Chapter 10
Environmental Tobacco Smoke and the Nonsmokers' Rights Movement

Strategic objectives [of sidestream smoke research] remain as follows: 1. Develop cigarettes with reduced sidestream yields and/or reduced odour and irritation. 2. Conduct research to anticipate and refute claims about the health effects of passive smoking.
Summary of BAT research activities, 1984 {1181.12, p. 2}

Introduction

During the 1970s, as the scientific evidence of the dangers of environmental tobacco smoke (ETS) was beginning to accumulate, a grassroots movement for nonsmokers' rights emerged (1). When it became evident that tobacco smoke can harm nonsmokers who inhale it passively, the public became less tolerant of smoking in public places and the workplace, and restrictions on smoking began to be implemented, by both government and private businesses. Although the mainstream health establishment was slow to appreciate the significance of the passive smoking issue, the tobacco industry was quick to recognize the need to counter this emerging shift in social attitudes toward smoking, particularly smoking in the workplace, and mobilized its public relations and political resources to deal with the potential threat. It used scientists, who were funded through the Council for Tobacco Research (CTR) special projects and special accounts (see chapter 8), to oppose restrictions on smoking in public places and workplaces, and it organized to fight ballot measures for clean indoor air in California and elsewhere.

The smoke that cigarette smokers draw into their lungs is "mainstream" smoke, while the smoke that comes off the burning tip of a cigarette is "sidestream" smoke. Sidestream smoke actually contains higher

concentrations of many toxic chemicals than mainstream smoke (2), because sidestream smoke is not filtered and because cigarettes burn at a lower temperature when they are smoldering, leading to a less complete, dirtier combustion. The air pollution resulting from sidestream and extracted mainstream smoke is called secondhand smoke or environmental tobacco smoke, and people who breathe this smoke are known as passive smokers or involuntary smokers. Research conducted in the 1970s showed that children exposed to ETS have higher rates of respiratory diseases (2). In 1981 several published studies showed that nonsmoking women married to smokers have a higher risk of dying from lung cancer than nonsmoking women married to nonsmokers (3–5). This work was widely reported in the press, and provided the first strong evidence that passive smoking causes fatal diseases such as lung cancer. Research on ETS rapidly accumulated during the 1980s, and in 1986 major consensus reports by the National Academy of Sciences' National Research Council (6) and the Surgeon General (7) confirmed the evidence that ETS endangers children and causes lung cancer in adults. In 1992 the Environmental Protection Agency listed environmental tobacco smoke as a Class A (known human) carcinogen and a major source of respiratory problems in children (2). Subsequent studies have shown that exposure to ETS also increases the risk of heart disease (8–11).

In 1978 the Roper Organization conducted a confidential study for the Tobacco Institute on the attitudes of the public toward smoking (12). This report, which was obtained by the Federal Trade Commission and subsequently made public, stated:

The original Surgeon General's report, followed by the first "hazard" warning on cigarette packages, the subsequent "danger" warning on cigarette packages, the removal of cigarette advertising from television and the inclusion of the danger warning in cigarette advertising, were all "blows" of sorts for the tobacco industry. They were, however, blows that the cigarette industry could successfully weather because they were all directed against the smoker himself.

The anti-smoking forces' latest tack, however—on the passive smoking issue—is another matter. What the smoker does to himself may be his business, but what the smoker does to the non-smoker is quite a different matter. ... six out of ten believe that smoking is hazardous to the nonsmoker's health, up sharply over the last four years. More than two-thirds of non-smokers believe it; nearly half of all smokers believe it.

This we see as the most dangerous development yet to the viability of the tobacco industry that has yet occurred [emphasis added]. (p. 6)

The Roper report recommended that the industry engage in research to discredit the evidence that passive smoking is dangerous to nonsmokers.

The strategic and long run antidote to the passive smoking issue is, as we see it, developing and widely publicizing clear-cut, credible, medical evidence that passive smoking is not harmful to the non-smoker's health [emphasis added]. (p. 7)

The documents indicate that the tobacco industry followed this advice.

Early Recognition Of The Passive Smoking Issue

The tobacco industry's early awareness of the importance of the passive smoking issue is reflected in a March 15, 1973, document that summarizes the results of a literature review on issues related to smoking and health {2114.02}. It specifically notes that passive smoking is a growing issue of concern to the industry because of the negative impact that increased regulation will have on the social acceptability of smoking:

This document reflects themes that the tobacco industry has used for over two decades when dealing with secondhand smoke: it has argued that cigarette smoke is "taking the rap" for environmental pollution and that people concerned about secondhand smoke are "zealots."

In contrast to the tobacco industry's claims, the scientific and medical communities are well aware that environmental toxins such as radon and asbestos are hazardous to health. However, they also are aware of the large body of scientific evidence indicating that exposure to environmental tobacco smoke can cause disease as well (2, 6, 7). Interestingly, the tobacco industry also appears to have recognized that it would have very few natural allies in its effort to alleviate concern over passive smoking:

Many major U.S. industries are quite willing to let cigarettes take the full rap (government control, anti-pollution forces) and the tobacco industry can expect little help or sympathy from fellow manufacturers. {2114.02, p. 2}

Tobacco industry lawyers also became interested in the passive smoking issue at an early stage. In 1978 William Shinn, an attorney at Shook, Hardy, and Bacon, wrote a memo discussing various scientific activities, particularly the activities of Dr. Gary Huber {1910.05}, then director of the Kentucky Tobacco and Health Research Institute. As discussed in chapter 8, the institute, a state program funded through cigarette taxes, claimed to be independent but actually worked closely with tobacco industry lawyers on occasion. In addition, Dr. Huber was a consultant for Shook, Hardy, and Bacon (table 8.1). Shinn's memo states that Huber will be conducting a two-hour presentation at an American Thoracic Society/American Lung Association meeting, and that he might include a section on passive smoking in his presentation {1910.05}. In addition, Shinn states:

Dr. Huber has mentioned from time to time the possibility of engaging in "passive smoking" research. ... He is also curious as to what factors may contribute to the strong feelings of certain anti-smokers with respect to the smoking of others. {1910.05}

The attorneys' interest in secondhand smoke has not waned over the years. On September 13, 1984, Donald K. Hoel, a lawyer at Shook, Hardy, and Bacon, wrote a letter to attorneys at B&W in which he discussed tentative arrangements for a meeting of the "Public Smoking Advisory Group" at the Tobacco Institute. The purpose of the meeting was to discuss possible research on "normally encountered" tobacco smoke {1832.02}. (Some of the research sponsored by tobacco industry lawyers is discussed later in this chapter.)

Research And Product Development Response To The ETS Issue

As discussed in chapters 3, 4, and 7, BAT held annual research conferences so that its subsidiaries from around the world could share their research findings and agree on the research agenda for the following year. BAT research was carried out at facilities operated by the individual companies, and also through a joint research program headquartered at the Group Research and Development Centre (GR&DC) in Southampton, England. Most of the research on environmental tobacco smoke appears to have been conducted in Southampton.

Duck Key Research Conference, 1974

During the early 1970s concern over ETS was focused on its irritating effects. For example, the minutes from a meeting of the Biological Testing Committee that was held in Southampton on January 27, 1970, note that research technicians have been complaining about irritation caused by sidestream smoke from one of the cigarettes under evaluation:

Dr. [S. J.] Green [of BAT R&D] drew attention to the additional point ... that the operators of the smoking machines at Battelle [which was conducting research for Project Janus at the time] have complained about the odour/irritating nature of the sidestream smoke from the cigarette containing 100% I-308. {1164.04, p. 3}

Minutes from later meetings indicate that most BAT scientists did not take these complaints seriously at first. At the 1974 research conference in Duck Key, Florida, Dr. Green proposed that irritation caused by sidestream smoke should be evaluated in all new products. His colleagues, however, reacted without enthusiasm. The conclusions and recommendations from the Duck Key conference state:

16. It was suggested by Dr. Green that now that we have an objective sensory difference test for assessing irritation of sidestream smoke, we might write in to all new product developments a constraint in the specification in this respect. This suggestion had a cool reception and most members felt that passive smoking was relatively unimportant. It was agreed to note disagreement on this subject [emphasis added]. {1125.01, p. 4}

Just one year later, however, BAT scientists began to pay more attention to the irritating and potentially dangerous effects of ETS.

Merano Research Conference, 1975

At the BAT research conference held in Merano, Italy, in April 1975, BAT scientists discussed passive smoking at length. Participants agreed that research into the irritating effects of sidestream smoke should be undertaken. The minutes from the meeting state:

12. Passive smoking was discussed and reviewed in detail. It is considered that this is an important area and interest in it is unlikely to recede. The meeting felt that the work on sidestream irritation at Southampton was a useful contribution to a part of the whole problem. R & D Southampton were asked to extent [sic ] their studies to cover a wider range of cigarettes and chemical constituents in the sidestream. It is desirable to be in a position to anticipate the identification of new sidestream constituents which may be considered harmful to non smokers [emphasis added]. {1173.01, p. 3}

BAT's scientists made this statement nearly a decade before the general scientific community had recognized ETS as a serious threat to public health.

Biological Research Meeting, Southampton, 1976

By the mid-1970s the scientific community had begun to identify toxic substances such as carbon monoxide (13, 14) and N-nitrosamines (15, 16) in sidestream smoke. In addition, Carl Becker, a researcher at Cornell University, had published a series of studies on glycoproteins in tobacco smoke (17–19). Glycoproteins are a class of proteins that often induce allergic reactions. Becker's first study showed that glycoprotein isolated from tobacco could produce allergic reactions in some individuals (17). His report caught the attention of BAT researchers, who discussed his findings at a biological research meeting held on October 14, 1976, in Southampton. The minutes of the meeting note that BAT scientists at Southampton had repeated Becker's experiments and had confirmed that glycoprotein is present in mainstream smoke. The researchers agreed that the studies should be repeated for sidestream smoke.

The work in GR&DC ... has shown that glycoproteins with characteristics similar to those found by [Carl] Becker and Stedman are present in tobacco leaf and in saline extracts of mainstream smoke. It was agreed that there was no intention to examine the biological effects of such materials and there was no necessity to examine condensate. Nevertheless, SJG [Dr. S. J. Green, of BAT R&D] considered that it was important to know whether or not these materials were present in sidestream smoke.

It was concluded that the project should be extended to an examination of sidestream smoke and to the examination of one or two other tobacco types including experimentally de-proteinated tobacco. {1164.17, p. 11}

By the next year's meeting, BAT researchers announced that they had found glycoproteins in sidestream smoke as well.

Biological Research Meeting, Chelwood, 1977

Becker published a second study on tobacco glycoproteins in 1977 (18). This study showed that glycoproteins from tobacco increase the formation of clots in human blood, and he concluded that tobacco glycoproteins "may be important to the pathogenesis of cardiovascular and pul-

monary diseases associated with cigarette smoking" (18). Becker's findings were reported in the New York Times (20).

Ironically, Becker's second study had been funded by CTR. As mentioned in chapter 8, publication of his results had prompted correspondence between Robert Hockett, the scientific director of CTR, and Addison Yeaman, president of CTR {1910.01}. Hockett stated in his memo that he was unhappy with Becker's publication and that he had attempted, but failed, to have acknowledgment of CTR funding deleted from the publication.

While CTR was attempting to distance itself from Becker's findings, tobacco industry lawyers and scientists took his findings very seriously. A letter from Timothy M. Finnegan, an attorney at Jacob and Medinger, to William W. Shinn, an attorney for Shook, Hardy, and Bacon, notes that the lawyers have hired a scientist to repeat Becker's experiments.

As a result of Dr. Carl Becker's report of a glycoprotein in tobacco leaf, tobacco smoke condensate and tobacco smoke, Dr. [John] Salvaggio and his colleagues have undertaken an analysis of these compounds for the presence of glycoproteins. {1910.06}

Dr. Salvaggio received $283,777 from 1976 to 1981 to conduct a CTR special project on the physical, chemical, and immuno-chemical properties of components present in tobacco smoke (table 8.1).

Scientists at BAT also repeated Becker's experiments and replicated his results. They adopted a defensive posture, however, regarding the implications of their research. The minutes from a biological research meeting held on November 27, 1977, in Chelwood note:

RB [R. Binns of BAT GR&DC] explained that, whereas Becker's findings in relation to the presence of glycoproteins in mainstream and sidestream smoke had been confirmed, this did not mean that we agreed with his interpretation of their effects on man. {1164.24}

Although Binns was hesitant to concur with Becker's conclusions, the researchers at the Chelwood meeting agreed that the presence of glycoproteins in sidestream smoke was an important problem. They recommended that it should be addressed on an industry-wide basis through the Tobacco Research Council (TRC) in the United Kingdom {1164.23; 1164.24}.

SJG [Dr. S. J. Green of BAT R&D] proposed that the glycoproteins question is an industry problem and should be pursued by TRC. This was accepted. {1164.23}

The documents and our review of the literature do not indicate whether the health effects of glycoproteins were ever studied by the TRC. The role, if any, that glycoproteins play in the mechanisms underlying tobacco-related disease also is not known precisely. It is noteworthy, however, that BAT had confirmed the presence of a potentially dangerous substance in sidestream smoke as early as 1977.

Sydney Research Conference, 1978

The research conference held in Sydney, Australia, in March 1978 marked two major shifts in BAT's research policy toward environmental tobacco smoke. First, the emphasis shifted from glycoproteins to nitrosamines. Second, BAT executives began to realize that the passive smoking issue represented a potential new commercial opportunity for the company.

Nitrosamines are potent carcinogens. Tobacco contains several types of tobacco-specific N-nitrosamines (TSNA), most of which are byproducts of nicotine formed during the curing, fermentation, aging, and burning of tobacco (21,22). TSNA cause a variety of cancers—most notably lung cancer—in laboratory animals, and most researchers today believe that they are one of the primary causes of many tobacco-induced cancers in humans (21–23).

BAT was actively engaged in measuring levels of nitrosamines in both mainstream and sidestream smoke by the late 1970s. Notes from BAT's Sydney conference explain BAT's concern over nitrosamines in ETS:

It is clear that in many countries there is concern over the level of nitrosamines in foodstuffs. This explains in part the sensitivity to the presence of nitrosamines in tobacco smoke and, perhaps particularly, the levels in sidestream smoke. The latter is a potential threat to the currently held view by many authorities that passive smoking does not constitute a direct hazard. {1174.01}

Minutes from later conferences indicate that research on nitrosamines in both mainstream and sidestream tobacco smoke grew in importance at BAT throughout the 1980s. Unfortunately, the conference reports in the documents rarely include the results of these studies, but only indicate that research was ongoing.

While BAT scientists acknowledge that nitrosamines in sidestream smoke could present a problem for the industry, they also began to realize during the late 1970s that the passive smoking issue could be used to their advantage. The report from the 1978 Sydney conference indicates a growing awareness that BAT could capitalize on the growing anti-

smoking sentiment by developing a new cigarette with less irritating sidestream smoke. The notes from the meeting state:

21. ... A worthwhile aim is to modify the quality of sidestream smoke, and it should be remembered that governments can produce markets by endorsing a particular aspect of the cigarette, e.g., charcoal filters. {1174.01, p. 3}

Throughout the 1980s BAT's research on environmental tobacco smoke was focused on measuring nitrosamine levels and on developing a new low-sidestream cigarette.

Uk Research Conferences, 1979

The tobacco industry was concerned that government agencies would use the nitrosamine issue to impose further regulations on tobacco products. BAT group scientists discussed this concern at an R&D policy conference held in the United Kingdom on February 10 to 14, 1979. The notes from the conference, prepared by Dr. S. J. Green of BAT R&D, indicate that BAT executives agreed that they should attempt to establish "safe level" thresholds for nitrosamines:

The likely increase in pressure in this area from the anti-smoking lobby was noted. In the absence of threshold figures (e.g. safe levels for nitrosamines) any measured number could harm the Industry. Consideration should be given to the possibility of establishing thresholds. It was agreed that on nitrosamines some sighting shots should be aimed on both ambient air and sidestream smoke. {1175.03, p. 4}

The implication here is that the industry would attempt to show that nitrosamine levels in all cigarettes were below the "safe level," thus preventing government regulation of cigarettes based on their nitrosamine content. On the other hand, the industry realized that any mention of a "measured number" could be dangerous because it would be an explicit admission that tobacco smoke contains hazardous substances.

An R&D conference held later in 1979 in London confirmed the growing realization of the importance of the passive smoking issue. The notes from the meeting, prepared by Dr. L. C. F. Blackman of BAT R&D, state:

18. SIDESTREAM

Concern for the passive smoker was regarded as likely to become a key issue in the future and the GR&DC programme was regarded as of importance—both for defensive and offensive (i.e., possible commercial advantage) purposes [emphasis added]. {1176.02, p. 9}

Sea Island Research Conference, 1980

By 1980 BAT's researchers were trying to develop a cigarette with low sidestream smoke emission. The direction of the research was discussed at a research conference held in Sea Island, Georgia, on September 15 to 18, 1980. Notes from the conference, prepared by Dr. L. C. F. Blackman of BAT, state:

SIDESTREAM

20. There was strong support for research into the generation and control of sidestream smoke. Factors investigated should include the role of pH on sidestream nicotine and aroma. Research into the attitude of smokers and non-smokers to substantial reduction or elimination of sidestream smoke should be established.

21. Effort should be directed to developing a smoking article with greatly reduced tobacco content to reduce the material available for generation of sidestream. {1177.01, p. 4}

In addition, the notes from the meeting indicated that the BAT Group continued to support research on nitrosamines in sidestream smoke.

19. The research into the source and mechanism of formation of nitrosamines in both sidestream and mainstream should be continued with urgency. {1177.01, p. 4}

The entry suggests that the researchers had already isolated nitrosamines in sidestream and mainstream smoke, because the purpose of the research was to determine their source and formation. Thus, BAT may have again confirmed in its own laboratories that ETS contains dangerous substances.

While BAT's scientists were quietly conducting research on sidestream smoke, the general scientific community was becoming increasingly aware that passive smoking could cause a variety of diseases, including lung cancer. In 1981 a large epidemiological study on the relationship between passive smoking and lung cancer was published by Dr. Takeshi Hirayama (3). The study showed that nonsmoking women married to smokers were more likely to develop lung cancer than nonsmoking women married to nonsmokers. The Hirayama study received a great deal of publicity and, as we will discuss later in this chapter, was criticized vehemently by the tobacco industry. Nonetheless, shortly after the publication of Hirayama's paper, BAT began to study the "biological activity" of sidestream smoke. As discussed in chapter 4, the tobacco industry uses the term "biological activity" as a euphemism for carcinogenicity and other adverse health effects.

Pichlarn Research Conference, 1981

The issue of environmental tobacco smoke grew in importance at BAT throughout the 1980s. A document describing BAT's proposed research program for 1982–84, which was prepared after a research conference in Pichlarn, Austria, in August 1981, states:

The broadly based Programme [on sidestream smoke] was approved. Particular points were:

- It was agreed that GR&DC should continue short-term testing (inhalation, Ames [test for mutagenicity] etc) to get a better understanding of the relative specific activity of sidestream and mainstream smoke. This should form a basis for a future decision as to the need, or otherwise, for more extensive biological testing (eg, mouse-skin painting) of sidestream smoke. {1178.01, p. 6}

The fact that BAT was studying the "specific activity" of sidestream smoke indicates that BAT was concerned about studies suggesting that ETS is carcinogenic and that it was attempting to measure the carcinogenicity of ETS in laboratory tests.

The proposed 1982–84 research program also contains a reference to a study of sidestream smoke emissions using different cigarette papers:

- Information on inorganic fibres thought to be available in Canada from prior use in cigar wrapper should be evaluated with respect to the current cigarette sidestream project. {1178.01, p. 6}

As discussed below, one of BAT's primary techniques for minimizing sidestream smoke was to use new cigarette papers.

Montebello Research Conference, 1982

The summary of BAT's 1982 research conference, held in Montebello, Canada, notes that the bulk of the conference was devoted to discussing topics of major importance to the group {1179.01}. One of the five topics discussed was environmental tobacco smoke. The summary of the meeting reflects the growing awareness that the passive smoking issue represented an opportunity for new product development. Under the topic of environmental tobacco smoke, the summary states:

(a) and (b) represent constraints on the tobacco industry as a whole, but within them lies the opportunity for commercial exploitation (c). {1179.01, p. 6}

The next item in the summary is very vague. It appears to suggest that BAT had determined that sidestream smoke had different biological effects than mainstream smoke, but also that BAT may have found a way to reduce the toxicity of sidestream smoke:

15. Sidestream has long been known to be different chemically from mainstream, but only very recently have there been signs from GR&DC inhalation studies that the biological activity of sidestream may also be significantly different from mainstream .

An early design of reduced sidestream product developed at GR&DC has recently been screened [emphasis added]. {1179.01, p. 6}

Sidestream smoke contains higher levels of toxic substances—such as carbon monoxide, benzo(a)pyrene, and nitrosamines—than mainstream smoke (24). The item above confirms that BAT's inhalation experiments had shown that sidestream smoke is "biologically active" and that researchers were actively seeking designs that reduced sidestream emissions.

The summary of the 1982 Montebello conference also mentions a paper written by Dr. Ian Ayres of BAT GR&DC, which apparently was presented or discussed at the conference:

The personal paper by Dr Ian Ayres was regarded as a useful contribution in that it highlighted our need for better knowledge and understanding of the key chemical and biological aspects of environmental smoke. Much further thought is clearly required but specifically it was recommended that:

It was also recommended that BAT should be prepared to share on an industry basis the development of techniques for monitoring chemicals in environmental smoke [emphasis added]. {1179.01, pp. 7–8}

This item demonstrates that BAT was attempting to develop a sophisticated understanding of the health effects of passive smoking and the pub-

lic's attitude toward environmental tobacco smoke. BAT planned to use some of its data to "counter anti-smoking attacks," while data supporting the evidence that ETS is dangerous would be withheld from the public. This is the same strategy that the tobacco industry has employed regarding active smoking.

Review Of Bat Research Program, 1983

In May 1983 BAT conducted an extensive review of its group research at Southampton. BAT's research operations at that time were divided into fifteen work areas: Biological, Filters, Nitrosamines, Future Technologies, Combustion, Sidestream, Human Smoking/Smoke Aerosol, Psychology and Sensory Testing, Smoke Taste and Flavour Improvement, Leaf and Biotechnology, Tobacco Processing, Tobacco Expansion, Novel Cigarette Making Technology, Process Control and Physical Test Method Development, and Chemical Test Method Development and Analytical Projects. The review of BAT's research program summarizes the activities in each of these work areas {1180.17}.

Work on environmental tobacco smoke was being carried out in several of the work areas. For example, the review notes that 20 percent of the work in the Biological area was related to the evaluation of sidestream smoke. In the Nitrosamine work area, "the importance was emphasized of ... Work on both mainstream and sidestream [emphasis in original]" {1180.17}. In addition, one of the projects in the Combustion work area was related to "The mechanism by which magnesium oxide filler in the cigarette paper reduces visible sidestream" [emphasis added] {1180.17}.

In the Sidestream work area, BAT's research effort was directed at designing a low-sidestream cigarette, primarily by developing new types of cigarette paper that would release less irritating or smaller volumes of sidestream smoke.

The general thrust of the work on sidestream is to design and evaluate cigarettes with reduced emission of sidestream smoke. This will also include the generation of data on the build-up of smoke in confined areas and the effect of this on occupants and furnishings. The project areas are:—

This research was aimed primarily at reducing the visibility and irritation of sidestream smoke. The review does not mention any attempts to study the health effects of sidestream smoke released from these new products. Evidently, BAT's first inclination was to develop a "health-image" cigarette to respond to public concern over ETS, just as it had initially responded to concern over active smoking by introducing filter cigarettes (see chapter 2).

BAT's 1983 review of its work program also mentions several other projects related to environmental tobacco smoke. For example, "Interest was expressed in determining the extent to which the level of visible sidestream smoke influences subjects [sic ] irritation response" {1180.17}. In addition, a smoking machine was being built that would collect both mainstream and sidestream smoke from the same cigarette; and the range of sidestream analysis was being expanded to include more vapor phase components, such as carbon monoxide and nitrogen oxide. Taken together, these projects indicate that BAT's scientists were making a sophisticated evaluation of the chemical, social, and biological aspects of environmental tobacco smoke. The primary focus of its program, however, was on producing a new cigarette with reduced sidestream smoke emissions.

Following this review of the research program, BAT subsidiaries were asked to provide priority rankings for each research project {1180.18}. The projects were rated on a scale of 1 to 3, with 1 having the highest priority. The documents include the rankings provided by the major countries in the BAT group—Australia, Brazil, Canada, Germany, and the United States—along with the average score that each project received. Virtually all the projects related to environmental tobacco smoke, described above, were given a priority of 1 by most of the delegates {1180.18}.

Broad Objectives Of Bat's Research Program, Circa 1983

BAT's primary objective in conducting research on environmental tobacco smoke was to develop a new cigarette that produced less sidestream smoke. However, by the end of 1983 BAT had added a second

primary objective to its ETS research program: to gather scientific data to refute the evidence that passive smoking is dangerous to health. This shift is shown in a document titled "Broad Objectives of the Group R&D Programme" {1180.14}. This document contains a series of tables describing eleven areas of research, corresponding loosely, but not exactly, to the work areas mentioned above. BAT's research on environmental tobacco smoke was considered both "defensive and offensive" in nature and was given a priority of 1. The main objectives of the program in this area were to "find ways of reducing the nuisance aspects of sidestream" and to "obtain scientific data to refute the alleged health risks of sidestream smoke" {1180.14} (see table 10.1, p. 433).

A document written by W. D. E. Irwin of BAT GR&DC and titled "Sidestream Research" confirms that BAT's main priorities for ETS research during the mid-1980s were to develop a low-sidestream cigarette and to conduct defensive research. This document appears to have been written in mid-1983, possibly in anticipation of BAT's research conference in Rio de Janeiro. It begins:

The B.C.A.C. [BAT Chairman's Advisory Committee] confirmed two requirements:

Again, it is noteworthy that BAT appeared more concerned with the irritative aspect of smoke than with whether passive smoking is dangerous to health. Its interest in health appeared to be limited to refuting any claims made by others about the effects of exposure to ETS.

Irwin then notes that a joint GR&DC/Marketing/Public Affairs Sidestream Working Party has been formed to coordinate BAT's effort to develop and market a low-sidestream product.

The Working Party will propose a programme of gradual reductions in sidestream emission levels as well as developing products taking maximum reductions. The former would be a safeguard to any future debate, but would not be communicated to the consumer at present [emphasis added]. {1180.24}

BAT appears to have been planning to make cigarettes with a range of sidestream emissions that would leave it free either to reduce sidestream smoke gradually, without informing the customer, or to introduce a radically new product if it were deemed marketable.

Irwin also summarizes BAT's research on cigarette papers that would reduce ETS emissions. Two types of papers were being evaluated: slow-burning papers and "sidestream filtration papers." However, the sidestream filtration papers did not appear to work well; two of them failed to reduce fresh sidestream irritation and smell {1180.24}.

Rio De Janeiro Research Conference, 1983

At BAT's 1983 conference in Rio, the biological activity (i.e., carcinogenicity) of sidestream smoke was addressed as a major issue. The meeting summary states:

5. The programme of work set up in response to the BCAC directive was supported—but it was stressed that the programme should consider the reduction of specific biological activity, as well as the reduction of visible smoke irritation and unpleasant odour . It should also consider the more general question of ambient smoke [emphasis added]. {1180.07, p. 5}

This statement suggests that BAT's scientists believed sidestream smoke could be biologically active, that is, carcinogenic. In addition, it implies that they were hoping to create a new product with less carcinogenic sidestream smoke, just as they had initially hoped to create a "safe" cigarette for active smokers.

The summary of this conference also refers to several contracts being negotiated to develop special cigarette papers that would reduce sidestream smoke emissions. The use of slow-burning cigarette paper could serve a dual purpose: reducing sidestream emissions and creating a self-extinguishing cigarette, which would be less likely to set accidental fires (see chapter 7) {1180.07, p. 5}. In addition, the participants agreed that defensive research should continue:

The analysis of ambient smoke was regarded as a priority need—to provide firm data to counter misleading statements in the literature and the media. {1180.07, p. 23}

The increasing emphasis that BAT placed on ETS research during the early 1980s is indicated in a document that provides projected resource allocations for 1984 {1180.16}. In 1983, 4.1 "graduate years" and 4.7 "assistant years" were allocated for ETS research (7.6 percent and 5.2 percent, respectively, of BAT's budget); in 1984 these values had increased by roughly 60 percent to 6.5 graduate years and 6.7 assistant years

(12.5 percent and 8.2 percent, respectively). The revenue expenditure for 1984 was estimated at 318,000 pounds for the sidestream research group {1180.16}.

Southampton Research Conference, 1984

BAT's 1984 research conference, held in Southampton, included lengthy discussions of BAT's research activities related to environmental tobacco smoke and to the psychology of smoking. In addition, several other technical conferences held earlier in the year were summarized. The main objectives of BAT's ETS research program remained unchanged from the previous year: to "Develop cigarettes with reduced sidestream yields and/or reduced odour and irritation" and to "Conduct research to anticipate and refute claims about the health effects of passive smoking" {1181.12}. As in previous years, the first objective was being addressed by attempting to reduce sidestream emissions through changes in cigarette composition and construction. This research was being coordinated with efforts to maintain satisfactory mainstream deliveries, taste, and ash characteristics {1181.12}. There was also an attempt to develop an alternative cigarette paper. Consumer tests had shown that a noticeable reduction in visible sidestream smoke could be achieved with "a 50% reduction in the rate of sidestream PMWNF [perhaps, particulate matter] emission" {1181.12}. For example, the paper company Ecusta had conducted consumer tests of a magnesium oxide-filled cigarette paper, but the ash and taste properties of this cigarette were judged unsatisfactory. BAT had next turned to Papeteries de Mauduit (PDM), which was testing cigarette papers with a combination of 8 percent potassium citrate additive and 11 percent magnesium oxide. This product performed fairly well in terms of taste but did not result in a large enough reduction of ETS emissions. PDM was currently testing papers with higher percentages of potassium citrate or magnesium oxide {1181.12}.

BAT was also measuring the buildup and decay of ambient smoke under carefully controlled conditions. In addition, it was monitoring levels of smoke in public places such as bars. Tests of human uptake of various smoke components as well as tests for odor and irritation were also being performed {1181.12}.

Turning to BAT's secondary objective of conducting defensive research, the 1984 conference summary notes that evidence related to the "alleged" health effects of passive smoking could be classified as:

The report noted that the rate of publication on ETS, particularly clinical and epidemiological studies, was continuing to grow. However, BAT's research effort was restricted to measurements of smoke components and body uptake.

[C]linical and epidemiological testing of the effects of ambient smoke are not part of the GR&DC programme [emphasis added]. {1181.12}

Also discussed at the 1984 meeting was BAT's research on the psychology of smoking. The group's strategic objective was threefold:

Among the projects undertaken in this area was a study of whether nonsmokers' reactions to environmental tobacco smoke might be affected more by the actions of smokers than by the smoke itself.

It has been hypothesised that the smoker, rather than the cigarette smoke, plays a key role in determining non smoker reaction to sidestream smoke. An alternative to modifying the cigarette may therefore be to encourage more "acceptable" behavior by the smoker. {1181.12}

BAT's preliminary results suggested that this hypothesis was correct. Studies were planned for 1985 that would further characterize nonsmokers' reactions to ETS. Specifically, BAT planned to study how nonsmokers react to the smoker's manner, the degree to which the nonsmoker perceives control over the passive smoking situation, and the effect of same-sex and different-sex pairs of smokers and nonsmokers {1181.12}. This and similar work may have contributed to current tobacco industry activities to create a "smokers' rights" movement and to provide social support for smokers (25, 26).

BAT's 1984 R&D conference report also contains summaries of several smaller technical exchange meetings that had been held earlier that year. Environmental tobacco smoke was discussed at several of these smaller conferences. For example, at a biological conference held in Southampton, BAT researchers confirmed their commitment to studying the health effects of the sidestream smoke produced by any new products.

It was thought prudent to ensure that the Company could show no adverse effects on sidestream toxicity for a product designed to have a lower visible sidestream [emphasis added]. {1181.06}

This statement raises the question of whether the additives and other modifications to the paper and tobacco rod used to reduce visible sidestream smoke may have increased overall toxicity of the smoke.

Southampton also sponsored a "structured creativity" conference in June 1984. The conference was essentially a brainstorming session to discuss the feasibility of developing a variety of new products. One of the products discussed was the "low sidestream/ameliorated aroma product." The purpose of this product was:

To pre-empt potential volume decline from smokers under pressure in social and work environments by providing them with an offer which combines re-assurance in social smoking with taste and satisfaction [emphasis added]. {1181.10}

This statement indicates that the motivation behind BAT's effort to develop a low-sidestream cigarette was profit rather than public health. The goal was to keep smokers smoking even though acceptance of smoking in public places was declining. The conference attendees rated this project as having "large market potential, high behavioral validation (evidence of need) but potentially high associated risks to the business" {1181.10}.

After the 1984 research conference in Southampton, BAT circulated a document titled "Proposed Revisions to the Group R&D Programme" {1181.13}. Few revisions were proposed for the work on ETS. However, in the section on "Novel Cigarette Technology," the research that had been carried out that year on low-sidestream cigarettes is described as promising.

Initially promising work using a food extruder, at the Food Research Institute, Norwich, produced highly expanded tobacco materials with low density and reasonable smoke character. Lower CO [carbon monoxide]/tar ratio and sidestream smoke levels were recorded in prototype products. Significant effort will be allocated to this activity during 1985–86. {1181.13}

Another study described as promising had to do with the effect of changing cigarette combustion/pyrolysis temperature profiles by the use of thermal conductors. The result was reduced carbon monoxide and tar levels.

Unexpected observations of reduced CO/tar ratios, especially in sidestream smoke, have encouraged a wider investigation of products employing the principle, as it is thought that there may be accompanying changes in specific activity. {1181.13}

These items suggest that BAT was meeting with some success in its efforts to reduce the carcinogenicity of sidestream smoke.

The reports from BAT's annual research conferences demonstrate that BAT's internal research efforts supported the conclusion that environmental tobacco smoke is dangerous to health. BAT had shown in its own laboratories that sidestream smoke contains toxic substances, such as nitrosamines, and that sidestream smoke was "biologically active," and therefore potentially carcinogenic. Publicly, however, BAT and the other tobacco companies have denied that ETS is dangerous.

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.

State And Local Efforts To Regulate Public Smoking

As discussed in chapter 7, during the 1960s and 1970s the tobacco industry lobbied to pass legislation limiting the federal government's authority to regulate tobacco products and preempting state and local actions aimed at protecting smokers. This legislation was ineffective, however, against government regulations designed to protect nonsmokers . During the 1970s the nonsmokers' rights movement emerged at the state and local levels (1). The goal of the movement was to protect nonsmokers from the effects of tobacco smoke by restricting smoking in public places.

In 1975 Minnesota became the first state to pass a Clean Indoor Air Law, which (by 1990s standards) mildly restricted where people could smoke. Tobacco control activists in California then attempted to convince the California Legislature to pass a similar bill. After failing in the Legislature, the activists (including one author of this book, Peter Hanauer) succeeded in passing a strong (for the time) nonsmokers' rights law in Berkeley. They then attempted to pass a stronger law statewide by placing it on the ballot as an initiative measure in 1978. California ballot initiatives are proposed laws that are placed on the ballot for a direct vote by the people after petitions have been collected with the signatures of

a sufficient number of registered voters. The tobacco industry defeated the initiative known as Proposition 5, as well as a similar initiative, known as Proposition 10, in 1980. The documents describe in detail how the tobacco industry worked behind the scenes to defeat these initiatives, which had initially enjoyed wide public support. The description of the industry's successful strategy provides important insights—still relevant today—into how these campaigns are waged.

California's Proposition 5 (1978)

Proposition 5, the California Clean Indoor Air Act of 1978, was the first attempt in the nation to pass a statewide clean indoor air law through the initiative process. Proposition 5 would have required smoking and no-smoking sections in workplaces, public places, and restaurants. The initiative petitions were circulated in late 1977 and early 1978, and the initiative was voted on in the November 1978 election. Brown and Williamson, working with the other tobacco companies, played a major role in defeating Proposition 5. In fact, the tobacco companies financed the effort to defeat Proposition 5 in direct proportion to their market shares of the California market (1).

The tobacco industry recognized the importance of the Proposition 5 campaign early in the initiative process. Since (as shown by its own polling) the industry knew that it had virtually no public credibility, it decided to act through a nominally independent campaign committee known as Californians for Common Sense (CCS). Even though CCS was created and controlled by the tobacco companies through a closely coordinated effort, it attempted to minimize and, in some respects, even hide its industry connections. The industry wanted the public to believe that CCS was a group of concerned California citizens.

Ernest Pepples wrote a detailed analysis of the industry's strategy for defeating Proposition 5 in a report dated January 11, 1979. Pepples's report summarizes the campaign from the industry's point of view and provides important insights into the organization and structure of the industry's campaign as well as the strategies employed.

Two decisions made in 1977 account for the victory that was achieved on November 7, 1978:

The foregoing decisions were made before the terms of Proposition 5 were even known or concepts to combat it had been developed. Because of the early start a California Action Plan was presented to the chief executive officers within three weeks of the time the sponsors filed their "Clean Indoor Air Act" initiative and its provisions became known for the first time. That Action Plan became the basic blue print of the campaign concepts, strategy, organization and tactics for the entire campaign to defeat Proposition 5. The Tobacco Institute made Jack Kelly a full time employee—he had been the paid executive of California's tobacco distributors group—to devote all his efforts to the campaign [emphasis added]. {2302.05, p. 1}

The tobacco companies' sponsorship of the CCS campaign is indicated by a memo dated February 15, 1978, from Pepples to the managers of B&W's major cigarette brands. Pepples stated that the industry had formed a campaign committee called Californians for Common Sense, Inc., to run the campaign against Proposition 5, and asked the brand managers to give him the names of any people they knew in California who could be recruited to participate in the campaign {2301.01}. This active role of the tobacco companies contrasts sharply with the industry's public position during the campaign: that Proposition 5 was a local California matter and that Californians for Common Sense was a campaign organization established by local citizens as a free-standing, autonomous organization. The tobacco industry's approach contrasted sharply with that of national voluntary health organizations, which did, in fact, stand back and treat Proposition 5 as a local California matter.

Pepples's "Campaign Report" continues:

The first step was to form a California-based campaign organization, Californians for Common Sense.

The concept: A broad based citizen membership, operating under the bipartisan co-chairmanship of prominent and respected Californians who had no past or present connection with the tobacco industry. That the proponents would attack the presence of tobacco money in the campaign was obvious. The answer was a non-tobacco organization with leadership so prestigious and membership so broad that its composition clearly belied the charge that only the tobacco companies opposed Proposition 5. {2302.5, pp. 1–2}

Although the tobacco industry sought local people to appear on behalf of the campaign, control rested firmly with the tobacco companies. In addition, in contrast to most initiative campaigns, the nominal local leaders were not required to contribute their own money or raise money. Like all campaigns involving the tobacco industry since then, more than 99 percent of the money came from the industry itself (1).

The industry conducted benchmark surveys in December 1977 and January 1978 which showed that the "vote no" side was a staggering underdog: California voters favored smoking restrictions by 68 percent to 24 percent {2302.05, p. 2}. Overcoming this significant voter deficit was the essence of the industry's (ultimately) successful plan. Indeed, the tobacco industry started its research well before the initiative had even qualified for the ballot; Pepples's "Campaign Report" states:

The first Tarrance data [from the tobacco industry's pollster V. Lance Tarrance and Associates of Houston, Texas] came in June 1977 . It showed that more than 82% of the electorate approved the idea of a new state law requiring smoking and nonsmoking sections in public places.

...

The same survey showed that the California voters' perception of the tobacco industry's credibility was very low. It removed all doubts that this campaign had to be a [sic ] California-grounded, with the Tobacco Institute as far in the background as possible and with tobacco industry involvement limited to financial contributions to a California citizens committee [emphasis added]. {2302.05, p. 10}

As soon as Californians for Common Sense was established, the tobacco industry began an active campaign for securing local endorsement, with particular emphasis on union leadership.

Perhaps the most significant achievement during this period was the amazing sign-up of California labor leaders first as individuals and later with official anti-Proposition 5 positions by their trade union organizations. Brown & Williamson's labor relations group, especially C. H. Teague and C. R. Baumgardner and Wilson Wyatt in Corporate Affairs, encouraged the TWIU [Tobacco Workers International Union] and other labor organizations to get in touch with labor officials in California on behalf of the NO-On-5 position. Lorillard and Philip Morris were similarly active in rounding up labor support. {2302.05, p. 3}

Having the union leadership on their side proved to be of tremendous benefit to the tobacco industry, not only because it gave the campaign an air of legitimacy but also because the union's connections in Democratic party politics were useful in neutralizing efforts to get prominent politicians to support the initiative. In particular, then-governor Jerry Brown was persuaded to take a neutral position on the initiative through the efforts of people in the union movement {2302.05}. The tobacco industry also used the industry's mailing lists of customers to provide direct mail access to smokers in the state {2302.05}. This technique was

expanded in later years as part of the effort to develop the smokers' rights movement (25).

The tobacco industry knew that, since it had very low public credibility, identification of the industry with the No-on-5 campaign would hurt it. Thus, it established several important guiding principles to keep its profile as low as possible. In his description of how the tobacco industry defeated Proposition 5, Pepples lists these guiding principles:

All campaign functions would be operated through the citizens committee, Californians for Common Sense.

Tobacco company visibility would be confined to financial contributions to CCS. There would be no attempt to disclaim or discount the amount of tobacco contribution.

Tobacco company personnel would not make campaign appearances, occupy campaign positions or make public statements relative to the campaign.

No campaign events, programs or advertising would be directed to college campuses, specifically, or to youth in general. {2302.05, p. 8}

Although Pepples says that "there would be no attempt to disclaim or discount the amount of tobacco contribution," the tobacco industry kept a low profile during the campaign and campaign spokesmen denied the industry's role until campaign disclosure statements proved that the industry was financing the campaign. On one occasion CCS issued a press release that misstated the amount of tobacco industry contributions to the campaign by leaving out approximately $270,000 of in-kind campaign contributions (38, 39).

The documents make it clear, however, that the tobacco companies maintained tight control of CCS activities from behind the scenes. Pepples's "Campaign Report" notes,

Extreme caution was exercised in preparation of the publicity. Company legal counsel approved all releases prior to dispatch [emphasis added]. {2302.05, p. 17}

In addition, high-level tobacco industry officials maintained contact with CCS throughout the campaign:

A group of 5 tobacco company representatives consisting of Jim Dowdell who was succeeded by Charles Tucker from RJR, Ed Grefe from Philip Morris, Arthur Stevens from Lorillard, Joe Greer from Liggett & Myers and Ernest Pepples from B&W kept in constant contact with the operation of CCS. Visits were made at least once a month by the group to the CCS headquarters in both San Francisco and Los Angeles. Also frequent telephone conferences were held between Woodward & McDowell [the firm hired to manage the campaign] and the five company people. During the final month of the cam-

paign, almost daily conferences were held by telephone including Woodward & McDowell and Jack Kelly together with Lance Tarrance [the pollster] in Houston conferring with the five company representatives. Occasionally it was necessary for the five company people to meet to iron out differences. At one point, for example, Reynolds insisted on launching a campaign to deal affirmatively with the nonsmoker issue in newspaper advertising. This was a clear deviation from the California Action Plan as originally submitted to the company CEO's. The RJR proposal was contrary to the advice of the professional campaign advisors who had been employed in California. RJR finally retreated from its insistence on a separate campaign.

...

As a rule, however, the injection of company views into the operation of the campaign was kept to a minimum, while at all times retaining in the companies complete control over legal approval both as to advertising copy and general operation of the campaign [emphasis added]. {2302.05 pp. 27–29}

Despite the tight control of the campaign by the tobacco industry, the public face of the campaign was very different. CCS sought to present opposition to Proposition 5 as a purely local matter involving prominent local opposition:

Public attention was focused on the three carefully chosen and prestigious cochairmen of the Californians for Common Sense campaign:

John F. Henning, Secretary Treasurer of the California Labor Federation (AFL-CIO), a University of California regent, former U.S. Undersecretary of Labor, former U.S. Ambassador to New Zealand and an active and prominent Democrat (a nonsmoker).

Houston I. Flournoy, Vice President Governmental Affairs, University of Southern California, former California State Controller, former member of the Legislature. In 1974, Republican candidate for governor (a heavy smoker).

Katherine D. Dunlap, President of the California Council for Environmental and Economic Balance, Director of the Metropolitan Water District of Southern California, a prominent civic leader and conservationist (a nonsmoker). {2302.05, pp. 13–14}

The campaign that the tobacco industry ran against Proposition 5 was to become the industry's classic three-phase approach to tobacco control measures, whether at the local or state level, which is still in use today. Pepples continues:

Pepples's discussion of the industry's strategy of equating the "right" to smoke with the constitutionally guaranteed rights of assembly and free speech is particularly ironic, given statements he had made in a memorandum only five months earlier that there is no constitutionally protected "right" to smoke and that regulating smoking is a legitimate government activity {2201.01, pp. 3–4} (see chapter 7).

The tobacco industry made the cost of implementing the initiative—primarily the posting of signs and the expenses of enforcement—a pivotal issue in the campaign. The supporters of Proposition 5 had obtained a copy of an industry-funded poll showing that there was a direct relationship between this cost and the percentage of people who would vote against the measure. Specifically, the poll indicated that a majority of voters would vote "no" if the costs were to exceed $60 million (1). A consulting firm hired by the tobacco industry, San Francisco-based Economic Research Associates, produced a study concluding that implementation of the initiative would cost $63 million. The proponents of the initiative, who had also obtained a copy of the calculations used to reach this conclusion, discovered an arithmetic error in the calculations that, when corrected, reduced the actual projected cost to only a few thousand dollars. Although the proponents attempted to publicize the error to undercut the industry's cost claims, as Pepples noted, the industry successfully shifted the debate into terms favorable to itself {2302.05}.

The tobacco industry's polling showed that the issues of health in general and secondhand smoke in particular were dangerous ones for the

industry. It therefore worked very hard to steer the campaign away from these questions and was largely successful at doing so.

The Tarrance [polling firm] tracking showed that it was not necessary to change our game plan; the health issue and the nonsmoker issue had not become dominant. Indeed the best issue for the Yes side was not health, despite the strong propaganda push by ACS and the lung and heart associations. Only 25% of those favoring the Yes position cited Health as their reason for voting Yes. The best issue for the Yes side was Smoke Bothers (50%). Tobacco smoke is seen by persons in the Smoke Bothers category as a nuisance and as an annoying invasion of their "life space". {2302.05, p. 36}

At the same time, the industry realized that the health effects of passive smoking might be introduced as an issue:

Lance Tarrance's organization kept a close watch on the effect of the pro-5 advertising. If other people's smoke became a dominant issue in the closing days of the campaign, we had an alternate ad campaign which was prepared and kept in the can in case it was needed. It had been tested in Madison, Wisconsin. It was based on work done by BBD&O [Batten, Barton, Durstine, and Osborne, an advertising firm with long-standing tobacco accounts]. The testing at Madison showed no perceptible improvement in attitudes about "other people's smoke," but it seemed to be bombproof. {2302.05, p. 35}

These advertisements were never needed.

Nevertheless, the industry did make use of a number of physicians to contest the evidence that passive smoking is a cause of disease.

Also we furnished witnesses such as Dr. Cosentino, who appeared before a legislative hearing that had been stimulated by the proponents of Proposition 5. Also Dr. Albert H. Niden was prevailed on to write a piece for the Los Angeles Times opinion page. It appeared on Sunday, October 29, 1978 in opposition to a similar article by Dr. Luther L. Terry [former Surgeon General; responsible for first report on smoking and health]. Niden's comment was simply "little is known about the effects, if any, of ambient tobacco smoke on people suffering from lung disease." In short the nonsmoker issue has not been conclusively decided. What little is available does not support the claims by the anti-cigarette lobby. This was in direct contradiction to the wild statements by Luther Terry. {2302.05, pp. 35–36}

At the time, in radio debates with one of the authors (Glantz), Dr. Cosentino denied that he had any financial involvement with the tobacco industry and stated that his testimony was based on his views as a libertarian and physician concerned about the misrepresentation of science. The documents show that he was paid an estimated $2,500 for "preparation of statement re: public smoking" by the tobacco industry through

its special accounts, although the date of payment is not specified (table 8.1). Similarly, Dr. Niden was paid on several occasions (the documents show no dates) through the industry's special accounts to prepare testimony on smoking-related issues. Niden's quote is typical of the way in which the tobacco industry spokesmen muddied the issue by carefully constructing restrictive clauses: he stated that little was known about the effects of ETS "on people suffering from lung disease," implying that lung disease was the only disorder associated with exposure to ETS. He did not mention what was known about the effects of ETS on other diseases or the implications of the weight of scientific evidence when examined as a whole.

Pepples's "Campaign Report" also notes the weaknesses of the pro-Proposition 5 campaign:

The reaction of the proponents was belligerent. They falsely accused Californians for Common Sense of deceit and misrepresentation. They challenged the accuracy of the cost estimates—with a variety of conflicting versions of their own. Their unfounded accusations influenced some broadcast station managers to remove certain of our spots. Most of them did so temporarily. Once the backup material supporting the claims was presented, the spots were allowed to resume. In presenting the backup for our claims, CCS took the opportunity to point out that the stations were offering free time for ACS and lung association PSA's [public service announcements] which were clearly pro-Proposition 5. As a result, several stations declined to continue running the PSA's until after November 7.

But most importantly the proponents abandoned their own battleground and came to fight on the battleground staked out by CCS.

The attacks by the opposition were troublesome and presented many concerns and additional work burdens on the campaign management and its legal defenses. They were major problems but in most cases they were overcome.

As troublesome as these battles were it meant that the proponents of Proposition 5 were now on CCS' turf arguing about the amount of costs, the degree of infringement, the technicalities of arrests and fines and trying to explain away such ridiculous inconsistencies as the Proposition's exemption of rock concerts and the smoking prohibition it would impose during jazz concerts in the same auditorium. {2302.05, pp. 5–6}

Pepples also notes that the tobacco industry had considered the long term as well as the short term when it planned the campaign.

On another occasion, Woodward & McDowell [the political campaign management firm that ran the day-to-day operations of the No-on-5 campaign] very much wanted to carry a theme in the advertising which was a parody on the legislature. The opinion surveys indicated that the voters currently hold the legislature in very low esteem. The proponents had begun to respond to

our original message that this was a bad law, poorly drafted. They conceded that it had some flaws but said not to worry, the legislature will take care of any flaw by amendment. Woodward & McDowell, therefore, urged a direct attack on the legislature to take advantage of the negative voter attitudes toward the legislature and to crowd the proponents into a corner. The companies differed in their reaction but after internal discussion, it was agreed that the tobacco industry must live with the California legislature for years to come and should not damage its relations by supporting advertising which made fun of the legislature [emphasis added]. {2302.05, p. 28}

This caution proved to be a wise move, since the California Legislature consistently supported the tobacco industry on a wide range of issues in succeeding years (40, 41).

Although the tobacco industry won the battle over the Proposition 5 campaign, Pepples notes in his report that the industry has not necessarily won the war:

Indeed the findings of the post-election survey indicate that a majority of California voters would still approve smoking regulations that they consider reasonable.

After election surveys show that 71% of the electorate say they would support "some regulation" of smoking in public places. Those who would stand for "no restrictions" numbered only 26%. Those numbers are not greatly different from the early 68–24 reading taken in 1977 and in January 1976. {2302.05, p. 40}

The report points to the need for a more active role in the Legislature to protect the tobacco industry's interests:

In California there has been little legislative equity of the type available to the tobacco industry. Strong personal relationships with legislators developed over the years by the companies were beneficial but should be reinforced more realistically in California and in other states where the industry may face problems. {2302.05, p. 41}

Passive smoking, Pepples realizes, is an ongoing issue that requires addressing, albeit carefully:

In the post-election survey 72% of the voters agreed with the belief that secondhand smoke is "hazardous" to nonsmokers; only 16% disagreed.

A measurement of the voting citizens who believe that secondhand smoke can "cause disease" in nonsmokers continues to be discouraging:

Agree 49%

Disagree 31%

Not Sure 21%

Perhaps the industry should consider a program of public education in hope of shifting this ratio of misconception.

Any program, however, must be cautiously designed and should be tested in selected markets before being applied nationally. The lesson of California is that such a program must never be part of—or coincide with—an election campaign in which smoking regulation is an issue. Credibility will be diminished or destroyed in a competitive atmosphere of a political campaign [emphasis added]. {2302.05, p. 42}

The fact that the tobacco industry viewed Proposition 5 as a potentially serious economic threat is underscored in a letter sent from Pepples to Jack S. Swaab of BAT on January 23, 1979 {2302.01}. Pepples notes that he is sending Swaab a copy of his report on the Proposition 5 campaign in response to Swaab's request.

We ask that you maintain the strictest sort of confidence for this report because it does contain our battle plan. {2302.01, p. 1}

Pepples clearly recognized that the financial stakes for the tobacco industry were very high in the Proposition 5 campaign. In the letter he attempts to quantify the effects of the initiative and to justify the expenses the industry paid to defeat it:

Although it is obviously conjectural to try to quantify the results of [B&W'S] expenditures [of over $1 million to defeat Proposition 5], we have looked at it from several points of view. ...

If it is assumed that the passage of Proposition 5 would have caused a decline in volume of just one cigarette per California smoker per day, the chart attached to this letter shows the industry would have suffered an after tax loss equal to $5.9 million in the first year. On that basis, it can be said that the industry [which spent $6.6 million to defeat the proposition] will recover its "investment" over a period of one year. If it is assumed that the passage of Proposition 5 would have caused a decline of 2 cigarettes per day per smoker, then the industry can expect to recover the $5.9 million expense in only 6 months.

California represents about 10% of the population of the United States or 20 million people. California is regarded as a trendsetter and theoretically if Proposition 5 had passed it would have had an impact on sales elsewhere in the United States.

...

A University of California study reported that the volume decline from the passage of Proposition 5 in California would be in the 15–20% range due to inconvenience. At 15% the annual incremental after-tax loss by the industry would be $24.6 million, and at 20% it would be $32.4 million. The 15–20% range translates into 4–6 fewer cigarettes per day per California smoker. In the 4–6 range, the payback period is less than three months. Limited strictly to the cigarette market in California, if Proposition 5 had resulted in a decline of 1–6 cigarettes, the industry can be said to recover its

costs for preventing that loss within 1–12 months' time [emphasis added]. {2302.01, pp. 2–3}

Ironically, the University of California report used by Brown and Williamson for its analysis was written by Stanton Glantz, one of the authors of this book, as part of material prepared to analyze the potential costs and benefits of Proposition 5. While the health community may have been slow to recognize the economic impact of smoking restrictions, the tobacco industry was acutely aware of how much even a small decline in smoking would affect its profits.

The Proposition 5 campaign also provided evidence that smokers could be motivated to vote for the industry's political and economic interests. At the beginning of the campaign, before the tobacco industry's massive advertising campaign, most smokers supported the initiative. However, the tobacco industry was successful in its attempt to sway them. In his letter to Swaab, Pepples observes:

Close to 90% of the smokers who voted on Proposition 5 voted against its enactment. They stood up against a restriction on their smoking pleasure. The opinion sampling indicates that smokers were in fact quite enthusiastic in support of the position of Californians for Common Sense [that Proposition 5 represented unnecessary government intrusion].

This contrasts with the pre-campaign mood which even among a majority of smokers was solidly in favor of restricting public smoking. Verbatims [comments?] from the early public opinion surveys had the smokers saying that Proposition 5 might help them quit or cut back and for that reason, at that early point in time, they expected to vote for it .

As the campaign progressed and as these smokers heard the messages which Californians for Common Sense put on radio and television, the attitudes of the smokers toward the right to smoke in public underwent a favorable change. Verbatims from focus groups held toward the end of the campaign demonstrated that smokers became much less defensive in the sessions and would actually pull out their packages of cigarettes and proudly display them on the conference table. The health issue was never addressed in the "Vote NO" messages; they raised instead the basic economic and freedom issues. It is possible to theorize, therefore, that in addition to avoiding a negative sales impact from the legislative restrictions which Proposition 5 would have represented, the industry may have achieved a positive effect among smokers in support of their custom of smoking [emphasis added]. {2302.01, pp. 2–3}

Since that time, the tobacco industry has continued to use this strategy, not only to oppose local and state clean indoor air laws but also in its attacks on the efforts of the federal Occupational Safety and Health

Administration to regulate passive smoking in the workplace and the Food and Drug Administration to regulate cigarettes and smokeless tobacco products as drug delivery devices.

The Proposition 5 campaign was only the first in a large number of initiative and referendum measures throughout the country, most notably in California, Colorado, and Florida, in which the tobacco industry became intimately involved. Just as in the Proposition 5 campaign, the industry usually formed local campaign committees with names designed to mask industry involvement. For example, in an effort to defeat a ballot measure in Dade County, Florida, the industry formed an organization named "Floridians Against Increased Regulation," or "FAIR" for short.

Tobacco industry executives appear to have expected that initiatives similar to Proposition 5 would be proposed in other localities. A memo from B. D. Cummins [affiliation unknown] to a group of tobacco industry lawyers and executives, dated August 24, 1979, suggests that money be set aside for voter referendums (a term sometimes used synonymously with "initiatives"):

[A]n amount of $500,000 should be budgeted for "Smoking Voter Referendum" and included in General Corporate as a separate line item. This is budgeted for any state or city referendums on smoking that may come up in 1980. {1503.12}

It is possible that the tobacco companies were already aware that tobacco control activists were planning to sponsor another initiative to restrict smoking in California, Proposition 10.

California's Proposition 10 (1980)

In 1980 the same people who had sponsored Proposition 5 made a second attempt to pass a statewide initiative to restrict smoking in workplaces, public places, and restaurants. This initiative was known as Proposition 10. While the documents do not contain the same kind of detailed analysis of the Proposition 10 campaign as the Proposition 5 campaign, one interesting document illustrates how the industry approaches scientific research implicating secondhand smoke as a cause of disease in nonsmokers.

In 1980, when Proposition 10 was before the voters, an important paper on the health effects of secondhand smoke, by James R. White and Herman F. Froeb (42), was published in the New England Journal of

Medicine . The paper demonstrated that nonsmokers working in smoky offices have pulmonary function similar to that of light smokers. This study represented the first medical evidence that workplace exposure to secondhand smoke could impair lung function in otherwise healthy nonsmoking adults. On October 7, 1980, Californians Against Regulatory Excess (CARE), the tobacco industry's organization that ran the campaign against Proposition 10, issued a statement to the press criticizing the White and Froeb paper.

This publication of White and Froeb has aroused new activity by the proponents of legislation and regulation aimed at restricting smoking in public places. This activity has occurred despite the many defects in the study and widespread criticism of the study by members of the medical and scientific communities. {2303.02}

The CARE statement drew heavily on an editorial comment by Claude Lenfant and Barbara Liu of the National Heart, Lung and Blood Institute that had accompanied the White and Froeb publication in the New England Journal of Medicine . The editorial (43) had stated:

[T]he evidence that passive smoking in a general environment has health effects remains sparse, incomplete, and sometimes unconvincing. Yet the dearth of scientific data has not prevented this issue from becoming the focus of major debates that have resulted in national and local legislative actions. These actions, in turn, have reinforced the endless conflict between the rights of smokers and those of nonsmokers. {2303.02, p. 2}

The CARE press release then asserts that many authorities have criticized the study:

Much criticism and many doubts about the study methods utilized and conclusions reached by White and Froeb have been voiced in letters to the New England Journal of Medicine . {2303.02, p. 3}

The authors of the criticisms included Franz Adlkofer, Gary Huber, Allan P. Freedman, Domingo Aviado, Michael Halberstam, and George E. Schafer (a former Surgeon General of the Air force and a self-identified consultant to the Tobacco Institute). As table 8.1 shows, Huber and Aviado received funding through the industry's special projects division. Aviado was paid $85,000 for a CTR special project from 1977 to 1978 and also received $675,500 as a consultant through Special Account 4 from 1981 to 1990. Huber received "computer and staff expenses" through a Shook, Hardy, and Bacon consultancy. Except for Schafer, none of this information was disclosed at the time. Adlkofer works at the German

Verband, which conducts activities similar to the Tobacco Institute and the Council for Tobacco Research.

CARE's press release also directs ad hominem attacks against White, suggesting that White's research was biased because he had volunteered to work in favor of the Proposition 5 and 10 campaigns.

White's extreme anti-smoking statements reveal his bias against smoking. ("When children are playing ball in the Little League, smoking parents should not be allowed within 50 yards of them.")

Dr. White, besides his involvement on the pro-Proposition 5 campaign in 1978, is a member of the Campaign Support Committee of Californians for Smoking & No Smoking Sections (the pro-Proposition 10 people) and appeared with Paul Loveday, the campaign chairman, at the news conference announcing the initiative drive. This "political" involvement may affect the objectivity necessary in science. {2303.02, pp. 11–12}

CARE's statement also included general comments from Dr. Hiram T. Langston, Duncan Hutcheon, Edwin R. Fisher, Suzanne Knoebel, and John Salvaggio criticizing the evidence that passive smoking is dangerous. All these individuals received money through the industry's special accounts (table 8.1).

Attacks on the White and Froeb study were not limited to the California campaign. A memo dated July 24, 1981, from J. K. Wells, B&W corporate counsel, to Ernest Pepples notes that a letter criticizing White has been sent to a member of Congress:

[Dr. Michael] Liebowitz has sent Congressman [Charlie] Rose [D-NC] an extensive and hardhitting letter very critical of James White. It is not clear whether the letter can be used by the industry in the present posture of the situation. {1825.01}

"The situation" might refer to a National Academy of Sciences report (44), completed for the EPA, urging increased restrictions on smoking in public buildings.

Proposition 10 was defeated in 1980. Nevertheless, the tobacco industry realized that the issue of secondhand smoke was here to stay. Five years later, in 1985, the "B&W Public Issues Environment" memorandum views the growth of smoking restrictions as a threat to the industry and predicts that smokers will probably support these restrictions.

Large numbers of local governments will adopt smoking restrictions which require segregation of smokers in indoor areas with public access and government office buildings . A substantial number of restrictions will apply to

office areas and a growing number will apply to factories. A minority of the restrictions will virtually prohibit smoking, with the severity and incidence of restrictions varying by geographical region. The trend of private businesses to adopt smoking restrictions and cessation programs for employees will accelerate. The Federal government will adopt tight smoking restrictions for its offices. The insurance industry will broaden the application of nonsmoker discounts, which will appear as a feature of health care plans. Few smokers will complain about these events and the press will continue to publish assessments that smoking restrictions are seen by all parties concerned as working well [emphasis added]. {2228.02, p. 3}

To put this memorandum in perspective, in November 1983 the tobacco industry had just suffered its first defeat in a ballot measure when the voters in San Francisco approved Proposition P, a referendum that ratified a city ordinance requiring employers to provide smoke-free areas for nonsmoking employees in office workplaces (45). The victory was accomplished despite an expenditure of $1,250,000 by the tobacco industry, including a sizable contribution from Brown and Williamson, which set a new national record for a local ballot measure. The success of Proposition P encouraged people throughout the country to work for legislation to protect nonsmokers from second-hand smoke and literally opened the door to the passage of hundreds of local laws regulating public smoking. Pepples therefore had good reason to predict that "large numbers of local governments will adopt smoking restrictions." Many of Pepples's other predictions have also since materialized. Nevertheless, the tobacco industry has continued to oppose controls on smoking in the workplace and public places with increasing intensity.

The New Jersey Sanitary Code

The documents provide a small glimpse of one tobacco industry effort in New Jersey to oppose the regulation of public smoking. When the Public Health Council of New Jersey planned hearings in October 1977 to amend the New Jersey sanitary code to restrict smoking, Brown and Williamson and the other tobacco companies, both directly and through the Tobacco Institute, organized to oppose this proposal, and worked to mobilize local groups, such as the Restaurant and Tavern Association and law enforcement associations {2300.01}. As a result of their efforts, the Public Health Council was shorn of its rule-making authority in this area, and within a few years

the Legislature passed a series of weak laws with strong preemption language that prevented localities and other jurisdictions from taking action to protect nonsmokers.

Conclusion

Privately, B&W and BAT have conducted internal research on environmental tobacco smoke, most of which has supported the conclusion that ETS is dangerous to health. The reports from BAT's annual research conferences show that BAT has identified harmful substances in sidestream smoke, including glycoproteins and tobacco-specific N-nitrosamines. In addition, the reports imply that sidestream smoke was "biologically active," and therefore potentially carcinogenic, in BAT's laboratory tests. BAT researchers were working throughout the 1980s to develop a new cigarette that would emit less sidestream smoke.

In contrast, the documents also show that, in their public pronouncements, B&W, BAT, and the tobacco industry in general have actively sought to mislead the public about the dangers of passive smoking. BAT's conference reports state that BAT and B&W were engaged in research to "refute the evidence" that passive smoking is dangerous. In addition, US tobacco companies jointly funded "special projects" related to ETS. In at least one case, data from a special project were apparently falsified to make passive smoking appear less harmful than it actually is. Also, according to its conference reports, BAT had a policy of "no disclosure" regarding internal research on the health effects of ETS. The tobacco industry has also publicly attacked scientific research on ETS in order to "create a controversy" over the evidence that passive smoking is dangerous. In at least one case, it publicly attacked research that its own consultants had privately acknowledged was valid.

Finally, the tobacco industry has actively sought to block efforts to minimize the exposure of nonsmokers to tobacco smoke. Although the industry states publicly that it is motivated by a dedication to freedom of choice, its true motivation is maintenance of profits.

Taken together, the documents demonstrate that the tobacco industry's strategy regarding passive smoking has been virtually identical to its strategy regarding active smoking. It has privately conducted internal research, which has largely supported the evidence that passive smoking is dangerous to health, while it has publicly denied that the dangers have been proven.

References

1. Taylor P. The Smoke Ring: Tobacco, Money, and Multi-national Politics . New York: Pantheon Books, 1984.

2. USEPA. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders . Indoor Air Division, Office of Atmospheric and Indoor Programs, Office of Air and Radiation, US Environmental Protection Agency, 1992. EPA/600/6-90/006F.

3. Hirayama. T. Non-smoking wives of heavy smokers have a higher risk of lung cancer: A study from Japan. Brit Med J 1981;282(6259):183–185.

4. Trichopoulos D, Kalandidi A, Sparros L, MacMahon B. Lung cancer and passive smoking. Int J Cancer 1981;27:1–4.

5. Garfinkel L. Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. J Natl Cancer Inst 1981;66(6):1061–1066.

6. National Research Council Committee on Passive Smoking. Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects . Washington, DC: National Academy Press, 1986.

7. USDHHS. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General . US Department of Health and Human Services, Public Health Service, Centers for Disease Control, 1986. DHHS Publication No. (CDC) 87-8398.

8. Glantz, S, Parmley W. Passive smoking and heart disease. Circulation 1991;83:1–12.

9. Taylor A, Johnson D, Kazemi H. Environmental tobacco smoke and cardiovascular disease. A position paper from the Council on Cardiopulmonary and Critical Care, American Heart Association. Circulation 1992;86:1–4.

10. Gidding S, Morgan W, Perry C, et al. Active and passive tobacco exposure: A serious pediatric health problem. A statement from the Committee on Atherosclerosis and Hypertension in Children, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 1994;90:2582–2590.

11. Glantz S, Parmley W. Passive smoking and heart disease: Mechanisms and risks. JAMA 1995;273:1047–1053.

12. Roper Organization. A Study of Public Attitudes toward Cigarette Smoking and the Tobacco Industry in 1978 . Vol. 1. Roper Organization, 1978.

13. Russell M, Cole P, Brown E. Absorption by non-smokers of carbon monoxide from room air polluted by tobacco smoke. Lancet 1973;1(803):576–579.

14. Cuddeback J, Donovan J, Burg W. Occupational aspects of passive smoking. Am Industr Hyg Assoc J 1976;37(5):263–267.

15. Brunnemann K, Yu L, Hoffman D. Assessment of carcinogenic volatile N-nitrosamines in tobacco and in mainstream and sidestream smoke from cigarettes. Cancer Res 1977;37(9):3218–3222.

16. Brunnemann K, Hoffman D. Chemical studies on tobacco smoke LIX. Analysis of volatile nitrosamines in tobacco smoke and polluted indoor environments. IARC Sci Publ 1978;19:343–356.

17. Becker, C, Dubin T, Wiedemann H. Hypersensitivity to tobacco antigen. Proc Natl Acad Sci 1976;73(5):1712–1716.

18. Becker C, Dubin T. Activation of factor XII by tobacco glycoprotein. J Exp Med 1977;146:457–467.

19. Becker C, Levi R, Zavecz J. Induction of IgE antibodies isolated from tobacco leaves and from cigarette smoke condensate. Am J Pathol 1979;96(1):249–255.

20. Altman L. Tobacco protein viewed as link to heart disease. New York Times 1977 September 18:29.

21. Hoffman D, Brunnemann K, Adams J, Hecht S. Formation and analysis of N-nitrosamines in tobacco products and their endogenous formation in consumers. IARC Sci Publ 1984;57:743–762.

22. Hoffmann, D, Brunnemann K, Prokopczyk B, Djordjevic M. Tobacco-specific N-nitrosamines and Areca-derived N-nitrosamines: Chemistry, biochemistry, carcinogenicity, and relevance to humans. J Toxicol Environ Health 1994;41:1–51.

23. Tobacco-specific N-nitrosamines (TSNA): Papers presented at the 15th International Cancer Congress in Hamburg, Germany, August 1990. Crit Rev Toxicol 1991;21(4):235–313.

24. Guerin M, Jenkins R, Tomkins B. The Chemistry of Environmental Tobacco Smoke: Composition and Measurement. Ann Arbor, MI: Lewis Publishers, 1992.

25. Samuels B, Glantz S. The politics of local tobacco control. JAMA 1991;226:2110–2117.

26. Cardador TM, Hazan AR, Glantz SA. Tobacco industry smokers' rights publications: A content analysis. Am J Pub Health 1995;85:1212–1217.

27. Barnes DE, Bero LA. Industry-funded research and conflict of interest: An analysis of research sponsored by the tobacco industry through the Center for Indoor Air Research. J Health Politics Policy Law 1995; in press.

28. Turner S, Cyr L, Gross A. The measurement of environmental tobacco smoke in 585 office environments. Environ Int 1992;18(1):19–28.

29. Levy D. Smoking data tampered with, researchers say. USA Today 1994 Nov 2:D1.

30. Tobacco firms called data fakers. San Francisco Chronicle 1994 December 21:A3.

31. Subcommittee on Health and the Environment. Environmental Tobacco Smoke Investigation: Exhibits . Subcommittee on Health and the Environment, Committee on Energy and Commerce, U.S. House of Representative, 1994.

32. Levin M. Who's behind the building doctor? The Nation 1993 August 9/16:168–171.

33. Levy D. Struggling to clear the air on tobacco. USA Today 1994 October 12:A1.

34. Editor. Correspondence: Non-smoking wives of heavy smokers have a higher risk of lung cancer. Brit Med J 1981;283:914–917.

35. Glantz S. Tobacco industry response to the scientific evidence on passive smoking. In Proceedings of the Fifth World Conference on Tobacco and Health, 1983 (pp. 287–292). Winnipeg: Canadian Council on Smoking and Health, 1983.

36. Glantz S, Parmley W. Dissent: Passive smoking causes heart disease and lung cancer. J Clin Epidemiol 1992;45 (8):815–819.

37. Fontham E, Correa P, Reynolds P, et al. Environmental tobacco smoke and lung cancer in nonsmoking women: A multicenter study. JAMA 1994;271(22):1752–1759.

38. Burns, J. Millions given to defeat Prop. 5. San Francisco Chronicle 1978 October 3:8.

39. Campaign Finance Statement filed by Californians for Common Sense, September 30, 1978.

40. Traynor M, Begay M, Glantz S. New tobacco industry strategies to prevent local tobacco control. JAMA 1993;270:479–486.

41. Glantz S, Begay M. Tobacco industry campaign contributions are affecting tobacco policymaking in California. JAMA 1994;272:1176–1183.

42. White J, Froeb H. Small airways and dysfunction in nonsmokers exposed chronically to tobacco smoke. N Engl J Med 1980;302:720–723.

43. Lenfant C, Liu B. (Passive) smokers versus (voluntary) smokers (editorial). N Engl J Med 1980;302:742.

44. National Research Council. The Airliner Cabin Environment: Air Quality and Safety. Washington DC: National Academy Press, 1986.

45. Hanauer P. Proposition P: Anatomy of a nonsmokers' rights ordinance. NY State J Med 1985;85:369–374.