Tobacco Documents Online

I I I I I I I I I I I I I I I I I Q'qC ~~g~.~w•• ~U1TC8 FklDA_Y, FEBRUARY 2, 1996 Letters Being near a lit cigarette has risks - whether you're smoking it or not A thorough reading of the recent Congressional Research Service (CRS) report on the health effects of environmental tobacco smoke (ETS) leads to very different con- clusions about ETS than those stat- ed by William Rusher in his Jan. 4 column "Miscalculltion of the smoke signals" (Commentary). The American' Medical Associa- tion (AMA) and the majority of the health community agree that seri- ous health risks are inherent in exposure to ETS, and we strenu- ously protest his facile assertion that physicians are "health fascists" who have manufactured a "scam" regarding ETS and health. The CRS report makes two kinds of calculations for the potential lung cancer risks from ETS exposure, based on either a "no-threshold model" that implies no safe lower limits for ETS exposure, or a "threshold" calculation based on an assumption that only persons at the highest levels of ETS exposure are at risk. The authors are careful to point out that the "threshold" method is "a hypothetical example and does not mean that nay lung cancer which might result from ETS exposure would actually exhib- it a threshold dose response behav- ior relationship." The basis for these calculations so gleefully cited by Mr. Rusher are two studies that, according to the CRS report, "pro- vide some indication of the possi- bility of a threshold" - hardly iron- clad data for him to conclude that the CRS report "makes hash" out of the risks of ETS exposure. Using the "no-threshold" model, the basis for the original Environ- mental Protection Agency (EPA) report, the CRS arrives at risk esti- mates almost identical to those of the EPA: about 2,800 lung cancer deaths per year among nonsmokers from ETS, compared with EPA's estimate of 3,300. The "threshold" method comes to about 440 deaths per year. The CRS authors admit that even if the threshold model were approxi- mately correct, public health officials may still choose to use a model clos- er to the non-threshold approach in order to ensure that all populations are protected. The CRS report also states, "If one accepts that there is a causal link between residential ETS expo- sure and lung cancer, then OSHAs [the Occupational Safety and Health Administration'sj approach is at least partially valid. Further, if occupational ETS levels are sim- ilar to those in residential settings where excess risk was measured, then OSHA's estimate of occupa- tional lung cancer risk . . . have merit:' The AMA, the American Cancer- Society, the American Heart Asso-- ciation, the American Lung Associ- ation, the National Cancer Institute, the National Research Council and the National Institute for Occupa- tional Safety and Health have all studied the questions of ETS and health, and all agree - the health risks of exposure to ETS are real„ and the best approach to the prob- lem is clean, smoke-free air for all.- LONNIE R. BRISTOW, M.D. President Amerncan Medical Association Chicago .