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* Funding bias in research; in all reviews of the effects of passive smoking on health published between 1980 and 1995, the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry.<ref name="pmid9605902"/>
* Funding bias in research; in all reviews of the effects of passive smoking on health published between 1980 and 1995, the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry.<ref name="pmid9605902"/>
* Delaying and discrediting legitimate research: Australia<ref>{{cite journal | author=Trotter L, Chapman S | title="Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking. | journal=Tob Control | volume=12 | issue=Suppl 3:iii | pages=102–6 | year=2003 | pmid=14645955 | doi=10.1136/tc.12.suppl_3.iii102}}</ref>
* Delaying and discrediting legitimate research: Australia<ref>{{cite journal | author=Trotter L, Chapman S | title="Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking. | journal=Tob Control | volume=12 | issue=Suppl 3:iii | pages=102–6 | year=2003 | pmid=14645955 | doi=10.1136/tc.12.suppl_3.iii102}}</ref>
* Promoting "good epidemiology" and attacking so-called [[junk science]] (a term popularised by industry lobbyist [[Steven Milloy]]): attacking the methodology behind research showing health risks as flawed and attempting to promote [[sound science]] [http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A13994-2004Feb27&notFound=true]. Ong & Glantz (2001) cite an internal Phillip Morris memo giving evidence of this as company policy<ref name="pmid11684593"/>
* Promoting "good epidemiology" and attacking so-called [[junk science]] (a term popularised by industry lobbyist [[Steven Milloy]]): attacking the methodology behind research showing health risks as flawed and attempting to promote [[sound science]] [http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A13994-2004Feb27&notFound=true]. Ong & Glantz (2001) cite an internal Philip Morris memo giving evidence of this as company policy<ref name="pmid11684593"/>
* Creation of outlets for favorable research. In 1989, the tobacco industry established the International Society of the Built Environment, which published the [[peer-reviewed]] journal ''Indoor and Built Environment''. This journal did not require conflict-of-interest disclosures from its authors. With documents made available through the [[Tobacco Master Settlement Agreement|Master Settlement]], it was found that the executive board of the society and the editorial board of the journal were dominated by paid tobacco-industry consultants. The journal published a large amount of material on passive smoking, much of which was "industry-positive".<ref>{{cite journal |author=Garne D, Watson M, Chapman S, Byrne F |title=Environmental tobacco smoke research published in the journal Indoor and Built Environment and associations with the tobacco industry |journal=Lancet |volume=365 |issue=9461 |pages=804–9 |year=2005 |pmid=15733724 |doi=10.1016/S0140-6736(05)17990-2}}</ref>
* Creation of outlets for favorable research. In 1989, the tobacco industry established the International Society of the Built Environment, which published the [[peer-reviewed]] journal ''Indoor and Built Environment''. This journal did not require conflict-of-interest disclosures from its authors. With documents made available through the [[Tobacco Master Settlement Agreement|Master Settlement]], it was found that the executive board of the society and the editorial board of the journal were dominated by paid tobacco-industry consultants. The journal published a large amount of material on passive smoking, much of which was "industry-positive".<ref>{{cite journal |author=Garne D, Watson M, Chapman S, Byrne F |title=Environmental tobacco smoke research published in the journal Indoor and Built Environment and associations with the tobacco industry |journal=Lancet |volume=365 |issue=9461 |pages=804–9 |year=2005 |pmid=15733724 |doi=10.1016/S0140-6736(05)17990-2}}</ref>


Revision as of 16:29, 5 June 2009

"Second hand smoke" redirects here. For the Sublime album, see Second-hand Smoke.
Tobacco smoke in an Irish pub before a smoking ban came into effect on March 29, 2004

Passive smoking is the involuntary inhalation of smoke, called secondhand smoke (SHS) or environmental tobacco smoke (ETS), from tobacco products. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Scientific evidence shows that exposure to secondhand tobacco smoke causes disease, disability, and death.[1][2][3][4]

Passive smoking has played a central role in the debate over the harms and regulation of tobacco products. Since the early 1970s, the tobacco industry has been concerned about passive smoking as a serious threat to its business interests;[5] harm to "innocent bystanders" was perceived as a motivator for stricter regulation of tobacco products. Despite an early awareness of the likely harms of secondhand smoke, the tobacco industry coordinated to engineer a scientific controversy with the aim of forestalling regulation of their products. Currently, the health risks of secondhand smoke are a matter of scientific consensus, and these risks have been one of the major motivations for smoking bans in workplaces and indoor public places, including restaurants, bars and night clubs.

Long-term effects

Research has generated scientific evidence that secondhand smoke (that is, in the case of cigarettes, a mixture of smoke released from the smoldering end of the cigarette and smoke exhaled by the smoker) causes the same problems as direct smoking, including cardiovascular disease, lung cancer, and lung ailments such bronchitis and asthma attacks.[2][3][4]

A wide array of negative effects are attributed, in whole or in part, to frequent, long term exposure to second hand smoke.[6][7][8] Some of these effects include:

Third-hand smoke

The phrase third-hand smoke was coined to identify the residual tobacco smoke contamination that remains after the cigarette is extinguished and second-hand smoke has cleared from the air. This is an issue that has been identified relatively recently, and is not yet well understood. In the mid 2000s, researchers began studying the chemical residue left on surfaces and clothing from smoking. They found that dust and surfaces in homes of smokers are contaminated with smoke residue, and that this residue contains many of the same toxic chemicals found in second-hand smoke. In addition, exposure to these smoke residues led to elevated levels of nicotine and nicotine byproducts in infants. Smoke residue exposure was 5-7 times higher in households of smokers trying to protect their infants by smoking outdoors than in households of non-smokers, although it was 3-8 times lower than in households where the parents smoked indoors.[41]

Subsequent studies determined that most smokers were unaware of the risks to children from third-hand smoke and thought that opening a window or turning on a fan would get rid of any hazardous by-products completely. The authors felt that emphasizing that third-hand smoke harms the health of children might encourage home smoking bans.[42][43] The magnitude of epidemiologic risk posed by third-hand smoke is currently unknown.

Causal mechanisms

A 2004 study by the International Agency for Research on Cancer of the World Health Organization concluded that nonsmokers are exposed to the same carcinogens as active smokers.[44] Sidestream smoke contains more than 4,000 chemicals, including 69 known carcinogens such as formaldehyde, lead, arsenic, benzene, and radioactive polonium-210,[4] and several well-established carcinogens have been shown by the tobacco companies' own research to be present at higher concentrations in sidestream smoke than in mainstream smoke.[45]

Environmental tobacco smoke (ETS) has been shown to produce more particulate-matter (PM) pollution than an idling diesel engine. In an experiment conducted by the Italian National Cancer Institute, three cigarettes were left smoldering, one after the other, in a 60 m³ garage with a limited air exchange. The cigarettes produced PM pollution exceeding outdoor limits, as well as PM concentrations up to 10-fold that of the idling engine.[46]

Tobacco smoke exposure has immediate and substantial effects on blood and blood vessels in a way that increases the risk of a heart attack, particularly in people already at risk.[47] Exposure to tobacco smoke for 30 minutes significantly reduces coronary flow velocity reserve in healthy nonsmokers.[48]

Animal experiments have directly shown a wide variety of adverse effects from tobacco smoke exposure including induced pulmonary emphysema[49] and degranulation of mast cells contributing to lung damage.[50]

Epidemiological studies

Epidemiological studies show that non-smokers exposed to secondhand smoke are at risk for many of the health problems associated with direct smoking.

In 1992, the Journal of the American Medical Association published a review of available evidence on the relationship between secondhand smoke and heart disease, and estimated that passive smoking was responsible for 35,000 to 40,000 deaths per year in the United States in the early 1980s.[51] Some studies find that non-smokers living with smokers have about a 25% increase in risk of death from heart attack, are more likely to suffer a stroke, and can sometimes contract genital cancer.[citation needed]

Research using more exact measures of secondhand-smoke exposure suggests that risks to nonsmokers may be even greater than this estimate. A British study reported that exposure to secondhand smoke increases the risk of heart disease among non-smokers by as much as 60%, similar to light smoking.[52] Evidence also shows that inhaled sidestream smoke, the main component of secondhand smoke, is about four times more toxic than mainstream smoke.[53] Some scientists believe that the risk of passive smoking, in particular the risk of developing coronary heart diseases, may have been substantially underestimated.[54]

Parental smoking can affect children and babies, and is associated with low birth weight, sudden infant death syndrome (SIDS), bronchitis and pneumonia, and middle ear infections.[55]

In 2004, the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) reviewed all significant published evidence related to tobacco smoking and cancer. It concluded:

These meta-analyses show that there is a statistically significant and consistent association between lung cancer risk in spouses of smokers and exposure to secondhand tobacco smoke from the spouse who smokes. The excess risk is of the order of 20% for women and 30% for men and remains after controlling for some potential sources of bias and confounding.[4]

Subsequent meta-analyses have confirmed these findings,[56][57] and additional studies have found that high overall exposure to passive smoke even among people with non-smoking partners is associated with greater risks than partner smoking and is widespread in non-smokers.[52]

The National Asthma Council of Australia cites studies showing that environmental tobacco smoke (ETS) is probably the most important indoor pollutant, especially around young children:[58]

  • Smoking by either parent, particularly by the mother, increases the risk of asthma in children.
  • The outlook for early childhood asthma is less favourable in smoking households.
  • Children with asthma who are exposed to smoking in the home generally have more severe disease.
  • Many adults with asthma identify ETS as a trigger for their symptoms.
  • Doctor-diagnosed asthma is more common among non-smoking adults exposed to ETS than those not exposed. Among people with asthma, higher ETS exposure is associated with a greater risk of severe attacks.

In France, passive smoking has been estimated to cause between 3,000[59] and 5,000 premature deaths per year, with the larger figure cited by Prime minister Dominique de Villepin during his announcement of a nationwide smoking ban: "That makes more than 13 deaths a day. It is an unacceptable reality in our country in terms of public health."[60]

Studies in animals

Experimental studies in which animals are exposed to tobacco smoke have produced results supporting the carcinogenicity of passive smoking. The International Agency for Research on Cancer expert group concluded that:

There is limited evidence in experimental animals for the carcinogenicity of mixtures of mainstream and sidestream tobacco smoke. There is sufficient evidence in experimental animals for the carcinogenicity of sidestream smoke condensates.[4]

Secondhand smoke is generally recognized as a risk factor for cancer in pets.[61] A study conducted by the Tufts University School of Veterinary Medicine and the University of Massachusetts concluded that cats living with a smoker were more likely to get feline lymphoma; the risk increased with the duration of exposure to secondhand smoke and the number of smokers in the household.[62] A study by Colorado State University researchers, looking at cases of canine lung cancer, was generally inconclusive, though the authors reported a weak relation for lung cancer in dogs exposed to environmental tobacco smoke.[63]

In 1990, a tobacco-industry researcher in Germany proposed a study of the effects on animals of lifetime exposure to secondhand smoke. The proposed study was blocked by Philip Morris,[64] as described in an internal company report:

PM [Philip Morris] recently succeeded in blocking Adlkofer's plan to conduct lifetime animal inhalation study of sidestream smoke. ( . . .an INBIFO study has shown that in 90-day inhalation test, no non-reversible changes has [sic] been detected. In a lifetime study, the results were almost certain to be less favorable. Based on the analysis, the other members of the German industry agreed that the proposed study should not proceed.)[65]

Risk level

The International Agency for Research on Cancer of the World Health Organization concluded in 2004 that there was sufficient evidence that secondhand smoke caused cancer in humans.[4]

Most experts believe that moderate, occasional exposure to secondhand smoke presents a small but measurable cancer risk to nonsmokers. The overall risk depends on the effective dose received over time. The risk level is higher if non-smokers spend many hours in an environment where cigarette smoke is widespread, such as a business where many employees or patrons are smoking throughout the day, or a residential care facility where residents smoke freely.[66]

The US Surgeon General, in his 2006 report, estimated that living or working in a place where smoking is permitted increases the non-smokers' risk of developing heart disease by 25–30% and lung cancer by 20–30%.

Opinion of public health authorities

Currently, there is widespread scientific consensus that exposure to secondhand smoke is harmful.[67] The link between passive smoking and health risks is accepted by every major medical and scientific organization, including:

While there is scientific agreement regarding the existence of a link between passive smoking and heart disease, the magnitude of the increased risk remains debated by a minority of epidemiologists.[79] For example, John Bailar of the National Academy of Sciences questioned the proportionality of the passive smoking risk, stating:

Regular smoking only increases the risk of cardiovascular disease by 75%, so how could second-hand smoke, which is much more dilute, have an effect one-third that size?

One proposed explanation is that secondhand smoke is not simply a diluted version of "mainstream" smoke, but has a different composition with more toxic substances per gram of total particulate matter.[79] The more toxic makeup of secondhand smoke was first recognized in the tobacco industry's own research, though it never published its findings.[53]

Public opinion

Recent major surveys conducted by the U.S. National Cancer Institute and Centers for Disease Control have found widespread public belief that secondhand smoke is harmful. In both 1992 and 2000 surveys, more than 80% of respondents agreed with the statement that secondhand smoke was harmful. A 2001 study found that 95% of adults agreed that secondhand smoke was harmful to children, and 96% considered tobacco-industry claims that secondhand smoke was not harmful to be untruthful.[2], Ch. 10, p. 588

A 2007 Gallup poll found that 56% of respondents felt that secondhand smoke was "very harmful", a number that has held relatively steady since 1997. Another 29% believe that secondhand smoke is "somewhat harmful"; 10% answered "not too harmful", while 5% said "not at all harmful".

Controversy over harm

Enstrom and Kabat

A 2003 study by Enstrom and Kabat, published in the British Medical Journal, argued that the harms of passive smoking had been overstated.[80] Their analysis reported no statistically significant relationship between passive smoking and lung cancer, though the accompanying editorial noted that "they may overemphasise the negative nature of their findings."[81] This paper was widely promoted by the tobacco industry as evidence that the harms of passive smoking were unproven.[67][82], p. 1383 The American Cancer Society (ACS), whose database Enstrom and Kabat used to compile their data, criticized the paper as "neither reliable nor independent", stating that scientists at the ACS had repeatedly pointed out serious flaws in Enstrom and Kabat' s methodology prior to publication.[83]

Enstrom's ties to the tobacco industry also drew scrutiny; in a 1997 letter to Philip Morris, Enstrom requested a "substantial research commitment... in order for me to effectively compete against the large mountain of epidemiologic data and opinions that already exist regarding the health effects of ETS and active smoking."[84] Judge Gladys Kessler, in her decision in the federal RICO case against Philip Morris and others, stated, "The study was funded and managed by the Center for Indoor Air Research",[67], pp. 1380 a tobacco industry front group tasked with "offsetting" damaging studies on passive smoking. Some contend the study was therefore funded by Philip Morris[85] who stated that Enstrom's work was "clearly litigation-oriented."[67], pp. 1380–1383 In the industry's 2006 racketeering trial, the Enstrom and Kabat paper was cited by the Court as "a prime example of how nine tobacco companies engaged in criminal racketeering and fraud to hide the dangers of tobacco smoke."[86] Enstrom himself has defended the accuracy of his study against what he terms "illegitimate criticism by those who have attempted to suppress and discredit it."[87] Additionally, UCLA's Academic Board of Regents found "that there was no evidence of scientific misconduct on Dr. Enstrom's part,"[88] and Richard Smith, editor of the BMJ, stated "Two top epidemiologists-- including George Davey-Smith--reviewed the paper. Then the paper went to our hanging committee, which always includes a statistician as well as practising doctors and some of us. Everybody reads every word of every paper."[89]

Gio Batta Gori

Gio Batta Gori, a tobacco industry consultant and spokesman[90] and an expert on risk utility and scientific research, wrote in the libertarian Cato Institute's journal Regulation that "...of the 75 published studies of ETS and lung cancer, some 70 percent did not report statistically significant differences of risk and are moot. Roughly 17 percent claim an increased risk and 13 percent imply a reduction of risk."[91]

Milloy

Steven Milloy, the "junk science" commentator for Fox News and a former Philip Morris consultant,[92][93] claimed that "...of the 37 studies [on passive smoking], only 7 – less than 19 percent – reported statistically significant increases in lung cancer incidence."[94]

Another component of criticism promoted by Milloy focused on relative risk and epidemiological practices in studies of passive smoking. Milloy argued that studies yielding relative risks of less than 2 were meaningless junk science. This approach to epidemiological analysis was criticized in the American Journal of Public Health:

A major component of the industry attack was the mounting of a campaign to establish a "bar" for "sound science" that could not be fully met by most individual investigations, leaving studies that did not meet the criteria to be dismissed as "junk science."[95]

The tobacco industry and affiliated scientists also put forward a set of "Good Epidemiology Practices" which would have the practical effect of obscuring the link between secondhand smoke and lung cancer; the privately-stated goal of these standards was to "impede adverse legislation".[96] However, this effort was largely abandoned when it became clear that no independent epidemiological organization would agree to the standards proposed by Philip Morris et al.[97]

World Health Organization controversy

A 1998 report by the International Agency for Research on Cancer (IARC) on environmental tobacco smoke (ETS) found "weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS."[66]

In March 1998, before the study was published, reports appeared in the media alleging that the IARC and the World Health Organization (WHO) were suppressing information. The reports, appearing in the British Sunday Telegraph[98] and The Economist,[99] among other sources,[100][101][102] alleged that the WHO withheld from publication of its own report that supposedly failed to prove an association between passive smoking and a number of other diseases (lung cancer in particular).

In response, the WHO issued a press release stating that the results of the study had been "completely misrepresented" in the popular press and were in fact very much in line with similar studies demonstrating the harms of passive smoking.[103] The study was published in the Journal of the National Cancer Institute in October of the same year. An accompanying editorial summarized:

When all the evidence, including the important new data reported in this issue of the Journal, is assessed, the inescapable scientific conclusion is that ETS is a low-level lung carcinogen.[104]

With the release of formerly classified tobacco industry documents through the Tobacco Master Settlement Agreement, it was found that the controversy over the WHO's alleged suppression of data had been engineered by Philip Morris, British American Tobacco, and other tobacco companies in an effort to discredit scientific findings which would harm their business interests.[85] A WHO inquiry, conducted after the release of the tobacco-industry documents, found that this controversy was generated by the tobacco industry as part of its larger campaign to cut the WHO's budget, distort the results of scientific studies on passive smoking, and discredit the WHO as an institution. This campaign was carried out using a network of ostensibly independent front organizations and international and scientific experts with hidden financial ties to the industry.[105]

EPA lawsuit

In 1993, the United States Environmental Protection Agency (EPA) issued a report estimating that 3,000 lung cancer related deaths in the United States were caused by passive smoking annually.[11]

Philip Morris, R.J. Reynolds Tobacco Company, and groups representing growers, distributors and marketers of tobacco took legal action, claiming that the EPA had manipulated this study and ignored accepted scientific and statistical practices.

The United States District Court for the Middle District of North Carolina ruled in favor of the tobacco industry in 1998, finding that the EPA had failed to follow proper scientific and epidemiologic practices and had "cherry picked" evidence to support conclusions which they had committed to in advance.[106] The court stated in part, "“EPA publicly committed to a conclusion before research had begun…adjusted established procedure and scientific norms to validate the Agency's public conclusion... In conducting the ETS Risk Assessment, disregarded information and made findings on selective information; did not disseminate significant epidemiologic information; deviated from its Risk Assessment Guidelines; failed to disclose important findings and reasoning…"

In 2002, the EPA successfully appealed this decision to the United States Court of Appeals for the Fourth Circuit. The EPA's appeal was upheld on the preliminary grounds that their report had no regulatory weight, and the earlier finding was vacated.[107]

In 1998, the U.S. Department of Health and Human Services, through the publication by its National Toxicology Program of the 9th Report on Carcinogens, listed environmental tobacco smoke among the known carcinogens, observing of the EPA assessment that "The individual studies were carefully summarized and evaluated."[108]p. 24

Tobacco-industry funding of research

The tobacco industry's role in funding scientific research on passive smoking has been controversial.[109] A review of published studies found that tobacco-industry affilation was strongly correlated with findings exonerating passive smoking; researchers affiliated with the tobacco industry were 88 times more likely than independent researchers to conclude that passive smoking was not harmful.[110] In a specific example which came to light with the release of tobacco-industry documents, Philip Morris executives successfully encouraged an author to revise his industry-funded review article to downplay the role of secondhand smoke in sudden infant death syndrome.[111] The 2006 U.S. Surgeon General's report criticized the tobacco industry's role in the scientific debate:

The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus.[112]

This strategy was outlined at an international meeting of tobacco companies in 1988, at which Philip Morris proposed to set up a team of scientists, organized by company lawyers, to "carry out work on ETS to keep the controversy alive."[113] All scientific research was subject to oversight and "filtering" by tobacco-industry lawyers:

Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be 'filtered' by lawyers to eliminate areas of sensitivity.[113]

Philip Morris reported that it was putting "...vast amounts of funding into these projects... in attempting to coordinate and pay so many scientists on an international basis to keep the ETS controversy alive."[113]

Tobacco industry response

The passive smoking issue poses a serious economic threat to the tobacco industry. It has broadened the definition of smoking beyond a personal habit to something with a social impact. In a confidential 1978 report, the tobacco industry described increasing public concerns about passive smoking as "the most dangerous development to the viability of the tobacco industry that has yet occurred."[114] In United States of America v. Philip Morris et al., the District Court for the District of Columbia found that the tobacco industry "... recognized from the mid-1970s forward that the health effects of passive smoking posed a profound threat to industry viability and cigarette profits," and that the industry responded with "efforts to undermine and discredit the scientific consensus that ETS causes disease."[67]

Accordingly, the tobacco industry have developed several strategies to minimize its impact on their business:

  • The industry has sought to position the passive smoking debate as essentially concerned with civil liberties and smokers' rights rather than with health, by funding groups such as FOREST.[115]
  • Funding bias in research; in all reviews of the effects of passive smoking on health published between 1980 and 1995, the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry.[110]
  • Delaying and discrediting legitimate research: Australia[116]
  • Promoting "good epidemiology" and attacking so-called junk science (a term popularised by industry lobbyist Steven Milloy): attacking the methodology behind research showing health risks as flawed and attempting to promote sound science [4]. Ong & Glantz (2001) cite an internal Philip Morris memo giving evidence of this as company policy[97]
  • Creation of outlets for favorable research. In 1989, the tobacco industry established the International Society of the Built Environment, which published the peer-reviewed journal Indoor and Built Environment. This journal did not require conflict-of-interest disclosures from its authors. With documents made available through the Master Settlement, it was found that the executive board of the society and the editorial board of the journal were dominated by paid tobacco-industry consultants. The journal published a large amount of material on passive smoking, much of which was "industry-positive".[117]

Citing the tobacco industry's production of biased research and efforts to undermine scientific findings, the 2006 U.S. Surgeon General's report concluded that the industry had "attempted to sustain controversy even as the scientific community reached consensus... industry documents indicate that the tobacco industry has engaged in widespread activities... that have gone beyond the bounds of accepted scientific practice."[118] The U.S. District Court, in U.S.A. v. Philip Morris et al., found that "...despite their internal acknowledgment of the hazards of secondhand smoke, Defendants have fraudulently denied that ETS causes disease."[67], p. 1523

Position of major tobacco companies

The positions of major tobacco companies on the issue of passive smoking is somewhat varied. In general, tobacco companies have continued to focus on questioning the methodology of studies showing that passive smoking is harmful. Some (such as British American Tobacco and Philip Morris) acknowledge the medical consensus that passive smoking carries health risks, while others continue to assert that the evidence is inconclusive. Imperial Tobacco describes secondhand smoke as "annoying" and "unpleasant", but denies any associated health risks. Several tobacco companies advocate the creation of smoke-free areas within public buildings as an alternative to outright smoking bans.[119]

Smoking bans

See also: Smoking ban and List of smoking bans

As a consequence of the health risks associated with passive smoking, a general ban on smoking in all establishments serving food and drink, including restaurants, cafés, and nightclubs, was introduced in Norway on 1 June 2004, in Italy on 10 January 2005, in Sweden on 1 June 2005 and Denmark on 15 august 2007. Other places, including Albania on 1 June 2007, throughout the United Kingdom between 26 March 2006 and 1 July 2007, and many parts of the United States have similar legislation in place.

These initial bans have grown in scope, with countries (such as Ireland, the UK, Australia and Uruguay), jurisdictions (like New York State, Washington State, Ohio, Pennsylvania, and Arkansas in the U.S.) now prohibiting smoking in public buildings as well as establishments such as restaurants and clubs.

The state of Hawaii recently passed a bill making it illegal to smoke in any public place or within 20 feet of an entrance or ventilation shaft intake of a building.

Some regions and local governments have banned smoking in all workplaces, in taxicabs, and in ventilated smoking rooms or enclosed smoking shelters such as those found in front of hospitals.

Opinion polls have shown considerable support for bans. In June 2007, a survey of 15 countries found 80% approval of smoking bans.[120] A survey in France, reputedly a nation of smokers, showed 70% supporting a ban.[60]

In the first 18 months after the town of Pueblo, Colorado enacted a smoking ban in 2003, hospital admissions for heart attacks dropped 27%. Admissions in neighboring towns without smoking bans showed no change. Raymond Gibbons, M.D., American Heart Association president said, "The decline in the number of heart attack hospitalizations within the first year and a half after the non-smoking ban that was observed in this study is most likely due to a decrease in the effect of secondhand smoke as a triggering factor for heart attacks."[121]

Alternative forms of mitigation

Alternatives to smoking bans have also been proposed as a means of harm reduction, particularly in bars and restaurants. For example, critics of bans cite studies suggesting ventilation as a means of reducing tobacco smoke pollutants and improving air quality.[122] Ventilation has also been heavily promoted by the tobacco industry as an alternative to outright bans, via a network of ostensibly independent experts with often undisclosed ties to the industry.[123]

Major medical, technical, and scientific bodies consider ventilation an inadequate mitigation alternative to indoor smoking bans. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) officially concluded in 2005 that smoking bans are the only means of effectively eliminating health risks associated with indoor exposure, and that neither ventilation nor air cleaning technologies could be be relied upon to control health risks from secondhand-smoke exposure.[124] The U.S. Surgeon General and the European Commission Joint Research Centre have reached similar conclusions.[125][126] The World Health Organization Framework Convention on Tobacco Control states that engineering approaches, such as ventilation, are ineffective and do not protect against secondhand smoke exposure.[127]

Others have suggested a system of tradable smoking pollution permits, similar to the cap-and-trade pollution permits systems used by the Environmental Protection Agency in recent decades to curb other types of pollution.[128] This would guarantee that a portion of bars/restaurants in a jurisdiction will be smoke free, while leaving the decision to the market.

See also

References

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  2. ^ a b c d e f g h i j k l m "The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General". Surgeon General of the United States. 2006-06-27. Retrieved 2009-01-12. Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke
  3. ^ a b c d e f "Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant". California Environmental Protection Agency. 2005-06-24. Retrieved 2009-01-12.
  4. ^ a b c d e f g h i "Tobacco Smoke and Involuntary Smoking" (PDF). International Agency for Research on Cancer. 2004. Retrieved 2009-01-12. There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans
  5. ^ Diethelm P, McKee M (February 2006). "Lifting the smokescreen: Tobacco industry strategy to defeat smoke free policies and legislation" (PDF). European Respiratory Society and Institut National du Cancer. Retrieved 2009-01-17. The industry quickly realised that, if it wanted to continue to prosper, it became vital that research did not demonstrate that tobacco smoke was a dangerous community air pollutant. This requirement has been the central pillar of its passive smoking policy from the early 1970s to the present day {{cite web}}: line feed character in |quote= at position 83 (help)
  6. ^ Taylor R; et al. (2001). "Passive smoking and lung cancer: a cumulative meta-analysis". Aust N Z J Public Health. 25 (3): 203–11. doi:10.1111/j.1467-842X.2001.tb00564.x. PMID 11494987. {{cite journal}}: Explicit use of et al. in: |author= (help)
  7. ^ He J; et al. (1999). "Passive smoking and the risk of coronary heart disease—a meta-analysis of epidemiologic studies". N Engl J Med. 340: 920–6. doi:10.1056/NEJM199903253401204. PMID 10089185. {{cite journal}}: Explicit use of et al. in: |author= (help)
  8. ^ Svendsen KH, Kuller LH, Martin MJ, Ockene JK. (1987). "Effects of passive smoking in the Multiple Risk Factor Intervention Trial". Am J Epidemiol. 126: 783–95. PMID 3661526.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ "1986 Surgeon General's report: the health consequences of involuntary smoking". MMWR Morb. Mortal. Wkly. Rep. 35 (50): 769–70. 1986. PMID 3097495.
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  11. ^ a b US Environmental Protection Agency. Template:PDF
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  19. ^ Hassan MM, Abbruzzese JL, Bondy ML; et al. (2007). "Passive smoking and the use of noncigarette tobacco products in association with risk for pancreatic cancer: a case-control study". Cancer. 109 (12): 2547–56. doi:10.1002/cncr.22724. PMID 17492688. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  20. ^ Bull, P.D. (1996). Diseases of the Ear, Nose and Throat. Blackwell Science. ISBN 0-86542-634-1.
  21. ^ Dietrich DF, Schwartz J, Schindler C; et al. (2007). "Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study". Int J Epidemiol. 36 (4): 834–40. doi:10.1093/ije/dym031. PMID 17440032. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  22. ^ Zou N, Hong J, Dai QY (2009). "Passive cigarette smoking induces inflammatory injury in human arterial walls". Chin. Med. J. 122 (4): 444–8. PMID 19302752. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  23. ^ Llewellyn DJ, Lang IA, Langa KM, Naughton F, Matthews FE (2009). "Exposure to secondhand smoke and cognitive impairment in non-smokers: national cross sectional study with cotinine measurement". BMJ. 338: b462. doi:10.1136/bmj.b462. PMC 2643443. PMID 19213767.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ^ Janson C (2004). "The effect of passive smoking on respiratory health in children and adults". Int J Tuberc Lung Dis. 8 (5): 510–6. PMID 15137524.
  25. ^ "Parents warned not to smoke at home". The Guardian. Retrieved 2007-06-24.
  26. ^ McMartin KI, Platt MS, Hackman R, Klein J, Smialek JE, Vigorito R, Koren G (2002). "Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS)". Journal of Pediatrics. 140 (2): 205–209. PMID 11865272.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  27. ^ Milerad J, Vege A, Opdal SH, Rognum TO (1999). "Objective measurements of nicotine exposure in victims of sudden infant death syndrome and in other unexpected child deaths". Journal of Pediatrics. 135 (1): 132–133. PMID 9709711.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ Vork KL, Broadwin RL, Blaisdell RJ (2007). "Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression". Environ. Health Perspect. 115 (10): 1394–400. doi:10.1289/ehp.10155. PMID 17938726.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  29. ^ Spencer N, Coe C (2003). "Parent reported longstanding health problems in early childhood: a cohort study". Arch. Dis. Child. 88 (7): 570–3. doi:10.1136/adc.88.7.570. PMID 12818898.
  30. ^ de Jongste JC, Shields MD (2003). "Cough . 2: Chronic cough in children". Thorax. 58 (11): 998–1003. doi:10.1136/thorax.58.11.998. PMID 14586058.
  31. ^ Dybing E, Sanner T (1999). "Passive smoking, sudden infant death syndrome (SIDS) and childhood infections". Hum Exp Toxicol. 18 (4): 202–5. doi:10.1191/096032799678839914. PMID 10333302.
  32. ^ a b DiFranza JR, Aligne CA, Weitzman M (2004). "Prenatal and postnatal environmental tobacco smoke exposure and children's health". Pediatrics. 113 (4 Suppl): 1007–15. PMID 15060193.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  33. ^ Chatzimichael A, Tsalkidis A, Cassimos D; et al. (2007). "The role of breastfeeding and passive smoking on the development of severe bronchiolitis in infants". Minerva Pediatr. 59 (3): 199–206. PMID 17519864. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  34. ^ den Boon S, Verver S, Marais BJ; et al. (2007). "Association between passive smoking and infection with Mycobacterium tuberculosis in children". Pediatrics. 119 (4): 734–9. doi:10.1542/peds.2006-1796. PMID 17403844. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  35. ^ Mahid SS, Minor KS, Stromberg AJ, Galandiuk S (2007). "Active and passive smoking in childhood is related to the development of inflammatory bowel disease". Inflamm. Bowel Dis. 13 (4): 431–8. doi:10.1002/ibd.20070. PMID 17206676.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  36. ^ Richards GA, Terblanche AP, Theron AJ; et al. (1996). "Health effects of passive smoking in adolescent children". S. Afr. Med. J. 86 (2): 143–7. PMID 8619139. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  37. ^ Scientific Consensus Statement on Environmental Agents Associated with Neurodevelopmental Disorders, The Collaborative on Health and the Environment’s Learning and Developmental Disabilities Initiative, November 7, 2007
  38. ^ Avşar A, Darka O, Topaloğlu B, Bek Y (2008). "Association of passive smoking with caries and related salivary biomarkers in young children". Arch. Oral Biol. 53 (10): 969–74. doi:10.1016/j.archoralbio.2008.05.007. PMID 18672230. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  39. ^ Glantz SA, Parmley WW (1991). "Passive smoking and heart disease. Epidemiology, physiology, and biochemistry". Circulation. 83 (1): 1–12. PMID 1984876.
  40. ^ Taylor AE, Johnson DC, Kazemi H (1992). "Environmental tobacco smoke and cardiovascular disease. A position paper from the Council on Cardiopulmonary and Critical Care, American Heart Association". Circulation. 86 (2): 699–702. PMID 1638735.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  41. ^ Matt GE, Quintana PJ, Hovell MF; et al. (2004). "Households contaminated by environmental tobacco smoke: sources of infant exposures". Tob Control. 13 (1): 29–37. doi:10.1136/tc.2003.003889. PMC 1747815. PMID 14985592. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  42. ^ Winickoff JP, Friebely J, Tanski SE; et al. (2009). "Beliefs about the health effects of "thirdhand" smoke and home smoking bans". Pediatrics. 123 (1): e74–9. doi:10.1542/peds.2008-2184. PMID 19117850. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  43. ^ Rabin, Roni Caryn (2009-01-02). "A New Cigarette Hazard: 'Third-Hand Smoke'". New York Times. Retrieved 2009-01-12.
  44. ^ "Disparity in Protecting Food Service Staff from Secondhand Smoke Shows Need for Comprehensive Smoke-Free Policies, Say Groups".
  45. ^ Schick S, Glantz S. (2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tob Control. 14 (6): 396–404. doi:10.1136/tc.2005.011288. PMID 16319363.
  46. ^ Invernizzi G, Ruprecht A, Mazza R; et al. (2004). "Particulate matter from tobacco versus diesel car exhaust: an educational perspective". Tob Control. 13 (3): 219–21. doi:10.1136/tc.2003.005975. PMID 15333875. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  47. ^ Barnoya J, Glantz SA (2005). "Cardiovascular effects of secondhand smoke: nearly as large as smoking". Circulation. 111 (20): 2684–98. doi:10.1161/CIRCULATIONAHA.104.492215. PMID 15911719.
  48. ^ Otsuka R, Watanabe H, Hirata K; et al. (2001). "Acute effects of passive smoking on the coronary circulation in healthy young adults". JAMA. 286 (4): 436–41. doi:10.1001/jama.286.4.436. PMID 11466122. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  49. ^ Pulmonary-Emphysema-Induced-By-Passive-Smoking-An-Experimental-Study-In-Rats
  50. ^ Effects of long-term passive smoking on the mast cells in rat lungs
  51. ^ Steenland K (1992). "Passive smoking and the risk of heart disease". JAMA. 267 (1): 94–9. doi:10.1001/jama.267.1.94. PMID 1727204. {{cite journal}}: Unknown parameter |month= ignored (help)
  52. ^ a b Whincup PH, Gilg JA, Emberson JR; et al. (2004). "Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement". BMJ. 329 (7459): 200–5. doi:10.1136/bmj.38146.427188.55. PMID 15229131. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  53. ^ a b Several medical journal articles have described both the more toxic composition of secondhand smoke and the tobacco industry's unpublished research confirming this. For example, see:
    • Diethelm PA, Rielle JC, McKee M (2005). "The whole truth and nothing but the truth? The research that Philip Morris did not want you to see". Lancet. 366 (9479): 86–92. doi:10.1016/S0140-6736(05)66474-4. PMID 15993237.{{cite journal}}: CS1 maint: multiple names: authors list (link)
    • Schick S, Glantz S (2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tobacco control. 14 (6): 396–404. doi:10.1136/tc.2005.011288. PMID 16319363.
    • Schick S, Glantz SA (2006). "Sidestream cigarette smoke toxicity increases with aging and exposure duration". Tobacco control. 15 (6): 424–9. doi:10.1136/tc.2006.016162. PMID 17130369.
    • Schick SF, Glantz S (2007). "Concentrations of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in sidestream cigarette smoke increase after release into indoor air: results from unpublished tobacco industry research". Cancer Epidemiol. Biomarkers Prev. 16 (8): 1547–53. doi:10.1158/1055-9965.EPI-07-0210. PMID 17684127.
  54. ^ "Passive smoking danger was underestimated, by Gaia Vince New Scientist 2004 June 30". Retrieved 2007-07-24.
  55. ^ "Fact sheet published by the Victorian government (Australia)". Retrieved 2006-07-26.
  56. ^ Taylor R, Najafi F, Dobson A (2007). "Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent". International Journal of Epidemiology. 36: 1048. doi:10.1093/ije/dym158. PMID 17690135.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  57. ^ Stayner L, Bena J, Sasco AJ; et al. (2007). "Lung cancer risk and workplace exposure to environmental tobacco smoke". American journal of public health. 97 (3): 545–51. doi:10.2105/AJPH.2004.061275. PMID 17267733. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  58. ^ "Health effects of indoor air pollution". Retrieved 2006-07-26.
  59. ^ Wirth; et al. (2005). "Passive smoking". Rev Pneumol Clin. 61 (1 Pt 1): 7–15. PMID 15772574. {{cite journal}}: Explicit use of et al. in: |author= (help)
  60. ^ a b "France to ban smoking in public". BBC. 2006-10-08. Retrieved 2006-10-09.
  61. ^ Thompson, Andrea (2007-08-31). "Secondhand Smoke Causes Cancer in Pets". LiveScience. Retrieved 2007-08-31.
  62. ^ Snyder LA, Bertone ER, Jakowski RM, Dooner MS, Jennings-Ritchie J, Moore AS. (2004). "p53 expression and environmental tobacco smoke exposure in feline oral squamous cell carcinoma". Vet Pathol. 41 (3): 209–14. doi:10.1354/vp.41-3-209. PMID 15133168.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  63. ^ Reif JS, Dunn K, Ogilvie GK, Harris CK. (1992). "Passive smoking and canine lung cancer risk". Am J Epidemiol. 135 (3): 234–9. PMID 1546698.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  64. ^ Drope J, Chapman S (2001). "Tobacco industry efforts at discrediting scientific knowledge of environmental tobacco smoke: a review of internal industry documents". Journal of epidemiology and community health. 55 (8): 588–94. doi:10.1136/jech.55.8.588. PMID 11449018.
  65. ^ "Smoking and health research activities in Europe" (PDF). Philip Morris document archive. Retrieved 2007-08-10. {{cite web}}: External link in |publisher= (help)
  66. ^ a b Boffetta P, Agudo A, Ahrens W; et al. (1998). "Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe". J. Natl. Cancer Inst. 90 (19): 1440–50. doi:10.1093/jnci/90.19.1440. PMID 9776409. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  67. ^ a b c d e f Kessler, Gladys (August 17, 2006). "United States of America v. Philip Morris et al" (PDF). United States District Court for the District of Columbia. Retrieved 2007-07-29.
  68. ^ "Environmental Tobacco Smoke" (PDF). 11th Report on Carcinogens. U.S. National Institutes of Health. Retrieved 2007-08-27.
  69. ^ "Secondhand Smoke Fact Sheet". U.S. Centers for Disease Control and Prevention. Retrieved 2007-08-27.
  70. ^ "Health Effects of Exposure to Environmental Tobacco Smoke". U.S. National Cancer Institute. Retrieved 2007-08-22.
  71. ^ "Health Effects of Exposure to Secondhand Smoke". United States Environmental Protection Agency. Retrieved 2007-09-24.
  72. ^ "The Truth about Secondhand Smoke". American Heart Association. Retrieved 2007-08-27.
  73. ^ "Secondhand Smoke Fact Sheet". American Lung Association. Retrieved 2007-09-24.
  74. ^ "Secondhand Smoke". American Cancer Society. Retrieved 2007-08-27.
  75. ^ "AMA: Surgeon General's secondhand smoke report a wake-up call to lawmakers" (Press release). American Medical Association. Retrieved 2007-08-27.
  76. ^ "Tobacco's Toll: Implications for the Pediatrician". American Academy of Pediatrics. Retrieved 2007-10-02.
  77. ^ "National Response to Passive Smoking in Enclosed Public Places and Workplaces" (PDF). Australian National Public Health Partnership. November 2000. Retrieved 2007-09-11.
  78. ^ Two relevant reports have been published by the Scientific Committee:
    • A 1998 report of the SCOTH concluded that passive smoking was a cause of lung cancer, heart disease, and other health problems.
    • A 2004 update by the SCOTH, reviewing new evidence published since the 1998 report, found that recent research had confirmed the initially reported link between passive smoking and health risks.
  79. ^ a b Novak K (2007). "Passive smoking: out from the haze". Nature. 447 (7148): 1049–51. doi:10.1038/4471049a. PMID 17597735.
  80. ^ Enstrom JE, Kabat GC (2003). "Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98". BMJ. 326 (7398): 1057. doi:10.1136/bmj.326.7398.1057. PMID 12750205.
  81. ^ Davey Smith G (2003). "Effect of passive smoking on health". BMJ. 326 (7398): 1048–9. doi:10.1136/bmj.326.7398.1048. PMID 12750182.
  82. ^ Tong EK, Glantz SA (2007). "Tobacco industry efforts undermining evidence linking secondhand smoke with cardiovascular disease". Circulation. 116 (16): 1845–54. doi:10.1161/CIRCULATIONAHA.107.715888. PMID 17938301.
  83. ^ "American Cancer Society Condemns Tobacco Industry Study for Inaccurate Use of Data" (PDF) (Press release). American Cancer Society. 2003-05-13. Retrieved 2007-08-29.
  84. ^ "PROPOSED RESEARCH ON THE RELATIONSHIP OF LOW LEVELS OF ACTIVE SMOKING TO MORTALITY: Letter from James Enstrom to Philip Morris Scientific Affairs office". 1997-01-01. Retrieved 2007-08-29.
  85. ^ a b Ong EK, Glantz SA (2000). "Tobacco industry efforts subverting International Agency for Research on Cancer's second-hand smoke study". Lancet. 355 (9211): 1253–9. doi:10.1016/S0140-6736(00)02098-5. PMID 10770318.
  86. ^ Dalton R (2007). "Passive-smoking study faces review". Nature. 446 (7133): 242. doi:10.1038/446242a. PMID 17361147. {{cite journal}}: Unknown parameter |month= ignored (help)
  87. ^ Enstrom JE (2007). "Defending legitimate epidemiologic research: combating Lysenko pseudoscience". Epidemiol Perspect Innov. 4 (1): 11. doi:10.1186/1742-5573-4-11. PMID 17927827.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  88. ^ url=http://www.scientificintegrityinstitute.org/HumeUCOP101607.pdf
  89. ^ url=http://www.bmj.com/cgi/eletters/326/7398/1057
  90. ^ ETS / IAQ SCIENTIFIC CONSULTANTS, from the Legacy Tobacco Documents Archive. Retrieved July 19, 2007.
  91. ^ http://www.cato.org/pubs/regulation/regv30n1/v30n1-5.pdf
  92. ^ Smoked Out: Pundit for Hire, by Paul D. Thacker. Published in The New Republic on January 26, 2006. Retrieved August 22, 2007.
  93. ^ Philip Morris budget for "Strategy and Social Responsibility", listing Milloy as a paid consultant. Retrieved August 22, 2007.
  94. ^ "Secondhand Joking", by Steven Milloy. Retrieved August 22, 2007.
  95. ^ Samet JM, Burke TA (2001). "Turning science into junk: the tobacco industry and passive smoking". American journal of public health. 91 (11): 1742–4. doi:10.2105/AJPH.91.11.1742. PMID 11684591.
  96. ^ Scientific Communications Through the Media, from the Philip Morris document archive. Retrieved October 3, 2007. Also cited in Ong EK, Glantz SA (2001). "Constructing "sound science" and "good epidemiology": tobacco, lawyers, and public relations firms". American journal of public health. 91 (11): 1749–57. doi:10.2105/AJPH.91.11.1749. PMID 11684593.
  97. ^ a b Ong EK, Glantz SA (2001). "Constructing "sound science" and "good epidemiology": tobacco, lawyers, and public relations firms". American journal of public health. 91 (11): 1749–57. doi:10.2105/AJPH.91.11.1749. PMID 11684593.
  98. ^ "Passive Smoking Doesn't Cause Cancer —Official".
  99. ^ "Smokescreens - The World Health Organization is showing signs of allowing politics to get in the way of truth. The Economist March 14th, 1998" (PDF).
  100. ^ Le Grand C. Anti-smokers blown away by study. Australian 1998, March 10.
  101. ^ WHO Rejects smoking link with lung cancer. Zimbabwe Independent 1998, Oct 23.
  102. ^ No Link Between Passive Smoking and Lung Cancer. The Times 1998, March 9.
  103. ^ "Passive Smoking Does Cause Lung Cancer, Do Not Let Them Fool You".
  104. ^ Blot WJ, McLaughlin JK (1998). "Passive smoking and lung cancer risk: what is the story now?". J. Natl. Cancer Inst. 90 (19): 1416–7. doi:10.1093/jnci/90.19.1416. PMID 9776401.
  105. ^ "Tobacco Companies Strategies to Undermine Tobacco Control Activities at the World Health Organization" (PDF). Retrieved 2008-12-30.
  106. ^ "The Osteen Decision".
  107. ^ "Flue-Cured Tobacco Cooperative vs. EPA" (PDF). Retrieved 2008-12-30.
  108. ^ "Final Report on Carcinogens - Background Document for Environmental Tobacco Smoke" (PDF), Meeting of the NTP Board of Scientific Counselors - Report on Carcinogens Subcommittee, Research Triangle Park, North Carolina, December 2–3, 1998 {{citation}}: |editor-first= missing |editor-last= (help); Cite has empty unknown parameters: |coeditors= and |coauthors= (help)CS1 maint: date format (link) CS1 maint: location missing publisher (link) CS1 maint: multiple names: editors list (link)
  109. ^ Thun MJ (2003). "Passive smoking: tobacco industry publishes disinformation". BMJ. 327 (7413): 502–3, author reply 504–5. doi:10.1136/bmj.327.7413.502-c. PMID 12946979.
  110. ^ a b Barnes DE, Bero LA (1998). "Why review articles on the health effects of passive smoking reach different conclusions". JAMA. 279 (19): 1566–70. doi:10.1001/jama.279.19.1566. PMID 9605902.
  111. ^ Tong EK, England L, Glantz SA (2005). "Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry". Pediatrics. 115 (3): e356–66. doi:10.1542/peds.2004-1922. PMID 15741361.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  112. ^ Executive Summary of the U.S. Surgeon General's 2006 report on passive smoking; see p. 21.
  113. ^ a b c "Minutes of a meeting of Philip Morris with British tobacco companies to discuss tobacco-industry strategy on passive smoking". Retrieved 2007-08-27.
  114. ^ A STUDY OF PUBLIC ATTITUDES TOWARD CIGARETTE SMOKING AND THE TOBACCO INDUSTRY IN 1978, produced for the Tobacco Institute and released under the terms of the Tobacco Master Settlement Agreement.
  115. ^ Smith EA, Malone RE (2007). "'We will speak as the smoker': the tobacco industry's smokers' rights groups". Eur J Public Health. 17 (3): 306–13. doi:10.1093/eurpub/ckl244. PMID 17065174. {{cite journal}}: Unknown parameter |month= ignored (help)
  116. ^ Trotter L, Chapman S (2003). ""Conclusions about exposure to ETS and health that will be unhelpful to us": how the tobacco industry attempted to delay and discredit the 1997 Australian National Health and Medical Research Council report on passive smoking". Tob Control. 12 (Suppl 3:iii): 102–6. doi:10.1136/tc.12.suppl_3.iii102. PMID 14645955.
  117. ^ Garne D, Watson M, Chapman S, Byrne F (2005). "Environmental tobacco smoke research published in the journal Indoor and Built Environment and associations with the tobacco industry". Lancet. 365 (9461): 804–9. doi:10.1016/S0140-6736(05)17990-2. PMID 15733724.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  118. ^ Executive Summary of the U.S. Surgeon General's Report, 2006.
  119. ^ The most current positions of major tobacco companies on the issue of passive smoking can be found on their websites. As of 13 January 2009, the following websites contain tobacco-industry positions on the topic:
  120. ^ Market Research World
  121. ^ "Reduction in the Incidence of Acute Myocardial Infarction Associated with a Citywide Smoking Ordinance". American Heart Association. 2006-10-03. Retrieved 2007-01-18. {{cite web}}: Cite has empty unknown parameter: |coauthors= (help)
  122. ^ Geens, Andrew (March 2005). "No ifs or butts". Building Sustainable Design. Retrieved January 28, 2009. {{cite web}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  123. ^ Drope J, Bialous SA, Glantz SA (2004). "Tobacco industry efforts to present ventilation as an alternative to smoke-free environments in North America". Tob Control. 13 Suppl 1: i41–7. doi:10.1136/tc.2003.004101. PMC 1766145. PMID 14985616. The industry developed a network of ventilation 'experts' to promote its position that smoke-free environments were not necessary, often without disclosing the financial relationship between these experts and the industry. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  124. ^ "Environmental Tobacco Smoke: Position Document" (PDF). American Society of Heating, Refrigerating and Air-Conditioning Engineers. June 30, 2005. Retrieved January 28, 2009.
  125. ^ "The Health Consequences of Involuntary Exposure to Tobacco Smoke" (PDF). Executive Summary. Surgeon General of the United States. 2006. Retrieved January 28, 2009.
  126. ^ "Institute for Health and Consumer Protection Activity Report 2003" (PDF). European Commission Joint Research Centre. 2003. Retrieved January 28, 2009.
  127. ^ "Guidelines on the Protection from Exposure to Secondhand Smoke" (PDF). Framework Convention for Tobacco Control. World Health Organization. 2007. Retrieved January 29, 2009.
  128. ^ Haveman, Robert (September 25, 2005). "Let Bars Buy, Sell Smoking Permits". Wisconsin State Journal. p. B2. Retrieved January 28, 2009. {{cite news}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
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