ROCHESTER, MINN. -- An analysis of tobacco-industry documents published in the September issue of the American Journal of Public Health finds that the industry went to great lengths to battle the environmental tobacco smoke (ETS) issue by camouflaging its

Researchers from Mayo Clinic, the University of Minnesota, an ETS expert and an independent tobacco document specialist came to this conclusion after reviewing and analyzing more than 1,500,000 pages of tobacco-industry internal documents filed between 1988 and 1993. The 1998 Minnesota tobacco settlement required U.S. tobacco companies and the British American Tobacco Company to provide public access to these documents. "The tobacco industry’s campaign to produce scientific research and influence public opinion on health consequences associated with ETS was developed to protect the financial and political interests of the companies," says Richard D. Hurt, M.D., an author of the study and medical director of the Mayo Clinic Nicotine Dependence Center. "As long as the industry could deny the health risk associated with ETS, they met their goal -- preserving the status quo." Background Concerns regarding the health efforts of ETS began as early as 1973 when the U.S. Civil Aeronautics Board required nonsmoking areas on all commercial airplanes. Investigation of ETS as a source of indoor air pollution and a potential carcinogen increased through the 1980s. An early 1990s investigation showed that approximately 37,000 annual heart disease deaths among nonsmokers occur in the U.S. due to ETS exposure. The U.S. Environmental Protection Agency (EPA) released a report in 1993 attributing 3,700 annual U.S. lung cancer deaths to ETS and classifying it as a group A carcinogen. Other group A carcinogens include arsenic, asbestos, benzene and radon. Five months after the release of the report, the tobacco industry filed suit against the EPA in an attempt to force withdrawal of the conclusion that ETS was a group A carcinogen. Findings The documents that the authors reviewed reveal that the tobacco industry feared the ETS issue and any governmental regulation of smoking in public places because both would significantly decrease cigarette consumption, decrease industry profits, increase litigation, and weaken support from business owners and politicians. The documents also showed: * A Phillip Morris Inc. executive identified the ETS issue as the "single most important challenge we currently face." A 1993 industry-funded group estimated that three to five fewer cigarettes smoked per day as a result of smoking restrictions would reduce annual profits by more than $1 billion per year. * Industry-retained attorneys feared that fall-out from the ETS issue would result in an increase in product liability, workers’ compensation and other ETS exposure litigation surrounding secondhand smoke. * The Center for Indoor Air Research (CIAR), a nonprofit organization funded by the tobacco industry, was formed in March of 1988 to sponsor research on indoor air issues. From 1989 to 1999, CIAR funded at least 244 published studies and supported industry-funded scientists to produce seemingly independent results aimed at contradicting ETS findings and disclaiming the EPA report. Industry documents indicate that research funded by CIAR was ultimately under the control of the tobacco industry. CIAR was required to disband as part of the Master Settlement Agreement between the tobacco companies and the States Attorneys General. * During the years between the first and second drafts of the EPA risk assessment document that classified ETS as a group A carcinogen, Phillip Morris spent more than $16.5 million on a scientific campaign against the ETS issue. * An industrywide ETS consultant program (funded by American, Japanese and European tobacco companies) was fully functioning in the United States by 1988. Documents show that the consulting scientists were paid to disseminate industry messages against the EPA via symposia, scientific publications, submissions to the EPA and the media. "It is important for all to understand the lengths to which the tobacco industry will go to influence and confuse the public and policy makers on issues of public health," says Dr. Hurt, who was recently awarded a $2 million grant from the National Cancer Institute to study tobacco industry documents on ETS. "They did it in the 1950s when cigarette smoking was scientifically proven to cause heart disease and lung cancer, and they are doing it now because ETS is a hazardous environmental toxin."

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