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DEPARTMENT OF HIEALTH'& HUMAN SERVICES Public Health Service RockvU/e MO 2©815'7 January 24, 1986 Nlark Pertschuk Californians for Nonsmokers' Rights 2054 University Avenue Suite 300 Berkeiey, California 94704 Dear Mark: RSCS1'WS0 f 4~ T~ 1986 It was pleasant to talk with you this morning. We have the deepest respect for what your organization : has done in protection of the nonsrnoker. Sorrae time ago, someone sent us the enclosed statement from the "Center for Environmental Health and Human Toxicology" and asked us for comments. Our comments were very simple: we found nothing,inithe statement to:bring into question the views of'the Public HealthiService. These views, which have been stated by the Surgeon General, are set forth in another enclosure. The workshops in Geneva in 1983 and Vienna In 1984 which were cited in the Center's statement involved'the work of many scientists -- a total of 16 papers were presentedlin Geneva and 16 papers in Vienna on-the signifiicance of human exposure to environmental tobacco smoke (ETS). None dismissed the possibility off health risk, although the conferees differed on the significance of this risk. o At, Geneva, Russell, in his summary paper on the health effects of' ETS, wrote that' although publGshed' data on,ETS and lung cancer cannot be considered conclusive, he believed the attributable risk in exposed nonsmoking wives in some studies is sufficient to indicate a potentially sizeable problem. In the case of chronic changes in lung fiunctiony he wrote that published studies are contradictory but that as these changes may affect, many people, this area deserves further research. He wrote that the evidence of relationship between ETS exposure and lower respiratory disease in children was fairly strong, and that' there are other potentiali risks of ETS exposure which deserve further research. o The papers presented in Vienna also acknowledged the possibility of, risk. Hirayama presented data from Japan which showed a positive linkage between lung cancer andIETS' exposure; Garfinkel reported he could not confirm this with U.S. data,, but, that the possibility of a relationship exists. Several speakers establlishedi the presence of nicotine and nicotine metabolites in nonsmokers exposed to, ETS, including their presence in infanrts. S -26.

C Page 2 - Mark Pertschuk The Center cites a workshop on possible respiratory effects of involuntary smoke, which was sponsored ln May of 1'983 by the National Heart, Lung, and B'lood' Institute. The workshop reviewed three community-based population studies and concl uded that these studies giive evidence of no, more than a small or negligible effect of' passive smoking on the respiratory system. However, as the Conference noted, none of' the three studies was designed specifically to look at the ef fects of I passive smoking. In one study, a measurable effect was found on the development of pulmonary function in children, whose mothers smoke. It is difficult to take seriously the Center's questioning,of, whether passive smoking is harmful or Irritating,to persons suffering,from chronic bronchitis, asthma, or angina pectoris. We have never known a patient with any one of' these disease conditions who welcomes exposure to cigarette smoke. Finally, the Center discusses whether there is a causal, relationship between lung cancer and passive smoking. A number of studies have been published on this question, as listed in Table 3, showing,positive relationships. .I' hope this information will be usefiul. Robert Hutchings Office on Smoking and Health C Enclosures