Public Attacks and Private Acceptance Of Ets Research
One of the techniques used by the tobacco industry to counter the evidence that passive smoking is dangerous is to fund scientific research specifically designed to "refute claims about the health effects of passive smoking" {1181.12}. The industry also has funded special projects related to ETS through CTR. As discussed in chapter 8, CTR special projects were funded at the request of tobacco industry lawyers, and their purpose was to generate data that could be used on the tobacco industry's behalf.
Using Ctr Special Projects To Exonerate Secondhand Smoke
In 1981 Patrick Sirridge, an attorney at Shook, Hardy, and Bacon, wrote a letter to a group of tobacco industry lawyers known as the Committee of Counsel recommending funding for a revised proposal that had been submitted by Dr. Theodor D. Sterling {2026.01}. The purpose of Sterling's project was to study sick building syndrome. (Sick building syndrome refers to buildings in which a substantial proportion of occupants experience symptoms such as headaches or eye irritation when inside the building. Sick building syndrome has become increasingly common since the 1970s, when new buildings were built without windows that opened
and in which air was recirculated to conserve energy. Outgassing of building materials, carpeting, and furnishings and accumulation of bacteria and other contaminants can contribute to sick building syndrome, as can tobacco smoke.) In his letter Sirridge notes that "Dr. Sterling has incorporated into the current proposal plans for collection of data on substances [other than tobacco smoke] present in buildings." In Dr. Sterling's previous work on sick building syndrome, Sirridge points out, "[s]moking was considered and found not to be a problem." Dr. Sterling's request of $207,913 for eighteen months was recommended for funding.
It is our opinion that this study could be useful with respect to the controversial issue of restriction of smoking in the workplace. {2026.01}
As discussed in detail in chapter 8, Sterling has regularly appeared on behalf of the tobacco industry at scientific meetings and legislative and administrative hearings as an independent scientist who believes that the risks associated with passive smoking are being overstated by health authorities. The documents indicate that Sterling has received more than $6 million in special project funding from 1971 to 1990 (table 8.1).
Another special project related to ETS was conducted by ACVA Atlantic, Inc. ACVA Atlantic was awarded $13,800 in 1985 to conduct a special project on air quality in the home. The proposal for the project stated:
Results of such a study ... could demonstrate that environmental tobacco smoke has a relatively insignificant effect on indoor air quality. {2041.03}
The methodology for the study is described as follows:
Twelve homes will be selected in three discrete areas of the country giving a total of 36 homes, the selection will be by the Tobacco Institute who will provide the names, addresses, phone numbers and contact at each of the homes chosen to ACVA [emphasis added]. {2041.04}
ACVA Atlantic, which later changed its name to Healthy Buildings International (HBI), characterizes itself as an independent firm that specializes in monitoring indoor air quality and in diagnosing causes of sick building syndrome. However, it is highly unusual for an "independent" company to allow an organization such as the Tobacco Institute, which clearly has a strong interest in the outcome of the study, to select the sites for its study.
To our knowledge, the ACVA Atlantic study has never been published, and the tobacco industry has never used the data for any purpose. However, a study conducted by ACVA Atlantic's successor, HBI, has been cited extensively by the tobacco industry. This study—which was funded
by the Center for Indoor Air Research (CIAR), a tobacco industry–sponsored organization similar to CTR (27)—was published in a peer-reviewed journal. Its authors measured levels of ETS in typical office buildings and concluded that "with good ventilation, acceptable air quality can be maintained with moderate amounts of smoking" (28). A congressional inquiry subsequently found, however, that more than 25 percent of the data from the HBI study was falsified (27, 29, 30). For example, employees of HBI who conducted the study stated that they had been instructed to put their measuring devices in lobbies and other open areas, in order to keep ETS readings as low as possible (31, exhibit 2). In addition, HBI employees stated that their data collection sheets were routinely altered, so that the levels of ETS recorded were lower than those that had actually been measured (31, exhibit 2). An independent analysis of HBI's data concluded that there were "many unexplained anomalies, raising serious questions about the integrity of [the] data" (27, exhibit 10). A reanalysis of HBI's data revealed that, in areas where moderate smoking occurred, "the impact of ETS on indoor air quality is 40-fold greater than HBI asserts publicly" (27, exhibit 10).
Gray Robertson, the president of HBI, and other HBI employees have testified on at least 129 occasions before local, state, and federal government agencies regarding various proposals to ban smoking in public places (27, exhibit 9). Their standard statement is that, according to their studies, moderate levels of smoking can be tolerated with adequate ventilation (27, 33). In many cases they did not acknowledge tobacco industry support (31, 32).
Analyzing London's Smoke-Free Underground Trains
A decision by the London Underground to end smoking in 1984 reflected the accelerating trend toward smoke-free environments that was beginning in the mid-to-late 1980s. One of the B&W documents is a report titled "An Investigation of the Atmosphere in London Underground Trains" {1181.04}, which was part of the papers for the 1984 research conference. Neither the author nor the audience is identified in the report, but it appears to have been part of an effort to gather data to demonstrate that ETS is not an important source of indoor air pollution. The report notes that smoking was ended on all Underground trains for a one-year trial period beginning July 9, 1984, and that a study was conducted to measure the air quality before and after ending smoking. Be-
fore smoking was ended, levels of nicotine and particulates were higher in the smoking cars than in the nonsmoking cars. However, all levels were below the industrial safety limits.
Before the total ban on smoking was introduced, smoking compartments contained on average five times the concentration of nicotine and four times the concentration of airborne particles as compared to non-smoking carriages. However, the concentration of nicotine (c. 30 µg/m3 ) and particulates (c. 0.7 mg/m3 ) found in the smoking areas are similar to those that are likely to be encountered in typical offices and public houses, and are far below recommended industrial limits for safe exposure (500 µg/m3 for nicotine). {1181.04}
One month after smoking had been ended, nicotine levels were lower than they had been in both smoking and nonsmoking cars. These results suggest that some smoke had been leaking into the nonsmoking cars. Moreover, there had been significantly elevated levels of air pollution when smoking was present, and these levels were reduced by ending smoking. The report, however, does not comment on either of these findings. Instead, it reiterates that levels of nicotine and particulates measured did not exceed recommended exposure levels.
Interesting Developments In The Hirayama Matter
Another technique that the tobacco industry has used to create a controversy surrounding the passive smoking issue is to attack published research on ETS. The documents show that, in at least one case, the industry has even criticized research that some of its own consultants acknowledged was valid.
In 1981 Takeshi Hirayama published a major study indicating that lung cancer could be caused by passive smoking as well as active smoking (3). The study, which was published in the British Medical Journal , received international attention. The tobacco industry responded by launching a public relations campaign to discredit Hirayama's work. The Tobacco Institute hired Nathan Mantel, a well-known epidemiologist, to critique the study, and it then cited Mantel's criticisms in a press release that was widely reported (34). The institute also reprinted several critical news articles as full-page advertisements in newspapers and magazines (35) (figure 10.1). Several months after the original publication of Hirayama's study, the British Medical Journal responded to the public attacks against Hirayama's work by reopening correspondence on his study. In particular, the editors stated that they were taking the "exceptional step" of publishing letters that had not been sent to BMJ , including
FIGURE 10.1. The Tobacco Institute ran this advertisement in newspapers and magazines all over
the United States shortly after publication, in 1981, of the first scientific paper linking
environmental tobacco smoke with lung cancer in nonsmokers.
Mantel's original report to the Tobacco Institute, to allow Hirayama to respond publicly to the criticisms of his work (33).
The documents show that, although the tobacco industry was publicly attacking Hirayama's paper, several of its own experts were privately admitting that his conclusions were valid. On July 24, 1981, J. K. Wells, B&W corporate counsel, wrote a memo to Ernest Pepples, B&W's vice president of law {1825.01}. The memo summarized a telephone conversation between Pepples and Tim Finnegan, an attorney with the firm of Jacob, Medinger, and Finnegan, regarding "Interesting Developments on the Hirayama Matter."
Dr. Adlkofer, who is the Scientific Director of the German Verband [the German equivalent of CTR, see chapter 2], has committed himself to the position that Lee [presumably Peter Lee, a British statistician and tobacco industry consultant] and Hirayama are correct and Mantel and TI [Tobacco Institute] are wrong. Adlkofer called Frank Colby at Reynolds [R. J. Reynolds Tobacco Co.] and said that Germany has received new data from Japan which confirms the Hirayama work. Adlkofer and Lee and another German associate were all asked to review Hirayama's work and did not find the error picked up by Kastenbaum [a statistician at the Tobacco Institute]. They believe Hirayama is a good scientist and that his nonsmoking wives publication was correct. Adlkofer invited Tsokos [affiliation unknown] and Kastenbaum to Germany to view the new data, although they would not be allowed to work with it or make copies. The proposal added that after the session in Germany Tsokos, Kastenbaum, and apparently Adlkofer would proceed to Japan to visit Hirayama. Adlkofer had previously proposed four research projects to examine the Hirayama work to be done by the research arm of the Verband. At a meeting of the board of the research arm of July 15 Adlkofer was asked how he could continue to support the projects if Hirayama's work was dead. He replied with a strong statement that Hirayama was correct, that the TI knew it and that TI published its statement about Hirayama knowing that the work was correct. Mr. von Specht [affiliation unknown] is reported to have cut Adlkofer short. Subsequently Adlkofer told Colby that unidentified authors would publish in an unnamed publication an article claiming that Hirayama was correct and that TI published its statement while privately acknowledging Hirayama's correctness. Within a few days Adlkofer called again to say that the article was off.
...
No comment is needed on the proposal to have Kastenbaum and Tsokos visit Germany to review the Hirayama data unless you believe the visit should take place. [Horace] Kornegay [of the Tobacco Institute] gave a forceful veto of the program and as of this point there is no dissent [emphasis added]. {1825.01}
The threatened letter from Adlkofer never materialized, and the industry and its consultants have maintained a unified public position that
Hirayama's study was flawed and that the health dangers of passive smoking have not been proven. Since then, Philip Morris and R. J. Reynolds have both run a series of full-page advertisements criticizing the U.S. Environmental Protection Agency's risk assessment of environmental tobacco smoke (2) (see figures 5.2 and 5.3). The Tobacco Institute has also continued to criticize Hirayama's paper and its use by regulatory bodies such as the Environmental Protection Agency and the Occupational Health and Safety Administration (35, 36). The scientific community, however, widely regards Hirayama's work as a landmark study on the health effects of ETS, and his findings have been confirmed by several other studies showing a link between passive smoking and lung cancer (37).
This episode indicates that the tobacco industry is not committed to learning and disseminating the truth about the health effects of its products. Rather, it has consistently attempted to discredit research even when its own scientists have admitted that the research results are valid. Just as the industry has continued to deny that active smoking has been proven dangerous to health, it continues to deny that the case is proven against passive smoking.