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.