Tobacco Newsletter June 5, 1994

CONTENTS:

HEALTH

Substance Abuse Kills 200,000 Women a Year
Smoking Increases Breast Cancer Deaths, Study Finds
Smokers' Babies Have More Limb Defects, Study Finds
Pollution Damages Lungs as Much as Smoking, Study Finds
Green Tea Found to Reduce Esophageal Cancer by 50%
Patch Increases Quit-rate, British Study Shows
Psoriasis Cure Burns Smoker

FEDERAL

Council For Tobacco Research: Devil or Angel?
Justice Dept. Investigation of Tobacco Industry Urged

LOCAL

NJ: High Schools Taking Smokers to Court
FL, MS, WV: The South vs. Tobacco
OH: Cincinnati Bans Tobacco Ads
CA: PM Petition on Nov. Ballot
CA: Minors Buying Cigs Easily

INTERNATIONAL

CUBA Raises Price of Cigarettes
ARGENTINA: Buenos Aires vs. Underage Smoking
W.H.O. Urges Tobacco Ad Bans
PORTUGAL: PM Gaining Share
CYPRUS vs. Smokers
SLOVAKIA: Cig Makers Battle Law
EASTERN EUROPE: Invasion Continues
BULGARIA: Tobacco Farmers Switch to Opium
IRAQ: Tobacco Prices Raised
JAPAN: Parliament Quits Smoking for a Day
CONGO: School Cig Kiosks Destroyed
AUSTRALIA: Marijuana & Tobacco

SOCIETY

Flat Earth Society vs. Smoking

HEALTH

SUBSTANCE ABUSE KILLS 200,000 WOMEN A YEAR

New York, NY June 2, 1994. Substance-abuse is by far the number one killer of women in the US today, former Secretary of Health Education and Welfare Joseph Califano told a Manhattan symposium today.

While 46,000 women will die of breast cancer this year, 200,000 will die of tobacco, alcohol and other drug-related illnesses, Califano said. 77% of those will die of tobacco-related illnesses, 20% of alcohol-related illnesses, and 3% from drug-related illnesses. The deadliest drugs, Califano pointed out, are the legal ones.

"These numbers represent a vast yet preventable tragedy among American women, that knows no boundaries of class or race," he said. "Tobacco, alcohol and drugs pose a savage threat to the health and well-being of women and their families, ravaging newborn babies, leaving thousands of children motherless, and precipitating violence against women and children in record numbers. An all out attack on substance abuse and addiction is essential to deal with these problems."

Mr. Califano spoke at the "Women and Substance Abuse: A Family Problem, A National Crisis," a symposium hosted by The Robert Wood Johnson Foundation and Califano's Center on Addiction and Substance Abuse at Columbia University (CASA). He also said more young women are using drugs than ever before.

"It took years to understand the reality of fetal alcohol syndrome and the damage of smoking, and it took the drama of crack babies to drive home to the nation how vulnerable the fetus is to what a woman eats, drinks and smokes."

Betty Ford also spoke at the symposium, along with her daughter. They discussed the painful events that ensued when her family finally confronted her about her 15-year addiction to alcohol and prescription drugs.

SMOKING INCREASES BREAST CANCER DEATHS, STUDY FINDS

May 30, 1994. A recent 6-year study of over 600,000 women has found smokers are up to 25% more likely to die of breast cancer than nonsmokers. Death rates increased with the number of cigarettes smoked--two-pack a day smokers were 75% more likely to develop fatal breast cancer. Former smokers had the same death rates as nonsmokers.

By no means should the study be construed to indicate smoking causes breast cancer. In fact, most scientists believe smoking may inhibit the onset of breast cancer due to its negative influence on estrogen levels.

Rather, said the study's director Dr. Eugenia E. Calle, an epidemiologist at the American Cancer Society, "Our results suggest that current smokers may be at increased risk of fatal breast cancer, either because of poorer survival or delayed diagnosis."

Women who smoke, she said, are thought to have diminished immune systems. They also may be more likely to develop complications from other diseases, such as heart or lung problems.

The study was published in the American Journal of Epidemiology, and is part of the American Cancer Society's massive Cancer Prevention Study which was begun in 1982 and involves 1.2 million men and women.

SMOKERS' BABIES HAVE MORE LIMB DEFECTS, STUDY FINDS

London. June 2, 1994. A Hungarian study of 905 mother/baby pairs has found smokers' babies tend to have more limb defects, according to a report in the British Medical Journal.

"Smoking during pregnancy was 60 percent more common among mothers of children with terminal transverse defect," researchers from the National Institute of Hygiene in Budapest wrote. "The differences are more obvious in smoking during the second and third trimesters."

The researchers said 20% of Hungarians smoked during pregnancy.

While the study adjusted for drinking, it did not control for nutritional factors.

POLLUTION DAMAGES LUNGS AS MUCH AS SMOKING, STUDY FINDS

Los Angeles, CA. May 30, 1994. A UCLA/American Lung Association study has found that pollution can create as large a decline in lung function as smoking. According to UPI's Lidia Wasowicz, the study found that "non- smoking men living in the most polluted areas had greater declines in lung function than smokers from the cleanest areas."

The worst lung function was found in men who both smoked and lived in polluted areas. Air pollution, the study authors said, contains many of the same lung-damaging ingredients as tobacco smoke.

GREEN TEA FOUND TO REDUCE ESOPHAGEAL CANCER BY 50%

Washington, May 31, 1994. A large epidemiological study has found that drinking green tea may help prevent the incidence of esophageal cancer by as much as 60% in Asian men and women. The study involving almost 2500 Chinese confirmed previous animal studies which have found a similar correlation. It is the first to show the correlation in humans, and its author said more studies are needed.

The study found smokers, drinkers, and imbibers of burning-hot liquids like soup--serious risk factors for esophageal cancer--did not receive the full benefits of green tea's effects.

The effects are believed due to anti-oxidant, cancer-inhibiting properties of polyphenol compounds in green tea.

Green tea, which is used mainly in Asian countries, is made by steaming, rolling and crushing the tea leaves. Black tea, which accounts for 80% of the tea used in the US, is made by heating the leaves.

The following is a full report from CancerNet:

STUDY FINDS GREEN TEA MAY PROTECT AGAINST ESOPHAGEAL CANCER

Researchers, reporting on a case-control study appearing in the June 1, 1994 issue of the Journal of the National Cancer Institute, found that Chinese men and women who drink green tea have a reduced risk of esophageal cancer of up to 60 percent.

Researchers from the National Cancer Institute (NCI) and the Shanghai Cancer Institute used a cancer registry to identify 902 esophageal cancer patients from urban Shanghai, People's Republic of China. This esophageal cancer study is part of a larger, multisite study that included pancreatic, colon, and rectal cancers.

"This is the first epidemiologic study to demonstrate that green tea may protect against esophageal cancer in humans," said Joseph McLaughlin, Ph.D., the lead researcher from NCI.

Animal studies have shown green tea infusions and extracts to protect against esophageal cancer, but this study is the first research in humans to support the experimental evidence, McLaughlin said.

Because 80 percent of tea consumed worldwide is black tea, there have been few studies on green tea, which is consumed mainly in Asian countries. Furthermore, studies of this large size in Asia have been nonexistent until a few years ago.

Patients aged 30 to 74 years, who were diagnosed with esophageal cancer between October 1990 and January 1993, were interviewed about residential and medical history, height and weight, diet, smoking habits, alcohol use, tea consumption, family cancer history, occupation, physical activity and reproductive history. There were 1,552 people without the disease (control subjects) who answered the same questions.

Information about tea consumption included types of tea consumed, frequency, and age at which tea drinking began. Researchers measured consumption in grams of tea leaves consumed per month. A tea drinker was defined as someone who drank at least one cup of tea per week for six months or longer.

The study found that drinking green tea was associated with a 50 percent lower risk of esophageal cancer in women. Among men, risk was also reduced, but this finding was not statistically significant. However, green tea drinking was linked to a 60 percent reduction of esophageal cancer among both men and women who did not smoke.

Individuals who drank burning-hot fluids (tea and soup) did not reap full benefits from the green tea -- which lowered, but did not eliminate cancer risk. These people experienced a fivefold increase in esophageal cancer risk over people who did not drink burning-hot liquids. Studies in China and other countries have shown that such repeated thermal irritation of the esophagus is likely responsible for the drinkers' increased esophageal cancer risk. Subjects who drank green tea in the absence of burning-hot fluids had significantly lowered cancer risk.

Scientists speculate that the protective effects of green tea arise out of polyphenol compounds in the tea. Polyphenols are a class of compounds that have strong antioxidant properties, the ability to halt enzymes that produce carcinogens, and are also able to inhibit cancer cell growth.

According to McLaughlin additional epidemiologic studies are needed to confirm the findings from this research. Should they be confirmed, McLaughlin believes that clinical trials should be undertaken to determine the preventative effects of green tea. These trials would allow researchers to better understand the biochemical mechanisms involved in the inhibition of esophageal cancer and to determine whether green tea can truly prevent its occurrence.

This year, about 11,000 Americans will be diagnosed with esophageal cancer, while 10,400 people will die of the disease.

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This document is available through the National Cancer Institute's CancerFax and CancerNet services, and in the News Section of the NCI's PDQ database. To get the document from CancerFax, dial (301) 402-5874 from the handset on your fax machine and follow the recorded instructions to receive the contents list. Individuals who have access to the Internet may access the document on CancerNet, through an electronic mail service or via the NIH gopher.

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PATCH INCREASES QUIT-RATE, BRITISH STUDY SHOWS

London, June 2, 1994. A recent British study found that 11% of smokers who kick the habit using a nicotine patch were able to quit for a year, whereas only 7% of those given a placebo patch were able to quit for a year.

The Imperial Cancer Research Fund published the study's findings in the British Medical Journal.

Various American patch studies have reported quit-rate ranges between 9-25%

PSORIASIS CURE BURNS SMOKER

Boston, May 15, 1994. A smoker taking a psoriasis cure which involved tar treatments set fire to one other thing besides his cigarette today--himself.

The smoker was unharmed, but when he lit his cigarette in the hospital courtyard, according to Reuters, "flames appeared at the top of his chest and spread to form a small ring of fire encircling his neck."

He quickly doused the flames, according to a report on the incident in the New England Journal of Medicine.

The tar used in the treatment of some skin conditions contains 5-15% alcohol, which had seeped into the patient's pajamas, creating a flammable condition.

The occurrence "illustrates the importance of obtaining a smoking history," doctors advised, and patients, "should be warned about the danger of smoking during treatment."

The doctors warned the danger can be even worse: patients with psoriasis often have lung disease, and are receiving oxygen.

FEDERAL

COUNCIL FOR TOBACCO RESEARCH: DEVIL OR ANGEL?

Washington. May 27, 1994. Is the Council for Tobacco Research a legitimate, impartial and important research facility which happens to be funded by the tobacco industry or is it "public relations masquerading as science," as claimed by Senator Henry A. Waxman (D-CA)?

This was the question addressed today by Waxman's House Energy and Commerce Committee's subcommittee on health and the environment.

Waxman released a flurry of papers--a report, studies, and corporate memos--from the industry's former PR firm. The papers showed, he said, that "from the very beginning, the council was a public relations ploy - a seemingly independent research body whose real purpose was to promote the idea that smoking is safe."

James Glenn, chairman and CEO of the New York City-based CTR, "reddened with anger," according to reports, as he "vehemently" denied the charge in a "contentious" appearance before the subcommittee.

"We are scientists and we seek scientific truth," Glenn, a surgeon and urologist who has headed the CTR for 4 years, said. "The industry exercises no control over our activities."

The two views of the CTR were diametrically opposed, although apparently the most damaging documents covered only CTR's early years, 1954-1956.

While Waxman's new shower of documents from the institute's first PR firm seemed to confirm the case for the CTR as a superbly effective public relations effort--at least in in its first few years--Waxman had a far more difficult time casting doubt on its later activities--save for unanswered questions about the exact nature and ownership of recent industry-suggested research. These projects remain undisclosed, having been ruled subject to attorney-client privilege.

The CTR was established in 1953. At the time, increasingly persuasive epidemiological studies on smoking's harmfulness were being published, but it was when Dr. Richard Doll painted tar taken from tobacco smoke on the backs of mice, producing tumors in 44% of them, that the industry felt it needed to react.

On December 15, 1953, at the Plaza Hotel in New York City, John Hill, founder of the PR firm Hill and Knowlton, met with the heads of major tobacco companies to consider how to combat the mounting scientific evidence linking tobacco with disease. According to a Hill & Knowlton memo, the company execs felt "they should sponsor a public relations campaign that is positive in nature and is entirely `pro-cigarette."

A H&K memo two weeks later apparently suggested to the companies that "the underlying purpose of any activity at this stage should be reassurance of the public through wider communication of facts to the public. It is important that the public recognize the existence of weighty scientific views which hold there is no proof that cigarette smoking is a cause of lung cancer."

Thus was the CTR--nee the Tobacco Industry Research Council--born. Later in 1954, a H&K memo suggested the CIRC "sponsor genuinely objective research and . . . bring to public attention the fact that there is now no conclusive proof that cigarette smoking is a cause of lung cancer or other serious problems of human health."

35 Hill & Knowlton publicists worked at the CIRC in its second year, striving to counteract damaging medical reports, and nearly half the CIRC's first year's expenses went to PR efforts, some of which included:

--sending booklets questioning the evidence of smoking's hazards to every doctor in the US.
--meeting with major news organizations to emphasize, in the words of a 1955 H&K memo, "the need for editorial responsibility in handling stories that rouse unwarranted fears." Staff met with journalists from the New York Times, Washington Post, Time and Newsweek, among others. One H&K memo contains a long list of contacted journalists--including Edward R. Murrow, Fred Friendly and William Randolph Hearst Jr.
--hiring writers to turn in appropriate articles for magazines
--seeking out studies and researchers which agreed with the industry's position, and promoting them heavily to the media.
--planting their own people in anti-smoking groups

The subcommittee report stated that such activities "ultimately succeeded in shifting national opinion."

In the sixties, the research conducted by the CTR followed two paths: one was scientific research by reputable scientists (3 later became Nobel Laureate's, one of whom, Harold E. Varmus, now heads the National Institutes of Health); the other, named "special projects" consisted of research selected by the industry and "vetted by corporate counsel," according to John Schwartz of the Washington Post.

Schwartz also wrote that Glenn testified that at this time the "CTR has no such 'special projects,'" nor a public relations function. In seeming contrast, the Times' Philip J. Hilts wrote that Glenn admitted CTR had indeed "also carried out 'special projects' that tobacco company lawyers recommended."

While Glenn stated he had not seen the H&K memos ("ancient history," were his words), he said he was proud of CTR's research, and that scientists were assured complete freedom. He said CTR had sponsored almost 1400 studies, and currently financed about $20 million worth of research a year in such areas as cancer, cardiovascular diseases and genetics. He said its files were open, and no research has been withheld from disclosure.

"I reject your premise that we are a biased organization, I reject the premise that smoking causes cancer and I reject the inference that our activities have been to obscure the truth," Glenn told the subcommittee. "On the contrary, they've been dedicated to developing scientific truth."

Hilts writes that when Glenn was asked about industry-suggested projects whose existence was uncovered in a New Jersey lawsuit, he claimed the CTR had done hundreds of such, but that he "did not count them as part of the council's regular work because they had been suggested by lawyers within the tobacco companies and were only administered by the council."

Waxman questioned Glenn about 1500 such documents that lawyers in the lawsuit had been denied access to because they were protected by attorney-client confidentiality.

Glenn said the court had erred when it said the documents belonged to the CTR.

When asked if he believed smoking caused cancer, Glenn said, "No, sir." When asked if he believed smoking was addictive, he said, "No, sir."

When asked if the CTR had ever done research to determine if smoking caused disease, he said no--rather, the CTR focused on the mechanisms of disease at a molecular level. He cited work on a genetic library of familial cancers, and the identification of cell growth factors.

Much of the hearing focused on a front-page Wall St. Journal article of Feb. 11, 1993, which called its activities ""the longest-running misinformation campaign in U.S. business history."

Dr. Glenn said the Wall St. Journal article was "totally misrepresentative of our activities" and contained "so many inaccuracies . . . it would be impossible to make a full defense."

The Journal's managing editor, Paul Steiger, said, "we believe the story to be accurate and fair, and in the 15 months since it appeared, no one from the industry has questioned a single fact in the piece."

Dr. Glenn is also chief of staff at the University of Kentucky Medical College Hospital. He has been president of New York's Mount Sinai Medical Center and dean of Emory University's medical school.

While much of the information revealed today is not new, and while the CTR has often been criticized, the release of the H&K memos shed a fuller light on CTR's birth and operations.

The papers were part of the estate of H&K founder John Hill, and had been on file at Wisconsin's state historical society

H&K stopped representing the CTR in the late 60s, and according to an H&K vice-president, no longer represents any tobacco companies.

JUSTICE DEPT. INVESTIGATION OF TOBACCO INDUSTRY URGED

Washington, May 27, 1994 Seven Congressmen asked Attorney General Janet Reno to open a criminal investigation of several tobacco companies for perjury, racketeering, conspiracy to defraud the public, conspiracy in restraint of trade, mail fraud and wire fraud, among other charges. The Congressmen accuse the tobacco companies of staging a decades-long campaign to hide the harmfulness and addictiveness of cigarettes from congress and the public.

A letter sent to Reno by Representative Martin T. Meehan (D-MA) read in part,

"We believe a criminal investigation is warranted by information contained in the industry's own internal documents revealed in recent weeks . . . Documents and testimony before Mr. Waxman's panel offer compelling evidence that tobacco companies -- through their executives, their lawyers, their advertising agencies, their lobbyists, their public relations agents, their scientists and their trade association officials -- have committed a series of serious crimes over a period of several decades."

In addition, documents from the Brown and Williamson Tobacco Corp., the letter said, indicated that "the tobacco companies conspired to suppress competition in the marketing of less hazardous cigarettes."

"Evidence is also accumulating that company executives perjured themselves when they testified that they had no knowledge of nicotine's addictive properties."

"Failure to hold cigarette companies and their executives fully accountable for such criminal activities would allow them to continue criminal activities that ultimately cause massive numbers of premature deaths."

The letter was also signed by Mike Synar (D-OH); Pete Stark (D-CA); Richard J. Durbin (D-IL); James V. Hansen (R-UT); Peter J. Visclosky (D-IN), and Thomas M. Foglietta (D-PA).

LOCAL

NJ: HIGH SCHOOLS TAKING SMOKERS TO COURT

Pennington, NJ Robert Hanley, writing in the New York Times, cites 3 New Jersey high schools that have taken to legal action in order to control student smoking.

This issue is hot right now not only because schools may face liability issues in the future, but because of the upcoming ban on smoking in schools which receive federal funds. Smoking students could cost school districts money.

A 1989 New Jersey ban on school smoking empowered health officials to go to court against smokers.

--At Hopewell Valley Central High, smokers had virtually taken over the bathrooms, generating complaints from parents and students. But in mid-April the new schools superintendent, Dr. David N. Thomas, instituted a 5-day suspension policy he has used in other districts in Florida, California and Virginia. A second offence merits a 9-day suspension and a possible $100 court fine.

6 students have been suspended. There have been no second offenses.

"I've always controlled smoking in all high schools I've been associated with simply with the five-day suspension," Dr. Thomas said.

Thomas indicated he initially felt the second-offense penalties were harsh, but "The kids were prime for it. They were fed up to the teeth with going into smoky bathrooms."

"There's no reason for any schools not to have these things under control. It's just a lack of will," Thomas said.

"Smoking is off probably 95 percent," said Hopewell Valley Central's principal. "Our bathrooms, which used to be pretty doggone bad, are much, much, much, much better. We're approaching it from a health standpoint first and a legal standpoint second. We don't want our kids slowly killing themselves and killing their peers."

The school nurse's office provides candy, gum and lollipops to help smokers get through the day.

Princeton High is more lenient, choosing to treat violators with 45-minute detention periods, counseling, education about smoking and a free 8-week stop-smoking class at Princeton Hospital. Only on a third offence are smokers in danger of a possible $25 court fine.

The court fines at Hopewell and Princeton are based on a civil health statute, whereas Bernards High uses a state criminal law prohibiting smoking in a "public place."

Bernards' principal can request the police issue a misdemeanor complaint to 3-time offenders, who would then face prosecution and a possible $1000 fine.

2 Bernards students are awaiting hearings on such charges in Family Court.

FL, MS, WV: THE SOUTH VS. TOBACCO

May 10, 1994. Three states--Florida, Mississippi and West Virginia--have served notice on the tobacco companies that they hold them liable for millions of dollars of state monies spent on tobacco related diseases. The suits if successful could cost tobacco companies hundreds of millions of dollars a year, and seriously drive up the cost of cigarettes to cover added liability.

--Mississippi fired the opening round last May 22 by filing the historic first suit by a government that seeks to hold tobacco companies accountable for the effects of their product.

--Florida followed a few days later when a "stealth amendment" to a health care plan slipped past tobacco lobbyists. The amendment smooths the way for Florida to file a similar class-action suit. The amendment survived a tobacco industry assault June 10.

--West Virginia announced June 8 that it would file a suit.

--The subject is expected to be intensely discussed at the annual meeting of state attorneys general this month in San Antonio. If such suits are successful nationwide, the tobacco companies could spend their entire profit margin--$5-6 billion a year--compensating states for health care, according to Richard Daynard of the Tobacco Products Liability Project.

Jennifer Lew, managing lawyer for the Project, explained the difference in the Mississippi and Florida actions this way: "Mississippi filed its suit under existing common law, whereas Florida has changed the law to make it easier to bring this sort of case. It basically tilts the playing field in favor of the state and streamlines the process of getting money from the tobacco companies."

Such class action suits could legally:

--relieve the state from having to prove every detail of each individual case. A class action would enable the states to use statistical data not only to determine the proportion of illnesses caused by tobacco, but also to assign culpability to each company based on market share.

--take away the tobacco industry's traditional lawsuit-fighting stance that smokers know the risks of smoking, and each smoker makes his or her own free choice to accept that risk. The states claim that they made no choice, but are forced to pay massive amounts in Medicaid (health care for the elderly) payments, programs for indigents' health care, and state insurance premiums as a result of those choices.

1. MISSISSIPPI--The Shot Heard Round the States

May 23, 1994. The first shot was fired today in Pascagoula, as Mississippi's Attorney General sued every major tobacco company, their wholesalers and even a former public relations firm. The suit seeks unspecified reimbursement for the monetary damages the state has lost treating tobacco-related diseases due, according to the suit, to a decades-long conspiracy to "mislead and confuse the public about the true dangers associated with smoking cigarettes."

Additionally, the suit seeks to enjoin cigarette companies from "aiding, abetting or encouraging" cigarette sales to minors through campaigns like RJ Reynolds' Joe Camel.

The suit asks for damages "under the legal theories of unjust enrichment and common-law public nuisance," according to the Wall St. Journal.

Mississippi's suit claims the industry has conspired "intentionally, fraudulently and maliciously to mislead the public" and to sell products the industry's leaders know are "addictive and deadly".

State Attorney General Michael Moore said, "This lawsuit is premised on a simple notion -- you cause the health crisis, you pay for it. The free ride is over."

The attorney general's office said tobacco-related illnesses cost Mississippi $200 million a year. "It's going to be hundreds of millions of dollars for the costs of covering lung disease, low birth weight children, heart disease and emphysema," Moore told Reuter.

The suit also seeks punitive damages, and money for all future payments for tobacco-related illnesses as needed.

Though a team of private lawyers--some involved in other tobacco liability cases--have agreed to work on the case for free, their fees will be sought from the tobacco companies.

The suit is stridently opposed by Mississippi's conservative Republican governor Kirk Fordice, who said he wants "to throw up when I think of all the lawsuits going on in this country." He predicts the lawsuit will end up costing Mississippi money.

The tobacco industry indicates it will fight on the grounds that the state must prove its case for each individual smoker, rather than for smokers as a class.

A spokesperson for RJR Nabisco said, "It would appear that this is an unprecedented ploy for suing tobacco companies. Beyond that, it changes nothing."

Some of the companies sued were:

TOBACCO COMPANIES:

Philip Morris Cos.
RJ Reynolds Tobacco Co.
RJR Nabisco Inc. (parent)
American Tobacco Co.
Brown & Williamson Tobacco Corp.
Liggett Group Inc.
Brooke Group Ltd.
Loews Corp.
Lorillard Corp.
Batus Corp.

WHOLESALERS:

Corr-Williams Tobacco Co.
Generic Products Corp.
Laurel Cigar & Tobacco Co.
Long Wholesale Inc.
Lewis Bear Co.
Wiley and Culp Inc.

TRADE GROUPS:

The Tobacco Institute
The Council for Tobacco Research

PUBLIC RELATIONS:

Hill & Knowlton Inc.

The presence of Hill & Knowlton on this list is a bit of an eyebrow-raiser. H&K is the public relations firm which was intimately involved in the establishment of the industry's Council for Tobacco Research. Though the company has not represented the industry for over 30 years, Moore said that "they've known tobacco products were addictive and cause injury, and (were) part of a conspiracy to hide those facts from the American public."

The addition of a public relations firm "sounds very important," according to Bob Dilenschneider, chairman and chief executive officer of the Dilenschneider Group, a public-relations firm. Th Wall St. Journal. quotes him saying, "If the PR firm is found to be a party, and made to pay damages, it will probably deter other PR firms" from representing the tobacco industry.

The suit also indicates it may drag in law firms which represent tobacco interests.

2. FLORIDA--The Stealth Smart-Bomb

June 10, 1994. Florida went a step further than Mississippi when Gov. Lawton Chiles signed a kind of "smart bomb" bill which would hold companies individually and jointly liable for the financial costs to taxpayers of the health effects of their products and give the state tremendous advantages over lawsuits pressed on individual terms.

"We're going to take the Marlboro man to court,". Chiles said. "With this law, Florida sends a loud and clear message to the tobacco giants that they will be held accountable for sponsoring sickness and death."

The law allows Florida to bypass traditional industry arguments:

--It specifically denies a manufacturer's defense based on assumption-of-risk or comparative negligence. Florida may sue as a third party--a victim of unnecessary health care obligations--for illnesses caused by a manufacturer's products, whether consumers knew of the risks or not.

"The state is the innocent victim," said Florida's Agency for Health Care Administration general counsel Harold Lewis, who designed the bill. "The state didn't smoke the cigarettes. The state didn't read the warnings on the cigarette packs... . But the state has to pay the bills."

--It obviates the need to provide absolute medical proof smoking caused each individual's specific illness. Florida may use statistics to prove a more general link between smoking and illness.

"Individual smokers have had problems showing their particular disease was caused by smoking. It's not clear that it wasn't caused by something else," Gary Schwartz, a law professor at University of California at Los Angeles told Reuter.

"But when states sue on behalf of a large number of people they can at that point rely on statistics to show that even though smoking didn't cause all the heart diseases it still caused some significant fraction of them.

--It allows the state to use statistics to assign a formula by which it can assess each company's damages, rather than have to prove which brand(s) each individual smoked, and for how long. Lewis said market-share culpability has been used in suits involving asbestos and breast implants.

The legislation, part of the "Medicaid Third Party Recovery Act," has been dubbed the "stealth tobacco amendment" because it slipped past the tobacco industry as a little-noticed amendment to a Medicaid fraud bill, and never specifically mentioned tobacco.

The bill has been the subject of fierce political infighting. Its language is general enough that businesses fear it could be applied to numerous other products like beef, cars, liquor and pharmaceuticals.

"No product of any type that is permitted to be sold in this country should have all of its defenses taken away," said Jon Shebel, president of one of Florida's most prominent business associations, Associated Industries of Florida. "This law makes conviction automatic. There is just no way to defend yourself under this law and that is wrong."

Shebel said that under the law, sugar manufacturers could be held responsible for tooth decay and obesity. He called the measure unfair and un-American.

But supporters say the bill is actually pro-business. "Smoking costs approximately $4 billion in Florida each year in increased health costs and lost productivity. . . Most of these costs are borne by employers. This legislation will help correct this inequity by forcing tobacco to pay its fair share,' said a spokesperson for The Florida Tri-Agency Coalition on Smoking OR Health.

"This is good public policy and good for business. It puts the staggering financial burden of paying for smoking-related diseases on the tobacco industry's back -- right where it belongs," said a representative of the American Heart Association.

The Tobacco Institute disagreed. "This bill cheats thousands of Florida businesses and legitimate products out of the right to evidentiary protection and defenses," Walker Merryman said.

The Tobacco Industry waged an all-out battle at a four-day special session early in June to repeal the law, but lost. In the complex intertwining of issues at the session, which had been called to pass a bill to continue Chiles' ongoing health-care reform plan. The battle was costly to Chiles and health care supporters.

"Tobacco sent 50 lobbyists, paid them tremendous amounts of money and gave them the sole assignment of repealing the cigarette bill. And you know what? They were so strong they couldn't get a single senator to file a bill to repeal," said state Sen. W.D. Childers (D-Pensacola).

Republicans refused to pass either legislation. Democrats, though many were unhappy with the way Chiles got the "stealth" tobacco bill through, and with its provisions that might apply to any business, wanted to support his health bill. They tried to trade passage of the health bill for the tobacco bill, but no deal was made. The health bill is stalled, and the tobacco bill is due to go into effect July 1, excepting certain provisions that require federal approval.

3. WEST VIRGINIA--Filing Suit

The office of West Virginia Attorney General Darrell McGraw announced that it would also file a suit based on the Mississippi case.

OH: CINCINNATI BANS TOBACCO ADS

Cincinnati, OH. June 3, 1994. Cincinnati's City Council voted 6-3 today to ban tobacco ads on bus shelters and buses immediately, and to ban tobacco ads on all billboards in two years.

Under the ban, ads would be removed from Riverfront Stadium, home of the Cincinnati Bengals football team and the Cincinnati Reds baseball team.

The tobacco industry and the ACLU have said they may go to court to block the ban.

CA: PM PETITION ON NOV. BALLOT

Sacramento, CA June 10, 1994. The Philip Morris-sponsored "Uniform Tobacco Control Act" seems assured of a place on the November ballot now that a judge has refused to allow officials to determine if petition gatherers misrepresented the bill.

Acting Secretary of State Tony Miller had requested to survey petition signers who volunteered for the survey. He said his office had received hundreds of complaints of misrepresentation. Signature gatherers, Miller said, "went to extraordinary means" to prevent signers from learning that Philip Morris was the petition's sponsor. They also failed to mention the measure would preempt local laws.

Calling Miller's proposed survey "an unwarranted intrusion of the initiative process and the rights of the public," Superior Court Judge John R. Lewis refused to grant Miller an exception to the state law that requires petition signers' names be kept confidential.

Lewis heard the case after initiative sponsors objected to its being heard by Judge Ronald B. Robie, who they described as "prejudiced" against "the sponsors or their interests."

Miller said he would not have time to appeal the decision before the June 30 deadline for certification of the measure for the November ballot. State workers will continue certifying signatures.

In bringing the action, Millers had said, "I have concluded that there is probable cause to believe that Philip Morris engaged in a systematic scheme of deception designed to mislead voters in California and that such deception constitutes a violation of California election law."

"As a result, an unknown number of persons signed the petition under false pretenses, not realizing that the measure is sponsored by Philip Morris Inc. and that it is designed to replace community control of smoking in public places with a statewide standard," he said.

Miller released documents he claims show that gatherers were instructed to limit their "pitches" to the idea that the initiative would impose "statewide smoking restrictions" and that it would increase penalties for selling tobacco to minors.

The hired workers also apparently were told not to mention that Philip Morris was the sponsor, nor that the initiative would preempt stronger laws.

The smoking initiative committee's financial statements show Philip Morris provided $491,213 to qualify the measure. A few bars and restaurants provided the remaining $480.

The measure received almost 600,000 signatures--almost twice the 385,000 needed for certification.

The initiative would

--allow up to 25% to be a smoking section if ventilation standards were met.
--prohibit smoking in workplaces but allow it in private offices and conference rooms with occupants' consent.
--prohibit smoking in public places, but allow it in some hotel rooms, private functions in hotel assembly rooms, and gaming clubs.

CA: MINORS BUYING CIGS EASILY

Sacramento, CA. June 1, 1994. The largest such test in the nation has shown that minors can easily buy cigarettes, despite California state laws forbidding such sales.

In a semi-sting operation involving 400 underage volunteers at over 2,000 stores, supermarkets, pharmacies, gas stations, motels, restaurants and liquor stores, 55% were able to buy tobacco products. 85% of vending machine sales went uncontested.

"Parents, community leaders, and lawmakers who are thinking kids can't buy cigarettes because they are underage, better think again," said Kimberly Belshe, director of the Department of Health Services, which coordinated the operation.

The 1992 Federal law which mandates that states halve underage tobacco sales by 50% or risk losing grant money has impelled many states to look at the problem anew. California has three bills meant to reduce teen smoking currently working their way through the legislature.

One bill, sponsored by Democratic State Sen. Tom Hayden, would authorize the state to use underage kids to buy tobacco products in sting operations, and greatly increase fines, especially for repeat offenders. The bill just passed the state senate by a 31-2 vote, and now heads for the Assembly.

Ms. Belshe was the subject of some controversy when Governor Pete Wilson appointed her to the Dept. of Health. She had been the chief Southern California spokesperson against Prop. 99, the initiative which taxed cigarettes 25 cents a pack for anti-tobacco education. As head of the Dept. of Health, she is in charge of the very program she fought against.

INTERNATIONAL

CUBA RAISES PRICE OF CIGARETTES

Havana, June 1, 1994. Cigarettes in Cuba will now cost 4-10 times more. Cuba raised the price in hopes of raising 2 billion pesos for its embattled economy, which has been in crisis since the collapse of the Soviet Union.

The price rise is part of a measure that will also increase the prices of alcohol and gasoline--and even drinking water--over the rest of the year.

A pack of the cheapest cigarettes on Cuba's rationing system sold for about 20 Cuban cents for almost 30 years. Now they will sell for 200 cents. (2 Pesos).

Non-rationed cigarettes have been off the market for a year due to shortages. They will reappear at about 10 pesos a pack.

Many Cubans earn their only living from selling their ration of cigarettes on the black market, where prices could range as high as 40 pesos a pack.

The loss of such income could hit hard in a country where the average income is 150-200 pesos a month.

The Cuban Peso is worth one US dollar officially, but on the black market is worth about a US penny.

BUENOS AIRES VS. UNDERAGE SMOKING

Buenos Aires. June 1, 1994. Knight-Ridder reports that members of the Buenos Aires City Council expect to pass this week a tough anti-smoking bill which would ban cigarette sales to those under 16, and prohibit smoking by teachers in classrooms.

W.H.O. URGES TOBACCO AD BANS

May 31, 1994. The World Health Organization urged the world's governments--especially those in Asia and Latin America--to ban cigarette advertising and sponsorship of sports and cultural events. The group also urged the news media to resist pressure from a tobacco industry which "has succeeded in blocking or counteracting essential measures of public health," and to give more coverage to anti-smoking campaigns.

The report predicted that at present smoking trends, death from "diseases caused by smoking" will "rise to 10 million a year in the 2020s or 2030s, 7 million of them in developing countries."

Much of the report focused on youth and the handling of tobacco promotional activities by the news media.

"The diversification of the tobacco multinationals into other fields such as food, perfumes and fashion has helped strengthen their advertising potential," the report said.

"This strategy has reinforced their ability to bring pressure to bear on the media."

The report said that "It is now acutely urgent to react rapidly to counteract this deceitful advertising that assimilates smoking to images of seduction, slimness, elegance and physical fitness."

Because of aggressive advertising campaigns, the report claimed, "increasing numbers of young women are taking to smoking as a sign of emancipation or a demonstration of their equality with men."

Who urged a ban on cigarettes on TV and the imposition of age restrictions on tobacco sales.

The report was issued as part of WHO's annual World No Tobacco Day.

PORTUGAL: PM GAINING SHARE

Lisbon, May 27. UPI reports that Philip Morris expects its share of the $1.2 billion Portuguese cigarette market to rise from 9.2% in 1993 to 17% this year.

Portugal's sole cigarette maker, Tabaqueira, currently controls about 80% of the market. Tabaqueira is expected to be privatized within a year.

Though PM must import its brands from Belgium and Germany, UPI connects the increase to PM's development of its own distribution system in Portugal.

CYPRUS VS. SMOKERS

Nicosia. June 3, 1994. Xinhua reports that a the Cyprus government is considering a new bill which bans smoking in public buildings, and requires non-smoking areas of restaurants. Smokers who violate the ban could be fined $US200-$US1,000. The bill is expected to become law by the end of the year.

The government is also considering proposals for a tobacco advertising ban.

Cypress has a 45% male smoking rate. The government is apparently concerned about increasing smoking rates among women and the young.

SLOVAKIA: CIG MAKERS BATTLE LAW

Bratislava. May 27, 1994. UPI reports that foreign and domestic cigarette makers are teaming up to weaken a national ban on cigarette advertising.

The law was passed just before Czechoslovakia broke up into the Czech republic and Slovakia in 1992. Czech still has some restrictions, but the total ban has been repealed.

The Slovak and foreign tobacco companies are questioning the wording of the law, which they claim does not make clear if the mere appearance of a logo or brand name constitutes advertising.

UPI says the companies involved are Philip Morris, Reemstma Hamburg, Tabak a.s. Praha, Rothmans and Slovak International Tabak Bratislava.

EASTERN EUROPE: INVASION CONTINUES

May 31, 1994. Major moves into Eastern Europe by foreign tobacco interests continued apace last week.
--RJ Reynolds International announced the opening of its $33 million tobacco factory outside Warsaw, hoping it will produce 15 billion cigarettes a year and give RJR more than its current 3% of the Polish market. RJR plans develop a new product using 30% Polish tobacco.
--Philip Morris bought for an undisclosed sum 51% of the Kharkov Tobacco Factory in the Ukraine.
--British tobacco giant BAT Industries bought 20% of the Saratov tobacco plant in Russia for US$5,630, and will invest $40 million in the plant.
--Rothmans, another British company, said it will invest $85 million in a St. Petersburg tobacco plant.
--In related news, on June 1, the Russian government slashed its excise duties on joint-venture-produced cigarettes from 50% down to 20%.

BULGARIAN TOBACCO FARMERS SWITCH TO OPIUM

Sofia. May 27, 1994. Bulgaria's severely depressed tobacco industry has led tobacco farmers to a new crop--opium, according to Reuter.

There are only 2 inspectors for the entire country, and officials are worried after they found 50 unreported acres of cultivated poppies.

Bulgaria used to be able legally to grow poppies for pharmaceutical processing, but poppies haven't been processed here for 10 years.

While Bulgaria, according to UPI, is on the "Balkan Route" by which smugglers transport heroin from the middle east to Europe, there is no evidence that Bulgarians are taking part in smuggling.

IRAQ: TOBACCO PRICES RAISED

May 23, 1994. The Baghdad Republic of Iraq Radio Network reports that Saddam Hussein has nearly doubled the price of tobacco.

Also suffering hefty price rises were cotton, soya beans and sunflower oil.

JAPAN: PARLIAMENT QUITS SMOKING FOR A DAY

May 31, 1994. Japan's politicians tend to be unrestrained smokers, often meeting in befogged rooms, and seen smoking on television. In observance of World No Tobacco Day, that situation will change, ever-so-slightly, this week

The Japanese Parliament, usually unrestricted in its smoking, went smokefree for this one day, and the Prime Minister's office announced that cabinet meetings would be smoke free for the entire week.

The ban in parliament was not announced for fear it would harm Japan's cigarette industry.

CONGO: SCHOOL CIG KIOSKS DESTROYED

Brazzaville, May 31, 1994. To mark World No Tobacco Day, the government of the Congo is banning schoolyard cigarette sales.

"Cigarette kiosks that sit alongside food stalls in school precincts will be banned and destroyed immediately," said an Information Minister, according to Reuter.

AUSTRALIA: MARIJUANA & TOBACCO

Canberra. May 30, 1994. Tobacco and marijuana have became embroiled in a political slugfest.

Opposition health spokesperson Bronwyn Bishop last week supported tobacco advertising.

Attempting to "distract attention" from the resulting controversy, according to Reuter, she accused Health Minister Carmen Lawrence of supporting marijuana use, and cited a statement Lawrence had made when a student. Lawrence had said that "unadulterated and taken under suitable conditions by normal, well adjusted persons marijuana is a harmless inducer of a pleasant and relaxed state."

Stung, Lawrence dragged a third party into the imbroglio when she retorted, "There is at least one other person in this house (parliament) who echoed some of my words, and that's the leader of the opposition, Mr. Downer." She produced a 1985 quote of Mr. Downer's: "Even though it was illegal," Downer told the Melbourne Herald when asked if he'd ever used marijuana, "it was just everywhere when I was a student."

Later in the interview he said, "It was foisted upon me."

Meanwhile, the Australian Medical Association has come out for partial decriminalization of marijuana.

BUSINESS

RJR LAUNCHES SECOND-HAND SMOKE CAMPAIGN

May 20, 1994. Cigarette maker RJ Reynolds launched a massive public relations campaign today "designed to provide the public with important facts to bring some balance to the debate surrounding second-hand smoke" in order to prove to the public that attempts to "totally ban smoke in workplaces...are simply not supported with science."

The campaign was kicked off by full-page ads in the New York Times, the Wall St. Journal, USA Today, the Washington Post, and several smaller Washington-read publications.

The ads claim health risks from exposure to second-hand smoke have been overstated.

The first ad questions how much second-hand smoke workers are exposed to, concluding that based on cotinine levels, a worker in an office with a smoker would receive 1.25 cigarettes a month.

The ad stresses in bold print "accommodation," "we encourage discussion that will help solve the issues without resorting to government intervention." and avers "Together we can work it (societal conflicts over ETS) out" without government interference.

Ad a press conference announcing the campaign, RJR toxicologist Dr. Chris Coggins, differentiating second hand smoke from sidestream (that which is emitted from the burning tip of the cigarette) and mainstream smoke, claimed that:

1. Levels of second-hand smoke exposure are "vanishingly small"
2. Such exposure is unlikely to be meaningful biologically.
3. Reports of lung cancer associations with second-hand smoke could be due to confounding variables, such as high fat diets.

compared typical levels of "respirable suspended particulates" from ETS to the amount one might find in one home after spraying a 12 oz. can of hairspray over 30,000 homes.

He also sharply criticized the EPA, and mentioned a Congressional Research Services report which found the EPA's estimate of 3,000 deaths from ETS overstated.

Spokesperson Maura Payne Ellis said current efforts of the anti-smoking lobby were actually aiming to outlaw cigarettes, and that there are 2 sides to every question, including this one.

In response to a question, she said that she had 3 children and that "When my children were very young -- I think parents use and awful lot of common sense -- I would not expose very young children, infants and toddlers, to a high concentration of environmental tobacco smoke."

Dr. Coggins also replied that in regards to smoking around children, people should "just exercise common sense."

Dr. Coggins indicated that increased risks of lung cancer in wives of smokers could be do to a "concordance" among spouses, i.e., that a non-smoking spouse could tend to take on the same risk factors of diet, exercise, etc., that smokers tend to share.

Dr. Coggins discussed his and other inhalation studies, claiming that, "in animal studies that have been performed over the years, none of them have ever produced any of the diseases -- certainly lung disease and heart disease that is shown epidemiologically to occur in population."

In fact, he said in answer to a later question, "As far as I know, for lung cancer in particular, there are no studies that have ever shown an increase in the (word unclear) rate of lung cancer in experimental animals exposed to mainstream smoke."

Dr. Coggins admitted smoking was a risk factor for some diseases. Upon questioning, he defined "risk factor" as "the odds ratio for disease occurrence in exposed groups divided by the odds ratio for disease occurrence in the non- exposed groups."

In answer to another question, Dr. Coggins said he believed smoking does "contribute to developing cancer," but he said he did not believe the relative risk from mainstream smoke was as high as the surgeon general has estimated.

Ms. Ellis responded to question about the "industry" of anti-tobacco by saying that "it's a business" and that money is to be made from it in grants, donations, etc. She also said, "there are also 85 separate federal government offices working in the anti-smoking movement. It's, I think, probably a unique circumstance, at least as far as I'm concerned, for one industry to have 85 separate federal offices lined up against it."

Rep. Henry Waxman responded to claims made at the press conference by accusing RJR of trying to create a "controversy" where none exists. He said the campaign was "a propaganda effort to try to fool people into thinking that issues that scientists have already reviewed and concluded are not resolved issues at all, but still uncertain, still controversial, and therefore to encourage people to continue to smoke and to encourage people to fight against efforts to deal with secondhand smoke."

"I think the tobacco companies have engaged in a decades-long practice of misinformation, disinformation, concealment of information, and propaganda efforts to raise controversies that don't exist"

"There aren't two sides to the question of whether there's a flat earth versus a round earth or whether man can travel faster than the speed of sound; these issues have been resolved by science," Waxman said. "If they can raise a controversy which suggests maybe there are two sides and some uncertainty, it buys them time."

He accused RJR of using "discredited methodology, the cigarette-equivalent methodology" when it measured nicotine content--"which...evaporates quite rapidly"--as an equivalent for all the other "thousands of chemicals in tobacco smoke."

If RJR had used ammonia, for example, "it would have found that some non-smokers smoke the equivalent of 56 cigarettes a day."

He said the CRS report was prepared by an economist for a tax question, and was not a report on the health aspects of ETS. He distributed to the press a letter that he said showed "CRS has taken no institutional position on the health effects of passive smoking and they are studying that issue and they're going to issue an official position later on."

"The overwhelming scientific consensus is that the most important public health measure we can take in this Congress would be to protect nonsmokers from having to breathe in someone else's Class A carcinogen tobacco smoke that's put into the environment," Waxman said.

SOCIETY

FLAT EARTH SOCIETY VS. SMOKERS

New York, NY June 19, 1994. Smokers and Flat-Earthers have had run-ins in the past, long before anti-tobacco advocates were comparing statements of the tobacco industry with proclamations from the flat earth society..

In the free weekly, The New York Press, John Strausbaugh covered Diane Kossy's compilation of news items about strange people, Kooks (Feral House, $16.95). One section of the book addresses how prevalent and fierce the Flat Earth Society once was. He writes:

"In the 1920s, Flat Earth patriarch Wilbur Glenn Voliva turned the little town of Zion, IL into what amounted to a concentration camp. His puppet government forbade citizens from smoking, drinking, movies, pork, medical care and, naturally, owning globes. Zion police boarded trains stopping at the town station to arrest smokers..."

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HEALTH

Low-fat, No-smoking Cuts Heart Deaths
Smoking & Impotence
Smoking & Oral Cancer-Mouthwash Studies
ETS & Nonsmoking Spouses
Taxotere(R) Treats Non Small Cell Lung Cancer

FEDERAL

Justice Dept. to Investigate Tobacco
Tobacco Exec Claims a "Set-up"
Tobacco Tax Rise Cut to 45 Cents

LOCAL

FL: Philip Morris Sues State
CA: Workplace Ban Passes Legislature
CA: Joe Camel Suit OK'd
CA: PM Bill on Nov. Ballot
CA: Santa Cruz Bans Smoking

INTERNATIONAL

CANADA: All Airlines Go Smokefree
BRITAIN: Smokers Get Legal Aid In Suit
POLAND To Privatize Tobacco Industry
LEBANON: Utility Strike Ends

BUSINESS

PM Unleashes Anti-EPA Ads
BAT's Escape Clause in American Buy

SOCIETY

Smoking Deaths Decline

PEOPLE

Limbaugh Called Unfair on Nicotine

**---------------------------------------------------------

HEALTH

LOW-FAT, NO-SMOKING CUTS HEART DEATHS--FINNISH STUDY

London, June 30, 1994. Results in a 20-year Finnish study of 29,000 people indicate that government policies urging people to eat less fatty foods and more vegetables--and to stop smoking--were working to dramatically cut the number of ischemic heart disease (that caused by artery blockage) deaths in Finland.

According to the British Medical Journal, researchers monitored the randomly-selected group's eating and smoking habits, weight, blood pressure and cholesterol levels at 5-year intervals.

From 1972 to 1992, serum cholesterol levels and blood pressure decreased. Men's rates of ischemic heart disease deaths were down by 55%, while women's declined by 68%.

Smoking among men decreased from 53% to 37%; however, smoking among women increased from 11% to 20%.

The researchers pointed out that Finnish men once had one of the highest rates of heart disease deaths in the world.

SMOKING & IMPOTENCE

Rome, June 29, 1994. An Italian hormone specialist says his study of "1500 cases of impotence" over 8 years has led him to the conclusion that men who are promiscuous are more likely to face "burnout" and sexual dysfunction by the age of 40.

"A man involved in many amorous exploits runs a high risk of sexually transmitted disease and infection of the penis and increases his chances of becoming impotent by the age of 40," Dr. Giulio Biagiotti said in La Republica newspaper, according to Reuter.

Other factors of impotence cited by Biagiotti were stress, irregular eating habits, long hours driving vehicles, and heavy smoking.

SMOKING AND ORAL CANCER/MOUTHWASH STUDIES

Washington, June 29, 1994. Amidst a flood of conflicting studies, some of which indicate a link between alcohol-containing mouthwashes and oral cancer, a scientific advisory panel has urged the FDA to study the matter.

The FDA's Dental Products subcommittee on plaque said that while no cause-and-effect relationship has been found in the studies, a "trumpet" had been sounded, heralding the need for a more definitive investigation on the subject.

Alcohol/mouthwash studies done thus far have yielded conflicting and inconclusive results, and most have not accounted for numerous possible confounding factors.

One potential factor often ignored: smokers and drinkers--considered at high risk for oral cancer--may use such mouthwashes more often to mask the smells of their habits.

ETS & NONSMOKING SPOUSES

Washington, June 7, 1994. New controversy has greeted results from the largest study ever done on nonsmoking women with lung cancer.

The study found that nonsmoking women who live with a smoker have a 30% greater chance of contracting lung cancer than those who don't. With regards to exposure outside the home, the study found nonsmoking women exposed to second hand smoke at work have an increased risk of 39%, and those exposed in social settings an increased risk of 50%.

Those exposed additionally to second hand smoke as children had double the risk of those only exposed as adults.

The study's authors said the risks begin to manifest after about 20 years, and increase with exposure as measured in pack-years (exposure in the home from a pack-a-day smoker). For those exposed for 80 pack years--the amount of exposure endured when living with someone who smoked 4 packs a day for 20 years--the increased risk rose to 80%.

"You have to be exposed for a long period of time for there to have been an effect," said the author of the study, Elizabeth T.H. Fontham of Louisiana State University Medical Center.

The study was published in the Journal of the American Medical Association, and compared 653 nonsmoking women with lung cancer with a control group of 1,253 women. Exposure was determined by survey answers from subjects and relatives, backed up by urine tests where available.

"If you keep seeing the same results over and over, it lends a lot of credence to the estimates," Fontham said at a news conference. She said that the "dose-effect" strengthens the connection between second hand smoke exposure and lung cancer in nonsmokers.

Representatives of the Tobacco Institute were waiting in the hall outside the conference to denounce the study.

"Press conferences tend to blow this kind of thing way out of proportion," said the Institute's Thomas Lauria. "There is a very, very low level of risk if there is any at all."

"This study, like 12 of the 13 other environmental tobacco smoke studies conducted in the U.S., reports no statistically significant increase in risk for nonsmoking wives of cigarette smoking husbands," the Institute said.

Dr. Fontham denied the statement was true, and said that before the study was published it had been peer reviewed by statistics experts who found the results academically valid. Fontham said the study had been specifically designed to address shortcomings of previous studies, controlling and adjusting for such factors as diet and reporting bias.

Chicago Tribune science and technology writer John Van wrote an article lambasting the media and the AMA for accepting the study's findings at face value. Echoing an argument from Jacob Sullum's Philip Morris ad, Van claimed the results of the study are not as clear-cut as presented, since in the case of rare occurrences like lung cancer in nonsmokers, "small changes can produce large percentage swings" and throw off statistical significance.

Van argues that error ranges, which normally are provided with every study, should be given for such news stories.

TAXOTERE(R) TREATS NON-SMALL CELL LUNG CANCER

Colorado Springs, CO June 28, 1994. Pharmaceutical company Rhone-Poulenc Rorer reports that its anti-cancer agent Taxotere(R) (docetaxel) has been found by researchers to produce a response rate of 38% in patients with advanced non-small cell lung cancer.

A Rhone-Poulenc press release said usual single-agent chemotherapy response rates--defined as a significant decrease in tumor size--generally range from 10-20%.

Non-small cell lung cancer is the most common kind of lung cancer, accounting for 75% of cases, and is the primary cause of cancer deaths in industrialized countries. A sub-type of NSCLC, Squamous cell (epidermoid) carcinoma, accounts for 35% of all lung cancer, and is strongly associated with smoking.

Taxotere is one of a new breed of anti-cancer agents called taxoids, which disrupt the assembly/disassembly process that leads to cell division. This disruption in turn leads to the death of the cancer cell.

FEDERAL

JUSTICE DEPT. TO INVESTIGATE TOBACCO

Washington, June 24, 1994. Attorney General Janet Reno said the Justice Department will look into allegations made by seven members of Congress that tobacco companies may have participated in a decades-long campaign of fraud, perjury and conspiracy to obstruct justice.

The Congressmen sent Reno a letter last May asking the Justice Department to investigate possibly illegal actions of the tobacco industry since the fifties, and specifically charged that tobacco executives may have perjured themselves recently by giving congressional testimony about the addictiveness of nicotine which seemed to directly conflict with their own company documents.

The letter, written by Rep. Martin Meehan (D-MA) charged that there was "compelling evidence that tobacco companies ... have committed a series of serious crimes over a period of several decades."

"We're looking at all the allegations, all the comments," Reno said, adding that the review involves the department's criminal, civil and antitrust sections--"all the divisions, to see what action should be taken, if any." A Justice Department official has indicated that the perjury charges are not on the "front burner."

A spokesperson for RJR said there was no basis for perjury charges, as Chairman James W. Johnston's answers about nicotine's addictiveness were "his opinions based on the facts as he understands them."

"He has a right," the spokesperson said, "to his opinion."

Other signatories of the letter were:

James Hansen, (R-UT)
Pete Stark (D-CA)
Peter Visclosky (D-IN)
Richard Durbin (D-IL)
Mike Synar (D-OK)
Thomas Foglietta (D-PA)

TOBACCO EXEC CHARGES SET-UP

Washington, June 1994. A tobacco company executive, faced with charges he lied to congress about the development and commercial use of a high-yield nicotine plant, denied the project was "secret or sinister" before a Congressional panel today and intimated that his company had been "set up" by FDA commissioner David Kessler.

Reputedly volatile and intimidating, Brown & Williamson CEO Thomas J. Sandefur kept his cool during the 5 hour session, but made his points forcefully to the subcommittee. He was accompanied by former Attorney General Griffin Bell.

Highlights of his testimony:

--Sandefur denied the "secretive and sinister" characterization by David Kessler of the development of "Y-1". He said the "Y-1" tobacco plant, developed in Brazil and used in some Raleigh, Richland and Viceroy cigarettes, was never a secret, and used traditional cross-breeding, not genetic engineering techniques.

"It was suggested there was something sinister or secretive about the development of Y-1 because it was patented in Brazil, using the language of Brazil, which is Portuguese," Sandefur said. "In fact it was grown in Brazil to prevent our competition from using it and because the growing conditions in Brazil were very good."

He said the search for a low-tar leaf had been started in the interest of health by the Agriculture Department in the late 70s, but the department had abandoned the project. B&W then took up one of the Department's strains and developed it further.

He said the company had actually applied for a patent on Y-1 earlier this year, which would have made its existence public, but later withdrew the request. The patent had originally been filed in 1991, but was rejected in 1993 by the US Patent Office as insufficiently unique.

B&W moved to re-apply, but the timing was interesting here. Kessler released his bombshell letter stating he was considering regulating nicotine as a drug on Feb. 25. On Feb. 28, B&W appealed the patent ruling, but two weeks later withdrew it.

--Rebutting one of Kessler's more serious charges of deception, Sandefur denied that FDA investigators visiting B&W on May 3 had asked about the breeding of tobacco for specific nicotine levels. Waxman's subcommittee has released affidavits from the four investigators stating that they did indeed ask, and were told no.

--Sandefur said the cigarettes in which Y-1 was used did not contain any significant level of added nicotine. "The brands that use Y-1 deliver essentially the same nicotine as the products they replaced," he said, and some contained less.

--Sandefur said that nicotine is only in cigarettes "as a matter of taste." It is a "flavoring agent," not a drug, he said, and is not addicting.

"I am entitled to express my view," he said, "even though it may differ from the opinions of others."

Sandefur said he wasn't qualified to address some research studies, because he wasn't a scientist.

When asked by subcommittee chair. Henry A. Waxman (D-CA) why, if nicotine was only a matter of taste, had B&W studied its effects on "brain wave alpha rhythms," as indicated by documents B&W had submitted to the committee, Sandefur answered, "I haven't read those documents."

--Sandefur did acknowledge Kessler's assertion that ammonia as an additive effectively increased the nicotine content of smoke.

--When asked about "Project Wheat," the 1976 study that advocated higher nicotine cigarettes for those with a high "inner need," Sandefur said, "This is the first time I've ever heard of Project Wheat."

--Sandefur testified that smoking is just one more "risk factor" for disease, like diet or lifestyle

--On a more personal level, Sandefur bitterly attacked Kessler's testimony last Tuesday.

He said Kessler's account of Y-1's development and commercialization was "highly misleading."

"Dr. Kessler's exaggeration of the situation fits his personal or political agenda," he said, and accused Kessler of "grandstanding."

"Dr. Kessler's efforts," he said, "are a perfect example of a crusade ... which is clearly in the dangerous stage."

"It now appears, at least to me, that FDA may have known about Y-1 early on and may have intentionally engaged in a course of conduct . . . in an effort to set B&W up."

Sandefur accused the government of being "on the pathway to prohibition."

A spokesperson for Kessler said, "Once you get past the personal attacks on Dr. Kessler, the company confirmed today the facts we presented to the subcommittee on Tuesday."

B&W has admitted it still has 3-4 millions of pounds of Y-1 stored in warehouses, and has said it discontinued Y-1 around May.

A note of grim humor was injected into the proceedings when Rep. Ron Wyden (D-OK) told Sandefur the tobacco executives stood in danger of becoming "irrelevant" to the tobacco issue, due to their insistence that nicotine is not addictive.

"I feel like a conductor at Union Station informing you that your train has left the platform. We need to get to work devising sensible new regulation ... but you are becoming more and more irrelevant to this debate," Wyden said.

"It's hard for me to envision becoming more of an outcast than I feel I already am," Sandefur responded.

Waxman has offered to meet with tobacco chiefs to privately seek common ground. Sandefur said he would attend such a meeting ("I don't want to be unreasonable"), but that he felt the current laws were adequate.

The New York Times on July 3 reported that "senior executives in two major tobacco companies were willing to say last week that they privately expect, and are willing to accept, some new regulations on tobacco, provided that no tobacco ban is attempted and no great damage is done to the industry's current markets."

Tobacco Tax Rise Cut to 45 Cents

Washington. June 30, 1994. Amidst vicious accusations about tobacco companies, the House Ways and Means Committee voted against an amendment that would have reinstituted a $1.25 tobacco tax in the subcommittee's health care package.. The vote let stand a 45 cent tax.

The modest price rise, down from the committee's original $1.25, had been instituted two weeks ago in order to win over the vote of Rep. L.F. Payne (D-VA), who represents 5,000 tobacco growers.

"Tobacco is a killer," said Rep. Mike Andrews (D-TX). Andrews. In defiance of acting chair Sam Gibbons' (D-FL) intense pressure to get out the health care bill, Andrews indicated he would not support a plan with such a low tax.

Tobacco executives are "killing millions of people every day," said Robert Matsui (D-CA). "They ought to be totally ashamed. They really are not American citizens." He said both his parents died of lung cancer, and that tobacco executives should be prosecuted for their crimes.

Tobacco executives, Pete Stark (D-CA) said, are "worse than murderers," and are "corporate felons."

Despite their feelings, the democrats, feeling the passage of the Clinton's health care bill was more urgent, voted against the $1.25 tax.

"I am not going to see the tobacco companies defile our attempt to improve the nation's health care delivery system," said Stark.

The angry words brought some ridicule from opposing forces.

"If you really believe that they're murderers and you're not going to vote for the tax increase ... maybe you should consider yourselves accomplices," said Rich Santorum (R-PA).

Don Sundquist (R-TN) said Democrats were "trying to pay for reform cheaply by targeting an industry that's not in their state. . . Maybe we should ban superhighways in California."

The vote against the $1.25 tax was passed 31-7. Only one Republican voted for the tax, Nancy L. Johnson (R-CT).

Also defeated (26-12) was an amendment proposed by Rep. Jim Bunning (R-KY) to delete any increase on tobacco products at all.

Ways and Means is one of 5 Committees struggling over versions of the package.

In the Senate Finance Committee, Sen. Daniel Patrick Moynihan (D-NY) proposed a $1.76 per pack cigarette tax rise, along with other tobacco taxes, as part of his health care plan.

Moynihan's plan--which would impose a 1% payroll tax on large corporations, and contains a "hard trigger" that would mandate employer coverage of workers' health care--is not expected to pass.

LOCAL

FL: PHILIP MORRIS SUES STATE

Tallahassee, FL. July 1, 1994. Philip Morris, which has suits pending against a Federal agency (EPA), a television network (ABC) and a major American city (San Francisco), added a state to its roster today--Florida.

On the day a Florida law facilitating the ability of the state to sue tobacco companies went into effect, Philip Morris, the National Association of Convenience Stores, Publix Supermarkets, and Associated Industries of Florida, a prominent business lobbying group, filed suit in a county court to void the law as in violation of the state constitution.

The law allows the state to use statistics to prove smoking causes disease, and allows the state to assess damages based on a company's market share.

The lawsuit holds that this law would deprive companies of the ability to defend themselves, violating standards of basic fairness and due process, and in addition claims its passage by the legislature by-passed proper procedures.

"We have always expected a challenge to the law," said a spokesperson for Gov. Lawton Chiles.

"`But Gov. Chiles fully intends to proceed under this law, in suing one industry -- tobacco -- to recover millions of dollars the state has lost through the Medicaid program for smoking-related illnesses."

CA: WORKPLACE BAN ADVANCES

Sacramento, CA. July 1, 1994. In a major victory for anti-smoking advocates, a hotly contested bill which would impose the toughest workplace smoking ban in the nation passed the California Senate today.

Assembly Bill 13 grants limited exemptions to hotels and motels, bars, and gaming clubs, but allows stronger measures to be passed by localities--a provision especially galling to tobacco adherents.

The bill was backed by health, labor and business groups--including the California Restaurant Association--and fiercely opposed by the tobacco industry. It was approved 22-9.

"AB 13 strikes an important balance between the health needs of California workers and the economic needs of California business," said Sen. Marian Bergeson (R-Newport Beach).

The infighting must have been intense, if unseen. Dion Nissenbaum of AP reported that "dozens" of tobacco industry lobbyists invaded Sacramento in an attempt to weaken or defeat the bill, but to no avail. Although some Senators tried to attach moderating amendments to it, no Senator spoke against the bill.

"The tobacco industry threw everything they had at us, and we won," said the bill's author, Assemblyman Terry Friedman (D-Encino).

The bill has already passed the Assembly, but will head back there for Assembly approval of amendments.

FLASH: July 7, 1994. The California legislature has passed AB13 in a bipartisan vote of 49-21, and awaits only Gov. Pete Wilson's signature to become law. He has not indicated if he will sign it.

In passing the Assembly again, only one legislator spoke against the bill, Gil Ferguson (R-Newport Beach), who said, "I think this is just pandering to a devil created by the government and the media . . . It's based on what's turned out to be a lie from the EPA, interpreting surveys and studies on secondhand smoke which have proven false and almost everyone interested in the subject knows that."

Should AB13 become law by November, and should the Philip Morris-sponsored Uniform Tobacco Control Act be approved by the voters on the November ballot, AB 13 would be nullified.

Lee Stitzenberger, campaign director for the UTCA, said, "This bill does nothing to change the patchwork quilt of local ordinances across the state . . . It goes much further than the public is willing to go on the issue, and I don't think it's reasonable or a fair solution."

CA: JOE CAMEL SUIT OK'D

July 1, 1994. San Francisco, CA. The California state Supreme Court has allowed to proceed a lawsuit which claims RJ Reynolds' "Joe Camel" advertising campaign is unfairly targeting children.

The court unanimously ruled that federal tobacco laws do not exempt an advertisers from state deceptive advertising laws.

Were that so, wrote Justice Armand Arabian in the court opinion, Joe Camel billboards could read, "Kids, be the first in your fourth-grade class cool enough to smoke Camels," and the state would be powerless.

The court denied Reynolds' claim that the Federal Cigarette Labeling and Advertising Act preempts states from regulating advertising. The Act only applies to advertising in regards to health claims, ruled the court.

In fact, Arabian said, the federal government specifically encourages the states to fight tobacco sales to minors.

"Congress left the states free to exercise their police power to protect minors from advertising that encourages them to violate the law," Arabian wrote.

A tobacco spokesperson said individual state advertising laws would create havoc. "Are the Joe Camel ads going to be torn out of Time magazine on the California-Nevada border?"

The suit claims that teen Camel sales nationwide went from $6 million a year in 1988 when the campaign began, to $476 million in 1992.

San Francisco lawyer Janet Mangini, who brought the suit "as an individual citizen," seeks to ban the ads and to make Reynolds forfeit the profits made from increased sales of the cigarettes to minors; in addition, the suit seeks a "corrective" Reynolds-funded anti-youth smoking campaign to convince kids that "smoking is not cool."

"We are extremely confident that the fact that this campaign is directed at adult smokers will prevail," Reynolds said in a statement. Some speculate the company could take the case to the Supreme Court.

CA: PM BILL ON NOV. BALLOT

Sacramento, CA. June 28, 1994. The Philip Morris-sponsored bill that would repeal or preempt all local smoking ordinances has more than enough signatures to assure it a spot on the Nov. 8 ballot, acting Secretary of State Tony Miller announced today.

Miller said the initiative had at least 440,000 signatures, well over the 385,000 required.

Miller had accused the initiative's sponsors of waging an orchestrated campaign of deception. His office had received "hundreds" of complaints that signature gatherers had misled signatories about the initiative, and Miller recently fought to interview volunteer signers of the petition, but a court recently denied the move as invasive.

After the ruling, Lee Stitzenberger of Californians for Statewide Smoking Restrictions said, "This ruling confirms the fact that the Acting Secretary of State, despite his personal opinions and campaign rhetoric, has no basis or authority to invalidate this initiative. This will give California the opportunity to enact reasonable, fair, but significant tobacco restrictions across the state."

Miller responded by acusing Philip Morris, which funds Californians for Statewide Smoking Restrictions, of "(taking) the position that misrepresenting the purpose of an initiative has nothing to do with whether it should be placed on the ballot, and that it's all right to lie about who is sponsoring a measure in order to obtain signatures. Philip Morris should be ashamed of itself."

CA: SANTA CRUZ BANS SMOKING

Santa Cruz, CA. June 30, 1994. Santa Cruz' City Council has approved by a vote of 6-1 a tough law that will ban smoking in "virtually every business and indoor public area in Santa Cruz." The only exemptions will be tobacco shops and bars without restaurants.

The ban goes into effect July 27.

The Santa Cruz city parks and recreation department is also considering the recommendation of some beaches, park trails and other outdoor areas as "smoke-free zones."

Elsewhere at the beach, Reuter reports that the tourism committee of Bournemouth (in south-west England) narrowly turned down (7-6) a proposal for a 200 yard smoke-free zone within its 7 miles of beaches.

INTERNATIONAL

CANADA: ALL AIRLINES GO SMOKEFREE

July 1, 1994. Ottawa. Canada today became the first country to ban all smoking on all its flights.

While the flight attendants' union fought for the ban, Canadian Airlines opposed it, fearing the loss of business on its lucrative routes between Canada and Japan. Transport Canada has agreed to delay the rule on those flights for two months.

The major Canadian airlines have already implemented smoke-free international routes--including those to Europe, South America, and most of the Orient except Japan--with no economic ill effects.

The ban does not apply to foreign carriers, but most other countries will be flying smokefree within the year. A 1992 agreement by the 183 member nations of the International Civil Aviation Organization called for phasing out smoking on all flights by July 1, 1996.

BRITAIN: SMOKERS GET LEGAL AID IN SUIT

London, July 1, 1994. 230 smokers who are trying to sue tobacco companies for failing to warn them of the hazards of smoking passed a major financial hurdle on their way to gaining public assistance for their suit today. London's High Court has voided a committee decision which barred their use of public funds for legal aid.

The Liverpool-area group is seeking to sue 5 tobacco companies--Gallaher, Rothmans, Imperial Tobacco, Philip Morris and British American Tobacco (BAT).

According to Reuter, "The High Court judge said the case had merit, and ordered another legal aid committee to consider it."

Many of the group are seriously ill ("They've got the whole range of smoking-related diseases" said their lawyer, Charlie Hopkins.), and three have died since aid was first applied for.

POLAND TO PRIVATIZE TOBACCO INDUSTRY

Warsaw. June 28, 1994. Reuter reports that Poland is moving to privatize its large but stagnant tobacco industry, beginning with the private sale of 6 large tobacco factories.

"The industry needs a lot of money to modernize and compete with western producers and this cash can only be obtained from privatization," said an adviser to a Privatization Minister.

"The factories," he said, "are likely to start negotiations primarily with those foreign companies with which they already cooperate."

"What we are selling," he added, "are not the factories themselves, but their share in the Polish cigarette market." And that market is 14 million often-heavy smokers partial to the "throat-scrapers" typically manufactured in Poland.

Germany's Reemtsma, Spain's Tabacalera, Britain's Rothmans and B.A.T. Industries, and Philip Morris already have interests in the various plants, and RJ Reynolds just opened its own large factory.

LEBANON: UTILITY STRIKE ENDS

Beirut. June 29, 1994. 20,000 Lebanese utility workers halted a week-old strike today, upon promises that the government would not cancel certain benefits which were under review.

The strike had started as a one-day action, but expanded to include not only the water and electrical workers, but grain silo operators and public transport workers, who halted ships for days at Beirut port.

The utility workers had threatened to cut off water and electricity. Besides the port, water and electrical workers, the group included employees at the state's REGIE tobacco monopoly. No word if they had threatened to cut off tobacco supplies.

BUSINESS

PM UNLEASHES ANTI-EPA ADS

Philip Morris has joined RJ Reynolds in unleashing a massive counterattack against the swell of anti-smoking sentiment and legislation. Reynolds' assault includes as well as ads a major multi-city tour of RJR representatives and scientists who meet with editors, writers and talk show hosts. Philip Morris' attack is limited for now to an expensive newspaper advertising campaign that questions the methods and conclusions of the EPA's Jan. 1993 report on second-hand smoke.

That report, "Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Diseases," is considered the impetus for an acceleration of anti-smoking legislation across the country that has shown no sign of slowing.

With the resignation of CEO Michael Miles--whose roots were in the food sector of Philip Morris, and who had recently been rebuffed in his move to split the company into separate food and tobacco arms--new leadership has pledged an all-out war for tobacco.

It is seldom that a formerly arcane science such as epidemiology achieves national prominence, and society suddenly finds itself introduced to specialized terms like "statistical significance," risk ratio," and "meta-analysis," but an understanding of this field has now become de rigueur for many Americans concerned about the tobacco issue.

THE ADS

The ads were created by New York ad agency Young & Rubicam and were published in major newspapers like USA Today, the Washington Post, the New York Times and the Wall St. Journal. One in an introduction, and 4 more reprint an article by Jacob Sullum which appeared in Forbes MediaCritic titled "Passive Reporting on Passive Smoke." The long article was then reprinted in its entirety in the Sunday editions of some 40 paper.

The article criticizes a number of EPA's methods and conclusions, focusing sharply on EPA's lowering in some studies of traditional levels of "statistical significance" along with its "meta-analysis" of US studies of nonsmoking spouses of smokers. Sullum spends most of the article taking the media to task for its unquestioning acceptance of health officials' endorsement of the report.

"Were you misled?" the first full page ad on Monday, June 27, began. "Ever since the EPA issued its report ... serious questions have been raised about the report's validity."

The top banner the following four proclaim "Secondhand Smoke: Facts Finally Emerge," and the bottom banner concludes, "In any controversy, Facts Must Matter."

THE TERMS

"Statistical significance" is a measure of doubt epidemiologists factor into the results of their studies. The traditional measure of statistical significance in the arcane area of population studies is 95%, which means there is a 5% possibility that the result occurred purely by chance.

A "meta-analysis" had been done on some smaller studies, and was meant to gather together material that may not be particularly significant by itself, but that in aggregate with other, similar studies, may be seen to present a clearer picture overall.

"Confounding Variables" are other factors which may influence the results of a study. These must be recognized by the study, and the study should be "adjusted for" any potential influence they may have.

Pretend you are trying to report on two groups--smokers and nonsmokers--to determine their relative risk ratios for lung cancer. Against all expectations, you find the nonsmokers have just as high a lung cancer rate as smokers. Upon investigation, you find the nonsmoking group are mostly low-income coal miners who have a high-fat diet and who smoke marijuana every night. In addition, they live in radon-infested, asbestos-lined houses next to chemical factories in the smoggiest part of town. Your study had better account for any such potential confounding variables before you submit it for fund approval.

THE ARGUMENT

The bulk of Sullum's article consists of attacks against the press for accepting the EPA's report at face value--for being "one-sided, credulous and superficial."

Admittedly, the 510-page report is not for amateur epidemiologists to pore over and come to coherent conclusions. In his critique of the report, Sullum himself, though quoting some of the handful of articles which have questioned the EPA report since its release, relies heavily on quotes--and presumably guidance--from James Enstrom, professor of epidemiology at UCLA.

--Sullum claims the report's conclusions are based on 30 studies of nonsmoking spouses of smokers done around the world. These studies, he writes, contained numerous confounding variables which easily could throw off results, especially when one is trying to determine ratios for something as rare as lung cancer in nonsmokers. Though most of these studies did find positive if weak associations between ETS and lung cancer, only 6 reports, Sullum says, achieved statistical significance.

--Sullum says also that of 11 US studies analyzed, none showed a strong link between ETS and lung cancer, and that only one was statistically significant--and that only because EPA lowered the threshold of statistical significance from 95% to 90%, which "in effect doubles the odds of being wrong."

--It was these 11 US studies that the EPA used as the base for its "meta analysis," which Sullum claims the EPA did "in order to bolster the evidence." Sullum writes that such a meta-analysis on studies done under such disparate conditions--differing groups studied, differing methods used, differing variables controlled for, etc.--is next to useless.

--Finally, Sullum criticizes the report for not including a large study published in Nov. 1992 (the EPA report was released in Jan. 1993.) That study also did not show a statistically significant risk.

--Sullum then attacks specific articles and reporters for biased reporting on the matter, and offers advice for science reporters (and readers), urging them to:

--include in their stories where appropriate, "confidence intervals," "statistical significance," and "risk ratios."

--be aware that correlation is not causation, especially where risk ratios are weak--anywhere between 1.0 (no additional risk) and 3.0 (30% additional risk).

--watch out for "weasel words"--like, "appears to," "the data suggests," and other words tempering or qualifying the results.

--where two sides differ sharply--as between the Tobacco institute and a health agency or doctor--reserve judgement.

REBUTTAL

The EPA has stood by its report, and claims that the scientific community as a whole does also.

"An independent science advisory board made up of experts from academia, government and research organizations examined virtually every one of the tobacco industry's arguments about lung cancer," Carol Browner of the EPA said. "The board concurred in EPA's methodology and endorsed EPA's conclusions."

"This is the first time," an EPA spokesperson said, "we have ever seen an industry attack a federal agency for doing its job."

--The EPA claims that the meta-analysis of the 11 US studies was not a major factor in the EPA's determination that ETS is carcinogenic, but merely done to try to quantify the risk, i.e., to come to EPA's estimate of 3,000 lung cancer deaths from ETS.

--EPA said that the determination that ETS had potentially deadly effects was derived from the fact that sidestream smoke contains the same carcinogenic material as mainstream smoke, from animal and genetic studies of its harmfulness, and from epidemiological studies which show a "dose response," a correlation between amount of smoke exposure and the likelihood of disease.

--EPA claims 24 of the 30 studies showed risks from ETS; though the majority of those did not show statistical significance, EPA said that 9 of them were statistically significant--not 6 as Sullum claimed--and that it is a 1 in 10,000 chance those results were accidental.

--EPA said of the 11 US studies that they were not found statistically significant because they were too small to assign probability. However, of the 7 that measured amount of exposure, all showed risks in those most exposed to ETS.

--EPA said a 95% confidence interval is used when scientists don't know what effect will occur. However, when the effect is known, as EPA had determined from its other data, it is sufficient to try to determine either no effect, or the expected harmful one.

--EPA claims the large report not included had arrived past the deadline. Though it indeed did not show a statistically significant increase in risk, it did show a significant risk among those living with heavy (2 pack a day) smokers.

"Not only is (the industry's) argument wrong, it's a very misleading argument because it implies the whole report hinges on that and it doesn't at all," Ron Davis, editor of "Tobacco Control" told AP.

"We don't have money to spend on ads," said an EPA spokesperson. "But we're not backing away from our position."

SULLUM AND REASON

At the time the article was first published, Mr. Sullum was managing editor of Reason, a libertarian magazine that tends to oppose government regulation on principle. The magazine has a readership of 50,000, has published full-page ads for Philip Morris and at least one back-cover spread for Forbes.

Chip Jones of Knight-Ridder writes that the Reason Foundation of Los Angeles received a $10,000 donation from Philip Morris, according to the magazine's editors.

Sullum, now at the National Review, denied any undue influence, and called attacks on his objectivity "a form of ad hominem. . . none of this should ever matter. . . People should be able to evaluate arguments and evidence on their merits"

Sullum pointed out that it was not he, but Forbes MediaCritic which allowed Philip Morris to reprint the article.

"I wasn't too pleased about it," Jones quotes Sullum. "I didn't want to be too closely tied with the tobacco industry."

Yet in another use of his writings by a tobacco company, RJ Reynolds republished Sullum's Wall St. Journal opinion piece, "Smoke and Mirrors," which covered similar material. Jones reports that Sullum said RJR paid him $5,000 for the rights.

SOME NOTES

Whatever the piece's provenance, it is highly unusual to find this sentence in a tobacco company ad: "The associations between smoking and lung cancer are sizable as well as statistically significant. Recent studies indicate that the average male smoker is 20 times more likely to develop lung cancer than a male non-smoker, while the risk ratio for women is about 10 to one. The figures are even higher for heavy smokers."

Also unique in an ad in which a tobacco company is ostensibly disseminating information is the uncontested quote, "The tobacco industry has established a reputation for disseminating misinformation."

Curiously, though Philip Morris sued the EPA in June of 1993 over the report, and while the company claims that it is only now that "Facts Finally Emerge," Philip Morris has seemingly never put forward its own in-depth criticism of the report, which action may have led reporters to discount the handful of critical articles in relatively obscure journals little known for their scientific acumen--publications such as Consumers Research, Investors Business Daily, Bostonia and Reason.

Also curiously absent from this discussion in the media are at least two major cases tried in Australia which found compelling evidence of ETS's risks--evidence based on data available years before the EPA report was released.

In 1991, Liesel Sholem won a $50,000 award for her employer's negligence in not protecting her from ETS--the dangers of which, the court ruled, her employer should have known, based on available knowledge from the period of her employ, 1975-1986.

In a more striking parallel, the Tobacco Institute of Australia in 1986 ran newspaper ads about ETS. Rather than reprinting someone else's article, however, the ads flatly stated there was "little evidence and nothing which proves scientifically that cigarette smoke causes disease in nonsmokers."

A suit was filed by the Australian Federation of Consumer Organisations seeking to enjoin the Tobacco Institute of Australia from running the ads.

In 1991, after a 30-month trial in which the world's literature on the subject was submitted to intense scrutiny by both sides, Justice Trevor Motling of the Australian Federal Court issued a 210 page decision which cited "overwhelming scientific evidence" of ETS's role in triggering respiratory diseases in children, and "compelling evidence" that ETS causes lung cancer in nonsmokers.

FINAL NOTES

Observers estimate the Philip Morris ads cost hundreds of thousands of dollars. Lauren Neergaard of AP says one full-page ad in the Sunday Washington Post costs $64,000.

Philip Morris reports it received 3,000 calls in three days from people asking for reprints of the ad.

BAT HAS ESCAPE CLAUSE IN AMERICAN PURCHASE

London, June 27, 1994. B.A.T. chief executive Martin Broughton revealed in an interview that B.A.T. could decide to drop its purchase of American Tobacco, depending on conditions of the US tobacco market--especially if the FDA moves to regulate cigarettes.

Broughton's revelation of a "material adverse change clause" in the purchase agreement arose in reference to his displeasure with FDA commissioner David Kessler's testimony this week before a congressional subcommittee. Kessler attacked B.A.T. subsidiary Brown & Williamson Tobacco for allegedly hiding its work on nicotine manipulation.

The adverse change clause, Broughton said, "does not enable us to change the price but we can choose not to consummate the deal."

A B.A.T. spokesperson verified that if the FDA changed market conditions, the deal would be re-examined; but for now, B.A.T. is "as interested" in the deal as ever.

SOCIETY

SMOKING DEATHS DECLINE

Atlanta, GA June 10, 1994. The Centers for Disease Control and Prevention's figures for 1990 estimate that 415,226 people died of smoking-related diseases in 1990, down from 434,000 in 1988. The drop is attributed to improvements in cardiovascular care and emergency treatment, which outweighed a slight rise in lung cancer.

The following is provided by the CDC.

1990 Smoking-related Death Rates, by State:
Deaths per % of all
100,000 deaths

Utah 218.0 13.4
Hawaii 257.2 17.3
New Mexico 287.7 16.4
Idaho 293.2 17.5
Minnesota 295.2 17.6
Kansas 300.8 17.2
Iowa 304.2 17.9
S. Dakota 307.9 18.6
N. Dakota 308.2 18.2
Wisconsin 313.3 17.8
Nebraska 321.0 18.1
Connecticut 325.7 19.4
Colorado 331.4 19.3
New Jersey 334.1 17.9
Montana 334.2 19.1
Arizona 339.6 19.8
Mass. 345.3 19.6
Penns. 346.8 18.6
Ohio 347.7 18.3
New Hamp. 349.3 19.5
Rhode Isl. 350.3 19.6
Alabama 350.4 17.3
New York 352.8 18.3
Florida 357.5 21.3
Illinois 360.0 18.7
Vermont 363.3 19.9
California 366.3 19.9
Virginia 366.6 19.2
Washington 367.4 21.0
N. Carolina 367.6 19.2
Oregon 369.3 20.8
Wyoming 371.0 20.6
Michigan 372.5 19.6
Mississippi 375.1 17.7
Arkansas 376.3 19.1
Maryland 378.1 19.2
S. Carolina 380.1 18.9
Georgia 383.5 18.7
Missouri 383.8 20.2
Louisiana 388.2 18.3
Texas 389.1 20.3
Maine 389.4 21.4
Oklahoma 300.4 20.2
Delaware 393.1 20.4
Indiana 394.3 20.7
Alaska 398.2 18.4
Kentucky 428.7 21.2
W. Virginia 433.6 21.8
Tennessee 442.1 22.1
Dist. of Col. 444.7 17.6
Nevada 478.1 17.6

Note that in Utah, where anti-smoking Mormons make up 70% of the population, smoking accounted for the least deaths and lowest percent of total causes of death.

Next door, Nevada had an extremely high rate of smoking deaths, yet as a percentage of all deaths in Nevada, smoking ranked very low (17.6%). One factor may be that Nevada has a large percentage of retirees.

Smoking accounted for the highest percentage of deaths in Tennessee.

PEOPLE

LIMBAUGH UNFAIR ON NICOTINE

June 26, 1994. Conservative Media star Rush Limbaugh has been criticized by the liberal group Fairness and Accuracy in Reporting (FAIR) as misleading and often just plain wrong.

The group noted inaccuracies such as Limbaugh's tirade against the non-existent assignment at Chelsea Clinton's school, "Why I Feel Guilty Being White," and Limbaugh's assertion that "The poorest people in America are better off than the mainstream families of Europe." Also noted was Limbaugh's statement that "It has not been proven that nicotine is addictive."

END OF DOCUMENT