allergy rather than mere aaaoyance even after the distinction bas been poiuted cut to t,hem. D6cb larger ra=bers of respoadients said they are 'aasr:oyec' by being near a pezson +r2io is smokiag eigarettes (Questio.n, 1'9). Jllmost no one (2s) finds it `pleasant' to be aear a pnrson who is smokiaq. Sixty percent of'noa-smokers say it is ammyiag, baL of those find it always so. Tn fact, 5% of smokers find' it annclring to be arouni' other smoke=s (92% aren't affected ome way or the 'ot3ier, and only, •4% find': it pleasant)~. But smnkinq is not by aWs+eans tbe aost troubiesome armcyasace (Qaestioa 11)ir anthitag so bad as a drivra: who refuses to dim bis heaClights at night, nQr a ~a~:ent who dcsesn't eon' ol ao a=_ly e3ild' in~ public. For ]1tae:icarss, smoking is sl'iqhtly' acrs annoyi.ag than si. .tL+.mg next to scmeoxie vbm mas an too such perfu:me or shaving lotion, and jus't a little sore anmoyiag than people rrho~ play t.sasis•.or radios an buses. iieves'tmeless, sMo:ce=s: are acutely aware of these aasnoyamces and fea_ s. We wanted to find out if all the iacreasiAg restrictiorss, taxes and prohibitioms on smokiaq have caused smoke=s to be sr:re careful aru!' sensitive about smckinq, or, wtether it has caused thea to be sere asrxoyed and agy'ressive abcut defer,dirnq, the!• rigbt to smoke!. It tvsns oi:t that smckess are in ao d to rebel against an,u- smobcing pressures. ( E A-12

Sioul'd smokers saoke :mre if there were ao cigarette tax? (Question 52) Yes 10% 3101 s0 Don't kncw,/no answer 10 1 esrtaia numbe.- said they wuld, indeed, saoke more if' there were cigarette tax 0 zelief--althoug2n the vast majori.ty denies t)iat. 8ut note that tt,is question deals with degrees of smoJcing w4ile the previous *ones have had to db~ with absolutes of =mo7cing and' aom-saobcing. It is possible that ciga; ette taxes ase more strongly CmirrelatrtWithclsanges o'f degree in saokingbehaecior tTMsan in absolute chanqesofs itatus Whatever the case, the quOstaan is prov+ocative as an indication of' s=kers, be~s about cigarette taxes and their effect on smo3cing behavior. Mhat does seea clsar, however, is that the series of questions is valuable as an i!ndication oi which seyments of the smrrkinq population are mcst a:fected' by dqarette.tax inereases. As'we have seen, light smokers (who also have a greater desire to quit smok:.n3) say they tirouldi give up smoking more readily, heavy, saokers auch less so. Yct:nger smokers seem nare vulnersble to price coraside:at.ions, while aany nare oldie.: smokers say they wuld contizsue. Blacks se= less able to predict what effect a tax increase might have, but they would probably ter,d to give up smk- Sng more so:tb&n whites. This study al'so eacplored pnblic reacti'on to another kindl of cigarette tax- the graduated tar tax. Or,der this scheme, a hig2ier tax would be~ imposed' on hi'gh tar eigarettes aald' a liowes t= on low tss ei'gaarettes. We asked half' tlie respondents to consider various a:g~aents favoring aM opposing the tax but'asked the entire saaple whethe'r they t2ought it war a, good idea or mt. There was less than majority ses:r.i- sent in f avo: of a graduated'. ta-- cigarette tax, al though there was slir,htly more acceptance of the idea amnq those wbo had' been given a chance to ronsider s+everal arquaoents pro aadl con.. a A-2'6

.34 (2d+estion 28'1 @a taxicabs stores ,, • Beauty parlors or barber sbsps S+r staur xats Sions outside rrhqre sxk3nq~ 4-s prohibited Should be recvlred Sts6uld not be :erul.-ed bbn- Dbin- 'lbtal Sa+okers s:aoks_-s 'ilotal SboDcers s=kers ~...... ~~ ~_,._. t f t . ~ 1 ~ '7 17 te . 10 11 10 ®8 88 s8 1'0 u . 1a d8 67 i8 10 II 9 90 ft 901 9 101 8 The assent is monolitra,ic. 7nd it sugges:.: a sbort tera tactic that might prove belpful in si'tuatioas vbe,re videspread ::ackiag restrictions are bei.-aq proposed. OQezators of restaurants, cabs and other public places aisd .ehic3es might be per- aitted to establish whatever sxkixq policy the: desi=e: 'Smcki.nq pestzitted',• '?b smokisr3 pes-aitted,• "Separate.facilitiss for smokars,• or 'Separate facilities for mn-smokrss'--aut vith the re3uire,meat that these smok3.:q coaditi.ar.s be posted aut- side the preaises for the eonv+aaiieacr of eustoaers. Our fiadimqs stiaSgost that such a aeasusw would receive widespread support. Wsxting Ubels on potentially hazardous pro+~acts have experienced isscreas- iaq acceptance. To place the cigarette .raraisag in context, we asked respondents to diecidie! whether eight different products should be banned, have varsaiag labels or no warti.nq labels. (Questiou 9) Rhe goweria-eat s*.ould faa the Prodiaet !+eqaire war-...iag la5els aot reTure wi-a=g 1'stels Don• t kssow/ no answer • ~ t t Cigarettes 1.2 82 ' 4 2 lricrvrrave overss 3 79 9 9 ia:r dyes 9 74 8 9 uaoho l 5 73 19 3 s+.cchar in 7 70 14 8 aaroscl caas 27 62 6 5 Tvt sets 1 51, 44 4 automobiles 1' 38 56 5 A-3 5

00k 3'3 2sasalt-I ~ Znz =c3;:srg in pabSic pLtces trlaere it is profii;ibited (Qnestion 29) 20tal S.oksrs 2an-=oksss 2+.ople dbo t2s,ink thaL smokers have aore of certain, Yir.ds of illnesses 1 People v2r think that any amwumt of' ssokiaq is danqerous 1 Faop e~~ v~ f~lyi~~a:ltly, oftea (ror~~~ than 3timesa 1~esr) 1 People ~o sat cut in restaurants 10 or anre tisies anomth l ?S~'_ bta.rnir Lbzn' t krjo.r/' tac answer 0 % s • 29 65 S 25 78 6'. C:? 37 S8 S'. 40 4 34. 6l S' 4z S~S 4 33 6~l Z'b~.re is a fa,irTy vid+e, assarasen~t of' groups which deviate fs~am the average on the question of fines as purcis2soes~t, aad their smtives .+o~sld seem to ranq~a all the way fz+am self-~:nterzst to paais2asent of smckers for tbe~ own good. Smc>kers, natural.ly ssiouqh~, areacrt infav or o.fjiailsentar~cesorfineslnr, illegal, smoki'ng vls~ilemrr- smo3c~ers atmd pec~ple vbo fly fairly often or dine ovt a great deal, ssay be pres=ed to be tnixsD~s.aq of t3am3:r own ocmfort aban s~os~e of them sndcrse fines for smc~k3:nq than the a~veraqe.oathrotherha~sd,per,~pl~e vi~2bo sayttsat, aasyaesocuitofsmokiiqi isI mha~gesoaxs~~ or that ssnkrss hsve wore of certain ltirdie~ of illnesses axe pres~~ably not tbinkimq j~xst of Lhasaselves vdasn they appro~ve of fiass for ille<pal smokinq, but .~ould a1s+o sees to ~~ve the well-being of the moker at beart,, whether be Zikes it or not,. Indieer~,, cc+~iassioi~ for smokers' is mt a quality that pervades this study. N Q i~at LAers is one ~rars, ~te., ilearly everyone apprAves: of' signs posted outside places N ~ tr}~e:re smcksnq is pror.ibited and this holds true tar' smoktz u~ noa-smokes aLke. ~ ~ ~ r ao A--34

T The New presss:res fiace our last study tsro years ago, there have been i'hcreasing pressures tor official restrictions on smoki'ng. Mr Secretary Gali_axso's recent wide ranging •florts are by, no 9eans anfique, notaritbstand3ng the fact that they w*^azate .rcar one of the hiqhest ranking officials in government. . '.his latest survey for Tae Tobacco Znstitute suggests that such pres- suras are aeceptable to ai substantial portion of the nation. S4* goe+ex-ment should conduct aati-smokimg c:mpaig;ns (0~24Y) Agrse 47% Disaqzee 43 Don''t kncrir/no aa'swer 30 Shis question is a restiteaent of aaother agree;/disagree question rrhich rre have ose+d in the past: 'Goveraa.ent neney sbovld be spent on aati-smotcimg caaPaiq!ns.' s.+caus+e of' the reference to spending tax dollars, fewer people agree with the old- •r wording of the questi'on; but the 35% who do agree with the statesaent a.re still figtificantly larger than, the 29% who agreed in 1'976. Nevertheless, the highez acceptance ot' aati-smkiag prograas in the qwestion, vrhich his no reference to spending, t:aar dollars suggests that government anti: smoking casnaigau may be vulnerable 'to charges of nnjustifie3 eapease. Sor the past eight years, about half of'the nation has been satisfied vitb governmnt cantrol's over cigarettes. 6cv~~ermest controls on cigarettes (Ip.23), 1'S N' C ~ 197'8' 1976 1974 1977 1'970 ~ ~ ~ Leave things as they are 49~ 46' 52 54 4i8 ~ fbre controls 32' 31 28 27 31 N 0 re.rer controls or gove.rn- stient sbouldt't be invo3v.Z! 14' 17 15 13' 15 a Don' t 1Caow/iso answ+er' S' 7' 4 5 7 A-16

Latg+.at period without sacsxing. (Quostion 47) . , n - 197'8 ~--- 1976 --- 1974 -- 1972 w- 1'970 -- ., • Caa tr.ek 16 16' 14 15 15 3•2' reeks 110 11 9 9 10 2 i-3 r,."a 9 0 8~ 10 110 3 - 4 aeeks 8' 9 8 & 9 1•3' aonths 1S 24 27 13 1S 3'1- 6 aoaths 20 11 13' 12 16 6- 12 acrnths 14 - 12 13 , 12' 12 .Over, aI year ' 17 18 I'e 18 13 DoW t lnow/no aasver 1 2 • 4 1 8tii.dian dayz .96 ' 51 69' 38 52 Z='idieatally, low tar cigaratte mmokars can quit a lot longer (89 days) than smokers of cigarettes with regular tar, contant (36'days). 8i=ty-onr gercent (Question 44) of fi:ty-sevea millica smnY.e. s(Questian 38) tril us that they tzi.d to quit smokinq an average of' 1.84, times (Question 46). Zbat is sore tham 64,000,000 unsinccesslul attempt.s to quit smoking,. Oee might mot be surprised to fiadi, therefore, t3Lat many smokers consider saaoking an addiction rather than a habit. Actually, aorr non-smokers consider it an.addiction than do smokers and, neither group considers i't the best description. Sabit or addiction (Question 32)' Mc,m- Total Smckers smokers • % 1 Eabit 501 37' 45 Addiction 29 22 33 uitbier 2 4 1! iioth (~rol. ) 17' 15' 18 Dcsn "t knone/ao anssw~er 2 1 3. A-45 I i

10i Smokino kn9 poittinq : 'ihe percemtagt ot people in our st;adies who say they sa+eke, isi today at tbs lowast level since we began tasting in 29b8.: 37%. (Because of rounding, this liqurs arpears to be the same as our finding in 1976, but ii acL71ality it is nearly 8 oehols percentage point lass.) Of course, not too ssuch should be madk o:' sueh . slight fluctuations because they stiay be sxplained by saig error. Oni the other bar.d''r 7iowsd oves a tan y,ear, pexiod the treod' seems unmista3:ably down. Yhere are, nevertheless more smckers today taari two years agp because of the rise in population. Dsing the latest Census Bureau est!imates tor, the apgrop- riate time periods in question which include the part of the population ia our itudy, the percentage im our studies proj'ect as followsz • 37,63'3,000, sankers in 1978 58,923,000, smokers in 1976' $'9,882,000 smokers in 1974' 51,700,000 smokers in 1972 54,012,000 ssnkers in 1970 Si,038,000 smokers in 1968 By the same token, there are more ncu-s=kers thanever before because of tbe decline ofl the percentaqe who smoke and al'so because of the population i,u- erwse. Xn iaportaat exception to this apparent pattern of decline in smckers is the 17 to 24 year old age group which shows a sarked rise over the past two years in ssmking participation and in the number of cigarettes sme3cbd per day. + S+ome of these estimates are slightly different than those reported'previouslv because they are based on later U.S. Census estim.tes for the periods in ques.ion. gut these stifnor variations do not alter our previous aasalyses. N O N ~ ~ N N (7) A-3'8

10 Even t.':e ccrvi-_:os has r_s~en ten poir.tr si-:e 1974 _'- a.~ o~:qq ~:..o'l;e-s, .. ... , _ still & n:•r.or:yo uoi'r.ion. But s.ore t:L.ass t•aM cut of r.on-s-ore-s 5el:eve that they are ha,.^.aed by cigarette snok . Snokers .3or.-str,o?a _ r s 1'9'78 19-16 1974 1976~ 1976 ' 19": . ~' ~ +! 1 t +l' Probably is hazardous 40 38 30 69: 61 57 Probably doesm't have any real' effeC' S0 53 64 23'. 32' 37 Don:'t )caow/no~ answer 10 8 7' 8 .:' 6 Thi''s sharp rise in the rno:.uer of people who believe t`ia: v-c_= sao!e::: haras arv health has made a whole new bal'1 game oz:t of the acr.4-sr.nk:.r.; ca=.pa:,.... ~ tso matter hoW' many people believe tLat smoking is ?n;r_ious to the srokers' owa health (more than ai.e out of ten do+--see Question 1'6) , t:-3at, in the -.rie:+ of' =any, is the sao'kers' owa business and t.*.us~ a matter for pe_sor.al rat.':e= than qz1kTes _e::__1 ccnt=ol. &ut or._e s-okiaq' becomes widely t.'iouQ::= of as a p.ubli: .`.eai_~ 'rsacz.=f, then the jtst'i_:ca_ion for legal measi:res aSaixst cica:et_e sales and use has -::ee_ established. Anc:he= ,uestion in this re;==t (Q+sest-on 30 osn, the ":C" :o=) st.ows t_'za: the s`.xornqest arquaera eited 5y' smokers ar.d' rion-=okers aZ,:-.<e in :avcr o: passi:.y laws against r...ok_.^g in public is the _act that "the health of tson-s~k~-s is hazaed by other peo=le saoking i.'Z their presence.'' T.,;1.-ty-twree percent o: :»e pr.b:lic believes that: and t:is is the fist time' that passive s=ici ; has been _':: ent against sr+oD;:r.g iz p~l:e places. 1L-.o`aer 22% say t.'ie s_o-,_st ntimsber one az,_,n as;urie-_ for .a:c:.; public s:ok:aq aleral is that "soz:e r.on-srekers are to tcbacco soke," ..v To tes t whet`e'r this °.-cWen_ c'---.. _c ==z=e _te =cke al'_e_- e=: e- sse.^.t'S sc.^..eth:.:j .:..._e t:':an ]S3I5: aC'S.=YZl:: _. 'de e'X71---: ed tcc^o-h_' of CL:r s_ ="e o: =eswnder._s (f;,-'e==_ors 3_) that "3n a2.le_;_1 is' a ' :v'sl_cc.I re3C._-C^ _.. c_ ___ . A-11

9 DLTIKIIED 3l2AZYS I'S non*Smokers' Ri4hts '!~e onerwhelming aajority of Anesicans todaybelieves that samking is dwoqerous to their bealth. This sixth in & series of studies of public attitudes tmrrard cigarette asr+okimq oncx again underseores that geaeral conviction, and its 8ocumentation nas been relegated to a later, a3nor position in this report because it oontaims little that is new.. Yhat i~s aewr today is the growiryq oontrov+ezsy ov,er +rhethe=, smokinq is dangerous to aon-smokers' bealt2i. Xnd if it is darogerous, then to what extent is it & personal responsibility to avoid the danger rather than a government responsi- bility to pro2si.bit tbe danger? And if it is serely annoyismg, tlnen to what estent sAould the sajority satisfy its oomfort at the expense of the mimarity? fieanwhile, the vbole eontrvversy takes: p1'act within an atmosphere of in- csasing offic3,al' sanctions and social presssires: against sn+okimg, and this study rill investigate these pherycmera as well. lbst 3mesicaass are «omviaced that it is probably hazardous to their, heal'*.2ih to be around, people vho are smokinr,, even if they are not theaselves =okiloc,. This view has risen by six percentage points since 1976, ttwelve sinor 2964. And the opposite belief' that smoking promably doesn't have amy real, eff ct on the bealth of aon--jmokess is driwn fifteen percentage points since 1974, to a low of 33%. Ys believe it would be diLtficult to ovrsemphasize the importanc+e of this finding, indicatinq, as it does that tMe battle to convince the public of the dangers of passive smoleimg' is in tbe process of' being lost,, it indeed it is not already over. Is smokimg ha2ardous to non- smokess' bealth?' (Q.211) 1978 1!9'716' 1974 s s a C, C c> Probably is hazardious S8 52 46 ?robably, doesn't have any real effect 33'. 40 48 ~ ~ L1oa't krx)+r/nc sasver 9 8 6: ~. ~ a-im

2025684138 ------- - --------- --

52 ifhAt do! yon think they a:s 8ciaq about it (Queatsioa 72) • 'P+mtal kezs Sm !'b'a-smokers 1978 1976 1974 1972 1970 1968 _ 24k:nq acme Worts 50 j*'3 45 S0 51 48 418 52 0 m't' d0iDQ sflch of ' awfthi.a9' 39 47 44 37' 36. 35 30 26 01nrkiaq, hard •, 6 7' 8 10 13 Le 1s DOn't kmW,/no :rLSVer • 3 4 .3 4' 4 s A-53

. /1 dj b-ofprs, hoalth prr.+bl=s ramk fi_st as a raa3on for z,tiaittisg, just as they do wit2s Gmckeza who say they are msking less. •Z1 of sz+oka;!s cite health raasons.. lor quitters, doctors advising aqainst s=+oking is isportant, but not so much as 1t sa.d to, be. Sut bothgovezzament reports on the effects of smokimg on 2ne.alth. W the varni'sygs of friends are increasingly parsuasive. Zov+Qwer, neither sm:okers aor non-saokers believe that increasing re- strictioas, taxes and prohibitions on saoking rri11 be an istportant reason for pec7pl e to, quit ssaoking. ('¢Qestions 51, 64) Increasinq pres~surel~s~s wi~ll' mak~e~~ smokers~ Quit' amtioking 1io't Q171t, saoking Do;A- t' knCV,/ no answeT Smo7rers 9 7 8 12 )ioa-smokers 12 75 . 13 On the o+ther, haasd, smokers rsao thought that increasing restrictions aight cause people to, quit bad theoselves tried to stop more so than the avezage., Si.milarly, smokera eho did not think the restrictions rAuld make people stop smoking, were aore likely not to try to quit themselves.

r 20 TSais solid approval of trut2l in adv,ertising as regards public ser~~ice 3.sisaq+es suggests that there may be public support for taking legal acti!on, wiL.%i the M and'for deasanding corrective advertising the Aext ti.ze non-profit organi- sations or the~ qovernment~ misrepresentthe facts~~, amout~ smo~king~~ and heal~th., 'Z'aere is only a minority of the public that trould he willing ta cnn- sider a aovel hiring practice iatroduced' by the Pire Caief' of Alexandria, Qirq,ini'a, Qdarfias Fula, v2w rejects job applications from anyone who saokes ciqarettes, pipes or cigars. G"iiet Rml., .iso ended 23, yeazs of ' pipe smok.ing, last Otaly,puttlqe 2ianinto sf factbecause, besaid,he did not want to~ subsidizell dis~ ahility retirsaeints for heart aru3 lung ai.laents. • We asked whether an employer had the right to refuse, to .mploy a number of diflaresat kinds of people. Dbss an smployer have the rignt' to refusetohire someone wlio~.... (¢zsstipn5Y Does Does not Ho. o inion A ` - Saokes cigarettes 22 76 ' 3 Drinkssoaeti.aew 25 71 1 Drives motorcycl'e 9 88 2 Zs ov+er 65 26 6~8 6 Ss a teenager 26' 69 5' 2s an atneiit 15'~ 79 6 Zsahomosexual Zs' blaek 28' 1'S 6p 87' 12 1 Is physically handicxpped' 21 70 7 Zs a woman of childbeari.zq age! 35 82 3 ' This kind' of hiring practice, it r+ould appea:, is not very tol_rahle to most. tV Izericars, ranging from a 2'8A acceptance when apr::ed to, 5oa,cse.xsals on dorr to a ~. 9% accep:arnce vhe::e~ motorcycl'istsart concerned..Sooke_sscore soWewhere in t!:a aiddleof that range. GO ~ ~ A-21 N'

.. Sar' content of cigarattss tiQssstion SC Lov Reqular E1c regular brand or Don't know/ no amswer • '11oLa1 36 ' 41 24 37 - 24 27' 49. 23 ---- - 25 aad tap 38 39 23 lliale 29 47 . 24' tsmal'e 43 35 23. 31ack 30 43 27' Mlai ts 37 410 23 VCmen sooke more lov tar ci'garettes than they do the reqnlar content brands and older smokers are about evenly divided_as to preference for tar pntent. we seation lov tar cigarette smokers in this sectian because they are potential ca.garette qttitters. More than the a!ve-age, they have read something that torri'ed tbem about smokingi, tlsey, believe it is definitely true that sa+ckers have more of certain kinds of illnesses, that smoking is the ma j;os cause of those ill- nssses assd t2n_t any amosant of' smokir,g is bazardous. And more of them than the averaepe have tried to quit smckinq. Since low tar smokers are an expanding share o'f the aarke=, their greater desire! to quit smoking poses a special probl'em fbrr the eigaretts industry. As in past studies, ve: find that ec-smokers report that they smokec more beav!ily at the' time they quit than the average of current smakers (27.7 cigarettes per day for quitters as coag,ared vith 23*9 per day for esurent smokers). As we havesuggestad bafor,et this, aaybe trme, be.auae: peopleriso quit really veresmQkimc, more h.avily. Ctt the other hand, it is more likely that ex-sankers te'rsd to exagger- ats their past cnns=p2ion vhereas current amckers tend to miniaize it. 2ie ==ber of' ex-ssaokers who report that they have quit s=king within tbe past year is perhaps up semetilaat since two years ago.

19 We tested the acceptability of aoti-cigarettw education by placing it 1a context witsi other kinds of' prflg:aas at various levels of' instruction. Re- spomdents reti asked to suggest the earliest qxad'e level ae wf,ich vazious subjects '~bould be taught in school--•or don't ycno tMirsk it shoui'd be taught in school at a117•' (Question 10) _Zar_ liest srrade I'evell tariaur.-uctionr concer:Ina S.x Damgers~ of' Dangers Diriver of Religxous in- e+dueati.oea ...__..._ drinking, ~ . trzininGgsro3cing structiM % _ t • i 1 Cradks 1 - 3' 14 17' 1 27 48 Grades 4' - 6 2W 32 1 318~ 11 Grades 7' - 9 31 36 ' 23 25' 4 Grades 10 - 22 12 10 71 6 2 nottaughnt h 3 1 2 28. Dion't k.vow/m answer 5 2 2 2' 6 CS'aarly, there was no objection to aoursesabout the dangers of smokiag.*Aidie. Zrom rei!i'g,ious, instruction and sexeducatioa,, the oaly' apparent opositio:n was to driver trair•L^:g in grades one thzrvugh six. !rt if Americans support aati-ssaokiAg education and anti-smokirrg cam- paigas,, they f.elscrongly thatadNercising, sessages by th+e! goverzxoent aad'hy pisblic interest groups likt the Canear Society or Ralph lsader, ought to be seasured by the same standkrds which~ the lederal Trade Coaasission imposes on G elaims by private ad4ertisvrs. ~ T"iX regulation of all advertisi'ng?, (Q.e) Q N Zas 70V GA 11o 1S ~ s~re Doa't k w/ 15 ~ no no aa r Ira' • 8ad' we asked taal: the respandien_s .rMetlier they would' be wi1liJ:ngi to use , 1 ic educatiorn ftrnds foz anti-cigarette education, we might have found' stststan:ially less support, as was the case vrhe.Z we asked about spar.ding tax dollars for arati- smekinr, caaspaigr.s inrtead' of' ae_ eiy conduc ting such caapaigns (see c==ents above on Question 24!Y) . . 0. A-20

,13 ,Oa^roroz-forbiddir,q it.*. :"„iiafissdiraqtbat oo= ron-srao9crrs would prefer to avoid ciq;arette smoDciagrather tlaus, taksactioaagainst it,, is inherent, in theidiea of' coa- seni'ent aaAidancam oa. asa p3e ix the Qradcminarit preference for avoidance in QnestS+an 62, wbera we fo=d that aoat amn-=:okers, .xen ltidoors, would 'try to mcv~e praye trca anooYiag ciqarstts socke rather than ma3ce a, acene. On the other harx3, the avoidar.ca, cal be too trQublesome or cause~non-swkers to altu tbeir, babitss v,s.arially. Ye ttsiss4c the results for Q¢aestian 37 above would' have been quite different if we had' asked abotat 'GbTdenrod grflwimg in a Eity gark' or Raather pil.Iaows in a bospital wara.` In such cases, the avoidability factor would have been r,educed'l and t3ie, possibility, of iacaaveaieaceaade qarealeer.Takess in this sease, ttaem,, snti-smokinq sentiment can be viewed as a con- tiautm dependent on convemient avoidance, ramqiaq, all the way from the 86% wto are vi1ling Lol ban amoking in e;levators (vhereavo3idability is almost, nil) tothe11% q rialimq to forbidcigarl iathis question (whereavoirdabilityismta'se•,.or),,Inideedl, the Frinciplc of' Convenient ]lwoi'dance underlies this enti.re e2tiapter awi h+el!ps to eacpla'fn, we be]:ieve,, other aajor developmen!rs,, swch as the empargence of subsuntial opposition to passive smokimq and, of cossrse, the ris,ir,g prefereace for ssgre+gation ofsnoki'ng; rather t~~saaoutrig3at prohibition. 'lbis study b+al found a decided grefer.eace for seq,reqati.ag smokers, but very little approval for drastic esafo;rcement aeaslares, ite asked' respondents what they thooqht the penalty sA©tald be for smokinq where it is prohibited by law. •'i'ldis 11% is probably the bedrock sentiment in favor of banning ciga.-ette s=king nnder _ drc~st~^.crs. Compare it with the 12% ' in f'i!vor cofbanning ciyazettesitsstead of, r'ecT+,¢iLl w~-:uasq, labelsi.n,'Question 9 =6 the 16's.rtso ttiizk alawsl be passed aqaizst the sale of' cigarettes in QEaestion 24. A-33

/ON . par•aittsd,' •5sparate facilities fpr smckers,• or •Sepasate faciSities for soon-smakers•--buit with the requirement that the smoking coryditions that apply be posted outsidia the preim:ises for tfie eonve2sience and pro- l..ctioa of' mokezs "' aoa-smokazs ali'ke. 3. Za vilev of the vidkspread public belief that pabli'c sez- •ics advertIsing by non-profit organizations s3=eld be subject to the same 7'i+C scrutiny as ocmmnercial advertising, we think it sight be d+esirable to ac+isil'y file an action vrit.b tbe M the next time public sezvice adVertsising sisquotes the facts about smokir,g, and' health, and to further demar,d that tbe !'iC ' require the offesodizsg, or+lanization to run •corrective• advertisiagias Listerine has been required' to do. •, lifbile the peblic widely supports goveznent proywaras to discouraqe cigarette smokisY?,, a sajority opposes spending tax dollars for such a program--vliieh, suggests such pscqrams sight be vsalnerable if people Mese made avaxe ot' theiz rnsts. 0 O C C' S,. Ssvesal questians in this study suggest that vhe,: e there is substantial support for gowerna+erst action against cigarette smok.inc,, there is a disce..~^nibl'e decline of such support when people are made aware of the othrs govrsnment iatrusions that aight follow. '%Mere vrill it all amd?• a,bght be effective in blunting assti-smo Xiaq regulation. f. Anot2irs short rstge tactic is suggested by the questi.on oeocexaiag •fmsaphcbes,•' The fiadings suggest that there is the possi- bSl'ity of dividing those who are relatively unexcitad about the passive ~. 0 smoking issue from the anti-sacking sealots, by poatrayi:nq, these zealots ~ as pecpl'e with an unreasonable fear of cigar ette smcycirg. ~ s s s . . ~ ~ But we would repeat t`sat since the anti-smoks ~*.g, forces have now gone 7 a losr., N way in oonv:.ncirAg, the mon-saoDce.r that his health, too, is at staDce, the muarbzs one A-8

/k. 21 One other QoS,nt. Uherr th,is qtiaes~aon ras asked in the field (&s with a., mvmbet of other sd'mi!l!ar cases iw this study) the order of the phrases was re- versed tor one-half'of the respondents, beginninq with womer. of childbearing age ~d proceeding~from the bottom to the top of the list. idzen this is done, people sra slightly less likely tors~use =ployment to ssokers--presumably because, sf•er consideriiag a sn;mbe: oS' similar situations, they are better able to see the situation as a kind of'job discrimirnation rather than as a case of saving money on disability payments. 'This question suggests a.short range tactic that may moderate the grovingg acceptance of restrictions on smo3cing. Ytien the restriction is presented first-- assd therefore aut of context-it.finds fairly general acceptance. But when it is suggested after, a series of'other similar restrictions, we think we see evidence ofan attitude that seems to say •Where will ail thisemd?'Ferhapsa snccessfuli pro-smoking campaign would be one which pointed out that restrictions on, smoking aerely open the door to intrusive restrictions about other public activity which some people might find uzutt-active or annoying. the lire Caia: who refuses to e=ploy smoke:s in order to save mcney on disability payments is not very mwcls different from a government which tries to stcp sackinq because it places a bnrden on welfare paymsznts, .etezaas' 2aospfital!s,, Nrdicai'd and' other health programs. Ye asked respondents whether they tlaought. the govezna+e n: has the right to eontrol tihe amount a person smokes and also about E` C_` other activities which iight contribute to the taxpayers' slsare of health costs.

(Question 27) ~ !hc+usld' :m+oki'rq, be~~. 3+astsed'. lb2. barosoed 19'79 1976 ' • 1978 1976 - S 7 Zn elevators Tm, doetors * or de,rrttist:s ~ waitizg rocros 69 s. 65 u 27 30 Zatetail stores SS' 52 41 44' In ttieatrsx 44 446 47 42 7lt iadoor' spoxtirq events 34 37 57' 49 it p:b1ic meetiaqs 32 34 58 52 Iacity,, state or fsderal builainqs 22 32' 63 62 Sataxis 31 30 64 65. Ia traias, piat4es, buses 26 25 6S Za ea+tiMg places 23 . 22 68 6t Za barlier or beauty shoQs 21 2a 70 65 2a work places or offices 17 17 73 68 In t;aia,, pl'are, b%s ststions 16 16 7'S' 69 2h"e vas V*xy little cha.nqe troa tWo years aqo, and most of ' it sisht be expTained by' saaplisq error alone. Dnt if there was a discernible isaczea:s+e in sesatimeat for smoikiryq, prohibitions, it ax:ld be fo=d' in pl,aces wbere separats facilities are not really a practical solution: placts like elevators, d+octors' waitiaq rooms, taxis or setail stores,. iie tbink the sequences of questions is iimportas4t bese, also. W+e asked about barunit'sg ciqarettRs ~ z:ee had esplmred the question of seqreg,ated s=k:.ng, areas. Bad we asked about ba:sciizq before me_~tiorLir:g, the acceptabl& a2.e=native of segregation, the semtiaent' for ban:xinq taigh't have been substzntially bi.ghe_. taote also that i`' there were a few, iastassces af, iacsease in ban sesstsient, they were re- latsd to ttyose places which had sot been merntioned earlier as ca,r.didates for segre- Saaan.A-31

1'e At the saae time, the r.asommost often selected in occ,o~ sition to laws against smo0ciriq does not dispute the: contantion of harm t.c others, it mearly aryues that such restrictions eanmt be enforced against 55 mSlliomsmokers,. Rnd the next sost popular arqument is in the same vein: the police would have to Vpsnd too much time aad mpney' tryisag to ersforce such laws. hirtYne_-:anre, the argu- sent with the greatest loss of'support since 1976 claims that the problem has a social solution: fewer people feel ttsat smoDcing in public places is a question of ea4rtesy azd ac>t of l*rgislation. All of wbichAoes not mean that the American public is prepared'to sup- port a law against the sale of' e3igarettes. Cf eight possible goverisaental restric- tions suggested in this survey, outlswing cigarettes had the least support. A law should be passed against the sale of'al'1 cigarettes (Q.24h). 1978~ 1976 19'74' 1972 19'70 7lgree 16 11 12' 13 15 Di'sagree 76 82 82 82 79 L1o'n''t kaaw/r.o answer 8 6 5' 6 6 Qn the other laatad, there was near uaaa,nimous acceptzaacs of the idea ttiat cigasette advertisitsq should contain cigarette warainqs--ia fact, most people favor a stronge:r wrninq, label than the present oa~e. There was substantial support for packaqe labels stowissg, nicotine and tar eontesstr, assd a,Lmost as high a preference for & legal lfsait an tar and' nicotine. A bare aajbrity rculd ban cigarette machis:es to make it aore difficost for minors to pasrchase ciqarettes. Turthes, there apFears to be, substantial suppo.~- for some of the more r e- cent aori-ciqa:rt:e mea ures. One withextensive and long-te:a i'mpl:caticns in- N 0 .olves Sscretaryc Cal'ano's plan for a six-fold i=rease of the tunds that t.ye De- pastment of Hea1Lh, F.ducatiben and Yelfare spends each year on anti-smoJc_nq e.:for =s in ttse:schools. A-1'9

of estiaation, oonsumption for 17 to 24 ymar alds i's up over the past tz+o yea.s any,- %*ur+s fzom Lwto thrse and a quarter cigwrettes per day. . Viewed over the longer period of tsn years, the rise in smoking and z,ckers s=rsq the 17' to 24 year old group is not so~ drazatic and other patterns seem aore prsdamni.aamt. parceat who smke (Qvestion ;8) 29'78 1976 1974 1 972 1970 1968 Zlotal 37 „ 37 41 39 39 41 hg6 groups 27' - 20 38 35' 40 31 40 34' 2.1 - 24 44' 41 39 45' 42 51 25 - 34' 37' 40 48 46: 43 49 35 - 49 44 44 49 47' 45 47 SCaad'over 3t4 ~ 31 31 29 ~ 31 31 Level of education coll.ge 28 33 37' 34 31 37 High scbool ~ 43 41 43' 43 44 45 Grade sctscol or less 33' 33 39 33 31 Sex 4 xale 39 41 46 43 44' 47 Tamale 35 34' 36 35 34 35 . Ybn-sa+okers in th,i~s study tend to be older, college .dwcatezl, conserva- Live, and live vest of the ltississi;ppi, and ia~ rural aarkets. Dc-smkers, as a subgroup, ar. also coilege .ducatad liviag tirest of' the liississippi, but particu- larly aales, whose ssnoking has drelinesi' steadily over the years while femaSe smcking~ has remaiAe_ relatively constasat. Za this study smckers were asked'' whether they are smoking mere or, less movr ca=pared' to a year ago. A-40

I !~ackirq lLs A iLta2thProbl-s . . The belief that smokinq is hazardous to health is tiov alaost totally icasptsd by7lmeri'cans. This vi!t+rpoiat prevails by a sargi'n ofl over nine to• oa~e. 47 Moreovsr, asaxly two out of' three people vlya believe ss+okirog is hazardous to health also believe that any aaexnt of smnDciag is darqerous, aot merely beawy smoking. go+r hazardous is aaakirq7 . (Question 16) 1'9'T8 1976 1974 1972 1970 % 1 t ' %I 1 Jlr:y am"nt _ 6l 54 54 48 47 Caly b'e'aroy' smoking 3'l 38 39 42 45 ' Dbt bazardnes 5 4 4 6 S' Doo't hacw/no ansver 4' 4 3 4 3 aaL'• the populiatioa also believes that it sukes a, great deal of diffar- sncK in personal longevity whether or not a person smokes a pack of cigarettes a a,ay. 3ssd this convi!cti'on is in second place smdonq seietted' health hazardt, up a significantly since two years ago, riakes a greit deal of dif f ersncm in longevity (QuestS+on 12) . 2f a person lives wder a lot of tension aasdl stess If' a p+rson smoka& a pack ot' cigarettes aI day' Zt'a persoa regularly sats a lot of food vith high cholesterol 2f a person drinks 3 or 4 bi'ghb lls a di.y, If a person dflesni''t get roqular esercise Zf a persan is 20, pounds ov+erwe3ght 1978 1976 1974 1972 1970 • % s s • 74 76 74 72 ' 69 So 45 44, 42 4,2 43 39 38 34 31 39 37 35 34 29 ~ 34 33 38 38 49 Q ~ ~ 24 24 25 26 23 ~ ~ N ~ ~ A-48'.

• iriL's the rastsiction:s ars they did with the Vdlstead Act, Scokers vho want to dli'ne, }iorlc or, travel aith~ ncA-su+okers say beea.e fed up with havisr7 to fcreqo s=king. Sba-mckazs vmo wa,nt to dine, vArk or travel with smokers say bec=e fad up with haviacg; to eadure "t2se exta smobca that exists in segregated smokiaq _acilities. Eoth oould' say `!o bell with it a11' and go bac'!c to a smokinq aaiyvt3ere sent3.-aerst. aut if L-Ae aati-se~ekiaq forces are successful in conpiaciar r,oin-smokers that their health is in danger, it's at least as Iikely that the seatit:eat for seSreq,ated' facilities viill be strerxqtbened. arsd if segregated facilities do not aca:asplists the aati-saekirsq forces' desire of a,akinq ser,regated smok:r+q so untessable that smokers rrill qive it up, the next step eov ld' be as out icpht ban. Zf' mn- seokers are by then canwinced that it's tlseir health that is at stake, the present seatimeat for separate facilities emald' beczrme support for a total ban. , The strateqic and' loaq' run antidote to the ;wwsive 'smoki,aq issue is, as ( we see it, dev+elopinq and widely pssblicisi:oq clear-cut, credible, medical erideace ` that passive smoki--q is mt harmtul to the aon-smo6cr.r•s health. tlh.tle that should be the fondamental objective of the tcbacco irsdtast-y in o%tz opiaion, this study suggests that there are soae short teszs tactical approaches that say slow the effor-tw of' the aati-smokizq forces and bay the iadustcy the necessary tiae to dievelop What we sec as the fundamental esidernce needed to reverse& tbe trend. &tt they are tactical and short terza in character. A=a3 these short raiaqe ta;ti'cs are tbe folloWrinq : l. Where outriqht be= an smckimq are proposed and appear li]SsLy, of' passage, the i'mdustry a:ould' propose separate facilities (as the lesser of taro evils) . 2. Wbere I+iltv Jers.y-type leq:slat'•on appears to be a real possibility, the imau:s'try a.iqht gxomcse t.'zat ope:ators of restas:rar.ts, cabs and ot2her public 'iAstitutiosss' be persitted to establish whatever smokinq policy they desire--'Smokirog perait:eG anyti+here,• •:tie saolcrag. A-7

r 24 ?bese data, we th.inkr s3=uld be ass.alyzed' cautiously. Zn the first placti, the tax rises in question fraaed themselves in the aind of' the respondent as a sudden eont:ast rrithreality and' Aot--as stight well' be the actual' case-as an atti'tude a!volv+td o4er' a fairly Lorg time aad' after suall step-by-step tax increases that ;ccoaVaay geretal price rises on all products diae, to inflation. The question was a.lso posed as an intellaetual hypothesis without any reference to the eaotional sad psycholWical satisfactions usually associated with saok9sn. &nd, quite pr+cabably, these findings reflect a certain amcunt of rejection of the idea of tax l;nceases o: any kind. lbst politieal poll takers rould' be hard pressed to th3rJe of ar.y question inwplvimg taX increases that might elicit a genuinely favorable response. Quite possibly here a certain nuiataes of smoke_-s are expressing d1staste for taz rises pex'se by opting for alternatives-in this case the only aiternati've: givinq, up smok:.ag. itbstever' the escplarution, an addit3ional' insight is suggested by a_-zotber question from this study.' One sdght reasonably arque that, if oost really, does . c.zsrreZatt strongly with giving up eigarettes, then nou-sa+okers might tell us that they would start smokirnp if' cigarette taxes were lifted. eut such is not the ease. tiouLd noa-saokers start szokinq if there were ae tax on cigarettes? (Questiion 57) Zes 2% sb 92 Doa •'t kaoW/ho answer 6 oirtually no mon-smo0cn:s tbought the elimiss.et;on of c_'gr:rette taxes would eacourage tbea to tiks up smo0ciacg. 3actiher piece! of evidence eoncersing, this compl,ex qaestion is suYplied' N by the compasLien to the last question: would smckers sr,ck_ more i: there ve_ e no: © cigarette taAC?' A-25'

. 1te consider this finding, important, especially in its yaplications for a tobacw industxy postsare. tiherei outr:ight prohibitions of :mokisu}, are being p.-o-, s. posed'., separate facilities might be "gested' as a more popular and s+ore acceptable altsrtaativs. :l Anothez" factor in the equation of cigarette opposi'ti= was tested in Question 37, where we as3ced' about the personal responsibility for avoidance of . atMyior or hazardous sit4ations. We told' respoxadents 'Some people are: allergic to galden.-,od. Do you thirsk sueh, people should take it upon themselves to avoid qolde:arod, or, do you think that a2lor.-ing goldenrod to grow in a field slsould be forbidden by lav?" x similar example tras cited concerning allierg;ie& to~ teather pilZows and then to eiqa_-ett,es. ivoida=e vs. prohibition • (Question 37) Cro idenr od s /ok ?satfiers~ Qiga_ ettes Peop:Ieshomld avoid 85 94 85 Sbould be forbidd'e:n S' 2 Lbm't kacwlno asoswe~~.r 6 4 4 A substantial majority lsels that it is the personal responsibility of allesgy suffererx to avoid irsitating situations. Reversing the order of the questions had littlr elfect_om this se::timent., fts last three questions (Questions 2167, 27' and 37) when taken togetlse: Suggest to us' that there is a fundamesatal principle ussderlyir,g the mechanies of cigarette opposi'tion: Ufhat we eall the Ttiest of Co'nv+e:Lient Avoidance. tjest people. .rt,oasw allsrgSc to feathers a+tedaotbevict.imi.zed; by~ feathe.r pillpvs,theyh,ave only to avoid the problea by selecting ar»ther' pillov, Szcs*:Sarly, few people are forced to pass by golderrad'l qrowitaq xild in a, field; the simplest antidbte for suffsrers is to avoid the vicinity. Zn,ttae question abbmve,. having menr.ionsed Smplyinq iacoove:3's.'nce, we find 05% will:.ng, to avoid cigarette smoke and Q. A-32

3mokiaq ~~ a+cre~ or ~ lsss thsn, a year~ ago (Qsest:ao 39) riorei Less Same. . . ~, • ~ s s 2972 2!4 14' 7,2 2'974 23 18 68 1976' 12 17 70. 1978 21 17 721 ' ~ A44 17 • 21 21' 12 65 Lo+r' tar smskers 11 _ 21 68 Don "t know/ ao answer . ~ 1 s Otu consistent tindiag, over the years has been that s,ost s=kers cla:a they are sa+ckiag less, aot more, than they,' were a year ago. This, despite the lsct that co:asuimptioa vfthin their respective groups may mot crontira such a per- asptioa. I'ta the case of younger s=kers, however, the opposite is true. They feel th.mselves to be smckisbg murh more and, tsnaloubtedly, they are, s3ssce many of thca •as~ mot too far anray lram their first gradual initiation to sa,okiug. On the other bamd, the 17 to 24 year old'group does.tsot smoke as many cigarettes per day a& do! older, smokers-they coasume anywliere! lsom l~ to almost 3 ciga.rettes less oa the average. ^hus, v!iile tM& 17 to 24 year, old category6as four gercentage points ncre ss+okers than the average, (21 to 24, has se!venpoints more) they d'o, not s=ke so much. By sach o!' three srthods of estimating daily cigarette consuim-ption, low tar smokers cons=e less than the average aus+ber of cigarettes per day and even less than regular brassd' smmkers. . , Zacidenta2ly, youroqer people do not eXpecially sreke low tar ciigaret.es. They much pref er the reqular tar brarsds..

2025684154 - ------------- -

STATES PLAC1NG LIMITATIONS ON SMiO'KING IN PUBLIC PLAC'ES. ALASKA M'dNNESOTA A'R I ZONA MIOINTANA. ARKANSAS NEBRASKA CALIFORNIA NEVADA COLORADO NEW HAMPSHIRE COiNNE'CTPC'.UT NEW JERSEY DELAWARE NEW YORK DISTRICT OF COLUMBIA NORTH DAKOTA FLOR'IDA' OiHIO GEOR'GIA OKLAHOMA' HAWAII OREGON I DAHO P'E'NNSYLVAN I1A IOW'A RHODE ISLAND KANSAS SOUTH DAKOTA K E N T U C'K Y' T'E X AS MAINE UTAH MARYLAND WISCONSIN MASSACHUESETTS ' ' WASHI'N!GTON MICHIGAN STATES WITH LAWS' ADDiRES'SING SMOKING IN THE WORKPLACE ALASKA (,198!4') CALIFORNIA (state employees only) CONNECTICUT (119'83) FLORIDA (1 1985!). HAWAII ('state employees only) MAINE (1985) M~I NN'E'SOTA (1975) NEBRASKA, G1980~) NEW JERSEY' (1985) UTAH (1,976)

to^ Oiveat.5e1'sss, 4u1'1y •6V of oaar sa--z23: used the siord aadd:iction to dlescri,be saokinc,, p1t,Aer aq,re+eiz-q rith that description or roluntaeriaq the opinion that smoking is batli a hha,bilt and, an, addiction. LasgiLa t3ia sGatist.ics vbic2rt dcw-umeat coatinuedl nnsuccessfial sfforts to give up cigarettes, smckers vbo persist are in the lonq run a3aos: as likeiy to lucceed as to fail. Ru cusrsat study indicates th~ odds. Quitting CQUestiaas 38,1 44, SB), Seo3c.rs iever tsied, to quit 15% Stiscll but tailed 22 11oo-snakers " Tried and succe,oded 20 8eqer smked' 43 Of the smaller suYsqsoup of' smokess who evar tri.d' to quit, 47% told us they succeeded while 53% said they lailyd. Uordiar to ss if there bad' been -aay change in the reasons why people give IIp smokiag, ve repeated in this stttdy a question which had beeess used last in 397<~. Siaasuns for quitting • (¢oestion 61) 1978 1974 19722970, s s s . Bea1Llr problesos 37 38 40 39 DbcWrs advisiaq against smckiaq 19 23 19 19 Gavernment reports on the effects of saekitig, en health 17' l+l ~ 1't ?ri'end3 or'rslati.es urging qudtrinq, smokinq 1'b 1'3 12 1'2~ Zbt erpense of smoking 12 13' 1S' 13 Qaildrea obj ectinq' ta, parents saokirrq 5' 6 4 8 3 sa+a k:nq clinic 1 Zz" ne 7oe 3oae 21 20 21' 21 Don't kmotiJm answer 2 3 1 l •' = i'ndicates that question was not asked in the study in question. A-46'

•38 ftcking aaeong the qeneral' popcnlatioq anid aaong 27 to 24 year oi!ds (Qoestiorss 3'8, 42 ) . ]l1'_ls ee IT- 24 Per+oent• of tatal pocu* ' lation vlzo sao3ce 197$ 1976' G`s,aaqe . 36, 64 40'.8 %' 37.i 37.9 -0.8 +2.7 Wumser of ciqarettyes. smoked per day as •stiasa'ted by D!e t.'y,od l1 197 24.05 C1g3'. 21.16 Qig's. 1976 24.5'9 17.91 C~aqe -O. S4 +3. 25' Method B 197._~. 1976 Chang e 19.93,Cigs. 20.00 ~ -0.07' 28.40 Cigs. 15.821 +2.58 !!lrthfld C ..~.r~ 197'8 19.10 oi'g~a. 17.37 Cigs. 1976, 19.04 151.31 ~ Cb=ga~ 40. 016` +2.06 IIsingltleSargeoa Gsnsril•seethod' oW' cl'assificat:iontMetbod! A): rss3r.fir satsds,ily,eiqa;rettreoasuarptl+on, thesiediian numbar ofeiqzzettesconsumed daily by the populxt3on 17 yeac& old and older is 24.1, dbrrn a half a cigarette from the 24-6e'igarettesperday estlzatadl, in Crurstudy tyo years aro,. But using tvo~ otber, a0z.'c4a of sstimatiorn--methods ve feel greater comfidencre, in (rethocs B ar.d C)-- aons=ption far the vrhole samle appears virtually uwnclbangied',.' But in eva.-j met.hod s Yt have also cansidereC the: possibility that the increased sensisiviry of smokers is sakinq them underreport smokiasq w2ume •ven aore so nov than in past years. ~~ A-39

24 R:ze graduated tar tax (Question 55) . Good.t,bt a Don't kncw/ idea goodl idea no a=~sver ~Am~oraq respondients who did not consider arq%zments 27 55 1s Jkcdr:g respondents who did '16oasider a y-uments' 32 S3 14' 'You ean't make people stop smok,inq so the next best thing is to make t`sem smoke ciqarrettss with less tar" was chosen as the strongest arg=ent by the forty-three percent of respocsdient,s who selected arquments f avorable to such a, tac. The most frequently selected arqaaeAt by the: sixty-t'^.ree percent who chose argutaersts opposed to the tax was: •Peopie have a right to smoke any cigarette they Vish." iaoke:s tended to dislike the idea of a gradusted tar tax, rangi'ng froa a 60% disapproval among lighfi smokers to a 73!1 rejection, rate among people who smoke lorty or morw cigarettes per day. Zow tar smckexs " non-saokers view t.SR proposal tri!t2a las distaste, alt3r)ough opponents stil'l enjoyed the: edge in eve.-y catetory with the possible exception of those people who feel the goverrmment's role with respect to cigarettes should be to ssspoae more controls. 3notlser tax proposal wh,ieh: has been put forward' rece-tly iznnrolues i..'1t^~. O s - ing a f*deral tax on cigarettes in such a way that the disparity, bbetween the various atate ¢igltrette taxes r+vu2d be equalized and the incentive for cig,arette boo tlegging e Ac,tuments in-faVCr of tax a. You eani't make: people stop smoking so: the next, best thing is to aa.: t2sem saoke cigarettes with less tar, b. It vill discouraqe aunufaeftrers from makirs high tar cigarettes. ~. J1rq%mer•ts aq,aLnst tax C ~. c. People have a right to smoke any ciqar'et te they wi'srh ~ ~ d. Ra,isir.g the tax on eer*aim ciga-rettes von"t change peopTe's . ~ preferesscss, it will jus_ tax some smokers more than o2:ze,s. ~ e. Mooody has yetproved thatts;r is, bad'for you. f. A lower tax on low tas' cigarettes wi31 es:couragr people to =okeoore ofthe= thanl everWore. A-27

Mre people th..- awer, boliave it is true that ...Aess haw+e aoa* ot , *ca.."aSa illr.zsses' than r,am,-swkars~, aora L"san tarae americans evt of five thirilc =, 3.oksss havi aore iilm+esses (gaestiaa 14Y 1978 1976 1974 197'2 .- 1970~ • • Dstiaitsly true 33~ . 31 31' 30 30 ?rob+ably' true 29 27' 27 26. 26 Pbssibly true 23 24. 27 26 26 mt trtoe! U 23 11 13 13 Dba't kmovr/'ao amsvrer 4 3 3' Oa the other hand, a aajcsri'ty of those who be:~: eve it is definitely, prct'sably os possibly ttue, see cigarette smo7c3:mq a& oae of szaay uases for the fact that ciga- setta ssokrss have aore of those illaesses, mst the aajor cause. ieokirxf as a cause fbr i11ness (O"s o, 15') 1•978 '1976 1974 1972 1970 t - % i • i % A sajor cause 27 23 23 21 24 O" of aany 51 51 55 54 52 11ot a causa 3 4 4' 5 3 Dma't knorr/ao amsver 3 3 - 3 3 3ut onay 3 percent sa+e cigarettes~ as mot a eaiase. Anarieaas; today tbiak (Question 18) that s.oking cigarettes is aore mare- !'tal to health thao drinkiog (swea sooltars think that) or .aybe even smokingi ssa.-ijuana. Zm both categories, belief in the UrA.tuiaess of cigarettes as oougared to! &inkiag amd saaijIuaas smoDcing has risea, ia thle past tWo years:. . On the positivo sidie, it shonld, be 2aotsd that selected oonresrsabanat prrsorsal' velfase (Question 6) are all down except for •erime in the streets•' ar,d `aaraotics addictioa.' Cigarette sa,obciacp ranks low aaosdg such concerns ('6w.h aorsg ttiosr tested) aadl is down significantly. is low cemp'ared! ta: aarrv other prob2ems, sees it as an evil. Thus the salience of the •eicyaret:e issz:e' Q. N 3at once it is fccused oa, n+ea,rly eve..-yoru Cfi[ ~. ~. ~ N W. A-49. W

A0MI_ ~ •r C Ci'ga.rattss have the highest a:cspt,ance anong, these products for Yarnisag labels and also the highest stppor: for sosae kind of gpvernnent liaitation over the product (94i). ~ Aat the very high acceptance of va_-ning labe ls for all of ' those p_ oducts (even 381% for axatomohil'es, presumably because youmight have an accident in one) ;aadicates that there is little milsage in the arg=ernt 2Tirst it's cigasettes, next ,. it wiIl be warning labels oa vhatsver.• M~e poblic seens satisfied' with .rarnirq labels on whatever. SeAtime--%t. Reversing the order of the p-odascts mentioned had little effect on, this C The relatively high ranking for banrsing, aerosol cans and the low ranking for TV sets are both interestin+g. They svg,3est .that pablic opinion conce.-n:irq the: prohibition of pctentiaLly 2'sazardous products dependls to soae extent on the ava: 1- ability of useful alternatives (as is the case with aesosol cans) " the perceptioa by the public of real dangers involv+ed' (which is uot the case with TV sets).Al- . though there are few saseful' alternatives to cigarettes, ttsere cer-tair.ly is a public awareness of potent.ial danger and this say acxuast for tbe modest seatiment for ma'k'Lmag tbsn illegal. Undoubtedl'y, the high Warnin3 label acceptance has se_-ved to reduce further efforts to outlaw cig,arettes. Ca the subject of cigarette warninq labels, we tested the prnposed neti label for cigarettes (Warrsaissg: Cigarette smoking, is diurerous to health, and may cause dieath fzom cancer, oorosszry heart disease, chronic bronchitis, pul=nary esphysieaa "'otMer diseases) against the present label (W'a_-ning: Zne Surgeon General has dietermined that cigarette smoking is daaaqe_-ous to your healta).the proposed label was a decided favorite, especially with iaon-snoxers. Old vs. proposed' varrsinul labels N Quesr-ion 25)1 ~ old R3-ocaosad Don "t know/ mo answies ~ 'ibt l 34 61 5' ~ ~ a sacck ers 47 47 5' r jV ibn-sa+o3ce= s 26 69 4 ~ A-3 6

C 51 8ince thwbegira%izq of' these stsdies for The Tobacco Iastitvts, re- ipoadents hav+e been asked what ttsy, think the tobacco i,ndustry itself believes about ,. the case against cigarettes-that they kao+r it's true but won't acsait it, or suspect it's true but don't think it has been prov+en, os don't beUeve it's true. Otnce again the rssults s2aow ar5athesirrrease in the percent arsstire/iag: 'xnov it's t.-ue,• up to . SO from S3's. Go.ly, 8% ansvered' the •don't believe i't's tszae'--dowss five points s'ince 1968',. 3bn-=okez,s eontisme: to be highly criti~cal of tobacco industry motiv!es,, risinq five points in the 'cnor it's true• category, since our last study in~ 1976. Yhat the tobacco industry beliRves about cigarettes (Question 71) Total Smokers 11on-sa+okers 19781976' 1974 , 1972 1970 1968 Tiaor+ it's t=ue 45 62 56 ' 52 SIO' 46' 46 36 iuspect lt's true Don't believe it's true 31 , 12 25 6 27 29 8 9 31 11 33 12 34 12 39 13. Dom't kncv/mo aassre: 1:1 7' 9 10 8' 10 7 11 Other grou!ps that are critical of the tobacco iridustry arntinue to be youmger people between the ages of 17 and 34, sien, people wmo saJre: ove:. $15,000 a ?sar, people rith a college education, or, bolding sanagerial or. Profcssioasal positions" liaally. respon3iants w2ao ans++rs that the tobacco imdust-y •Saaoars it's triae' or 'suspecr.s it's t-ve• are asked what they think the tobacvo i;ndustry iss dbizg aboat~ it-r+orSai'ng hard' tm find' aa, ans,wer, aa]d.mq some, efforts butcould do sore, or' aet, doing saach of' anything about it. Artsress to this question have: s?oovn a oon- tiauous erosiyon, since it was first asked isn. 1968. Cnly 71 of the 2,074 respondents vbo.veree asked' the question in this ss-.ad1y tsim3t the industry is rorkinr; hard to find amwers. Tlsera azt vir^..iaS2y as sany people vhe say the i:ndustsy is s+aJci:q usne tfforts: as say it"s' mt doing sues' o: aart.'sinq about it. ]1mong mn-smakers,. 'mt doing such, of any'•la::ng' is now a plura2.ity. C C A-52'

^ • Light Mtokars try to qui't aiore frequently t!= acdiazate smokers, and ~ Dodsrats mass smora than h"vy. { ' • IIw lomq ago vas the last time . =M triod-to stop smokinql. (Qu.sti,oa 45) 1-9/ 10-19;/ 20-39/' O+ver ~_ day day 40/day Total _ Lsst' 7roath, ~ 9~ 310 & 9 7 l- 3 aonths 1S' iS 1T 7 2'3 3- 6' soaths ls 12 - 7' 2 9 6' • 32 aaaths 2+1 23 17' 18 20 ~! . Z ys=s 19- 16 22 21 20 ~ 2• lfl ytars 10 17 23' 32 21 pwsr 10 yssrs S 6 13 11 lo Lba't imow/ao answer 2 1 * - l Si=lr-six percent of light ssaksrs tried to qRait sometime in the past yaar, 60% of sod!erats ssickers did, 41% s of propls vho ssnke frca ome to lass th+zmtwo packs a day " ttiod to quit last year amd only 36%of hsavy smokers tried to give up cigarettes in the last tyrelve aoaths. Locked at aa+ather vray, the last time a sediaa light smoker tried' to quitt packiaq' was less than siqht aaaths ago. Fvr saderate smo3cers it was a litrSe ower pia,e seaths ago. !or, a:iakers of f=o. 20 to 39 cigarettes a day, it his been a year •ad msarly five moaths, and tor ssnkers of forty Or' scre cigarettes daily, it has been a sediaa Liss; of one year aad' s3ght aoaths siacsi they tried to quit ssflkinq. ' &W once De tried, the ae."iaa smoker in 1978' vras able to go five aere days tritmaut smnkimq thaa his oountezpast could ttio years ago. . F: A-44 •

rc-=eekars (Questioa 59) 1978 1976 1974' 1972 1,970 1968 • i % ! • % Yixhia the last yeas 15 13. 14' 13 21 23 Ovar 1' rear# lasa than 2 14 1'3 10 SS }2 10 oftr' 27Saza 71 73 75 73 65 65 Lcm "t know/ao iasrrer 1 1 1 2 1 2 Sh+ese data arv aot sasy to amalyze, caasistiag as they do of shiftiaq aumsers of quitters, relapses and new cohorts of smokers. ?or esa~aple, ruriag, the period be- twoea 1968 and 1976p a total of 107; of the then existing ex-smokess re?ort that th4y quit duriaq the previous two Years, tvea allo.rsMg for the Chanqinq sise of' the populatioa, only .71% af, tbem can be found in this 1'978 study. There aaoe-a..-s to bayi been corss3,derabl'e hac3ulidiar,,. Ye asked' smokers vhether, they wanted to eoeatiane sanrskinq. would •scr, of 1l:ka to• q,iv+r it up or whether they would very saseh 1ike to quit. S.-six perQent of' ®okers would like to quit. !bv sueh mo, you raat to ;:Uit? (Question 43) Yaat to contiaue 31t Sort of like tD quit 32 Qary s~ach like to quit ' 29 LiJc+e to qnit' but can't 5 Ooa't ka,ar,/no answer 3 Smokers dividid thsmselves almost esactly into thirds om the issue, with sookers of 40 cigarettes a day or more vaAtitxy, to eoatinue and to quit in eqnai aubers, saokers of 20' ta+, 39 cigarettes a day •sort of vaatinq to quit' aore, and moderate smokers (10' -19, a day) raritinq mst to quit very such. Light smckers, Iike heavy saokers, Merw ot two s~iZSdis, vatntitaq, to quit and' wanting to continue ia almost equal n=bess. ~. Saokers irantiaq to quit also had read' or beard somethiaq that caused them to wo._ f ~ iore, felt that smkers aze prone to certain illnesses and that any amou*st o? ~ ~ saokinq is hazardous. ~ ~ ~ a-43 . jU ~

I 0 Elevators; Food markets and supermarkets; (.indbor),Servdce lines; Rest rooms (sometimes "public" onlj); Pharmacies; Buses and!other public transit vehicles and facilities. CAART,V - ENFORCEISNT: ERCEPTIONS: OTHER AREAS AFFECTED HNFORCEMENif: This column, indicates any, special enforcement mechanisms. A' violation, is usually an infraction; this is.true even if' "Infraction" is not specifically shown6 unlessi "misdemeanor" or "none" (inot a violation of law) appears. "Misdemeanor" means any violation is a misdemeanor. Many laws also provide that a, vi'olation ia a public nuisance and allow the city to abate it by the appropriate procedure. "Pub.Nuis." means individuals al'solhave this right. If a particular'of'fice or person!is given enforcement responsibility, that is shown here. "City t'lacager/comp,laint" means any person may initiate aa complaint with the city manager. "Bus.Lic." means compliance is a condition othaving,a business license. Self-certification.of compliance may be requiredc "Bus.Lic.Ren." means it,is required onilicense renewal; "Inspect" means required during otherwise mandated inspection by fire or health department. EXCEPTIONS: "Appl." indicates that an affected,business or facility may apply for a publiic hearing and, upon paying the applicable hearing fees and,making, certain showings which vary from place to p1'ace, may be granted'an exception6 "S3'gr"'indicates that a place may be exempted by posting,.a "smoking permitted" sign. OT}IER AFFEC'IM ARfiAS: Lists other places where smoking is,prohibited. F00'1N0'11F5 T0 CHA'RTS' I' - V + Revised information or new ordinance since~last revdsioniof chart. • Indicates city or county for which: we do not'have complete or most recent information. [1] Smoking prohibited'in all public places and places of employment except in designated smoking areas. Ordinances using,this languagg al'most always contain a list of' specific public places in which a smoking,area may not be designated~ and further restrictions affecting places of employment. [2] County population includes unincorporated:areas onl'y. [3J Year and month.of most recent addition or change. [4'] Exceptionsx Appl. - by application; Sign - by posting a sign. [5] Preference of a majority of'the nonsmokers shall prevail. [6J Workplace minimums are suggested, not required.. [7] If nonsmokers can not be otherwise.accommodated, smoking will be prohibited entirely. [8]! Retail' stores over 1,000 square feet. [9] Violation of the ratailiation, provision is a misdemeanor;,all other violations are infractions. (1i0i] No sections required but policy must be,posted. (I1] Exception can be al'lowed''for, certain places certified as meeting,a specific minimum air, circulation stantard. (121 Smoke free work area must be provided to any employee reques,ting,one im, writing. (13] Smoking is prohibited in all retail,stores, including pharmacies. [14] Smoking prohibited in inner hallh+ays~only,. [15] Private offices may be designated nonsmoking by the occupant. C'-3

Bibliography on Involuntary Smoking/March, 1986I Baker, R.R. Product formation mechanisms inside a burning cigarette. Prog,. Energy Combustion Sci. 7(2):135-15'3, 1981. Barad, C.B. Smoking on the job: the controversy heats up. Occup. Heal th Saf. . 48 (1)1: 21-241, 1979. Bardana, E.J., Jr. Effect of cigarette smoke on formaldehyde data (letter). J. Occup. Med. 26(6):410-411, 19'84. Barrows, W.R. Smokers', nonsmokers' rights collide in the work envi ron:nent. Occup. Health Saf. 54 ( 2): 31-3'3 , 1985. Basu!, P.K., Pimm, P.E., Shephard, R'.J'., Silverman, F. The effect of cigarette smoke on the human tear film. Can. J. Ophthalmol. 13 (1) : 22-26', 1978. Baumberger, J.P. The amount of smoke produced from, tobacco and i'ts absosptiom, in smoking,as determined by electrical precipitation. J. Pharmacol. Exp. Ther. 21:47-57, 1923. Bausnberger, J.P. The carbon monoxide content of tobacco smoke and its absorption on inhalation. J. Pharmacol. Exp. Thier. 21:23-34', 1923. Baumberger, J.P. The nicotine content of tobacco smoke. J. Pharmacol. Exp. Ther. 21:3I5-46, 1923. Baumgartner, E. Proceedings of the interna ional symposiuaa on medical perspectives on passive smoking; opening address. Prev. Med. 13:558, 1984'. Bavarian, Academy of Occupational and Social Medicine. Passive smoking at work. A survey and analysis from a medical and legal point of view. Munich: Bavarian Academy of Occupational and Social Medicine, 1977. 159 pp,. (German) . Becker, C.G., Dubin, T., Wiedemann, H.P. Hypersensitivity to tobacco antigen. Proc. Natl. Acad. Sci. USA 73(15)r1712-17'16, 1976. Beil, M. Smoking,, chronic airway disease and'lung,cancer. Prax. Pneumol. 29(',7):40'3-412, 1975. Ben Hassine, M.R., Ben Mi1ed', M.T., el Gharbi, T., Bea, Ayed,, N. Passive smoking in asthmatics. Tunis. Med. 62(,3'):251-154, 1984. (French) Benner, J., Keene, C.K., Holt, T.W. Smoke analysis, condensate preparation, and condensate fractionation. In: Proceedingis, 4th Tobacco Health WorkshoplConference. Lexington, Kentucky : Tobacco Health Research Institute, University of Kentucky, 1973. pp. 408- 420. Bennett, J.S. Sic transit non fumare (,ed!itorial). Can. Mied'. D -5

abbreviations and footnotes have been used extensively. The indicatiow "Yes" in a col'umn,means that smoking,is prohibited or restricted'in the corresponding,place, or that the law contains the corresponding provision. A, blank means that smoking is not regulated,in that place. Abbreviations specific to certainicolumns are explained below. Footnotes appear at the end of this text. CHART II - SUw11ARY,OF MAJOR PROVISIOYS For each city and county with a smoking ordinance, this chart shows whether the law restricts smoking inipri.ate workplaces, in retail stores,,andiin restaurants. This chart is similar to Chart I, but more information is given on the specific restrictions in each place. WORKPLACES RECULATEDs "All" indicates that all private workplaces are required to have a smoking policy. "All 4+" (for example) means that all private employers vithi4 or,more employees are covered. "Ofc." or "Ofc.Wkpl" means that the ordinance covers onIly office workplaces. RETAIL STORES: "Dept." means only department stores are affected. "Ai1Bus" means retail stores and all other'business establishments are affected. RESTAURANTS: Most entries in this coSumn show the minimum percentage of seats required in the nonsmoking,sectibn, and the minimum size of restaurants which are required to have a nonsmoking section. For eiample, "25Z'40,*" means restaurants with 40 or more,seats are required,to have at least 25Z of those seats in a(usual'ly contiguous) nonsmoking section. "NOx" indicates no minimum percentage; often there is a requirement for sufficient,nonsmoking seats to accommodate nonsmokers. If no restaurant size is shown. alll restaurants suat have a nonsmoking section. CHART IIP - SUt44ARY OF WORKPLACE PROVISIONS. This chart lists only those cities and counties with ordinances requiring all or most'employers to have a smoking policy in the workplace. A"Yes° in most col'umns indicates that smoking is prohi'bited in the indicated!area. Other abbreviations: WORKPLACES REGULA'TED: See Chart II above. Cafeteria: An entry in this column indikates the minimum percentage of cafeterias, lunchrooms and (usually) employee lounges required to be nonsmoking. Medicai' Facil.: "Yes" indicates smoking prohibited in medical facilities and' nurses aid stations. Mt¢. Rooms: "Yes" indllcates smoking prohibited in (usually all of)'meeting rooms, conference rooms and auditoriiums. Some ordinances allow for smoking by unanimous consent of'those present. DesiX. OwnArea: "Yes"'indicates that anlempl'oyee,can designate his/her immediate work area as a nonsmoking area6 Nonsmkr Prefnce: "Yes"'indicates that when a dispute arises under the workplace smoking policy, priority must be given to the nonsmokers. Some, ordinances require that,nonsmokers must be satisfied, even if this requires banning,smoking in a work area. Nonretal'n: "Yes" indicates that it is unlawful to dismiss or discriminatee against an employee for requesting,his/her rights under the smoking law. CflART'IV - OTHER PUBLIC PLACES .aF!Fr-C''ED A "Yes" indicates that smoking is prohibited inithe indicated places (abbreviated in column headings)I: Theaters (,sometimes exeepting,the Lobby); Museums, libraries and galleries; Public (i'.e., gavernment)~ meetings; C-2

BIBLIOGRAPHY ON INVOLUNTARY SMOKING Compiled by Stanton A.~ Glantz and' Lydia Jense~~n. University of California, San Francisco: March, 1'986 Aas, B. Motivating governments to act. In: S'teinfeld, J., Griffiths, Wi., Ball, I+c., Teylor, R.M. (eds.). Smoking,and health II. Health consequences, education, cessation activities, and governmental action. Vol. II. Proceedings of the 3rd'world conference on smoking and'health, New York City, June 2-5, 1975. DHEW Publication No. (NIH) 7'7-1413. pp. 959-963.. Abel, E.L. Smoking and reproductionc an annotated bibliography.. Boca Raton, Florida: CRC Press Inc., 1984. Abelin, T., Winethrich, P. Sample survey of smoking~habits: in the German, Frenoh, and Romansh speaking parts of Switzerland. Soz.. Praventivmed'. 2l1(1)':17=23', 1976. (German) Abelson, P.H. A damaging source of air pollution (editorialY. S'ci~ence 158 ( 38A6Y:1527 , 1967. Adams, J'.D1., LaVoie, E.J., Shigematsu, A., Owens, P., Hoffmann, D., Quinoline and methylquinolines~i'n cig,arette~smoke: coamparative data and the effect of filtration. J. Anal. Toxicol. 7(16),:293-296, November-December 1983. Ad'lkofer, F'., Scherer, G., von Hees, U. Passive smoking ,(,letter). N. Engl. Ji., Med. 31!2(11):719-720, March 14, 1985. Adlkofer, F., Scherer, G'., Heller, W.-D. Hydroxyproli~ne excretion in urine of smokers and passive smokers. Prev. Med. 13:670-679, 1984!. Adlkofer, F., Scherer, G., Wei'mann, H. Small-airways dysfunction in passive smokers (letter),. N. Engl. J. Med. 303(7)r392, 1980. Advisory CounciL on the Environment of Quebec. The use of tobacco in public places and protection of nonsmokers. The Government of Quebec, Publication.No. ISBN 2-550-00193'-I;" May 1979. 28'9 pp. Akh¢neteli, Mi.A. The report of a WHO expert commitee on smoking and its effect on health,. In: Steinfeld, J., Griffiths, Wi., Alarie, Y. Sensory irritation by airborne chemicals. CRC Crit. Rev. Toxicol. 2'( 3 ) : 2'99'-36'3 , 1971.. Alfheim,, I., Ramdahl, T. Contri'butioin oflwood combustion to indoor air pollution as measured by mutaigenicity iin Salmonellal and' polycycl'~ic aro:nati'c hydrocarbon con~centration. Eraviron. Mutagen. 6' ( 2):121, 130, '1984. r J American Academy of~ Pediatrics. Committee,~ on Genet~ics~ and ~i ~. ~ ~ D-1

0 Bibliography on Involuntary Smoking/March, 1986 Bland, M., Bewley, B.R., Pollard, V., Banks, M.H. Effect of children's and~ pa~rent~~s'~ smok~i~ng,on respirato~ry~syrtptoms~. Ar~ch:. Dis. Child. 53'(2):1O0i-105, 1978'.. Bleda, P.R., Sandman, P.H. In smoke's way: socioemotional reactions to another's smoking. J. Appl. Psychol. 62(4):452-458,. 1977. Blue, J.A. C'igarette asthma and tobacco allergy. Ann. Allergy 2'8(13):110-115, 1970. Biocaneg,ra,~ T.~S'.,, Espinoza, L.R. Raynaudi'~s, ph~en~om~enon~ in passive smokers (letter). N. Engl. Ji. Med. 303(24):1419, 1981. B!ock, F.G., Repace, J.L., and Lowrey, A.H. Nonsmokers and cigarette smoke: a modified perception of risk (letter). Science 215'(,45219),:197, 1982'.- Bogard, H., Shoenfeldi, Y., Pinkhas, J. Passive smoking (editorial). Harefuah C(7):3'45-34'7, 1981. (,Hebrew) Bogen, E. The composition of cigarets and cigaret smoke. JAMA 93(115'):1110-1114, 1929.. Bolin, J.F., Dahms, T.E'., Slavin, R.G. Effects of passive smoking on asthma, (abstract). J1. Allergy C9.in. Immunol. 6'3(3):151-152, 1979. Bonhami, G.H. Fasten your seat belts--no smoking. Br. Columbia Med. J. 1S(14):304-305', 1973. Bonham,, G.S~., Wilson, R.W. Minor error noted in study on child health in smokers' families (,letter). Am. J'. Public Health 72 ( 4 ) : 4!03', 19812. Bonham, G.S., Wilson, R.W. Children's heal'th in families with cigarette smokers. Am. J1. Public Health 71(3):2'90',293, 1981. . Bookman, R. Tobacco sensitivity (letter). Ann. Allergy 46(3):182, 1981. Bos, R.P., Henderson, P.T'. Genotoxic risk of passive smoking. Rev. Environ. Health 4(2):161-178, 1984. Bos, R.P1., Theuws, J.L.G., EBenderson, P.Thi. Excretion of mutagens in human urine after passive smoking,. Cancer Lett. 19(,1Y:85-90,. 1983. Bottoms, S.F., Ruhnert, B.R., Ruhnert, P.M., Reese,, A.Li. Maternal passive smoking and fetal serum thiocyanate levels. Am,. J. Obstet. Gynecol. 144 ( 7 )i:787-7'91', 1982'. Breisacher, PI. Neuropsychological effects of alir pollution. Am. 7 D-7

Co."JNINITY. Nr. places regulating: Antioch + Berkeley Brea Brentwood! Carlsbad C.rpbnteria + Cathedral City ChulaiVi'sta Clayton Concord' Coronado Cupertino Danville Del Mar El Cajon El Cerrito Escondido + Crand,Terrace Hemet Hercules ++ Huntington Beach Imperial Beach India Irvine La Mesa Lafayette Laguna Beach Livermore Long Beach + Los Altos Los Angeles Los Gatos Martinez + Menlo Park Mili Valley Milpitas Mountain Viiev - Nationail City Nevport'Beach, Oceanside + Orinda Palo Alto Pasadena, Pinoie Pittsburg Poway + Rancho Mirage Richmond Riverside Sacramento San Anselmo San Diego San Francisco San Jose San Luis Oblspo San Marcos San Pablo San Ramon Santa Barbara Santa CLara Santa Monica, Santee Tust3n! Ukiah Vi!sta Walnut Creek Yorba Linda County of Contra Costa County of Marin County of Orange County of'Riversi'de County of Secramento County of San Diego Caunty of,Santa Cruz CHART IV - OTHER PUBLIC PLACES AFFECfED, Thea- Museums Health Public Elevar Food Service Rest Pharma- BusJ ters b,Libr.Fac'Ity, Mtgs» tors' 1Bcts. Lines Rooms cies PubTran 73' 54 73' 67' 71 54 60 58' 45 52' Yes Tes Yes Yes, Yes Yes Yes, Yes~ Yes Yesi Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tes Yes Yes Yes (1l Yes Yes Yes [1] Yes Yes Yes Yes Yes Yes Yes, Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (1]'' Yes Tes Tes [I1]' Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yea Yes Yes Yes, Yes Yes Yes Yes Yes Yes Yes Yes Yes (1] Yes Yes Yes (1) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes(13] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tes [1J Tes Yes Yes (1] Yes Yes Yes Yes Yes Yes Yes Yes Yes -Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (II] Yes Yes Yes (1]' Yes Yes Yes Yes Yes Yes Yes [1] (1) (1] [1'1 (1] (1] (1) [1') (1] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tes Yes Yes Yes (1] Yes Yes Yes [1] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (1]' Yes Yes Yes (1], Yes Yes Yes Yes Yes Yes Yes Y!e.s Yes Yes Yes Tes Yes Yes Yes Yes Yes Yes Yes Yes Yes. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes, Yes Yes Yes Yes Tes Yes Yes 50% Yes Yes' Yes Ies Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tes Yes Yes Yes Yes Yes Yes Tes Yes 80% ' Yer Yes Yes Yes Yes Yes Yes. Yes Yes Yes Yes Yes Yes Yea Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes, [1] Yes Yes Yes (!1] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tes (1] Yes Yes Yes (,1] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes [1] Yes Yes Yes (1j Yes Yes Yes Yes Yes [I1] Yes (1)I Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Ies Yea Yes Yes Yes Tea Yes Yes Tes Yes Yes Yes Yes 1/3 Yes Yes Yes Yes Yes Yes [1] Yes Yes Yes [1] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes, Yes Yes Yes Yes (1] Yes Yes Yes [1] Yes Yes Yes Yes Tes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes. Yes Yes Yes Tes. Yes Yes Yes Yes Yes Yesi Yes Yes (1] Yes Yes Yes [11 Tes Yes Yes [ 1'] (1) (1] (1'] (ll [i1l [1] (1'1 [i'1 (1l1 Yes Yes Yes Yes Yes Yes, Yes Yes Yes Yes Yes Yes [I] Yes Yes Yes (1!] Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yiesi Yes. Yes Yes Yes Yes Yesi Yes Yes Yes, Yes Yes Yes, Yes Yes Yes, [1] Yes Yes Yes [',ll Yes' Yes Yes. Yes Yes Yes Yes Yes Yes Yes C-7

CALIFORNIA CITY A'ND COUNTY SMOKIYG OP:DINANCES Americans for'Nonsmokers' Rights 2054 University Avenue, Suite 500 Berkeley, CA'94704 (415) 841-31032 March 1, 1986 SUMMARY This set of charts summarizes the provisions of the significant city and county smoking,ordinances in Californ2a. State law regulates smoking,in supermarkets. health facilities, and public meetings: (Sqx nonsmoking) and'certain, parts of publicly owned buildings. Most localities regulate smoking in theaters. Many communities have enacted far stronger smokinglaws. To be incLuded in this compilation, an ordinance must affect either private workplaces, restaurants, or a substantial numberof significant public places. Among California cities and counties.atleast 74 cities and counties have asignificant nonsmoker protection law. 66 regulate smoking iniprivate workplaces. 62 require nonsmok4.ngsections in restaurants. 54 restrict smoking in retail stores. 44x ofthe population ofCal'i'fornia (11,296I,065 people) lives in a place where a smoking policy is required of private employers. We say "at least" because ordinances are now being enacted at the rate of severalia month. In additionto the jurisdictions counted'above, 6 counties have laws protecting only county, gpvernment employees. They are: Fresno County Lake County IasiAngeles County Monterre7, County, Orange County (also has publicplacesIaw) Yolo County (by resolution) '141E CHARTS I Five chartsare provided. They are: I' Cities and Counties with Ordinances III Summary of Major Provisions III, Workplace Provisimns IV Other Public Places V Enforcement; Exceptions; Other Places A Q!?ICL REFERENCE Chart I is; the "quick reference" for California,smoking ordlLnances. It lists all counties and cities with significant smoking,laws. It,shows population, county,and year and month (when known) of enactment of the most recent ordinance. It also tells whether the lav regulates smokingfor restaurantsy private employers and retail stores. MORE DETAILS Charts IIthrough V contain details of each smoking law. In, order to condense agreat deal of information into a small space, C'-1.

C CHART I: CALIFORNIA CIT'IES'AND COUNTIES WIITH SMOKING ORDINANCES COMMUNITY COUNTY POPULATION YSvtR/`lONTH PRIVATE RESTAURANTS RETAIL E."IACTED WORKPLACES STORES Nr. places regulating: 74 66 68 56 Anti'och Contra Costa 46,600 1985/11 Yes~ Yes: Yes + BerkeLey Alameda 106.500 1980 Yes~ Yes Yes Brea Orange 32,050 1985/07 Yes Brentwood Contra Costa 5,,150: 1'985/1'1, Yes Yes Yes Carlsbad San Diego 44,550 1'983/06 Yes Yes Yes Carpinteria Santa Barbara 11,400 1985/03 Yes + CathedraliCity' Riverside 16i,050, 1982/12 Chu1a Vista San Diego 90,300 1984 Yes Yes Yes Clayton Contra Costa 4,490 1985/11 Yes Yes Yes Concard' Contra Costa 105,000 1985/11 Yes Yes Yes Coronado San Diego 90,300 1984/08' Yes Yes Yes Cupertino Santa Clara 33,950 198'5/02I Yes Yesi Yes Danvi!11e. Contra Costa 27,600 1985/11 Yes Yes Yes, Del Nlar San Diego. 5,125 1983/06 Yes Yes Yes~ E1,Cajon San Diego 80,1100 1985 Yes Yes Yes El Cerrito, Contra Costa 23,300 1'985i/'lli' Yes Yes Yes Escondido San Diego 75,800 1'983112 Yes Yes Yes +.Grand Terrace San Bernardino 9,875 1'985/11 Yes Yes Yes Hemet Riverside 28,050 1985/05 Yes Yes Yes Hercurles Contra Costa 7,$00' 1985/10 Yes Yes Yes +*~Huatington Beach Orange 179,900 1986/02 Yes Yes Imperial Beach San Diego 24,550 1985/10 Yes Yes Yes Indio Riverside 28',200 1985/11, Yes Yes Yes Irvine, Orange 80,100 1985/10 Yes La' Itlesa San Diego 52,200 1984/02' Yes Yes Yes Lafayette Contra Costa 22,500 1985/10 Yes Yes: Yes Laguna Beach Orange 18,450 1985 Yes: Yes Livermore Alameda 52,100 1985/06 Yes Yes Yes Long, Beach Los Angeles 3811,800 1985/07 Yes Yes + Los Altos Santa Clara 27,400. 1'979 Yes Yes Yes Los Angeles Los Angeles 3',144,800 1984/11 Yes I:os' Gatos Santa Clara' 27„750' 1'980i/06 Yes Yes Yes Martinez Contra Costa 25,300~ 1!985/11 Yes Yes Yes + Menlo Park San Mateo 27,850, 1986/02 Yes Mill Vailey Harin 12,800 1982 Yes Mi'lp,itas Santa Clara 41,850 1985/08 Yes Yes Yes Mountain View SantaiClara 61,600 1984/06 Yes Yes Yes National City San Diego 51,200 1984/05' Yes Yes Yes Newport Beach Orange 66.100 1985/06 Yes Yes Oceanside San Diego 91,800 1983 Yes Yes Yes +-0rinda Contra Costa 15,000 1985/12 Yes~ Yes Yes Palo Alto Santa Clara 56,200 1983/i0, Yes: Yes Pasadena Los Angeles 126,600 1'984 Yes Yes Pinole Contra Costa 14,550 1985/1'11 Yes Yes Yes Pittsburg. Contra Costa 38,600 1'985/11i Yes Yes Yes ~ Poway San Diego 35.950: 1983/03 Yes Yes Yes + Rancho Mirage Riverside 7,575 1986/02 Yes Yes Yes Richmond Contra Costa 76.900' 1985i!09 Yes Yes Yes Riverside Riverside 1!83',400 1985/05: Yes Yes Yes Sacramento Sacramento 875,900 1985 Yes Yes Yes San Anselmo Marin 11,950 1985? San Diego San,Diego 971,600 1982/12' Yes Yes Yes San Francisco San Francisco~ 719;200 1983/11 Yes San Jose Santa C1ara 696,000 1984 Yes Yies, Yes San Luis Obispo S.Luis Obispo 37,150 198'5/1'2' Yes: Yes~ San Marcos San Diego 19,800 1983/03 Yes Yes Yes San Pablo Contra Costa 211,200 1985/10 Yes Yes Yesi San Ramon Contra Costa 23,450 1,985/'111~ Yes Yes Yes: Santa Barbara Santa Barbara 327,200. 1'984 Yes Yes ~J Santa Clara Santa Clara 89„000: 1'985/07 Yes Yes Yes Santa ttlonica Los Angeles 93,1'00: 1'985/04' Yes Santee San Diego 49,500, 1983/02 Yes Yes Yes Tustin Orange 40,800 1985/12 Yes Yes Yes Vf Ukiah Mend'ocino 13',050 1981/07 Yes Yes Yes ~ Vista San,D'ieg!o 43,450 1983/04 Yes Yes Yes VJ Walnut Creek Contra Costa 57,700 1985/11 Yes Yes Yes ~ Yorb'a Linda Orange 36,100 1985/09 Yes Yes Yes ~ County of Contra Costa [2] 139',800 1985/09 Yes Yes Yes County of 5larin (2] 62,500 1981/07 Yes Yes County of Orange (2] 294,900 1985/06 Yes: Yes /!+ Count'y, of Riverside [2] 323.500 1985 Yes Yes Yes. un County oflSacramento [2] 543,,500 1985/02, Yes: Yes Yes County of San Diego [2] 406,1100 1982/12 Yes Yes Yes County of Santa Cruz [2] 121!,300. 1985 Yes, Yes Yes C-4

Bibliography on Involuntary Smoking/Mar..ch, 19'86 Respiratory effects of household exposures to tobacco smoke and gas cooking. Am. Rev. Respir. Dis. 124(2):143-14'8, 1981. Commission of the European Communities. Report on the EC epidemiological survey on, the relationship between air pollution and respiratory health in primary school children. Blrussels: Commission of the European Communities, Environmental Research .. Programme, December 1983, pp. 215. Consentino, A.M. Environmental tobacco smoke and pulmonary function testing. Eur. J'. Respir. Dis. (Suppl.] 133:88-89, 19'84. Consumer Reports. The murky hazards of secondi-hand smoke. Consumers Reports pp. 81-84, February 1985. Conti, R., Fagioli, F., Pasquini!, R., Savino, A., S'icassellati Sforzoliini, G. Application of' the salmonella mi~crosome test' i,n the evaluation of the mutagenic activity ofl cigarette ssaoker the difference between sidestreamiand mainstream smoke. Ig. Mod. 73 (1) :10-27, 19801. Coodley, A. Effects of passive smoking (lietterY. N. Enlgl. J. Meld. 299 (16 1: 89'T, 19781. Copeland, G.K.E., Stockwell, P.B. Automatic large-scale analysis of cigarette smoke. In: Foreman, J.R., Stockwell, P.B., (eds.) Topics in automatic chemical analysis. Chichester, Eng. : Ellis Horwood, 1979; New York : Halsted Press, 1979. CCormia, F'.E., die Gara, P.F. Vesic'ulobullous diermatitils from tobacco smoke. JAMA 193(5):391-39'2, 1965.. Corn, M. Characteristics of tobacco sidestream smoke and factorss influencing its concentration and distribution in occupied spaces. Scand. Ji. Respir. Dis. SUppl. 91:21-36, 1974. Correa, P'., Pickle, L.W., Fontham, E., Lin, Y., Haienszel, W. Passive smoking and 1'ung cancer. Lancet 2(8350):5'95'-597, 1983. Cousin, Mi., Budwig, J. The smoke-containing atmos'phere or the smoke of others. Rehabilitation (Bonn) 25(11):34-3!6, 1972. (French) Cox, B.D., Whichelow, Mi.J. Carbon monoxide levels in the breath of smokers and' nonsmokers: effect of do:nestic heating sytems. J. Epidemiol. Community Health 3'9:75-78, 1985. Cross, F'.T'. Radioactivity in cigarette smoke issue. Health, Physics 48(1):20'5-208', 1984. Cucu, F. Carbon monoxilde and its implications in atherosclerosi!s ~ O etiopat}trogeny. Med. Interne 16(3):229-242, 1978. C!1 13 ~' N ~. ~ D-13

0 ' Sr.du'st-v L•save 7be laiaqo of' the tobacco indust.-y c»ntismues to deelirse arad its favor- ability rating is aow at the lowest point re hav+e yet mea.sured. Starting i'n 19+68, !tlisn cigarette sasaafactttrars were aakiaq a'deoidied'ly positive impressioa on t2se pub7:io, t3vr trand' has sloped dowravs,:dl,,, until our last stady, vdaen the bal.anee turned' iy.q;ttive. W+r, in this report, tbe original position in 19b8' is a.Iimost exactly za- Ti~cssd. , Tbe Tcbacco Industry (Question 73) . _ 1978 t 1976' 1974 1972. 1970 19'6e • s savorable 36 43 • 47' 47 • s8 51 Dalavcraale 51 48 45 42 42 37 Don't tnoer,/no answer 23 20 8 22 1m~ 11 tatiarab3lity index 42 dS 47 48 49 51 ''fhe faworability l:ndex is perhaPs a little mors sensitive toehadings of feelirqs *SOd is oosPutad' by giving 'vR.Ty favorable'' a rating of 100, 'moderately favorabl'e• a rating of 66 2/3rds, `tWt very favorable• a saore •af 33 1f3, and 'nc: at all favorab3,e'' a sero. Zhe favorability index among; smnke=s is 54 and among aon-smokers 35. Sbe sub9tatstia2 dzop in favorability between 1978 and 1976 is part of a qeneral' imaqK dlsalisye amoag controaersial' indiastries. Placing the public attitudle tovasd the tobaea industry in ooatext,, we have asked respondents their impression of bow Jatssestsd' a few mrjor ibdsastries are ia the safety and welfare of tbe people mt,c nss tbeir'products or services. A-50

Bibliography on Involuntary Simoking/Marchi, 1986 19 8 3' . Frisch, A.F., Francis, B.W., Chavis, M.K., Jenkins, R.W., Jr.. Cigarette smoke formation studies. VI-I. The fate of (5-14C)- Methoprene in ci'garette smoke. Bei!tr. Tabakforsch. Int. 11(4):203_ 206, 1982. F'rishman, W.H. Involuntary smoking: Cardiovascular effects of'. smoke on nonsmokets. Cardiovasc. Med. 4(13):28'9-292, 1979. Fulghum, Ji.E., Mitchell, R.Bl. Does my smoking bother you? It doesn't bother me as muchl as it is going to bother you. J. Fla.. Med. Assoc. 60(7'):91, 1973. Fulton, H.B. Jr. A pilot's guide to cabin ai!r quality and fire safety. NY State J. Med. 85(7'):184-38'8,, 1985. Gallup Opinon Index. Smoking in America: publi~c attitudes and behavior. Gallup Opinion Index 1978; 155:1-30, June 1978. Galuski'nova, V. 3, 4-Benzpyrene determination iin the smoky atmosphere of social meeting rooms and restaurants. A contribution to the problem of the noxiousness of so-called passive smoking. Neoplasma 11('5'):465-468I, 1964. Garfinkel, L., Auerbach, 0., Joubert, Li. Involuntary smoking and lung cancer: a case-control study. JNCI' 75'( 3')i:463-4'69, 1985. Garfinkel, L. Passive smoking and cancer--American, experiEnce. Prev. Med'. 13:691'-b]'9, 1984.. Garfinkel, L. Let us not be diverted! from the real problem. MW 123'(,40):1483-1484, 1981. (German). Garfinkel, L. Time trends in lung cancer mortality among, nonsmokers and a note on, passive smoking. JNCI 66(61)1:1061-1066,. 198'1. Garfinkel, L. Cancer mortality in nonsmokers: Prospective study by the American Cancer Society. JNCI 65:1169-117'3, 198,0. Garland, C., Bairrett-Connor, E; Suarez,, L., Criqui, M.H., Wingaird,. DL. Effects of passive smoking on ischemic heart disease mortality of nonsmokers. A prospective study. Am. J!. Epidmiol. 121(5):645- 650, 1985. Garrett, R.J.B., Jackson, M.A. Cigarette smoke and protein synthesis in the lung,. Environ. Resi. 2'1(2):399-406', 1980. GASP. Passive smoking: the facts. Bristol : Avon Area Healtli. Authority Education Service, 19'81. N Gavalov, S.Ml., Demchenko, A.E., Kaznachleeva, L.F., Gorshkova, N.F.R ~ 19 ~ ~ ~ N ~'. 4CO . D-L9

Bibliography on Involuntary Smoking/March, 1986 Environmental Hazards. The environmental consequences of tobacco, smoking: implications for public policies that affect the health of children. Pediatrics 7'0(',2):314-31'5, 1982. American Conference of Governmental Indiustrial' Hygienists. Threshold'liimit values for chemical substances and physical agents. in the workroom environment. Cincinnati : American Conference of Governmental Industrial Hygienists, 1981. American Conference of Government Indlustrial Hygienists. TLVs(IR)) thresholdil!imit values for chemical substances in workroom air adopted by the Ameriean Conference oflGovernment Industrial Hygienists for 19731. J. Occupi. Medi. 16 (i1) :39-49, 1974. American Society of'Heating, Refrigeration and Ventilation Engineers. Standards for natural and'mechanical ventilation.. ASHRAE Standard 62, New York, NY., 1973. Amindzhanov, S.A., Achilova, A.B., Rybin, I.S. Cigarette smoking and gastric functions (secretion and motility) in duodenal ulcer and some other diseases of the digestive organs. Ter. Arkh. 52(2):36'-3'9, 19'801. (Russian) Anderson, E.W., Andelman, R.J., Strauch,, J.M'., Fortuin,N.Ji., Knel'soni, Ji.H1. Effect of low-level carbon monoxide exposure on, onset and duration of angina pectoris. Ann. Intern. Med. 79'(1):46- 60, 1973. Anderson, G., Dalhamn, T. The risks to health of gass:!ve smoking. Lakartidningen 70, (',3'3):28I33'-2836, 1973'. (Swedish). Andren, A.W., Harri!ss, R.C'. Mercury content of tobaccos. Environ. Lett. 1(4):231-234!, 1971. Andresen, B.D., Ng, K.J., Iams, J.D., Bi!anchi'ne,, J.R. Cotinine in amniotic fluids from passive smokers (letter). Lancet 1(8275'):7911- 792', 1982. Anglenot, L. Chemical composition of tobacco smoke. J. Pharm. Belg. 38'( 31:172-180, 1981- ( French). Anglenot, L. Chemical composition of tobacco smoke. Rev. Med.. Liege 38'(17 )':632-6'40, 1983. ( F'renich ) Arany, S., Makleit, S., Szigeti, K. Analysis of'the physiologically active compounds in cigaret smoke. Dohanyipair (3):100-1013, 1983. (Hungiarian) Aronow, W.S. Effect of' carbon monoxide on cardiovascular disease. Prev. Med. 8( 3):27'1-278, 1979. Aronow, W.S. Effects of passive smoking (letter). N'. Engl. J. Med. 299(1i6'):897, 1978. 2. e C D-2

Bibliography on Involuntary Smoking/Marchi, 1986 Patrikeeva, I4.Mi. Passive tobacco smoking andi the incidence of bronchopulmonary pathology in children. Pediatriia (1) :32-34, 198'4. (Russian) Germouty, J, Malau'zat, C. The innocent victims of tobacco. Ji. Med. Chir. Pratiques 155(6'-7'):2'93-298, 19'84. (French) Gilder, S.S.B. The passive smoker. Can. Medi. Assoc. J. 109(11):,1084 and 1089, 1973. Gillis, C.R., Hole, D.J., Hawthorne, V.M., Boyle, P. The effect off environmental tobacco smoke in two urban communities in the west of Scotland. Eur.,J. Respir. D'is [Supplj 133:121-126, 1984. Glantz, S.A. What to do because evidence links involuntary (passive) smoking with lung cancer. West. J. Med. 140:636-637, 19'84. Glaatz, S.A. Health effects of ambient tobacco smoke In Indoor Air Quality. Walsh, P.J., Dudney, C.S. (ediltors) Boca Raton, Florida: CRC Press, 1984. Gliner, J.A., Raven, P'.8., Horvath, S.M., Drinkwater, B.L., Sutton, J.C. Man's physiologic response to long-term work during, thermal and pollutant stress. J. App1. Physiol. 3'9(4):628-632, 1975. Godin, G., Wright, G., Shephard, R.J. Urban exposure to carbon monoxide. Arch,. Environ. Health 25(5):305-313, 1'972'.. Gberth, C.R. Economics and court decisions leading to smoke-free workplace. Occup. Health,Saf. 53'(7):2'4, 27, 1984. Gordon, Guyatt H. and Newhouse, Michael T. Are active andi passive smoking harmful? Chest 88:3', September 1965. Gorski, T'. Pressence of polychlorinated dibenzo-P-dioxins CPCDDs) and polychlorinated dibenzofurans (PCDFs) in cigarette ash and pharmaceutical charcoal. Rocz. Panstw. Zakl. Hig. 3'5(13):2'39-241, 1984'. Gortmaker, S'.L,., Walker, D.K., Jacobs, F.H., Ruch-Ross, H. Parental smoking and the risk of childhood asthma. Am. J. Public Health 7'2 ( 6): 57'4-579, 198'2. Gostomzyk, Hi.-G. After all--is passive smoking not dangerous? MMW 1261(42):21-22, 1984. (German) Gostomzyk, H.-G. Sickness as a result of passive smoking?' (letter) MMW 124(4):11, 1982. (,German) Gosto:nzyk, .7.G'., Franck, R. Passive smoking from the medical viewpoint--results of a discussion among experts. Off. 20, c (I r D-20

:.~..J+.......:._..-._..~r+i::r.~ ~ .~~._r.. ~ _ -. . _ ~ - . . .. ~ CHART III: StiMt`4A'RY OF WORKPLACE PROVISIONS ` ' CO'L"ft3NITY' WORRPLACES Cafe- Rest Eleva-Medical Mtg. Hal1- Desig. Nonsmkr Nonre- REGULA'TED teria Rooms tors Facil. Rooms Ways OvnAreaPreface tal'w Nr. places regulating: 67 42 56 57 40 54 38' 40 43 25 Antioch All 4+ 40% Yes Yes Yes Yes Yes Yes Yes Yes + Berkeley A11 50% Yes Yes Yes Yes Yea Yes Tes Yes Brea Brentwood' All 4+ 40% Yes Yes Tes Yes Yes Yes Yes Yes Carlsbad A'1'1 (1]I Yes Yes Yes Carpinteria A'll (5i' + Cathedral City Ctiwia Vista , A,11 (1] Yes Yes Yes Clayton All 4+ 40% ' Yes Yes Yes Yes Yes Yes Yes Yes Concord All 4+ Coronado All [1'] 4Dw Yes Yes Yes, Yes Yes Yea Yes Yes Yes Yes Yes Cupertino Ofc.Wkpl. 2/3 Yes Yes Yes Yes Yes Yes Yes Danville A11,4+ 40% Yes Yes Yes Yes Yes Yes Yes Yes Dei!Msr All (1j Yes Yes Yes E2'Ca,ion All 5+ 2/3 Yes Yes Yes El Cerrito All 4+ 40R Yes Yes Yes Yes Yes Yes Yes Yes Escondido All (I 1]' Yes Yes Yes + Grand Terrace All [61 50Z Yes Yes Yes Yes Yes Yes Yes C Hemet A,11! (11 Hercules A11'4+ 40Z' Yes, Yes Y!es' Yes Yes Yes Yes Yes +; Huntington Beach All 4+ Yes Yes Imperial Beach A11 (1] Yes Yes Yes Indio A11 (6'] 502 Yes Yes Yes Yes Yes Yes Yes Irvine La Mesai A11 [1] Yes Yes Yes Lafayette All 4+ 40% Yes Yes Yes Yes Yes Yes Yes Yes Laguna Beach Ofc.Srkpl'. 1/2 Yes Tes Yes Yes Yes Yes Yes Livermore All 50% Yes Yes Yes Yes Yes Yes Yes Yes Long Beach All 5+ 1/2 Yes Yes Yes Yes Yes Yes Yes + Los Altos All Los Angeles, AQl' 5+ 2/3' Yes Yes Yes Yes Los Gatos All Martinez A11'4+ 40% ' Yes Yes Yes Yes Yes Yes Yes Yes + Menlo Park Mill Valle7 Milpitas • Aa'1, 75x Yes Tes Yes Yes Yes Yes Yes Mountain View A11' 1/2 Yes Yes Yes Yes Yes Yes Yes National CitY, All [1] Yes Yes Yes Newport Beach Ofc. > 4 Yes Oceanside A11,[1] Yes Yes Yes + Orinda, All 4+ 40% Yes Yes Yes Yes Yes Yes Yes Yes. Palo Alto Ofc.Wkp1. 2/3 Yes Yes Yes Yes Yes Yes Yes Pasadena Ofc.Wkp1. 50% Yes Yes Yes Yes Yes Yes Yes Pinole All 4+ 40S Yes Yes Yes Yes Yes Yes Yes Yes. Pittsburg, A'll, 4+ 40% Yes Yes Yes Yes Yes Yes Yes Yes. Po.ray All' [11 Yes Yes Yes + Rancho Mirage All'[1] Yes Richsond All 4+ 402 ' Yes Tes Tes Yes Yes Yes Yes Yes Riverside A11 [6] 507. Yes Yes Yes Yes Yes Yes Yes Sacramento All [1] 1/2 Yes Yes Yes Yes Yes Yes San, Anselbo San,Diiego All [1!] Tes Yes Tes SaniFrancisco Ofc.Wicpl. [71 (7) (7) [71. [7']I [7l [7'] Yes(7] San ./ose All 2/3 Yes Yes Yes Yes Yes Yes Yes San Luis Obispo All 5+f [7] (7') (7) [7J (7'j [7] [7] Yes[7] San Marcos All [1], Yes Yes Yes San Pablo All 4+ 401. Yes Yes Yes Yes Yes Yes Yes Yes San Ramon, All 4+ 40: Yes Yes Yes Yes Yes Yes Yes Yes Santa Barbara All [7)I [l]I [7]I [ 7]I [7j [7] ('7jl Yes[7jl Santa Clara All 2/3' Yes Yes Yes Yes Yes Yes Santa Monica All 6+ Santee A11, ('1] 2/3' Yes Yes Yes Yes Yes Yes Yes N Tustiln Alli [1] Ukiah A'l'l (1Z] [,1'2] Vista All [1] Yes Yes Yes Vl 'Walnut Creek, All 4+ 4,0% Yes Yes Yes Yes Yes Yes Yes Yes ~ Yorba Linda All 11+ 50% Yes Yes Yes Yes Yes Yes Yes VM , County of ContralCosta All 4+ 40Z Yes Yes Yes Yes Yes Yes Yes Yes W County of Mar,in ' A ~ County of Orange Co.Gov[1i1 County of Riiverside All,[6'J 501. Yes Yes Yes Yea Yes Yes Yes County of Sacramento All (1J, 1/2 Yes Yes Yes Yes Yes Yes W1 A11 (1] County of' San Die Yes Yes Yes Q , , , go County of'Santa C'ruz All 50Z Yes Yes Yes Yes Yes Yes Yes Yes C-6

Bibliography on -Involuntary Smoking/March, 1986 Doyle, N.C'. Pipe & cigar smoking--is it safe? Am. Lung Assoc. '. Bull. 60 ( 2 ) :12-13, 1974. Dri, E.A., Cheddie, M. Substance abuse and the prenatal employee: A nursing diagnosis perspective. Occup. Health Nurs. 32(9):485- 488, 497, 1984. Dubli~n, W.B. Unwilling s:noking, ('letter)'. Calif. Med. 117(1):7'6- 7'7, 1972. Duncan, D. B. , Greaney, PI. P'. Passive smoking and' uptake of' carbon monoxide in flight attendants (letter). JAMA 251(2'0):2658-26I59, 198'4. Dutau, G., Corberand, J., Leophonte, P., Roichiccioli, P. Respiratory signs linkedi to passive inhalation of tobacco smoke in infants. Poumon Coeur 3'5(2):63-69, 1979. (French) Dutau, G., Corberand, J., Enij'aume, C., Rochiccioli, P. Passive inhalation of tobacco smoke in, preschool children. Clinical andd biological study. Rev. Ft. Mal. Respir. 6:549-553, 1978. Dutau, G., Corberand, J'. Respiratory manifestati'ons in the preschool child caused by the passive inhalation of cigarette smoke. Rev. Med. Toulouse 14:28'3-289, 1978. Dutau, G'., Enjaume, C., Petrus, M., Darcos, P., Demeurisse, P., Rochiccioli, P. Epidemiology of passive smoking of children from 00 to 6 years. Arch. Fr. Pediatr. 38(9f:7'21-72'5, 1981. (French) Ecanow, B., Blake, M'.I. The hazards of particulates in tobacco smoke. N. Engl. J. Med. 2'99(25):1415', 1978. Ekwo, E.E., Weinberger, M.M., Lachenbruch, P.A., Huntley, W.H. Relationship of parental smoking and gas cooking to respiratory disease in, children. Chest 8'4(6):662-668, 1983. EElliott, L.P., Rowe, D.R. Air quality during, public gatherings. J. Air Pollut. Control Assoc. 25(6):635-636, 197'5. Ellis, E.F. Asthma in childhood. J. Allergy C1ini. Immunol. 7'2(5 Pt 2):526-539, 1983. Eng, Wi.G. Survey on eye comfort in aircraft: I. Flight attendants. Aviat. Space Environ. Med. 50(4):401-404', 1979. Enstrom, J.E. Risingilung cancer mortality among nonsmokers. JNCI 62(4):755-760, 1979.. Enstrom, J.E. and Godley, F.H. Caner mortality among a representative sample of nonsmokers in the UnitediStates during, C r 1966-68. JNC'I' 65:117'5-1183, 1980. ~ ~ ~ ~ 16' N ~ ~

Thr, 3;over Zb Ssx . Tycation is oae of th-e aore rigorcus fo=s of' gRve:rrsnent control a:ad 2ias 1009 been recogatsed' as ao effactive Way to emoawrage sccia1 objectives. And' for. & q,rarirsq' =zmber of Americans, the tax power, is maw being seen as a way to =*- duc+e cigarette amokirq. f laise riqarette tax to cut mm0king, (+QSestion 24g) Total fackers 1bn-sa+okers: 1978' 1976 1978 1976 197'B 1916' ...._ .__.. ~..._, . igzse 32, 33 16 12' SiD 46 Disagree S4 61 78' 83 40 48 D©a"t knov/oo asswer, d 6' 6 S' 10 6 It is perhaps instzvctive that the incrsase of seAtiMesst in favor of taxes to stop rmokiAg i:s fcund' not only among eaon-smnke.r s Dtirt also asor,g smokers, even though their~ aumber,s~ areaot~ la:,ge., 7ndi amecag~ oen-smo kers~ fo=~ the~ f,is~st~~ t,imey there~ isa sajority sesati:®ent in fa~ or of' cigarette tax lnereases to force smokrss to quit. Whether ot aot such taxes accompli'sh their purposes is arguable. Bo: Lhcse is a suggestion that this eould be so. We asked ssaokers if they would con- tistn+s to smoke despite three separate cigarette tax izereases. 9;irsety-thr.e per- Cssat told us they would continue to smnke aftsr a hypot2oetical tax rise of five cents per pack. S;iacty-three percent said tAey would sti12 be smokYrg after a: fifty am't' tax ineraase. Snd fos'ty-,one percent of all smoke:s said' they vosild' remai.n smekers if the tax went up by ons dollar a. pack. i.okers eontiming, to smoke aftaz a.tax increase of.... (Question 53? ?i.e cents: tittv crnts One dall,a: ~ Q e ri Light saooDuezs 92 51 35 ~ lka,dexats smokers 87 53 33 ~ ' ~ 20 - 39 a,day 95 65 42 ~ 40 or siaze 1!04 42 64 QGO !'1 62' 41 A-24

Bibliography on Involuntary Smoking/March~, 1986 Assoc. J. 115( 91) :836 and 838, 197'6'. Bennett, W. The nicotine fix. RZ Med'. Ji. 66 ( L1) :455-45,8, 1983'. Bense, T., Gastellu, C. Estimation of total volatile bases in tobacco by near infrared (NIR) reflectance of spectrophotometry. Tob. Iint. 185(15):183-1851, 1983. Bentley, H'.R., Berry, E.G.N. The constituents of tobacco smoke: an annotated bibliography. Tobacco Manufacturers' Standing Committee,. Research Papers No. 3, London, England, 1959. Berggreen, S. Parental smoking at home and height of children (letter). Br. Med. J. 283(,6306):1612, 1981. Bergman, A.B., Wiesner, L.A. Relationship of passive cigarette- smoking to sudden infant death syndrome. Pediatrics 58(5):66'5-66'8, 1976. Bergman, H., Axelson, 0. Passive smoking,and'indoor radon daughter concentrations (letter). Lancet 2(',8'362):13'08-L309, 1983. . Berkey, C.S., Ware, J.H., Speizer, F.E., Dockery, D1.W'., Ferris, B.G., Jr. FEV1 growth tate of'preadolescent children and passive smoking (abstract). Am. Rev. Riespir. Dis. 129(4 Pt 2):A14A, 1984. Berkey, G.S., Ware, J.H., Speizer, F.E., Ferris, B.G., Jr. Passive smoking and height growth, of preadolescent children. Int. J. Epidemiol. 13'( 4 ) :4'54-4518, 1i9'84. Berkowitz, S. Smoking and asthmal(',letter). Pediatrics 76(4):6514- 655, 1985. Bernal-Mad'razo, Mi.A., Ham-Carrillo, M.S. Effect of tobacco onithe imaaune system. I. Production of' the cell' migration inhibition factor in the presence of' tobacco extract as an antigen in smokers and non-smokers. Gaic. Med. Mex. 117(10):412-414,, 1'981. (Spanish) Beske, F. Recommendations on governmental social action: governmental programs. In: Steinfeld, J., Griffiths, W., Ball, K., Taylor, R.M. (eds.). Smoking and health, I,I. Health consequences, education, cessation activities, and governmental action. Vol. II. Proceedings of the 3rd world conference on smoking and health, New York City, June 2-5, 19'75. DHEW Publication No. (NIH) 77-1413. pp. 953-957. Binder, R.E., Mitchell, C.A., Hosein, H.R., Bouihuys, A. Importance of the indbor environment i~n air pollution exposure. Arch. Environ. Health 31(16):277-279, 1976. Black, N. The aetiology of glue ear--a case-control study. Int. J. Pediatr. Otorhiinolaryngol. 9( 2')1:121-133, 1985. 6 N O ~ ~ ~. OPh ~ 0 f C

Bibliography on Involuntary Smoking/March, 1986 Aronow, Wi.S. Effect of passive smoking on angina pectoris. N. Engl. J. Med. 299(',1):21-24, 1978. Aronow, Wi.S. Effect of cigarette smoking and of carbon monoxide on coronary heart disease. Chest 70(4):514-518, 1976. Arono!w, W.S. Effect oflpassive smoking, on the cardiovascular and respiratory systems. In: Steinfeld, J., Griffiths, W., Ball, K., Taylor, R.M. (eds.). Srnoking and health II. Health consequences,, education, cessation activities, and governmental actilon. Vol. I'I. Proceedings ofl the 3rd world conference on smoking and! health, New York City, June 2-5, 1975. DHEW Publication No. (NIH) 77-1413. ppi. 883-89~0. Aronow, W.S. Tobacco and the heart. JAMA 22'9(13):1799-180'0, 1974. Aronow, W'.S. Smoking, carbon monoxide, and coronary heart disease ( ed'itorial f. Ci rculati'on 48'( 6') :1169-1172, 1973. Aronow, W.S., Cassidy, J. Effect of carbon monoxide on maximal treadmill exercise. A study in normal persons. Ann. Intern. Med. 83( 4) :4916-499, 1975. Aronow, W.S., Isbell, Mi.W1. Carbon monoxide effect on exercise induced angina pectoris. Ann. Intern. Med'. 7'9:3'92-395, 1973. Aronow, W.S., Kaplan, Mi.A., Jacob, D. Tobacco: a precipitatingg factor in angina pectoris. Ann. Intern Med. 117:2'69-80, 19'83'. Aronow, W.S., Stemmer, E.A., Isabell, M.W'. Effect of carbon monoxide exposure on intermittent claudication. CircuSation. 4'9 : 415-4'17', 1974. Artho, A., Koch, R. Characterization of the olfactory properties of cigarette smoke components. Ann. Tabac (Section 1-11):3'7-45,. 1973. ( F'rench ) Asano, M. Physiology and hygiene of smoking. 17. In vivo effects of passive smoking (4). Ilts relationship to lung cancer. Kango!gaku Zasshi 4'6(12):1413-1416, 198'2. (Japanese) Asano, M. Physiology and hygiene of'smoking. 16. In vivo effects of passive smoking (3): chronic effects on children. Kango!gaku Ziasshi 4'6(11):1293-1296, 1982. (Japanese) Asano, M. Physiology and hygiene of smoking. 15. In vivo effects of'passive smoking (2): on acute objective effects. Kangiog,aku Zasshi 416(10):1173-1176, 1982. (Japanese) Asano, M. Physiology and hygiene related to smoking,. 14. Physiological effects of passive smoking. (1)1: on acute effects. Kangogaku Zasshi 46(9):1053-1056, 1982. (Japanese), 3 D-3

Bibliography on Involuntary Sknoking/March,, 1986 Hirayam&, T'. Cancer mortality in nonsmoking women with smoking husbands based on a large-scale cohort study in Japan. Prev. Med. 13:68'0-690, 1984. Hirayamal, T. Passive smoking and lung cancer: consistency of association (letter). Lancet 2(8'364):14'25-142!6, 1983. Hi~rayamal, 'r'. Arguments pro and con on passive smoking hazard. MMIW 12'3 ( 40 ) :14!80-1483, 1981. (G'ermani) HilraYamal, T. Non-smokinig wives of heavy smokers have a higher rilsk of lung cancer (',letter),. Br. Med. J. 283'(,6304):1466, 1961. Hirayama, T. Non-smoking wives of heavy smokers have a higher risk of lung cancer (letter). Br. Med. J. 283I(',6296):916-197, 1981. Hirayaana, T. Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. Br. Med. J. (Clin. Res.) 282(6259):183-185, 1981. Hirayama, T. Passive smoking and lung cancer (letter). Br. Med. J. 282('6273):1393-13914, 1981. Hirayama, T. Prospective studies on cancer epidemiology basedion census population in Japan. Proc. XI'I'nternational Cancer Congress, October 20-26, 1974. Florence. Hlousek, Z. The effect of passive smoking on the young person with a history of respiratory tract disease. Cas. Lek. Cesk. 122(9'):27'0-27'7, 1983. ((Czech) Hlousek, Z. Passive smoking. Prakt. Lek. 63'(17):623-628,, 198!3. (Czech) Hlousek, Z. Passive smoking and the health status in pre-school age children. Cesk. Pediatr. 35(,11):606-607, 1980. (Czech) Hodges, M.E. Time to give up smokers?' Bi~bra Bull. Sept.:359- 364, 1981. Hoeigg, U.R. Cigarette smoke iniclosedispaces. Envilron. Health Perspect. Experimental Issue no. 2:117-128, 1972. Hoegg, U.R. Cig;arette smoke in closed spaces. Environ. Health, Perspect. Experimental Issue no. 2:117'-128, 1972. Hoegg, U.R. The significance of cigarette smoke i~n confined spaces (master's thesis). C'incinnati, Ohio : University of 0 Cincinnati, Division of Graduate Studies, Dept. of Environmental N' Health,, 1972'. ~ ~. 26' KDk ~ ~ ~. D-2'6. F,

Bibliography on Involuntary Smoking/March, 1986 Respiratory Diseases. 6(4):245-24'6, August 1983, Chinese. Hecht, S.S., Adams, J.D., Hoffmann, D. Tobacco-specific nitrosamines in tobacco and tobacco smoke. IARC Sci. Publ. 45:93'- 1A1, 19183. Hecht, S.S., Chien, C.B., McCoy, G.D., Hoffmanni, D. Tobacco specific N-nitrosamines: occurrence, carcinog?nicity, and metabolism. ACS Symp. S'er. (101):125-152, 1979. Hecht, S.S., Schmeltz, I., Hoffmann, D. Nitrogenous compounds in cigaret smoke and theilr, possible precursors. Recent Adv. Tbbacco Sci. 3:59-93, 197'7. Heitz von, M., Herzog, H. Lung dliseases in the eldlerliy-pathioenetic significance of pollutants and environmental factors. Fortschr. Miedl. 102('17):47'7-482, 1984. (German). Heller, Wl.D. Lung cancer and passive smoking (letter). Lancet. 2(8362):13'09, 1983. Heller, Wl.D. Hirayamas data are not representative (lietter), MMW1124(4):11-12, 1982. (',German) Hess,, H. The hazards of passive smoking,. Quintessence Int. 4 (11) :89-95, 1973'. Hess, H. AA contribution to the problem of "passive smokin~ ('letter). Munch. Mied. Wochienschr. 113'(18):705-7016, 1971. (German) " Hess, H. on "passive smoking". Wi!ss. Dienst (Literatur-Eildienst "Roche") 3'7(7):49-52, 1969. Higgi!ns, I. Lifetime passive smoking and cancer risk. (letter). Lancet 1(8'433):8616-867, April 13, 1985.. Higgins, M.W., Howatt, W., Keller, J.B. Childhood determinants of adult lung function (abstract). Am. Rev. Respir. Dis. 124(4 pt 2):14'5, 1982. Hiller, F'.C. Deposition of' sidestream cigarette smoke in the human respiratory tract. Prev. Mied. 13:602-607', 19'84.. Hiller, F'.C., McCusker, K.T.,, M'azu!mdler, M.K., Wilson, J.D., Bone,. R.C. Depostition of sidestream cigarette smoke in the human, respiratory tract. Am. Rev. Respir. Dis. 125(4)1:4016-408, 1982'. Hinds, W.C. Smoke and heat (letter). Ni. Engi. J. Med. 293(1):48, 1975. Hinds, W.C., First, M.W. Concentrations of nicotine and tobacco smoke in public places. N. Engl. J. Med. 2'92'( 1b ):844-8'45, 1i97'5. 25 D-25

Bibliography on Involuntary Stoking,/March, 1986. Hoffmann, Di., Adams, J.D., Brunnemann, K.D., Rivenson, A., Hecht, S.S. Tobacco specific N-nitrosamines: occurrence and bioassays. IAR,C Sici. PubS.(41) : 109-318, 1982. Hoffmann, Di., Adams, J.D., Piade, J.J., Hecht, S.S. Chemical studies on tobacco smoke LXVIII. Analysis of volatil!e and tobacco-specific nitrosamines in tobacco products. IARC Sci. Publ. 31:507-516, 1980.. Hoffmann, D., Adams, J.D., Brunnemann, K.D., Hecht, S.S. Assessment of tobacco-specific N-nitrosamines in tobacco prodiucts. Cancer Res. 39(7 Pt 1): 2505-2509, 1979. Hoffmann, D., Adams, J.D., Wynder, E.L. Formation and analiysis of carbon monoxide in cigarette mainstream and sidiestream smoke. Prev. Med. 8'(,3I) :344-350, 1979. Hioffman, D., Brunneman, K.D., Adams, J.D. Hoffmann, D., Brunnemanni, K.D., Webb, K.S. Volatile nitrosamines in tobacco and mainstream and sidestream smoke and indoor environments. IARC' Sci. Publ. 45:69-83, 1983. Hoffmann, D., Chien, C'.-H.B, Hecht, S.S. The role of volatile and nonvolatile N~-nitrosamines in tobacco carcinogenesis. In: Gori, G.B., Bock, F.G. (eds.). A safe cigarette? Banbury report. New. York : Cold Spring Harbor Laboratory, 1980. pp. 113-127. Hoffmann, D., Haley, J.J., Adams, A.D., Brunneman, K.D. Tobacco sidestream smoke: Uptake by nonsmokers. Prevent. Miedi. 13':608!- 617, 1984. Hoffmann, D., Haley, N.J'., Brunnemanni, K.D. et al. Cirgairette sidestream smoke: formation, analysis and'mod'el studies on the uptake by non-smokers. Presented at the U.S-Japan Meeting on New Etiology of Lung Cancer, Honolulu, March 21-23,, 1983. Hioffmann,, D., Hecht, S.S. Tobacco and tobacco smoke (volatile and tobacco-specific nitrosamines). General aspects. IARC Publ'. 45:63-67, 1983. Holland, R.H., Kozlowski, E.J., Booker, L. The effects of cigarette smoke on the respiratory system of the rabbit. A final report. Cancer 16(5):612-615, 1963. Holiland, W.W. Beiginnings of bronchitis (editorial). Thorax 37 ( 6 ) : 401-403!, 19821. Holimal, B., Kjaer, G., Stokholm, J. Air pollution, hygiene and health of Danish schoolchildren. Sci. Total Environ. 12(3):25'1- 286, 1979. 27

Bibliography on Involuntary Smoking/March, 1986 J. (Clin. Res.) 282(6273):1393, 1981. Burchfiel, C.M., Howatt, W. F'. , Keller, J.B., Butler, Wi.J., Hig.ginsi, I.T.T., Higgins, M.W. Passive smoking, respiratory symptoms and pulmonary function in the pediatric population of Tecumseh (abstract). Am. Rev. Respir. Dis. 127 (,S1rpp1. 4 Pt 2):1516, 198'3.. Bureau, M.A.,, Monette, J., Pare, C., Lippe, J., Mathieu, J.-L., Blouin, D., Berthiaume, Y., Begin, R., Shapcott, D. Passive smoking and' the fetus: a study of'carbon monoxide in pregnant women and neonates. Union Medi. Can. 10'9(9):134!1-1345, 1980. (French) Burns, D.M. Consequences of smoking--the involuntary smoker. In: Steinfeld, J., Griffiths, W., Ball, K., Taylor, R.M. (eds.). Smoking andihealth II. Health consequences, ediucation, cessation activi~ties, and governmental action. Vol. II. Proceedings of the 3rd world conference on smoking,and health, New York City, June 2- 5, 1975. DHEW Publication No. (NIH) 77-14I13. pp. 45, 51-58'.. Burns, D.M. Scientific evidence on the hazards of involuntary smoking. J'. Breathing, 38:6-7, 1975. Burrows, B., Knudson, R.J., Lebowitz, M.D. The relationship of childhood respiratory illness to adult obstructive airway disease. Am. Rev. Respir. Dis. 11S(5):75'1-760, 1977. Businco, L., Cantani, A. Prevention of atopy - current concepts and'perso'nal experience. Clin. Rev. Allergy 2(2):10'7-123', 19'84: Biutler, N.R. Smoking and pregnancy. In: Steinfeld, J'., Griffiths, W., Ball, K., Taylor, R.M. (eds.). Smoking and health,IZ. Health, consequences, education, cessation activities, and governmental action. Vol. II. Proceedings of' the 3'rd' world conference on smoking and health, New York City, June 2-5, 1975. DHEW Publication No. (NIH) 77-1413. pp. 43-49. Cabo, J., Bravo, L., Fernandez, F., Jimenez, J'., Navarro, C. Stud!y of Spanishitobacco. V. Quantitative determination of pyrolysis products. Ars. Pharm. 2'3(4):493-499, 1982. (Spanish). Cain, W.S., Leaderer, B._P., Isseroff, R.:, Berglund, L.G., Huey, R.J. Lipsitt, E.D., Perlman, D. Ventilation requirements in build'ing,s--I. Control of occupancy odor and tobacco smoke odor. Atmospheric Environ. 17(16'):1183'-1197, 1983. Cameron, P. Children's reactions to second-hand tobacco smoke. J'. Appl. Psychol. 561:171!-17'3, 1972. Cameron, P. Secondi-hand tobacco smoke: children's reactions. Sch. Health 4!2(15):280-28'4, 1972. ~. CCameron, Oselett, P.,, B'., F.ost'ini, Stocker, J.S., Zaks,, J.M., 641olfe, ii.Hi., R., Winton, J. The health of Tighe, Gi.„ smokers'' and! O N ~ ~ 10 ~ 04 C /I- C C C ID-10.

Bibliography on Involuntary Smoking/March, 1986 nonsmokers' chilidren. J. Allergy 43(6'):336-34'1, 1969. Cameron, P., Robertson, D. Effect of home environment tobacco smoke on family health. J. Appl. Psychol. 57(2):142-147, 1973. Canada. Department of Health and Welfare. Carbon, monoxide yields of cigarettes. Canada, Department of'Health and Welfare News Release, 198'2-11, January 26, 1982. 41 pp. Cano, J.-P., Catalin, J'., Badre, R., Dumas, C., Viala, A., Guillerme, R. Determination of nicotine by chromatography in the g;aseous phase. II. Applications. Ann. Pharm. Fr. 2'8(11):633-640, 1970. (Frernch), Carlens, E. o'bstructive lung disease caused by passive smoking. Lakar'tidningen 7'7 ( 23 ):217'7-2178, 1980'. ( Swed'ish) Castello, D., de Candussio, G., Franchi!, D., Bertocchi, F'. The relationship between, ambient cigarette smoke and respiratory diseases in childreni. First results. Minerva Pediatr. 3'0(19):14'89- 14916, 1978. (,Italian), Castot, A., Efthymiou, M'-Li. Cancers and passive smoking. Slem. Hop. Paris 59(27-28):2028-2'030, 198'3. (French). Catford, J.C., Nutbeam, D. Smoking in hospitals. Lancet 2('8341):94-96, 1983. Cederlof, &., Ciolley, J. Epidemiological investigations on environmental tobacco smoke. Scand. J. Respir. Dis. Suppl. 91:47- 49, 1974. Chan, W.C., Fung, S.C. Lung cancer in non-smokers in Hong Kong. In: Grundmanrn, E., Clemmesen, J., Muir, C.S. (edsi.). Geographical pathology in cancer epidemiology. (Cancer campaign, v. 6) Stuttgart; New York : Gustav Fischer Verlag, 1982. pp. 199-202. Chan Woon Cheung. Data from Hong Kong ( lietter ). MMW 124 ( 4):16,. 1982. ('German). Chappell, S.B., Parker, R.J. Smoking and carbon monoxide levels inn enclosed'places in New Brunswick. Can. J. Public Health, 68(2)1:15'9- 1'61, 1977. Chappell, S. B., Parker, R.J. A study of'carbon monoxide levels in enclosed'public places. New Brunswick Council on Smoking,and! Health, Fredericton, New Brunswick, Canada, June 19'75. 16 pp. Charlton, A. Children's coughs rel'ated to parental smoking. Br. Med. J. ( Cli'n. Res. ]I 228 ('6I43'1) :1647-164'9, 1984. Charpin, D. Passive smoking. Hyg. 42:30i09-3017, 1984. (French) 11 D-11

Bibliography on Involuntary Smoking/March, 1986' Chen, C.B., Hecht, S.S., Young, R., Ohmori, T'., Hoffmann, D. Comparative carcinogenicity andimetabolism of the tobacco specilfi!c carcinogens, NNN and NNK (Abstract),. Proc. Am. Assoc. Cancer Res. 20:81, 1979. Chojnowski, J.R. The harmfulness of cigarette-smoking. Przegl. Lek. 24(6):527-531, 1968. (',Polish), Chopra, N.M'., Verma, M.M., Zuniga, T.H. On the fate of' maleic hydrazide in t~obacco~ smok~es.~ J Ag,r~ilc.~ Fo~~od~ Chem. 30 (4)~ :!67~2-676 , 1982. Chretien, J'. Inhalation carcinogenesis: an overview. Recent Results Cancer Res. 82:1-10, 1982. - Chyle, P., Chy1e,.M., Korb, J., Papanek, M. Tobacco mosaic virus, polyphenols and the carcinogenicity of the tobacco habit. Cesk. Epide:aiol. Mikrobiol. Imunol. 2'0 ('1)1: 32-42', 1971. ( Czech ). Claoule, C. Smoking habits in the main entrance hall of' a, hospital (,letter),. Br. Med!. J. 283'(6288):4'39-440, 1981. Cohen, J.D. and Bartsch, G.E. A comparis!on-between carboxyhemoglobin and serum thiocyanate as indicators of 'cigarette smoking. Amer. J. Public Health 70:284'-2'8.6, 1980. Cole, P.V. Comparative effects of atmospheric pollution and cigarette smoking on, carboxyhaemog,lobin levels in man. Nature. 2515(5'511):699-701, 1975. C ll i k ' ' o ey, Jl. Pass ve smo ing in children. Nurs. Times 7 1(147 )1:1858- 1859, 1975. Coll'ey, J1.R.T. Respiratory symptoms in children and'parental smoking andiphliegm production. Br. Med. J. 2(59'12):201-204, 1974.. Colley, J.R.T., Doug,las, J.W.B., Reid, D.D. Respiratory disease in young adults: influence of early, childhood lower respiratory tractt illness, social class, air, pollution, and smoking. Br. Med. J. 3 ( 5873 ) :195!-198, 1973. Colley, J.R.T., Holland, W.W., Coxkhill, R.T'. Influence of passive smoking and parental phlegm on pneumonia and bronchitis in early childhood. Lancet 2'(7888'):1031-1034', 1974. Collig;an, M.J. The psychological effects of indoor air pollution. Bull. NY Acad. Med. 57(10+:1014-1026, 1981. Collishaw, N.E., Kirkbride, J, Wigle, D.T. Tobacco smoke in the workplace: an occupational health hazard. Can. Med. Assoc. J. ~ 13'1(10):1199-12'04, 1984. 0 Comstock, G.'r7., Meyer, M'.B., Hielsing, K_J., Tockman, M.S'. NI ~ ~ 12 ~ ~ ~ M.' C C ID-12'.

Bibliography on Involuntary Smoking/March, 1986 Cuddeback, J.E., Donovan, J.R., Buirgi, W.R. Ambient tobacco smoke measurement. Am. Ind. Hyg. Assoc. J. 3'7:656-657', 1976. Cuddeback, Ji.E., Donovan, J.R., Burg,, W.R. Occupational aspects of passive smoking. Am. Ind. Hyg. Assoc. J. 37(5'):263-267', 1976. Currier, R.W. On tobacco smoke and the nonsmoker. J. Iowa Med. Soc. 681(3) :97, 19781. Czerwiecki, L. Harmful substances in cigarette smoke. Roca. Panstw. Zakl. Hig. 35(13 ):23'3-238', 1964. (Polish) Daff, M.E., Kennaway, E.L. The arsenic content of tobacco and of tobacco smoke. Br. J'. Cancer 4:173-182, 1950'. Dahms, T.E., Biolin, J.F., Slavin, R.G. Passive smoking effects on bronchial asthma. Chest 80(5)1:5'30-5'34, 1981. Dalager, N'., L. Pickle, and T. Mason, et al,. Passive Smoking and lung, cancer. Am. Ji. Public Health 20:482, 19'84. Davies, D.M. The application of threshold'liimit values for carbon monoxide under conditions of'continuous exposure. Ann. Occup. Hyg. 18 (1)': 21-28', 197'5. Davis, G.L., Gantner, G'.E'., Jr. Carboxyhemoglobin in volunteer blood donors. JAMA 230(7):996-997, 1974!. Dawley, H.H., Jr. Protecting hospital patients from passive ssaoking. Psychol. Rep. 46I(,2') :6'78I, 19'801. DeMarini, D.M. Genotoxicity of tobacco smoke and tobacco smokee condensate. Mutat. Res. 114:59-89, 1983. Derbes, V'.J., Engelhardt, H.T'. Urticaria due to inhalantt substances. South. Med. J. 37'(12):72'9-731, 1944. Derouane, A. A comparison betweenismoke concentrations measured indoors and outdoors. Atmos. Environ. 6:209-220, 1972. ((French) Derouane, A., Verduyn, G'. Study of some factors affecting air polliution inside buildings. Trib. Cebedeau 27':482-48'8, 1974. ( F'rench ), Diamond, G.A., Forrester, J'.S. Clinical trials and statistical verdicts: probable grounds for appeal. Ann. Intern. Med'. 9813 ) : 3'85I-394, 1983. Ding, D.J'1. The effect of long-term, passive smoking on pulmonary function. Chung Hua Chieh Ho Ho Hu Hsi Hsi Chi Ping, Tsa Chiih 7(16): 359-362, 383, 1984. '( CMinese ) Dinman, B.D. Pathophysiologic determinants of community air. 14 f D-14

Bibliography on Involuntary Smoking/March, 198!6 1977. 24 pp. Brunnemann, K.D., Hoffmann, D. N-ni'trosodiethanoSamine in tobacco and mainstreaaa and sidestream smoke. IARC Sci. Pub1. 45:85-92,. 1983. Brunne:nann, K.D., FHoffmann, D. Chemical studies on tobacco smoke. LIX. Analysis of volatile ni'trosaunines in tobacco, smoke and, polluted indoor, environmentsi. I,ARC S'ici. Publ. 19:343-356, 1978. Birunne:aanni, K.D., Hoffmann, D. Chemical studies on tobacco smoke XXXIV. Gas chromatographic determination of ammonia, in cigarette and cigar smoke. J. Chromatogr. Sci. 13'( 4):159-16I3, 1975'. Brunne:aann, K.D., Hoffmann, D. Chemical studies on tobacco smoke.. XXV. The pH of' tobacco smoke. Food Cosmet. Toxicol. 12(1) :115- 124, 1974. - _ B'runnemanni, K.D., Lee, H-C., Hoffmann, D. Chemical studies on tobacco smoke. XLVII. On the quantitative analysis of catechols and' their reduction. Anal. Lett. 9(10):939-955, 1976. B:runnemanni, R.D., Masaryk, J., Rof fmann, D.Ro1e oftoba~cco stems in the formation of N-nitrosamines in tobacco and cigarette mainstream and sidestream smoke. J1. Agric. Food Chem. 31(6):1221- 122'4, 1981. Brunnemann, K.D., Scott, J.C., Haley N.J., FHoffznann, D. Endlogienous formation of N-nitrosoproline upon cigarette smoke inhalation. IARC Sci. Publ. ('5'7):819-828, 198'4. Brunnemann, K.D., Stahnke, GI. , Hoffmann, D. Chemical studiles on tobaccoismoke. LXI. Volatile pyridines: quantitative analiysis in mainstream and sidestream smoke of cigarettes and cigars. Anal.. Lett. All(7):545'-560, 1978. Brunnemann, K.D., Yu, L., Hoffmann, D. Assessment of carcinogenic volatile N-nitrosamines in tobacco and in mainstream and sidestream smoke from cigarettes. Cancer Res. 37('9)i:3218-322I2, 1977'. Brunnemann, K.D., Yu, L., Hoffmann, D. Chemical studies on tobacco smoke. XLIX. Gas chromatographic determination of hydrogen cyanide and cyanogen in tobacco smoke. J. Anal. Toxicol. 1(i1) r3'8- 4'2, 1977.. Buratowski, J'. , Warczynski, A., Piasecki, M. The effect of smallil concentrations of nicotine on the ability of visual adaptation and acuity in non-smokers. Pol. Tyg. Lek. 2'9(25):1077'-1078', 1974. Burch, P.R.J. Lifetime passive smoking and cancer risk. (Letter). Lancet 1(,8433):866, 1985. Burch, P.R.J. Passive smoki'ng and lung cancer (,letter). Br. Med.

Bibliography on Involuntary Smoking/March, 1986 Behav. Sci. 14(6):837-864', 1971. Bridge, D.P., Corn, M'. Contribution to the assessment of exposure of nonsmokers to air pollution from cigarette and cigar smoke in, occupied spaces. Environ. Res. 5(2):192-209, 1972. Brody, B. Breathing other people's smoke (letter). Br. Med. J. 2(16141):8195, 1978. Bronisz, H., S'zost, T., Li'pska, M., Zawadal, M. Cadmium content in cigarets. Bromatol. Chem. Toksykol. 16(2):121-127', 1983. (Polish) Browne, C.L., Keith, C.H., All!en, R.E. The effect of filter ventilation on the yield'and composition of mainstream and sidestream smokes. Beitr. Tabakforsch. int. 10(2):8'3-90, 1980. Browne, E.V. N-heterocyclic and biologically active compounds inn tobacco smoke. In: Proceedings, 3rd Tobacco Health workshop Conference. Lexington, Kentucky : Tobacco Health,Research. Institute, University of Kentucky, 1971. pp. 158,1!6'6. Brumbaick, C.L. The poliitics of smoking, prevention: a report from the field. J'. Public Health Policy 2'(l):3'6-41, 1981. Brunekreef', B., Boleij, J.S.M. Long-term average suspended particulate concentrations in smokers' homes. Int. Arch. Occup.. Environ. Health,50(3):299-302, 1982. Brunekreef, B., Fischer, P., Remijn, B., van der Lende, R., Schouten, J., Qiuanjer, P. Indoor ai~r pollution and' ilts effect on pulmonary function of adult non-smoking women: III. Passive smoki'ng and pulmonary function. Int. J. Epidemiol. 14(2):2'27-23'0, 19'85. Brunnemann, R.D., Adams, J.D., Ho, D.P.S., Hoffmann, D. The influence of'tobacco smoke on indoor atmospheres. II. Volatile and tobacco specific nitrosamines in main- and sidestream smoke andd their contribution to indloor, pollution. In: Proceedings of tMe 4th joint conference on sensingi of environmental pollutants, New Orleans, Louisiana, 1977. Washington, D.C'.: American Chemical Soci~ety, 1978. pp. 876-8'80. Brunnemann, K.D., Fink, W., Moser, F. Analysis of volatile N- nitrosaaaines in mainstrsaan and sidiestream smoke fromicigarettes by GLC-TEA. Oncology 3!7(4):217-222, 1'980. Brunnemann, K.D., Hecht, S.S., Hoffmann, D. N-nitrosamines: environmental ocurrence, in vivo formation and metabolism. J. Toxicol. Clin. Toxicol. 19(16&7):66l-6&8, 1982-83'. Brunnea:ann, K.D., Hoffmann, D. Volatile N-nitrosamines in tobacco smoke and i~n polluted indoor environments. Presented at the 2ndi Q joint conference sponsored by the Chemical Institute of' Canada, and! jV American Chemical Society, Montreal, Quebec, Canada, May 29-June 2, (f[ . ~ ~ 8 ~ al' N C D-8

CHART V: E'JFORCFTSE7T; EXCEPTIONS; OTHER PLA'CES~ AFFECTED COMMUftITr, EXCEP- ENF'ORCEMENT TIONS(4] Antioch + Berkel'ey App1'. Brea Appt. Brentwood Carlsbad Appl. Carpinteria +' Cathedral City (!11y Chula:Vista Appl.. Clayton Concord Coronado Appl. Cupertino Danville Del Mar Appl. El Cajon EliCerrito Fscond'idw Appl. + Grand,Terrace Appl. Hemet, Sign, Hercules +* Huntington Beach Imperial Beach Appl. IndioI Appl. Irvine La Mesa Appl. Lafayette Laguna Bieaeh Livermore Appl. Long Beach Appl. + Los Altos Los Angeles Los Gatos Martinez + MenloiPark Mill Valley, (1'1i] Milpitas Mountain View National City Appl. Newport Beach Oceanside Appl. t Orinda, Pal'o Alto Pasadena Ap,pl. Pinole Pittsburg Poway Appl. + Riancho Mirage Appi. R3chmondi Riverside Appi'. Sacramento San Anselmo San Diego Appl. San F'rancisco San Jose. San Lu1s Obispo, San Marcos Appii. San Pablo San Ramon Santa Barbara Santa Clara Santa Monica Santee Appli. Tustin, Appli. Ukiah Appi1. Vi'sta, App~L. Walnut Creek Yorba Linda Appl. County of~Contra,Costa, County of~Marin [11] County oflOrange. County oflRi'verside Appl. County of~Sacramento County oflSan Diego Appl. County of'Santa Cruz Infraction Infraction Infraction/Pub.Nuis. City Mgr/complaint. Infraction, Infraction Infraction. Infraction Infraction City Mgr/complaint Infraction, City Mgr/complaint City'Mgr/complaint Infraction Misdemeanor/Infr. City'Mgr/complaint Infraction Infraction Infraction City Mgr/complaint OTHER AFFECTED A'REAS A11i enclosed areas used by the general public Alli enclosed areas used by the general public A11'enclosed areas used by the general public A11i public places except designated! areas [1!] Laundromats; city facilities A11'public'places except designated'areas! [1i] All enclosed, areas used by the generai' public All encLosed, areas used by, the general' public All public,places except designated,areas;[1] All enclosed'areas used by the general public All public,places except designated areas: (1] All enclosed,areas usediby the general public All public places except designated areas [1J All public places except designated areas [1] All enclosed areas used!by the general public Public buildings Infraction All public places except designated areas [1j'. Infraction Infraction Infraction City Mgr/complaint Infraction All public places except designated areas [I1]I All enclosed areas used by the general public City Mgr./Inspect. Health Dept. Inf'raction Infraction [9J Mlsdemeanor Infraction All,enc7osed areas used by the,general public Infraction Dir.Coem.Devel. Infr./$us:.l.ic.Ren. City Mgr./Inspect. Infraction Infraction Infraction City Mgr/complaint Infraction Infraction City Mgr/complaint Infraction Infraction Infraction City Mgr/complaint Infraction Infraction None specified Infraction Civi1/Dir.Pub.Health Health Officer Admin.Ofc/Pub.Nuis., Infraction Infraction City Mgr/complaint Infr. / Pub.Nuis. City Manager C3vi1/Infraction Infraction Infraction City Mgr/complaint Infraction City }lgr/cpmplair.t Misdemeanor Health,Dept. Infraction Infraction Infraction Director of Health Infraction HealthOfcr/inspect Schoo,ls; child care facilities Encl. public areas;~ child'care facil.; schools. All public places except designated areas [1] All public places except,desi!gnated areas [1] All,enc7osed areas used by the general public All enclosed areas used by the general publ'ic. All enclosed areas used by the general public All public places except desi!gnated areas (1] All public places except desi!gnated areas [,1] All enclosed areas used by the general publiic, A1l,public places except designated areas [1] All public places except designated areas [1] All city buildings; laundromats All public places except designated areas [1] All enclosed areas used by the general publ'ic All enclosed areas used by the general publ!i!c Iaundromats All public places except designated areas (1] [L]; but no area,is required to be all nonsmoKinr All public places: except designated areas [1'] All enclosed areas used by the general public All enclosed areas used by the general public County'buildings except desig. smoking areas All public places except designated: areas (,1!] A11 public pPaces except designated areas (,1!] Enclosed'.public areas c f C-8

Bibliography on Involuntary Smoking/March, 1986'. Ashley, M.J., Forbes, W.F., Frecker, R.C. Smoking or health in, the '80s? (editorial) Can. Med. Assoc. Ji. 125(10):107'7-1078, 1981. ASHRAE: Standards for ventilation required for minimum acceptable indoor air quality. Standard 62-73R. Atlanta, Ga. : American Society of Heating, Refrigerating and Air-Conditioning Engineers, 1981. Australian Council on Smoking and Health,. List of illnesses and disabilities associated with smoking. Med. J. Aust. (Special. Supplement on Smoking and Health. July 26, 1975'] 2(1):3-4, 1975. ~' Aviado, D.M. Carbon monoxide as an index of environmental tobacco il smoke exposure. Eur. J. Respir. Dis. [Suppl.]I 133':47-60, 1984. Avciado, D.M'. Small-airways dysfunction impassive smok rs (letter),. N. Erngl. J. Med. 303(7):393, 1980. Axelson, 0. Room for a role for radon in lung cancer causation? Med. Hopotheses 13'(1):51-61, 1984. Ayer, H.E., Yeager, D.W. Irritants in cigarette smoke plumes. Am. J. Public Health 7'2(11):1283-1285, 1i9'82 Ayres, S.M., Mueller, H.S., Gregory, J.J., Giannelli, S., Jr.,. Penny, J.L. Systemic and myocardial hemodynamic responses to relatively small concentrations of carboxyhemoglobin (COHB). Arch.. Environ. Health, 18('4!):699-709, 1969. Baldre, R., Guillerm, R., Abran, N., Bourdin, M., Dumas, C. Atmospheric pollution by smoking. Ann. Pharm. F'r. 36(9/10):443- 452, 1978. (French) Bahrmann, E., Paun, D. The scientific basis for tobacco injury by active and'passive cigarette smoking. Dtsch. Gesundheitsw.. 2'9 ( 43 ) :2'017-202'2, 1974'. (,German) Ball, K., Taylor, R.M. ( eds. ). Smoking and'health II . Health consequences, education, cessation activities, and governmental -action. Vol. I'T. Proceedings of' the 3rd world conference on smoking and health, New York City, June 2-5, 1975. DHEW Publication No. (NIH) 77-1413. pp. 891-8!95. Bake, B. Does environmental tobacco smoke affect lung, function? Eur. J. Respir. Dis. [Suppli] 133:85-87, 1984. Baker, R.R. Variation of sidestrea:n gas formation during the smoking cycle. Beitr. Tabakforsch. Int. 1'1(4):181-193, 1982. Baker, R.R. Primary and secondary formation of carbon monoxide during combustion of tobacco. Oxid. Commun. 3(3'4):269-281, 1983. 0 N 0 ~ ~ 4 ~ N. ~ ~ D-4.

. r /IftN /-I- 2atad iach4strias 'vsry i•stxrestsd• or Incdaratsly iztarsztad• (¢assticn 4) 78 1976' _' 074 197ZI 1970 1968*9 ~ 0 i~uq' 1. 66 s 6+6' . 70: • 39 ~ 63 a 73 A¢tcacbile 65 68 73 67 71 79 fbod 65 69 =* * ZT a t' 2~c Maaiaal 47 55 59 53' a ZT Cil 44 49 42 ~ DC Z7C . Ubestos 32 Zac z~ ~ ~c nc. Stbaeco . 27 28 31' 30 33 36 Licpuar . 25 25 26 25 24 28 S~e drug, iacsustxy ancl' the liqstor industry held tbeis rating of tw, years ago 33 the facs of dieclim,es in e!yery other category. 2a the case of the liquor imdustry, it Us naintiiaed its low rating omnsistantly since 1970 anA is now being c2salleaged' !ar that posixiion by tha: tabacco industsy. Ctber industries schieved' scme sort off peak at the aiddle of the decade but are aar tailing off . As in the past, aoa-aoDcess rate the tobacao industry l'awer thran saokers. ~ Sbey also rats the liquor industsy lower, brrtt tbers is .3rtmally no distinction be- twen smokers and' non-mokars as regards the rema{**ing iadust;ies. satsd industries 'vs_-y intrrested- or Soderately ints.rested' (4uextion 4) Smckers lkan-smcke=s ~_ . .. e , 3n't.omobile 65' 67 D'styq ?ood 64 64 66' 64 Cmemical ~I6 47 oiili 64' 4b 1sbestos 31 31 N' . ~. Sbmacca 37 20 jv Liquor 31 21 . (in * S~C indicates t21at ,cvestioa was not asked ia the study in aaaestion. kthk sr In 1968' the question tiordiaq r,as slightly di-Oferent in that we asked fo: rati.r:,s ~, oa biorr •concsrned!" industsies''vere, rather t.1tara Mv `interesteC' they were. CAI A-51

Bibliography on Involuntary Smoking/March, 1986 the buildup of carbon monoxide from cigarette smoking in rooms and houses. Am. Soc. Heat. Riefrig. Air Cond. Eng,. J.:49-53, 1974.. Just, J., Borkowska Mi., Maziarka, S. Tobacco smoke contained inn the air of Warsaw coffee rooms. Rocz. Panstw. Zakl. Hig.. 2'3(2):129-135, 1972. (Polish) Kabat, G.C., Wynder, E.L. Lung cancer in nonsmokers. Cancer 53I(',5) :121i4-1221, 1984'. Kalchulis, C.J. Secondhand cigarette smoke as a cause of chronicc carbon monoxide poi'soningi. Postgrad. Med. 701(1!) :77-79, 1!981. Kahn, A.,,Rutledge, R.B., Davis, G.L., Altes, J.A., Gantner, G.E., Thornton, C.A., Wallace, N.D. Carboxyhemogliobin sources in the metropolitan St. Louis population. Arch. Environ. Health 29:127-115, 1974. Kalandidi, A. Lung cancer and passive smoking. Conclusion of Greek study ('thesis). University of Athens, Greece, 19837 Kamstrup, 0., Hugod, C., Larsen, E. Measurements of low concentrations of carbonyl sulfide. Beitr. Tabakforsch. Int. 11(1):33-38, 1981. Karakostov, P. Passive smoking among,pregnant women and its effect on the weight and'growth of the newborn infant. Akush G'inekoli (Sofiia) 24(2'):28!-31, 1983. Kastenbaum, M.A. Consistency of research data, on passive smoking and lung,cancer (letter'),. Lancet 1(8391):1406, 1984. Kasuga, H. Hydroxyproline and passive smoking. Presented at New Etiologies in Lungi Cancer Conference, March 21-23, 1983, Honolulu, Hawaii. Kasuga, H., Hasebe, A., Osaka, F'., Matsuki, H. Respiratory symptoms in school children and the role of passive smoking. Tokai J'. Exp. C1in. Med. 4(2):101-114, 1979. (iJapanese) Kauf'fmanin, F. Small airways dysfunction in nonsmokers (,letter). N. Engl. J. Med. 303'(',7 ): 393, 1980. Kauffmann, F., Tessier, J-F'., Oriol P. Adult passive smoking in the home environment: a risk factor for chronic ai!rflow . limitation. Am. J. Epidemiol. 117(i3):26'9-280, 119,83. Kauffmanni, F., Perdrizet, S. Effect of passive smokingionn respiratory function. Eur. J. Respir. Dis. 62 [Suppl. 113):109- ~' 110, 1981. 0 ~ Kawane, H. Drinking and passive smoking (letterY. Chest ~ ~ 32 ~1 C JI C D-32

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Bibliography on Involuntary smoking/March, 1986I Gesundheitswes. 46(11) :582-587', 1984. (G'erman) Grandjean, E., Weber, A., Fischer, T'. Passive smoking. B'ull. Schwei~z. Akad'. Med'. Wiss. 35(1-3 ):99-109, 19'79'. ('German). Gravella, E. Smoke and'oncogenesis. Minerva Med. 73(36'):2349- 235'6, 1982. (Italian) Great Britain Laboratory of the Government Chemist. Report of the Government Chemist, 1!9791. Londlon : Her Majesty's Stationery Office, 1980. Chapter 51: smoking and health issue. Greenberg, R.A., Etzel, R.A..and Haley, N.Ji. Exposure of thee fetus, neonate, and nursed infant to nicotine and cotiniine from maternal smoking. (better ) Ni. Eng,l. J. Med., 311(101) : 672, 1984 . Greenberg, R.A., Haley, N.J., Etzel, R.A., Loda, F.A. Measuring the exposure of infants to tobacco smoke: nicotine and cotinine in urine and saliva. N. Engl. J. Med. 310(17):1075-1078, 1984. Greene, G.E. Nons:nokers' rights. A public health issule. JAMA 23'9(20):2125-2127, 1978. Gregory, J'. Office air quality, "tight buildings," and job stress--the impaict on women office workers' occupational health. Conference of the American Industrial Hygiene Association,/American Conference of Government Industrial Hygienists, Portland, Oregon, May, 251, 1981. - Grimmer, G. Causal connection questionable (letter). MNtW 124(4):16', 1982. (Germa!n) Grimmer, G., Bohnke, H., Harke, Hi.-P. Passive smoking: intake of polycyclic aromatic hydrocarbons by breathing of cigarette smoke containing air. Int. Arch,. Occup. Environ. Health 40(2):93-99, 1977. '( Ge rmazn ). Grimmer, G., Bohnke, H., Harke, H'.-P. Passive smoking: measuring of concentrations of polycyclic aromatic hydrocarbons in rooms after machine smoking of cigarettes. Int. Arch. Occup. Environ. Health 40(2):83-9'2, 1977. (German)' Grob,, K. Gas chromatography of cigaret smoke. III. Separation ofl the overlapiregion of'gas andiparticulate phase by capillary columns. J. Gas Chromatogr. 3('2):52-56, 1965.. Grob, K. Gas chromatography of cigaret smoke. II. Beitr. Tabakforsch. 9:315-323, 1962. Grob, K. Gas chromatography of cigaret smoke. I. Beitr.. Tabakforsch. 7:285-2'901, 1962. O Grufferman, S., Delzelil, E.S., Maile, M.C., Michialopoulos, G. ~ ~ 21 ~ ~ ID-21

Bibliography oni Involuntary Smoking,/March, 1986 First, M.W. Environmental tobacco smoke measurement: retrospect and prospect. Eur. J. Respir. Dis. (Suppl) 133:9-16, 1984. First, M.W. Exposure. [Environmental tobacco smoke.] Eur. J. Respir. Disi. [Suppl] 133:13'7-139', 1984. First, M.W. Passive smoking. In: 1975Isymposium nicotine and carbon monoxide, proiceedings-I, University of Kentucky, 1977. pp. 173-175. First, M.W'., Hinds, W.C. Ambient tobacco smoke measurement (',letter). Am. Ind. Hyg. Assoc. J. 37'(11):655-65'6, 1976I. Fischer, T'., Weber, A. Passive smoking, in the work place. Soz. Praventivmed. 2S(6):401-406, 1980. (German) Fischer, T., Weber, A., Grandjean, E. Air pollution, due to tobacco smoke in restaurants. Int. Arch. Occup. Environ. Health 41(4'):267'- 280, 1978. (GermaniT Fletcher, C.M., Dionovani, J.W., bawther, P.J., Waliler, R.E., Ball, R.P. Pipe, and cigair smoking: the report of an expert group appointed by action on smoking and health. Practitioner 2101(1!259 )1:6'45-6'52, 1971. Foliart, D., Benowitz, N.L., Becker, C.E. Passive absorption of nicotine in airline flight attendants (letter). N. Erngl. J. Med. 3081(,18 ) :1105', 1983. Foote, K. D. Children's coughs related to parental smoking (letterY. Br. Med. J. [',Clin Res] 23:2'88(16434):1917, 1984. Fortmann, S'.P., T'. Rogers, and K. Vranizan, et al. Indirect measures of cigarette use: Expired-air carbon monoxide versus plasma thliocyanate. Prev. Med., 13:127-35, 1984. Foster, SI. Stmoke and heat (letter). N. Engl. J. Miedi. 293(l):48, 1975. Frank, R. , Lebowi~tz, M. D. The risk of staying in ( editorial ). Am,. Rev. Respir. Dis. 124(5):521-522, 1981. Fredieriksen, Li.W'., Martin, J'.E. Carbon monoxide and smoking behavior. Addict. Behav. 4(1):21-30, 1979. Freedman, A.P. Small-airways dysfunction in passive smokers (letter). N. Engl. J. Med. 303'(7):393, 1980. Freimanis, A.K. Smoke and heat (letter). Ni. 2'93(1):48, 1975. Ezgl. J. Med'. ~ 0 Friedman, G.D., Petitti, D.Bi., Bawol, R.D. Prevalence and' U1 correlates of passive smoking. Am. J. Public Health 7'3(4):401-405',(7) X ~ 18 r ~ N C - 10.

Bibliography on Involuntary Smoking/March, 1986 Lenfant, C., Liu, B.M. (Passive) smokers versus (voluntary) smokers (editorial). N'. Engl. J. med. 302(13):742-743, 1980. Letzel, H.W., Johnson, L.C. The extent of passive smoking in the Fedleral Republic of Germany. Prev. Med. 13(6'):717-729, 1984'. Lewis, O.D. Establishing smoke-free environments. In: Ramstrom, L.Ml. (ed.). The smoking,epidemic, a matter of worldwide concern. S'tockholm : Almqvist & Wiksell International, 1979. pp. 255-259. Liard, R., Perdrizet, S., Reinert, P. Wheezy bronchiltis in infants and palrents'' smoking habits (letter). Lancet 1( 8267 ) : 33'4-33'S, 1982. Lindell, S.E. Passive smoking. In: Ramstrom, L.M. (,ed.). The smoking epidemic, a matter of worldwide concern. S'tockholml: Almqvist & Wiksell International, 1979. pp.5'7-59'. Lindesmith, L.A. Clean indoor alir--a fight for rights for health--not unwarranted government intervention. Wis. Mled. J. 78'(',11) :12-13, 1979. Litzinger, E.F., Miatti~na, C.F., Bush, L.P. (,eds.). Formation, analysis, and composition of tobacco smoke. Proceedings of the 36th Tobacco Chemists'' Research Conference, Raleigh, North Carolina,, October 24-27, 1982. Recent Adv. Tobacco, Sci. 8':1-185'. Liu, Y.-Y., Schmeltz, I., Hoffmann, D. Chemical studies on tobacco smoke. Quantitative ana-lysis of'hydrazine in tobacco and cigarette smoke. Anal. Chem. 46(7'):885-889, 1974. Lloyd, D.S'. Connecticut's clean indoor, air act. J'. Public Health Policy 2(2):153!-157, 1981. Loeb, L.A., Ernster, v.Li., Warner, K.E., Abbotts, J., Laszlo, J. Smoking and lung cancer: an overview. Cancer Res. 4!4(112'P't 1):5940-59,58, 1984. Longo, L.D. Some health consequences of maternal smoking: issues without answers. Birth Defects: Original Article Series. 18I(,3A) :13-31, 1982. Longlo, L.D. The biological effects of'carbon monoxide on the pregnant woman, fetus, and newborn infant. Am. J. Obstet. Gynecol. 129(1):69-103, 1977.. Luck, W. , Nau, H. Nocotine and cotinilne concentrations in, serum and urine of infants exposedi via passive smoking or milk from smoking mothers. J. ediatr. 107(5):816'-8'20, 1985. Luck, W'. , Nau, H. EScposure of the fetus, neonate, and' infant to nicotine and cotinine from maternial smoking. 37 nursed N (letter). ~ D-3 7

Bibliography on Involuntary Smoking/March, 1986 Holsclaw, D.S., Jr., Topham, A.L. The effects of smoking on fetal, neonatal, and childhood development. Pediatr. Ann. 7(3),:105-136, 1978. Holt, P.G., Turner, K.J1. Environmental tobaicco smoke. Effects in humans. 'Respiratory symptoms in the children of smokers: an overvi'ew. Eur. J. Respir. Dis [Suippl. ] 13'3:10'9-20, 1984. Holt, P.G., Turner, K.J. ETS--environmental tobacco smoke, Report from a workshop on ffects andiexposure levels. March 15- 17, 1983, Switzerlandl. Eur. J. Respir. Dils. [Suppl] 133•1-152, ~ 1984. . Holt, P.G., Turner, K.J. Nonsmoking in hospitals, AMA Council on Scientific Affairs. Conn. Med. 4!8(5):2'97'-305, May 1984. Holzer, G., Oro, J., Bertschl, W. Gas chromatographic-mass spectrometric evaluation of exhaled tobacco smoke. J. Chromatogir. 126:771-785, 1976. Horn, D. Smoking and disease-what must be done. WHO C'hroni. 31:355-361, 1977.. Horning, E.C., Horning,, M.G., Carroll, Di.I., Stillwell, R.Ni.,. Dzidic, I. Nicotine in smokers, non-smokers and'room ai'Ir. Life Sci. 13(10):13'31-1346, 1973. Hosein, H.R., Corey, P. Multivariate analysis of nine indoor factors on FEV1 of~ caucasian children (~a~b~~st~ract).~ Am,. Rev. Respir. Dis. 129'(4 Pt 2):A1401, 1984. Hosen, H. Tobacco sensitivity (letter). Ann. Allergy 29111) : 608!-6109 , 1971. House, R. The health effects of involuntary exposure to tobacco smoke. Health Studies Service, ©ntairio Ministry of Labour, June 19851.. Huber, G.L. Small-airways dysfunction in passive smokers (,letter). N. Engl. J. Med. 303(17):3'92'-3'91, 19'80~. Huber, G.L. Smoke and heat (letter). N. Engl. J. Med!. 2'93(1):48-49, 1975. Huber, G'.L. Smoking and nonsmsokers - what is the issue? (leditori~ali) N. Eng,l. J. Med. 292(16):858-859, 1975. Huch, R., Danko, J., Spatling, L., Huch, A. Risks the passive smoker runs (,letter). Lancet 2(8208-8209):1376, 1980. Huglod, C. Passive smoking. Ugeskr. Laeger 143'( 3'4 )• 218'1-2184, 1981. (Danish) Hugod, C. Indoor air pollution with smoke constituients: An 28 i D-28

Bibliography on Involuntary Smoking/March, 1986 74, 1961. (,French) Morgan, P'.Pi. Time for action on passive smoking. Can. Med. Assoc. J. 1'27( 9):8'10-8!11, 1982. Morgan, W'. J., Taussig, L.M. The chronic bronchitis complex in children. Pediatric Clinics of North America 31(4):851-864, August 1984. Morimoto, K., Miura, K., Kaneko, T.,, Iijima, K., Sata, M'. Koizumi,, A. Humanihealth situation and chromosome alterations: sister chromatid!exchange frequency in lymphocytes from passive smokers andl patients with hereditary diseases. Basic Li~fe S'ci. 29, Pt 8:801-811, 19841. Morozov, V.V. Harm of passive smoking (material for talks')i. Feldsher Akush. 47(2) :57-5&, 198'2. (Russian), Mossman, P.B. A smoking argu¢nent ('letter) . J1. Occup. Med. 25(12):81, 1981. Mozherenkov, V.P, Finkelberg, E.I. Kurenie Tabaka i Organ Ereniia. Smoking and the organ of vision. Vestn. Oftalmol. (2):66-68, 198I4. (Russian) Muir, D. Tobacco smoke inhalation. Scand. J'. Respir. Dis. Suppl. 91:44-46I, 1974. Muramatsu, S., Muramatsu, T., Weber, A. A survey on attitudes towards passive smoking among schoolchildren and students in Switzerland. Soz. Praventivmed. 28(2):82-84, 1983. Muramatsu, M. , Umemura, S~. ,©bcadia, T., Tomita, H. Estimation of' personal exposure to tobacco smoke with a newly developed nicotine personal monitor. Environ. Res. 3'5(1)218-227, 1984. Muramatsu, T., Weber, A., Muramatsu, SI. , Akermann, F. An experimental study on irritation and annoyance due to passive smoking. Int. Arch. Occup. Environ. Health 51(4):305-317, 1983.. Myers, M.G., Fomon, S.J., Koontz, F.P.,, McGui'nness, G'.A.;, Lachienbruch, P.A., Hollingshead, R. Respiratory and gastrointestinal illnesses in breast- and formula-fed infants. Am. J. Dis. Child'. 138(7')1:629-6I32', 1984. Nadkarni, R.A. Some considerations of metal content of' tobacco products. Chem. Ind. (17):693-696, 1974. Nagday N.L., Koontz, M.D. Microenvironmental and total exposures to carbon monoxide for three population subgroups. J. Air Pollut. Control Assoc. 35(2'):134'-137, 1985. Nahum, L.H1. Toxic prodiucts in cigarette s:noke: pleasure or 41 D-41

CHART II: MAJOR PROVISIONS OF CALIFORNIA' LOCAL StdORZNG ORDINANCES COi POPULATION YEAR/MONTH WORKPLACES ENACTED REGULATED RETAIL RESTi1URA;YTS'. ST1aRES' Nr.,places regulating: 66: 54 62' Antioch 46,600 1985/11 All 4+ A11Bus. 40Z 50+ + Berkeley 1'06y500 1980 All A17Bus. 504' All Brentwood 5,150 1985/111 All 4+ A11Bus. 40% 50+ Carlsbad' 44',550 1983/0fO' All ('.1] Yes NoZ 20ir Carpi'nteria 11,400' 1985/03 All Chula Vista 90,300 1984 All [1] Yes NoZ 20+ Clayton 4,490 1985/11 All 4+ A'lil!Bus. 40'. 50+ Concordi 105,000 . 1'985/'11 All 4+ -A11Bus. 40T 50+, Coronado 90,300 1984/08 A1'1 [1]i Yes No»'20+ Cupertino 33,,950 1985/02 Ofc.Wkpd. Yes 30Z 50+ Damvil'1e 27,600 1985/11 A11 4+ A11Bus,. 40» 504 Del Mar 5,125 1983/06 All (1'] Yes; NoZ 20+ El Ca jpa 80;100 1'985' All , 5+ Yes NoA 20+ El' Cerrito 23,300 1'98511i1 All 4+ A11Bus. 4'02 50+ Escondido 75:,,800 1983/12 A'1'1, (',1 ]' (8] Noz 20+ + Grand Terrace 9,875 1985/11 All [6] Dept. 25% 50+ Hemet 28,050 1985/05 All C17 [i11, No7r 50+ Hercules 7;300 1985/10 All 4+ A'1'1'BUs.40z 50+ ++ Huntington Beach 179,900 1'986/02' A11,4,r 252 50+ Imperial Beach 24,550 1985/10 All (1), Yes No' 20+ Indic 28,,200 1!985/11'. A'11 (16 ] Dept. 50~ 50+ La Mesa 52,200' 1984/02 AS1'(1) Yes Noi 40+ Lafayette 22,500 1985/10 All 4+ A11Bus,. 40Z 50+ Laguna Beach 18;450 1985 Ofc.Wkpl. 25: 40+ Livermore 52,100 1'985/06 A11 A1iliBus. 501. Long Beach 381,800 1'985/07 A'1'1 5+ 25' SO+, + Los Altos 27,400 1'979 All Yes 25Z',50+ Los Angeles 3,,144,800i 1984/11 All 5+ Los Gatos 27,750 1980/06 A1'1, Yes 50S 25+ Martinez 250300 1985/11' All 4+ A11Bus. 40% 50+ Milpitas 41,850 1'985/08 A1l' A'l.118us. 50'» Mountain View 611,600: 1984/06 All A11Bus. 50Z Nat'ionalCity 51;,,200 1984L05 A11, (11 ]I Yes Noz, 40+ Newport Beach 66,1KJ0~ 1985/06 Oft. > 4 25% 50+t Oceanside 91,800 1983 All [1] Yes No7. 20+ • Orinda 1'5,000 1985/12' All 4+ A'i1Bus.40S 50+ Palo-AStw 56,200 1983/'110i Ofc.Wkpl. 1/3 50+ Pasadena 126,600 1984 Of;c.Wkp1'_ 25Z ' 50+~ Pinol~e~ 1f+„550 11985I11~ A'1'1, 4+ A11Bus. 40:~ 50,. Plttsburg, 38,600i 1985/11 A11 4+ A11Bus. 40' 50* Poway 35,950 1983/03' All [1] Yes No : 20+ + Rancho Mirage 7,575 1986/02' All [IlJ Yes Yoa 20+ RicHmond 76,900 1'985/09 A11 4+ A1iliBus. 40x 50+ Riverside 183,400 1'985J05 All (6J Dept. 25Z 50+ Sacraoento 875,900 1985' All (1]', Yes 10% 50+ San Diego 971,600 1982/12 All (1] Yes NoZ'20;. San Francisco 71'9,2001 1983/11 Ofc.Wkpl. San Jose 696,000 1984' A11' Yes 30: 100t San Lub's Obispo 37,150 1985/12 A11 5+ NoZ 50+ San,"larcos 19,800 1983il03 All (1) Yesi Noi 20+ San Pablo 21,200~ 1985/10 All 4+ Ai1Bus. 4'0A'50+~ San Ramon 23,4'50, 1985/11 A17, 4+ A11Bus. 40% ',50+ Santa Barbara 327,200, 1984 All 25: 20+r Santa Clara 89,000 1985/07' a1D Yes 30% 50+ Santa hlonica 93,100 1985/04 All 6+ Santee 49,500 1'983/02 A11.[1] Yes NoZ 20+ Tustin! 40,800 1985/12 All (1], Yes No2 20++ Ukiah 13,050 1981/07 All Yes 502 Vista 43,450~ 1983/04 All (1] Yes No. 20+ Walnut C'reek 57,700 1985/11 All 4+ A11Bus,. 40X 50+ Yorba Linda 36,100 1985Jd9' All 11'+ Yes 1/3 40+ County of Contra Costa 139,800 1985/09 All 4+ A1!liBus. 402 5G1+ County af. R^_versd.de 323,500 11985 ' All (.61 Dept. 25+ 50+ County of' Sacramento543, 500 1985/02.All, (' 1]' Yes 1'OZ~50;r County of'San Diego, 406,100' 1982/12 A11 (7) Yes 44 20+ County of Santa Cruz 1'21 300 1985 A'1!1 Yes No ~I , Populati'nn covered 11,296,065 Percentage of state: 44 '. (3/1/86): C-5

Bibliography on Involuntary Smoking/March, 1986 Parents" cigarette smoking andichildhood cancer. Med. Hypotheses 12'(l):17-20, September, 1983. 1Grufferman, S., Wang, H.H., DeLong, E.R., Rilmm, S'.Y.S., Delzell, E'.S., Fallettal, J.M. Environmental factors in the etiology of rhabdomyosarcoma in childhood. JNCI 68(1):107-113, 1982. Grundmann, E., Muller, R.-M., Winter, K.D. Non-smoking wives of heavy smokers...risk of lung, cancer (iletter),. Br. Med. Ji. 282(16270):1156, 1981. Guerin, M.R. Detection of sulfur-containing,compounds in the gas phase of cigarette smokes. Anal. Lett. 4(11):7'51-759, 1971. Guillerm, R., Hee, J. Effects of nonoccupational air pollutants upon the tracheobronchial mucosa (except bronchial cancerJ. Bronicho-Pneumologi~e 2'6'(1) : 3-22', 1976. ( F'rench) Gulovali, M.C'.,~ Guniduz~, C. T~r~ac~~e~ e~le~~ment~s~ in Tur~k~~ilsh tob~ac~co~ determined by instrumental neuron activation analysis. J. Radlioanal. Chemi. 78(1):189-198, 1983. (Turkish). Gunby, P. Wives'' ischemic heart disease linked with husbands' smoking (newst. JAMA 2'53 ( 20 ): 2945 , 198'5. Gutenmann, W1.H., Lisk, D.J., Hoffmann, Di., Adams, J.D. Selenium in, particulates and gaseous fractions of smoke from cigarettes prepared from tobacco grown on fly-ash-amended soil. J. Toxicol. Environ. Health 12r2-3):385-393, 1983. ft . Gutenmann, W.H., Bache, C.A., Lisk, D.J., Hoffmann, D., Adams, J.D., Elfving, D.C. Cadmium and nickel in smoke of cigarettes prepared from tobacco cultured on municipal sludige-amendedisoil. J. Toxi~col. Environ. Health 10(3):423-431, 1982. Guyatt,, G.H., Newhouse, M.T. Are active and passive s'mokingi harmful? Determining causation. Chest 88(13):445-4'51, 1985. GGvozdjakova, A., Kucharska, J., Sany, L., et al. Effect of smoking on the cytochrome and oxidase system of the myocardiuan. Bratisl. Lek. Listy 8'3('1):10-15', 1985. (Czech) GNozdjakova, A., Kucharskai, J, Sany, L., et al. The effect of cigarette smoke on cytochrome-oxidaise of the heart muscle. Cor Vasa, 26 (,6 ) : 4!66-4618, 1'984 . Haagien-Smit, A.J., Brunelle, MI.F'., Hara, J. Nitrogen oxide content of smokes from different types of tobac o. A.M.A. Arch. Indust. Health 20:399-400, 1959. Halfpenny, P.F., Starrett, P.S. Control of odor and'irritation due to cigarette smoking aboard aircraft. Am. Soc. Heat Air Cond. Eng. ,7. 3 : 3'39-344, 1961. 22. 0

Proposition P: anat©my of a nonsmokers' riigbtss ordinance hF:TL'R I IANAI'JCR', t:SQ On Norember 8, 1983, voters in San Francisco passed', "Proposition P;' a referendum on the city's workplacc smoking ordinancc which ha& bccn cnacted by the Board! of Supervisors (uht .~tquivalcnt of a city council) six months earlicr: The vote matkt:d the first' time t'hao the tobacco iitdustry, which has consistently opposed all laws rcgulatin,g public smoking, hud' been defeated in such an election contiest, and it meant that San, Franciscans had approved what was thenithc strongest workplacc smokiitg lsw in the country. The ordinance reyuires that all public and private offcc~ workplaces havc policies on, smoking that seek to accommodate thc nct:ds of smokers and nonsmokcrs. it requires that notice of the policies bc giNCnto employacs and that appropriate signs be posted. The'law is enforccd by the citry's health department, and civil penalties are imposed on employers who fail to establish rcasonable policiies. WINNING OVER BusINESS' LEA4DERS To~understand why the'ordinance reached the ballot in the forrnlof a referendum, it is helofullto review the proctss by which it became law: VlJhen first i'ntroduced before a threie-member committee of the Board of Supervisors, in January i'983, the'ordinantx was stroogly supported by Californians fmr Nonsmokers' Rights (a non-profit orga- niYationdeveloping legislative, legal; and eduealtional ap- proaches tocurtail'smokiieg in ipublic places a~nd the work- site) land by the health cqmmuni'ty ingenerai. It drew vir- tually, no opposition. But by the end of the second hearing,, the sympathetic committee had reservations abouu thee specific language; partly due to a, letter from Robert Beck„ a Bank of Arnerica vice-presidbnt and a, leader in the 3merican Cancer Society. Although he expressed sbrong, support for the concept of the ordinance, Beck was con- cerned that the rigid conditions'of certain provisions would adversely affect businesses. The committee asked for a one-month continuance to see if' the problems eould' be : ironed out. On the day before the ne:tt scheditled hearing, the Chamber of Commerce asked for a meeting with Cal* iforrians for Nonsmokers' Rights to discuss an alternative proposal by the Bank of America. The bank presented the idca xltat became the corners3one of the ordinance and the center oficontroversy: that every'empUoyer be required!to establish, a smoking policy to satisfy the needs of' both smoking and nonsmoking office workers; but if an accom- modation satisfactory to the nons'mokers„whatever their number, could not be made, then smoking would be pro- hibited in that' work area. This proposal would give busi- nesses flexibility inisolving a problernl buvwould giveem- Ployeesa statutory right to a smokc+free environment. In cxchange for acceptiinS', the proposed compromise N r. Hanauer is an editorof law booki and r past-president of the :9oand o('.Di- reetoniof CGlifornians (or Nonsmokers' Riehts. Addi%swtreyponderee to d,y r: Hlanauer, Cal i(orntans for Nonsmokers' R~i 6hts, :*S4 Uni,ersn yA,e. Suiie 500, , 8arkelery. C A.9a7114 . language, the Chamber of Commerce agreed not to;oppose' the ordinance. The precise language was hammered out at one further meeting; attended by Supervisor Wendy Neldcr,. the author.of the ordinance, and representatives of'Calii- fornians for Nonsmokers' Rights; the Chamber of Com- merce, the Small Businessmen's Association, Bank of' America, and two othcr, banks. The ordinance was passed unanimously by uht; supervisors' committec in early May. In two reyuircdivotcs by the full Boardl the mcasure passed by 9 to12 and 10 to 1. It was signed into law by Mayor Dianne Feinstein on June 3. This happened despite intensive lobbying against the law by the'Del!Monte Corporation, a subsidiary of'RJ Rcynolds since 1'979, the localiattorney for the Tobacco instlitutc„and even some members of the na- t,ional Democratic Party who tried to persuade the Mayor to veto the law, In support of themeasure were hundreds of telephone ca11s and letters from San Franciscans. The Mayor later reported that she had recciveti more than 100 letters from people'around the country who urged her, to sign the ordinance so thaetheir local governing,bodies would be encouraged to enact similar legislation. Shortly before the first vote by the full Board, the Chamber of Commerce broke the agreement not, to oppose the ordinance. Since its promised neutral stance had'never been publiciied„thcChamber of Commerce did not appear to have changed its position. On June 1 S, siit people held a press conferencc to announce a campaign for a referendum: to repeal the ordinance. Having eonfrontedl the tobacco industry in Uwo statiewide initiative campaigns in 1'978 and 1980, proponents of the ordinance knew the real signlir, cance of' the announcement and were prepared for what followed. Each tobacco industry campaign, has certain predictable elt:ments, and the Proposition P carnpaigrt fol~ lowed the usual pattern: . The major cigarette companies, thrtatghi their public rela- tions arm„ the Tobacco Institute, hire a campaign manager, whose fursvtask,is toorgrnize a9ncal organizationlof "concerned'; oitizens,"'whicli'then becomes the nominal campaign organisa- tioa. In a ttormal'politial campaign„al group of people forms a steering committee : to act as a policy-making, body, and it,, in, turn, hires a campaign manager, The tobacco industry does ex- actly the opposite, because no grassroots or lor„ally financed or- ganizations opposed to nonsmokers' rights'ttogistation have ever been formed. Moreover, the industryseeks'total controliover pol- icy matters, and the way tolaccomplish that is to hire its own campaign manager. • The tobacco companies contribute to the campaign in di- rect proportion to their rapective market shares. This is a keyy indication thaith'e campaign is actually being run,by the indsu- tryitself-as a single entity-and not by theloeat'organization. • The tobacco companies go to great lcngths to downplay both the extent and nature of their involvement.,They denN that they are doing,any,thing other'uhanimaking financial! contribu- tions to a locaJ campaign organization and'they grossly undtres- timate the amounts of money they are,contributing. They also delay in making the largcst contributions until the end! of the JULY 19N5/NF.W YORK STATE JOURNAL O'F M1EDICINIE 3G9 B-I

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C f LIE #1: I I I lil~e/ /.l 9rl U~ iM Ttibexo ibr.r/Y oM Corl iMt /rl~aettlr ~ b at tfl ilrtloC tsn.ae. ww. lw.r..oro. rn.-r.w+w~n s... t~~ . Ttu'tonscco liaduslrY 71ed sbout povenrmeat't rote In rnloroinq iPropoation iP. I The toeuto ardastary li.d iemd +rse,i3 sthCad'btt, Pn aerpmud .....w ....w.yv...~w L~~ I ll T funQS CxtO'wOusUY 6td sUOUt ltae'use af Du01it LIEI #5: LIE #61 TtstltottaetO!admy Ibe laooa wrrptan disurai. tw.'n..~m~..x.rrK~...o ..a.....~.ns...a..~..,.a tMtrC 0. PY W~. ~/ .IIf.Vw OiiMw9~w'.wTOW~C~ ~.~•. w...~r ~.Lw~L.~..W.. Trie'tabacoo Industry Ilrea IsDOut emploYet oxqaia• ap nqpts. ''~  Tl+e tmsoeo liatl6s~ Iied at0ort itlfat~ AaaneY's i` f.7ii  a~..~+.+n..nm.aa+., ..r..~ ,....r•...... v.... LI1E #8: Ll E ' LIE. #10: I Ttte tobacca' laeustrY Ned aAaut the eftects of'sea onQ-lliad IIoOaCia!sttlate: TAe tatbow Nrlr.>nYIt1.llseerA tts yelttioas. ...., ..e.~.,,w.~.d.....~ .....d~.b.. ~nart.,u.......o.~w.er~, a+.. t....:........... .. f .~. The tuascto mduoY he'tl sAorA ftlowt wpport. 374 NEW YO'RA STnTI: JIO'UR"Vnd- OF N1FtDIICINE/J'UllY 1985 B-6' ..,.,...~...>o. ~. d ~..._...~.e.. s.lMawrawtn.ero~aslrn~.n wewa~e. /.ww I..'ui7sL~aa.f.~.r Iw r ~..ww~ar~ 1e w...r ae~ U W(hme ~ w w ert .. ProDOStoan P is n eatuety' TaUTH: 'Uq-entors,nq tme: ~Q I.~.~.PdOQ091S0a/~dOESOf11f:7YA!'~s~I0flY~el ' ie ~'.CIIQIpfeE{li4d00{ aQ Rail'~ IqoYMOaleat ~. itiors..om~erw.aeul..aww. aimn~oam~r.e~ S-:.N- . rI ¢1.~~~.Ar ~a~a.. NO..~4'OMYiJVW~Y~7 1~... ~.~~o.. ~....'wnw.. ~...~+.....S.Y A. , THUN: ProtpLlwn P wu lcosf aotlwtq to ttre lupayac' '/'@~ /"~'{~. theposirre iP aoa eat ttroaab s sav 'saf. ,,.rt~fap arra>a~urear ~~ . . . VpViw./ P'&naEeaa emDlrrnes Uaqaunaq nqa13 I If71IM` The Cify AtlereeN.ill raat ' . .1 , P I . . , q• Ae..u...'..n.w..~....w.._.a,.... rn.Gw,ro... ....ae....a~..*..o.-,,.w.v~.~., woe~w.~. ..rr..mw~.waw I Seovid-tuM uaoke Ina qe CeadlYl r THUM: ITfr roAooe YrdrstrY Aad to Ipq, ifsiaefl0wwts f6 ptt Pre~ralbtrP m tM lYia ~. L.,~.....~.....a.~.., _... .rrwN~~®re.+w.w~w~~arw.o tr..l. ~MI.7mawr.pY.ww..s~.~.. w~a~ro~ tw. w.a.a~..~r la NS Om ie y~ ..q...w nq ~r o.v Iw Y. F..ee.~~e.w ee. w. qr.. ~ ..me.0'. Pvwi.ro+aa...a.a»rawrw.~ ~//~]. ~. TAe+t rs,MfM appo~bm to 111 N ~ ii. Plvqaalan IP ....+.r .~0.Y n ~ iY.tw..... ~ ~....frw ~~ w.. ~.................. w ... C

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Bibliography on Involuntary Smoking/March, 1986 smoking on pulmonary function in children. Environ. Iint. 37:151- 155, 1982. Lebowi~tz, M.D., Burrows, B. Respiratory symptoms related to smoking habits of family adults. Chest 69(1):48-510, 1976. Lebowitz, M.D. Airway responses of children to environmental irri~tants (,editorial). Lee, P.N. Passive Smoking,. Food Chem. Toxicol. 20(2):223-22'9, 198'2. Lee, F.N. Passive s:noking,(letter). Lancet 1(8275):791, 1982. Lee, P.N. Non-smoking,wives'of heavy smokers ... risk of lung cancer (letter). Br. Med. Ji. (Clin Res) 283(6304):14165-1466, 1981. Leeder, S.R., Corkhill, R.T'., Irwig, L.M., Holland', W.W., Colley, J.R.T. Influence of family factors on asthma and wheezing during the first five years of 1ife. Br. J. Prev. Soc. Medi. 30(4):213- 218, 1976. Leeder, S.R., Corkfiill, R.T'., Irwig, L.M., Holland, W.W., Colley, J.R.T. Influence of family factors on the incidence of lower respiratory illness during the first year of life. Br. J. P'rev. Soc. Med. 30 ( 4):203-212, 1976. Lefcoe, N.M., Ashley, M.J., Pederson, L.L., Keays, J'.J. The health risks of passive smoking. The growing case for control measures in enclosed environments. Chest 84(1):90-915, 1983. Lefcoe, N.M., Inculet, I.I. Particulates i!n domestic premises. II. Ambient levels and indoor-outdoor relationships. Arch. Envi~ron. Health 30(12):5165-570, 1975. Lefcoe, N.M., I'nculet, I.I. Particulates in domestic premises. I. Ambient levels and central air filtration. Arch. Environ. Health, 22:230-2138, 1971. Lehnert, G. Conclusion: the realm of the speculative (letter). MMW 12'4(4):19-2'0, 1982. (German) Lehnert, G. Sick by passive smoking? MMW 123(',40):1485-1488, 1981. (German) Lehnert, G., Garfinkel, L., Hirayama, T., Schmahl, D. , Uberla, K., Wynder, E.L., Lee, p. Roundtable discuission: symposium: medical pers!pectives on passive smoking. Prev. Med. 13(16):730-7'46, 1984. Lehnert, G., Wynder, E. L. Medical perspectives on passive smoking: foreward to passive inhalation. Prev. Med. 13:557, 1984. 36 r D-36

Bibliography on Involuntary Smoking/March, 1986 standard for ambient tobacco smoke. Proceedings of the 3rd International Conference on Indoor Air quality and Climate, August 20"24, 1984 S'tockholmi. Repace, J.L., Lowrey, A.H. Modeling exposure of nonsmokers'to ambient tobaccoismoke. Paper presented'at the 76th annual meeting of the Air Pollution Control Association, Atlanta, June 19-24, 1983. Repace, J.L., Lowrey, A.H. Nonsmokers and cigarette smoke: a modified perception of risk (letterf. Science 215(4529):197, 191821. . Repace, J.L., Lowrey, A.H. Tobacco smoke, ventilation, and indoor air quality. ASHRAE Trans. 88(Bt 1)1:8915-914, 1982. Repace, J.L., Lowrey, A.H. Indoor air pollution, tobacco smoke, and public health. Science 2A8(4443):464-472', 19'801. Repace, J.L., Seba, D.B., Lowrey, A.H., andiGregory, T.W. Effect of negative ion generators on ambient tobacco smoke. J. Clini. Ecology 2:90-94, 19831-8'4. Repetto, M., Martinez, D. Benzopyrene from cigarettes and its urinary excretion. Eur. J. Toxicol. Environ. Hyg. 7(4'),:234-23'7, 19'7 4. ( F'r e nc h) Rickert, W.S. "Less hazardiouis" cigarettes: fact or fiction? NY State J. Mied. 83'(13):12'69-1272, 1983. Rickert, W.S., Robinson, J.C., Bray, D.F., Roers,, B., Collishaw, N.E. Characterizatiion of tobacco products: a, comparative study of the tar, nicotine,, and carbon monoxide yields of cigars, manufactured cigarettes, and cigarettes made from fine-cut tobacco. P'rev. Med. 14!(,2'):226-233, 1985. Rickert, W.S., Robinson, J.C., Collishaw, N. Yields of tar, nicotine, and carbon monoxide in the sidestream smoke f'rom 15 brands of Canadian cigarettes'. A:n. J. Public Health 74(3):228- 23'1, 1984. Robinson, B.F. Effects of passive smoking (letter). N. Engl. J. Med. 299(16):8196!-897, 1978. Robinson, S.A., Wolfe, S.M. Smoking: It's adverse effects on airli~ne piot performance. Public Citizen. Report by Health Research Group, Washington, D.C., April 1976. 52'pp. Roemer, R. Restrictions on smoking in the workplace. In: Roemer, R'. Legislative action to combat the world smoking epidemic. Roemer, R'. Geneva : World Health Organization, 1982. Restrictions on smoking, in public places. pp. 60-63. In: 499 D:-4' 9

BibSiography o Involuntary Smoking/Marchl, 1986 specific U-nitrosainines in the smoke of selected cigarettess fromn the U.S.A., West Germany and France. J. Anal. Toxicol. 4'(',5') :25'5-259, 1980. Rummel, R.M., Crawford, MI., Bruce, P'. The physiological effectss of inhaling exhaledicigarette smoke in relation to attitude off the nonsmoker. J. Sch. Health 45(9):52'4-529, 19751.. Russell, M.A.H., Feyerabend; C. Blood and urinary nicotine inn non-smokers. Lancet 1('7900):179-181, 1975. Russell, M.A.H., Cole, P.V., Brown, E. Absorption by non-smokers of carbon monoxide from room air polluted by tobacco smoke. Lancet 1(,7803 ) : 5'76-5'79, 1973. Russell, M.A.H., Cole, P.V., Brown, E. Passive smoking,: absorption by non-smokers of carbon monoxide from room-air polluted by tobalcco smoke. Postgrad. Med. Ji. 49(57'6),:688-692, 1973. RRussell, M.A.H., Cole, P.V., Brown, E'. Absorption by nonsmokers of carbon monoxide from room air polluted by tobacco smoke. In: Edwards, G., Russell, M.A.H., Hawks, D., MacCafferty, M'i. (eds.). Alcohol depend'ence andismoking,behaviour. London : Saxon House/Lexington Books, 1976. pp. 183-190. Russell, M.A.H., Lebowitz, M.D. Effects on health. Eur. J. Respir. Dis. (Suppl.] 133:14A-142, 198'4. Russell, M.A., West, R.J., Jarvis,, M.J'. Intravenous nicotine simulation of passive smoking to estimate dosage to exposed non- smokers. Br. J. Addict. 80(2):201-2'061, 1985. Rutsch, M. Statistical support lacking (letter). MMW 124'(',4')•1'5, 19'82'. (Germani) ~ Rutsch, M. Non-smoking wives of heavy smokers ., ri'sk of lung, cancer (letter). Br. Med. J. 282(6268):985', 1961. Rylander, R. Environmental tobacco smoke and lung cancer. ~ Eur. J. Respilr~- D'is,. [Supp~~l. ] 133:127-133, 1984. Rylander, R. Workshop perspectives. Eur. J. Respir. Dis. [Suppl] 133:143-145', 19841. Ryland'er, R. The effects of tobacco smoke on nonsmokers. Med'. Hyg. 33(1i136'):2516-257, 1975. (French) Rylander, R. Perspectives on environmental tobacco smoke effects. Scand. J. Respir. Dis. Suppl. 91:79-87, 19'74. Rylander, R. (ed.). Environmentail tobacco smoke effects on the non-smoker. Report from a workshop. Scand. J. Respir. Di's. 51 D-51

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v 2025684230 ----- - - --------------------------------------- Ir.

Bibliography on Involuntary Smoking/March, 1986'. Cond. Etrg. Trans. 75.93-10'2, 1969. Pachman, J.S'_, Frederiksen, L.W. "Yes I1 do mind"; social skills training,for nonsmokers. Addict. Behav. 4(1):75-81, 1979. Pakozdi, L. The legal protection of non-smokers in,Hungary (statutes, regulations, directions, rules). Scand. J. Respir. Dis. Suppl. 102:147-148, 1978. P'andi~t, V.I., Phadke, K.M. Gaseous composition of ci~garette smoke: effect on human health and air pollution. Indian J. Publi~c Health 17'(1):16-18, 1973. Paris, R. Smoking, restrictions in hospitals (',letter),. Can,. Med. Assoc. J. 115(1):17, 1976. Pascasio, F., Scassellati Sforzolini, G., Savino, A., Conti, R. Tar andinicotine content both i'n inhaled smoke and in smoke dispersed in room-air by various cigarette brands. Ann,. Sanita Pubblica 27(15):971-978', 1966. (Italian) Patrianakos, C., Hoffmann, D. Chemical studies on tobacco smoke LXIV. On the analysis of aromatic amines in cigarette smoke. J. Anal. Toxicol. 3(4):150-154, 1979. Patterson, J.M., Issidorides, C.Hi., Groutas, V.C., Smith, W.T., Jr. Pyrolysis of maleilc hydrazide and N,N-dimethyldodecylamine. Chem. Indi. (London) (',8): 337'-339', 1972. Pedersen, J.T. Passive smoking. Ugeskr. Laeger 14206)':2355- 235'6, 1980. (Danish) Pedreira, F.A. Smoki~ngiand asthma (letter). Pediatrics 76I(4'):655, 1985. Pedreira, F.A., Guanadolo, V.Li., Feroli, E.J., Melta, G.W., Weiss, I.P. Invountary smokiing and incidence of respiratory illness dluring, the first year of life. Pediatrics 7'5(3):594-597, 1985. Pekkanen, T.J.,, Elo, 0., Hanninen, M'.L. Changes in non-smokers' saliva thiocyanate levels after being in a tobacco smoke-filled room. World Smoking and Health 1('1):37'-39, 1'976. Penkala, S.J., de Oliveira, G. The simultaneous analysis off carbon mono~xide and suspended particulate matter produced by cigarette smoking. Environ. Res. 9(2):99-114, 1975. Perdrizet, S., Liard, R., Cooreman, J. Respiratory symptoms in schoolchildren in 7 French survey areas. Arch. Fr. Pediatr. 36(,9):940-948', 1979. (French) Perry, J. Fasten your seat belts. No smoking. B'r. Columbia Med. J. 15(10):304-305, 1973. 44 ( ID-44

Bibliography on Involuntary Smoking/March, 1986 Roemer, R. Legislative action to combat the world smoking epidemic. Geneva r World Health Organization, 19'82', pp. 51-59. Rogers, K.D., Paradise, J.L., Bluestone, C.D. R'isk factozs for persis-tent middle-ear effusions (letter). JAM1A 251(,'12):1,55!6, 1984. ' Romer, J., Hermann, H1. The significance of tobacco smoking for asthma and rhinitis. Ugeskr. Laeger 145(13):1025-1027, 1983. (D'aniish) Rona, R.J., Chinn, S., Florey, C.D.V'. Exposure to cigarette smoking and children's growth. Int. J. Epidemiol. 14(3):402-409, 1985. Rona, R.J., F'lorey, C. du V., Clarke, G.C., Chinn, S. Parental' smoking, at home and height of childr'en,. Br. Med. J. (Clin. R'es. ) 283'(6303):1363, 1981. Roper Organization. A study of public attitudes toward cigarette smoking and the tobacco industry in 1978. Vol. 1. The Roper Organization Inc., May 1978. Rosano, A.T., Owens, Di.F'. Design procedures to cont.rol cigarette smoke and other ai~r pollutants. Amer. Soc. Heat Refrig. Air Cond. Enig. Trans'. 75:93!-102, 1969. Rosemberg,, J. Jeopardiy to the health of' children diue to smoking habits oflparents. AMB 31(1-2),:-6i, 1985. (Portuguese) Rosemberg, J. Risks to which passive smokers are exposed. Thee right of non-smokers. AMB 3'1'(1-2):7-12, 1985. (Port'ugu.ese) Rosemberg, J. Tobacco use, serious problem in public health. Sao Paulo : ALMED-EDUSP, 19'81. (Portuguese) Rosen, F.L. S'tudies in tobacco allergy. J. Med. Soe. NJ 51(3):109.114, 1954. Rosen, F.L., Levy, A. Bronchial asthma due to allergy to tobacco smoke in am infant. JAMA 14A:62'0-62'1,1950. Rossiter, C.E. Passive smoking (letter). Lancet 1:13516, 198'2. Rozenberg, S. The environment and cardiovascular disease. Arq. Bras. Card'iol. 37(5'):403-407, 1981 Rud'ni'k, J., Hermani, S., Pisiewicz, K., Roszkowska, H. Long-term eff'ects on health of air pollution in children. Z. E'rkr. Atmungsorgane 161(2),:177-191, 1983. N Ruhl, C., Adams, JI.D., Hoffmann, D. Chemical studies on tobacco 0 smoke LXV'I. Comoarative assessment of volaitile and tobacco- 1V ~ Cjji M' 50 Q~ ~ N O ~ C C f C D-50

Bibliography on Involuntary Smoking/'Mairch, 1986 1( li ) : 2'5-27, 19761. ACKNOWLE'DGEMENTS'. This bibliography was compiled using MEDLINE and CArtCER'Li'NE,. the National Library of Medicine's computerized bibliographies. of' the world's general biomedical and toxicology literature, as well, as standard manual bibliographic techniques. This bibliography could'not have been complietedwithout the patience and understanding of Ted Jensen, husband of Lydia Jensen. The text was preparediusing his computer and a word processing;program under his tutelage. N O 117' ~ 75 ~ ~ ~ ~ ~ ~ D-7 5'

i to this because the wording was visual only and in relatively sanall type, but they rcfuscJ to do itfor radiu and thereby, lust their largest rudiu buy for the last three wceks of the election. Thi>;nvas the first time that any, rttdioior tclevision .tatiitn in the country had acted to require such a tugl'ine change without having becn urdt:rcrd to do io by the Federal Communications Commission. I'dowever; none uf'the other stations acceded to the request. The third' major component of the campaign, a voter contact mailing prugraim, was where much of the money was spent. VlJhilc free radio andacicvision time was obtained under the Fairness Doctrine, $50;0100 was put into a mailing progr:um. Three hundhed thousand pieces of mail inisevcn versions were tairgeted to particular groups within a larger population of probable voters. The two most important'mailings were one featuring pictures of six celebrities who had dicd'of cancer and sugbestiing that tihcy would all votee for Proposition P if they wcrcaiivc„and one entitled. "Thc. I 13ig Tubact:u Companies Have Licd To You 10 Times." in. which 10 lics of the tobacco industry were docuntcnteJ. As the campaign drew, to a clu.e one humorous and tell- ing incident stood out. A week befurc the election the local public broadcasting station tclecast a program focusing on the campaigns fior two ballot measures-Pruposition P and one aimed at imposing a moratorium on high-rise dcvcl- upmcnt. One of thc aaff people whom the tobacco industry hired fiur its "Nit un P" effort was also the campaign man- agcr of the anti-high-risc proposition. It had bt:cniaKsumcd' that he took the tobacco industry job so he could!deft•aytiho management expenses for the other proposition, which had a very low budgec. Indeed, hrspcnt very little time cam- paigninb against Phupusiuiun P, and it is doubtful the to- bacco industry was getting its money's worth. As the teli- vision show focused on the a.inti+high-ri:+e proposition, it showed this individual sitting behind a battered old'd'esk, in a spartan room, bemoaning how his barcbones campaign The basics of beating the tobacco industry . LSStJES CERTAIN To ARISE Hedt6. The deleterious effects of secondhand tobacco smoke are the raison d'Ltue for any law limiting smoking. Proponents of the law should'have a firm grasp of all the reievant evidence, pary tictilarly the most reliable studies showcing a link' between secondhand smoke and serious diseases, as well as l other studies that may be less conclusive. Even though the health issue is the one in which the proponenta' stand on the mostsoiid ground, the tobacco industry, can confuse voters (as it has even on the issue of smoking's role in lung cancer and heart disease) by claiming that "proof" is lacking and that more "research" is needed.t`3 Costs. The tobacco industry will' claim that any law that restricts smoking will be too expensive both to goverttmentt and private industry. The purported cost factors will include the posting of signs, enforcement; and disruption of businesss operations. The industry will clnimthat the law will force some businesses to close or relocate. Proponents pn safely rely on the experiencrin communities in which such laws have already, been in effect to demonstrate that any costs arc negligible. Enforceatemt. Whether the law is to be enforced by the police or a health authority, the industry will raise the spectre of important criminal or health matters'being ignored Iwhiie smokers arc heing hauled off'to jail. The fact is that the law is intended solely as a recourse in the event' ofl a dispute over, the right to 372 smoke inithe presence of others who may be adversely affieaed. In all places where such laws have beenenactedi they ha'vee proven largely self-enforcing, and, few fines or'citations have been issued.• Govet- P, t regulation. The tobacco industry's argument that nonsmokers' rights legislation represents'government intcusion iinto essetttially private matters has proven to be an effective weapon. The countier argument'must begin with the fact thar the law is a measure to protect publichealth, which isoneofthr most important funetions of govern- ment. Cjrll Gbertia. The tobacco industry maintains that any, infringement on the right to smoke is a violation of' civil liberties. (In the black community ad- vertising by the industry suggests that restrictions on smoking are a first step in bringing back segregationls'To Miami s Jewish community the tobacco industry warned "flon't let it happen here."s) The industry also compares eiean indoor air laws to Prohibition. Such a comparison is not difficult to rebut, for there are numerous governmental restrictions on the useof alcohol to protect public heaith and1 safety that have almost universal l support. Scope of law, No matter how limited' or comprehensive the proposed luw may be, the tobacco ind'ustrry, will oppose all restrictions onsmoking,that may cutinto cigarette sales. The industry will claim either that the law is discriminatory be- cause it applies to some busincsses and not to others or will claim that it is too sweeping and repressive. `GA'' YORK STATE JUt;ttNAL OF ' \ll'IAIt.'1NF; Jl,'1.5° Ivttt Campaign financing. The sudden infusion of enormous funds from the to- bacco industry to defeat clean indoor air laws will become a major issue in the campaign, The industry never enters a campaign halfheartedly and always provides nearly every penny of't'he op- position campaign. The proponents of the law must ezploit'this from the be- ginning of the campaign and must' make the public and press realize that the op. position campaign and the tobacco in+ dustry are one and the same. Many of the local contributors to the opposition campaign are also likely, to have direct financial ties to the sale of tobacco products. Endorsements. Closely connected' wiih the issue of campaign financing is the question of'who supports and who opposes the law, Apart from the to- bacxtrgrowing,and manufacturing states of Connecticu4 Florida, Georgia, Ken- tucky, Mary;land„North Carolina, South Carolina„and Virginia, or New York (where three of the six Unittd States cigaretrte companies are hcad4uartered)6 voters will be interested to learn that the opposition is led by out-of-state interests. Moreover, as such legislation gains in popularity, local public figures are in- creasingly eager to lend! their names too the rampaign. Thc contrast between the quality and quantity of locall support versus that of the outsdde tob:tcco inter- ests is striking; CAIt'tPH7t:N STRATEGY Build a coali'tion. Essential to the passage of clean indoor air measures is B'-4.

Bibliography on Involuntary Smoking/'March, 1986' fl Stewart, R.Di. The effect of carbon monoxide on humans. Annul. Rev. Pharmacol. 15:409-423, 1975. Stewart, R.Dl. The effects of'low concentrations of carbon monox3de in man. J. Occup. Medl. 18:304-309, 1976. Stewart, R.Di., Baretta, E.D., Platte, L.R., Stewart, E.B., Kalbfleisch, J.H., van Yserloo, B., Rimm, A.A. Carboxyhemoglobin levels in American blood dionors. JAMA 229(',9):1187-1195I, 1974... Stewart, R.Dl. The efffects of low concentrations of carbon monoxidle in man. S'cand. J. Respir. Dis. Suppl. 91:56'-6'2, 197'4. Steyrer, K. Proceedings of',the international symposiumi on medical perspectives on passive smoking,. Prevent. Med. 13:561-562, 1984. Stober, W. Lung dynamics and uptake of smoke consitulents by: nonsmokers - A survey. Prevent. Med. 13:5'89-601,, 1984. Stock, S'.L. Passive smoking and lung cancer (letter). Br. Med. J. 282(6265):733-734, 1981. Stock, S.L. Breathing other people's smoke ('letter). Br. Med. J. 2(6138):69'9-70!0, 1978. Stock, S.L. Passive smoking, and.lung cancer (letter). Lancet 1(~8~27~91:10~~14-1015',~ 19,8~2~. Stock, S.L. Passive smoking.and nicotine (letter). Lancet 2(82541:10144, 1981. Stock, S.L. Risks the passive smoker runs (letter). Lancet. 2(l82031:1082, 1980. Stock, S. The perils of second-hand smoking. New Scie.nti~st, 8811221) :10-13, 1980. Stone, Ji.D., Breidenbach, S.T., Hei!mstra, N.W. Annoyance response of nonsmokers to, cigarette smoke. Percept. Mot. Skills 49(,3'):907-916, 1979. Strasser, A.L. Smoking in the workplace: shoul'd it be p.rohibited'? (editori'lal). Occup. Health Saf. 48(l):9-10, 1979. Strope, G.L., Stempel, D.A. Risk factors associated with the development of chronic lung disease in childrem. Pediatrilc C1inics of North America 31(14 ):757-7'71, August 1984. Sudani, B.J.L., Sterboul, J. Nicotine: an hapten (,letter). Br. J. Dermatol. 104(31:349-350, 1981. Sudlan, B.J.-L. Breathing otlier people's,smoke (letter),. Br. 611 D-61

Bibliography on Involuntary Stnoking/Maxch, 19'86, Med. J. 2(614!1):895, 1978'. Sudan, B.J.L. Passive smoking: nicotine, a hapten, (',letter). Food Chem. Toxicol. 2015J:629, 1982 Sutton, G.C. Passive smoking, and lung cancer (letter). Br. Med., J. Z82'( 6I265 ) :73'3, 19'181. Swartz, H. Tobacco smoke: a noxious, air pollutant, part 2. Rev. Allergy 25:490-505, 1971. Swartz, H. Tobacco smoke: a noxious air pollutant., part 1. Rev. Allergy-25(4).3'97-405, 1971. S1wartz, J. Winnepeg conference declares international war on smoking,. Can. Mied. Assoc. J. 129( 6):636, 638-64'1, 1983. S'zadkowski, D~., Harke!, H.-P., Angerer, J. Body burden of carbonn monoxide from, passive smoking in offices. Innere Med. 3'(6)1:310- 313, 1976. (,German). Szilagyi, L. Passive~smoking [iletter]. Orv. Hetil. 1A7(52):,2486-2'487, 1966. (ttungarian) Tager, I.B., A word to smokers with spouses and/or children. J. Resp. Dis. 6(2):103, 106, 110, February 1985. Tager, I.B., Weiss, S.T., Rosner, B'..,, Speizer, F'.E. Effect of parental cigarette smoking on the pulmonary function oflchildren. Am. J. Epidemiol. 110(',1)~:15-26, 1979. Tager, I.B,., Weiss, S.T., Speizer, F'.E., Rosner, B:. Longitudinal effect of parental cigarette smoking on, the pulmonary function of children. Am. J. Epidemiol. 110(1):15-26, 1979. Tager, I.B., Weiss, S.T., Speizer, F.E., Rosner, B. Longitudinal assessment of the relationship of parents' cigarette smok' ing and level of pulmonary functionli~n children (abstract). Am. Rev. Respir. Dis. 125(4 pt 2):145', 1982. Ta~ger, I.B., Rosner, B., Tishler, P.V., Speizer, F.E., lEass, E.H. Household aggregation of'pulmonary function! and chronic bronchitis. Am. Rev. Respir. Dis. 114:485-492, 1976. Tager, I.B., Weiss, S.T'., Munoz, A., Rosner, B., Speizer, F.E. Longitudinal study, of the effects of maternal smoking on pulmonary function in children. N. Engl. J. Med. 309(12):699'- 703, 1983. Takano, Maedal, C., Miyazaki, Y., Shimaue, Y., Kadokura, Y., Hata, A., H. Cyanide content in the smoke of cigarettes. Jpn. J. Public Health 28(2):100-102, 1961. ((Japanese) ~ ~. ~ 62 ~ ~ ~ ~ D-62 (

Bibliography on Involuntary Smoking/March, 19816 : presented'at 72nd Annual Meeting of the Air Pollution Control Association, June 24-29, Montreal, Canada, 19'80. Spengler, J.D., Soczek, M.L. Evidence for improved ambient air quality and the need'for personal exposure research. Envir.- Sci. Technol. 18:268a-80a, 1984. Srch, M. The significance ofl carbon monoxide in cig;arette, smoke in passenger car interiors. Dtsch. Z. Gesamte Gerichtliche Med. 610(3):80-8I9, 1967. (German), Stahle, I., Tfbblingi, L. Tobacco allergy among patients with bronchial asthmal. Lakartidningen 75(17'):1711-1713, 1978. Stedmam, R.L. The chemical composition of tobacco and tobaccoo smoke. Chem. Rev. 68(2):153-207, 1968. Steensberg, J. Environmental pollution withicarbon monoxide.. Ugeskr. Laeger 136(18):1i006-1009, 1974. (Dani~sh) Stehlik, G., Richter, 0., Altmann, H!. Concentration of dimethylnitrosamine in, the air of smoke-filled'rooms. Ecotoxicol. Environ. Safety 6'(6):495-5010, 1982. Steinfeld, J.L. Women and children last? Attitudes towardd cigarette smoking and nonsmokers' rights, 1971. NY State J. Med.. 83 (13') :1257-1258', 19181. Stelilman, S'.D. r Stellman, J.M. Women's occuipations, smoking, and cancer and other, diseases. CA-A Cancer J. for CZini. 31(1):2'9-43', 1981. Sterling, T.D. Non-smoking wives of heavy smokers...lung cancer (letter). Br. Med. J. 2'82(62'70):115I6,, 1981!. Stsrling, T.D., Kobayashi, D.M. Exposure to pollutants in enclosed 'living spaces"'. Environ. Res. 13(1):1-35, 1977. Sterling,, T.D., Dimich, H., Kobayashi, D. Indoor byproduct levels of tobacco smoke: a, critical review of the literature. J. Air Pollut. Control Assoc. 32(',3):250-25'9, 1982'. Sterling,, T'.Di., Sterling, E.M. Environmental tobacco smake. Investigations on the effect of regulating smoking on levels of indoor pollution and on the perception of health, and comfort of office workers. Eur. J. Respir. Dis. (Suppl.) 133:17-32, 1984!. S'terling,, T.D., Sterling, E.M. General references on studies of' environmental tobacco smoke (ETS). Eur. J. Respir. Dis (Suppll 133:147-52, 19814. N Stewart, C.T., Jr. Air pollution, human health, and public ~ policy. Lexington, Mass. : Lexington Books, 1979. p. 161, 68. N CA ~ 60, GO KDb N N D-60.

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Bibliography omInvoluntary Smoking/March, 198,6 Sebben, J., Pimm, P., Shephard, R.J. Cigarette smoke in enclosed public facilities. Arch. Environ. Health 32(2)':53-58', 1977. Secker-Walker, R.H., Ayres, S.M'., Cohen, J.D. Cigarette smoking, or your health. Medi. Times 110 (16 ):37-4'4, 1982. Seehlofer, F., Hanssen, Di., Rabitz, H., Schroder, R. Balance of water in the smoking of a, cigarette. Part 2. Beitr. Tabakforsch. 3(1):491-5'03', 1966. ('German). Seiff, H.E. Carbon monoxide as an indicator, of cigarette-caused pollution levels in intercity buses. (,BMCS-I'HS-73-1) Washington, D.C. : U.S. Department of Transportation, Federal Highway Administration, B'ureau of Motor Carrier Safety, 1973. Report No. PB-222'973. 11 pp. Sem, G.J., Tsurubayashi, R'. A new mass sensor for respirable dust measurement. Am. I'nd. Hyg. Assoc. J. 36':791-8!00', 1975. Senilor, S'.L. Study of smokingl habits in hospital and attitudes ofl medical staff' toward's smoking. Can. Med'. Assoc. J. 126(1):131-133, 1982. Seppaneni, A. Smoking in closed space and its effect on carboxy- halemoglobin saturation of smoking and nonsmoking subj!ects. Ann. C'liln. Res. 9(5):28I1-2'83I, 1977. Seppanen, A., Uusitalo, A.J. Carboxyhaemoglobin saturation in relation to smoking and various occupational conditions. Ann. Clin. Res. 9( 5) :26'1-268, 1977'. Sfozzolini, G.S., Savino, A. Evaluation of a rapid index of environmental pollution by tobacco smoke and study of the compositilon of'the main-stream and side-stream cigarette smoke.. Presentediat "Environment and Health" C.E'.C'.-E.P.A.-W.H'.0. Paris, France, June 1974!. Shamani, D. It might have been a beautiful baby. Am. Lung Assoc. Bull. 6'8 (13): 6, 9-11, 1982. Shlephairdi, R.J'. Some hazards of passive smoking. Can. Fam. Physician 2'8:299-302, 1982. Shephard, R.J. Involuntary smoking. Can. J. Public Health 72(6):394-396, 198'1. Shephard, R.Ji., Labarre, R. Attitudes of the public towards cigarette smoke in public places. Can. J. Public Health 69(4):302-310, 1978. Shephard, Pt.J., Collins, Pt'., Silverman, F. "'Passive" exposure of asthmatic s!ubj!ectsito cigarette smoke. Environ. Res. 20111) : 3'92-402, 1979'. 57

Bibliography on Involuntary Smoking/March, 1986 Purcell, Hi. Passive smoki~ng--the evidience confirmed'. Midwif'e, Health Visit. Community Nurse 16(',10):408, 4110, 1'980. Rabkin, M.T. Segregation of smokers at medical meetings. (letter),. N. Engl. J. Med. 292(5):271, Radford, E.P., Jr., Hunt, V.R. Polonium-210: a volatile radioelement imicigiarettes. Science 143(3603):247-249, 1964. Ramaciotti, D., Imhoff, C'., Rey, P., et al. Alveolar CO as ann index of' ambiant C0 in schoolchildren. Rev. Epidemiol. Medl. Soc. Sante Publique 2'4(i1):69-76, 1976. (French) Ramstrom, L.M. Economic losses to the society due to smoking. In: Ramstrom, L.M. (edi.). The smoking epildemic, a matter of worldwide concern. Stockholm : Almqvist & Wiksell International, 1979. pp. 112-116. Randolph, F.L. The regulation of smoking in public p1'aces: predictors of compliance and voluntary enforcement behavior (dissertation). Berkeley : iPniversity ofl California, 1982. 293' pp. Diss. Abstr. Int. 44B('1)':126, 1!983.. Rantakallio, P. A follow-up study up to the age of 14 of children whose mothers smoked during pregnancy. Acta Paediatr. Scand. 7'2(5):]47:753, 1!983'. Rantakallio, P. Relationship of maternal smoking to morbidity and mortality of the childiup to the age of five. Acta Paediatr. Scand. 67('5'):621-631, 1978. Rantakallio, P. The effect of maternal smoking o birth weightt andi the subsequent health of the child. Early Human Dev. 2(4):371-38I2, 1978. Ray, A.M., Rockwell, T.H. An, exploratory study of automobile drivi'ngi performance undier the influence of low levels of carboxyhemoglobin. Ann. N.Y. Acadi. Sci. 17'4:396-408, 1970. Readier, K. Totally unacceptable ( letter ). New Scientist 88(1223):182, 1980. Reed, K. Tobacco smoke is hazardous to non-smokers. J. Dent.. Assoc. S. Afr. 36(6):4'09-411, 1981. Remi~j'ni, B., Fischer, P., Brunekreef, B., Lebret, E., Bioleij, J.S., Noij, D. Indoor air pollution and its effect on pulmonary function of adult non-smoking women: I. Exposure estimates for nitrogen dioxide and, pasisiive smoking. Int. J. Epidemiol. 14 ('2 ) : 2'1'5!-220, 1985. Remmer, H. Is cancer avoidable? Med. Klin. 79(18):4163-467, 484,. 1984. (German) 47

-3- C) To answer the risk assessment question, Or. Alfred Lowrey, of the Naval Research Laboratory and I used the principles of quantitative risk assessment. After five years of work, and based ini part on our 13'previous sci'entific publica- tions on the health physics of environmental tobacco smoke, we pub1lished!estimates that in the United States, exposure of nonsmokers to indoor air pollution from tobacco combustion products causes a minimum of'about 500, but more 11ilkely 5000 lung cancer deaths per year, with an average loss of life-expectancy of about 1'1 years per vi'ctim.3 To place this into perspective, 5000 lung~cancer deaths per year i s nearlyone-thi rdl of' the annualllung cancer; nartal ity in nonsmokers., There have been no credible scientific attacks on our previous work, although the Tobacco Institute has publicized some failed8 attempts. Insofar as our publltshed! ri sk assessment i s concerned, i n an accompanyi ng edi tori al , the ed'i tor-i'n-chi ef' of the journal stated: "'Diue to the controversial nature of the paper by Repace and, Lowrey, added measures were required to assure adeqpate peer review and'the documentation, of underlying information, including assumptions".1'9 In summary, he concluded that "... Repace andlLowrey make a convincing case for public health hazards of public smoking."19 To explore risk-management options, we assessed the risks associated withi five common types of control measures for tobacco smoke. We found that in the typical! U.S. office workplace, under average condiitions of occupancy and ventilation, the tobacco-smoke-caused lungi cancer risk to the nonsmoking office workers appears to be, depending upon the ventil'ation, 250 to 1000 times the level of' acceptable risk using standard federal guidelines for carcinogens in air or water or food.2• 7 . Q We then explored the risk reduction achievable by various controll options. CA We found that separati on of nonsmokers wi thi n a gi ven space offers only a ~ PON N' ~ ~ G~-3'

Bibliography on Involuntary Smoking/March:, 1986 Shephard, R.J., Collins, R. Silverman, F'. Responses of exercising subj!ects to alcute "passive" cigarette smoke exposure. Environ. Res. 19(2):279-291, 1979. Shephard, R.J., Ponsford, E., LaBarre, R., Basu, P.K. Effects of. cigarette smoke on the eyes and airway. Int. Arch. Occup. Environ. Health 43(2):13'5-144, 1979. Shephard, R.J. The risks of passive smoking. New.York : Oxford University Press, 1982. Shephard, R.J. Cigarette smoking and reactions to air pollutants. Can. Mied. J. 118:37'9-83', 392, 1978. Shilling, R.S.F., Letai, A.D., Hui~, S.L.,, Beck, G.J., Schoenberg, J.B., Bouhuys,A. Lung function, respiratory disease and smoking in families. Amer. J. Epidemiol. 1D6(4):2'74-28'3, 1977'. Shor, R.E., Shor, M'.B., Williams, D.C. The distinction between the antismoking,and nonsmokers' rights movements. J. Psychol. 106:129-146, 1980. Shor, R.E'., Williams, D.C. Reported physiological and' psychological symptoms of tobacco smoke pollution in nonsmoking and smoking college students. J'. Psychol. 101(iSecond Half):203- 218, 1979. Shor, R.E., Williams, D.C. Small-airways dysfunction in passive smokers (letter). N. Engl. J. Med. 303(7):393, 19801. Simecek, C. Reflection of passive exposure to, smoking in the home on, the prevalence of chronic bronchitis in non-smokers. Czeah. Med. 3'( 4): 3'.08'-310, 19810. Sims, D.G., Downhaaai, M.A.Pi.S., Gardner, P.S., Webb, J.K.G., Weightman, D. Study of 8-year-old children with a history of respiratory syncytial virus bronchiolitis in infancy. Br. Mied. J. 1(61i0A):11-14, 1978. Singer, G.M., Lijinsky, W. Naturally occurring, nitrosatable amines. II. Secondary amines in tobacco and cigarette smoke condensate. J. Agr. Food Chem. 2'4('3):553-555', 1976. Sinzinger, B'., Kefalides, A. Passive smoking severely decreases platelet sensitivity to ant.iaggregatory prostaglandins (letter). Lancet 2( 82'94 )1: 3'92'-393, 1982. Sjolin, K.E. Tobacco Smoking a serrvicel of local pollution. Ugeskr. Laeger 133'(44),:218J'-2188, 1971. (Danish), Slavin, R.G., Hertz, Mi. Indoor air pollution: A study of the 30th annual meeting of the American Academy of Allergy. Paper 58 C C C D-5&

TESTIMONY OF JAMES' L. REPACE IN THE MATTER OF SENATE' BILL 1440, THE NONSMOKERS' RIGHTS ACT' OF 1985. BEFORE THE U.S. SENATE SUBCOMMITTEE ON CIVIL SERVICE, POST OFFICE AND GENERAL SERVICES, COT4ITTTEE ON GOVERNMENTAL AFFAIRS WASHIINGTO'N„ D.C. September 30, 1985 § MR. CHAIRMAN, AND SENATORS: My name is James L. Repace. As a scientilst whoihas worked for a deca!de on the health physics of environmental tobacco: smoke., and as a policy analyst i n a fedieral regul atory agency, 11 woul d lli ke to share~ wi't you the ri sk assess- ment results and risk management op ions which I have developed in my work. My qualifications are discussed in an appendix to my statement. STATEMENT OF JAMES L. REPACE ON THE HEALTHIIMPACT OF TOBACCO COMBUSTION PRODUCTS 0N NONSMOKERS It has long been known that high levels of outdoor alir pollutioni from! factory chimneys and automobiles could cause acute illness and even death duri ng ai r pol l ution epi sodes a~nd that el evated 1 evel s of outdoor ai r polliuti on were responsible for chironic morbidity and mortality.6 These: serious heal'th effects from air pollution have lied to fede al standards for the regulation of outdoor exposure, lievels, and considerable progress.has been made i'n curtailing outdoor ai r polll uti on. Hbviever, Ameri cans spendl an average of 90% ofi' thei r l i ves ilndoors. Therefore the~ levels of' indoor air pollution assume great importance i n determilni ng total human exposures to many ai r pol l!utants.G.14,,15' Indoor air.pollutilon from tobacco combustion products is not only chemically related to the smoke: factory chimneys andlotfier sources of outdoor air pol- O lution, but generally occurs at far higher level's indoors than does factory smoke ~ and automobile exhaust outdoors 6 Because one-thi'rd of the U adult population: S ~ . . . ~. ~ ~ G-1

-2- smokes, andl because ventilation rates are primarily diesilgned to conserve energy rather than to~preserve indoor ai'r quality5,6,8,1'4„16 the smoke fromi burningi cigarettes, pipes, and! cigars overwhelms the capability of typical building ventilation systems, inflicting substantial air pollutiion burdens upon nonsmokers -- far in excess of those encountered inismoke-free indoor environments, outdoors, or i'n vehicles on busy commuter hilghways.6,S,15 For more than 20 years, reports of the Surgeon Genera1 -- which now amount to a: stack more than a foot high! -- have, indicted the smoke whichi the smok r inhales (called mainstream smoke) as cause of cancers in many organs of the human body.3'+5 we now, know that the smoke which the nonsmoker inhales (calied side- stream smoke) i's even more carcinogenic than an equal amount of'mai'nstream smoke.3 C7 early„ there i s good reason to bel i eve that nonsmokers are exposed to the ri sk of smoking-reTated diseases from repeated exposure to tobacco combustilon products.3 In a recent official' position paper18 in which it was stated'that environ- mental tobacco smoke appears to be carcinogenic, The Amerilcan Association for Cancer Riesearth stated that gpvernment shouldl"enact and enforce! legislation that restricts smoking i'n public pTaces". In another recent medical journal pap r,17 three offilcials concerned with smoking and health from Canada's Mational Department of Health and'Welfa~re examined the evidence that exposure to tobacco smoke in the workplace Is harmful' to nonsmokers. They concluded that "passive smoking Is an occupational health, hazard to nonsmokers'. This raises two essential questions pertinent to Senate Bi11 1440: First: What are the risks to nonsmokers from breathing envlronmental tobacco smoke in, the workplace? And secondly: What are, the options for management of those risks? G-2

C campa6gn so as w minimize any adverse publicity, • The tobacco cumpvniesstudiously avoid the subject oflth'e hcalth'ihaaardi uf seeond-handsmoke and attempt to stcer the debate to such ixsucs as gavcrnmcntregulation,and the costs to taxpayers of enacting the lsw. Thcy do this in a manner designcd to convince the votcrs that extremely'harmful consequences will necessarily flow from the law. For exsmple, it is usually predict- cd that smokers will ibe'arrested whila'rupists and robbers go un- detectal. thattpaople will be drivcn out'of business, and that vital x,cial services will be shonchanged!in ordbr, to pay forthe law. • Two important secondary themes are always present to back up thc primary arguments: (1) the Jltw represcntsan attack on civil libcrties and'denics smokers the freadom of choices (2) the industrywill admit there is a problem but claim the proposed lanv is not t hc right solution. Thus thc slogan that appeared at the end of TV advertisements against Proposition, P: "Proposition P is simply not the answen" Thc industry position is that to the ex- tent second-hand smoke might be a minor annoyance to a few particularly sensitive pcopic, "common sense" and, "common eourtcsy"-not Fovcrnmcnt' regulstion-will- suffice: This has the double advantage of sceming to be understanding of'the probltm and at the,samc time depicting,propuncnts of the law as wcillmea'ning but sadly misguided. • When the sub1eatof the effects of second-hand smoke can- not be avoided, such as during live debates and press interviews, the tobacco industry representatives will deny there are any health hazards, often misquoting and quoting out of conte:tt medical authorities in the process. They will claim that,even if some studies show secondlhand Ismoke to be harmful, others do not, and thus the jury is still out. In other words; they impiy;, vir- tual unanimity in the medical community is needed before any laws should be passed that would limit smoking, • The industry uses i'ts economic'and political powerto secure endorsements from both individuals and organizations. • On a general level, the industry7s best weapon is eonfusion.. As any political lanalystwill attest, when voting on ballorissues, a confused, voter will invariably vote "No." Thus, a eommon, thread running through all the industry's campaign advertising and debating is the attempt to confuse the public. All of these factors came into play during the Proposi- tion P campaign. The first public movewas the press con- fercnce tio announce that "Citizens Against Government Intrusion" (later changed to "San Franciscans Against Government Intrusion" doubtless when it was rcalized that the acronyrn for the name would have been CAG'I)'would place a rcferendum onithc ballot to repeal the workplace smoking ordinance. The group announced'thatJim Foster, the founder of one of the city's gay Demoeratic clubs ('San Francisco has the' largest gay community in the United States); would manage the campaign and that, at the group's reqttcst, the tobacco i industry would contribute S4!0,000 to fund thcir petition drive'because of insufficient time to raise funds locally." SLEIGHT O'E HAND None of the people ai'thc news conference had ever tes- tified'against the ordinancc, and cxeept, for Foster;,none of them was hcard!froni again!d'urinig,thc campaign. A few days latcr Foster stated ina newsp:tper intervicw that he had becn recruited for the campaign by, the Tobacco Institute's atuorncy: Another person who lost out on the job later re- vealed that he had been intierviewcd by a vice-president of the Tobacco Instiiute: The S40,000 fagurc„which was re- pcatcd in every interview on the subject'over the next two wccks; was untrue. Theindustry had pledged more than S t00,pfD0; and, in fact, 597,0n0 was spent to put the measure onithc ballot. The tobacco industry, huwever, denied any involvement in the campaign otihcr than as a, financial supporter and at one point stated that subscquent'fu!nding, by the industry would be contingent on a demonstration of local support. The induxt'ry ended up putting Sll,2'50,000 into the campaign; the liacal contributions amounted to $3.300. The moneyspcnt by the "1'Jo on P"'campaign set a new national record for a, locai'ballot measure (surpassing the 51.11 miIDionithe tobacco industry spent in Miami in 11979 to defeat a similar ordinance). To find out firsthand why the tobacco companies were contributing so much money to overturn a local health regulation, Supervisor N+elder field l a press conference early in the campaign to announce tihat she had sent tell:grams to thc presidents of four cigarette companies challenging them toldcbatc her onitht: merits of the law. None replit:d: The petition drive itself was a travesty of the democratic process. Since thclobaccolindustry was not likely to fnd! volunteer signature gatherers, it hired a professional peti- tioning',cornpany.from Los Angelas and paid'petition cir- cu!lators as much as S0.70 per signature. One method'used to collect signatures was for the paidlcirculatots to explain that they were merely trying to put the measure on' the ballot for a public vote-rather than to repeal a law that had' already been enacted. At least two of the paid circulators (who had obtained several thousand signatures between them) were not bona fide registered''voters of'San Francisco, as required by the election laws. lronically, when the de• ceptive practices of the tobacco industry were brought to the attention of the press, they were so confused by the referendum'prtxedure (they could not understand that the tobacco industry put the measure on the ballotinorder to repeal an existing law),,that, they madritappear that the supporters of the ordinance had committed the improper practices. OBJEICiIVEc HOME RULE The campaign organization in favor of'Proposition_ P was formed iniAugust under, the same "San Franciscans for Local Control."'The decision was to make the central issue of the campaign the alttempt by a, large out-of-state special interest group to overturnia local health ordinance. The organization included representatives from Californians for l*lonsmokers"R'ig!hts, the'San Francisco Chapter of the American Cancer Society; the San Francisco Lung AsstD- ciation„the Sicrra Club, and Common Cause, as well as several political activists. The proposition was soon endorsed and supported by'a number of prominent individuals and organizations, including the San Francisco Pblice Officers Association. Early in the campaign, a local attorney appeared on a television debatc with Supervisor Ncldcr and'claimed that imposing restrictions on smoking in the workplace wouldN set a precedent' for denying employment to gays tnni uhq= . grounds that they might, have AIDS. This was pcrccivcdiasN a crass attempt by the tobacco industryta scare the largeN gay community, and several gay leaders denounccd tihcM tactic. The argument was not raiscd aglun; and thc ;ttt0rncyG0i never apreared' agai'n on behalf of the "';`lio on P'' cam-4~, paign. The tobacco industry's efforts settled on the fiullinwinc~A :ullegations tha0 the law con,titutes governmcnt intrusiion~ 370 NEW YORK ST,1Tf? JO'UR'NAIi UU WLIDICI'tiF./JUt.Y IwBt B'-2 cl

I Bibliography on Involuntary Smoking/March, 1986 Sandl'er, D.P., Wilcox, A.J., Everson, R.B. Cumulative passive. exposure to cigarette smoke andicancer risk (abstract). Am. Ji. Public Health 120:482, 1984. . Sapolsky, H.M. The political obstacles to the control of cigarette smoking in the UnitediStates. J. Health Polit. Policy Law 5(12):2'77-2'90, 1980. Savel, H. Clinical hypersensitivity to cigarette smoke. Arch. Environ. Health 21:146-148,, 1970. Scassellati Sforzolini, G., Saldil, G. Further research on the polycyclic hydrocarbons of cigarette smoke. Comparisons of smoke inhaled and that taken from the ambient atmosphere. Boll. Soc. Ital. Biol. Sper. 37(16):769-771, 19,61. (Ital'ian) Scassellati-Sforzolini, G., Savino, A. Evaluation of a rapid index of' environmental pollution by tobacco smoke and stud'yofl composition of the main-stream and side-stream cigarette smoke. Proc. Int. Symp. Recent Adv. Assess. Health Eff. Environ. Pollut. 3:11749-175'6, 1975. Scassellati-Sforzolini, G., Savino, A. Evaluation of a rapid index of environmental pollution by cigarette smoke, with special reference to the composition of the gaseous phase of the smoke. Riv. Ital. Ig. 28 (1-2):43!-5'5, 1968. Schelenz,, R. , Fischer, E'. On the fate of postassium and cesium- 137 during the machine smoking of cigarettes. Z. Lebensm. Unters. Forsch. 178(2)1:118-119, 1984. (German) S'chenker,, M.B., Samet, J.M'., Speizer, F.E. Rilsk factors for childhoodirespiraltory disease. The effect of host factoxs and home environmental exposures. Am. Rev. Respir. Dis. 128,(6):1038- 1043, 1983. S'chenker, M.B., Samet, J.,, Batterman, S., Speizer, F.E. An epidemiolog,ic study of air pollution effects on childhoodd respiratory disease. Am. Rev. Respix. Dis. 125(4 Part 211:145, 1982. S'chlenker, M.B., Samet, J.,, Speizer, F.E. Biologic and' environmental determinants of childhoodirespiratory disease (abstract). Am. Rev. Respir. Dis. 123(4 Pt 2):13&, 19'81. Schievelbein, H. Are there really important recent findings on passive smoking? Off. Gesundheitswes. 44(7):454-456, 1982. (G'erman)' Schievelbein, H. No proof of health hazard (,letter). MMW 124'('4') :13-15, 1982. (Germam), 53 D-53

Bibliography on Involuntary Smoking/March, 198'6 3314 ) :249, 197'4. Zussman, B.M. Tobaccol sensitivity (letter). Ann. Allergy 291111) : 6'09-6I1-0, 1971. Zussman, B.M. Tobacco sensitivity in the allergic patient. Ann. Allergy 2'8('8):37'1-377, 1970. Zussman, B.M. Atopic symptoms caused by tobacco hypersensitivity. South. Med. J. 61(11):117'5-1179, 1i968'. -----, Breathing other people''s smoke. Br. Med. J..2(6135I):45'3- 45'4, 1978'.. -----, Warning: smoking may damage your childreni's health (editorial). Br. Med. J. 1(6070):11i79-118!0, 1977. -----, The cowardice continues (editorial). Br. Med. J.. 1(6074):1428-1429, 19717. -----, Segregatedismokers ( editorial ). Br. Med. J. 1(6004): 244,- 2'45, 1976. -----, Smoke-pollutedi food (,editorial ),. Bir. Med. J. 4( 59'93') : 37'0, 1975. --, Symposiu!m, tobacco and alcohol!. Medical and social problems. Bull. Sichweiz. Akad. Med. wiss. 35('1r31:1-2'68, 1979. (German) -----, Tobacco smoke pollution. CAN Bull. 7(2):1-39, 1981. -----, Smoking, may harm some nonsmokers. Chem. Eng. News 53(23'):5',197'5. -----, General references on studies of environmental tobacco smoke (ETS). -----, Eur. J. Respir. Dis. (lSupp1) 133:147 152, 1984. -----, Government Manager: The debate lights up. Smoking and the workplace. National Interagency Council on Smoking and Health, Business Survey. I4ICS'M', New York, N.Y. Gov Manager 138':2,. 1978. -----, Smoking in the car. J. Traffic Med. 1!1.(2):36, 1983. -----, Lifetime passive smoking and cancer risk (letter). -----, Lancet 1 (844'3 ): 144,4 , 1985'.. -----, Lifetime passive smoking and cancer risk (lietter). 73

Bibliography on Involuntary Smoking/'March, 1986 Suppl. 91':1i-90, 1'974'. Rylander, R. Review of studies on environ:nental' tobacco smoke. Scand. J. Respir. Dis. Suppl. 91:10-20, 1974. Rylander, R., Peterson, Y., Snella, M.-C. ETS--environ¢nentall tobacco smoke. Report from a workshop on effects and'exposure level's. Eur. J. Respir. Dis. [Suppl. ] 133:1-152, 1984. Said, G., Paitois, E., Lellouch, J. Infantile colic and parental smoking. Br. Med. J. [Cliini. Res.] 289(6446):660, 1984. Said, G., Zalokar, J. Incidence of upper respiratory tract disorders in children of smokers. Ann. Otolaryngiol. Chir. Cerviicofac. 95( 3')':23'6-240, 1978. ( French) Said, G., Zalokar, J., hellouich, J., Patois, E. Parental smoking related to adenoidectomy and tonsillectomy in chi,ldren. J. Epiidemiol. Community Health, 32(2):97-101, 1978. Sai~d, G., Zalokar, J., Lellouich, J., Patois, E. Adienoidectomy and'tonsillectomy in children and'parental smoking. Lancet 1(8015):797, 197'7. Saint-Jalm, Y. Qualitative analysis of'the hydroxyl fraction of cigarette smoke. Ann. Tab. Sect. 1. 18:41-48, 1981. (,French). S'akuma, H., Rusama, Mi.,, Munakata, S., Ohsumi, T., Sug,awara, S. The distribution of cigaret smoke components between mainstream and! sidestream smoke. I. Acidic components. Beitr. Tabakforsch. Int. 12(2):63-71, 1983. Sakuma, H., Kusama, M., Yamaguchi, K., et al. The distribution of cigarette smoke compornents between mainstream and sidestream smoke. IIiI. Middle and higher boiling components. Beitr. Tabakforsch. Int. 12(5):2'51-258, 1964. Samfield, M. How important is cigarette sidiestream smoke? Tob. J. Int. 1:45-47, 1985. Sandler, D.P., Everson, R.B., Wilcox, A.J., Browder, J.P. Cancer risk in adulthood' from early life exposure to parents' smoking. Am,. J. Publ. Health 7'5(15) :4!87-492, 1985. Sandler, D.P., Everson, R.B., Wilcox, A.J. Passive smoking in adulthood andicancer risk. Am. J. Epidemiol. 12'1(1):37-48, 1985. Sandler, D.P., Wilcox, A.J'., Everson, R.B. Lifetime passi!ve smoking and'cancer risk (letter). Lancet 1(84'33):867, 1985. Sandler, D.P., Wilcox, A.J., Everson, R.B. C1:mulative effects of lifetime passive smoking on cancer risk. Lancet 1(8424):312 315',. 1985. 52 D-52

Bibliography on Involuntary Smoking/M'arch, 19186 ;;. &chmeltz, I., Hoffmann, D., Wynder, E.L. The influence of tobacco smoke on indoor atmospheres (letter). P'rev. Med.. 4( 3') : 375-377, 1975'. S'chmeltz, I., Hoffmanni, D., Wynder, E.L. The influence of tobaccoo smoke on indoor atmospheres. 1. An overview. Prev. Mod. 4(1):66-82, 1975. Schmidt, F. Passive smoking and lung cancer, (letter). Lancet 1(8378):684, 1984. Schmidt, F. Passive smoking--only a nuisance or a, real health risk? Oeff. Gesundheitswes. 45(5):2'49-251, 19'83. (,German). Schmidit,, F. Important new findings on passive smoking. Off. Gesundheitswes. 44!(,2'):130-132, 1982. (German) Schmidt, F. Smoking and, passive smoking. Oeff. Dienst 3'5(6):12'2-129, 1982. (German) Schmidt, F. Smoking and passive smoking. Oeff. Dienst 35(5):97- 104, 198'2. (German) Schmidt, F. Health damage from passive smoking. Fortschr. Med. 97(42):1920-1927, 1979. ('German) Schmidt, F. Health damage through forced smoking. Report on the fourth world conference on smoking and health, Stockholm, Sweden, June 18-21, 1979. 22p. Schmidt, F. Passive smoking at work--a critical opinion. Kassenarzt 19(34):3060-3076, 1979. (German,) Schmidt, F. Passive smoking and'cancer. Med. Klin. 74(51/52):1967-1973', 1979. (,German) Schmidt, F. Health risks of passive smoking. World Smokingiand Health 3(1):19-24!, 1978. Schmidt, F'. Current problems of'smoking and passive smoking,. Osterreichische Arztezeitung 31(4):200-203, 1976. (German) Schmidt, F'. Passive smoking as a health halzard. Neue Jurist. Wochenschr. 29(91):358!-3I59, 1976. (German) Schmidt, F. Prohibition of smoking in working areas should bee our goal. MMW 118(341):1043-1046', 1976. ((German) Schmidt, F. Impairment of traffic safety by smoki~ng. Z. Verkehrssicherheit 2D(2)':10'9-122, 1974. (German) N Schmidt, F. Passive smoking of pipes and cigars. Arztl. Praxis 0 2'6(16')':761, 1974. N' ~ ~ 55' ~ ~ ~ D-55

C Dr. Koop is concerned about the increasing evidence "that environmental tobacco smoke can bring about disease, includ- ing lung cancer, in healthy persons, including infants and children," he advises nonsmokers "to avoid exposure to ciga- rette smoke wherever possible" and particularly, urges that children and infants be protected from involuntary smoking. The number of states that have overcome the well- bankroll'ed efforts of the tobacco lobby and restricted smok- ing in public places has been steadily rising. Twenty-ei~ght states now, limit or ban smoking in health facilities, 17 states restrict smoking in public buildings, 14 in restau- rants, 11 in government work places and eight in private work places. Scores of towns, cities and couritri'es havee enacted such laws even in states which have not yet moved to restrict smoking in enclosed spaces. The self-serving ad- vertisi~ng campaign of the Reynolds Tobacco Company against smoke-free space attests to the impact of such policies in reduced smoking. The issue i's not smokers' rights. The issues are whether we intendito protect non-smokers from involuntarily breathing tobacco smoke, whether we care enough about our fellow human beings who smoke to encourage them to stop killing themselves, and whether we're seri!ous about the billions of dbllars of health care costs smoking causes. Cigarette smoki~ng is slow-motiorn suicide. It is tragic when 0 peaple do it to themselves, but it i's inexcusable to allow ~Cl1' ~. ~ smokers to commit slow-motion murder. . ~. ~ ~ 4 G-12 C F

other people's cigarette smoke and lung cancer. Just this month, the American Cancer Society study reported that when a woman's husband smokes a pack of cigarettes~a day, he doubles her chances of'getting lung cancer. A study spon- sored by the National Institute of'Environmental Health Sciences found evidence that non-smokers exposed to the smoke of'others have an increased risk not only of lung cancer, but of breast cancer, cervicaL cancer and leukemia as well. Mr. Chairman, there is tremendous fear in this country about AIDS, and it is a!very grave problem. We haven't yet found a c!ure for this terrible disease, but we have no excuse where smoking is concerned. Because we deny people smoke-free space, cigarette smoking is turning cancer into~America's top contagious killer. Tobacco smokee breathed by non-smokers is already killing 5',Oi001 people eachh year, according to Environanental Protection Agency re- searcher James Repace, *far more than the combined deaths from all industrial emissions regulated by the EPA. L,ast year, U.S., Surgeon General Dr. C. Everett Koop wrote that "there is all the medi~cal evidence neces- sary" to protect the non-smoker against "The irritation and potential harm that comes from other people's smoke." Dr. Koop noted that "pollution from tobacco smoke in homes, offices, other works.ites and in, certain, public places can reach levels which exce~ed~contami~,nantle~velspermittedunderenvironmentali and occupational healith, regulations. "' Because 3 G-11

C r . Surgeon General Koop has called, on Americans to create a smoke-fbee society by theyear 2000. Passing this legislation will send a powerful signal -- through every federal courthouse, every one of Social Security's 1300, field off'ices, every House and Senate hearing room, and. 310,000 post offices -- that the health hazards of second- hand smoke are real' and require protective measures. Itt will ensure a healthier federal workforce and a safer, more pleasant atmosphere for our citIzens who visit federal offices. Mr. Chairman, let me conclude by cong,ratuilating you on your couragie.andiyour commitment to the health and safety of'our people in sponsoring this bill. 6 G-14 N C N ~ ~ ~ N ~. Go f

Bibliography on Involuntary Smoking/March, 198'6 presented at the American Academy of'Allergy, 3'0th Annual Meeting, San Diego, Calif., February 15-1'9, 1975. 4 pp. Smith, N., Austen, J., Rolles, C.J. Tertiary smoking by the fetus (letter). Lancet 1(8283'):1252, 1982'. Smith, R.G. Disc!ussion, of paper by Dr. Dinman. J. Occup. Med. 10 ( 9 ) : 4516-462, 1968'.. Smoke in occupied spaces: Ventilation requirements. Paper 8'1- 2'2.6' to, be presented at the 74th Annual Meeting of' the Air Pollution Control Association, P'h~iladelp~hia~,~ Pennsylvani~a:,~ J~une 2'2-251, 1981. Sonnenfeldl, G. Effect of'sidestreaan tobacco, smoke components on alpha,/betaii'nterferoniproduction. Oncology 40(1):52-56, 1983.. Spears, A.W. Quantitative determi'nation of phenol in cigarette smoke. Anal. Chem. 35( 3'):32'0-322, 1963. Spears, A.W., Routh, W.E. A combinediapproach to thee quantitative analysis of the volatile coanponents of cigarette smoke, 18th Tobacco Chemists' Research Conference, Raleigh, N.C., 1964. pp. 47-49. Speer, F. Passenger smoking effects on bus drivers (letter). Arch. Envrion. Health 22(4):512, 1971. Speer,F. Tobacco and the nonsmoker. A study of subjective symptoms.,Arch. Environ. Health, l6(3):443-446, 1968. Speizer, F.E., Ferris, B., Jr., Bishop, Y.M.M., Spengler, J'. Respiratory disease rates and pulmonary function in children associatediwith N02 exposure. Am. Rev. Respir. Dis. 12'1(l):3-10, 1980. Speizer, F.E., Thger, I.B. Epidemiology of chronic mucus hypersecretion and obstructive airways disease. Epidemiol. Rev. 1:124-142, 1979. Spengler, J.D., Dockery, D.W., Turner, W.A., Wolfson, J.Mi., Ferris, B.G., Jr. Long-term measurements of respirable sulfates andiparticles inside and outside homes. Atmos. Environi. 1S(1),:23'-30,, 19'81. Spengler, J.D., Sexton, K. Indoor air pollution: a public healthh perspective. Science 22'1(46051):9-17, 1983. Spengler, J.D., Soczek, M.L. Evidence of healthieffects of sidlestream tobacco smoke. ASHRAE Transactions 90(1)1, 1'984.. , Spengler, J.D., Dockery, D.W., Reed, M.P., Tosteson, T., Quinlann, P. Personal exposure to res!pirable particles. Paper 59

APPENDIX -5'- J.L. REPA'CE: CURRICULUM Y1TAE: For the past six yeam, I been a poJ!icy analyst iin the air pol!icy offi'ce at the U.S. Environmental Protection Agency, Washington, DC. However, my testimony here thi s morni ng wi l l be as a pri'vate ci'ti'zen,, and shoul d not be i nterpreted as representing official U~.S. E~nvironmental Protection Agency pol!ilcy., Prior to: EPA, 11 worked for 1b'years as a, research physicist at the Naval Research Laboratory, at RCA Sarnoff Laboratory, and at two New York hospitals. I earned a Master's degree in physics.from the Polytechnic Institute of Brooklyn. I am a technical advisor to the Nati'onal A'cadiemy of Sciences Committee, on Passive Smoking. I'am a contributor to ani Lnternational Agency For Research on Cancer monograph on Sidestream Srnoke, concerning modeling and measurement of' nonsmokers' exposures., I am executive secretary of the Indoor Air Quality Ciommfittee of the. Air Pml]ution Controll Association. I am a member of' the Interagency Technical Working Committee, on Smoking, Heart, Lung and Blood Diseases. I have been a member of a Natilonal Institute of Health special study committee to review, grant proposals on passi've smoki'ng and lung cancer. I have, testified as an expert witness on the subjiect of'passive smoking at a U.S. House of Representatives hearing on Indoor air pol!lution research. I have been a consultant to both the World'Healthi Organization and the National Acadenpr of Sciences Cbmeittee on Ai rl i ner Cab1 ni Ai r Quality, on the question of' passive smokiing oni passenger ai rcraft. I was a: consultant on, the Involluntary Smoking Chapter of the 1984 Svrgeon. General "s Report on Smoking and Chronic Obstructive Lung Diseases. I served as a consultant to the Federal Trade Commission i'n the area of tobacco, smoke and air, cleaners. Three of my papers are cited in the 1984: Surgeon Generall's Report on, Smoking and' O' Lung Di'sea.se, and' my work is extensi'vely d'i scussed i n two books: "Indoor Ai r UT Quality" by B:. Meyer, Addison Wesley, 1983,, and i'n "I'ndbor A1r Quality" by Walsh, ~~ Dudney, b Copenhaver, CRC Press, 1984. APh N W' G-5

Bibliography on Involuntary Smoking/March, 1986 Schmidt, F. Tobacco smoke as the most important source of air pollution in enclosed spaces and as a pathogen for passive smokers. Med. Welt 25(44):1824-18'32', 1974!. (German) Schmidt, F., Wiischnath, A. Protection of nonsmokers at the working place. Contribution to the working site regulation and to the reform of'the Industrial Safety Act Adolescents. Zentralbl. Arbeitsmed. 25(5):141-145 concl., 1975. (German) Schmidt, F.,, Wischnath, A. The protection of nonsmokers at the job site -- contributions to the job site regulations and the reform of the child labor law. Zentralbl. Arbeitsmed. Arbeitsschutz 4/'5:129-136, 1975. (German) Schmidt, F. "Active" and "passive" smoking as serious bronchial noxae. MMW 11S(41):177'3-1778,, 1973. (German) Schmidt, F. Health damages andiimpairment of mental efficiency by passive smoking,. Oeffr. Gesundheitswes.. 35(3):150-156, 1973. (,Ge rman) Schmidt, F. Active smoking and~ passive smoki~ngi. Fortschr. Med. 90( 314 ):125I3-12'56, December 7, 1972. (,German) Schmidt, F. Hitherto unpublished legal' violations in, smoking: nonsmokers protection,-,an urgent task of environmentali protection. Z. Allgemeinmed. 48(14):709-713, 1972. (G'erman) Schmidt, F. Concerning the problem, of "passive smoking" (letter).. Munch. Med. Wochenschr. 113'(18):702-705, 1971. (German) Schmidt, F., Wischnathi, A. The protection of nonsmokers at work. Work place regulations andireform of child labor laws. Zentralbl. Arbeitsmed. 25(4):1016-110contdi., 1975. (German) Schneider, S.Z., Primavera, L.H., Tantillo, J. The effect of an anticipated reverse smoking rule on, the perceived distraction, of persons attending organizationa,l meetings. J. Psychol. 1131(First Ha1f):41-45, 1983. Schulte, J.H. Sealed environments in relation to health and disease. Arch. Environ. Health 8'(3):438-452, 1964 Schulte, J.H. Discussion of'paper by Dr. Dinman. J. Occup. Med. 10(9) ' : 46 2'- 46 3, 1968. 8. Schwartz, J. Anti-s'moking, movement--pairt I. P'rogrami gains momentu:n. HealthiSci. J. 5(8):1, &, May 1977. Searle, C.E. Slmoki~ng and FOREST (letter). New Scientist 88 ( 12'31) : 73'4-735,, 1980.. ~ ~. 56 ~ -56 N N O C

C cancer of the mouth andlesophag!us and has been reLated to kidney cancer and cancer of the cervix. • Up to 90 percent of'the deaths from chronic lung disease • 40 percent of the deaths fr=coro- nary heart disease. The total financial cost of cigarette smokingi is about $65 billion each year -- more than $2'for every pack of cigarettes consumed. The cost in personal anguish, suf- fering and needlessly lost lives is incalculable. As the damage that cigarette smoking does to our health has become clear, the proportion of adult smokers has gone down. In 1965, more than half of the adult men in this country smoked; today it is just over, one-third. The per- centage of women who smoke has also declined, although not nearly as rapidly, from 3'4' to 29 percent. Smoking among, teenagers has dropped dramatically since the late 1970s. Per capita cigarette cpnsumption has been falling steadily since 19'73'. For the first time in two decades total cigarette consumption fell two years in a row in 1982 and 19'83'. These declines have taken place in spite of the tobacco industry's record-breaking levels of advertising which reached more than $2.5 billion in 1983. Now a new wave of evidence is revea1ing,the dan- gers of involuntary, second-hand smoking -- dangers that require a new set of government responses. Studies i'n Japan, Germany, Hong Kong, Greece, Scotland, and the United States point to a, clear relationship between exposure to 2 G-10

Biblio!graphy on Involuntary Smoking/Mairch, 1986 Schievelbein, H. Sick from passive smoking--no proof of a hazardd to health (letter). MMW 124(8):12', 1982. (German) Sthievelbein, H. Lung cancer iin passive smokers. Munchi. Med. Wochenschr. 123(17)1:668-6'69, 1981. (German) S'chievelbeini, H. Involuntary smoking. Med. Klin. 73 (10 ): 33I3- 340, 1978. (German) Schievelbein, H. On the question, of the influence of tobacco smoke on the morbidity of nonsmokers. Internist (Berlin) 14(15)•236-243, 1973. (German,) Schievelbein, H'., Richter, F. The influence of passive smoking on the cardiovascular system. Prev. Med. 13': 626-644, 1984. Schilling, R.S.F., Bouhys, A. Breathing other people's smoke (letter). Br. Med. J. 2(614,1):895, 1978. Schilling, R.S.F., Letai, A.D., Hui, S.L., Beck, G.J., Schoenberg, J.B., Bouhuys, A. Lung function, respi'ratory disease, and smoking in families. Am. J. Epidemiol. 1016(4):274- 283, 197'7 . Schindl, R. Effect of environmental factors on, pulmonary function. Screening study of flow-volume in children from urban and rural areas. Z. Erkr. Atmungs!organe 16'1(2):199-2'03', 1983. Schmeltz, I. The chemistry of tobacco and tobacco smoke. (Proc. of the symposium on the chemical composition ofl tobacco and . tobacco smoke, September 1971, Washington, D.C'.) New York: Plenum Press, 1972. Schmeltz, I., Hoffmann,, D. Nitrogen-containing compounds in tobacco and tobacco smoke. Chem. Rev. 7'7(3):295-311, 1977. Schmeltz, I., Hoffmann, D. Chemical studies on tobacco smoke,. XXXVIII. The physicochemical nature of cigarette smoke. In: Wynder, E.L., Hoffmann, Di., Gori, G.B. (eds. )1. Modifyingi the rilsk for the smoker. Vol. 1. Proceedings of the 3rd world conference on smoking and health, New York City, June 2-5, 1975. DH'EW Publication No. (NI'H') 76-122'1. pp. 13-34.. Schmeltz, I., Wenger, A., Hoffmann, D., Tso, T.C. Chemical studies on tobacco smoke. 63. On the fate of nicotine during pyrolysis andi in a burning cigarette. J. Agric. Food C'hemi. 27'('3):602-608, 1979. Schmeltz,, I., Wenger, A., Hoffmann, D., Tso, T.C. Chemical studies on tobaccoismoke. 53. Use of radioactive tobaccoo isolates for studying the formation of smoke components. ,7. Agric. Food Chem. 26(i1):2'34-239, 1978. 54.

{TritteniTestimony of STANTON A. GLANTZ',, PH.D. Associate Professor of' Medicine University of Cali'fornia San Francisco, CA 94143 President Californians for Nonsmokers'' Rights . 2054 University Avenue,, Suite 500 Berkeley, CA 94'704 Submitted to the Subcommittee on Civil Serv ice, Post Office, and General Services Committee on Governmental Affairs Uniltedl States Senate For Hearing,on S.1440 The Non-Smokers Rights Act of 1'9'B'5 September 30, 19'H5 E G-22

Bibliography on Involuntary Smoking/Maxch, 1986 Lancet 1 (8433'):866-867, 1985. Treatment for alpha 1-antritrypsin deficiency ('editorial). Lancet 2(845'9):8'12'-813, 1985. -----, Passive smoking and lung cancer (letter). Lancett l(8378):6814, 1984. -----, Passive smoking: FOREST, GASP, and facts (editorial). Lancet 11(18271)1:548-5'49, 1982. -----, Passive smoking and angina (editorial). Lancet 2'(,8'086 ) : 413-414 , 1978. -----, Tobacco smoke and the non-smoker (',editorial)I. Lancet 1(',7868 ) :12'01-1202, 1974'. ------- Where there's smoke. MD 17'(3):69-7'1,, 75, 1973. -----, Prohibition of smoking dhiring, courses of continuing medical education. Med. Monatsschr. 29(3):141-142', 1975. -----, Passive smoking (letter) Ni Engi J Med 19'851 Mar 14;312(11):719-21 -----, Contemporary comment. Pennsylvania's Health 30111:9, 1969. -----, Smoke in occupiedispaces: Ventilation requirements. Paper 81-22.6 to be presented at the 74th, Annual Meeting, of the Air Pollution, Control Association, Philadelphia, Pennsylvania, June 22-25, 1981. -----, Statistical error cited in smoking,-cancer study. Tob. Int. 183 (113 ): 73-74, 1981. -----, New method of leaf protection through insect growth regulati'on. Tob. Int. 182(4),:18, 21', February 22, 198 0. -- --, Anti-smokingimomentum threatens cigarette industry. Tob. Reporter 107(1):12, 1980. -----, Smoking affects whole family. West Virginia Med. J. 6 5' (1) : 2 2', 19 6'9 . -----, Smoking and its effects on health. Report of a WHO Expert. Committee. World Health Organization. Technical Report Series, I No. 56'8, 1975. -----, Smoking in the cockpit, and smoking by flight crewmembers before com,merical flight operations. Worldi Smoking and Health 74 f D.-74

As Secretary, of'HEW, I issued an order requiring that each employee's right to smoke-free space be recog- nized. After a few shakedown weeks:, all employees, smokerss and non-smokers alike, not only lived with~it, they reported that they were much happier than before. I'n April 1984, Malcolm T. Stamper, President of the Boeing Company, estab- Lished a corporate policy to create a smoke-free workplace. As an initial step, Boeing prohibited smoking in common areas throughout the workplace, such as hallways, restrooms,, lobbies, libraries, andicomputer rooms. When Stamper first put this policy in place, he expected resistance from the workers and the union,. Instead he got acceptance and appre- cia ion. Many companies are strictly limiting smoking to designated areas. Workplace no-smoking policies make health andibusiness sense because smokers are sig;nilfi1cantly less producti've and far more accident- and'illness-p.rone. The short-term, costs to business of smoking emplioyees are esti- mated at $3'00 to, $3'50 per year, with long-term effects on productivity, absenteeism and premature death raising this tolabout $1,0100 per year. Mr. Chai~rman, I have one suggestion for your con- silderation, as you continue your deliberations on this legis- lation: Stipulate that when disputes arise from policiess established under the Act, the rights of the non-smoker take precedence. This has been effective in a number of' statee and local statutes. i 5 G-13

Bibliography on Involuntary Smoking/March, 1986 Praventivmedi. 25(16):32'8-332, 1980. (German). Ware, J.H., Dockery, D.W., Spiro, A., 3d, Speiizer, F'.E., Ferris, B.G., Jr. Passive smoking, gas cooking,, and! respiratory health, of children living in six cities. Am. Rev. Respir. Dis.. 129 ('3 ) : 3616-374, 19841. Warner, R.E. The economics of smoking: dollars and sense. NY State J. Med. 8'3(13):1273-1275, 1983. Watson, W.C. "Bingo brain"'(letter). Can. Ned. Assoc. 126 (11i ) :126'6 , 1982. Weber, A., Jermini, C'. , Grandjean, E. Irritating effects on man of air pollution due to cigarette smoka. Am. J. Public Health 66(7'):672-6I76, 1976. Weber, A. Passive smoking--alhealth hazard?' Dtsch. Ned. Wochenschr. 107'(91:3I23-325, 1982. ('German) Weber, A., Fischer, T., Grandjean, E. Passive smoking in experimental and fileld conditions. Environ. Res. 20(1):205-216, 19791. Weber, A., Fischer, T. Coneentrations of pollutants in the "blowi!ng cloud"' of smokers. Int. Arch. Occup. Environ. Health 53 (11: 47-50, 1'9'83'. (German) Weber, A., Fischer, T. Passive smoking;at work. Int. Arch.. Occup. Environ. Health 47('3):209-2'21, 1980. Weber, A., Fischer, T., Grandjean, E. Passive smoking: irritating,effects of the total smoke and'the gas phase. Int. Arch. Occup. Environ. Health 43(3):183-193, 19'79. Weber, A. Passive smoking,. Schriftenr. Ver. Wasser. Bodien Luft- hyg. 53:17-23, 19'82. (,German) Weber. A., Muramatsu, T., Muramatsu, S. Acute and chronic effects of passive smoking. Soz. Praventivmed. 27(5):262-263, 1'9'82'. (iGerman) Weber, A. Passive smoking, air quality, and protective measures. Soz. Praventivmed. 26(3):182-18'4,, 1981. (German) Weber, A., Acute effects of environmental tobacco smoke. Eur. J. Respir. Dis. [Supp1. ] 133:98'~1i018, 19'84. Weber, A., Fischer, T., Grandjean, E. Passive smoking: irritant effect of the total smoke and the gas phase. Soz. Praventivmedl. 24(4):280-28'1, 1979. (German) Weber, A., Fischer, T., Grandjean, E. Passive smoking under 68 ! n D-68

; into the private workplace: that'thc 1ltnv isunnrccss:ury and the mattcr of stninking should be worked out privately; and that the lawfosters "anc-man rule" by giving a.ingll• nonsmoker the power tu dictate personal behavior by all llhe other pct+plv in lho office. One of the liirni pirc4s of hlerature by tlhe tobacco industry told citizonx that thcy should be :rngry that tlhey wcrc'being forced to vcttc'in an unnecessary elcctlion, thereby heaping scorn on propuncnts ol' the ordi- nancc for what the tubaccoindustr} itself'hatd engineered. They claimed that thc law' is d'isc,rintinatory because it applies to all private empluyccw but only :(I°i of public employces- in otihcr wurds, city as oppu.ed'tu state and fudcrallcnipliwcc,: Actually,, t'hc City Attorney had deter- mined that the city did not have the tx)wcr tocnfurccthc'lativ in state and' federal officus and, in any evcnt.,allist;ttc cmr ployccs were already protected by a st:uc Iitnv. The most outlandish'allcgatiom c:rntc inimponsc to the growing public awnrenc.s that the "Nlo on P" rtmpaigni wa:s receiving 99,7"l0 of its money from out-of-state tobacco companies. One "Nru on P" rcprerkntativc charged during a dubatic that proponents were gctting 94.''~;% of their money from outside San Franci:u:o, and this absurd claim was continued throughout the campaign. Probabli,v the mos2'important endorsement would be that' of the San Francisco Democratic Central Committee. The Committee had solidly supported the twostatta+idc'inifia- tlixes for nonsmokers' rights in 197'8 and 1'980, and there seemed'to be no reason why, they wouldl not endorse the ordinance, particularly since it, had the backing of the Mayor. But no one reckoned on just how much pressuree would be brought to bear, all the committee endorsed "1Vo on P" by a vote of 15 to 14l Just how much that, endorse- ment meant was brought home the day after the election, whcnthe contact person for the "Yes on P"'campaign in the Mayor's off ce said thao her own!husband Iwas so confused upon receiving the voting recommcndations from the Democratic Central Committee that hc' almost voted against the proposition. Perhaps the saddest moment in the campaign came when The Bav Guardian, a liberal biweckly ncwspapcr, which had been the only ncwspapcr in thestate to support the 197K' statewide initiative and one of the few to support the 19800 initiative, announced itsoppo»ition to Propcflxition P. Neither the publisher nor his support for nonsmokers' rights had cltangcd, but the perceived threat of the loss of cigarette advertising evidently becanne ovcrwhelming. UNDEuSTANUIIVG~ MAtiS 141It•:1rtA Prupuncntsof the ordinance developed three kcy com- poncnts of their campaign. First, Edgar Spi7.ci, a mediaa consultantiand produccrof thousandit qf radiu'and tclcvision commcrcials, volunteered his services. The "1'es on P"television commercial he created featured a, tough-looking cowboy riding a horsc' on a San Francisco street and decrying the fact that the tobacco companics were spending 9970 of the money to overturn the new smoking ordinance. At the end tic repeats the campaign slogan: "Tclllthc to- bacco companies tobuttiuut!i" (The advertising community namcd it the best television commcrcial in Nort'hcrn Cali- forniia for 1'9133'.) The second key clemcn, was to force the ttubacco industry to changc thc'taglines at the end of the "No on P" radio and TV advertisements to say "paid for by the tobacco industry" rather than "paid for by, San Franciscans Against Gov- ernment Intrusion." The Federal Communications Act of' 1934 retquires'broadcast stations to identify the true sponsorr of all politicalladvcrtisementsl fJsingall volunteer attorneys, AUOq(westemlmusic up and undar) . You know, we San Franeisean's aro a proud twnchi We like to idb rtt+inqs our own way. So when soms 4ottcs, like the low tli0iYl9ttDbaeeol eoRpanies from oul of statel qa'up 199.5 % of the doUars to iovertum ourneiw smokinq orQinal . wel1, ttnt just imakes ms mad. It'yuu're as mad as'J am.,why not IPin me in tellinq tMese tobacco companies to ~t7Un OIJ4 Vote Yes on P (music up and iout)) headed by Paul' Loveday, who had led'the twoistatewide initiative campaigns, proponents put together a, 31D+page . memorandum (and more than 100 pages of'supportling documents), which was thcn presented to adl'thrstatidnsl broadcasting "No onP" commercials. W'ithin twod'ay,s of rl of this material„K'RON-TV, the NBC affiliate and tihest'ation with the largcsramount of "No on P"campaiign advcrtising, informed San Franciscans Against Govcrnmcnt Intrusion that if they did! not modify, the ta'glinc, the ad- vcrtlivcmcnts would be taken off the air. KNBR (NBC radio) followed suit. The tobacco industry then chanecd!tht: taglinc for' KRON to rcad; '"paid fior by San Franciscans Against Government' Intrusion, which is funded by com- panies in the tobacco industry."'They reluctantly agreed Jl:liY I1)X5/'!vfw YORK STA'Tf JOtURNTI. O1' NLI)tCIMIi' 371 B -3'.

Bibliography on Involuntary Smoking/March, 1986 experimental conditions and'in field studies. Soz. Praventivmed'. 23(4):261-262', 1978. (German) Weber, A., Fischer, T., San!cin, E., Grandjiean, E. Air pollution from cigarette smoke: Physiological effects and irritations. Soz. Praeventi'vmed. 21(4):130-1i32, 1976. (French) Weber, A. Annoyance and i'rritation by passive smoking. Prev. Med. 13:618-625, 1984. Weber, A. Air, pollution and burden from cigarette smoking: the . problem of passive smoking. Z. Krankenpfl. 69(4):115-118, 1976. ( Ge rman,) Weber-TSchopp, A., Fischer, T., Gierer, R., Grandij',ean, E. Experimentally induced irritating,effects of acrolein in man,. In'tt. Arch. Occup. Environ. Health 40(',2'):117'-130, 1977. (,German) Wieber-Tschopp, A., Fischer, T., Grandj,ean, E. Irritating effects of formaldehyde in man. Int. Arch. Occup. Environ. Health 39M ': 207-2'18', 1977 . (,Ge rman ). Weber-Tschopp, A., Fischer, T., Grand'j'ean, E. Objective and subjective physiologic and psychologic effects of passive smoking. Int. Arch. Occupi. Environ. Health 37(4)1:277-288', 1976. (German) . Weber-Tschopp, A., Jermini, C., Grandjean, E. Air pollution and irritations due to cigarette smoke. Soz. Praventivmed!. 21(2- 3):101-106, 1976. Weber-Tschiopp, A. Passive smoking--a health risk. Tbbakken Og Vi 4:3-7, 1980. (Norweg,ian) Weir, F.W., Johnson, D.F., Angleni, D.M., Rockwell, T.H.,. Nieu!hard't, J.B., Harshman, D.J., Baliasubramanian, K.N. Thee interactive effects of carbon monoxide and! alcohol on driving . skills. Columbus : Ohio State Univ., 1975. Weir, F.W., Rockwell, T.R.,, Mehta, M.M., Johnson, D.F., Anglen, D.M., Attwood, D.A., Herrin, G.D., Safford, R.R. An investigation of the effects of'carbon monoxide on humans in the driving task. Columbus : Ohio State Univ. Res. Foundation, RF Pro jiects 3'141, 3'332, 1973. Wei~s, W.Li. Clearing the air on office smoke (letter). Bus,. Week Indus. Ed. (12776):4, February 7, 1983. Weis, W.L. Clearing the air on, office smoke (1'etter)1. Bus. Week Indus. Edi. (2776):4, February 7, 1983. Weiss, S.T., Tag!er, I.B., Schenker, M., Speizer, F.E. The health, effects of involuntary smoking. Am. Rev. Respir. Dis. 69 D-69

Bibliography on Involuntary Smoking/March, 19'86. 128 ( 51:933'-942, 1983. Wei,ss, S.T., Tager, I.B., Speizer, F.E., Rosner, B. Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children. Au. Rev. Respir. Dis. 1'22(5) :697-707, 19'80'. Weiss, S.T., Tager, I.B., Speizer, F.E. Passive smoking. Its relafiionship to respiratory symptoms, pulmonary function and nonspecific bronchial responsiveness (editorial). Chest 84(6):651-652 1983. Weiss, W.L. "No ifs, ands or butts"--why workplace smoking should be banned. Management World!, Sept.:39-4'0, and 44, 1981. Weiss, W'. Smoking: burning a hole in the balance sheet. Personnel Management 13 ( 5): 2'4-2'9, 1981. WWelch, R.M'., Harrison, Y.E., Conney, A.H. Cilgarette smoking: stimulatory effect on metabolism of 3,4-Benzpyrene by enzymes in human placenta. Science 160(3827):5'41-54'2, 1968. Wexler, P. Passive smoking: January 1972 through, September 1980, 1621 citations. Bethesda, Md. : U.S'. Department of Health and Human Service&, Public Health Service, National Institutes of Health, National Library of Medicine, 1980. National Library of Medicine Literature Search No. 80-1. Whidden, P. Clean air charter for airlines (letter). Br. Med. J. 286(6365'):646, 1983. Whidden, P. Scope for legislation on smoking (letter). Lancet 2'( 8296 ) : 498, 19182. White, J.R. Selected pulmonary functions of nonsmokers chronically exposed~ to tobacco smoke (abstract),. Med. Sici. Sports 11(1):8,8(6), 1979. White, J.R., Froeb, H.F. Small-airways dysfunction in passivee smokers ( letter ). N. Engl. J. Med'. 303 (;7') : 393-394, 1980. White, J.Ri., Froeb, H.F. Small-airways dysfunction in nonsmokers chronically exposed to tobaoco smoke. N. EngI. J. Med. 3!021(,13 ) :72'0-723', 19810. White, J.R. Effects of residual tobacco smoke on non-smokers. The International Congress of Physical Activity Sciences, 1976. Wigle, D.T. Publilc health enemy number 1: smoking. Can. Pharm. J'., 117('4'):140-144, 146, April 1984. Wigle, D.T. Forced smoking. Can. J. Public Health 2'32, 198'3. 70 74(4):23'1- f D-70.

~x- Here is what Surgeon General C. Everett Koop says about involuntary smoking: There is all the medical evidence necessary to support reasonable and sensible protection for the nonsmoker against the irritation and potential harm that comes from other people's smoke. The harmful constituents of mainstream cigarette smoke are found in sidestream smoke, sometimes to a greater atent than in mainstream smoke. Pbllution from tobacco smoke in homes, offices, other uarksites and in certain public places can rrach levels which exceed contaminant levels permitted under environmental and occupational health hn regulations. r- Nonsmokers absorb the constituents of tobacco smoke into their bodies, even though in smaller amounts than is true of those who smoke. - Passive smoking can make the symptoms of asthma and chronic bronchitis worse, and make life miserable for people with allergic conditions. Maternal smoking has a harmful effect on pregnancy, including an increased risk of miscarriage, prematurityt stillbirth, death soon after birth, low birth weight and fetal death. There is increasing evidence to suggest that anoironmental tobacco smoke can bring about disease, - including lung cancer, in healthy adults, children and in/ants. ft is on the basis of these facts that I advise nonsmokers to auoid aposure to cigartite smoke wherever possible, and that, in particuFar, they should protect infants and children from this smoke. Americans for Nonsmokers' Rights and the - - - - American Nonsmokers' Rights Foundation seek to develop a coordinated action-oriented program of legislative, educational and legal activities to permit nonsmokers to avoid involuntary exposure to tobacco smoke in public places and places of employment. Norismoe rs Rights 2054 University Avenue. Suite 500 8erkeky, California 94704 (415)841-3032 VCzV8sRz0z 0 1985 Americans for Nonsmoken' Rights NONSMOKER ;..- .~ . ..: -r ~

the indoor environment. o The children of smoking parents have an increased prevalence of reported respiratory symptoms,, and have an increased frequency of bronchitis and pneumonia early in life. As you, Mr. Chairman, are aware from legiislation in your own state of Alaska,, many states have exhibited leadershiip to protect the pubI!ic from health risks associiated with passive smoking by enacting 1!egilslatilon which pl!aces limi'tations on smokiing, in public places. A total of 37' states, have such legiislation in pl'ace. Of these, 24, states limit or restrict smoking in forms of' public transportation. Twenty-one states restrict or ban smoking during public meeti'ngs' or restrict smoking to! certain areas within publ,ic bui'ldtngs owned, - operated, or run by the state. Over half of the states--2'b--restrict smoking within certain health care establishments, usually hospiltaTs or clinics. E'1!even states have laws requi'ring, separate seati'ng for nonsmokers in resturaints and 9 states address smoking in places of retail sales. Finally, 10 states have enacted laws specifically addressing smokiing in the workpllace. Hlowever, a review of statewide regullatiion onlly touches the tip of th~e icebergi. Literally hundreds of county and, muinici'ple governments have. G'-19

Coalition on Smoking OR Health A PUeuC tOUCY PROJECT WITH THE NATIONAL INTERAGENCY COUNCIL ON SMOKING AND HEALTH 1607 New Hampshire Avenue, N.W., Washington, D.C. 20009 (202) 234-9375 fTEfRItaG CO/wMRRFE .. Rebe" C. WerwftwUM. CIW.wuw Aw...kOR l+M.{ A..aciai" ksn :0.~. 4Nu Awr.icrs Hean Awniathn~ M@nC. 0..'s AwK.icreCawn. fxwry fTytN'~OqRKTOR ~.. M.nM.1. Myen M" M"iw kNv...A ~wl/.wie.. ASfRDOATf DIRICTCIR Da:d iL hrwnrrw "R ww. iww.., a anw.. TE~ST~IMON~Y~, OIF~~ ALFRED MUNZE'R, M.D. ON BEHALF OF THE COALITION ON' SMOKING OR HEALTH AND ITS MEMBER ORGANIZATIONS THE AMERICAN LUNG AS'SOCI'AT1UN' THE AM'ERICANI HEART ASSOCIATION THE AMERICAN CANCER SOCIETY ON THE NIO'NSM'0KER5' RIGHTS ACT' OF 19'85 BEFORE THE SUBCOMMITTEE ON CIVIL SERVICE, POST OFFICE AND, GENERAL SIE'RV I CES COMMITTEE ON GOVERNMENT AFFAIRS U.S. SENATE SEPTEMBER 30, 1985 "CIGARETTE SMCiK1NG 15 THE SINGLE MOST PREVENTABLE CAUSE Of DEATH IN THE UNITED STATE!5" G-15'.

l Mr. Chairman and Members of' the Subcommittee, I am Dr. Alfred Munzer a practicing physici'an who specializes in lung di'sease. As a voliunteer with th~e American Lung Association,, I serve on their Board of Dilrectors, and chair their Government Relations Committee. I appear before you today on behalf' of the Coalition on Smoking or Health. T~he C'oaliti'on on Smoking or Hiealth, was formed by the A'mericani Lung Association, the American Heart Association and the American Cancer Society and is backed by many of' this nation's leading private health, education and youth leadership org,anizationis. The Coal!fti'on was created to bring to the attention of legi'slators and other governmental officials smokiing preventi'on and education issues. On behalf of the C'oali'tioni and its member organizati'ons, I waint to, thank you: for the opportunity toi express our views about the merits of the "N'on-Smokers'' Rights Act of 1985"', aind'' commend' you,, Mr. Stevens, for initroducing this legisl!ation. Currently, too little is done to protect the health, safety and comfort of non-smokers who work in, or who v1sit United States government bu i'1 dings . The "'Non-Smokers' RIghts Act of 1985" recogn i zes. this problem and will require responsible government officicals to address it. N O ~ Exposure of noinsmokers, both chil!dren andl adults, to tobacco ~ ~ combustion products is referred to as passive or involuntary. ~ ~ ~ ~ fl G.-16:

o Several-studies have indicated that from one-half to three-fourths of' nonsmoking adults experience sym- tomiatic effects from ambient tobacco smoke exposu.re i'ncl'udi'ng eye, nose and throat irriltation, headache,, and nausea, withi moire severe effects reported im per- sons with chronic heart or liunig di'sease. Two recent sttudies of lung caincer in nonsmokers showed evidence that passive smokinig more than doubles the nonsmoker's rilsk of lungi cancer. Two epi!demiollogi'cal studies of the indoor environment and marbidity--one of 400 adult nonsmokers who were chronical'ly exposed!to tobacco smoke at work and th~e other of young children raised in households with simokers--fou!nd evidence of pullmoinary impairment from passive smoiking. Miost recently, the 1'984 Surgeon G~eneral's Report oni the Health Consequences of Smoking concluded on the ilssue of passive smokinig: ~ o Cigairette smoke can make a si'ginificaint, measureable N contributioni to the leveT of indoor air pollution at ~ levels of smoking and ventillaitian that are common, in ~ ~ i17 C G-18

TBSTIMONY' OF JOSEPH A. CALIFAhTiO, JR. BEFORE THE U.S. SENATE SUHCC14MITTES ON CIVIL SERVICE, FOST' OFFICE XNIJ. GENERAL SERVICES September 310, 1985 Mr. Chairman and Members of the Committee: I appreciate your invitationito testify on the Non-Smokers Rights Act ofl 1985. Mr. Chairman, this bill -- by requiring that all Federal agencies restr'ict to limited'l areas any smoking in their buildings -- will help propel us into a second major phase in the nation"s progress towards'a, smoke-free soci'ety. Twenty-one years ago Luther Terry issued'the first Surgeon General's Report on Smoking and Health., That report found cigarettes guilty of murder and mayhem by cancer, heart disease, emphysema!, and chronic bronchitis. The evidence in that first report has grown to;an avalanche of data detailing with grisly precision the toll of cigarette smoking,. It causes at least 3'60',0i00 deaths each year, 170,0!00 from heart disease, 130,0010 from cancer, and'i 60,0100 from chronic lung diseases, including: 9 810 to 815 percent oE al l d'eaths f rom lung cancer ill 40 to 60 percent of bladder cancers among men, and 25 to 3'.5 percent among, women • Up to 84 percent of' cancer of the larynx. Smoking is a major factor in G-9

STATEMENT OF' THE HONORABLE BILL ROSS CONIIrIISSIONER. ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION S'-1440 , ON THE NON-SMOKERS RIGHTS ACT OF 1985 B'EFORE THE UNITED STATES SENATE C0MMITTEE ON GOVERN?iENTAL AFFAIRS WASHINGTON, D. C'. SEPTEMBER 30, 1985

In cllosinig I would li'ke to review the results of' a survey the Ameri'can Lung Association conduicted om the issue of non-smoker's rights. The survey, carri!ed out for ALA by the Gallup Organi'zationi„ showedl that 82%' of the nonsmokers and 55% of current smoikers agree that smokers should not smoike around nonsmokers. On the issue of smoking in the workplace, 64% of the nonsmokers andl 63% of the smokers preferred designated smoking areas in the workplace. These results are indicative of the concern of the American public about the health risks of passive smoking. "The Non-Smokers' Rights Act of 198I5I", providlingi for the limitation of smokiing in federal buildings, is a common sense approach designed to reduce exposure to tobacco smoke,, a substance which in our opinion requiires no further study to justify governmental action to protect the non-smoker. M'ore than sufficient evi'dence of its harmfulness exists. We shiould not wait for further before enacting reasonable regulations restricting smoking in public places, includling, the workplace, as a means of protecting publ!ic healith. The Coalition looks forward' to working with you to einact this very important publilc health legisllation. Thank youl.

DEPARTMENT OF HEALTHi & HUMAN SERVICES Public Health Service Health iResnurces and I Services Administration February 7, 1986 Rockville MD 20857 StantoniA. Glantz, Ph.D. President„ Americans for Nonsmokers' Rights 2054 Uinfiversity A'venue, Suite. 500 Rerkeley, CA 947'OU'. IDear S'Lan s You asked me to summarize for your memberd what we know about the dangers of iinvoluntary, or passive, smoking,to nonsmokers. There is all the medical evidence necessary to support reasonable and sensible protection for the nonsmoker against the irritation and potential harm that comes from other people's smoke~. The harmful constituents of mainstream cigarette smoke are found!in, sidestream smoke,, sometimes to a greater extent than in mainsteram smoke. Pollution from, tobacco smoke in homes, offices, other worksite's and in certain public places can reach levels which exceed contaminant levels permitted under environmental and'occup'ational health,regu'lations. Nonsmokers absorb the constituents of'tobacco smoke into their bodlies, even thougta in smaller amounts than is true of those who smoke. Passive smoking can make the symptoms of asthma and chronic bronchitis worse, and make life miserable for people with allergic conditions. Maternal smoking,ha's a harmful effect on pregnancy, including,an increased risk of miscarriage, prematurity,, stillbirth, death soon after birth, low birth weight and fetal death. There is increasing evidence to suggest that environmental tobacco smoke can bring about disease, including lung cancer, in healthy adults, chi'ldren, and infants. It is on the basi& of these facts that I'advise nonsmokers to avoid exposure to cigarette smoke! wherever'pos'sible„ andithat, in particular, they should protect infants and childl^en from this smoke. Americans for Nonsmokers' Rights is doing outstanding work in not enly, bringing these dangers to the public''s attention, but also i'n helping to pass legislation and creating educational pro'grams that will help us reach the goal of a Slaoke Free Society by the Year 2000. I encourage responsible individuals everywhere to support your good work. Sincerely yours, ~. C. Everett Koop, M.D. Surgeon General E-1

Bibliography on Involuntary Smoking/March, 19'86' 0'ffice on Smoking and Healthy 1984. DHHS (PHS) 84-50205. p. 3'63-410. Uniited States. Ofice on Smoki'ng and Health. The health consequences of smoking: cancer. A report of the Surgeon General:1982. Rockville, Mdi. : U.S'. Department of Health and' Human Services, Public Health Service, 0'ffice on Smoking and Health, 1982. DHHS (PHS')~ 82-50179. pp. 91, 181-182, 213-214,. 239-254. United States. Office on Smoking and'Health. The health consequences of'smoking: the changing cigarette. A report of'the. Surgeon General. Rockville, Mid. : U.S. Department of Health and Human Services, Public Health Service, Office on Smokinig and Health, 1981. DHHS(PHS) 81-50156. pp. 561, S'8, 204. United States. Office on Smoking and Health. Smoking and health: a report of'the Surgeon General. U.S. Department of Health, Education, and Welfare, Publ'ic Health Service, Office of the Assistant Secretary for Health,, Office on Smoking and Health, 1979. DHEW(PHS) 79-50066. pp. Ii:6-II:24. United States. Public Health Service. The health consequ-ences of smoking. A report of the Surgeon General: 1972. Washington,. D.C. : U.S. Department of' Health, Education, andiWelfare, Public Health Servicel, Health Services and Mental Health,Administration, 1972._ DHEW Publ'ication No. (HSM) 72-7516. pp. 119-135. United State Department of Health and Human Services. The Health Consequences of Smoking,: Cardiovascular Disease. A Report of the Surgeon General (DHHS' ['PHS] 8t-502'04), Rockville, Md. 1983. Urbach, E. Odors (osmyls) as allergenic agents. J. Allergy 13:387-396, 19,42. Vandlenbroucke, J'.P., Verheesen, J'.H., dieBiruin, A., Mauritz, B.J., van der Heidle-Wessel, C., van, der Heide, R.M. Active and passive smoking in married couples: results of 25lyear follow-up. Br. Med. J. (iClin. Res. ] 28i8(6'433):1801-2, June 161, 1984'. Vainio, H., Hietanen, E. Tobacco smoke as an environmental hazard'. Duodecim 9'9(22):1638'-1645', 1983. (FYnnish,) Valentin,, H. Passive smoking: A scientific consideration. Prevent. Med. 13:565-569, 198'4. Valentin, H. Proceedings of the international symposium on medical perspectives on passive smoking. Prevent. Med. 13':559- 560, 1984. Valentin, H., Bost, H.P., Wawra, E. Passive smoking at the workplace--inj'urious to health? 2entralbl. Bakte: i'oli. B 167 ( 5- N 6') :405-434, 1978. (,German,) ~ N VI 65 ~ ~ D-65

Bibliography on Involuntary Smoking/March, 1986 Portheine, F. A contribution to the problem of "passive smoking" ('letter ),. Munch. Med. Wochenschr. 113'(,18 ):707-709, 1971. ( Ge rman,), Poultoni, J., Rylance, G.W., Taylor, A.W.J., Edwards, C'. Serum thiocyanate levels as indicator of passive smokoing,in children (,letter). Lancet 2'(',8'416):1405-1406, 1984. Preston-Martin, S., Henderson, B.E. N-nitroso compounds and human intracranial tumors'. IAR'C' Sci. Publ.( 57 ):88I7-8914, 198'4 . Preston-Miartin,, S., Yu, M., Benton, B., Henderson, B. N-nitroso compounds andichildhood brain tumors (abstract). Am. J. Epidemiol. 116(3):563, 1982'. Preston-Martin, S., Yu, M., Benton, B., Henderson, B.E. N-nitroso compounds andichildhood brain tumours: a case-control study. Cancer Res. 42(12)1:52'40-5245, 1982. Preussman, R. Occurrence and exposure to N-nitroso compounds and precursors. IARC Sci. Pub1. (57):3-15, 1984. Prevalence in Canada of health conditions aggravated by tobacco smoke. Chronic Dis. Can. 4:9-11, 1983'. Prier, D.G. Detection of free radicals from, the reactions of ozone with olefins and from cigarette smoke by electron spin resonance techniq,ues (dissertation). Baton Rouge, Louisiana : Louisiana State University and Agricultural and Mechanical Col!lege, 1981. 282'pp. Diss. Abstr. Int. 82'-07834. Pryor, W.A. Free radical biology: xenobiotics, cancer, and aging. Ann. NY Acad. Sci. 393:1-22, 1982. Pryor, W.A. Mechanisms and detection of pathology caused by free radicals. Tobacco smoke, nitrogen dioxide and ozone. In:. M'cKinney, J.D. (ed.). Elnvironmental health cheaaistry: the chemistry of envrionmental agents as potential human hazards. Ann Arbor, Michigan : Ann Arbor Science, 1979. pp. 445-466. Pryor, W.A. Smoking at ACS meetings (letter). Chem. Eng. News 53(33):3, 1975. Pryor, W.A., Dooley, M.M'., Chruchl, D.F. Human alpha-l-proteinase inhibitor is inactivated by exposure to sidestream cigarette smoke. Toxicol. Lett. 28(',1):65-70, 19185. Pryor, W.A., Prier, D.G., Church, D.F'. Electron-spin resonance study of mainstream and sidestream cigarette smoke: nature of the free radicals in gas-phase smoke and in ci'garette tar. Envi!ron. Health Perspect. 47:345-355, 19,83. 46 C)1 (-: D~-46

-7- , SEL'ECTED PRESEMTA'TIONS, J.L. REPACE, 1983 - 1985 "Tobacco Smoke and the Nonsmoker"', lnvited talk, Session on Nonsmokers' Air Environment, 5th World Conference on Smoking & Health, Winnipeg, Canada, 1!3 July, 1983.. Testimony on Passive Smoki'ng, Hearing before the Svbcommittee on Energy Development and'Appllcations and the Subcommittee on Natural Resources, Agriculture Research an& Environment of the Commfittee on Science and Technology, U.S. House of Representatives, Washington, D.C. August 2, 1984. Invitedlparticipant, Internationall Conference on Assessment of'Passive Smoking, sponsored by the International Agency for Research on Cancer, at the American Health Foundation, Va1halla, NY. 8-9 December 1983. "Workplace Passive Smoking"'', Invited talk presented at the, National Safety Management Society Conference, Hotel Sheraton4ashingxon,-Washiington DC, April 23-26, 1984. "Passilve Shioki'ng"', invited talk presented at the 19th A'nnual! Meetin% of the U.S. Publ'ilc Health Service Professional Association, Scottsdale, Arizona, 4-8 June 1984. "A Proposedl'Indoor Air, @Quality Standard for Ambient Tobacco Smoke": paper presented at Third International Conference on Indoor Air Quality and! Indoor Climate, • Stockholm„ Sweden, 20-24 August 1984. "Risks of Passive Smoking" Guest Lecturer at Pierce Foundation Laboratory, Yale Uni'versity, New Haven, CT, 17 December 1984. . Invited Talk oni "Risk Assessment'of Passive Smoking", Interagency Technical Working Committee on Smoking, Heart, Lung,,and!Blood Diseases, National Institutes of I Health, Bethesda, MD, 16 January 1985. Invited Talk on "Risk Assessment of Passive Smoking"', Interagency Task Force on Envi ronmental Lung Cancer, U.S.EPA, Washington, DX. 7 February 1'985.. Panelist, Special Study Section for Review of National Cancer Inst1'tute Grant Appli- cations ('RFA-84!-CA-14) for Passive Snaki ng Research, Arl i ngton VA. 1'S Marchi 1985. Invited Talk on "Cancer Risk fromWorkplace Smoking", Conference on Smokingiand the Workplace, Society for Occupational and Environmental Health, Washingtoni DC, 10 April 1985. Invited participant, Planning, Workshop on Research Programi for Passive Smoking on Aircraft, sponsored by the World Health Organization, Geneva, Switzerland, N Aprili 17-19, 19815. . Invited Talk on ".Risk Assessment of Passive Smoking", University of'California, ~ Berkel ey/Sani Franc1 sco, Program i n Bi o-Engi'neeri ng, Sain Franei sco, CA, 30 Apri'1 19815. ~ Invited Tal k on Model i'ng of Si destream Smoke on Passenger Ai rcraft. Nati onal ~ Academy of Sci'ences Committee on Ai'rliiner Cabin Air Quality. Woods Hole„ Mass. ~ July 25, 1985. ~ OA G-7

Bibliography on Involuntary Smoking,/March, 19'86 Vutuc, C. Quantitative aspects of passive smoking and lung cancer. Prev. Med. 13':698-704, 1984. Vutuc, C. Lung cancer risk and passive smoking: quantitative aspects. Zentralbl. Bakteriol. Mikrobilol. Hyg. (B) 17'7(i1-2):910- 95, 1983. (German) Waite, C.L. Effects of passive smoking (letter). N. Eng3. J. Med. 299(16):897, 1978'. Wakeham, H. Effects of passive smokingi (letter),. N. Engl. J. Med. 299 (16 ) : 8'96I, 1978. Wakeham, H.R.R. Environmental carbon monoxi~de from, cigarette smoking--a critique. Prev. Med. 6( 4):52'6-5341, 197'7. Wald N' ; Ritchi~e C. Validation of studies on, 1'ungi cancer in non- smokers married' to ssnokers ('letter). Lancet 1(',8'385'):1'067, 11984. Wald, N., Doll, R., Cbpeland, G. Trends in tar, ni'cotine, and carbon monoxide yields of UR cigarettes manufactured since 1934. Br. Med. J. 282(62'66'):763-765', 1981. Wald, i4. J,. , Bo reham; Ji., Bailey, A., Ri tchie, C., Had'dmw, J. E., Knight, G. Urinary cotinine as marker of breathingiother, people's tobacco smoke (,letter). Lancet 1(8137A):230-231, 1984. Walker, D. Histopathology of the nasal cavity in laboratory animals exposed to cigarette smoke and oth~er irritants. In:: Re.znik, G., Stinson, S.F (Edlitors). Nasal Tumors in Animals and. Man. Boca Raton, Fla. : CRC Press, 1983'.. Wa1l M; Brooks J: Holsclaw D ; Reddi~ng G. Health effects of smoking on children. Am Rev Respir Di's 1985INov;13'2(5):113'7-8 Walt, N.J. and Ritchie, C. Validation of'studlies on lung, cancer in nonsmokers married to smokers. Lancet 1:1067, 198:4. Walt, N.J., Boreham, J., Bailey, A., Ritchie, C., Haddow, J.E., FCnight, G. Urinary coti'ni!ne as marker of breathing other people''s tobacco smoke. Lancet, ('837'0), 1: 23i0-1, 1984. WWalsh, D.C. Corporate smoking, policies: a review and ann analysis. J'. Occup. Med. 26(1):17-2'2, 1984 Walters CL. III'.1. a General introdbction. [N-Nitroso compou!nds. ]I. IARC Sici. Publ. 45':2I85-29'4, 1983. Wanner, H.U. Indoor air pollution producedlby man (carbon dioxilde, odors). Schriftenr. Ver. Wasser. Boden Lufthyg. 53:11- 16,, 1982'.. Wanner, H.U. Ai~r quality in residences and places of work. Soz. 67 D-67

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...............y.~..~:.w......._,_...:. smo o t'hly . No city or county that has ever passed an ordilnance has weakened or repealedl it. While it is important that there be strong enforcement provisions in the law to ensure that people take it seriously, Lhere! has never, to, my knowledge,, been the.need to fine anyone. Enforcement has taken, the form of education and negotiation, vith legali sanctions playing a quiet but secondary role to back up the negotiations. Inisum, there are four simple principles that, lead to successful,, trouble-free nonsmokers'' rights legislation: (1) There need to be signs posted in,the nonsmoking areas. (2) There needs to be the capacity for strong enforcement; i!roni'cally,, the presence of sanctions avoids the need for using them. (3) There needs to, be a clear statement that the right to breathe clean air takes precedence over the choice to smoke. The existing,bill meets the first two criteria; to meet the third cri'terfion, I suggest that the followi'ng,language be added at page 3!line 9 after "government buildings": "providedi, however, that in any dispute ari'sing,under such rules and regulations, the needs of'nonsmokers shall ben given precedence;" I have no doubt that passage of the legislation before youivill, qui'ckly, simply and inexpensively clear the ai~r for Federal employees. It will aSso help encourage other public and private employers to follow your lead and produce a safer and healthi'er environment for all of us. Thank you. 6 G-27

-4!- sl!iight reduction in'risk.5•8 We found that increases in ventilation rates or air cleaning potentially offered much greater reductions in risk, but because such i ncreases requi re respecti vely large amounts of energy and capital, they do not appear to be very cost-effective.2•7 We found that if smokers andi nonsmokers are separated in dilfferent enclosed spaces but not' on different venti',llation systems, as for example in a large building, the background concentrationiof smoke recirculated into the nonsmokers offiices via the venti'llating system would probably be reduced toonly a few times the acceptable risk lieve1,1•2 but this option does not appear to offer the most cost-savings. Separation of smok rs and nonsmokers into different spaces with different ventilatilon systems offers mortprotection than the previous option, but at a potentially higher cost. We found that a ban on smoking in the workplace,appeared to offer the most cost-effective approach of'all.1•2,2m In summary: it appears that the typicaT nonsmoking federal worker in: workplace where smoking is unrestricted faces a large lung cancer risk from , environmentall tobacco smoke. It also appears tfiat there are a variety of' reasonable and cost-effective controll measures which, can provide mitigation of' tfiat ri sk. REFERENCES: 1-15. Listed onipage 6. 16. ASFiRAE Standardl 90-80, Energy Conservati on i'n New Bwi l di ng Oesi'gn, Ameri can Society of Heatiing„ Refrigerating, and Air Conditioning Engineers, Atlantal, 1980. 17. Collishaw NE, Kirkbride J, and Wi'gl'e OT: Tobacco smoke in the workplace: an occupational- health, hazardl. Cain Med Assoc J 1'984;, 131: 11199-12104. 18. Loeb LA, Ernster VL, Warner KE, et al.: Smoking and lung cancer, ain overview. Cancer Res 1984; 44: 5940-5958. 19. Moghissl A: Health risks of passive smoking. Envirom International 1985; , 11:1. 20. Office of'Technology Assessment: Smoking-related deaths and financial costs. 1985. G:-!+.

Attachments: "San Francisco Anti-Smoking I:av a Success", Wall' Street Journal, August. 15, 1984. Letter from Surgeon General Koop regarding, the health effects of involuntary smoking Letters from eity, county, and state officials regarding ease of enforcement of various ordinances: John Lockvood, Assistant City Manager, San Diego Roger Hedgecock, Mayor, San D!'egp, George Story, Director, Citizens Assistance & Information,, San, Diego James Forde,, Director, Department of Heath Services, San Diego: County Bruce Tsutsi~, Inspector, Department of Publiic Health, San Francisco Rita Hardin,, Director, Neighborhood Preservation, San Jose C. B. Schneider, Chiet, Section of' Environmental Field Services, Minnesota department of'Healtli Letter from Art Pick, Executive Vice President, Greater Riverside Chambers of Commerce, endorsing a proposed! ordinance (vhich passed). ~ Q ~ ~ ~. ~ 7 ~ ( ( G-28

My name is Stanton A Glantz. I hold a PhD in Engineering and Economics from Stanford University and am nov an Associate Professor of Medicine and Chairman of the Bioengineering Gtadwate Program at the University of Celifornia, San Francisco, vhere I conduct research into the mechanicall function of the heart. I am also President of Californians for Nonsmokers' Rights, an organization that has helped'to pass legislation protecting, nonsmokers from the toxic chemicals in second-hand cigarette smoke in 44' California communities, encompassing approximately 9 million people. Before discussing the specifics of our experience vith legislation in California, I vould like to speak briefliy to two important general issues: the need'for such legislation to protect the public health and'the fact that the only organized opposition to such legislation comes from the tobacco industry. First, there is absolutely no question that, as the National Academy of Sciences concluded in 19811, "involuntary exposure to tobacco smoke has adverse health, effects and ought to be minimized or avoided vhere possible." There are over 600 papers in the medical literature on the effects of involuntary smoking supporting this conclusion. As vith primary smoking, the tobacco industry has tried to diffuse this overwheliming,case by taking advantage of honest differences of opinion in the scientific community on the precise magnitude of the problem, ffsrepresenting the views of'reputable scientists, or hiring,professi'onal quibblers to claim that "the case is not in." After every independent scientific body that addressed the question concluded that involuntary smoking represented a health, hazard, the industry took the creative step of convening its own scientific panels -- in such scientifically impressive places as Geneva and Vienna, -- in an effort to cast an, aura of jU respectability on i'ts position. Contrary to whalt the industry had hoped, 2' G-2'3'. 0 05 ~ ~ N !I

enacted le!gisllation to protect the public from the health, risks associated passive smoking. The Coalition supports the "N'on-Smokers' Rig;hts Act of 198'5" as a posi'tive step towards addressing the federal role in the prevention of health effects related' to, passive smoking. It is appropriate that the issue of simolkinig in federal bui'.ldings be addressed in the manner providedi. We wouilid make 2 suggestions regarding improvements to this legislation: o The non-smokinig worker and non-smoking vi'sitor dieserve the same health protection in buil4ingsr under the federal government's juridiiction. We woul'd recommend that language speci'fq, that both worker and visitor areas woul1dlbe covered by such regulations developed - under this proposal. o The bill recognizes several jurisd!ictions for thee development of regul'iations for the limitation of smoking in federal builidi.ngs. We would recommend that the 0'ffice of Smoking or Health or a similar office withiin the HIHS also be iinvolved iln the d'evelopment of these regiulations to ensure a consistent approach amoing the speci'fied'l jurisdictions.

A departmental task force was developed and operated for a period of 901 days. Some of' the duties of that task force may be informative in highlighting areas which need consid'eration in order to successfully implement S 1440. The task force.was directed to: ° plan and coordinate public education activities; ° inform operators,, owners', and "persons-in-charge" reg,arding, their legal obligat;ions and assist them in complying, with: the new no smoking, law, including a distribution of required signs; ° produce guidelines which interpreted' the statute and providied recommendations for implementation of the new law; prepare: guidelines emphasizing education; post smoking and nonsmoking areas; and' present methods of complying with the intent of the law without capital outlay, for, such,projects as reconstruction of'worksites or installation of ventilation equipment; °. N familiarize Department staff with the new law in order Q N to respond to inquiries and to implement provisions of ~ the law in a uniform manner; and ~ N - 8 - G-37

c INTRODUCTION Mr. Chairman,, I'm Bill Ross, Commissioner of the State of Alaska's Department of Environmental Conservation. I would,like tothank you fort,his opportunity to testify =Senate Bi1L.1440~, the Federal Nonmokers' Rights Act-of 1985. This Senate Bill is very similar to legislation that has become law in Alaska; therefore, I believe my testimony here today has particular relevance when considering its merits. With all smoking legislation, there ~ arethree affected parties to~o be cpnsidered: smokers, nonsmokers, and the owners or operators of facilitie~~s- in whi~ch~ smok~ing~ is to~~ b~e~~ restricted Persons who smoke have made a personal decision that the act of s.moking~ outweighsthe threat: of cancer and other diseases. This is their privilege; and they should be allowed it, as long as their s,mol.ingdoes not infringe on therightsofnansmokers,. Just a s~ smokers have~ the rig~ht~ to ~ smok~~e,~ nonsmokers~~ h~a~ve the~ right to protection from the recognized heaTth hazards of second,-hand smoke~,~ as well as the right to~~ work in a smoke~-free~ ~V. environment. ~ C11 ~ ~ N ~ ~ G-3 0

I A COMP'E N DI U'M ON IN'~DOOR POLLUTION' DEPARTMENT OF CONSUMER AFFADRS H'-1

Z!. s.mokingi. In enclIosed spaces, s.moke accumulates. The concentrations vary wi'th the number of smokers, wiith the type of smoking, and with the characteristics of the mtcroenviroinment,especial!lyventilation!.Amiong th e constiituents of tobacco smoke that have! been measured, nitrogen, oxidie, carbon monoxide, nicotine and respi.rable partic,les, nitrosamines, and aldiehydes have been shown to, be, significantly el!evatedl indoors as the resuil!t of tobacco smoking. A vari'ety of measures have been utiTized! to quaintify th~e nonsmoker's exposure to tobacco smoke. For example, studies of th~e level's of respirable particles generated by smoking under natural conditions i'n indoor micro- environments showed a ranige of 90-1140 ugLm , diepend!ingi on the smoker density and the effective ventilation. These 1'evels im most instances, if the exposures were repeated, would be a violation of the Natilonal Ambi!ent Air Q!uality Standard for T'otal Suspended Parti'culate; the outdoor equivalent. More than sufficient sci'entif'i'c evidence exiists of the harmfuT effects of smoking on the th~e nion-smoker to 3',usti'fy strong governmental acti'on to protect the non-smoker. Since thee publitation of the Wihtte-F'roeb study, "Small Airways. Dysfunction in Nonsmokers Chronically Exposed to!Tobacco Smoke", the evi'dlence has accumullated: c-li7

Bibliography on Involuntary Simoking,/March, 1986 Tashkin, D.P., Clark, V.A., Simmons, M., Reems, C'., Coulson~, A.H., Bourque, L.B., Sayre, J.X., Detels, R., Rokaw, S. The UCLA population studies of chronic obstructive, respiratory disease,. VII'. Relationship~between parental smoking and children''s lung function. Am. Rev. Respir. Dis. 198'4 June, 129 (6):891-7. Tate, C.F. The effects of tobacco smoke on the non-smoking cardio-pulmonary public. In: Steinfeld'i, J., Griffiths, W., Ball, K., Taylor, R.M. (eds.). Smoking and health II. Health consequences, education, cessation activities, and governmental action. Vol. II. Proceedings of the third world!conference on smoking and health. New York City, June 2-5, 1975. (DHEW1 Publication No. (NIH) 77-1413) pp. 329-3'35. Taylor, G. Tobacco smoke allergy--does it exist? Scand!. J.. Respi'r. Dis. SuppS. 91:50-55, 1974. Taylor, I.B., Weiss, S.T'., Rosnez, B., Speizer, F'.E'. Effects of parental cigarette smoking on the pulmonary function of children. Am. J. Epi'demiol. 110:15-26, 1979. Teppo, L. Ymparisto ja Syopa. Environment and cancer. Duodecim, 99112'2):37-411, 1981,, Finnish. Terr, A.I. Respiratory symptoms in children whose parents smoke.. West. J. Med. l3'5(l):47-48', 1981. Terry, L.Li. On the subject of non-smoking--you count (editori~al). Am. J. Public Health 64(2):169-170,_197'4. Thiel, H. Inhalation of harmful substances. Verh. Dtsch. Ges. Inn. Med. 88:280-295, 19'82'. (German) Tobaken OchiVi. Passiv Roekning och S:naa Barn. - Nyal Forskningsroen. (Passive smoking and the infant - New research findings. )I Tobaken Och Vi 2'9(13):7-9, 198'4, Swedish. Tobacco Institute. New national survey of smoking and productivity in the workplace. Tobacco Observer 9:6-7, 1984.. Trichopoulos, D., Kallandidi, A., Sparro&, L., MacMahon, B. Lung cancer and passive smoking. Int. J. Cancer 27 (11) :1-4, 1981. Trichopoulos, D. Passive smoking and lung cancer (letter). Lancet 1( 8378 ) :68'4, 19184. Trichopoulos, D., R;alandidi, A., Sparros, L. Lung cancer and passive smoking: conclusion of Greek study (letter). Lancet 2 ( 8355 ) : 67'7-678, 198I3. Triebig, G., Zober, M.A. Indoor air pollution by Smoke constituent& - A survey. Prevent. M6d. 13:570-581, 1984. 63 D-63

Thus, the 1984 legislation which: finally passed, represented a compromise that went~further than the 1975 law, but did'l not go as far as the original sponsors would'have taken it. Reference! to any ventil!ation, standards or to regulations was deleted, substituting instead the "reasonable accommodation" standard.. Coverage of privately-owned places was eventually li'mited to include: grocery stores, restaurants with a seating capacity of' 50 or more!, schools, pre-schools and day-care centers, health care facilities,, waiting or boarding areas for public transportation, and vehi'cles of public transportation. Coverage was expanded to include State and local government office facilities. C1321PAFRI'S0N OF STATE AND FEDERAL LAW The proposed Senate Bill 1440 would restrict smoking to designated areas~ in all United States' government buildings. Alaska Law includes similar coverage for State buildings. 1. Alaska's law is broader in scope than S 1440 in that it specifically, prohibits~ smoking in are~assuchasschooIs, elevators, taxicabs, convention! halls, courtrooms, jury rooms, grocery stores, and some restaurants, as well as in State buildings. The State law provides that portions off a place or vehicle may be designated as smoking areas, if. "reasonable accoamod'ations" for needs of smokers and - 5 - G-3 4

nons~mokersare~~ p~rovided,~ whereas S'~ 1~440~ states, that~ smok~ing~~ a~re~~as~~, sha11~ be prow3.de~~d`~ and that the "'r~eas;onable accomtnodations" sha~hl be prescribed as necessary when designa~ting, smoking area~s. Such a distinction appears~ to create a difference in the basic underlying assumption regar~ding~ nonsmoking at named '~ p~Iace&. That i's, the~ Alaska 2aw~~ ass~umes~~ nonsmoking~ is the rule and permits,~ but doesnot~ require, designation of smoking areas using the "reasonable accoramod~ati~ons•, measure. S~~ 1440 dbe& niot~, sperc~ify~ that~ nornsmoking~ is~~, the~ rul~e~~ but rather~ requires d~es~ignat3~on of~ smoltingareas using the~ "reasonable accomodation" measur~e.~ 2. The State~ law requires posting of smoking and'nonsmoking' areas with signsof' prescri'be~d& dimensions in appropriate, areas. S 1440 makes a similar requirement for posting. 3. The State law provides civil fines for violators smoking in nonsmoking areas and for operators o~r"persons-irn-charge" failing to post required signs., Fines range from $10 to $50 . for smoking violations,,, and from $20, to $300 for posting violations. S 1440 provides for a civil fine of from $5,0 to $'5.00fo~rviolatorswho smoke in nonsnokingarea~sofbuild'ings, but it assesses no fine for failure to post signs. This is presumably because GSA or the C.ommittee on

As a result of' numerous complaints regarding,substanti'al policy inconsistency between State agencies, and! at least one grievance action brought through; an employee union,, a jointt labor-management committee was formed to identify specific problems and to recommend policy and guidelines for the consistent and equitable statewide implementation of'the law. The guidelines emphasize that a cooperative effort be made to provide equitable and reasonable accommodations for smokers, as welli as nonsmokers, wherever possible.: Of'prime consideration is the recommendatioxn that smoking areas be designated, wherever reasonably possible and in accordance with the law. A priority order was established covering situations which cr,at2 the least amount of ambient second-hand smoke to those with the highest acceptable level. Designation of entire areas as "nonsmoking" is the final optioniand i&to be used only when no other arrangement is: or where a!n employee has a medically certified condition which is aggravated by smoke. Upper management is held accountable for implementation and enforcement of guidelines. tti'.' O NI The committee recognized that new difficulties might arise.dule to~~ changes in the work force, or as a result of implementation_of' On «P the proposedipolicy, and therefore provided a neutral method for ~ ~ uniform~ resol!ution of disputes throughout the State. Disputes - 11 - c-4'0

Rules and Ada~;ng. Neither Alask.ies for failure tc 4. The State la% regulations 1Canseqnaently, . Cbnservation,li recoranended gtreas and the defirh;e Senate Bill dk and regulations. I2'IFLEMENTATION .~' ~I In Alaska, the "Siucias ~ received strong puf,blic ;. awareness about the TASK FORCE Initially, considez)ut the coverage of thethan the law actually "reasonable acco=che worksite. t

at minimal cost to the State and'affected facilities. However, I believe that the most significant benefit of'the Alaskan law is one which is difficult to quantify. There is a much gareater public awareness of the rights of nonsmokers by smokers. Because of the attention the law has received, smokers are now more conscious that their habits causes discomfort and~aggravation too innocent parties, and' children see fewer examples of a habit they should best avoid. Theair i'n restaurants, grocery stores, and off.ices is undoubtedly of a better quality--a cleaner environment achieved for the most part in an, atmosphere of cooperation, and consideration. C

, Indoor Po,~utants Committee oni Indpor Pollutants Board on Toxicology andi Environmental Health Hazards Assembly of Life Sciences National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1981 r (

° develop Department protocol for handling, complaints responding m inquiries and processing, enforcement actions. AGENCY RESPONSE Department Directive Following,dissolution of'the task force, the Department developed' a field directive outlining policy and! procedures regarding implementation and enforcement of law, and addressing educational activities, the provision of information and technical assistance, the distribution of signs, the ha•A1'ng of complaints, and fair and' consistent enforcement. As a part of the field directive, a complaint/request for assistance form was developed'to document activities with regard to the smoking,law. Education Efforts To reduce public confusion about the requirements of the new law, the Department undertook a series of educational efforts, including: press releases, newsletter, and a press conference. In addition,,, the Department sent a letter and copies of the guidelines and statutes to a11 affected facilities. N ~. N. ~ Go ~ N .1 N - G-38

C courtesy" is a recipe for individual confrontation. Under the current situation, individual nonsmokers are forced to confront indi'vidual' smokers to ask that they smoke elsevhere. Most people are simply not that' aggressive. Furthermore, the ubiquity of cigarette advertising and second handd cigarette smoke in the air, nonsmokers feel very i'solatedland are often afradd to speak up. The presence of a simple "No Smoking" sign dramatically changes this situation. With the sign available, nonsmokers feel comfortable in asking people not to smoke. Let me give yowan example. Several years ago I vas sitting in the Minneapolis airport enjoying the benefimof the Minnesota Clean Indoor Air Act vhich vas passed in 19.87. A man then sat dbwn next mme and began to take out a cigarette. I asked him not to smoke. He initially objected to my intrusi'on, until I pointed out that ve vere in a nonsmoking area:. He then apologized and put the cigarette away. Surprisingly enough, he did not move to the smoking,section. He simply smoked one less.cigarette. That was one less cigarette that a tobacco company soldl. To understand the impact of that simple act consider this: If every smoker in America smokedijust one less cigarette a day due to changing;socialg attitudes or legal restrictions,, there wouldibe 22 billion fewer cigarettes soldieach, year. Given,these stakes, it is not surprising,that the tobacco companies are villling to spend a•fev million dollars initheir unsuccessful attempts to convince Americans that smokers should be~free to pollute the indoor air without restriczi~on. Despite dire predictions of earthquakes iniSan Flranci!sco and ftres~ in N Q Los Angeles, California, every ordinance I'knov of has gone into force ~ ~ 5 ~ ~ ~ G-2'6. ~'

f 14. Harl,. Hosp 529- 15. 3ave a Hira High Brit 16. Study Hira 17. from of Hirarit. Med. J. Hiea'v . .~ 282: ~ 18. lated to~ LeBc9'76. 19. Smol e on Nat yfr - Indc C 20. Pre: he ottatal 1. Lit+E'. Prof Tobacco: Repa8i0. Smol ~ N.Y. 22. Rep+l Ac'ac 23. nberg', Schuase J.,i-283,, and 197 xa1, 24. "Sm, 25. Pub. .al,. "Sm 26. Ptnb SR and PrC ~ 27. Hea p :f'.fect ~ TaSction ~ of ~ of j~ ~ tJ ~ ~

The third group in the smoking matrix consists of'the proprietors and employers in buildings where smokers and nonsmokers sharee space.. Uithout a legal framework, proprietors and employers are forced to make difficult decisions regarding the rights of nonsmokers versus the: of smokers. In, addition,, employers have no recourse but to accept the increased, costs associated withh smokers in the work place. These costs are in the form of more frequent absenteeism and higher costs for health insurance, fire insurance, 13fe! insurance, and workers' compensation. A wide body, of research and public opinion has clearly identified uncontrolled smoking as both a nuisance and'.health hazard. It has been suggested that the control of smoking,is.not a proper function of government and that nonsmokers should rely on the willingness of smokers to accommodate.thleir needs. The State of Alaska disiagrees~. No: oneshiould~ ever have to: depend' upon, the~ courtesy of others for the protectiori of their rights. It is they dqty of government to protect individuals from dangers and'' nuisances caused by the actions of others. In Alaska, the most significant areas of'S'tate effort have been in d'eveloping guidelines and ed'ucating, the public. We have net - 2 - G-31

f The Department of Environmental Conservation's experience inn enforcement of Alaska's own State law leads to some observations which may benefit you in your consideration of S 1440. First, detailed direction on the definition of "reasonable a~ccommodations" for smokers and nonsmokers and effective patterns of'designation of smoking areas would b~e helpful. The authority to, adopt regulations provid'ed'in S 1440 should providie for this. Secondly, if program costs are a consideration,, it may be desirable to amend the size of required signs to conform with a, standard print size. The dimensions currently proposed are the same as those in Alaska's law and these do not result in cost-effective sign reproduction. Another consideration in implementation of th~e law is the provision for sufficient personnel to monitor nonsmoking areas~ and to process complaints. Creation of a labor-management. committee may be helpful in developing policy for the designation of'smoking areas in offices and other work areas. In conclusion,, I wholeheartedly give this senate bill my unqualified endorsement. The Alaskan experience with smoking legislation has shown, that this type of law can be effectively implemented without undue discomfort or expense. Even though the Alaska law is broader in scope than S 1440, it has been well received by the public; it has been effective in the protection: of'rights of nonsmokers and'smokers; and'it has been implemented - 13 - 6-42.

nonsmoker protection ordinances. We beIi'evedithat,, since the tobaccoo industry had!no real support, informed and organized local consituients could overcome the pressure of lobbyists, lawyers and campaign contributions. '- Th,is strategy has proven successful. As of' this date, every California community that has considered a law protecting nonsmoker sin;the workplace has enacted'it, despi'te vigorous, ve1l-financed opposition from the tobacco industry. The industry's failure to stop us~and other like-minded groups around'. the country has led them to another strategy: they are attempting to shift the fiel&of play back to the ball~ot box where they hope.they cambuy elections vith slick ad!vertising,campaiigns. Fortunately, the Ameri'can public has not been tricked by their efforts. Inladdition to the industry's highly-publicized $1.3'mi'llion effort to get the San Francisco Vorkplace Smoki!ng Ordinance repealed two years ago, their front groups have been rejected!by the voters in Arizona and,Colorado. Thisivillingness oflthe populace to stand up to:the industry attests to the importance and popularity of'protecting nonsmokers from second hand smoke. In fact, our success is not surprising, given that every poll dbne on the subject (including those done for the Tobacco Institute) have shown a majority -- including a majority of'smokers - in favor of legislation to protect nonsmokers. This overvhelming,consensus about the desirability of'protecting nonsmokers is!vhy legislation such as that before you is easy mimpiiment and enforce. It essentially codifies a change in social attitudes that has already occurred. Given this broadlconsensus,, why do we need laws? Why can't we depend on "'commonicourtesy" as the ciagarette companies suggest? Because "common 4 G-25'.

scientists at both meetings presented evidence that involuntary smoking was harmful~. As a result the tobacco indiustry was reduced to quoting from press releases issued!after the meetings by individuals. In contrast to statements made by the National Academy of Sciences and Surgeon General, these releases vere not subject to any scientific quality control. As a result the only people that seem, to take them seriously are the cigarette companies and their advertising,agencies.. The simple fact is that one need not hold a, PhD and ovn complex scientific equipment to know that second hand tobacco smoke is a serious form of indoor air pollution. Consider a room where people are smoking. Think about what the air looks like, what it smells like, what it tastes like. Consider the fact that your eyes or throat may burn# or that you may develop nausea, or a headache. If you vent outdoors and1the air was that. polluted, you vould be outragedi. And you.vould be right. That is vhy we have passed legislation cleaning up the outdoor air, and' why this bill is necessary to help clean up the air indoors, vhere most Federal workers spend most of their time. Hy, involvement in this issue dates to 1978 when I'vorked with others in, an unsuccessful attempt to pass, by initiative, the California Clean Indoor Air Act vhich wouldihave created nonsmoking sections in the workplace and public places. Before the campaign started, every poll conducted (including those dbne for the Tobacco Institute) shoved the initiative passing by a 3-1 majority. The cigarette companies spent $6,5©0,0IOO on a massive advertising campaign and defeatedithe law. The tobacco industry represented to only organized opposition we faced. The same thing happened again, in 198'a. _ In 1981, we began working at~the state andllocal 1'evel to pass 3 G-24 C

which~ cannot be resolved at the worksite! may be referred to aa regional subcommittee for discussion and recommendation, and then to the statewide committee for development of' al final recoarmendation, whickh would then be presented tc the appropriate diepartmental commissioner. SALIENT ISSUES Fiscal Impacts. DEC was given a fiscal note for $20,0100 to: implement the law. These monies were used for development, distribution, and printing of the guidelines; educational efforts; and signs.. Costs of enforcing the law have been minimal. Monitoring,is done during the course of regular inspections by departmental sanitarians, or in response to publ!ic complaints. First time violators are warned and are not issued a citation until a second" offense. A record is kept of all warnings. Expenses to buiLding,operators have been minimal or nonexistent. DEC has not required any structural modifications~ orinstalla~tionof smrakel-removing equipment. Some facilities have chosen to makee physical modifications or install equipment but not through any direction from DEC.

Enforcement. A unique enforcement ticket was developed ('Uniform Citation), since the smoking law contains the only DEC violation which has a bailment associated with a violationi fine. Close coordinationn with the court system was required to develop a procedure consistent with methods used by other agencies to prosecute minor offenses, such as parking violations and some fish and game violations. Basically, after a citation is issued, the violator may mail in the bailment or challenge the matter in, court~. To date, the program has: relied on warnings for enforcement. Four cases involving $10 fines were taken to small claims court before the current procedure was developed. A Statewide procedure was deveLoped for issuance of a Uniform Citation, and, arrangements for processing in district courts were made at each court location:,, accommodating any special circumstances unique to thee area. . L.abor Management Committee oniSmoki~nk in State Buildings Of particula!r, interest to you may be our experience with enforcement of the law in State buildings. This experience should closely parallel the types of problems which may be encountered' at the federal level, and may provide solution.. a potential - 10 - G-39

7 smoke in any building they entered. Nine years later, with increased medical' evidence concerning the hazards of second-hand smoke, the legislature removed that mandate. The current Alaska law was draftedl to addres& a finding by the Alaska Legislature that second-hand smoke is definitely a health hazard and to~ acknowledge increasing j',udicial recognition, of nonsmokers' rights w work in a smoke-free: environment. The amendtnent& to the State's statute became effective on July 17,, 1984.. The bill as it was initially proposed in 1983'was far broader in scope than the 1975' 1'aw; in that it prohibited smoking in all vehicles and, indoor places open to the public, even those of private oxanership. It also retained'the statutory authority for DEC to develop regulations, specifically mandating use of the! ASHRAE ventilation standards forany designated smoking area&. Review of legislative testimony indicates that the intent of the lav was to recognize: the health issues~~ associated with second-hand smoke, rather than to: pursue active enforcement and require extensive physical modifications to, regulated facilities. Expenses such as these would b~e borne not by smokers, but by the owners and operators of buildings and, businesses. The Alaska Legislature did'not wish to impose this economic burden on those owners and opera.tors. - 4 - G-33

very little resistance in implementing the law. That is because our law, just as the proposed federal law, stresse_s "reasonable" rules and'arcommodations. ALASKA LAW Pre 19'83 Alaskal enacted its first smoking statutes in, 1975, prohibiting smoking in all public meetings sponsored by any State agency; in public schools, libraries, museums, and swim¢aing pools; in indoor publicly owned or operated'places of entertainment or recreation; in el!evators, and vehicles of public tramsportat=-)n and inn public! area& of hospitals, nursing, homes, and medical andl dental offices. The statute stated that reasonable smoking,areas must be provided. Businesses could elect to post "no~ smoking" signs and were then afforded'.coverage of the law. The 1975 regulations were.promulgated, which made the standards of designated smoking areas more restrictive. Such designation was allowed only if'the affected facility met the American Society of Eeating,, Refrigeration, and Air Conditions Engineers' Standards (ASIHP.AE)1(62-73') for ventilation. N O N ~ One interesting feature of that initial law, is that it mandated ~ the designation of smoking areas in buildings covered by the law. Cb ~ ~ In other words, smokers were almost always assured of a place to ~ ~. 6 C - 3 - G-32

() I 28. Trihopoulos, D.,,Katandini, A., Sparros, L., McMehov, Bi., "Lung Cancer and Passive Smoking" Int.'J. Cancer 27:1-4, 1981. 291. Wyatt, Paula,, "Tomaccio Smoke: Its Effect on You and Others" unpublished'.thesis, University of California, Santa Cruz, by permission of the author, 1981. V i H-17 I'II.E'. 14'

was being xac:u»rolilcrcd by the highly financcdcopp,••lsitictn; backed by developers and major cor{klratiun.. A1omcnth Iatcr the same individual u•as IDhutt/graiphcd in the elegunt9y furnirhtal "tiu un F'" ht:adyuartk:rs in front of a sulnhisti- catud cuntruter„which w;ts puttinE out infAlrmtttiion con voter suht?urt by neit:hbuncowuls.. Ih±pite the hugc cxqxnf3iturL. ;ud deceitful tactics ctf the cigarette ctontpaulics, they were braticn in this campaign bew:ausc tlwy cnwrctuntertid a rc.clurccful group cDf non, smukcrx' rights atl'vcoc:ucs who had been through tttc wriing.critwicc before and w•hu iknew what tu cxpCet and 1what had tKa lDr done to win. lu i. hoped that their experience will bc tof hcJto tu people in utllcr communities whu nni¢ht square to(lf against the tubztccto inclitstry in the future. Tile accotm- p;anyinu ;trticlc tln issues tto Ix: faced and campaign stratcgy isclc..igncd ttl provide the basics af!running, a c.tntpaign! The final tally, in thc'clectiiun was iit'J;7-3N tu17KJ;4a'I-a remarkable victc,ry in light uf thc uverwhclming odds. As a broad base of support among , con- stituencics such as health agencies. en- vironmental organizations, and public interest groups. Environmentalists ap- preciate learning or being,remindusd tha't' tobacco smoke is thalargest contributor to indoor air pollution. Getting as many people from different organizations in- volved'as eariyas possible gives them the feeling that they arrpart of tihc'decision making process and gives their organi- zations a stake in the campaign. Gmpaign staff. With the exeeption, of a close-knit community where it is still . possible for local values to prevail against commercial pressures from outsiders, a campaign cannot be run against the to-, bacco industry without' a competent full-time staff. It is important to hire people who are committed to the issue. FYatd-nisinq. Although it is not possible to compete dollar-for-dollar with the tobacco industry for'campaign money,,, there may be no, need to. The tobaaao, industry can be'beaten, even when, it' ouLspends the opposition by 10 to one. On the other hand, a minimum amount of money must be raised'in orderr to run a, creditable campaign. This means mounting a full-scale fund raising effort using both direct mail and per+ son,taperson contact. Campaigrt focus. The most effective issue for proponents of a local' or state nonsmokers' rights law is the invoive- ment and'virtually complete financing of the opposition by the tobacco companies. The proponents"campaign should never focus on the tobacco industry's theme song of costs, enforcement, and govern- ment, intrusion. A campaign that can frDcus the voters' attention on its issues (in a resultL Californians for Nonsmukers'. Rights has suc- cecdrd in lubbying,ot'hcr contmunitics tarcDug,hcout Cali- fornia to pass similar laws„thc most rrcct-t of which is 11 us. nngult:.e, whose ±trict ordinance v.an.ibn(• by Mayor Tum i 1iraJllcycx;tctly, aone year after the vutie, :t l'rutwsiitiun I°. Perhaps with the po..+ibility of a chainL rcactitln in mind, the tobacco industry tricd'one last dcslxtratc r.waaure aftier thc. elcution, On the follwwing5unday the indu.try, ran a full page newspaper advertixement complaining that'the clcl,ee vote was nut sufficient to warrant, imposition of such a controversial law and askingpeuple to urge their Icgixl.•unor.s to amcndl Proposition P. The cigarette cuminanics.huultd have saved their mwney, fur, bby placing the referendum un the ballot they had in,ured; under the terms of the C:ity. Chartcr: that the law could not bc touched for a yc:ur. I3y that timt:, a news story in the anti-rcgulatur} t.UiJlV'.Srrccr JrJUrnaJ'(nugu!;t 15. , 1984) wwould be pronouncing the law a success, this cassc, health and'tobat:co industry money) willl stand' a good chance of winning; a campaign that spends its time answering eharges by the other side will I inevitably lose. Endorsements. It is important to se- cure key local endorsements early. Many subsequent endorsements wiil depend on who has already endorsed the initiative, every radio and'television advertisement must identify the source thatpaid for it. In seeking to defeat clean indoor air measures, the tobacco industry invari- ably organi><es undl:r a mislcading name of an apparent local group (for example, "FAIR. Floridians Against Increase& Regulation"). A challenge can be madee to the use of such a name as the true. Some individuals who may have no sponsor of the advertisements. Even if strongnpinion on the issuemaygivetheir the effort does not succced in forcing a endorsement'to thefinstperson who ap- - change in tagline, it can gcnerate algreat proaches them with a reasonable pre- deal of journalistic scrutiny which will' sentation. Police: sheriffs', and fire- further highlight the issue of tobaxo' fightierrs organizations have been prime early targets of~ the tobacco industry. For the proponents, enlisting the full eom- mitmentof tbelocal medical'assaciation and Ispocifuc physician-spokespersons and other health professionals for hearings, press conferences, and other public ac: tivities is imperative. Regrettably, there are too few physicians with sufficient political and media experieasx: Fairoess time. The tobacco industry will flood the'airwaves.rith advertising. Nevertheless, the law reyttires that all radio and television stations must give each side of a ballot measure fair time (but not equal time) to present'its views. Some stations attempt to fulfill this ob- ligation by giving,the "poor' side of a campaign a chance to present its views on an off-hours public a'ffairs'program, but others will give between one-fourth and one-third of'the advertising time purchased by the tobacco industry. The effort to obtain this time should begin early,,, and' legal advice should be ob- tained' on how to pursue it most effec- ttvely. Radio and tele.i•sion taglines. By laww industry involrvement. ' In.Rstigation of tobacco industry daims. Claims by the tobacco industry concerning the costs of implementing andlenfnrcing the legislation as well as the "evidence of medical experts" should be fully investigated and exposed for whatever fraud is present. For exampie, tobacco industry claims relating to medical evidence often involve either a tnisquote'or a quote out of cotttett. It is important that the press and public be made aware of anysucli fraud'as earlyy and often as possible. REFEatENC'Es 1. A rwb/rraa IJ Qrearoes ad Au.,rrr W eshieqnn, tDC, The Totiweo tmtitute, t 981. 2 Tie Swwkfng Cmunooeays A Irrvpernior. W.atunqon, aC, The Tob.cop tiutituta.,l94i. 3. Tpt f.on Atwr1 ... 1rDlic Seto(uns, Wie- uaa-5akr,u RJ Reynotds Tobacw Co. 1916. a4. KaAn Pt:: The Ntirtncrota Ckan dndoor Air Aot: NYSrareJ,Ned 19tf3i 83:1300-I3o'1, 5. T.te Jr CF. A plnician-lod rrferrndum for cfeaavr air iei Ftonda. .'YY Siare J.1led' 19B3:8J: 1302. 6'. Blum A: CiEaretta smokin}.nd litt prontmwa: editoriuh iare not enouili. Ni)~Srare..J'.Nnl 1983; 83: 1_15:1281. . Jt:I \'' 1'Ix<,tit 11'l }^(lK',1; ST,AfP IUUR'VAi! 01 Mt IDIICINI. B -S t7'T

-6- SELECTEIDPUBLICATI'ONS, J.L.REPACE 1. "Passive smok4ng has no place in the workplace'. J.L. Repace,, Guest Editorial, CANADIAN MEDICAL ASSOCIATION JOURNAL, 133I: 737-738' (1985). 2. "An Indoor air quality standard for ambient tobacco! smoke based'on carcino- genic risk. J.L., Repace and A.H. Lowrey, NEIV' YORK STATE JOURNAL OF MEDICINE,, 8'5 : 381-383 (19'85) . 3. "A'quantitative estimate of Nonsmokers' Lung Cancer Risk From Passilve Smoking", J.L. Repace and A.H. Lowrey, ENVIRONMENT INTERNATIONAL 11: 3-22'(11985).. 4. "Consistency of research data on passive smoking and 1ung cancer" J.L. Riepace, THE LANCET (ii'): 3 March: 11984, p. 506. 5. "The Problem ofPassive~Smokiing", J. L. Repace, BULLETINIOF THE NEW YORK ACA'DEM'Y' OF MEDICLNE57: 936-946 (1981). 6. "Indoor Air Pollution, Tobacco Smoke, and Public Health", J. L. Repace and A. H. Lowrey, SCIENCE 208: 4I64-474 (1980)1. 1. "Effect of ventilatilon on passive smoking risk in a model workpliace'. Proceedings of an Engineering Foundation Conference on Management of Atmospheres In Tight1y Enclosed, Spa es, Santa Barbara,, Oct. 17-21, 1963, American Society of Henting,, Refrigerating, and Air Condytiioning,Engineers, ASHRAE Special Publliicati on„ 1984. 8. "Tobacco Smoke, Ventil,lation„ and!Indoor Air Quality", J. L. Repace and A. H. Lowrey, ASHRAE TRANSACTIONS 88: Part I,8915-914 (1982). 9. 'The Dosimetry of Passive smoking"', J.L. Repace, Proceedings of The 5th Worldl Conference on Smoking b' Health, Winnipeg, July 10-15, 1'.983. 10. "'Modeling Exposure ofMonsmokers To Ambient Tobacco Smoke", J.L. Repace and A.H. Lowrey, Proceedings of the Tbthi Annual Meeting ofttie Air Pollutilon Control Association,, Atlanta, June 20-24, 1983. 11. "Risks of Passive Smaking', J.L. Repace, in To: Breathe Freely, a book by the Center for Philosophy and, Pub]'ic Policy, University of Rary and, in, press. Pub1ished as al Center Working Paper in 1983. 12. 'Nonsmokers and'.ciigarette smoke: a modified perception of risk", F. G. Bock, reply by J. L. Repace and A. H. Lowrey, SCIENCE 215: 197 (1982). 13. "Effect of'ficegative Ion Generators on Ambient Tobacco Smoke"', J.L. Repace, D.B. Seba, A.H. Lowrey, and T.W. Gregory, J'OURNAL OF CLINICAL ECOLOGY 2: 90-94 (1984)1. 14. "Indoor Air Pollution', J. L. Repace„ ENVIRONMENT INTERNATI'0'NAL 8: 21-36 (1982)1. C 15. °7ota1l Human Exposure to Air Pollution"„ Ji. L. Repace, W. R. Ott, and L. A. Wallace, Proceedings of the 73rdiAnnual Meeting of the Air Pollution Control Association, June 22-27, 1980; Montreal. C tV ~. G-6

2025684310 N H

I CLEAN YO'lJ R ROOM ! I A Compendiiam Describing a Wide Variety of Indoor Pollutants and!Their Health Effects, andi,Containing Sage Advice tolBot!h Housetioldiers and! Statespersons in the Matter of Cleaning,Up,, C C AND INCLUDING I A List of Experts Who Know What They're Talking About I AS WELL AS A Consurner Clean-Up Kit REPLETE WITH A Body Chart EDMUND G. BROWN JR. Governor ALICE A. LYTLE, Secretary Sta~te~ and'lConsume~~r'S~erwices ~ Algency RICHARD B. SPOHN, Director Department of Cornsumer Affairs j!V ~. ~ ~ ~ ~~ €nsumer ~ " ~ Fsa?~r.~arv TQ07 ~, a H-2

FIGURE I ' -f a s 120 100 80 60 20 . . ~........s ~ Q a0 . ~, .__ ` % ~ ~ ~ . ~ .~ . I •. No. Jan Mar Miv Jul Seo tNmr Jan ANSr 1976 1977 1978 Sample represents 80 homes across six cities (approximately 10-15, homes per city),. Ft'eprintedw.ithperrnissionfr:om S~peing,le~retr al. Source: 2aational'Research Council. Indoor Pollutants. Committee on Indoor Pollution. Washington D.C.: National Academy Press, 19:81. p. IV.109. III-.S. 4 a-T

Celebrities Who Have Supported Nonsmokers' Rights Eddie Albert Ed Asner Lloyd Bridges Carol Burnett Red Buttons Mary Cost& John Forsythe Zsa Zsa Gabor Steve Garvey John Gavin Robert Goulet Buddy Hackett Larry Hagman Charlton.Heston Lena Horne Dennis James Gene Kelly Jack Rlug¢nan Tedl Rnight. Art Linkletter France Nuyen Gregory Peck Tony Randall Kenny Rogers Stan Smith Abigail Van,Buren. Dennis Weaver Cornell Wilde Michael York J-1

non-smokers, equal to $650,000 in excess wage costs per year (22). Bodxd:found th~aL5'm1$of' non-smokers reported di,fficulty working near & smoker, andl7'$' reported the use of sick leave due to tobacco smoke exposure at work MerleNorman CosmeticsCorportation, saved $33, 0!00~ per year subsequenttoba~nning smoking fo~rits 82'Semployees. It then returned the savings from rediuced' housekeeping, sick leave and increased productivity to the employees in the form of quarte'rly cash bonuses (22)~. L Improvi,ng,ventilation,will help to reduce the hazards of' involuntary smoking,, but the most effective measures must reduce the sources of' tobacco smoke. Specific recommendations for reducing exposure to involuntary smoking are fbundin therecomme~nd'ation section of this report. III.E. 11 C 01 H-14

2025684312 ' r

Speer assessed the nature of this irritation byy interviewing 25'A1non-allergenic patients about their reaction to cigarette smoke. 69.2% reported eye irritation, 31.6% headache, 29.2$ nasal symptoms and 25.2% cough (19). Barad surveyed 21,3'66 people and found that non-smokers reported 47.T$ eye irritation, 314.7% nasal discomfort and 30.5$'cough, sore throat or sneezing, when exposed to cigarette smoke (1!9). Weber, et al, and Hagod et. al, both documented that eyes aret most sensitive to the irritants in smoke,, followed by the nose (19). Luguette, et al. exposedl40 children to smoke- contaminated and clean atmospheres. Exposure to smoke was associated'with increase in bothiheart rate and bloodpressure (19),. 4. RECOMMENDATIONS FOR REDUCING' THE HEALTH HAZARDS ASSOCIATED WITH INVOLUNTARY SMOKING Tobacco smoke iniconcentrations commonly, encountered in everyday life can produce measurable physiological changes associated with d'isease in children, healthy adults a