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INFOTAB WORKSHOP GROUP DISCUSSION - WEDNESDAY SEPTEMBER 21 - Michael Thompson Group_4___"Smoking_Issues_- 'Passive' Smoking" ------------------ Our group was particularly grateful for George Schafer's overview of the CHD situation. Noted was the ominous silence, or relative silence, in the media, surrounding the MRFIT studies, compared with the media clamour that surrounded the Hirayama statements. This pointed to the fact that apparently professional people don't encourage publicity of findings, if the research hasn't come out their way. A recommendation of the group is that we should endeavour internationally to encourage further coverage, preferably in medical journals. This may result in wider media coverage and could be preferable to NMAs using their own press releases on this particular subject. We feel there is a need for a professional overview paper on all of the intervention trials. Such a paper would hopefully conclude that more research is needed. A professional overview paper of this type might also achieve medical journal coverage. George Schafer commented that trends in smoking don't fit trends in CHD. W.H.O. is in a dilemma in that area with their own country-by-country studies. Again we think there is a need for a current status report on CHD trends and a follow-up statement that maybe will highlight the W.H.O. dilemma. Regarding the Finnish experience, our group certainly appreciates that the situation in that country does create the need for attitudinal research. We have some comments and some questions which should not be regarded as being in any way critical of that Association's activity - they are rather directed at the research itself. We were puzzled by apparent inconsistencies in some of the results from question to question, and therefore wonder whether there were design shortcomings on the part of Gallup. We also wonder whether the questions were pre-tested or piloted and whether there is any

2 plan to have post-enumeration research on a selection of them. We felt that the results demonstrated that the 'Yes/no' question has shortcomings. Also, perhaps, the five-point scale measuring degrees of agreement and disagreement on either side of the medium point may be preferable to the four-point rating used in that research. Dealing with the 'passive' smoking issue covered by Harald Konig, the group were of the view that this was a fine example of an NMA in action consistently on one subject over a number of years. It was also a good example of taking advantage of a sitaution where adversaries are clumsy and loose with their facts. We will be interested in learning more of the dividing line drawn between 'public' and 'passive' smoking. We applaud the use of a wide range of allies in the exercises, and we congratulate the Verband on the media coverage achieved in various exercises over a number of years. We do hope that further developments in that country will provide further facts with which to counter William Weis. Our group is concerned at the increasing exposure Weis is achieving from a very shaky data base. We recommend Harald's report as essential reading for every NMA, and we take Harald's point that when ordering cabs, we should make sure to order smoking cabs. I would close my remarks on this session with the hope that Harald can report on the situation with regard to insurance companies in West Germany. He has an encouraging situation to report on and time did not permit him to do so yesterday. My thanks to the group for their input.

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